1.Clinical application of plasma exchange combined with early continuous renal replacement therapy in patients with multiple injuries and high myoglobinemia
Hongbing REN ; Yuansong ZHANG ; Haoran ZHU ; Wenjun DENG ; Chaojun LI ; Han LIU
Journal of Army Medical University 2025;47(12):1276-1283
Objective To explore the clinical safety of plasma exchange(PE)combined with early continuous renal replacement therapy(CRRT)and its effects on coagulation and immune functions in patients with polytrauma and hypermyoglobinemia.Methods A non-randomized controlled study was conducted on 60 patients with severe polytrauma and myoglobinemia hospitalized in our department from January 2021 to December 2024.Based on different blood purification,the patients were divided a control group(CRRT)combined with conventional basic treatment,n=30)and an observation group(PE+CRRT and conventional basic treatment,n=30).Biochemical indicators(myoglobin,Mb),inflammation-related indicators,peripheral blood lymphocyte subsets,coagulation indicators,clinical-related indicators,and scores were observed and compared between the 2 groups before and after treatment.Results After 1,2 and 3 d of treatment,the levels of Mb,creatine kinase(CK),creatine kinase-MB isoenzyme(CK-MB),lactate dehydrogenase(LDH),serum creatinine(SCr),blood urea nitrogen(BUN),K+,C-reactive protein(CRP),procalcitonin(PCT),IL-6 and D-dimer(D-D),and white blood cell(WBC)count were significantly decreased in both groups(P<0.05).Among them,the observation group obtained obviously lower levels of all above indicators than the control group at the 3 time points(P<0.05).Additionally,notably shorter average length of total hospital stay,shorter average length of trauma intensive care unit stay,and lower score of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)was observed in the observation group than the control group(P<0.05).There were no statistical differences in coagulation function indicators or T lymphocyte subsets between the 2 groups.No complications occurred.Conclusion For patients with polytrauma and hypermyoglobinemia,early application of PE+CRRT can effectively reduce serum myoglobin level,improve serum biochemical inicators,renal function and inflammatory status,and maintain homeostasis,but shows no effect on immune or coagulation functions.This approach is worthy of promoting in clinical practice.
2.Prediction of MRI-Based Peritumoral Edema of Lymph Node Metastasis Burden in Patient with Invasive Breast Cancer
Hongbing LUO ; Zhe CHEN ; Qianqian XIAO ; Jing REN ; Peng ZHOU
Chinese Journal of Medical Imaging 2025;33(1):55-62
Purpose To investigate the predictive value of MRI-based peritumoral edema(PE)of lymph node(LN)metastasis burden in patient with invasive breast cancer.Materials and Methods A total of 213 patients in Sichuan Cancer Hospital with invasive breast cancer confirmed by pathology after surgery were enrolled retrospectively from September 2017 to February 2019.Based on the status and number of LN metastases proved by axillary surgery pathology,all patients were divided into high-burden LN metastasis group(n=47 cases,total number of metastatic LN greater than 2)and low-burden LN metastasis group(n=166 cases,total number of metastatic LN less than or equal to 2).T2WI features,including PE type and PE degree,were analyzed.On DCE-MRI,MRI features of breast cancer were analyzed based on BI-RADS.The predictive value of T2WI features and MRI features for LN metastasis burden was assessed by univariate analysis,and the statistically significant features identified by univariate analysis were further subjected to multivariate Logistic regression analysis to establish a prediction model.The model's performance for LN metastasis burden prediction was evaluated via receiver operating characteristic curve,and the predictive metrics were calculated based on the Youden index.Results The rate of high-burden LN metastasis was 22.1%(47/213).The results of univariate analysis showed that PE degree(OR=18.70,P<0.001),PE type(OR=16.00,P<0.001),tumor maximum diameter(OR=1.40,P=0.025),and tumor minimum diameter(OR=2.01,P=0.003)were predictive features for high-burden LN metastasis.The multivariate regression analysis showed that the peritumoral edema features,including PE degree(OR=8.02,P<0.001)and PE type(OR=5.53,P=0.001)were independent predictive features for high-burden LN metastasis.The area under the curve of the final predictive model was 0.842.The diagnostic sensitivity was 0.766,the specificity was 0.861,the positive predictive value was 0.610,and the negative predictive value was 0.929.Conclusion The PE on preoperative MRI have good predictive performance for LN metastasis burden prediction in patient with invasive breast cancer,particularly for low-burden LN metastasis.
3.Relationship between preoperative blood glucose control and perioperative insulin resistance in patients with diabetes mellitus complicated by cervical cancer and its effect on prognosis
Hongbing QIU ; Yanan REN ; Xiaoming LI ; Zhen XIE
Journal of China Medical University 2025;54(4):318-322
Objective To investigate the relationship between preoperative blood glucose control and perioperative insulin resistance(IR)in patients with diabetes mellitus(DM)complicated by cervical cancer(CC)and its effect on prognosis.Methods A total of 100 patients were categorized into IR(n=61)and non-IR(n=39)groups based on their IR levels.Additionally,patients were classified into poor prognosis(n=34)and good prognosis(n=66)groups according to the occurrence of adverse events during the follow-up period.The clini-cal data of each group were compared to evaluate the association of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),and two-hour postprandial plasma glucose(2hPG)with perioperative IR,as well as correlation between HbA1c,FPG,and 2hPG levels and the homeostasis model assessment(HOMA)of IR with the risk of poor prognosis.Results HbA1c,FPG,2hPG,and HOMA-IR were identi-fied as risk factors for the prognosis of patients with DM and CC(P<0.05).Compared with the respective control groups,the IR group and poor prognosis group had higher preoperative levels of HbA1C,FPG,and 2hPG(P<0.05).Conclusion Poor preoperative blood glucose control is positively correlated with the risk of perioperative IR in patients with DM and CC.Moreover,HOMA-IR,HbA1c,FPG,and 2hPG are independent risk factors for poor prognosis in patients with DM and CC.
4.Prediction of MRI-Based Peritumoral Edema of Lymph Node Metastasis Burden in Patient with Invasive Breast Cancer
Hongbing LUO ; Zhe CHEN ; Qianqian XIAO ; Jing REN ; Peng ZHOU
Chinese Journal of Medical Imaging 2025;33(1):55-62
Purpose To investigate the predictive value of MRI-based peritumoral edema(PE)of lymph node(LN)metastasis burden in patient with invasive breast cancer.Materials and Methods A total of 213 patients in Sichuan Cancer Hospital with invasive breast cancer confirmed by pathology after surgery were enrolled retrospectively from September 2017 to February 2019.Based on the status and number of LN metastases proved by axillary surgery pathology,all patients were divided into high-burden LN metastasis group(n=47 cases,total number of metastatic LN greater than 2)and low-burden LN metastasis group(n=166 cases,total number of metastatic LN less than or equal to 2).T2WI features,including PE type and PE degree,were analyzed.On DCE-MRI,MRI features of breast cancer were analyzed based on BI-RADS.The predictive value of T2WI features and MRI features for LN metastasis burden was assessed by univariate analysis,and the statistically significant features identified by univariate analysis were further subjected to multivariate Logistic regression analysis to establish a prediction model.The model's performance for LN metastasis burden prediction was evaluated via receiver operating characteristic curve,and the predictive metrics were calculated based on the Youden index.Results The rate of high-burden LN metastasis was 22.1%(47/213).The results of univariate analysis showed that PE degree(OR=18.70,P<0.001),PE type(OR=16.00,P<0.001),tumor maximum diameter(OR=1.40,P=0.025),and tumor minimum diameter(OR=2.01,P=0.003)were predictive features for high-burden LN metastasis.The multivariate regression analysis showed that the peritumoral edema features,including PE degree(OR=8.02,P<0.001)and PE type(OR=5.53,P=0.001)were independent predictive features for high-burden LN metastasis.The area under the curve of the final predictive model was 0.842.The diagnostic sensitivity was 0.766,the specificity was 0.861,the positive predictive value was 0.610,and the negative predictive value was 0.929.Conclusion The PE on preoperative MRI have good predictive performance for LN metastasis burden prediction in patient with invasive breast cancer,particularly for low-burden LN metastasis.
5.Relationship between preoperative blood glucose control and perioperative insulin resistance in patients with diabetes mellitus complicated by cervical cancer and its effect on prognosis
Hongbing QIU ; Yanan REN ; Xiaoming LI ; Zhen XIE
Journal of China Medical University 2025;54(4):318-322
Objective To investigate the relationship between preoperative blood glucose control and perioperative insulin resistance(IR)in patients with diabetes mellitus(DM)complicated by cervical cancer(CC)and its effect on prognosis.Methods A total of 100 patients were categorized into IR(n=61)and non-IR(n=39)groups based on their IR levels.Additionally,patients were classified into poor prognosis(n=34)and good prognosis(n=66)groups according to the occurrence of adverse events during the follow-up period.The clini-cal data of each group were compared to evaluate the association of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),and two-hour postprandial plasma glucose(2hPG)with perioperative IR,as well as correlation between HbA1c,FPG,and 2hPG levels and the homeostasis model assessment(HOMA)of IR with the risk of poor prognosis.Results HbA1c,FPG,2hPG,and HOMA-IR were identi-fied as risk factors for the prognosis of patients with DM and CC(P<0.05).Compared with the respective control groups,the IR group and poor prognosis group had higher preoperative levels of HbA1C,FPG,and 2hPG(P<0.05).Conclusion Poor preoperative blood glucose control is positively correlated with the risk of perioperative IR in patients with DM and CC.Moreover,HOMA-IR,HbA1c,FPG,and 2hPG are independent risk factors for poor prognosis in patients with DM and CC.
6.Molecular characteristics and mechanisms in related diseases of peptidylarginine deiminase from Porphyromonas gingivalis
Jiaxiang MO ; Siyu SUN ; Jiayin HUANG ; Hongbing GUAN ; Xuechun FANG ; Yanling ZHENG ; Saisai REN
Chinese Journal of Microbiology and Immunology 2021;41(8):650-655
Porphyromonas gingivalis peptidylarginine deiminase (PPAD), an isoenzyme of animal endogenous peptidylarginine deaminase, is secreted by the Por system and catalyzes the citrullination of arginine. Recent studies have found that PPAD can affect the formation of Porphyromonas gingivalis biofilm and reduce the body′s immune defense function, which is related to the occurrence and development of many diseases such as periodontal diseases and rheumatoid arthritis. In this paper, we reviewed the molecular characteristics of PPAD, including the genetic and functional characteristics, as well as the mechanisms related to the inflammatory and autoimmune diseases. We also pointed some issues that should be pay attention to in the further study.
7.In vitro expression of sodium taurocholate cotransporting polypeptide in bone marrow mesenchymal stem cells and its role during HBV infection
Meijuan WEI ; Sican WEI ; Xingnan PAN ; Hongbing DING ; Yuxia CHEN ; Queling REN
Chinese Journal of Microbiology and Immunology 2020;40(11):832-837
Objective:To investigate whether in vitro cultured human bone marrow mesenchymal stem cells (BMSCs) express sodium taurocholate cotransporting polypeptide (NTCP), assess their susceptibility to hepatitis B virus (HBV) infection and analyze the role of NTCP during HBV infection. Methods:BMSCs were infected with HBV-positive serum under different conditions. HBV DNA load in cell culture supernatants as well as in BMSCs and the amount of hepatitis B virus surface antigen (HBsAg) and hepatitis B virus e antigen (HBeAg) in cell culture supernatants were detected. To analyze the role of NTCP, BMSCs were first transfected with small interfering RNA targeting NTCP (NTCP-siRNA) and then infected with HBV-positive serum under different conditions. Virus loads and the amount of HBsAg and HBsAg were also detected. Western blot assay was performed to measure the expression of NTCP in BMSCs in each group.Results:In vitro cultured adherent BMSCs were susceptible to HBV infection albeit with a really low efficiency, but the infection efficiency was significantly increased when infecting the BMSCs in suspension. NTCP was expressed in BMSCs and the expression could be upregulated during HBV infection, especially in BMSCs in suspension. HBV infection was blocked when BMSCs were transfected with NTCP-siRNA. Conclusions:In vitro cultured human BMSCs were susceptible to HBV infection and the expressed NTCP served as a functional receptor for HBV. Human BMSCs could be used as a highly susceptible and stable cell model that needed no molecular adjuvant modification for research on the early stages of the HBV life cycle and for development of antiviral therapy.
8.The Role of Plasma CDO1 Methylation in the Early Diagnosis of Lung Cancer.
Pan WANG ; Honglin ZHAO ; Ruifeng SHI ; Xingyu LIU ; Jinghao LIU ; Fan REN ; Qingchun ZHAO ; Hongbing ZHANG ; Yongwen LI ; Hongyu LIU ; Jun CHEN
Chinese Journal of Lung Cancer 2020;23(5):314-320
BACKGROUND:
The incidence and mortality of lung cancer often rank first in all malignant tumors. DNA methylation, as one of epigenetics, often participates in the development and progression of tumors. CDO1 as a tumor suppressor gene always undergoes methylation changes early in tumor development. Therefore, this study aims to discuss the value of CDO1 methylation in the early diagnosis of lung cancer.
METHODS:
Peripheral blood samples were collected from tumor patients and healthy people. Detection of the methylation level of CDO1 in plasma by sulfite modification and quantitative real-time PCR.
RESULTS:
The level of gene methylation in peripheral blood of lung cancer patients was significantly higher than that of benign lung disease patients and healthy people. The methylation level of CDO1 was significantly different in the stratified comparison of gender, lymph node metastasis and tumor-node-metastasis (TNM) stage (P<0.05). The sensitivity and specificity of CDO1 were 52.2% and 78.6%, respectively. The overall accuracy of the diagnosis was significantly higher than that of the clinical tumor markers, and the sensitivity of CDO1 to stage I and II patients was the highest (40.8%, 47.1%). In addition, CDO1 could effectively increase the sensitivity of diagnosis in multiple joint examinations.
CONCLUSIONS
Detecting the methylation level of CDO1 has a potentially huge advantage for the early diagnosis of lung cancer.
9.Quantification of the nonpolar amino acids in amniotic fluid of congenital malformation by gas chromatography mass spectrometry (GC-MS) derivatization method
Lihong REN ; Gang LIU ; Hongbing XU ; Rong LUO
Basic & Clinical Medicine 2017;37(7):1004-1009
Objective To develop a gas chromatography-mass spectrometry (GC-MS) detection method for quantification of the nonpolar amino acids in amniotic fluid of congenital malformation including alanine (Ala),leu cine (Leu),isoleucine (Ile),proline (Pro) and phenylalanine (Phe).To compare the different amino acids in amniotic fluid between pregnant women with congenital malformation and normal control and analyze the corresponding pathogenesis.Methods After precipitated protein of the 100 μL supernatant of amniotic fluid by methyl alcohol,the supernatant was dried by nitrogen.The extractions were treated with MSTFA for derivatization.Then gas chromatography-mass spectrometry was used to detect and analyze the amino acids.Results This method was proved to have good sensitivity,precision,accuracy and recoveries.Under the optimum testing conditions,the limit of detection (LOD) was 0.12-0.38 mg/L.The calibration curves showed good linearity over the investigated concentration range between 0.5 and 10 mg/L.The recoveries were 91.12% to 104.41%.The relative standard deviation of intra and inter-day was 0.84% to 9.33%.The developed method was applied to the quantification of 5 nonpolar amino acids in amniotic fluid of 17 pregnant women with congenital malformation and 13 normal control pregnant woman.The contents of leucine and isoleucine decreased in disease group compared to controls.The difference of the other three amino acids between the two groups had no statistical significance.Conclusions The validation results showed that the method was suitable for detection of the amino acids in amniotic fluid and having broad prospect of clinical application.Leucine may participate in the pathogenesis of congenital malformation.
10.Bioinformatics analysis of radioresistance key gene and pathway in esophageal carcinoma
Ya GUO ; Hongbing MA ; Baofeng WANG ; Hongtao REN
Chinese Journal of Radiological Medicine and Protection 2017;37(10):730-735
Objective To explore key gene and pathway of radioresistance in esophageal carcinoma and reveal its molecular mechanism of radioresistance. Methods The gene expression profiles of GSE61772 and GSE61620 were downloaded from the Gene Expression Omnibus (GEO). Differentially expressed genes ( DEGs ) were screened by GEO2R. Gene Ontology ( GO ) enrichment, Kyoto Encyclopedia of Genes and Genomes ( Kegg ) enrichment and protein-protein interaction ( PPI ) network construction were performed by DAVID and String softwares. RT-PCR was used to detect the differences in the expression of different genes in different radiosensitivity cells. Results A total of 49 differentially expression genes were screened. These genes were mainly involved in the regulation of multicellular biosynthesis, ion transport, DNA synthesis, metabolism, cell proliferation and so on. The major biological pathways included a Wnt signal pathway. 12 DEGs interacted with each other, and CHN2 may be a key node. The expression of CHN2 gene had no obvious difference between TE13R and TE13. Conclusions 49 differentially expressed genes, including CHN2, may be involved in radioresistance of esophageal carcinoma, and the Wnt signaling pathway may be an important pathway in this radioresistance.

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