1.Recognition of breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine syndrome elements based on electronic nose combined with machine learning: An observational study in a single center
Shiyan TAN ; Qiong ZENG ; Hongxia XIANG ; Qian WANG ; Xi FU ; Jiawei HE ; Liting YOU ; Qiong MA ; Fengming YOU ; Yifeng REN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):185-193
Objective To explore the recognition capabilities of electronic nose combined with machine learning in identifying the breath odor map of benign and malignant pulmonary nodules and Traditional Chinese Medicine (TCM) syndrome elements. Methods The study design was a single-center observational study. General data and four diagnostic information were collected from 108 patients with pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Hospital of Chengdu University of TCM from April 2023 to March 2024. The patients' TCM disease location and nature distribution characteristics were analyzed using the syndrome differentiation method. The Cyranose 320 electronic nose was used to collect the odor profiles of oral exhalation, and five machine learning algorithms including random forest (RF), K-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and eXtreme gradient boosting (XGBoost) were employed to identify the exhaled breath profiles of benign and malignant pulmonary nodules and different TCM syndromes. Results (1) The common disease locations in pulmonary nodules were ranked in descending order as liver, lung, and kidney; the common disease natures were ranked in descending order as Yin deficiency, phlegm, dampness, Qi stagnation, and blood deficiency. (2) The electronic nose combined with the RF algorithm had the best efficacy in identifying the exhaled breath profiles of benign and malignant pulmonary nodules, with an AUC of 0.91, accuracy of 86.36%, specificity of 75.00%, and sensitivity of 92.85%. (3) The electronic nose combined with RF, LR, or XGBoost algorithms could effectively identify the different TCM disease locations and natures of pulmonary nodules, with classification accuracy, specificity, and sensitivity generally exceeding 80.00%.Conclusion Electronic nose combined with machine learning not only has the potential capabilities to differentiate the benign and malignant pulmonary nodules, but also provides new technologies and methods for the objective diagnosis of TCM syndromes in pulmonary nodules.
2.Thalidomide alleviates ferroptosis and oxidative stress in diabetic nephropathy by upregulating nuclear factor E2-related factor 2/heme oxygenase 1/glutathione peroxidase 4 signaling pathway
Lu ZHAI ; Xiaoxiao XUE ; Xiaomei LIU ; Yuxiao MA ; Hongxia ZHANG
Chinese Journal of Nephrology 2025;41(4):276-281
To investigate the potential protective effect of thalidomide (THD) on diabetic nephropathy (DN) and its underlying mechanisms. Twenty-four C57BL/6J mice were randomly divided into control, DN and DN+THD200 groups by random number table method. The DN mouse model was established via intraperitoneal injection of streptozotocin. The DN+THD200 group received THD treatment (200 mg·kg -1·d -1) for 8 weeks. Blood and urine biochemical parameters, as well as renal histopathological changes, were compared among the three groups. For in vitro experiments, a high glucose (HG)-induced injury model was established in mouse glomerular podocytes (MPC5). Cells were divided into control (NG), HG, HG+DMSO, HG+THD100 (100 μg/ml), and HG+THD200 (200 μg/ml) groups. THD-treated cells were exposed to THD for 24 h. Western blotting and real-time quantitative PCR were performed to respectively detect protein and mRNA expression levels of ferroptosis-related molecules, including nuclear factor erythroid 2-related factor 2 (NRF2), heme oxygenase 1 (HO-1), and glutathione peroxidase 4 (GPX4). Immunofluorescence was used to evaluate the expression of solute carrier family 7 member 11 (SLC7A11) and 4-hydroxynonenal (4-HNE). The results showed that, compared with control group, DN group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Compared with DN group, DN+THD200 group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Histopathological examination revealed glomerular expansion, mesangial widening, and basement membrane thickening in DN group compared to control group, which were markedly ameliorated by THD treatment. In vitro, HG group showed significantly decreased protein and mRNA expression levels of GPX4, NRF2 and HO-1 compared to NG group. Both HG+THD100 and HG+THD200 groups exhibited upregulated expression levels of these proteins and corresponding mRNA compared to HG group (all P<0.05). Immunofluorescence demonstrated HG group had enhanced 4-HNE fluorescence intensity and reduced SLC7A11 fluorescence intensity, which were reversed by THD treatment. THD alleviates renal injury in DN mice and mitigates HG-induced ferroptosis in MPC5 cells, potentially via activation of NRF2-HO-1-GPX4 signaling pathway.
3.Pathogenetic characteristics of human isolates of Streptococcus suis in Henan Province from 2020 to 2023
Xue LUO ; Baifan ZHANG ; Yujiao MU ; Yafei LI ; Hongxia MA ; Haifeng WANG ; Ying YE ; Xueyong HUANG ; Wanshen GUO
Chinese Journal of Preventive Medicine 2025;59(7):989-996
Objective:To investigate the pathogenetic characteristics of clinical isolates of Streptococcus suis in Henan Province from 2020 to 2023. Methods:Eight clinical isolates of S. suis in Henan Province from 2020 to 2023 were identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and real-time fluorescence polymerase chain reaction (PCR). Serotype and virulence genes were detected by the serum agglutination test and PCR, and antibiotic susceptibility was evaluated using the microbroth dilution method. Multilocus sequence typing (MLST), minimum core genome (MCG), identification of antibiotic resistance genes, and core genome single nucleotide polymorphism (cgSNP) analysis were conducted using whole genome sequencing. Results:The results showed that eight S. suis strains isolated from humans were mainly serotype 2 (75.0%), while the rest were serotype 14 (25.0%). ST353 (62.5%) was the predominant genotype, followed by ST1 (25.0%) and ST7 (12.5%). All isolates belonged to the MCG1 group. The virulence genotypes of these isolates were primarily mrp(NA2)/ sly+/ ef+/ gapdh+(75.0%), while the remaining were mrp(EU)/ sly+/ ef+/ gapdh+(25.0%). These isolates carried tetracycline, macrolide, lincosamide and aminoglycoside resistance genes, and their resistance rates to tetracycline, erythromycin and clindamycin were 100.0%, 87.5% and 87.5%, respectively, and 62.5% strains were intermediate-resistant to penicillin. The cgSNP analysis indicated that these isolates were closer to the isolates from Guangdong, Zhejiang and Guangxi Provinces, with five ST353 strains and one ST7 strain belonging to Clade Ⅰ, and two ST1 strains belonging to Clade Ⅱ. Conclusion:The human isolates of S. suis in Henan Province are mainly ST353, harboring multiple virulence and antibiotic resistance genes.
4.Cross-lagged panel analysis of resilience, social support and negative emotions in college students
Yuqi ZHANG ; Mengming LOU ; Zixin YANG ; Alyas ZAIN ; Yulian TU ; Hongxia MA
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(7):633-638
Objective:To investigate the longitudinal relationships among resilience, social support, and negative emotions in college students.Methods:Questionnaire surveys were administered to 1 739 college students from a university in Hebei Province born in the same year in November 2020 and November 2021 respectively, and 1 183 valid responses were finally obtained. The survey battery comprised the 11-item resilience scale, the social support questionnaire, and the 21-item depression anxiety stress scales. Cross-lagged panel analysis was conducted using Mplus 8.3 software. Mediating effects were tested via the Bootstrap method.Results:The scores of resilience, social support and negative emotion at T1 were 58 (51, 65), 57 (51, 66), and 3 (0, 10), respectively. The scores of resilience, social support and negative emotion at T2 were 59 (48, 66), 56 (44, 65), and 11 (1, 24), respectively. Resilience at T1 and T2 were significantly and positively correlated with social support at T1 and T2 ( r=0.66, 0.75, 0.40, 0.33, all P<0.01), while negatively correlated with negative emotion at T1 and T2( r=-0.45, -0.23, -0.26, -0.24, all P<0.01). Social support at T1 and T2 were negatively correlated with negative emotion at T1 and T2( r=-0.44, -0.28, -0.28, -0.28, all P<0.01). T1 resilience significantly and positively predicted T2 resilience ( β=0.35) and T2 social support ( β=0.15). T1 social support significantly and positively predicted T2 resilience ( β=0.07) and T2 social support ( β=0.35), while negatively predicted T2 negative emotion ( β=-0.15). T1 negative emotion significantly and negatively predicted T2 resilience ( β=-0.06) and T2 social support ( β=-0.07). The total effect of T1 resilience on T2 negative emotion was -0.35, and the mediating effect of T2 social support was -0.09, accounting for 25.71% of the total effect. Conclusion:T2 social support partially mediates the relationship between T1 resilience and T2 negative emotions.
5.Multi-center Study on Specific IgE Antibodies to Alternaria Alternata and Aspergillus Fumigatus in Sera of Clinical Allergy Patients in Selected Provinces in China
Chao XU ; Xingyuan ZHU ; Caizhi HUANG ; Hong ZHU ; Shu WANG ; Hongxia YUAN ; Pengfei ZHAO ; Ji YAN ; Jianhua MA ; Chunlei KUANG ; Yanli XIE ; Rongcai WU ; Yu ZHANG ; Sheng LIANG ; Qunying WANG ; Yingsha DUAN ; Yiwu ZHENG
Journal of Modern Laboratory Medicine 2025;40(3):13-17
Objective To investigate the prevalence of specific IgE antibodies against Alternaria alternata and Aspergillus fumigatus in serum samples from clinical allergy patients across selected provinces in China.Methods Data on specific IgE antibodies for Alternaria A.and Aspergillus F.were collected from 20 hospital laboratories in 17 cities spanning 11 provinces.The study analyzed the levels of specific IgE and their variations across different provinces and seasons.Results A total of 27 471 cases of Alternaria A.and 32 843 cases of Aspergillus F.specific IgE data were included.The national average positive rate of Alternaria A.IgE was 10.40%,with the highest rate of 22.68%in Jiangsu and the lowest rate of 2.06%in Guangxi.For Aspergillus F.specific IgE,the average positive rate was 4.24%,with Hubei province having the highest rate(7.25%)and Hunan province the lowest(1.23%).The difference in IgE levels for both Alternaria A.and Aspergillus F.among provinces were statistically significant(H=9 955,16 993,all P<0.0001).Among patients,5.85%had Alternaria A.specific IgE levels at grade 3 or above,while only 0.57%had Aspergillus F.specific IgE levels at this level.When examining seasonal variations using data from Liaoning,Hunan and Anhui provinces,significant seasonal changes were observed for both Alternaria A.and Aspergillus F.IgE antibodies(HAlternaria A=347.6,338.0,401.3,HAspergillus F=196.6,133.7,231.7,all P<0.0001).Conclusion The sensitization to Alternaria A.and Aspergillus F.exhibits distinct geographical characteristics and vary significantly with seasons.Given the relatively high IgE levels associated with Alternaria A.,it should be given adequate clinical attention.
6.MDT treatment strategy for organophosphorus and anticoagulant rodenticide poisoning in an elderly patient with depression
Shasha FU ; Yue JIA ; Hongxia SHAO ; Yu GUO ; Longyan MA ; Tong HAN ; Hao SUN ; Hongzhi YU
Tianjin Medical Journal 2025;53(9):1000-1004
Organophosphorus pesticide(OP)is one of the most widely used pesticides in the world with the largest dosage.Acute organophosphorus pesticide poisoning(AOPP)is a common clinical disease,and AOPP accounts for 20%-50%of poisoning cases in China every year,with case fatality rate of 3%-40%.Bromophos(BDF)is a long-acting anticoagulant rodenticide,which inhibits vitamin K epoxide reductase and interferes with the synthesis of coagulation factorsⅡ,Ⅶ,Ⅸ and Ⅹ,leading to coagulation dysfunction.This article discusses the multidisciplinary diagnosis and treatment(MDT)process of a patient with combined poisoning of dichlorvos and bromadiolone.The article explores blood purification,management of coagulation abnormalities,secondary infection,atropinization and altered consciousnes in patients with organophosphorus poisoning and anticoagulant rodenticide compound poisoning,with the aim of providing clinicians with references for early diagnosis and treatment.
7.lncRNA GAS5 targets miR-21 to inhibit epithelial-mesenchymal transformation and autophagy in lung cancer cells through the PI3K/Akt/mTOR signaling pathway
Qian ZHANG ; Jie LIU ; Hongxia MA
International Journal of Laboratory Medicine 2025;46(5):568-574
Objective To investigate the inhibitory effect of long non-coding RNA(lncRNA)GAS5 on mi-croRNA-21(miR-21)in lung cancer cells through phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR)signaling pathway on epithalium-mesenchymal transforma-tion and autophagy.Methods Real-time quantitative polymerase chain reaction(qPCR)was used to detect the expression of lncRNA GAS5 in 5 patients with non-small cell lung cancer(NSCLC)and adjacent groups.Dual luciferase reporter gene assay was used to detect the targeting effect of lncRNA GAS5 on miR-21.A549 cells were divided into 5 groups,including pcDNA-null group,pcDNA-GAS5 group,pcDNA-GAS5+mimic group,pcDNA-GAS5+mimic group and pcDNA-GAS5+mimic+BEZ235 group.lncRNA GAS5 and miR-21 expression were detected by qPCR.PI3K,phosphorylated Akt(p-Akt),phosphorylated mTOR(p-mTOR),Beclin1,microtubule-associated protein light chain 3(LC3)-Ⅱ,LC3-Ⅰ,E-cadherin,N-cadherin,Vimentin,Twist1,proliferation associated nuclear antigen(Ki67)and proliferating cell nuclear antigen(PCNA)expres-sion.The cell proliferation activity was measured by 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide method.Results lncRNA GAS5 expression in NSCLC group was significantly higher than that in ad-jacent group,with statistical significance(P<0.05).Dual luciferase reporter gene assay determined that ln-cRNA GAS5 in A549 cells had a direct targeting effect on miR-21.Compared with pcDNA-null group,cell pro-liferation activity decreased in pcDNA-GAS5 group.lncRNA GAS5,PI3K,p-Akt,p-mTOR,Beclin1,LC3-Ⅱ,N-cadherin,Vimentin,Twist1,Ki67 and PCNA were down-regulated,while miR-21,LC3-Ⅰ and E-cadherin were up-regulated,the difference was statistically significant(P<0.05).Compared with pcDNA-GAS5+mimic group,the cell proliferation activity of pcDNA-GAS5+mimic group was up-regulated.The expressions of PI3K,p-Akt,p-mTOR,Beclin1,LC3-Ⅱ,N-cadherin,Vimentin,Twist1,Ki67,and PCNA were up-regulated,while the expressions of miR-21,LC3-Ⅰ,and E-cadherin were down-regulated,with statistical significance(P<0.05).Compared with pcDNA-GAS5+mimic group,the cell proliferation activity of pcDNA-GAS5+mimic+BEZ235 group was down-regulated.The expressions of PI3K,p-Akt,p-mTOR,Beclin1,LC3-Ⅱ,N-cadherin,Vimentin,Twist1,Ki67 and PCNA were down-regulated,while the expressions of LC3-Ⅰ and E-cad-herin were up-regulated,with statistical significance(P<0.05).Conclusion lncRNA GAS5 inhibits PI3K/Akt/mTOR signaling pathway through miR-21,thereby inhibiting epithelial-mesenchymal transformation and autophagy of lung cancer cells,and reducing cell proliferation activity.
8.Thalidomide alleviates ferroptosis and oxidative stress in diabetic nephropathy by upregulating nuclear factor E2-related factor 2/heme oxygenase 1/glutathione peroxidase 4 signaling pathway
Lu ZHAI ; Xiaoxiao XUE ; Xiaomei LIU ; Yuxiao MA ; Hongxia ZHANG
Chinese Journal of Nephrology 2025;41(4):276-281
To investigate the potential protective effect of thalidomide (THD) on diabetic nephropathy (DN) and its underlying mechanisms. Twenty-four C57BL/6J mice were randomly divided into control, DN and DN+THD200 groups by random number table method. The DN mouse model was established via intraperitoneal injection of streptozotocin. The DN+THD200 group received THD treatment (200 mg·kg -1·d -1) for 8 weeks. Blood and urine biochemical parameters, as well as renal histopathological changes, were compared among the three groups. For in vitro experiments, a high glucose (HG)-induced injury model was established in mouse glomerular podocytes (MPC5). Cells were divided into control (NG), HG, HG+DMSO, HG+THD100 (100 μg/ml), and HG+THD200 (200 μg/ml) groups. THD-treated cells were exposed to THD for 24 h. Western blotting and real-time quantitative PCR were performed to respectively detect protein and mRNA expression levels of ferroptosis-related molecules, including nuclear factor erythroid 2-related factor 2 (NRF2), heme oxygenase 1 (HO-1), and glutathione peroxidase 4 (GPX4). Immunofluorescence was used to evaluate the expression of solute carrier family 7 member 11 (SLC7A11) and 4-hydroxynonenal (4-HNE). The results showed that, compared with control group, DN group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Compared with DN group, DN+THD200 group exhibited significantly lower blood urea nitrogen, serum creatinine and 24 h urinary albumin levels (all P<0.05). Histopathological examination revealed glomerular expansion, mesangial widening, and basement membrane thickening in DN group compared to control group, which were markedly ameliorated by THD treatment. In vitro, HG group showed significantly decreased protein and mRNA expression levels of GPX4, NRF2 and HO-1 compared to NG group. Both HG+THD100 and HG+THD200 groups exhibited upregulated expression levels of these proteins and corresponding mRNA compared to HG group (all P<0.05). Immunofluorescence demonstrated HG group had enhanced 4-HNE fluorescence intensity and reduced SLC7A11 fluorescence intensity, which were reversed by THD treatment. THD alleviates renal injury in DN mice and mitigates HG-induced ferroptosis in MPC5 cells, potentially via activation of NRF2-HO-1-GPX4 signaling pathway.
9.Pathogenetic characteristics of human isolates of Streptococcus suis in Henan Province from 2020 to 2023
Xue LUO ; Baifan ZHANG ; Yujiao MU ; Yafei LI ; Hongxia MA ; Haifeng WANG ; Ying YE ; Xueyong HUANG ; Wanshen GUO
Chinese Journal of Preventive Medicine 2025;59(7):989-996
Objective:To investigate the pathogenetic characteristics of clinical isolates of Streptococcus suis in Henan Province from 2020 to 2023. Methods:Eight clinical isolates of S. suis in Henan Province from 2020 to 2023 were identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and real-time fluorescence polymerase chain reaction (PCR). Serotype and virulence genes were detected by the serum agglutination test and PCR, and antibiotic susceptibility was evaluated using the microbroth dilution method. Multilocus sequence typing (MLST), minimum core genome (MCG), identification of antibiotic resistance genes, and core genome single nucleotide polymorphism (cgSNP) analysis were conducted using whole genome sequencing. Results:The results showed that eight S. suis strains isolated from humans were mainly serotype 2 (75.0%), while the rest were serotype 14 (25.0%). ST353 (62.5%) was the predominant genotype, followed by ST1 (25.0%) and ST7 (12.5%). All isolates belonged to the MCG1 group. The virulence genotypes of these isolates were primarily mrp(NA2)/ sly+/ ef+/ gapdh+(75.0%), while the remaining were mrp(EU)/ sly+/ ef+/ gapdh+(25.0%). These isolates carried tetracycline, macrolide, lincosamide and aminoglycoside resistance genes, and their resistance rates to tetracycline, erythromycin and clindamycin were 100.0%, 87.5% and 87.5%, respectively, and 62.5% strains were intermediate-resistant to penicillin. The cgSNP analysis indicated that these isolates were closer to the isolates from Guangdong, Zhejiang and Guangxi Provinces, with five ST353 strains and one ST7 strain belonging to Clade Ⅰ, and two ST1 strains belonging to Clade Ⅱ. Conclusion:The human isolates of S. suis in Henan Province are mainly ST353, harboring multiple virulence and antibiotic resistance genes.
10.The effect of cytomegalovirus and EB virus activation on hematopoietic reconstitution after intensive immunosuppressive therapy for severe aplastic anemia
Qian ZHANG ; Hong WANG ; Xiaoli LI ; Miao MIAO ; Hongxia MA ; Yaoyao SHEN ; Nan WEI ; Kai ZOU ; Wanxiu SU ; Jingqiu YU ; Depei WU ; Limin LIU
Chinese Journal of Internal Medicine 2025;64(6):514-521
Objective:To investigate the infection rate of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with severe aplastic anemia (SAA) after intensive immunosuppressive therapy in combination with a thrombopoietin receptor agonist (lST+TPO-RA) as well as assess the clinical impact of treatment.Methods:A retrospective, case series study was undertaken involving patients with SAA who were admitted to Soochow Hopes Hematonosis Hospital, The First Affiliated Hospital of Soochow University, and Zhengzhou Third People′s Hospital from June 2022 to February 2025. Thirty patients with complete CMV and EBV monitoring data after IST+TPO-RA treatment were enrolled. The first activation time of CMV and EBV, the maximum viral load, the first negative conversion time, and blood routine tests within 3 days before CMV and EBV positivity, during the positive period, and within 3 days after turning negative were recorded. The patients were followed up for 9 months after the completion of IST. One-way analysis of variance was used to compare the changes of blood routine before and after virus positivity and after turning negative. The χ2 test was used to compare the viral infection rate and the therapeutic effect of IST between the two groups. Results:The 30 SAA patients comprised 15 males and 15 females with an average age of (40.0±16.9) years. Of the 30 patients, 18 (60.0%) were infected with CMV and 6 (20.0%) with EBV. Among them, 17 cases received rabbit anti-human thymocyte immunoglobulin (r-ATG) treatment (r-ATG group), 13 cases received porcine anti-human lymphocyte immunoglobulin (p-ALG) treatment (p-ALG group). The CMV infection rate was significantly higher in the r-ATG group than in the p-ALG group (15/17 vs. 3/13, χ2=13.03, P<0.001); meanwhile, the rate of EBV infection was only slightly higher in the r-ATG group than in the p-ALG group, and the difference did not reach statistical significance (5/17 vs. 1/13, χ2=2.17, P=0.196). In patients infected with CMV, neutrophil, hemoglobin, and platelet counts were significantly decreased during the infection phase, followed by significant increases after CMV clearance ( F=14.48, 11.38, 4.73; all P<0.05). No significant differences in treatment efficacy were found between the r-ATG and p-ALG groups at 3, 6, and 9 months post-IST (all P>0.05). Conclusions:This preliminary study showed that the incidence of CMV and EBV infection in patients with SAA increased after IST, with CMV infections occurring significantly more frequently than EBV infections. The CMV infection rate was significantly higher in patients treated with r-ATG than in those receiving p-ALG. CMV infection was associated with notable alterations in hematological parameters, highlighting the need for close clinical monitoring.

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