1.Severity of SARS-CoV-2 infection in children with kidney disease undergoing immunosuppressive therapy
Yunfan ZHANG ; Huanhuan YANG ; Jun HUANG ; Ai FENG ; Guizhi XIA ; Chengfeng WANG ; Guangming CHEN ; Xiaobin CHEN ; Zengfeng WENG ; Yi CHEN ; Jinrong WU ; Jingjing LIU ; Yuen YANG ; Yuzhen ZHANG ; Jinfeng LIN ; Yuxian TANG ; Junyan CHEN ; Xiaojing NIE
Chinese Journal of Pediatrics 2025;63(5):529-534
Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.
2.The value of T1 mapping in the non-invasive assessment of the Oxford classification of IgA nephropathy
Chaobo LI ; Pu CHEN ; Shaopeng ZHOU ; Huanhuan KANG ; Xuewei WEN ; Sicheng YI ; Xu BAI ; Yong WANG ; Li ZHANG ; Haiyi WANG
Chinese Journal of Internal Medicine 2025;64(10):954-962
Objective:To evaluate the diagnostic value of native T1 mapping in differentiating Oxford classification (MEST-C) scores in patients with IgA nephropathy.Methods:In this prospective study, patients who underwent both T1 mapping and renal biopsy at the First Medical Center of the Chinese PLA General Hospital between April 2023 and October 2024 were consecutively enrolled. Two radiologists, blinded to clinical and pathological information, measured renal T1 mapping parameters, including cortical T1 (cT1), medullary T1 (mT1), the corticomedullary difference (ΔT1), and the corticomedullary ratio (T1 ratio). Clinical and renal biopsy data based on the Oxford classification from patients with IgA nephropathy were collected. The Oxford classification includes five indicators: Mesangial hypercellularity (M), Endocapillary hypercellularity (E), Segmental glomerulosclerosis or adhesion (S), Tubular atrophy/interstitial fibrosis (T), and Cellular or fibrocellular crescents (C). Spearman correlation analysis was applied to evaluate the associations between MEST-C scores and T1 parameters. The diagnostic performance of T1 parameters for discriminating among scores of the Oxford classification was analyzed using the receiver operating characteristic (ROC) curve.Results:A total of 124 patients with IgA nephropathy were included in this study [66 males, 58 females; age 19-70 years, 39 (30, 51) years]. Except for the E indicator, M, S, T, and C were significantly correlated with renal T1 values ( ρ=0.177-0.414, all P<0.05). cT1 showed the best diagnostic efficacy for the S score, with an area under the curve (AUC) of 0.798, a sensitivity of 68.7%, and a specificity of 88.0%. The best T1 parameter for differentiating the T score was the T1 ratio, with an AUC of 0.687, a sensitivity of 57.9%, and a specificity of 79.1%. Conclusion:Native T1 mapping can be used for the non-invasive assessment of the S and T scores in the Oxford classification of patients with IgA nephropathy.
3.Research progress on the impact of obesity on oocyte quality and early embryo development
Jie ZHANG ; Haixing YI ; Huanhuan JIANG
Chinese Journal of Reproduction and Contraception 2025;45(7):751-756
This paper comprehensively discusses the impact of obesity on female fertility, oocyte quality, early embryonic development, and assisted reproductive technology (ART), and evaluates the relationship between obesity and pregnancy complications, proposing corresponding prevention and treatment strategies. Studies have shown that obesity adversely affects oocyte quality through chronic inflammation, oxidative stress, and disruption of metabolic pathways, including meiotic defects, mitochondrial dysfunction, and epigenetic alterations. Obesity also affects early embryonic development, potentially leading to placental dysfunction and restricted fetal growth. In the field of ART, obese women face more challenges, such as increased risk of gestational diabetes and decreased success rates of in vitro fertilization. Additionally, obesity is associated with an increased risk of various pregnancy complications, including hypertensive disorders of pregnancy, gestational diabetes, preterm birth, and cesarean section. This paper emphasizes the importance of preconception and prenatal weight management and proposes strategies to improve the fertility of obese women through lifestyle changes, pharmacological treatment, and surgical intervention. Ultimately, this thesis provides personalized recommendations for the reproductive health of obese women to improve fertility and pregnancy outcomes, ensuring the health status of both mother and child.
4.Research progress on the impact of obesity on oocyte quality and early embryo development
Jie ZHANG ; Haixing YI ; Huanhuan JIANG
Chinese Journal of Reproduction and Contraception 2025;45(7):751-756
This paper comprehensively discusses the impact of obesity on female fertility, oocyte quality, early embryonic development, and assisted reproductive technology (ART), and evaluates the relationship between obesity and pregnancy complications, proposing corresponding prevention and treatment strategies. Studies have shown that obesity adversely affects oocyte quality through chronic inflammation, oxidative stress, and disruption of metabolic pathways, including meiotic defects, mitochondrial dysfunction, and epigenetic alterations. Obesity also affects early embryonic development, potentially leading to placental dysfunction and restricted fetal growth. In the field of ART, obese women face more challenges, such as increased risk of gestational diabetes and decreased success rates of in vitro fertilization. Additionally, obesity is associated with an increased risk of various pregnancy complications, including hypertensive disorders of pregnancy, gestational diabetes, preterm birth, and cesarean section. This paper emphasizes the importance of preconception and prenatal weight management and proposes strategies to improve the fertility of obese women through lifestyle changes, pharmacological treatment, and surgical intervention. Ultimately, this thesis provides personalized recommendations for the reproductive health of obese women to improve fertility and pregnancy outcomes, ensuring the health status of both mother and child.
5.Severity of SARS-CoV-2 infection in children with kidney disease undergoing immunosuppressive therapy
Yunfan ZHANG ; Huanhuan YANG ; Jun HUANG ; Ai FENG ; Guizhi XIA ; Chengfeng WANG ; Guangming CHEN ; Xiaobin CHEN ; Zengfeng WENG ; Yi CHEN ; Jinrong WU ; Jingjing LIU ; Yuen YANG ; Yuzhen ZHANG ; Jinfeng LIN ; Yuxian TANG ; Junyan CHEN ; Xiaojing NIE
Chinese Journal of Pediatrics 2025;63(5):529-534
Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.
6.The value of T1 mapping in the non-invasive assessment of the Oxford classification of IgA nephropathy
Chaobo LI ; Pu CHEN ; Shaopeng ZHOU ; Huanhuan KANG ; Xuewei WEN ; Sicheng YI ; Xu BAI ; Yong WANG ; Li ZHANG ; Haiyi WANG
Chinese Journal of Internal Medicine 2025;64(10):954-962
Objective:To evaluate the diagnostic value of native T1 mapping in differentiating Oxford classification (MEST-C) scores in patients with IgA nephropathy.Methods:In this prospective study, patients who underwent both T1 mapping and renal biopsy at the First Medical Center of the Chinese PLA General Hospital between April 2023 and October 2024 were consecutively enrolled. Two radiologists, blinded to clinical and pathological information, measured renal T1 mapping parameters, including cortical T1 (cT1), medullary T1 (mT1), the corticomedullary difference (ΔT1), and the corticomedullary ratio (T1 ratio). Clinical and renal biopsy data based on the Oxford classification from patients with IgA nephropathy were collected. The Oxford classification includes five indicators: Mesangial hypercellularity (M), Endocapillary hypercellularity (E), Segmental glomerulosclerosis or adhesion (S), Tubular atrophy/interstitial fibrosis (T), and Cellular or fibrocellular crescents (C). Spearman correlation analysis was applied to evaluate the associations between MEST-C scores and T1 parameters. The diagnostic performance of T1 parameters for discriminating among scores of the Oxford classification was analyzed using the receiver operating characteristic (ROC) curve.Results:A total of 124 patients with IgA nephropathy were included in this study [66 males, 58 females; age 19-70 years, 39 (30, 51) years]. Except for the E indicator, M, S, T, and C were significantly correlated with renal T1 values ( ρ=0.177-0.414, all P<0.05). cT1 showed the best diagnostic efficacy for the S score, with an area under the curve (AUC) of 0.798, a sensitivity of 68.7%, and a specificity of 88.0%. The best T1 parameter for differentiating the T score was the T1 ratio, with an AUC of 0.687, a sensitivity of 57.9%, and a specificity of 79.1%. Conclusion:Native T1 mapping can be used for the non-invasive assessment of the S and T scores in the Oxford classification of patients with IgA nephropathy.
7.Advances in researches of classical Wnt/β-catenin signal function in allergic asthma
Shengnan LIU ; Wenjing WANG ; Huanhuan ZHANG ; Shuying YI
Chinese Journal of Immunology 2024;40(9):1964-1968
Allergic asthma is a complex heterogeneous disease of respiratory system.It has extensive variability at the genetic level,and has a variety of opportunities to change genetic diversity.More and more studies have shown that targeting Wnt/β-catenin signaling pathway can affect the occurrence and development of allergic asthma,but its specific immune mechanism is not clear.In this paper,we mainly introduce Wnt/β-catenin signal and its role and function in allergic asthma provide a new target for drug inter-vention in the treatment of allergic asthma.
8.Application research of micronized acellular dermal matrix transplantation
Mengling YUAN ; Huanhuan ZHAO ; Yi LIU
Chinese Journal of Plastic Surgery 2024;40(6):698-701
With bio-materials being widely applied in clinical practice, acellular dermal matrix (ADM), one of the most competitive techniques in tissue engineering, has been developed rapidly in recent years, gaining popularity for its advantages in clinical application. What’s more, micronized acellular dermal matrix (mADM) has received an increasing amount of attention for its unique morphological characteristics, particularly in the field of cosmetic injection. Compared with other techniques, mADM has the advantages of great safety and sustainability, with less minimal invasion. However, further practical validation is still needed to determine the most suitable media for mADM injection as well as the most appropriate ratio of media to mADM transplantation. This paper reviews the relevant research findings.
9.Screening of Core Prescriptions for Tremors Based on Integrated Strategy of "Empirical Prescriptions in Ancient Books-medical Cases by Prestigious Doctors-computational Analysis"
Huanhuan WANG ; Mengli CHANG ; Yu LI ; Fengrong ZHANG ; He XU ; Yi ZHANG ; Shihuan TANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):194-202
ObjectiveBased on the integrated strategy of "empirical prescriptions in ancient books-medical cases by prestigious doctors-computational analysis", this study aims to explore and analyze the prescriptions and medical cases for treating tremors in traditional Chinese medicine (TCM), predict their efficacy, and obtain the core prescriptions for treating tremors in TCM, providing references for clinical application and new drug development. MethodThe Chinese Medicine Prescription Database and the China National Knowledge Infrastructure (CNKI) were searched for relevant prescriptions and medical cases for treating tremors in TCM to establish a database of prescriptions for tremors. The Traditional Chinese Medicine Inheritance Computer System (V3.0) was used to analyze and explore the medication rules including drug frequency, properties, flavor, meridian tropism, and pharmacological effects, as well as core drugs and formula associations. A multi-target drug efficacy prediction platform based on network robustness was used to evaluate the predicted efficacy of the core prescriptions obtained. Based on the integration of ancient prescriptions, prestigious doctors' medical cases, and network analysis results, the priority level of the developed prescriptions was determined through comprehensive evaluation. ResultA total of 81 ancient prescriptions were screened, involving 246 drugs, and 171 prescriptions were screened from prestigious doctors' medical cases, involving 278 drugs. The frequently used TCM drugs were mostly warm in nature and sweet in flavor, mainly acting on the liver, spleen, and kidney meridians. In terms of efficacy, they were mainly effective in tonifying deficiency, soothing liver and extinguishing wind, activating blood and resolving blood stasis, clearing heat, and resolving exterior. Through association rules and K-means clustering, the core prescriptions were composed of high-frequency drugs such as Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma, Astragali Radix, Atractylodis Macrocephalae Rhizoma, Angelicae Sinensis Radix, Poria, Gastrodiae Rhizoma, and Uncariae Ramulus Cum Uncis. Drug combinations mainly focused on tonifying Qi and nourishing blood, with the additional functions of calming wind and dredging collaterals. Clustering analysis of core prescriptions from ancient prescriptions and prestigious doctors' medical cases, as well as multi-target drug efficacy prediction, showed that Combination 1 had the highest disturbance score on the disease network. Furthermore, comparative analysis revealed consistent results with both the analysis of ancient prescriptions and prestigious doctors' medical cases, indicating its optimal development potential based on theoretical inheritance and empirical practice. In comparison, Combinations 3, 2, and 4 were less utilized in contemporary clinical practice, with lower rankings in network disturbance scores, suggesting that their development value still warranted further exploration. ConclusionTCM clinical treatment of tremors emphasizes the regulation of the liver, spleen, and kidney. In line of syndrome differentiation, drugs potent in soothing liver, extinguishing wind, activating blood, and resolving blood stasis are added based on deficiency-tonifying drugs. The core prescriptions based on Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, Astragali Radix, Poria, and Atractylodis Macrocephalae Rhizoma (combination 1) have the highest potential development value. The integrated strategy "empirical prescriptions in ancient books-medical cases by prestigious doctors-computational analysis" can be used for the screening of candidate prescriptions for new TCM drugs.
10.Impact of early and timely treatment and initial antiviral treatment regimen on antiviral treatment mortality and attrition among HIV-infected patients in Liuzhou, Guangxi
QIN Litai ; HUANG Jinghua ; CHEN Huanhuan ; LAN Guanghua ; FENG Yi ; XING Hui ; ZHU Jinhui ; CAI Wenlong ; RUAN Yuhua ; ZHU Qiuying ; XIE Yihong
China Tropical Medicine 2024;24(2):126-
Objective To understand the impact of early and timely treatment and initial antiviral treatment regimen on mortality and attrition of antiretroviral therapy. Methods A retrospective cohort study was conducted using download data on antiretroviral therapy for HIV-infected patients in Liuzhou City, Guangxi Province, from the database of the Basic Information System for AIDS Control and Prevention (BISAC) from 2010 to 2020. The Cox proportional risk regression model was used to analyze the influencing factors of mortality and attrition. Results A total of 15 713 infected patients were included, including 53.4% aged 18-<50 years, 69.4% male, 61.0% farmer, 75.1% CD4 count <350 cells /μL before initial antiviral treatment, the overall mortality rate was 4.30/100 person-years, and the overall attrition was 2.42/100 person-years. The results of Cox regression analysis showed that the influencing factors of mortality were pretreatment CD4 counts of 350-<500 cells/μL(AHR=0.72, 95%CI: 0.63-0.81) and ≥500 cells/μL (AHR= 0.64, 95%CI: 0.55-0.76); duration from diagnosis to initial antiviral treatment 91-180 days (AHR=1.25, 95%CI: 1.08-1.45), 181-365 days (AHR=1.26, 95%CI: 1.08-1.47), and ≥365 days (AHR=1.26, 95%CI: 1.11-1.44); initial antiviral treatment regimens of D4T+3TC+EFV/NVP (AHR=1.47, 95%CI: 1.32-1.63) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.73, 95%CI: 1.50-1.99). Factors affecting attrition were pretreatment CD4 counts of 350-499 cells/μL (AHR=1.32, 95%CI: 1.16-1.50) and ≥500 cells/μL (AHR=1.28, 95%CI: 1.10-1.50); interval from HIV positivity confirmation to initial dosing ≥365 days (AHR=1.21, 95%CI: 1.04-1.40), initial antiviral treatment regimens of TDF+3TC+NVP (AHR=1.32, 95%CI: 1.13-1.55), AZT+3TC+EFV/NVP (AHR=1.43, 95%CI: 1.26-1.62) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.33, 95CI%: 1.06-1.67). Conclusions Early and timely treatment and the initial antiviral treatment regimen of TDF+3TC+EFV have good efficacy, but attention should be paid to the high risk of attrition of HIV-infected people with high CD4 count before treatment.

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