1.Influencing factors for colonoscopic compliance to colorectal cancer screening in outpatients
Xuejiao TAN ; Xin PENG ; Jian QIN ; Jiaxue LI ; Lina YE ; Ronghui PU ; Li LAI ; Jiajing MA ; Weigang CHEN
Chinese Journal of Digestive Endoscopy 2024;41(2):131-136
Objective:To explore the influencing factors for compliance to colonoscopy screening for colorectal cancer in outpatients.Methods:Patients aged 40-74 years who visited the outpatient gastroenterology department of 7 tertiary hospitals in 7 regions of Xinjiang from January 2022 to June 2022 were enrolled. Recommendations for colonoscopy screening were made according to the patient's medical conditions, and the questionnaire was used to collect information. The Chi-square test was used to compare the differences of compliant and non-compliant patients. Multivariate logistic regression was used to analyze the influencing factors of compliance to colonoscopy screening.Results:A total of 463 valid questionnaires were obtained from 7 centers, in which, 427 outpatients (92.2%) followed the recommendation for colonoscopy screening, and 36 (7.8%) did not. Chi-square test results showed that there were statistically significant differences between the two groups in gender, age, education, subjective cognition of intestinal polyps, personal history of colorectal polyps, family history of colorectal cancer, family history of colorectal polyps, abdominal pain or distension, and defecation habit or stool changes ( P<0.05). The results of multivariate regression analysis showed that the screening compliance of patients aged 40-49 years ( P=0.005, OR=0.141, 95% CI: 0.036-0.549) and 50-59 years ( P=0.039, OR=0.257, 95% CI: 0.071-0.932) was lower than that of patients aged 60-74 years. The screening compliance of patients with high school education ( P=0.011, OR=3.121, 95% CI: 1.304-7.473) and college education or above ( P=0.016, OR=3.544, 95% CI: 1.270-9.890) was higher than those with primary school education and below. Patients with personal history of colorectal polyps ( P=0.015, OR=12.288, 95% CI: 1.629-92.719), family history of colorectal cancer ( P=0.038, OR=8.506, 95% CI: 1.124-64.351) and changes in defecation habit or stool trait ( P=0.039, OR=4.794, 95% CI: 1.085-21.192) also had higher compliance. Conclusion:Age, educational level, personal history of colorectal polyps, and family history of colorectal cancer are related to colonoscopy screening compliance in outpatients of 7 tertiary hospitals in 7 regions of Xinjiang. The independent risk factors affecting compliance to colorectal cancer screening in outpatients are age of 40-59 years, lower educational level, no previous history of polyps or family history of colorectal cancer, and no defecation habit or stool changes.
2.Distribution of urinary tract pathogens and susceptibility to nenofloxacin and levofolxacin in patients with community-acquired urinary tract infection
Zhen DU ; Shan CHEN ; Liang CUI ; Huiling WU ; Zhan GAO ; Jin YANG ; Gang CUI ; Jiajing WANG ; Tiehuan SHU ; Ninghan FENG ; Ludong QIAO
Chinese Journal of Urology 2024;45(1):24-28
Objective:To investigate the distribution characteristics of urinary tract pathogens in patients with community-acquired urinary tract infection and their sensitivity to nenoxacin and levofloxacin.Methods:This prospective, multicenter clinical trial included patients with community-acquired urinary tract infection who were admitted to urological clinics at 9 clinical research centers from November 2021 to August 2022.Inclusion criteria: Patients aged 18-70 years with community-acquired acute uncomplicated cystitis(AUC), recurrent acute episodes of urinary tract infection(rUTI), and non-febrile complicated urinary tract infection(cUTI) with signs of urinary tract irritation and abnormal elevation of routine white blood cells in urine. Exclusion criteria: ①Patients who received effective antimicrobial therapy within 72 h before enrollment and lasted for more than 24 h. ②Fever (>37.3℃) or symptoms of upper urinary tract infection such as low back pain, tapping pain in the kidney area, etc. ③Indwelling urinary catheter. At the first visit, clean midstream urine samples were taken for bacterial culture, and the distribution characteristics of urinary pathogens of different types of urinary tract infections were analyzed. Extended spectrum β-lactamases (ESBLs) were measured for Gram-negative bacteria. The susceptibility of nenoxacin and levofloxacin to urinary tract pathogens was determined by disk diffusion method. Drug resistance rate, sensitivity rate were analyzed between different disease groups.Results:There were 404 enrolled patients from 9 hospitals, including 364 (90.1%) females and 40 (9.9%) males. A total of 177 strains of pathogenic bacteria were isolated, among which the highest proportion of Escherichia coli was 66.1% (117/177).Klebsiella pneumoniae was followed by 6.8% (12/177) and Streptococcus agalactis 5.1% (9/177). The bacterial spectrum distribution of AUC and rUTI were similar, and the proportions of Escherichia coli were 70.6% (85/119) and 65.9% (29/44), respectively. However, the proportions of Escherichia coli isolated from cUTI patients were only 28.6% (4/14) and Enterococcus faecalis 7.1%(1/14). The overall detection rate of ESBLs in Gram-negative bacteria was 30.9%(43/139). The sensitivity rate of nenoxacin was 74.6%(91/122), and the resistance rate was 25.4%(31/122). The overall sensitivity rate of levofloxacin was 44.9%(70/156) and the resistance rate was 36.5%(57/156). The rate of resistance of urinary tract pathogens to levofloxacin was 48.2% (27/56) in patients with previous urinary tract infection history, and 30.0% (30/100) in patients with no previous urinary tract infection history, the difference was statistically significant( P=0.023).The sensitivity rate of Gram-negative bacteria to nenofloxacin was 70.7% (65/92) and that to levofloxacin was 50.0% (46/92, P<0.001). The sensitivity of Gram-positive bacteria to nenofloxacin was 80.0% (16/20), and that to levofloxacin was 70.0% (14/20, P=0.009). Conclusions:The bacterial profile of out-patient community acquired urinary tract infection varies greatly according to different diseases. The proportion of Escherichia coli in AUC and rUTI patients is higher than that in cUTI. The detection rate of ESBLs in Gram-negative bacteria was lower than the domestic average.Patients with a history of urinary tract infection had a high risk of treatment failure with levofloxacin. The sensitivity of common urinary tract pathogens to nenofloxacin was higher than levofloxacin.
3.Analysis of viral infections in adult acute respiratory infection cases in Shanghai, 2023
Huanru WANG ; Jiabin MOU ; Qi QIU ; Jiajing LIU ; Fang YUAN ; Meihua LIU ; Xiaode TANG ; Jingyi ZHANG ; Jian CHEN ; Min CHEN ; Huanyu WU ; Zheng TENG
Chinese Journal of Experimental and Clinical Virology 2024;38(4):439-445
Objective:To elucidate the etiological and epidemiological characteristics and epidemiological patterns of viral acute respiratory infections (ARI) in Shanghai during 2023, with the aim of providing robust laboratory evidence for effective prevention and control strategies against related respiratory diseases and facilitating risk assessment.Methods:Respiratory pathogens were detected in the clinical surveillance specimens submitted by sentinel hospitals through multiplex PCR, as part of the multi-pathogen surveillance of acute respiratory infections in Shanghai during 2023. The obtained detection result were statistically analyzed in conjunction with sample information.Results:The positive detection rate of viral pathogens in 2023 was 21.17% (984/4 648), with rates of 33.53% (504/1 503) observed in ILI cases and 15.62% (480/3 145) in SARI cases. Influenza A virus (FluA) was the predominant virus detected, accounting for 13.7% (637/4 648). Other viruses identified in the surveillance samples included influenza B virus (Flu B), human rhinovirus/enterovirus (HRV/HEV), respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus (PIV), adenovirus (ADV) and human bocavirus (HBoV). Regarding temporal distribution, HRV/HEV and RSV exhibited the highest detection rates during the second quarter at 2.27% each (28/1 236). PIV had its peak during the third quarter at a rate of 2.49% (35/1 405), and HMPV showed prevalence mainly during the third and fourth quarters, with detection rates of 2.63% (37/1 405) and 2.35% (32/1 360), respectively.Conclusions:In acute respiratory infection surveillance cases in Shanghai in 2023, Flu A emerged as the predominant respiratory pathogen. The detection rate of HMPV ranked second only to Flu A, while other respiratory viruses such as HRV/HEV, RSV, and PIV were detected during different seasons and co-circulated. The prevalence of various respiratory viruses varied among different infected populations and over times.
4.Molecular characteristics of HA1 and NA genes of influenza A (H3N2) virus in Yancheng city from 2022 to 2024
Chunxiang LI ; Xiongying SUN ; Min YANG ; Peng SHEN ; Jiajing YUAN ; Min ZHANG ; Chen CHEN ; Changcheng LI ; Guoqing CHEN
Chinese Journal of Experimental and Clinical Virology 2024;38(4):446-453
Objective:To analyze the molecular evolutional characteristics of the hemagglutinin and neuraminidase genes of influenza A (H3N2) viruses isolated in Yancheng from 2022 to 2024.Methods:The throat swab specimens of influenza-like illness ( ILI) from sentinel surveillance hospital and outbreak sites were detected using the method of real time Rt-qPCR. The influenza A(H3N2) viruses were isolated using MDCK cells culture method from April 2022 to Marh 2024. The strains isolated from 2022 to 2024 were selected randomly and their sequences of the HA1 and NA genes were amplified through one step RT-PCR method and the PCR products were sequenced.The nucleotide and amino acid site variations and evolutionary characteristics of the genes were analyzed using relevant bioinformatics software. The mutations of genes and nucleic acid locus were analyzed and the evolutional trees were generated using bioinformatics software.Results:A total of 5 020 samples were collected between April 2022 and March 2024, the positive detection rate of influenza virus nucleic acid was 18.59%(933/5 020).The winter and spring influenza peaks were obvious in the two monitoring seasons from April 2022 to March 2024. Among them, the summer influenza peak was obvious in the monitoring season from April 2022 to March 2023, and the H3N2 subtype influenza virus was the dominant epidemic strain in the two monitoring seasons. Genetic evolution tree displayed: the clustering relationships of the respective branches of HA1 and NA genes of 32 strains isolated in Yancheng were basically the same.The HA1 and NA genes of 24 strains isolated from 2023-2024 in Yancheng and the 2022-2024 Northern Hemisphere vaccine strain A/Darwin/9/2021 (H3N2) were located in the 3C.2a1b2a.2a.3a.1 evolutionary lineage, while the 8 strains isolated in the 2022 in Yancheng and the 2021-2022 Northern Hemisphere vaccine strain A/Cambodia/e0826360/2020 (H3N2) were located in the 3C.2a1b.2a.1a evolutionary lineage.The 6 strains (A/JSTH/11735/2023, A/JSTH/11788/2023, A/JSTH/11974/2023, A/JSYD/353/2023, A/JSYD/354/2023, A/JSTH/138/2023) all exhibited variations in the F79L, N122D, P239S, and K276E amino acid sites, which were present in both sporadic and outbreak strains. Because the strains of the antigen epitopes, receptor binding sites and glycosylation sites in the HA1 genes had a certain degree of variations in Yancheng in the 2022-2024 year, the immunogenicity matching between the 24 strains isolated in the 2023-2024 and the Northern Hemisphere vaccine strain A/Darwin/9/2021 was good, while the immunogenicity matching between the 8 strains isolated in the 2022 and the Northern Hemisphere vaccine strain A/Cambodia/e0826360/2022 was good; 32 strains isolated from 2022 to 2024 had no mutations in catalytic residues and drug resistant sites of NA genes.Conclusion:These result indicated that the HA1 and NA genes of influenza A/H3N2 viruses circulated in Yancheng city from 2022 to 2024 are changed gradually.The accumulation of these mutations would result in antigenic drift of influenza A(H3N2) viruses and increase the mismatching of the recommended vaccine strain.Compared with the vaccine strain A/Darwin/9/2021(H3N2), the strains isolated in the 2022 had substantially result in antigenic drift on the whole.The influenza A(H3N2) viruses surveillance should be strengthened to find the new mutant of virus in time.
5.A Study on the Characteristics of Articulation Movement in Patients with Dysarthria under Different Vowel Tasks
Jiamei CHEN ; Qin WAN ; Jiajing LIANG ; Fenfen HUI ; Hongfen QIAO ; Wenzhuo SHU
Journal of Audiology and Speech Pathology 2024;32(5):413-417
Objective To investigate the acoustic characteristics of monophthong vowels and compound vow-els articulation movement in patients with dysarthria.Methods A total of 24 patients aged 40~81 years old with dysarthria from hospitals,and 24 healthy adults aged 40~80 years old from communities in Shanghai were recrui-ted.The first and second formants(F1,F2)of monophthong vowels/a/,/i/,/u/were extracted from the speech samples,and mandibular distance,tongue distance,vowel space area(VSA)and vowel articulation index(VAI)were calculated.The slope of the second formant of compound vowels/ai/,/ua/,/uai/was extracted and calculat-ed.The acoustic parameters of two groups of subjects were compared under different tasks.Results Under the monophthong vowels task,F1 of/a/,F2 of/i/,mandibular distance,tongue distance,VSA and VAI in the pa-tients were significantly lower than those in the control group(P<0.01).F2 of/u/was significantly higher than that in the control group(P<0.01).F2 slope of/ai/,/ua/,/uai/was significantly lower than that of the control group(P<0.05).Conclusion The space of monophthong vowels articulation movement was reduced in the pa-tients with dysarthria,presenting a state of aggregation.The speed of compound vowels articulation movement was decreased.
6.Design of a nanozyme-based magnetic nanoplatform to enhance photodynamic therapy and immunotherapy
Bai CHEN ; Liu JIAJING ; Bai LUYAO ; Yao DAPENG ; Li XIAOFENG ; Zhang HAORAN ; Guo DONG
Journal of Pharmaceutical Analysis 2024;14(9):1320-1329
The tumor microenvironment,particularly the hypoxic property and glutathione(GSH)overexpression,substantially inhibits the efficacy of cancer therapy.In this article,we present the design of a magnetic nanoplatform(MNPT)comprised of a photosensitizer(Ce6)and an iron oxide(Fe3O4)/manganese oxide(MnO2)composite nanozyme.Reactive oxygen species(ROS),such as singlet oxygen(1O2)radicals produced by light irradiation and hydroxyl radicals(·OH)produced by catalysis,are therapeutic species.These therapeutic substances stimulate cell apoptosis by increasing oxidative stress.This apoptosis then triggers the immunological response,which combines photodynamic therapy and T-cell-mediated immunotherapy to treat cancer.Furthermore,MNPT can be utilized as a contrast agent in magnetic resonance and fluorescence dual-modality imaging to give real-time tracking and feedback on treatment.
7.Data mining research on traditional Chinese medicine formulas for epilepsy treatment based on national patents
Haiwen HUANG ; Jiajing HU ; Yi ZHANG ; Shaolan CHEN ; Qianqian HUANG ; Min GAO
China Pharmacist 2024;27(7):1220-1230
Objective To investigate the medication and compatibility patterns of traditional Chinese medicine(TCM)compound patents in the treatment of epilepsy through data mining research.Methods Data on TCM compound patents for treating epilepsy were retrieved from the China National Intellectual Property Administration's patent publication website.Descriptive analysis,association rule analysis,and cluster analysis were conducted using softwares such as Excel,Origin 2021,R 4.3.1 and Cytoscape 3.9.1,and the relevant topological property values were calculated to construct the core complex network.Results A total of 346 TCM compound patents for treating epilepsy were included,involving 738 different herbs.The top 5 frequently used herbs were Acorus tatarinowii,Gastrodia elata,Buthus martensii,Eupolyphaga seu steleophaga,and Uncaria rhynchophylla.The predominant drug category was liver-soothing and wind-extinguishing drugs.Cluster analysis identified two major categories of drug combinations,and the core combination in the co-occurrence network was Rhizoma acori tatarinowii-Scorpio-Gastrodiae rhizoma-Bombyx batryticatus-Uncariae ramulus cum uncis.A total of 23 association rules were obtained.Conclusion This study reveals the primary characteristics of treating epilepsy,which mainly focus on therapeutic directions such as soothing the liver and suppressing wind,calming wind to arrest convulsions,and calming the mind to tranquilize the spirit.It incorporates individualized dialectical diagnostic and treatment strategies,such as promoting blood circulation and resolving stasis,invigorating the spleen,and transforming phlegm.This discovery aims to provide reference and reference value for the clinical treatment of epilepsy in traditional Chinese medicine.
8.Usage and management of central venous vascular access in hematology departments of 48 hospitals
Miaomiao YANG ; Jian ZHANG ; Jiajing ZHEN ; Mengchuan WANG ; Yuwen CHEN ; Li XU ; Wenjun XIE ; Huimin ZHANG
Chinese Journal of Nursing 2024;59(11):1310-1318
Objective To investigate the status of application of the central venous access in the departments of hematology to develop targeted administrative strategies and provide evidence for management.Methods A self-de-signed questionnaire was applied and convenience sampling was adopted in 93 hematology departments from 48 hospitals in 19 provinces(autonomous regions,municipalities).Results A total of 91 valid questionnaires were col-lected,with a valid questionnaire response rate of 97.85%.Among the 91 hematology departments,91(100%),73(80.22%),and 68(74.73%)carried out PICC,central venous catheter,and totally implantable access port catheteriza-tion,respectively.In the evaluation of blood test indicators before central venous access,the items with a higher e-valuation proportion were platelet count(100%)and D-dimer concentration(87.91%),while the evaluation proportion of other items was<85%.When PICC catheterization,97.80%of hematology departments prefer basilic vein;83.52%of hematology departments used zone insertion method;95.60%of hematology departments had a skin disinfection range of ≥20 cm;98.90%of hematology departments had catheterization under ultrasound guidance;67.03%and 96.70%of hematology departments used the intracardiac electrocardiogram method or ultrasound assisted localiza-tion,postoperative X-ray localization;12.09%and 53.85%of hematology departments carried out tunnel catheteriza-tion and blunt separation expansion techniques,respectively.In terms of maintenance of central venous access de-vices,82.42%of hematology departments used disposable specialized maintenance kits;61.54%of hematology de-partments used transparent patches to fix PICC;45.21%of hematology departments used suture to fix central venous catheters;24.18%of hematology departments used cotton swabs to disinfect infusion joints;60.44%of hematology departments did not use disposable infusion joint disinfection cap;74.73%of hematology departments used gauze compression to prevent puncture site bleeding;only 6.59%hematology departments used antibacterial dressings con-taining chlorhexidine to prevent puncture site infections.In terms of quality management of central venous access devices,94.51%and 86.81%of hematology departments regularly conducted quality inspections of central venous access,and collected,calculated and analyzed relevant data.50.55%of hematology departments conducted complica-tion risk assessments,and 10.99%of hematology departments had established information management systems for venous therapy.Conclusion The implementation rate of PICC catheterization in the hematology department was relatively high,and the insertion operation basically meets the standard requirements.The evaluation before central venous access catheterization was relatively completed,and the maintenance and management are relatively stan-dardized.However,the evaluation of blood test indicators before the placement of central venous access urgently needs to be standardized and unified.When PICC catheterization,attention should be paid to the application of new technologies,and the information management of venous therapy needs to be improved.
9.Causality between hypertension and malignant tumors:A Mendelian randomization study
Ruoxin MAO ; Xiya ZHAO ; Yudan CHEN ; Xinyi CHEN ; Xiya YANG ; Jiajing GU ; Wenming HE
China Modern Doctor 2024;62(25):40-46
Objective To assess the causality between 14 malignant tumors and hypertension.Methods Publicly available datasets from genome-wide association study were used,from which independent genetic variants strongly associated with hypertension and 14 malignant tumors were extracted as instrumental variables for bidirectional Mendelian randomization(MR)analysis,including random effect inverse variance weighted(IVW),simple mode,weighted median,weighted mode and MR-Egger to evaluate the causal effect.Sensitivity analysis was used to test the validity and robustness of the analytical results,and multivariate MR method was used to further control for the effects of confounding factors.Results In the MR analysis of malignant melanoma and hypertension,the study included a total of 11 single nucleotide polymorphisms(SNPs)strongly associated with malignant melanoma.After Bonferroni correction,the IVW-based results showed a causal relationship between malignant melanoma and hypertension(OR=1.67,95%CI:1.27-2.21,P<0.001).Cochran's Q test,Mendelian randomization pleiotropy residual sum and outlier test and MR-Egger intercept test showed that there were no outliers and no horizontal pleiotropy among the instrumental variables,and the sensitivity analysis of the leave-one-out method showed that there was no single SNP that had a significant impact on the overall results.In the analysis of hypertension and leukemia,the preliminary analysis results showed that there may be a relationship between the two,but after adjusting for confounders,the effect of hypertension on the risk of leukemia was no longer significant.Conclusion Malignant melanoma may be a risk factor in the development of hypertension.
10.Analysis of anxiety and depressive status and influencing factors in patients with colorectal polyps in part of Xinjiang area
Xuejiao TAN ; Yaqiong PENG ; Xin PENG ; Miaomiao LUO ; Jian QIN ; Jiaxue LI ; Lina YE ; Ronghui PU ; Li LAI ; Jiajing MA ; Qinglin ZHANG ; Fang LIU ; Weigang CHEN
Chinese Journal of Digestion 2023;43(7):472-480
Objective:To investigated the prevalence of anxiety and depression symptoms in patients with colorectal polyps in part of Xinjiang area and to explore the associated influencing factors related to psychological status, and to provide evidence and clues to promote the diagnosis and treatment of psychosomatic diseases in digestive system.Methods:From December 2021 to June 2022, at the First Affiliated Hospital of Shihezi University, the Fourth Division Hospital of Xinjiang Production and Construction Corps, the Third Division Hospital of Xinjiang Production and Construction Corps (Kashgar Hospital), the Thirteenth Division Red Star Hospital of Xinjiang Production and Construction Corps, the Tenth Division Beitun Hospital of Xinjiang Production and Construction Corps, the Seventh Division Hospital of Xinjiang Production and Construction Corps, the Fifth Division Hospital of Xinjiang Production and Construction Corps, patients who underwent colonoscopy and colorectal polyps detected were enrolled. The generalized anxiety disorder scale-7 (GAD-7) was used to screen anxiety symptoms, and the patient health questionaire-8 (PHQ-8) was performed to screen depression symptoms, and the general situation questionnaire was used to collect clinical information of patients. The questionnairs were completed via the Questionnaire Star platform or paper questionnaire, and a database was established. The patients were divided into groups according to whether with anxiety and depression symptoms. Multivariable logistic regression models was performed to analyze the factors related to anxiety and depression.Results:A total of 516 questionnaires were distributed and collected, among which 9 questionnaires were incomplete and 507 questionnaires were valid, the effective rate of questionnaires was 98.26%. The detection rates of anxiety and depression symptoms in 507 patients with colorectal polyps were 21.50%(109/507) and 19.33%(98/507), respectively. The results of multivariable logistic analysis revealed that female ( OR=3.87, 95% confidence interval (95% CI) 2.30 to 6.51, P<0.001), maximum diameter of polyp ( OR=1.74, 95% CI 1.14 to 2.67, P=0.011), perception of polyps as cancer ( OR=13.96, 95% CI 1.48 to 132.07, P=0.022), and the occurrence of gastrointestinal symptoms after polyp detection ( OR=5.43, 95% CI 1.74 to 16.92, P=0.004) were independent risk factors of anxiety in patients with colorectal polyps. Female ( OR=2.42, 95% CI 1.47 to 4.00, P=0.001), the number of polyps ( OR=1.07, 95% CI 1.01 to 1.13, P=0.028) and the count of gastrointestinal symptoms ( OR=2.04, 95% CI 1.34 to 3.10, P=0.001) were independent risk factors of depression in patients with colorectal polyps. Conclusion:Gender, polyp size, number of polyps, disease perception, and concomitant gastrointestinal symptoms are associated with anxiety and depression in patients with colorectal polyps.

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