1.Visual analysis of Kangfuxin liquid in promoting wound healing based on CiteSpace
Jielin SONG ; Zhenling XIE ; Xinrui ZHANG ; Yunen LIU ; Xiang LI
Journal of Shenyang Medical College 2025;27(3):250-260
Objective:To analyze Chinese and English literature related to Kangfuxin liquid for wound healing using CiteSpace Knowledge Graph,and to understand its research hotspots,current status,and development trend.Methods:Chinese literature on Kangfuxin Liquid in promoting wound healing was retrieved from the China National Knowledge Infrastructure(CNKI),and English literature from Web of Science(WOS),covering the period from January 1,2004,to October 1,2024.CiteSpace 6.1.R6 was used to perform visual analyses based on publication volume,institutions,authors,and keywords.Results:A total of 795 Chinese articles and 21 English articles were included.Overall publication volumes for both languages showed an upward trend,though Chinese publications slightly declined after 2017.Author collaboration network analysis revealed scattered and limited cooperation among researchers,with the field predominantly led by domestic scholars.Institutional collaboration analysis identified Chengdu University of Traditional Chinese Medicine as the most prolific institution in both Chinese and English literature.The mapping indicated closer collaboration among English literature institutions compared to Chinese counterparts.High-frequency keywords in Chinese literature included Kangfuxin liquid,pressure ulcer,and wound healing,while English keywords included expression,chitosan,and induced gastric ulcer.The representative clustering tags in the Chinese database were#0 Kangfuxin,#1 nurse,and#2 therapeutic effect.The representative English clustering tags were#0 diabetic wound,#1 marine polysaccharide,and#2 slamf 9.The research hotspot of the Chinese database before 2019 focused on Kangfuxin Liquid's role in wound healing,while post-2020 studies shifted toward the role of inflammatory factors during healing.Conclusions:Visual analysis confirms Kangfuxin Liquid in wound healing as a research hotspot.Future studies should strengthen interdisciplinary and regional collaborations,with mechanistic exploration and clinical applications prioritized.
2.Effects of hyperthermic intraperitoneal chemotherapy on immune cells and PD-L1 in patients with post-surgery of advanced adenocarcinoma of esophagogastric junction
Zetian ZHANG ; Tongling WANG ; Jielin YANG ; Na WU ; Na LIANG ; Long TIAN
Chinese Journal of Immunology 2025;41(5):1114-1121
Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26%,45.65%,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17%,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67%,77.27%and 54.17%,90.91%,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95%CI(0.248~0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95%CI(1.440~9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.
3.Visual analysis of Kangfuxin liquid in promoting wound healing based on CiteSpace
Jielin SONG ; Zhenling XIE ; Xinrui ZHANG ; Yunen LIU ; Xiang LI
Journal of Shenyang Medical College 2025;27(3):250-260
Objective:To analyze Chinese and English literature related to Kangfuxin liquid for wound healing using CiteSpace Knowledge Graph,and to understand its research hotspots,current status,and development trend.Methods:Chinese literature on Kangfuxin Liquid in promoting wound healing was retrieved from the China National Knowledge Infrastructure(CNKI),and English literature from Web of Science(WOS),covering the period from January 1,2004,to October 1,2024.CiteSpace 6.1.R6 was used to perform visual analyses based on publication volume,institutions,authors,and keywords.Results:A total of 795 Chinese articles and 21 English articles were included.Overall publication volumes for both languages showed an upward trend,though Chinese publications slightly declined after 2017.Author collaboration network analysis revealed scattered and limited cooperation among researchers,with the field predominantly led by domestic scholars.Institutional collaboration analysis identified Chengdu University of Traditional Chinese Medicine as the most prolific institution in both Chinese and English literature.The mapping indicated closer collaboration among English literature institutions compared to Chinese counterparts.High-frequency keywords in Chinese literature included Kangfuxin liquid,pressure ulcer,and wound healing,while English keywords included expression,chitosan,and induced gastric ulcer.The representative clustering tags in the Chinese database were#0 Kangfuxin,#1 nurse,and#2 therapeutic effect.The representative English clustering tags were#0 diabetic wound,#1 marine polysaccharide,and#2 slamf 9.The research hotspot of the Chinese database before 2019 focused on Kangfuxin Liquid's role in wound healing,while post-2020 studies shifted toward the role of inflammatory factors during healing.Conclusions:Visual analysis confirms Kangfuxin Liquid in wound healing as a research hotspot.Future studies should strengthen interdisciplinary and regional collaborations,with mechanistic exploration and clinical applications prioritized.
4.Effects of hyperthermic intraperitoneal chemotherapy on immune cells and PD-L1 in patients with post-surgery of advanced adenocarcinoma of esophagogastric junction
Zetian ZHANG ; Tongling WANG ; Jielin YANG ; Na WU ; Na LIANG ; Long TIAN
Chinese Journal of Immunology 2025;41(5):1114-1121
Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26%,45.65%,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17%,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67%,77.27%and 54.17%,90.91%,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95%CI(0.248~0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95%CI(1.440~9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.
5.Mechanism of Dihuangyin in Treatment of Mice with Atopic Dermatitis by Regulating JAK1/STAT3 Signaling Pathway
Xuening MA ; Juncheng ZHANG ; Teng YU ; Suqing YANG ; Xiaowen WEN ; Shulin JIA ; Suitian WANG ; Jielin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):11-19
ObjectiveTo investigate the effect and potential mechanism of Dihuangyin on 2, 4-dinitrochlorobenzene (DNCB) -induced model mice with atopic dermatitis (AD). MethodA mouse model with AD was established by repeatedly stimulating the back skin of mice with DNCB. After successful modeling, the mice were randomly divided into model group, Runzao group (0.78 g·kg-1), and high, medium, and low dose (40.30, 20.15, and 10.08 g·kg-1) groups of Dihuangyin, with 12 mice in each group, and the blank group consisted of 12 mice, 72 in total. The administration groups were given the corresponding liquid by dose, and the blank group and model group were given the same dose of pure water by intragastric administration, once a day. The skin lesions and scratching times of mice were observed after continuous administration for two weeks. The back skin lesions of mice were stained with hematoxylin-eosin (HE) and toluidine blue to observe the pathology. The contents of serum immunoglobulin E (IgE), interleukin-4 (IL-4), interleukin-6 (IL-6), and interferon-γ (IFN-γ) were detected by enzyme-linked immunosorbent assay (ELISA). The mRNA expression levels of IFN-γ, IL-4, IL-6, Janus kinase 1 (JAK1), and transcriptional activator 3 (STAT3) in skin lesion tissue were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The expressions of JAK1, phosphorylation(p)-JAK1, STAT3, and p-STAT3 proteins in skin lesion tissue were detected by Western blot. ResultCompared with the blank group, the back skin of the model group showed large-scale scab, dryness, erosion, hypertrophy with scratching, epidermal hyperplasia with hyperkeratosis and parakeratosis, hyperacanthosis with edema, and a large number of mast cell infiltration in the dermis, some of which were degranulated. The contents of IgE, IL-4, IL-6, and IFN-γ in the serum of mice were significantly increased (P<0.01), and the protein expression levels of p-JAK1, STAT3, and p-STAT3 and mRNA expressions of IL-4, IL-6, IFN-γ, JAK1, and STAT3 in skin lesion tissue were significantly increased (P<0.01). Compared with the model group, only a small amount of dryness and desquamation were observed in the back skin of mice in each administration group, and cell edema was reduced. The inflammatory infiltration was significantly reduced, and the number of mast cell infiltration was significantly decreased. The serum IgE, IL-4, IL-6, and IFN-γ of mice were decreased to varying degrees (P<0.05, P<0.01). The protein expression levels of p-JAK1, STAT3, and p-STAT3 and mRNA expressions of IL-4, IL-6, IFN-γ, JAK1, and STAT3 in skin lesion tissue were significantly decreased, and the effect of high dose group of Dihuangyin was the best (P<0.01). ConclusionDihuangyin can improve skin lesions and pruritus in mice with AD, and its mechanism may be related to the effective regulation of cytokines on the helper T cells (Th1)/Th2 axis by interfering with the JAK1/STAT3 signaling pathway and affecting skin barrier function.
6.Heterozygous CARD9 mutation favors the development of allergic bronchopulmonary aspergillosis.
Xia XU ; Haiwen LU ; Jianxiong LI ; Jielin DUAN ; Zhongwei WANG ; Jiawei YANG ; Shuyi GU ; Rongguang LUO ; Shuo LIANG ; Wei TANG ; Fengying ZHANG ; Jingqing HANG ; Juan GE ; Xin LIN ; Jieming QU ; Xinming JIA ; Jinfu XU
Chinese Medical Journal 2023;136(16):1949-1958
BACKGROUND:
Previous research demonstrated that a homozygous mutation of g.136372044G>A (S12N) in caspase recruitment domain family member 9 ( CARD9 ) is critical for producing Aspergillus fumigatus -induced ( Af -induced) T helper 2 (T H 2)-mediated responses in allergic bronchopulmonary aspergillosis (ABPA). However, it remains unclear whether the CARD9S12N mutation, especially the heterozygous occurrence, predisposes the host to ABPA.
METHODS:
A total of 61 ABPA patients and 264 controls (including 156 healthy controls and 108 asthma patients) were recruited for sequencing the CARD9 locus to clarify whether patients with this heterozygous single-nucleotide polymorphisms are predisposed to the development of ABPA. A series of in vivo and in vitro experiments, such as quantitative real-time polymerase chain reaction, flow cytometry, and RNA isolation and quantification, were used to illuminate the involved mechanism of the disease.
RESULTS:
The presence of the p.S12N mutation was associated with a significant risk of ABPA in ABPA patients when compared with healthy controls and asthma patients, regardless of Aspergillus sensitivity. Relative to healthy controls without relevant allergies, the mutation of p.S12N was associated with a significant risk of ABPA (OR: 2.69 and 4.17 for GA and AA genotypes, P = 0.003 and 0.029, respectively). Compared with patients with asthma, ABPA patients had a significantly higher heterozygous mutation (GA genotype), indicating that p.S12N might be a significant ABPA-susceptibility locus ( aspergillus sensitized asthma: OR: 3.02, P = 0.009; aspergillus unsensitized asthma: OR: 2.94, P = 0.005). The mutant allele was preferentially expressed in ABPA patients with heterozygous CARD9S12N , which contributes to its functional alterations to facilitate Af -induced T H 2-mediated ABPA development. In terms of mechanism, Card9 wild-type ( Card9WT ) expression levels decreased significantly due to Af -induced decay of its messenger RNA compared to the heterozygous Card9S12N . In addition, ABPA patients with heterozygous CARD9S12N had increased Af -induced interleukin-5 production.
CONCLUSION
Our study provides the genetic evidence showing that the heterozygous mutation of CARD9S12N , followed by allele expression imbalance of CARD9S12N , facilitates the development of ABPA.
Humans
;
Aspergillosis, Allergic Bronchopulmonary/complications*
;
Aspergillus fumigatus/genetics*
;
Asthma/genetics*
;
Aspergillus
;
Mutation/genetics*
;
CARD Signaling Adaptor Proteins/genetics*
7.Recent advances in research on chelators as metallo-β-lactamase inhibitors
Zhixi ZHU ; Jielin ZHANG ; Yijun CHEN
Journal of China Pharmaceutical University 2022;53(4):410-422
The major reason for the resistance of Gram-negative bacteria to β-lactam antibiotics is the expression of β-lactamases.Metallo-β-lactamases (MBL) hydrolyze almost all types of β-lactam antibiotics including carbapenems, posing a challenge to global public health. Developing MBL inhibitors is an important method to treat the infections caused by resistant bacteria. As an important type of MBL inhibitors, chelating agents can inhibit MBL by chelating, stripping, and binding Zn2+ in the active center of MBL.This review summarizes recent publications on chelators as MBL inhibitors, discussing their chemical structures, inhibitory potency, synergistic effects with antibiotics, selectivity and mechanism of action, including EDTA and related compounds, aspergillomarasmine A (AMA) and its derivatives, NOTA and related compounds, pyridine carboxylic acid and pyridine methylamine compounds, aiming to provide reference for future development of potent, selective and safe clinical MBL inhibitors.
8.Analysis of risk factors associated with endoscopic retrograde cholangiopancreatography for patients with liver cirrhosis: a multicenter, retrospective, clinical study.
Jielin LI ; Jiexuan HU ; Peng LI ; Yongdong WU ; Yongjun WANG ; Ming JI ; Haiyang HUA ; Wenbin RAN ; Yanglin PAN ; Shutian ZHANG
Chinese Medical Journal 2022;135(19):2319-2325
BACKGROUND:
Endoscopic retrograde cholangiopancreatography (ERCP) is the endoscopic modality of choice for the treatment of biliary and pancreatic diseases. However, patients with cirrhosis, particularly those with decompensated cirrhosis, are believed to be at increased risk for complications associated with ERCP. There is a paucity of literature describing the outcomes of ERCP for patients with cirrhosis. This study aimed to investigate the outcomes of ERCP for cirrhosis patients, especially adverse events, and evaluated its safety and efficacy.
METHODS:
We performed a multicenter, retrospective study of all patients at Beijing Friendship Hospital affiliated to Capital Medical University, Xijing Hospital affiliated to Air Force Military Medical University, Beijing Youan Hospital affiliated to Capital Medical University, and the Fifth Medical Center of the People's Liberation Army General Hospital from June 2003 to August 2019. The adverse events of inpatient ERCP for patients with ( n = 182) and without liver cirrhosis (controls; n = 385) were compared.
RESULTS:
A total of 567 patients underwent ERCP between January 2003 and December 2019 were enrolled in this study. Compared to patients without cirrhosis, patients with cirrhosis were at higher risk for postoperative complications (odds ratio [OR], 4.172; 95% confidence interval [CI], 1.232-7.031; P < 0.001) such as postoperative pancreatitis (OR, 2.026; 95% CI, 1.002-4.378; P = 0.001) and cholangitis (OR, 3.903; 95% CI, 1.001-10.038; P = 0.036). The main indications for ERCP for patients with cirrhosis in this study included choledocholithiasis (101 cases; 55.5%), benign bile duct strictures (46 cases; 25.3%), and malignant bile duct strictures (28 cases; 15.4%). Among them, 23 patients (12.6%) underwent balloon dilation and 79 patients (43.4%) underwent sphincterotomy. Of the patients with cirrhosis, delayed bleeding occurred in ten patients (5.5%), postoperative pancreatitis occurred in 80 patients (44.0%), and postoperative cholangitis occurred in 25 patients (13.7%). An additional multivariate analysis showed that the total bilirubin (TBIL) level (OR, 4.58; 95% CI, 2.37-6.70) and Child-Pugh score of C (OR, 3.11; 95% CI, 1.04-5.37) were risk factors for postoperative complications in patients with cirrhosis.
CONCLUSIONS
Compared with the general population of patients undergoing ERCP, patients with cirrhosis were more prone to postoperative pancreatitis and cholangitis. TBIL levels and Child-Pugh scores were risk factors for postoperative complications in patients with cirrhosis.
Humans
;
Cholangiopancreatography, Endoscopic Retrograde/adverse effects*
;
Retrospective Studies
;
Constriction, Pathologic
;
Risk Factors
;
Liver Cirrhosis/complications*
;
Pancreatitis/etiology*
;
Postoperative Complications/epidemiology*
;
Cholangitis
9.Reproductive toxicity and associated mechanism of tricresyl phosphate on Caenorhabditis elegans
Jielin TANG ; Hongdan ZHANG ; Qinyu ZHOU ; Jiayi LI ; Tong WANG ; Juan ZHANG
Journal of Environmental and Occupational Medicine 2022;39(5):532-538
Background Tricresyl phosphate (TCP) is mainly used as a flame retardant. Studies have confirmed that it has cytotoxicity and neurotoxicity, but its reproductive toxicity is not clear. Objective To investigate the reproductive toxicity and potential mechanism of TCP subacute exposure on Caenorhabditis elegans. Methods Caenorhabditis elegans were exposed to solvent control and 0.1, 1, 10, 100, and 1000 μg·L−1 TCP respectively for 72 h. Brood size and number of fertilized eggs in the uterus were detected to evaluate reproductive ability. The number of total germline cells and the relative area of gonad arm were measured to evaluate the development of gonads. The body length and body width of Caenorhabditis elegans were detected to evaluate growth and development. The activities of reactive oxygen species (ROS) and superoxide dismutase (SOD) in Caenorhabditis elegans, and the mitochondrial active oxygen metabolism genes (mev-1 and gas-1) of N2 nematodes were detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) to evaluate oxidative stress. WS1433 transgenic nematodes and wild-type nematodes N2 were exposed to solvent control or TCP (0.1, 1, 10, 100, and 1000 μg·L−1) respectively. DNA damage in germ cells of WS1433 transgenic nematodes was detected, the relative expressions of DNA damage-related genes (hus-1, clk-2, cep-1, and egl-1) in N2 nematodes were detected by qRT-PCR to evaluate the effect of TCP exposure on genetic damage. Results Compared with the solvent control group (217.00 ± 12.20), the brood size of N2 nematodes in the 100 μg·L−1 and 1000 μg·L−1 TCP groups decreased (170.80 ± 11.51, 169.60 ± 10.52, P < 0.05). Compared with the solvent control group (18.43 ± 1.69), the number of fertilized eggs of N2 nematodes in the 100 μg·L−1 and 1000 μg·L−1 TCP groups decreased (13.47 ± 0.81, 11.95 ± 0.90, P < 0.05). Compared with the solvent control group (312.46 ± 77.4), the number of total germline cells of N2 nematodes in the 100 μg·L−1 and 1000 μg·L−1 TCP groups decreased (281.80 ± 12.98, 273.50 ± 8.53, P < 0.05). Compared with the solvent control group, the relative area of gonads of N2 nematodes in the 100 μg·L−1 and 1000 μg·L−1 TCP groups decreased by 13.83% and 17.25% respectively (P<0.05). Compared with the solvent control group [(1058.10±80.12) μm, (78.21±14.69) μm], the body length and body width of N2 nematodes in the 100 μg·L−1 and 1000 μg·L−1 TCP groups decreased (P<0.05). Compared with the solvent control group, the relative fluorescence intensity of ROS in nematodes in the 10, 100, and 1000 μg·L−1 TCP groups increased significantly (107.60%±1.02%, 105.90%±1.40%, and 106.40%±1.85%, respectively, P<0.05), and the activities of SOD were reduced (by 20.66%, 15.88%, and 16.44%, respectively, P<0.05). Compared with the solvent control group (1.3±1.3), the number of DNA-damaged germ cells of WS1433 nematodes in the 100 and 1000 μg·L−1 TCP groups increased significantly (2.4±0.3, 2.7±0.3, P<0.05); the expressions of mev-1 and gas-1 genes in N2 nematodes in the 10, 100 and 1000 μg·L−1 TCP groups decreased significantly (P<0.05); the expressions of hus-1 in the 0.1-1000 μg·L−1 TCP groups significantly increased (P<0.05); the expressions of clk-2 and egl-1 in the 100 and 1000 μg·L−1 TCP groups increased significantly (P<0.05); the expressions of cep-1 in the 1, 10, and 100 μg·L−1 TCP groups increased significantly (P<0.05). Conclusion TCP may cause reproductive damage to nematodes through oxidative stress and germ cell DNA damage.
10.Clinical characteristics of adult Chinese patients with syncope: a multicenter clinical study
Fengjing YANG ; Xu LI ; Peng LIANG ; Zhongmei LIU ; Tong LIU ; Yun WU ; Shuanli XIN ; Gaoxing ZHANG ; Shilin YAN ; Lingping XU ; Lixin WANG ; Bo HU ; Wenwei YUE ; Jielin PU ; Zhichun HUANG ; Rui WANG ; Wen WEN ; Peihong LIN ; Li LI ; Zaixin YU ; Xiaodong WANG ; Xijiu LIU ; Jie ZHANG ; Xiufen QU ; Gary TSE ; Yikun PAN ; Kui HONG ; Jieming ZHU ; Lihua LI ; Wen PAN ; Yong WU ; Min WANG ; Changjun SONG ; Zengshuai WANG ; Jianting DONG ; Xinchun YANG ; Xitian HU ; Fujun WANG ; Wenling LIU
Chinese Journal of Cardiology 2022;50(10):1014-1020
Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

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