1.Progress in the application of deep learning in prognostic models for non-small cell lung cancer
Ruikang ZHONG ; Jinghua LI ; Ximing LIN ; Xueni FANG ; Kaiwen HU ; Tian ZHOU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(09):1345-1350
Non-small cell lung cancer is one of the cancers with the highest incidence and mortality rate in the world, and precise prognostic models can guide clinical treatment plans. With the continuous upgrading of computer technology, deep learning as a breakthrough technology of artificial intelligence has shown good performance and great potential in the application of non-small cell lung cancer prognosis model. The research on the application of deep learning in survival and recurrence prediction, efficacy prediction, distant metastasis prediction, and complication prediction of non-small cell lung cancer has made some progress, and it shows a trend of multi-omics and multi-modal joint, but there are still shortcomings, which should be further explored in the future to strengthen model verification and solve practical problems in clinical practice.
2.Expression and significance of ubiquitin-specific proteases 20 and hypoxia inducible factor-1α in breast cancer
Lingyu FANG ; Jinghua HU ; Junfeng WEN ; Shiqi HAN ; Yali WANG ; Lulan PU ; Jingjia LI ; Yi YANG ; Shishan DENG ; Lingmi HOU ; Fangfang ZHOU
The Journal of Practical Medicine 2024;40(16):2270-2276
Objective To explore the changes and significane of USP20 and HIF-α expression in breast cancer.Methods Following transfection of shRNA-USP20 lentivirus into breast cancer MDA-MB-231 cells,the gene and protein expression levels of USP20 were detected using fluorescence quantitative PCR and Western Blot.Subsequently,the overexpression of USP20 was observed to determine its effect on HIF-α expression.Similarly,siRNA-USP20 was used to knock down USP20 in breast cancer MDA-MB-231 cells,followed by detection of gene and protein expression levels using fluorescence quantitative PCR and Western Blot.The subsequent changes in HIF-α expression were then examined.Rusults The positive expression rates of USP20 and HIF-α in breast cancer tissues were 69.6%and 46.83%,respectively,while they were negatively expressed in the adjacent normal tissues,with statistically significant differences(P<0.01).The positive expressions of USP20 and HIF-α were predomi-nantly observed in the cytoplasm of breast cancer tissue,with a smaller amount present in the nucleus.There was a significant positive correlation between USP20 and HIF-α in breast cancer.Following transfection of shRNA-USP20 lentivirus into MDA-MB-231 cells,both the protein and gene expression levels of USP20 significantly increased(P<0.01).Over-expression of USP20 did not affect HIF-α mRNA levels but led to a significant increase in HIF-α protein expression(P<0.01).Conversely,siRNA-USP20 interference resulted in a significant decrease in both the protein and gene expression levels of USP20(P<0.01),without affecting HIF-α mRNA levels;however,it caused a notable reduction in HIF-α protein expression(P<0.01).Conclusion The expression of USP20 exhib-ited a significant positive correlation with HIF-α in breast cancer.Overexpression of USP20 led to a substantial increase in HIF-α protein expression,while knock-down of the USP20 gene resulted in a significant decrease in HIF-α protein levels.Therefore,it can be inferred that USP20 may exert its influence on the development of breast cancer through modulation of HIF-α expression,thereby providing crucial experimental evidence for clinical treat-ment,prognosis,and further investigations.
3.Efficacy and safety of tislelizumab combined with sorafenib in the treatment for unresectable hepatocellular carcinoma
China Pharmacist 2024;27(8):1336-1342
Objective To Analyze tislelizumab(TIS)combined with sorafenib(SRF)as the first-line treatment regimen for unresectable hepatocellular carcinoma(HCC).Methods Clinical data of patients with unresectable HCC treated in Jinhua Hospital and Shulan(Hangzhou)Hospital affiliated to Zhejiang University School of Medicine from January 2020 to January 2023 were retrospectively analyzed.They were divided into a combined group(TIS combined with SRF)and a control group(SRF)according to the diagnosis and treatment protocol.The main observational indexes of the study were objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and overall survival(OS).In addition,attention was paid to the occurrence of adverse reactions during the treatment to assess safety.Results A total of 61 patients were included in the study,with 31 in the combined group and 30 in the control group.The difference in ORR between the two groups was not statistically significant(P>0.05),while DCR was significantly higher in the combined group than in the control group(P<0.05).Survival analysis showed that the median PFS and median OS of the combined group were significantly higher than those of the control group(P<0.05).In terms of safety,there was no statistically significant difference in the incidence of hand-foot syndrome,transaminase elevation,loss of appetite,proteinuria,rash,diarrhea,thrombocytopenia,and malaise between the two groups(P>0.05);whereas 8 cases of hypothyroidism(25.81%)and 4 cases of capillary hyperplasia(12.90%)occurred in the combined group,and no hypothyroidism or capillary hyperplasia occurred in the control group.In addition,no patients died or discontinued treatment due to adverse effects.Conclusion Compared to single drug SRF,the combination of TIS and SRF first-line treatment for unresectable HCC can improve DCR,prolong median PFS and OS,and the safety is controllable.
4.Influencing factors of the therapeutic effect of PD-1 inhibitor pembrolizumab on cervical cancer
Jinghua HU ; Xuemei SANG ; Wei QIAO ; Miao ZHANG
China Pharmacist 2024;27(8):1375-1382
Objective To explore the influencing factors of the efficacy of programmed death-1(PD-1)inhibitor pembrolizumab in the treatment of cervical cancer.Methods The clinical data of cervical cancer patients admitted to the Department of Obstetrics and Gynecology of Anhui Women and Children's Medical Center from January 2020 to October 2023 were retrospectively analyzed and the patients were divided into the ineffective group and the effective group according to the pembrolizumab treatment efficacy.The clinical data of patients in the two groups were compared[age,tumor type,pathological type,lesion size,differentiation degree,number of pregnancies,number of births,number of miscarriages,menopausal status,tumor mutation load(TMB),DNA repair gene mutation status,PD-L1 expression,diabetes mellitus,hypertension,mode of treatment,body mass index,tumor-infiltrating lymphocyte(TIL)expression,neoantigen intra-tumor heterogeneity(ITH)status,presence of liver disease,and family history],and logistic regression analysis was used to determine the risk factors affecting the efficacy of pembrolizumab in cervical cancer patients.Results A total of 60 patients were included in the study,with 42 in the effective group and 18 in the ineffective group.The proportion of patients with TMB<143/Mb,no mutation in DNA repair genes,low expression of PD-L1,simple immunotherapy,TIL negative,and high PTH in the ineffective group was higher than that in the effective group(P<0.05).Multivariate Logistic regression analysis showed that TMB<143/Mb,non-mutated DNA repair genes,low PD-L1 expression,simple immunotherapy,TIL negative,and high PTH were risk factors affecting the efficacy of pembrolizumab in cervical cancer patients(P<0.05).Conclusion The efficacy of the PD-1 inhibitor pembrolizumab in cervical cancer patients is influenced by factors such as TMB,DNA gene mutations,PD-L1 expression,treatment mode,TIL,and ETH.
5.Exploration and practice of information-based points system in medical management of laboratory medicine
Yunhu ZHAO ; Hui ZHOU ; Guanghua LI ; Maohua ZHOU ; Jinghua LI ; Xuejiao HU ; Bing GU
Chinese Journal of Laboratory Medicine 2024;47(8):958-962
Objective:To explore the role of information-based points system management platform in enhancing the medical management capabilities of laboratory medicine.Methods:A total of 106 personnel who were on duty from January 2021 to December 2022 in the clinical laboratory of Guangdong Provincial People′s Hospital were selected and divided into 8 professional groups, including 24 in Clinical Routine Lab, 22 in Clinical Biochemistry Lab, 11 in Clinical Immune Lab, 13 in Clinical Microbiology Lab, 10 in Clinical Molecular Lab, 9 in Flow Cytometry Lab, 9 in HuiFu Lab, and 8 in Interdisciplinary Lab. Information-based points system management platform was established by formulating the detailed rules for the assessment of this points system, and the points achieved by the 106 participants in 2021 and 2022 were obtained and analyzed. The points were divided into 6 intervals (<41, 41-45, 46-50, 51-55, 56-60 and>60).Results:The overall medical points of laboratory medicine was significantly higher in 2022 than in 2021 (52.15±5.48 vs 49.81±3.73, P<0.001). In 2022, the number of participants with points between 41-45 and 46-50 intervals was lower than those in 2021; with points 51-55, 56-60 and>60 intervals was higher than those in 2021 (χ2=10.479, P<0.05). In addition, the points of Clinical Molecular, Clinical Microbiology and HuiFu Lab were 57.46±7.40, 52.05±5.43 and 54.98±4.31 respectively, which were significantly higher than those of 2021 (50.16±4.14, 49.10±4.06, 49.23±4.28, respectively;all P<0.05). The number of report revisions has significantly decreased in 2022 (18) compared to that in 2021 (48), clinical communication and various levels of publicity and promotion were significantly increased from 52 and 58 (2021) to 108 and 137 (2022), respectively. Conclusion:The construction and application of the information-based points management system have effectively improved the enthusiasm and subjective initiative of laboratory personnel, enhanced the quality and service capabilities of laboratory medicine, and might serve as an important tool for standardized management of laboratory medicine.
6.Multimodal magnetic resonance imaging of subjective tinnitus related mood disorder
Biao LI ; Xiaomin XU ; Yuchen CHEN ; Jinghua HU ; Jinjing XU
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(6):570-576
Subjective tinnitus refers to the subjective sound perception of patients in the absence of an external sound stimulus.Tinnitus patients are often accompanied by emotional disorders, such as depression and anxiety, which seriously affect the quality of life of patients.Therefore, understanding the mechanism underlying the occurrence of tinnitus emotional disorders can help relieve the pain of tinnitus.Tinnitus was considered a simple ear disease in the early stages, but with the progress of neuroimaging technology and the development of animal models, increasing attention has been given to the changes in the neural structure and function of tinnitus patients.As a powerful technique for in vivo investigation of neural activity in the brain, multimodal magnetic resonance has been widely used in the study of subjective tinnitus.By observing the changes of brain structure in subjective tinnitus patients, the neural mechanism of the occurrence and development of tinnitus has been explored.This article reviewed recent multimodal magnetic resonance imaging studies on the neuroimaging mechanisms of tinnitus with mood disorders, compared the differences in neural activity between subjective tinnitus patients and healthy people, and found that the limbic system, default mode network and other neural network abnormalities were closely related to the mood disorders of tinnitus.The application and development of multimodal magnetic resonance techniques in subjective tinnitus were also discussed to elucidate the neural mechanism of subjective tinnitus accompanied by mood disorders with the help of multimodal magnetic resonance techniques.
7.Construction of AQHI based on joint effects of multi-pollutants in 5 provinces of China
Jinghua GAO ; Chunliang ZHOU ; Jianxiong HU ; Ruilin MENG ; Maigeng ZHOU ; Zhulin HOU ; Yize XIAO ; Min YU ; Biao HUANG ; Xiaojun XU ; Tao LIU ; Weiwei GONG ; Donghui JIN ; Mingfang QIN ; Peng YIN ; Yiqing XU ; Guanhao HE ; Xianbo WU ; Weilin ZENG ; Wenjun MA
Journal of Environmental and Occupational Medicine 2023;40(3):281-288
Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO2, NO2, CO, PM2.5, PM10, and maximum 8 h O3 concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM2.5, NO2, SO2, and O3 were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM2.5, NO2, SO2 and O3 were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.
8.Repair effects and mechanism of Zhixu burn ointment on deep second-degree burned model rats
Jiao LIU ; Xiao LIANG ; Tao HU ; Wanjuan DENG ; Jinghua RUAN ; Haibing QIAN
China Pharmacy 2023;34(11):1320-1325
OBJECTIVE To study the repair effect and mechanism of Zhixu burn ointment on deep second-degree burned model rats. METHODS The deep second-degree burned model was established with a temperature-controlled apparatus. The model rats were randomly divided into model group, Jingwanhong ointment group and Zhixu burn ointment high-dose, medium-dose and low-dose groups (specifications were 20 g core+20 mL wetting agent, 10 g core+20 mL wetting agent, 5 g core+20 mL wetting agent, respectively). Another blank control group (only dehairing treatment, no modeling) was set up, with 10 rats in each group. The rats in each administration group were given corresponding drugs, the rats in the blank control group were not treated, and the rats in the model group were given normal saline once a day for 21 d. The healing of burn wounds and histomorphological changes of burned skin in each group of rats were observed, and the healing rate of wounds was calculated; the levels of vascular endothelial growth factor (VEGF), interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α(TNF-α) in the wound skin tissue of rats were detected by enzyme-linked immunosorbent assay; immunohistochemical method was used to detect the expression levels of VEGF and platelet endothelial cell adhesion molecule-1 (CD31) protein in burned skin tissue. RESULTS Compared with model group, the wound area of the rats in the Jingwanhong ointment and Zhixu burn ointment groups gradually decreased and healed significantly by day 21, and the wound healing rate was significantly higher (P<0.05 or P<0.01); thicker new epidermal layer was seen in the skin tissue, and connective tissue and new blood vessels were significantly increased in the dermis; the expression levels of IL-1β, IL-6 and TNF-α were significantly decreased (P<0.05 or P<0.01), and the expression levels of VEGF and CD31 protein were significantly increased (P<0.05 or P<0.01) in the burned skin tissue. CONCLUSIONS Zhixu burn ointment can repair the skin of deep second-degree burned model rats, and the mechanism may be related to reducing the inflammatory response of burn wound and promoting the angiogenesis.
9.Research Progress on the Technology of Microparticle Coating Pediatric Formulations
XU Yichong ; ZHANG Yihua ; PEI Rui ; MENG Tingting ; YUAN Hong ; HU Fuqiang
Chinese Journal of Modern Applied Pharmacy 2023;40(22):3090-3096
ABSTRACT
Currently, there is a limited range of specialized oral preparations available for children, and it is common to find adult medications being used for pediatric purposes. This indicates a need for the development of new formulations specifically designed for children. Microparticle coating technology shows promise in masking the unpleasant taste of drugs, improving compliance and convenience in administration. Therefore, it can be considered an ideal approach for developing pediatric preparations. This article summarizes the current research and application status and development prospects of children's micro powder coating technology, providing reference for the application of micro powder coating technology in the field of children's oral preparations.
10.Effects of Xuefu Zhuyu decoction and its extracts on a mouse model of nonalcoholic fatty liver disease induced by high-fat diet
Hao TANG ; Yixiao YIN ; Wei LIU ; Yi FANG ; Jun WANG ; Yiyang HU ; Jinghua PENG
Journal of Clinical Hepatology 2022;38(12):2728-2737
Objective To investigate the effect of Xuefu Zhuyu decoction on nonalcoholic fatty liver disease (NAFLD) and its material basis. Methods In experiment 1 for exploring the effect of Xuefu Zhuyu decoction on mice with NAFLD induced by high-fat diet, 50 healthy male C57BL/6J mice were randomly divided into normal group, model group, high- and low-dose Xuefu Zhuyu decoction groups, and obeticholic acid control group, with 10 mice in each group. The mice in the normal group were given control diet, and those in the other groups were given high-fat diet. Gastric administration was started at week 13, and related samples were collected at the end of week 16. Food intake and body weight were recorded, enzyme-linked immunosorbent assay was used to measure the serum level of fasting insulin, fasting blood glucose was measured, and insulin resistance index was calculated. HE staining and NAFLD activity score (NAS) were used to observe liver histopathology in mice, oil red O staining was used to observe lipid deposition, and triglyceride (TG) level in liver tissue and serum alanine aminotransferase (ALT) level were measured. In experiment 2 for exploring the effect of different extracts of Xuefu Zhuyu decoction on mice with NAFLD induced by high-fat diet, the methods of water decocting, water extraction and alcohol precipitation, and petroleum ether extraction were used to obtain the extracts 1, 2, and 3 of Xuefu Zhuyu decoction, and 54 healthy male C57BL/6J mice were randomly divided into normal group, model group, Xuefu Zhuyu decoction extract 1, 2, and 3 groups, and Xuefu Zhuyu decoction control group, with 9 mice in each group. The mice in the normal group were given control diet, and those in the other groups were given high-fat diet. Gastric administration was started at week 13, and related samples were collected at the end of week 16. Food intake and body weight were recorded, and enzyme-linked immunosorbent assay was used to measure the serum level of fasting insulin, fasting blood glucose was measured, and insulin resistance index was calculated. HE and NAS were used to observe liver histopathology in mice, oil red O staining was used to observe lipid deposition, and the levels of TG and gamma-glutamyl transpeptidase (GGT) in liver tissue and the serum level of ALT were measured. The t -test was used for comparison of normally distributed continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t -test was used for further comparison between two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and further comparison between two groups. Results In experiment 1, compared with the model group, the high- and low-dose Xuefu Zhuyu decoction groups and the obeticholic acid control group had significant reductions in body weight, insulin resistance index, the distribution of vacuolar lipid droplets in liver tissue, intralobular inflammation, the ballooning degeneration of hepatocytes, NAS score, the level of TG in liver tissue, and the serum level of ALT (all P < 0.05). Compared with obeticholic acid, high- and low-dose Xuefu Zhuyu decoction had a significantly better effect in reducing body weight, insulin resistance index, and total NAS score (all P < 0.05), and low-dose Xuefu Zhuyu decoction had a significantly better effect in improving serum ALT ( P < 0.05). In experiment 2, compared with the model group, the Xuefu Zhuyu decoction extract 1, 2, and 3 groups had significant reductions in fasting blood glucose, insulin resistance index, the distribution of lipid droplets in liver tissue, intralobular inflammation lesions, the ballooning degeneration of hepatocytes, total NAS score, and the level of TG in the liver (all P < 0.05). Compared with the model group, the extract 1 group had a significant reduction in body weight ( P < 0.05); the extract 2 and 3 groups had a significant reduction in the serum level of ALT ( P < 0.05); the extract 2 group had a significant reduction in the level of GGT in liver tissue ( P < 0.05). The extract 2 of Xuefu Zhuyu decoction had the closest effect to compound Xuefu Zhuyu decoction. Conclusion Xuefu Zhuyu decoction and its extracts can help to achieve varying degrees of improvement in NAFLD induced by high-fat diet in mice, and the extract 2 of Xuefu Zhuyu decoction might be the main material basis for Xuefu Zhuyu decoction.


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