1.Influence of SH2B1 rs7359397 polymorphism on hepatic fibrosis in patients with metabolic dysfunction-associated steatotic liver disease aged ≥65 years in Beijing, China
Sitong CHEN ; Shuang ZHANG ; Jinhan ZHAO ; Xiaodie WEI ; Yaning LI ; Lixia QIU ; Jing ZHANG
Journal of Clinical Hepatology 2025;41(11):2286-2293
ObjectiveTo investigate the association of SH2B1 rs7359397 (C>T) polymorphism with the progression to hepatic fibrosis in the elderly patients with metabolic dysfunction-associated steatotic liver disease (MASLD) in Beijing, China, and to provide an important genetic basis for the precise subtyping, prognostic evaluation, and individualized treatment of elderly MASLD patients in China. MethodsA total of 505 elderly patients (aged ≥65 years) who participated in regular physical examination in Mentougou Kuangshan Hospital of Beijing Jingmei Group General Hospital from November 2020 to September 2021 and were diagnosed with MASLD by abdominal ultrasound were enrolled as MASLD group, and 381 elderly population who underwent physical examination in the same community hospital during the same period of time and were not found to have MASLD by abdominal ultrasound were enrolled as control group. FibroScan was used to measure liver fat content and determine fibrosis stage. The 96-well microfluidic chip technique was used to identify SH2B1 rs7359397 polymorphism. The independent-samples t test was used for comparison of normally distributed continuous data between the two groups, and the chi-square test or the adjusted chi-square test was used for comparison of categorical data between the two groups. Univariate and multivariate Logistic regression analyses were used to identify the independent predictive factors for MASLD and its comorbidities. ResultsCompared with the control group, the MASLD group had a significantly younger age and significantly higher levels of waist circumference, hip circumference, waist-hip ratio, body mass index (BMI), alanine aminotransferase, aspartate aminotransferase, triglyceride, platelet count, and fibrosis-4 (FIB-4) index, as well as a significantly lower level of high-density lipoprotein cholesterol (all P<0.05). Among the 381 patients in the control group, 264 (69.29%) had genotype CC and 117 (30.71%) had genotype CT+TT, while among the 505 patients in the MASLD group, 317 (62.77%) had genotype CC and 188 (37.23%) had genotype CT+TT, suggesting that the MASLD group had a significantly higher proportion of patients with genotype CT+TT compared with the control group (χ2=4.09, P=0.043). In the MASLD group, compared with the genotype CC group, the genotype CT+TT group had a significantly lower proportion of patients with FIB-4 ≥2 or atherosclerotic cardiovascular diseases (P<0.05). The multivariate Logistic regression analysis showed that after adjustment for age, sex, and BMI, carrying T allele was a protective factor against progressive hepatic fibrosis (odds ratio [OR]=0.481, 95% confidence interval [CI]: 0.249 — 0.929, P=0.029). In the subgroups of comorbidities with hypertension, metabolic syndrome, and obesity, genotype CT+TT was associated with a significant reduction in the risk of progressive hepatic fibrosis (hypertension: OR=0.27, 95%CI:0.09 — 0.77, P=0.014; metabolic syndrome: OR=0.30, 95%CI: 0.11 — 0.79, P=0.015; obesity: OR=0.11, 95%CI: 0.03 — 0.48, P=0.003). After adjustment for age, sex, and BMI, in the patients with MASLD, the patients with genotype CT+TT had a significant reduction in the prevalence rate of atherosclerotic cardiovascular diseases compared with those with genotype CC (OR=0.506, 95%CI:0.336 — 0.761, P=0.001). ConclusionSH2B1 rs7359397 (C>T) polymorphism is associated with the reduction in the risk of hepatic fibrosis and atherosclerotic cardiovascular diseases in MASLD patients.
2.Prediction model and feature analysis of pneumonia hospitalization duration based on CT radiomics and clinical indicators
Xiaofen SUN ; Zhihao WU ; Yinan ZHANG ; Jinhan ZHANG ; Jianqiang CHEN
Chinese Journal of Preventive Medicine 2025;59(10):1741-1747
Objective:To analyze clinical indicators and imaging data of hospitalized pneumonia patients and develop prediction models for length of hospital stay based on CT radiomics features and clinical indicators.Methods:Patients admitted to the First Clinical School of Hainan Medical University for pneumonia treatment between November 2020 and May 2024 were enrolled. Clinical data and CT imaging were collected, and radiomics features were extracted. Patients were divided into three groups based on the length of stay (<8 d, 8-28 d,>28 d, and poor prognosis). Three prediction models were constructed using logistic regression (LR): clinical features model, imaging features model and a combined clinical and imaging features model. The predictive performance of three models was evaluated using the area under the receiver operating characteristic (ROC) curve and DeLong test, followed by feature analysis. The Kappa test was used to compare the consistency of the overall classification.Results:A total of 343 subjects were included, with an average age of 61.46±20.98 years. The area under the curve (AUC) values of the combined model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.73, 0.65 and 0.78 in the training set, and 0.71, 0.65 and 0.76 in the validation set, respectively. The AUC values of the clinical feature model in different hospitalization duration classifications were 0.63, 0.64 and 0.73 in the training set, and 0.60, 0.52 and 0.63 in the validation set, respectively. The AUC values of the imaging feature model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.67, 0.66 and 0.73 in the training set, and 0.68, 0.54 and 0.66 in the validation set, respectively. The DeLong test results showed that the combined model outperformed other models in hospitalization duration classification (validation set AUC, all P<0.05, Bonferroni correction). Kappa test results showed that the combined model achieved the highest consistency between predicted classifications and actual hospitalization classifications ( K=0.615). Shape features, texture features and clinical features all contributed proportionally to the combined model. Conclusion:The combined model integrating radiomics features with clinical indicators can significantly enhance the predictive efficacy for the length of hospitalization in pneumonia patients.
3.An analysis of deaths in medical X-ray diagnostic workers in Jiangsu province during 1950-2021
Xindi WEI ; Wei CHEN ; Jin WANG ; Zihao ZHANG ; Yuji MIAO ; Yuanyuan ZHOU ; Xiangyong FAN ; Jinhan WANG ; Yeqing GU
Chinese Journal of Radiological Medicine and Protection 2025;45(7):655-662
Objective:To study the risk and pattern of deaths caused by various diseases in the population and in the case of long-term occupational X-ray exposure.Methods:Using a combination of retrospective and prospective cohort research methods, an exposure group of medical X-ray diagnostic workers who worked in the radiology department of Jiangsu Provincial Hospital between 1950 and 1980 and a control group of medical workers from other departments who did not work with radiolog during the same period in the same hospital were selected to form a study cohort. The cumulative number of person years of observation in the cohort during 1950-2011 was calculated, and the Cox regression model was used to calculate the risk of deaths of medical X-ray diagnostic workers for various diseases through adjusting sex, attained age, birth age, and starting working age.Results:A total of 6 953 follow-up visits was completed to the cohort, including 3 649 in the radiation group and 3 304 in the control group, with a total of 347 362 person years of observation. There were 2 099 deaths in the cohort as of December 31, 2021. Cox regression results showed that diseases with a significantly higher risk of death in the radiation group compared with the control group were: all-cancer ( RR=1.20, 95% CI: 1.04-1.39, Z=2.56, P<0.05, including lung cancer RR=1.52, 95% CI: 1.17-1.98, Z=3.10, P<0.01, and pancreatic cancer RR=1.96, 95% CI: 1.11-3.46, Z=2.31, P<0.05); diseases of the circulatory system ( RR=1.29, 95% CI: 1.06-1.57, Z=2.58, P<0.01); endocrine, nutritional and metabolic diseases ( RR=1.90, 95% CI: 1.06-3.42, Z=2.14, P<0.05). Stratified analyses showed that, of male workers, the radiation group had an increased risk of death caused by all-cancer and lung cancer ( Z=3.50, 2.92, P<0.01); of the age group at starting ages 26 to 30, the radiation group had an increased risk of death distributed to circulatory diseases ( Z=2.06, P<0.05); and in the age group at attained ages elder than 61 years, the radiation group had an increased risk of death distributed to all cancers, lung cancer, and circulatory diseases ( Z=2.90-4.31, P<0.01). Conclusions:As has been shown, threre is an increasing risk of death distributed to lung cancer, pancreatic cancer, and circulatory diseases in medical X-ray diagnostic workers in Jiangsu province. Further in-depth research in related areas may be conducted in the future.
4.Prediction model and feature analysis of pneumonia hospitalization duration based on CT radiomics and clinical indicators
Xiaofen SUN ; Zhihao WU ; Yinan ZHANG ; Jinhan ZHANG ; Jianqiang CHEN
Chinese Journal of Preventive Medicine 2025;59(10):1741-1747
Objective:To analyze clinical indicators and imaging data of hospitalized pneumonia patients and develop prediction models for length of hospital stay based on CT radiomics features and clinical indicators.Methods:Patients admitted to the First Clinical School of Hainan Medical University for pneumonia treatment between November 2020 and May 2024 were enrolled. Clinical data and CT imaging were collected, and radiomics features were extracted. Patients were divided into three groups based on the length of stay (<8 d, 8-28 d,>28 d, and poor prognosis). Three prediction models were constructed using logistic regression (LR): clinical features model, imaging features model and a combined clinical and imaging features model. The predictive performance of three models was evaluated using the area under the receiver operating characteristic (ROC) curve and DeLong test, followed by feature analysis. The Kappa test was used to compare the consistency of the overall classification.Results:A total of 343 subjects were included, with an average age of 61.46±20.98 years. The area under the curve (AUC) values of the combined model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.73, 0.65 and 0.78 in the training set, and 0.71, 0.65 and 0.76 in the validation set, respectively. The AUC values of the clinical feature model in different hospitalization duration classifications were 0.63, 0.64 and 0.73 in the training set, and 0.60, 0.52 and 0.63 in the validation set, respectively. The AUC values of the imaging feature model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.67, 0.66 and 0.73 in the training set, and 0.68, 0.54 and 0.66 in the validation set, respectively. The DeLong test results showed that the combined model outperformed other models in hospitalization duration classification (validation set AUC, all P<0.05, Bonferroni correction). Kappa test results showed that the combined model achieved the highest consistency between predicted classifications and actual hospitalization classifications ( K=0.615). Shape features, texture features and clinical features all contributed proportionally to the combined model. Conclusion:The combined model integrating radiomics features with clinical indicators can significantly enhance the predictive efficacy for the length of hospitalization in pneumonia patients.
5.An analysis of deaths in medical X-ray diagnostic workers in Jiangsu province during 1950-2021
Xindi WEI ; Wei CHEN ; Jin WANG ; Zihao ZHANG ; Yuji MIAO ; Yuanyuan ZHOU ; Xiangyong FAN ; Jinhan WANG ; Yeqing GU
Chinese Journal of Radiological Medicine and Protection 2025;45(7):655-662
Objective:To study the risk and pattern of deaths caused by various diseases in the population and in the case of long-term occupational X-ray exposure.Methods:Using a combination of retrospective and prospective cohort research methods, an exposure group of medical X-ray diagnostic workers who worked in the radiology department of Jiangsu Provincial Hospital between 1950 and 1980 and a control group of medical workers from other departments who did not work with radiolog during the same period in the same hospital were selected to form a study cohort. The cumulative number of person years of observation in the cohort during 1950-2011 was calculated, and the Cox regression model was used to calculate the risk of deaths of medical X-ray diagnostic workers for various diseases through adjusting sex, attained age, birth age, and starting working age.Results:A total of 6 953 follow-up visits was completed to the cohort, including 3 649 in the radiation group and 3 304 in the control group, with a total of 347 362 person years of observation. There were 2 099 deaths in the cohort as of December 31, 2021. Cox regression results showed that diseases with a significantly higher risk of death in the radiation group compared with the control group were: all-cancer ( RR=1.20, 95% CI: 1.04-1.39, Z=2.56, P<0.05, including lung cancer RR=1.52, 95% CI: 1.17-1.98, Z=3.10, P<0.01, and pancreatic cancer RR=1.96, 95% CI: 1.11-3.46, Z=2.31, P<0.05); diseases of the circulatory system ( RR=1.29, 95% CI: 1.06-1.57, Z=2.58, P<0.01); endocrine, nutritional and metabolic diseases ( RR=1.90, 95% CI: 1.06-3.42, Z=2.14, P<0.05). Stratified analyses showed that, of male workers, the radiation group had an increased risk of death caused by all-cancer and lung cancer ( Z=3.50, 2.92, P<0.01); of the age group at starting ages 26 to 30, the radiation group had an increased risk of death distributed to circulatory diseases ( Z=2.06, P<0.05); and in the age group at attained ages elder than 61 years, the radiation group had an increased risk of death distributed to all cancers, lung cancer, and circulatory diseases ( Z=2.90-4.31, P<0.01). Conclusions:As has been shown, threre is an increasing risk of death distributed to lung cancer, pancreatic cancer, and circulatory diseases in medical X-ray diagnostic workers in Jiangsu province. Further in-depth research in related areas may be conducted in the future.
6.Effects of Bimin Formula (鼻敏方) on the Nasal Mucosa TMEM16A/NF-κB/MUC5AC Signaling Pathway in a Rat Model of Allergic Rhinitis with Lung-Spleen Qi Deficiency
Ningcong XU ; Yiwei HUA ; Xi TAN ; Jinhan WANG ; Zihua LIANG ; Shiqing ZHOU ; Yunying LI ; Wenyong CHEN ; Jiyan XIA ; Qiulan LUO
Journal of Traditional Chinese Medicine 2024;65(8):842-848
ObjectiveTo explore the possible mechanism of Bimin Formula (鼻敏方) in treating lung-spleen qi deficiency syndrome of allergic rhinitis (AR) with high mucin secretion. MethodsThirty-four SD rats were randomly divided into a blank group (8 rats), a model group (8 rats), a low-dose Bimin Formula group (8 rats), and a high-dose Bimin Formula group (10 rats). Except for the blank group, the other groups were subjected to AR lung-spleen qi deficiency rat models induced by smoking, gavage of Ginkgo biloba leaf extract, and ovalbumin. After modeling, rats in the low- and high-dose Bimin Formula groups were given Bimin Formula concentrate (concentration of 2.16 g/ml) by gavage at doses of 1.08 g/100 g and 2.16 g/100 g, respectively, while rats in the model group were given 0.5 ml/100 g of normal saline by gavage, once daily for 28 days; the blank group was not intervened. Behavioral assessments were performed after intervention. ELISA was used to detect the levels of peripheral blood total immunoglobulin E (IgE). HE staining was used to observe the pathological changes of nasal mucosa epithelium in rats, while immunohistochemistry was used to detect the expression of transmembrane protein 16A (TMEM16A) and mucin 5AC (MUC5AC) protein in nasal mucosa. Western Blot was used to detect the expression of nuclear factor kappa B (NF-κB) protein, and RT-PCR was used to detect the expression of TMEM16A, MUC5AC, and NF-κB mRNA in nasal mucosa. ResultsHE staining showed that the nasal mucosa epithelial cell structure in the blank group was intact without shedding, swelling, or necrosis; the nasal mucosa epithelial tissue of rats in the model group was thickened and partially shed, with infiltration of eosinophils and lymphocytes visible; the pathological changes in nasal mucosa tissue of rats in the high- and low-dose Bimin Formulagroups were improved, and more improvement was showen in the high-dose group. Compared with those in the blank group, the behavioral scores and peripheral blood total IgE levels of rats in the model group significantly increased, as well as the expression of TMEM16A, MUC5AC, and NF-κB proteins and mRNA in nasal mucosa (P<0.05 or P<0.01). Compared with those in the model group, the behavioral scores and peripheral blood total IgE levels of rats in the high-dose Bimin Formula group decreased, and the expression of TMEM16A, MUC5AC, and NF-κB proteins and mRNA in nasal mucosaalso decreased (P<0.05 or P<0.01); the behavioral scores and peripheral blood total IgE levels of rats in the low-dose Bimin Formula group were reduced, and the expression of TMEM16A and MUC5AC proteins and mRNA in nasal mucosa, as well as the expression of NF-κB protein decreased (P<0.05 or P<0.01), but the difference in NF-κB mRNA expression was not statistically significant (P>0.05). Compared with the low-dose Bimin Formula group, the expression of NF-κB protein in the high-dose group decreased (P<0.01). ConclusionBimin Formula may improve the symptoms and high mucus secretion of AR lung-spleen qi deficiency by regulating the TMEM16A/NF-κB/MUC5AC signaling pathway in nasalmucosa.
7.Cohort analysis of tumor effect for medical diagnostic X-ray workers in Jiangsu province
Xindi WEI ; Jin WANG ; Wei CHEN ; Zihao ZHANG ; Yuji MIAO ; Yuanyuan ZHOU ; Xiangyong FAN ; Jinhan WANG ; Yeqing GU
Chinese Journal of Radiological Medicine and Protection 2024;44(10):841-848
Objective:To investigate the effects of long-term X-ray radiation exposure on the tumor risk of medical X-ray workers in Jiangsu province, and to provide a scientific basis for the development of occupational protection policies and the improvement of workers′ health.Methods:By using a combination of retrospective and prospective cohort research method, the medical diagnostic X-ray workers who worked in the radiology department of all hospitals in Jiangsu province between 1950 and 1980 were selected as the radiology group.In the meantime medical personnel in internal medicine, otorhinolaryngology, pediatrics and other medical departments who had not been engaged in radiology during the same period of time at the same hospital were selected as the control group to form a survey cohort. The cumulative number of person-years of observation of the cohort during 1950-2011 was calculated, and the relative risk of various malignant tumors among medical X-ray workers was calculated by using Cox regression model after adjusting for sex, attained age, year of birth, and year of work initiation.Results:A total of 6 954 follow-ups was completed for the cohort, including 3 649 in the irradiation group and 3 305 in the control group, totally 340 483 person-years of observation. As of December 31, 2021, there were 1 328 patients with malignant tumors in this cohort. Cox regression result showed that compared with the control group, the irradiation group who had developed lung cancer ( RR=1.60, 95% CI 1.24-2.08), lymphoma ( RR =4.28, 95% CI 1.54-11.93), solid cancer ( RR =1.17, 95% CI 1.04-1.31), and total cancer ( RR =1.29, 95% CI 1.14-1.46) had significantly higher relative risks ( Z=3.56, 2.78, 2.71, 3.96, P<0.05). Stratified analyses showed that the risks of lung, lymphoma, solid and total cancers were higher in the radiation group than in the control group for males and for those who arrived at the age of 61 years or older ( χ2=6.70-33.86, P<0.05). The risks of lung, solid and total cancers were higher in the radiation group than in the control group for those who started to work in the age group of 21 to 25 years ( χ2=6.46, 6.16, 5.62, P<0.05). Conclusions:The relative risks of lung, lymphoma, solid and total cancers among medical X-ray workers in Jiangsu province are significantly higher, suggesting that attention should be paid to strengthening radiation protection for radiation workers in their radiological practices.
8.Investigation of occupational health of nuclear medicine radiation workers in Jiangsu Province, China, 2023
Wei CHEN ; Shihao WU ; Xindi WEI ; Xiangyong FAN ; Yuanyuan ZHOU ; Yuji MIAO ; Yeqing GU ; Jinhan WANG ; Zhili XIA ; Zihao ZHANG ; Jin WANG
Chinese Journal of Radiological Health 2024;33(5):542-548
Objective To investigate the basic situation and occupational health conditions of nuclear medicine radiation workers in Jiangsu Province based on the research protocol developed by the Institute of Radiation Medicine, Chinese Academy of Medical Sciences for the nationwide study on the health effects of nuclear medicine radiation in China, understand the impact of occupational radiation on the physical health of nuclear medicine radiation workers, and provide a basis for improving the occupational protection of nuclear medicine radiation workers and reducing the risk of occupational radiation-related health issues. Methods A census approach was used to collect general data and occupational health information of nuclear medicine radiation workers in Jiangsu Province. The analysis focused on the abnormalities in physical examination indicators among radiation workers of different genders, ages, and working years to evaluate the health effects of occupational radiation exposure. Results The occupational health examination data of 472 nuclear medicine radiation workers were collected from 76 medical institutions in Jiangsu Province. The results showed that the detection rate of abnormal hypothyroidism in female workers (8.90%) was higher than that in male workers (2.54%) (P=0.028). With increasing working years, the detection rates of cataract and continuous decrease in white blood cell count increased (P<0.001). The multivariate logistic regression identified working years as a risk factor for cataract and continuous decrease in white blood cell count (OR=1.59, 95%CI=1.40-3.35, P=
9.Investigation of occupational health of nuclear medicine radiation workers in Jiangsu Province, China, 2023
Wei CHEN ; Shihao WU ; Xindi WEI ; Xiangyong FAN ; Yuanyuan ZHOU ; Yuji MIAO ; Yeqing GU ; Jinhan WANG ; Zhili XIA ; Zihao ZHANG ; Jin WANG
Chinese Journal of Radiological Health 2024;33(5):542-548
Objective To investigate the basic situation and occupational health conditions of nuclear medicine radiation workers in Jiangsu Province based on the research protocol developed by the Institute of Radiation Medicine, Chinese Academy of Medical Sciences for the nationwide study on the health effects of nuclear medicine radiation in China, understand the impact of occupational radiation on the physical health of nuclear medicine radiation workers, and provide a basis for improving the occupational protection of nuclear medicine radiation workers and reducing the risk of occupational radiation-related health issues. Methods A census approach was used to collect general data and occupational health information of nuclear medicine radiation workers in Jiangsu Province. The analysis focused on the abnormalities in physical examination indicators among radiation workers of different genders, ages, and working years to evaluate the health effects of occupational radiation exposure. Results The occupational health examination data of 472 nuclear medicine radiation workers were collected from 76 medical institutions in Jiangsu Province. The results showed that the detection rate of abnormal hypothyroidism in female workers (8.90%) was higher than that in male workers (2.54%) (P=0.028). With increasing working years, the detection rates of cataract and continuous decrease in white blood cell count increased (P<0.001). The multivariate logistic regression identified working years as a risk factor for cataract and continuous decrease in white blood cell count (OR=1.59, 95%CI=1.40-3.35, P=
10.An Empirical Study on the Use of Diagnosis Related Group Tools for Grouping Adjustments in Large Public Hospitals
Guojie ZHANG ; Xutong TAN ; Zhiling CAI ; Qiang XU ; Weifeng XU ; Yihang CHEN ; Yating WANG ; Jinhan LIU ; Zheng CHEN ; Jiong ZHOU ; Xiaojun MA
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1052-1058
To analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources. We retrospectively collected DRG data from two surgical departments in a large public hospital in Beijing from 2017 to 2023. When the case mix index (CMI) of the two surgical departments declined, interventions such as performance appraisal, department education, and hospital publicity were promptly adopted. The changesin CMI values were observed and the trends in disease group weights, time consumption index, cost consumption index, and mortality rate in low-risk groups were analyzed. After the interventions, in surgical department Ⅰ, the proportion of patients with lower-weight diseases, such as major thyroid surgery (KD1), significantly decreased, while that of patients with higher-weight diseases, such as colorectal malignancy surgery (GB2) and pancreatic malignancy surgery (HB1), significantly increased. In surgical department Ⅱ, the proportion of patients with lower-weight diseases, such as chemotherapy (RE1), decreased markedly, while that of patients with higher-weight diseases, including major surgery for malignancy of kidney, ureter, and bladder (LA1), adrenal gland surgery (KC1), surgery for kidney/ureter/bladder except for major malignancy surgery (LB1), and male genital organ malignancy surgery (MA1), increased significantly. Both surgical departments achieved the goal of increasing their CMI values. In terms of efficiency, cost, and quality indicators, the time consumption index and cost consumption index of the two surgical departments were significantly lower than 1, and the mortality rate in low-risk groups was 0. Based on actual conditions and development goals, large public hospitals can achieve improvements in CMI values and optimization of disease group structures through reasonable interventions, thereby enhancing medical efficiency and rational utilization of resources.

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