1.Feasibility of MAGIC pure tone screening in children aged 3 to 6 years.
Qingjia CUI ; Fang GE ; Renjie HAN ; Jin YAN ; Cheng WEN ; Yue LI ; Xin DAI ; Lihui HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(1):14-18
Objective:To explore the feasibility of the multiple-choice auditory graphical interactive check(MAGIC) screening module in childhood hearing screening in children aged 3 to 6 years. Methods:A hearing screening was conducted on 366 children(732 ears) aged between 3 and 6 years. The screening methods included MAGIC, DPOAE, and acoustic immittance.The cooperation, screening time, pass rate, and correlation of the three screening methods were compared. Results:There was a statistically significant difference in the degree of cooperation among the three screeningmethods(P=0.004).The MAGIC pure tone screening method was 98.6%, the screening DPOAE was 99.5%,and the acoustic immittance screening was 100%. For the screening duration, the MAGIC pure tone screening method was(116.3±59.1)s, the screening DPOAE was(27.2±19.7)s, and the acoustic impedance screening was(24.6±14.6)s. There was a significant statistical significance differences among the three or two groups(P<0.01). The passing rates of MAGIC pure tone screening,screening DPOAE and acoustic immittance screening were 64.7%, 65.4%, and 69.3%, respectively, and there was no significant statistical difference among the three or two groups(P>0.05). There was no significant difference between MAGIC pure tone screening method and screening DPOAE(P=0.827>0.05), and acoustic impedance(P=0.653>0.05), while the difference between screening DPOAE and acoustic impedance was statistically significant(P<0.01). Conclusion:MAGIC pure sound screening method has good feasibility, can comprehensively reflect the hearing level of screened children, and can be promoted for hearing screening in children aged between 3 and 6 years.
Humans
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Child, Preschool
;
Child
;
Female
;
Male
;
Audiometry, Pure-Tone
;
Mass Screening/methods*
;
Feasibility Studies
;
Acoustic Impedance Tests/methods*
;
Hearing Loss/diagnosis*
;
Hearing Tests/methods*
2.Clinical efficacy and safety of intravenous colistin sulfate monotherapy versus combination with nebulized inhalation for pulmonary infections caused by carbapenem-resistant gram-negative bacilli: a multicenter retrospective cohort study.
Danyang PENG ; Fan ZHANG ; Ying LIU ; Yanqiu GAO ; Lanjuan XU ; Xiaohui LI ; Suping GUO ; Lihui WANG ; Lin GUO ; Yonghai FENG ; Chao QIN ; Huaibin HAN ; Xisheng ZHENG ; Faming HE ; Xiaozhao LI ; Bingyu QIN ; Huanzhang SHAO
Chinese Critical Care Medicine 2025;37(9):829-834
OBJECTIVE:
To compare the efficacy and safety of intravenous colistin sulfate combined with nebulized inhalation versus intravenous monotherapy for pulmonary infections caused by carbapenem-resistant organism (CRO).
METHODS:
A multicenter retrospective cohort study was conducted. Clinical data were collected from patients admitted to the intensive care unit (ICU) of 10 tertiary class-A hospitals in Henan Province between July 2021 and May 2023, who received colistin sulfate for CRO pulmonary infections. Data included baseline characteristics, inflammatory markers [white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), C-reactive protein (CRP)], renal function indicators [serum creatinine (SCr), blood urea nitrogen (BUN)], life support measures, anti-infection regimens, clinical efficacy, microbiological clearance rate, and prognostic outcomes. Patients were divided into two groups: intravenous group (colistin sulfate monotherapy via intravenous infusion) and combination group ((intravenous infusion combined with nebulized inhalation of colistin sulfate). Changes in parameters before and after treatment were analyzed.
RESULTS:
A total of 137 patients with CRO pulmonary infections were enrolled, including 89 in the intravenous group and 48 in the combination group. Baseline characteristics, life support measures, daily colistin dose, and combination regimens (most commonly colistin sulfate plus carbapenems in both groups) showed no significant differences between two groups. The combination group exhibited higher clinical efficacy [77.1% (37/48) vs. 59.6% (52/89)] and microbiological clearance rate [60.4% (29/48) vs. 39.3% (35/89)], both P < 0.05. Pre-treatment inflammatory and renal parameters showed no significant differences between two groups. Post-treatment, the combination group showed significantly lower WBC and CRP [WBC (×109/L): 8.2±0.5 vs. 10.9±0.6, CRP (mg/L): 14.0 (5.7, 26.6) vs. 52.1 (24.4, 109.6), both P < 0.05], whereas NEU, PCT, SCr, and BUN levels showed no significant between two groups. ICU length of stay was shorter in the combination group [days: 16 (10, 25) vs. 21 (14, 29), P < 0.05], although mechanical ventilation duration and total hospitalization showed no significant differences between two groups.
CONCLUSIONS
Intravenous colistin sulfate combined with nebulized inhalation improved clinical efficacy and microbiological clearance in CRO pulmonary infections with an acceptable safety profile.
Humans
;
Colistin/therapeutic use*
;
Retrospective Studies
;
Administration, Inhalation
;
Anti-Bacterial Agents/therapeutic use*
;
Carbapenems/pharmacology*
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Male
;
Female
;
Middle Aged
;
Gram-Negative Bacteria/drug effects*
;
Aged
;
Treatment Outcome
;
Respiratory Tract Infections/drug therapy*
3.Prediction of PD-1 monoclonal antibody human pharmacokinetic characteristics based on PK in cynomolgus monkeys
Yanjun XU ; Zijun HAN ; Liang WANG ; Fang YANG ; Beilei LOU ; Shaoyu YAN ; Jiman ZHU ; Lihui BAI ; Yong GAO
Chinese Journal of Pharmacology and Toxicology 2025;39(2):109-117
OBJECTIVE To establish a population pharmacokinetic(PopPK)model to predict the PK characteristics of GLS-010 in humans.METHODS Fifty-eight cynomolgus monkeys were used,18 of which were randomly divided into three groups and received a single intravenous infusion of GLS-010 at doses of 2,6,and 18 mg·kg-1,respectively.The rest were randomly assigned to four groups and received multiple intravenous infusions of GLS-010 at doses of 0,5,25,and 100 mg·kg-1,respectively,once a week(quaque week,qw)for five consecutive weeks.Blood samples were collected before and after administration.The concentrations of GLS-010 in the monkey serum were measured using a validated enzyme-linked immunosorbent assay,while those of anti-drug antibodies(ADA)in the cynomolgus monkey serum were determined by ultra-sensitive electrochemiluminescence immunoassay.The PK data on GLS-010 in cynomolgus monkeys was obtained,and the drug-time curves were plotted.A PopPK model was constructed using non-compartmental analysis and evaluated by goodness-of-fit plots and visual predictive checks.The constructed PopPK model was used to predict the PK characteristics in humans,which were finally compared with actual Phase Ⅰ clinical study results for validation.RESULTS The predictive results of the PopPK model were highly consistent with the actual Phase Ⅰ clinical study results.The model was able to predict the human PK characteristics under various dosing regimens,including 1 mg·kg-1 quaque 2 weeks(q2w),4 mg·kg-1(q2w),240 mg(q2w),240 mg(q3w),and 10 mg·kg-1(q2w).The predicted maximum plasma concentrations(Cmax)were 24.8,99.1,85.0,85.0,and 247.8 mg·L-1,respectively,and the AUC0-336h was 4 902.0,20 060.0,17 147.7,22 145.7(AUC0-504h),and 50 817.6 mg·h·L-1,respectively.The safety risks for the corresponding dosing regimens were 47.3,11.6,13.5,10.5,and 4.6,respectively.The predicted receptor occupancy at steady state(ROss)at Cmax,average plasma concentration(Cavg),and minimum plasma concentration(Cmin)were 38.8%,72.7%,69.4%,64.1%and 87.2%,29.1%,63.8%,60.0%,49.8%and 82.1%,21.9%,55.5%,51.3%,36.3%and 76.7%,respectively.CONCLUSION The PopPK model can effectively predict the human PK characteristics under different dosing regimens with high consistency with actual Phase Ⅰ clinical study results,which can serve as an important reference for selection of safe and effective doses for first-in-human research.
4.Clinical features of nontuberculous Mycobacteria pulmonary disease patients with previous pulmonary tuberculosis
Fei WANG ; Xiaojun WANG ; Qian JIN ; Duo HUA ; Juan DU ; Lihui ZHAO ; Jian YU ; Jing XU ; Lu HAN ; Yi REN
Chinese Journal of Nosocomiology 2025;35(10):1483-1488
OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary dis-ease(NTMPD)patients with previous pulmonary tuberculosis(PPTB)and analyze the clinical difference from the recurrence of pulmonary tuberculosis.METHODS By means of retrospective survey,the patients who were diag-nosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar.2021 to Oct.2023 were recruited as the research subjects,a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB.The baseline data,clinical symptoms,imaging findings,underlying diseases,pulmonary diseases,and species of nontuberculous Mycobacteria(NTM)were observed and compared.Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculo-sis group in a 1:1 ratio by matching the PPTB-NTMPD group with the gender and age.The major clinical charac-teristics were compared between the two groups.The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases,the 10-30 years group with 37 cases,and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD.The major clinical characteristics were compared among the groups.RESULTS The age was(64.21±10.71)years old in the PPTB-NTMPD group,(60.26±11.83)years old in the NPPTB-NTMPD group(t=3.020,P=0.003).The proportion of patients with body mass index less than 18.5 kg/m2 was 59.78%in the PPTB-NTMPD group,41.25%in the NPPTB-NTMPD group(x2=6.155,P=0.013);the proportion of patients with cough was 77.17%in the PPTB-NTMPD group,65.68%in the NPPTB-NTMPD group(x2=4.313,P=0.038);the inci-dence of cavitary shadow was 50.00%in the PPTB-NTMPD group,35.31%in the NPPTB-NTMPD group(x2=6.414,P=0.011);the incidence of emphysema and pulmonary bullae was 29.35%in the PPTB-NTMPD group,12.87%in the NPPTB-NTMPD group(x2=13.766,P<0.001);the incidence of chronic obstructive pulmonary disease(COPD)was 22.83%in the PPTB-NTMPD group,14.19%in the NPPTB-NTMPD group(x2=3.875,P=0.049);the incidence of damaged lung was 9.78%in the PPTB-NTMPD group,2.97%in the NPPTB-NT-MPD group(x2=7.530,P=0.014);there were significant differences.Mycobacterium intracellulare and Myco-bacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NT-MPD group,there was no significant difference in the distribution of NTM species between the two groups of pa-tients.The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P<0.05),the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P<0.05).There were significant differences in the age,incidence of pleural thickening and incidence of COPD among the patients with different time intervals between ini-tial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P<0.05).CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m2 and the post-tuberculosis pulmonary diseases such as cough,pulmonary cavity,emphysema,pulmonary bullae,COPD and damaged lung of the NTMPD patients.The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis.It is necessary for the clinicians to attach great importance.
5.Clinical features of nontuberculous Mycobacteria pulmonary disease patients with previous pulmonary tuberculosis
Fei WANG ; Xiaojun WANG ; Qian JIN ; Duo HUA ; Juan DU ; Lihui ZHAO ; Jian YU ; Jing XU ; Lu HAN ; Yi REN
Chinese Journal of Nosocomiology 2025;35(10):1483-1488
OBJECTIVE To explore the clinical characteristics of the nontuberculous Mycobacteria pulmonary dis-ease(NTMPD)patients with previous pulmonary tuberculosis(PPTB)and analyze the clinical difference from the recurrence of pulmonary tuberculosis.METHODS By means of retrospective survey,the patients who were diag-nosed with NTMPD and recurrent pulmonary tuberculosis in Wuhan Pulmonary Hospital from Mar.2021 to Oct.2023 were recruited as the research subjects,a total of 395 patients with NTMPD were enrolled in the study and were divided into the PPTB-NTMPD group with 92 cases and the NPPTB-NTMPD group with 303 cases according to the history of PPTB.The baseline data,clinical symptoms,imaging findings,underlying diseases,pulmonary diseases,and species of nontuberculous Mycobacteria(NTM)were observed and compared.Totally 92 patients with recurrent pulmonary tuberculosis were randomly screened and assigned as the recurrent pulmonary tuberculo-sis group in a 1:1 ratio by matching the PPTB-NTMPD group with the gender and age.The major clinical charac-teristics were compared between the two groups.The 92 patients with PPTB-NTMPD were divided into the 1-10 years group with 40 cases,the 10-30 years group with 37 cases,and the more than 30 years group with 15 cases according to the interval between the initial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD.The major clinical characteristics were compared among the groups.RESULTS The age was(64.21±10.71)years old in the PPTB-NTMPD group,(60.26±11.83)years old in the NPPTB-NTMPD group(t=3.020,P=0.003).The proportion of patients with body mass index less than 18.5 kg/m2 was 59.78%in the PPTB-NTMPD group,41.25%in the NPPTB-NTMPD group(x2=6.155,P=0.013);the proportion of patients with cough was 77.17%in the PPTB-NTMPD group,65.68%in the NPPTB-NTMPD group(x2=4.313,P=0.038);the inci-dence of cavitary shadow was 50.00%in the PPTB-NTMPD group,35.31%in the NPPTB-NTMPD group(x2=6.414,P=0.011);the incidence of emphysema and pulmonary bullae was 29.35%in the PPTB-NTMPD group,12.87%in the NPPTB-NTMPD group(x2=13.766,P<0.001);the incidence of chronic obstructive pulmonary disease(COPD)was 22.83%in the PPTB-NTMPD group,14.19%in the NPPTB-NTMPD group(x2=3.875,P=0.049);the incidence of damaged lung was 9.78%in the PPTB-NTMPD group,2.97%in the NPPTB-NT-MPD group(x2=7.530,P=0.014);there were significant differences.Mycobacterium intracellulare and Myco-bacterium abscessus were the predominant species of NTM in both the PPTB-NTMPD group and the NPPTB-NT-MPD group,there was no significant difference in the distribution of NTM species between the two groups of pa-tients.The incidence of patch shadow of the PPTB-NTMPD group was lower than that of the recurrent pulmonary tuberculosis group(P<0.05),the incidence of bronchiectatic shadow of the PPTB-NTMPD group was higher than that of the recurrent pulmonary tuberculosis group(P<0.05).There were significant differences in the age,incidence of pleural thickening and incidence of COPD among the patients with different time intervals between ini-tial diagnosis of pulmonary tuberculosis and the diagnosis of NTMPD in the PPTB-NTMPD group(P<0.05).CONCLUSIONS The previous pulmonary tuberculosis mainly affect the body mass index less than 18.5 kg/m2 and the post-tuberculosis pulmonary diseases such as cough,pulmonary cavity,emphysema,pulmonary bullae,COPD and damaged lung of the NTMPD patients.The NTMPD patients with previous pulmonary tuberculosis are more likely to have bronchiectasia than the patients with recurrent tuberculosis.It is necessary for the clinicians to attach great importance.
6.Prediction of PD-1 monoclonal antibody human pharmacokinetic characteristics based on PK in cynomolgus monkeys
Yanjun XU ; Zijun HAN ; Liang WANG ; Fang YANG ; Beilei LOU ; Shaoyu YAN ; Jiman ZHU ; Lihui BAI ; Yong GAO
Chinese Journal of Pharmacology and Toxicology 2025;39(2):109-117
OBJECTIVE To establish a population pharmacokinetic(PopPK)model to predict the PK characteristics of GLS-010 in humans.METHODS Fifty-eight cynomolgus monkeys were used,18 of which were randomly divided into three groups and received a single intravenous infusion of GLS-010 at doses of 2,6,and 18 mg·kg-1,respectively.The rest were randomly assigned to four groups and received multiple intravenous infusions of GLS-010 at doses of 0,5,25,and 100 mg·kg-1,respectively,once a week(quaque week,qw)for five consecutive weeks.Blood samples were collected before and after administration.The concentrations of GLS-010 in the monkey serum were measured using a validated enzyme-linked immunosorbent assay,while those of anti-drug antibodies(ADA)in the cynomolgus monkey serum were determined by ultra-sensitive electrochemiluminescence immunoassay.The PK data on GLS-010 in cynomolgus monkeys was obtained,and the drug-time curves were plotted.A PopPK model was constructed using non-compartmental analysis and evaluated by goodness-of-fit plots and visual predictive checks.The constructed PopPK model was used to predict the PK characteristics in humans,which were finally compared with actual Phase Ⅰ clinical study results for validation.RESULTS The predictive results of the PopPK model were highly consistent with the actual Phase Ⅰ clinical study results.The model was able to predict the human PK characteristics under various dosing regimens,including 1 mg·kg-1 quaque 2 weeks(q2w),4 mg·kg-1(q2w),240 mg(q2w),240 mg(q3w),and 10 mg·kg-1(q2w).The predicted maximum plasma concentrations(Cmax)were 24.8,99.1,85.0,85.0,and 247.8 mg·L-1,respectively,and the AUC0-336h was 4 902.0,20 060.0,17 147.7,22 145.7(AUC0-504h),and 50 817.6 mg·h·L-1,respectively.The safety risks for the corresponding dosing regimens were 47.3,11.6,13.5,10.5,and 4.6,respectively.The predicted receptor occupancy at steady state(ROss)at Cmax,average plasma concentration(Cavg),and minimum plasma concentration(Cmin)were 38.8%,72.7%,69.4%,64.1%and 87.2%,29.1%,63.8%,60.0%,49.8%and 82.1%,21.9%,55.5%,51.3%,36.3%and 76.7%,respectively.CONCLUSION The PopPK model can effectively predict the human PK characteristics under different dosing regimens with high consistency with actual Phase Ⅰ clinical study results,which can serve as an important reference for selection of safe and effective doses for first-in-human research.
7.Baihe Wuyaotang Ameliorates NAFLD by Enhancing mTOR-mediated Liver Autophagy
Rui WANG ; Tiantian BAN ; Lihui XUE ; Xinyi FENG ; Jiyuan GUO ; Jiaqi LI ; Shenghe JIANG ; Xiaolei HAN ; Baofeng HU ; Wenli ZHANG ; Naijun WU ; Shuang LI ; Yajuan QI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):66-77
ObjectiveTo investigate the therapeutic effect of Baihe Wuyaotang (BWT) on non-alcoholic fatty liver disease (NAFLD) and elucidate its underlying mechanism. MethodC57BL/6J mice were randomly assigned to six groups: normal control, model, positive drug (pioglitazone hydrochloride 1.95×10-3 g·kg-1), and low-, medium-, and high-dose BWT (1.3,2.5 and 5.1 g·kg-1). Following a 12-week high-fat diet (HFD) inducement, the mice underwent six weeks of therapeutic intervention with twice-daily drug administration. Body weight was monitored weekly throughout the treatment period. At the fifth week, glucose tolerance (GTT) and insulin tolerance (ITT) tests were conducted. Subsequently, the mice were euthanized for the collection of liver tissue and serum, and the subcutaneous adipose tissue (iWAT) and epididymal adipose tissue (eWAT) were weighed. Serum levels of total triglycerides (TG) and liver function indicators,such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were determined. Histological examinations, including oil red O staining, hematoxylin-eosin (HE) staining, Masson staining, and transmission electron microscopy, were performed to evaluate hepatic lipid deposition, pathological morphology, and ultrastructural changes, respectively. Meanwhile, Western blot and real-time quantitative polymerase chain reaction (Real-time PCR) were employed to analyze alterations, at both gene and protein levels, the insulin signaling pathway molecules, including insulin receptor substrate 1/2/protein kinase B/forkhead box gene O1 (IRS1/2/Akt/FoxO1), glycogen synthesis enzymes phosphoenolpyruvate carboxy kinase (Pepck) and glucose-6-phosphatase (G6Pase), lipid metabolism-related genes stearoyl-coA desaturase-1 (SCD-1) and carnitine palmitoyltransferase-1 (CPT-1), fibrosis-associated molecules α-smooth muscle actin (α-SMA), type Ⅰ collagen (CollagenⅠ), and the fibrosis canonical signaling pathway transforming growth factor-β1/drosophila mothers against decapentaplegic protein2/3(TGF-β1/p-Smad/Smad2/3), inflammatory factors such as interleukin(IL)-6, IL-8, IL-11, and IL-1β, autophagy markers LC3B Ⅱ/Ⅰ and p62/SQSTM1, and the expression of mammalian target of rapamycin (mTOR). ResultCompared with the model group, BWT reduced the body weight and liver weight of NAFLD mice(P<0.05, P<0.01), inhibited liver lipid accumulation, and reduced the weight of white fat: it reduced the weight of eWAT and iWAT(P<0.05, P<0.01) as well as the serum TG content(P<0.05, P<0.01). BWT improved the liver function as reflected by the reduced ALT and AST content(P<0.05, P<0.01). It improved liver insulin resistance by upregulating IRS2, p-Akt/Akt, p-FoxO1/FoxO1 expressions(P<0.05). Besides, it improved glucose and lipid metabolism disorders: it reduced fasting blood glucose and postprandial blood glucose(P<0.05, P<0.01), improved GTT and ITT(P<0.05, P<0.01), reduced the expression of Pepck, G6Pase, and SCD-1(P<0.01), and increased the expression of CPT-1(P<0.01). The expressions of α-SMA, Collagen1, and TGF-β1 proteins were down-regulated(P<0.05, P<0.01), while the expression of p-Smad/Smad2/3 was downregulated(P<0.05), suggesting BWT reduced liver fibrosis. BWT inhibited inflammation-related factors as it reduced the gene expression of IL-6, IL-8, IL-11 and IL-1β(P<0.01) and it enhanced autophagy by upregulating LC3B Ⅱ/Ⅰ expression(P<0.05)while downregulating the expression of p62/SQSTM1 and mTOR(P<0.05). ConclusionBWT ameliorates NAFLD by multifaceted improvements, including improving IR and glucose and lipid metabolism, anti-inflammation, anti-fibrosis, and enhancing autophagy. In particular, BWT may enhance liver autophagy by inhibiting the mTOR-mediated signaling pathway.
8.Summary of the best evidence for exercise intervention in patients with multiple myeloma
Shiyu HAN ; Hong CHU ; Xiuhua YING ; Lihui WANG ; Qian WANG ; Qizi WU ; Jie WU ; Si CHEN
Chinese Journal of Practical Nursing 2024;40(25):1969-1976
Objective:To summarize the relevant evidence of exercise intervention for patients with multiple myeloma at home and abroad, and provide evidence-based basis for medical staff to formulate exercise intervention programs.Methods:Through the method of evidence-based nursing, the literatures related to exercise intervention for patients with multiple myeloma were systematically retrieved from relevant guideline websites, professional association websites and databases at home and abroad, including best practices, recommended practices, guidelines, expert consensus, evidence summary, systematic reviews and so on. The search time limit was established until April 16, 2024. Two researchers evaluated the quality of the literature and extracted the data. JBI pre-classification of evidence and level of Recommendation system (2014 version) was used to determine the level of evidence items and recommendation level.Results:A total of 15 articles were included, including 1 clinical decision, 4 guidelines, 8 systematic reviews, 1 expert consensus and 1 evidence summary. A total of 26 pieces of evidence were summarized, including 5 aspects, including applicable population, exercise evaluation, exercise plan, exercise precautions and exercise management.Conclusions:The best evidence summarized in this study provides a basis for the development and management of exercise intervention in patients with multiple myeloma. It is suggested that clinical staff should fully consider the clinical context when applying the evidence, and develop personalized exercise intervention programs based on the patient′s status and preferences.
9.Predictive value of blood urea nitrogen for in-hospital death risk in patients with septic shock
Ting PANG ; Yong HAN ; Li ZHOU ; Lihui XIE ; Jingheng LEI ; Zhe DENG
The Journal of Practical Medicine 2024;40(13):1874-1878
Objective To investigate the relationship and predictive value of blood urea nitrogen(BUN)levels with the risk of in-hospital mortality in patients with septic shock.Methods Clinical data of 328 patients diagnosed with septic shock from January 1,2018 to September 30,2023 in Shenzhen Second People's Hospital were retrospectively collected.The primary outcome indicator was in-hospital death in patients with septic shock.Simple logistic regression analyses was used to explore the correlation between BUN and in-hospital death in patients with septic shock;multiple logistic regression analyses model was used to explore the quantitative relationship between BUN and in-hospital death in septic shock,sensitivity analyses was utilized to test the stability of the results.Results Simple logistic regression analyses suggested that BUN was a risk factor for in-hospital mortality in patients with septic shock.Multiple logistic regression analyses showed a positive correlation between BUN and in-hospital mortality in patients with septic shock:the risk of in-hospital mortality in patients with septic shock was increased by 3.3%for every 1 mmol/L increase in BUN(OR=1.033,P<0.01);after adjusting for different vari-ables,the risk of in-hospital death increased by 2.9%(OR=1.029,P<0.05)and 3.2%(OR=1.032,P<0.05)for each 1 mmol/L increase in BUN,respectively.Sensitivity analyses further confirmed the stability of the results(OR=1.04,P<0.05).Conclusion There is a positive correlation between BUN levels and in-hospital death in patients with septic shock,and it has a predictive value for the risk of in-hospital death in patients with septic shock.
10.Analysis of the predictive value of amplitude integrated electroencephalogrphy and brainstem auditory evoked potentials for cognitive and affective disorder in patients with cerebral small vessel disease
Rui WANG ; Keke HAN ; Yonggang HAO ; Lihui YANG ; Wanli DONG
Chinese Journal of Cerebrovascular Diseases 2024;21(12):813-822
Objective Exploring the predictive value of amplitude integrated electroencephalography(aEEG)and brainstem auditory evoked potentials(BAEP)in cognitive and affective disorders related to cerebral small vessel disease(CSVD).Methods Retrospectively,100 patients with CSVD who visited the Department of Neurology at the Fourth Affiliated Hospital of Soochow University from January 2021 to February 2024 were included in the CSVD group.From January 2021 to February 2024,100 healthy people who underwent physical examination in the Physical Examination Center of the Fourth Affiliated Hospital of Soochow University and matched with the CSVD group for age and sex were prospectively included as the control group.Basic and clinical data were collected and compared between the CSVD group and the control group,including age,sex,years of education,hypertension,diabetes,smoking,drinking,total cholesterol,triglycerides,low-density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP),galactin-3(Gal-3),cystatin C,homocysteine(Hcy),blood Tau protein,and glial fibrillary acidic protein(GFAP).Cognitive function was assessed using the mini-mental state examination(MMSE)and the Montreal cognitive assessment(MoCA)scale,with a MMSE score<24 and a MoCA score<25 indicating cognitive impairment.affective disorders were assessed using the Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD),with a HAMA score ≥ 14 or a HAMD score ≥20 indicating the presence of affective disorders.The scores of the above four scales were compared between the CSVD group and the control group.aEEG and BAEP data were collected and compared between the CSVD group and the control group.aEEG results were evaluated based on a composite score of background activity stability,sleep-wake cycle,lower boundary amplitude,and narrowband width,with a score of 0-3 indicating aEEG abnormalities.In the BAEP waveform,the Ⅰ,Ⅲ,and Ⅴ waves and the inter-wave intervals of Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅰ-Ⅴ were observed and recorded,along with their peak latencies and inter-peak latencies.If the latency of each wave is prolonged>mean+3 standard deviations and/or the interwave period is prolonged>mean+3 standard deviations,it was considered a BAEP abnormality.CSVD patients were divided into cognitive impairment and non-cognitive impairment based on MMSE scale score and MoCA scale score,and all CSVD patients were divided into affective disorder and non-affective disorder based on HAMA score and HAMD score.The independent variables with statistically significant differences and no collinearity in the univariate analysis of cognitive and affective disorders in CSVD patients were included in the multivariate Logistic regression analysis,and the statistically significant factors were used to form the multivariate model.The area under the receiver operating characteristic(ROC)curve was used to analyze the predictive value of the multi-factor model for CSVD-related cognitive and affective disorders.Results(1)The proportion of hypertension patients,the levels of CRP,Gal-3,cystatin C,Hcy,Tau protein,GFAP,HAMA and HAMD scores in the CSVD group were higher than those in the control group(all P<0.05),and the MMSE and MoCA scale were lower than those in the control group(both P<0.05).The scores of continuity,sleep-wake cycle,lower boundary amplitude and narrow band width of aEEG in the CSVD group were lower than those in the control group(all P<0.05).The peak latency and interpeak latency of BAEP in the CSVD group were higher than those in the control group(all P<0.05).(2)There were 52 patients with cognitive impairment and 48 patients with non-cognitive impairment in CSVD patients.There were 36 patients with affective disorder and 64 patients with non-affective disorder.There were 17patients with both cognitive and affective disorders.The age,Tau protein,GFAP,the proportion of patients with abnormal aEEG and the proportion of patients with abnormal BAEP in patients with cognitive impairment were higher than those in patients without cognitive impairment(all P<0.05).The age of patients with affective disorder,the proportion of patients with abnormal aEEG and the proportion of patients with abnormal BAEP were higher than those of patients without affective disorder(all P<0.05).(3)Multivariate Logistic regression analysis showed that the risk of cognitive impairment in patients with abnormal aEEG CSVD was 4.364 times higher than that in patients with normal aEEG CSVD(OR,4.364,95%CI 1.554-12.252,P=0.005).The risk of cognitive impairment in patients with abnormal BAEP CSVD was 3.218 times higher than that in patients with normal BAEP CSVD(OR,3.218,95%CI 1.218-8.503,P=0.018).The ROC curve was used to analyze the predictive value of the multi-factor model jointly constructed by aEEG abnormalities and BAEP abnormalities for CSVD cognitive impairment.The results showed that the area under the ROC curve was 0.732,the sensitivity was 76.38%,and the specificity was 82.59%.(4)Multivariate Logistic regression analysis showed that the risk of affective disorder in patients with abnormal aEEG CSVD was 3.203 times higher than that in patients with normal aEEG CSVD(OR,3.203,95%CI 1.288-7.966,P=0.012).The risk of affective disorder in patients with abnormal BAEP CSVD was 2.553 times higher than that in patients with normal BAEP CSVD(OR,2.553,95%CI 1.011-6.446,P=0.047).The ROC curve was used to analyze the predictive value of the multi-factor model jointly constructed by aEEG abnormalities and BAEP abnormalities for CSVD affective disorders.The results showed that the area under the ROC curve was 0.700,the sensitivity was 74.21%,and the specificity was 83.49%.Conclusions The abnormality of aEEG and BAEP are important factors in constructing the prediction model of cognitive and affective disorders in CSVD patients.The multi-factor model constructed by aEEG and BAEP has certain value in predicting CSVD-related cognitive and affective disorders.

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