1.Trend analysis of pulmonary tuberculosis incidence among the elderly in Shanghai, 2014‒2023
Yu HUANG ; Lixin RAO ; Biao XU ; Qi ZHAO ; Xin SHEN
Shanghai Journal of Preventive Medicine 2025;37(3):227-233
ObjectiveTo describe the epidemiological characteristics and trend of pulmonary tuberculosis among the elderly in Shanghai from 2014 to 2023, to estimate the incidence between 2024‒2025, so as to provide references for optimizing the prevention and control strategies of pulmonary tuberculosis for elderly in Shanghai. MethodsData of pulmonary tuberculosis patients aged ≥60 years in Shanghai registered in the Tuberculosis Registration and Management System of Chinese Center for Disease Control and Prevention from 2014 to 2023 was derived to describe the demographic characteristics of the elderly patients with pulmonary tuberculosis, and to calculate the reported incidence rate and annual percentage change (APC) of pulmonary tuberculosis. The autoregressive integrated moving average (ARIMA) model was constructed using monthly reported incidence data from January 2014 to June 2023, and data from July to December in 2023 were used to validate the model and predict the reported incidence rate of pulmonary tuberculosis among elderly in 2024 and 2025. ResultsA total of 19 208 elderly pulmonary tuberculosis patients were registered and reported in Shanghai from 2014 to 2023, with an average annual reported incidence rate of 35.04/100 000. The reported incidence rate of pulmonary tuberculosis in elderly showed an overall decreasing trend, APC=-3.34% (t=-3.360,P=0.010). While, the proportion of elderly pulmonary tuberculosis patients showed a yearly increasing trend among the total registered and reported cases, APC=5.65% (t=10.820, P<0.001). The difference in the average annual reported incidence rate of pulmonary tuberculosis in elderly was statistically significant in different regions (χ2=31.762, P=0.007), with the central urban areas(33.23/100 000) being lower than that in suburban areas (36.46/100 000), and the annual decreasing rate was faster in central urban area, APC=-4.88% (t=-4.838, P<0.001) and -2.76% (t=-2.811, P=0.023), respectively. The incidence rate was significantly higher in males than that in females (χ2=514.395, P<0.001). Additionally, the difference in reported incidence rate was statistically significant among different age groups(χ2=119.751,P<0.001), among which patients aged ≥80 years had the highest average annual incidence rate (59.69/100 000), and those aged ≤60 years had the lowest average annual incidence rate (28.57/100 000). Compared with the non-residential permanent elderly population (47.68/100 000), the average annual incidence rate of pulmonary tuberculosis among the elderly with household registration in Shanghai was lower (33.82/100 000) (χ2=24.295, P<0.001). The ARIMA (0,0,1) (0,1,1) 12 model was used to predict the incidence rate of pulmonary tuberculosis among the elderly in Shanghai in 2024 and 2025, and which was predicted to be 37.41/100 000 and 35.92/100 000, respectively. ConclusionThe reported incidence rate of pulmonary tuberculosis among the elderly in Shanghai showed an overall yearly downward trend from 2014 to 2023, but its proportion in the total number of reported pulmonary tuberculosis cases increased year by year. Prevention and control efforts should still not be slackened and emphasis should be placed on male, suburban and non-residential permanent elderly populations.
2.Mid- to long-term outcomes of median sternotomy ascending-descending thoracic aortic bypass grafting for complex aortic coarctation
Yongqiang JIN ; Lixin FAN ; Enrui ZHANG ; Xiaoya ZHANG ; Hui XUE ; Zhonghua XU ; Qingyu WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(07):963-967
Objective To investigate the mid- to long-term follow-up results of ascending aorta (AAO)-descending thoracic aorta (DTA) bypass grafting via median sternotomy incision for the treatment of complex aortic arch coarctation. Methods A retrospective analysis was conducted on the clinical data of patients with complex aortic arch coarctation who underwent AAO-DTA bypass grafting via median sternotomy incision at the First Hospital of Tsinghua University from August 2004 to May 2017. Results A total of 7 patients were enrolled, including 4 males and 3 females, aged (13.3±4.6) years, and weighted (40.2±12.2) kg. Six (85.7%) patients had concomitant upper limb hypertension. Four patients were aortic arch coarctation combined with intracardiac malformations, two were post-operative restenosis, and 1 was post-operative restenosis combined with intracardiac malformation. All patients underwent surgery under cardiopulmonary bypass. There were no perioperative deaths or major complications. The pre-operative upper-lower limb pressure difference was (39.3±19.2) mm Hg, which decreased to (2.9±2.7) mm Hg post-operatively (P<0.01). The follow-up period was (14.9±5.9) years. There were no long-term deaths or artificial graft-related complications. Except for one patient who still had mild hypertension, the blood pressure of the remaining patients returned to normal. Conclusion AAO-DTA bypass grafting via median sternotomy incision for the treatment of complex aortic arch coarctation can effectively reduce upper limb blood pressure and the upper-lower limb arterial pressure difference, has fewer complications, and demonstrates satisfactory mid- to long-term efficacy.
3.Introduction to Implementation Science Theories, Models, and Frameworks
Lixin SUN ; Enying GONG ; Yishu LIU ; Dan WU ; Chunyuan LI ; Shiyu LU ; Maoyi TIAN ; Qian LONG ; Dong XU ; Lijing YAN
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1332-1343
Implementation Science is an interdisciplinary field dedicated to systematically studying how to effectively translate evidence-based research findings into practical application and implementation. In the health-related context, it focuses on enhancing the efficiency and quality of healthcare services, thereby facilitating the transition from scientific evidence to real-world practice. This article elaborates on Theories, Models, and Frameworks (TMF) within health-related Implementation Science, clarifying their basic concepts and classifications, and discussing their roles in guiding implementation processes. Furthermore, it reviews and prospects current research from three aspects: the constituent elements of TMF, their practical applications, and future directions. Five representative frameworks are emphasized, including the Consolidated Framework for Implementation Research (CFIR), the Practical Robust Implementation and Sustainability Model (PRISM), the Exploration, Preparation, Implementation, Sustainment (EPIS)framework, the Behavior Change Wheel (BCW), and the Normalization Process Theory (NPT). Additionally, resources such as the Dissemination & Implementation Models Webtool and the T-CaST tool are introduced to assist researchers in selecting appropriate TMFs based on project-specific needs.
4.Visualization of nasal powder distribution using biomimetic human nasal cavity model.
Jiawen SU ; Yan LIU ; Hongyu SUN ; Abid NAEEM ; Huipeng XU ; Yue QU ; Caifen WANG ; Zeru LI ; Jianhua LU ; Lulu WANG ; Xiaofeng WANG ; Jie WU ; Lixin SUN ; Jiwen ZHANG ; Zhigang WANG ; Rui YANG ; Li WU
Acta Pharmaceutica Sinica B 2024;14(1):392-404
Nasal drug delivery efficiency is highly dependent on the position in which the drug is deposited in the nasal cavity. However, no reliable method is currently available to assess its impact on delivery performance. In this study, a biomimetic nasal model based on three-dimensional (3D) reconstruction and three-dimensional printing (3DP) technology was developed for visualizing the deposition of drug powders in the nasal cavity. The results showed significant differences in cavity area and volume and powder distribution in the anterior part of the biomimetic nasal model of Chinese males and females. The nasal cavity model was modified with dimethicone and validated to be suitable for the deposition test. The experimental device produced the most satisfactory results with five spray times. Furthermore, particle sizes and spray angles were found to significantly affect the experimental device's performance and alter drug distribution, respectively. Additionally, mometasone furoate (MF) nasal spray (NS) distribution patterns were investigated in a goat nasal cavity model and three male goat noses, confirming the in vitro and in vivo correlation. In conclusion, the developed human nasal structure biomimetic device has the potential to be a valuable tool for assessing nasal drug delivery system deposition and distribution.
5."Medicinal Part-Habitat-Tissue-Component" Correlations of Aquatic Chinese Medicinal Plants
Lin CHEN ; Baoyu JI ; Lixin PEI ; Shuangquan XU ; Tangshuai LI ; Suiqing CHEN ; Chengming DONG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):212-221
ObjectiveTo explore the correlations between the medicinal parts, habitats, tissue, components, and medicinal properties (natures, tastes, and effects) of 100 aquatic Chinese medicinal plants, thus providing evidence for the relationship between image and analogy and laying a theoretical foundation for the clinical use and development of aquatic Chinese medicinal plant resources. MethodThe Aquatic Plants of China, Flora of China, and related literature were searched, and a total of 100 aquatic Chinese medicinal plants included in the Chinese Pharmacopoeia (2020 edition), Chinese Materia Medica, National Compilation of Chinese Herbal Medicines, Dictionary of Chinese Materia Medica, and local standards were screened out. The medicine-taxonomic status-life habit associations and nature-component-traditional Chinese medicine classification-pharmacological effect associations were analyzed respectively. ResultThe aquatic Chinese medicinal plants mostly had a cold nature, bitter, pungent, and sweet tastes, and tropism to the liver meridian. The whole plant or aerial part was mainly used for medicinal purposes, and these plants generally had well developed aerenchyma. These plants mainly contained flavonoids, alkaloids, and volatile oils and had the effects of clearing heat, detoxifying, and promoting urination. ConclusionThere are correlations between the medicinal parts, habitats, tissue, components, medicinal properties, and effects of aquatic Chinese medicinal plants, which provide reference for the development and utilization of aquatic Chinese medicinal plant resources.
6.Based on "Medicinal Part-Chemical Component-Pharmacological Activity-Nature, Taste, and Effect" Correlations of Thorny Medicinal Plants
Tangshuai LI ; Baoyu JI ; Lin CHEN ; Shuangquan XU ; Jianglong HE ; Suiqing CHEN ; Chengming DONG ; Lixin PEI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):222-230
ObjectiveTo make statistics on the biological characteristics, medicinal parts, chemical components, and other aspects of thorny medicinal plants and systematically analyze the correlations between their natures, tastes, and meridian tropism, so as to provide a theoretical basis for the clinical application and resource development of these plants. MethodThe Chinese Pharmacopoeia (2020 edition) and the processing standards of various provinces and cities and other related documents were reviewed, on the basis of which 46 species of thorny medicinal plants were selected. The natures, tastes, meridian tropism, medicinal parts, chemical components, pharmacological activities, and geographical distribution of these plants were summarized and analyzed in Excel 2013 and SPSS Statistics 26.0. ResultThe 46 species of thorny medicinal plants belonged to 25 families, 1 class, 1 phylum of 1 kingdom. In terms of the location of thorns, the frequency of these medicinal plants followed the trend of leaf thorns>peel thorns>branch thorns>fruit thorns. In terms of the nature, taste, and meridian tropism, the frequency of these plants was in the orders of warm>plain>cold>cool>hot, bitter>sweet>pungent>sour>salty, and liver>lung>spleen=large intestine>heart>kidney, respectively. In terms of the medicinal parts, the frequency followed the trend of roots and rhizomes>fruits>whole plants>flowers>leaves. The thorny medicinal plants were mainly distributed in north and southwest China. The thorny medicinal plants mainly contained flavonoids, alkaloids, and saponins and had the effects of clearing heat and detoxifying, resolving stasis and eliminating carbuncle, moving Qi and relieving pain, and alleviating edema and expelling pus. Moreover, 24 of them had anti-tumor activity. ConclusionMost of the thorny medicinal plants belong to Compositae, Leguminosae, and Rosaceae, have leaf thorns, a warm nature, a bitter taste, tropism to the liver meridian, and roots as the medicinal part. These plants are mainly distributed in north China, with the effects of clearing heat and detoxifying, resolving stasis and eliminating carbuncle. In summary, the thorn location, distribution, and medicinal parts of thorny medicinal plants are correlated with the natures, tastes, and meridian tropism. The findings provide clues for the development and utilization of these plants.
7.Analysis of the current status and influencing factors of myopia among the primary and middle school students in Jiading District, Shanghai
Feng ZHAO ; Wanyue WANG ; Long ZHANG ; Lixin XU ; Yingnan JIA ; Jian LI
Shanghai Journal of Preventive Medicine 2024;36(9):894-898
ObjectiveTo explore and analyze the influencing factors of myopia among the primary and middle school students, and to provide an evidence for the prevention and control of myopia in students through the combination of scientific use in electronic products and adherence improvement to outdoor activities. MethodsStratified cluster sampling method was used to select 4 schools in Jiading District, in which all the students in grades 3‒5 of primary school and grades 7‒9 of middle school were enrolled into the study for a questionnaire survey and refraction examination. The χ2 test was used to compare the data between the myopic and non-myopic group. Logistic regression analysis was used to analyze the influencing factors of myopia. ResultsThe total myopia detection rate among the primary and middle school students in the industrial zone of Jiading District was 62.8%, with a detection rate of 46.9% for primary school students and 75.6% for middle school students, respectively. Logistic regression analysis showed that middle school (OR=3.639, 95%CI=3.045‒4.349, P<0.001), female students (OR=1.278, 95%CI=1.081‒1.510, P=0.004), the frequency of school desks and chairs was adjusted>1 semester (OR=1.227, 95%CI=1.031‒1.461, P=0.021), the length of time spent on extracurricular tutorial classes for main courses ≥1 hour in a week (OR=1.205,95%CI=1.009‒1.440, P=0.040), parents reduced the length of time that their children spent on exercise (OR=1.205, 95%CI=1.009‒1.440, P=0.040), and parental myopia (OR=2.611, 95%CI=2.157‒3.160, P<0.001) were associated with myopia among the primary and middle school students in the industrial zone of Jiading District. ConclusionThe detection rate of myopia among students in Jiading District was relatively high. More attention should be paid to the effect of school desks and chairs’ adjustment frequency, the length of time spent on extracurricular tutorial classes for main courses, electronic screen exposure time on students’ vision, so as to prevent and slow down the occurrence and development of myopia.
8.Effects of MYD88 overexpression on proliferation and apoptosis of diffuse large B cell lymphoma cells and its mechanism
Piaopiao HU ; Chengrui XUAN ; Hua DU ; Shirong LI ; Lixin WENG ; Ling HAI ; Yunga WU ; Xiaoyan XU
Chinese Journal of Clinical and Experimental Pathology 2024;40(1):44-50
Purpose To investigate the effect of MYD88 gene overexpression on the proliferation and apoptosis of human diffuse large B cell lymphoma(DLBCL)cells,and to prelimi-narily explore the mechanism of MYD88 gene action.Methods PEGFP-C2-MYD88 overexpressing MYD88 L265P gene was transfected into DLBCL cells by plasmid transfection.The exper-iment was divided into blank control group,negative control group and MYD88 L265P overexpression group.The fluores-cence expression of MYD88 L265P after overexpression was ob-served under inverted fluorescence microscope.RT-PCR and Western blot were used to detect the mRNA and protein expres-sion of MYD88 L265P,IRAK4,NF-κB and BCL2 in DLBCL cells before and after overexpression of MYD88 L265.CCK8 method was used to detect DLBCL cells proliferation and Ho-echst staining was used to detect DLBCL cells apoptosis.Re-sults After overexpression of MYD88 L265P,compared with the blank control group(0.670 4±0.017 5)and the negative control group(0.715 3±0.019 6),the MYD88L265P overex-pression group(1.157 2±0.010 2)increased significantly,with statistical significance(all P<0.05).After overexpression of MYD88 L265P,compared with the blank control group(0.69 ±0.04)and the negative control group(0.81±0.07),the MYD88L265P overexpression group(0.48±0.05)was signifi-cantly decreased,with statistical significance(all P<0.05).After overexpression of MYD88 L265P,compared with the blank control group(mRNA:1.0158±0.0115,0.987 3±0.010 2,1.007 6±0.015 3,protein:0.183 4±0.058 9,0.096 8± 0.015 7,0.147 5±0.0418)and negative control group(mR-NA:0.9132±0.0098,1.0032±0.0156,0.9327± 0.011 2,protein:0.187 9±0.042 3,0.088 9±0.0513,0.134 8±0.050 1),the mRNA(3.243 2±0.013 6,2.976 6 ±0.0213,1.585 9±0.019 8)and protein expressions(0.452 7±0.052 4,0.218 9±0.047 5,0.301 4±0.059 8)of IRAK4,NF-κB and anti-apoptosis protein BCL2 in MYD88L265P overexpression group were significantly increased,which was statistically significant(all P<0.05).Conclusion After overexpression of MYD88 L265P,the apoptosis rate of DLBCL cells decreased and the cell proliferation rate increased.The mechanism may be related to the mutation of MYD88 L265P gene,activation and amplification of NF-κB pathway,and pro-motion of the overexpression of antiapoptotic protein BCL2.
9.Expert consensus on the bi-directional screening for Mycobacterium tuberculosis and human immunodeficiency virus
Xin SHEN ; Yinzhong SHEN ; Eryong LIU ; Dingyong SUN ; Dongmin LI ; Yun HE ; Jinge HE ; Lin XU ; Bin CHEN ; Chengliang CHAI ; Lianguo RUAN ; Yong GAO ; Aihua DENG ; Zhen NING ; Jing CHEN ; Xiaofeng LIU ; Kaikan GU ; Lixin RAO
Shanghai Journal of Preventive Medicine 2024;36(4):327-336
Tuberculosis (TB) and human immunodeficiency virus infection / acquired immune deficiency syndrome (HIV/AIDS) are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years, with the promotion and application of new TB and HIV detection technologies worldwide, TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening, summarizes important progress of research and applications, and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.
10.Molecular markers of postoperative recurrence and malignant transformation in low-grade gliomas and their predictive value
Xuzhao LI ; Shiqi ZHOU ; Haibin LENG ; Dakuan GAO ; Lixin XU
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(2):284-291
【Objective】 To identify the risk factors for recurrence and malignant transformation (MT) in patients with low-grade glioma (LGG) after surgery. 【Methods】 The data of 163 patients who underwent LGG resection and subsequent follow-up from March 2009 to April 2019 were retrospectively collected. Patients who did not experience recurrence or MT after surgery were included in the control group (85 cases), those who experienced recurrence after surgery were included in the observation 1 group (44 cases), and those who experienced MT after surgery were included in the observation 2 group (34 cases). Based on the clinical data of the three groups of patients, their clinical characteristics were analyzed, and the risk factors and predictive value for recurrence and MT were explored using Logistic regression model and receiver operating characteristic (ROC) curve. 【Results】 There were significant differences between the control group and the observation 1 group in preoperative seizure, preoperative Karnofsky performance status (KPS) score, and surgical approach (P<0.05). There were significant differences between the control group and the observation 2 group in gender, preoperative KPS score, tumor size, and surgical approach (P<0.05). There were significant differences between the control group and the observation 1 group in isocitrate dehydrogenase (IDH) mutation, proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-9 (MMP-9), cancer-testis antigen OY-TES-1, OY-TES-1 mRNA protein, tumor suppressor protein p53, mouse double minute 2 (MDM2), vascular endothelial growth factor (VEGF), or epidermal growth factor receptor (EGFR) (P<0.05). There were significant differences between the control group and the observation 2 group in PCNA, MMP-9, cancer-testis antigen OY-TES-1, OY-TES-1 mRNA protein, or VEGF (P<0.05). Logistic regression analysis showed that IDH mutation, MMP-9, and PCNA were independent risk factors for LGG recurrence (P<0.05), while VEGF, MMP-9, and PCNA were independent risk factors for LGG MT (P<0.05). The area under curve (AUC) of PCNA, MMP-9 and IDH mutation for predicting LGG MT after surgery was 0.744, 0.790, and 0.799, respectively. The AUC of PCNA, MMP-9, and VEGF for predicting LGG recurrence after surgery was 0.729, 0.750, and 0.900, respectively. 【Conclusion】 This study found that IDH mutation, MMP-9 and PCNA were independent risk factors for LGG recurrence, while VEGF, MMP-9 and PCNA were independent risk factors for LGG MT by retrospectively analyzing the clinical data and protein expression of 163 patients with LGG after surgery. These proteins have high accuracy in predicting LGG recurrence and MT after surgery. Therefore, the proteins may play an important role in the biological behavior and treatment effect of LGG, and can be used as reference indicators for prognosis evaluation and individualized treatment of LGG patients after surgery.

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