1.Progress on body composition assessment techniques and clinical applications in infants
Ting ZHANG ; Mai GAO ; Li ZHANG ; Huijuan LIU ; Yan LI
International Journal of Pediatrics 2025;52(4):248-253
Infancy is a critical period for children's growth and development. During this period,the reasonable increase of fat mass percentage and fat mass index is very important for children's healthy growth. However,excessive increases in fat mass percentage and fat mass index may increase the risk of metabolic related diseases. In China,the research field of body composition in infants is still in the development stage,and the relevant research results and literature are relatively few. This article summarizes the domestic and foreign research on infant body composition,including application techniques,influencing factors and application significance,so as to provide reference for the formulation of domestic infant body composition reference standards and related clinical and scientific research work.
2.Knowledge-embedded spatio-temporal analysis for euploidy embryos identification in couples with chromosomal rearrangements
Fangying CHEN ; Xiang XIE ; Du CAI ; Pengxiang YAN ; Chenhui DING ; Yangxing WEN ; Yanwen XU ; Feng GAO ; Canquan ZHOU ; Guanbin LI ; Qingyun MAI
Chinese Medical Journal 2024;137(6):694-703
Background::The goal of the assisted reproductive treatment is to transfer one euploid blastocyst and to help infertile women giving birth one healthy neonate. Some algorithms have been used to assess the ploidy status of embryos derived from couples with normal chromosome, who subjected to preimplantation genetic testing for aneuploidy (PGT-A) treatment. However, it is currently unknown whether artificial intelligence model can be used to assess the euploidy status of blastocyst derived from populations with chromosomal rearrangement.Methods::From February 2020 to May 2021, we collected the whole raw time-lapse videos at multiple focal planes from in vitro cultured embryos, the clinical information of couples, and the comprehensive chromosome screening results of those blastocysts that had received PGT treatment. Initially, we developed a novel deep learning model called the Attentive Multi-Focus Selection Network (AMSNet) to analyze time-lapse videos in real time and predict blastocyst formation. Building upon AMSNet, we integrated additional clinically predictive variables and created a second deep learning model, the Attentive Multi-Focus Video and Clinical Information Fusion Network (AMCFNet), to assess the euploidy status of embryos. The efficacy of the AMCFNet was further tested in embryos with parental chromosomal rearrangements. The receiver operating characteristic curve (ROC) was used to evaluate the superiority of the model. Results::A total of 4112 embryos with complete time-lapse videos were enrolled for the blastocyst formation prediction task, and 1422 qualified blastocysts received PGT-A ( n = 589) or PGT for chromosomal structural rearrangement (PGT-SR, n = 833) were enrolled for the euploidy assessment task in this study. The AMSNet model using seven focal raw time-lapse videos has the best real-time accuracy. The real-time accuracy for AMSNet to predict blastocyst formation reached above 70% on the day 2 of embryo culture, and then increased to 80% on the day 4 of embryo culture. Combing with 4 clinical features of couples, the AUC of AMCFNet with 7 focal points increased to 0.729 in blastocysts derived from couples with chromosomal rearrangement. Conclusion::Integrating seven focal raw time-lapse images of embryos and parental clinical information, AMCFNet model have the capability of assessing euploidy status in blastocysts derived from couples with chromosomal rearrangement.
3.Secondary metabolites of mulberry leaves exert anti-lung cancer activity through regulating the PD-L1/PD-1 signaling pathway
Ye GUIQIN ; Sun XIN ; Li JIUZHOU ; Mai YUANYUAN ; Gao RUILAN ; Zhang JIANBIN
Journal of Pharmaceutical Analysis 2024;14(6):914-925
Lung cancer ranks the top of malignancies that cause cancer-related deaths worldwide.The leaves of Morus alba L are traditional Chinese medicine widely applied in respiratory diseases.Our previous work has demonstrated the anti-lung cancer effect of secondary metabolites of mulberry leaf,but their mechanism of action has still not fully elucidated.We synthesized Moracin N(MAN)-Probe conjugated with alkyne to label lung cancer cells and identified protein targets by chemical proteomic analysis.MAN and its probe exerted similar growth-inhibitory effect on human lung cancer cells.Chemical proteomic results showed that MAN targeted the programmed death ligand 1(PD-L1)checkpoint pathway and T cell receptor(TCR)signaling pathway,indicating its immune-regulatory function.Cell-free surface plasmon resonance(SPR)results showed the direct interaction of MAN with PD-L1 protein.Molecular docking analysis demonstrated that MAN bound to E158 residue of PD-L1 protein.MAN downregulated the expression levels of PD-L1 in a time-and dose-dependent manner and disrupted the PD-L1/programmed death 1(PD-1)binding,including other secondary metabolites of mulberry leaves Guangsangon E(GSE)and Chalcomoracin(CMR).Human peripheral blood mononuclear cells(PBMCs)co-cultured with MAN-treated A549 cells,resulting in the increase of CD8+GZMB+T cells and the decrease of CD8+PD-1+T cells.It suggested that MAN exerts anti-cancer effect through blocking the PD-L1/PD-1 signaling.In vivo,MAN combined with anti-PD-1 antibody significantly inhibited lung cancer development and metastasis,indicating their synergistic effect.Taken together,secondary metabolites of mulberry leaves target the PD-L1/PD-1 signaling,enhance T cell-mediated immunity and inhibit the tumorigenesis of lung cancer.Their modulatory effect on tumor microenvironment makes them able to enhance the therapeutic efficacy of immune checkpoint inhibitors in lung cancer.
4.Clinical characteristics and antiviral therapy of influenza in immunosuppressed hospitalized patients
Yafen LIU ; Yue WANG ; Yanxin WANG ; Huan MAI ; Yuanyuan CHEN ; Yifan ZHANG ; Baiyi LIU ; Yisi LIU ; Ying JI ; Xu CONG ; Yan GAO
Chinese Journal of Clinical Infectious Diseases 2023;16(2):120-127
Objective:To analyse the clinical characteristics and antiviral therapy in immunosuppressed hospitalized patients with influenza.Methods:The clinical data of 273 patients with positive influenza A or B virus nucleic acid admitted in Peking University People’s Hospital from November 2015 to March 2022 were retrospectively analyzed. Among them, 123 were immunosuppressed and 150 were non-immunosuppressed. The clinical characteristics and antiviral therapy in immunosuppressed patients with influenza were analyzed. SPSS 22.0 software was used to analyze the data.Results:Chemotherapy for malignancies was the most common cause of immunosuppression (61.8%, 76/123), followed by haemopoietic stem cell transplantation (24.4%, 30/123). The common symptoms were fever (93.5%, 115/123) and cough (41.5%, 51/123). The proportions of co-infections (22.8%, 28/123) and complications (43.9%, 54/123) in immunosuppressed hospitalized patients were higher than those in non-immunosuppressed patients ( χ2=9.365 and 7.496, both P<0.01). Compared with single drug therapy, combination of antiviral drugs did not shorten the fever time, negative conversion time of virus nucleic acid and the length of hospital stay, and reduce the death ( U/ χ2=312.5, 356.0, 749.5 and 0.185, all P>0.05). Compared to patients without corticosteroids use, the use of corticosteroids did not increase mortality in immunosuppressed patients ( χ2=2.508, P=0.113). Conclusions:Classical symptoms may be absent in immunosuppressed patients with influenza, and early detection of influenza virus is still an important means of early diagnosis. Co-infections and complications are more common in immunosuppressed influenza patients. Immunosuppressed influenza patients did not benefit from the combination of antiviral therapy.
5.Study on African herbal medicine registration management measures and TCM registration strategy in Africa
Jianhua MAI ; Huanxin CHEN ; Zhanwang GAO ; Xin ZHANG ; Lingli WANG
International Journal of Traditional Chinese Medicine 2023;45(5):531-536
African herbal medicine is widely utilized with a long history. Most African countries have legalized herbal medicine and established a registration and listing mechanism. The present study firstly described the historical exchange and modern trade of TCM between China and Africa, and briefly described the herbal medicine registration management system of African countries from the regulations and guidelines of herbal medicine management and registration management institutions. Then it compared and analyzed the differences of registration systems in African countries from the following aspects: application materials, registration path, quality control and production, effectiveness evidence and food supplements, as well as summarizing the common points of African herbal medicine registration management. The registration strategy of TCM includes assessing the risk of registered investment, building a multilateral and diversified cooperation network between China and Africa, adhering to integrity and innovation, and promoting the international development of TCM, so as to form a standardized registration path of TCM in Africa and expand the TCM market in Africa.
6.Construction and reflection of mixed evaluation system of physiology
Wenli MAI ; Ce XU ; Ying GAO ; Yuanyuan ZHOU ; Xinghai LIU ; Tuanxiao ZHANG ; Huae JING ; Jiewei LUO
Chinese Journal of Medical Education Research 2023;22(2):208-211
The mixed evaluation system uses the network platform as a carrier to construct a dynamic evaluation model that spans time and space between online and offline, between individuals and teams. Mixed evaluation system of physiology was performed for two years, and the process evaluation and the summative evaluation in the mixed evaluation system showed a good correlation, and the students' learning ability and learning effect showed consistency with the evaluation results. Practice has proved that the mixed evaluation system not only optimizes the traditional evaluation system, but also fully expands the five principles of formative evaluation; however, while reflecting the advantages of the network platform, it also exposes the defects of insufficient supervision of the network platform. Thus, we should further improve the mixed evaluation system of physiology.
7.Automated Classification of Inherited Retinal Diseases in Optical Coherence Tomography Images Using Few-shot Learning.
Qi ZHAO ; Si Wei MAI ; Qian LI ; Guan Chong HUANG ; Ming Chen GAO ; Wen Li YANG ; Ge WANG ; Ya MA ; Lei LI ; Xiao Yan PENG
Biomedical and Environmental Sciences 2023;36(5):431-440
OBJECTIVE:
To develop a few-shot learning (FSL) approach for classifying optical coherence tomography (OCT) images in patients with inherited retinal disorders (IRDs).
METHODS:
In this study, an FSL model based on a student-teacher learning framework was designed to classify images. 2,317 images from 189 participants were included. Of these, 1,126 images revealed IRDs, 533 were normal samples, and 658 were control samples.
RESULTS:
The FSL model achieved a total accuracy of 0.974-0.983, total sensitivity of 0.934-0.957, total specificity of 0.984-0.990, and total F1 score of 0.935-0.957, which were superior to the total accuracy of the baseline model of 0.943-0.954, total sensitivity of 0.866-0.886, total specificity of 0.962-0.971, and total F1 score of 0.859-0.885. The performance of most subclassifications also exhibited advantages. Moreover, the FSL model had a higher area under curves (AUC) of the receiver operating characteristic (ROC) curves in most subclassifications.
CONCLUSION
This study demonstrates the effective use of the FSL model for the classification of OCT images from patients with IRDs, normal, and control participants with a smaller volume of data. The general principle and similar network architectures can also be applied to other retinal diseases with a low prevalence.
Humans
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Tomography, Optical Coherence
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Deep Learning
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Retinal Diseases/diagnostic imaging*
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Retina/diagnostic imaging*
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ROC Curve
8.Analysis of quality difference of different specifications and different origins of Citri Grandis Exocarpium
Zelin GAO ; Xiaoying ZHANG ; Baoyu MAI ; Xiating LIN ; Jiaqi FANG ; Jiarui ZHONG ; Ruoting ZHAN ; Fengxia XIAO
China Pharmacy 2022;33(7):825-829
OBJECTIVE To study the quality difference of different specifications of Citri Grandis Exocarpium from different origins,and to provide reference for the orderly development of Citri Grandis Exocarpium industry. METHODS Different specifications [ Citrus grandis ‘Tomentos’young fruit ,Citrus grandis (L.)Osbeck young fruits ,exocarp] of 93 batches of Citri Grandis Exocarpium medicinal materials (decoction pieces )from different origins [ Citrus grandis ‘Tomentosa’or Citrus grandis (L.)Osbeck] were taken as samples. The contents of naringin and rhoifolin in samples were determined by HPLC. Through pheatmap parameters of R language ,heatmap was drawn for the contents of naringin and rhoifolin according to origins and specifications (young fruit and exocarp ). RESULTS Of 93 batches of samples ,the contents of naringin and rhoifolin were 16.52-214.64 and 1.03-10.96 mg/g,respectively. Among different specifications ,the contents of naringin and rhoifolin in the young fruit were the highest (their average contents were 108.96 and 6.30 mg/g respectively ). Heatmap analysis of R language content showed that the contents of naringin and rhoifolin in Citri Grandis Exocarpium from origin of C. grandis ‘Tomentosa’were generally higher than those from origin of C. grandis (L.)Osbeck. Of different specifications of Citri Grandis Exocarpium from origins,the contents of naringin and rhoifolin were higher in KTP young fruit relatively. CONCLUSIONS The quality of Citri Grandis Exocarpium from origin of C. grandis ‘Tomentosa’with the young fruit as specification is the best.
9.Exploration on the cultivation of holistic thinking in endodontic practice teaching
Qi ZHANG ; Hao CHEN ; Ruoxun WANG ; Yipin QI ; Xi WEI ; Yan GAO ; Sui MAI
Chinese Journal of Medical Education Research 2022;21(12):1700-1704
Objective:To investigate the effect of holistic thinking training mode on establishing clinical holistic thinking in endodontic practice teaching for students.Methods:Holistic thinking training mode was applied among Batch 2013 (group A, n=174) and Batch 2014 (group B, n=92) students of Guanghua School of Stomatology, Sun Yat-sen University. The teaching results were evaluated by the scores before and after the training and questionnaire, and by comparing their scores with those of Batch 2012 (group C, n=88) students. SPSS 20.0 was used to conduct one-way ANOVA and t test. Results:Compared the scores of students in group A with group B, the total scores before and after the training and the scores of "case report" were not statistically different, but the scores of holistic thinking were significantly improved after the training. Compared with the scores of students in group C, the total scores after the training and the "case report" scores of group A and B were significantly higher. The results of the questionnaire showed that 87.9%(153/174) of the students thought the training mode was conducive to the establishment of holistic thinking, but 77.6%(135/174) thought further improvement was needed in terms of content and time allocation.Conclusion:Holistic thinking training mode has a positive effect on the endodontic practice teaching, and is worth promoting in other departments after further improvement.
10.Prognostic value of pretreatment systemic immune-inflammation index and lactate dydrogenasein nasopharyngeal carcinoma
Fengge ZHOU ; Liting LIU ; Xiaodong HUANG ; Shiran SUN ; Xuesong CHEN ; Qiuyan CHEN ; Linquan TANG ; Haiqiang MAI ; Kai WANG ; Yuan QU ; Runye WU ; Ye ZHANG ; Qingfeng LIU ; Jianghu ZHANG ; Jingwei LUO ; Jianping XIAO ; Li GAO ; Guozhen XU ; Jingbo WANG ; Junlin YI
Chinese Journal of Oncology 2022;44(8):842-850
Objective:To evaluate the prognostic value of pretreatment systemic immune-inflammation index (SII) and lactate dehydrogenase (LDH) in non-metastatic nasopharyngeal carcinoma (NPC).Methods:We retrospectively collected the data of 839 patients with non-metastatic NPC from National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Sun Yat-sen University Cancer Center between January 2007 and October 2015. All patients received intensity modulated radiation based treatment. Optimal cutoff value of SII and LDH were determined by X-title software. The association between SII, LDH and clinical prognosis of non-metastatic NPC patients were analyzed. Kaplan-Meier method was used for survival analysis, and Log rank test was used for comparison of survival rates between groups. Propensity score matching (PSM) analysis was carried out to minimize the effects of confounding factors. The risk stratification model of prognosis by combining N stage, SII and LDH was constructed to compare the prognosis of patients in high risk group, middle risk group and low risk group, and the receiver operating characteristic (ROC) curve analysis was used to evaluate its prognostic value.Results:The optimal cutoff value of SII is 447.2×10 9/L for predicting the 5-year overall survival (OS) of NPC patients, and the best cutoff value of LDH is 198.9 U/L. The proportion of patients with stage T3-4 and stage III-IVB in high SII group was higher than that in low SII group ( P<0.001). Multivariate Cox regression analysis showed that N stage, SII and LDH were independent factors of OS, progression-free survival (PFS) and distant metastasis-free survival (DMFS) of NPC patients (N stage, HR=1.705, 95% CI: 1.247-2.332; HR=1.755, 95% CI: 1.342-2.295; HR=2.161, 95% CI: 1.515-3.082. SII, HR=1.525, 95% CI: 1.097-2.119; HR=1.518, 95% CI: 1.150-2.004; HR=1.837, 95% CI: 1.272-2.653. LDH, HR=2.041, 95% CI: 1.403-2.968; HR=1.725, 95% CI: 1.233-2.414; HR=2.492, 95% CI: 1.690-3.672, respectively). After PSM, SII was still an independent prognostic factor of OS, PFS and DMFS in NPC patients ( HR=1.52, 95% CI: 1.09-2.12; HR=1.52, 95% CI: 1.15-2.00; HR=1.82, 95% CI: 1.26-2.63, respectively). Combined with N 2-3 stage, SII (>447.2×10 9/L), and LDH (>198.9 U/L), patients were divided into high-(3 risk factors), intermediate- (2 risk factors) and low-risk (0-1 risk factors) groups. The 5-year OS rates of patients in low-, intermediate- and high-risk groups were 86.1%, 79.8% and 41.2% respectively, the 5-year PFS rates were 80.7%, 70.2% and 33.9% respectively, and the 5-year DMFS rates were 88.9%, 79.2% and 47.5% respectively. There were significant differences in OS, PFS and DMFS among these three groups ( P<0.001). Distant metastasis was the main failure pattern in low-, intermediate- and high-risk groups, and the highest rate of distant metastasis was 83.3% (15/31) in high-risk group. ROC curve of the risk stratification model for predicting 5-year OS of NPC patients is 0.610, which is higher than TNM stage (0.609), SII (0.574) and LDH (0.558). Conclusions:Pretreatment SII and LDH are significantly correlated with the prognosis of patients with non-metastatic NPC. The combination of SII, LDH and N stage can stratify the prognostic risk of NPC patients. The risk stratification model can enhance the accuracy of prognosis.

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