1.Interpretation of "Guidelines for prevention of respiratory syncytial virus infections in mothers and infants (2025 Edition)"
Pengxiang ZHOU ; Wei ZHOU ; Huixia YANG ; Meihua PIAO ; Yangyu ZHAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1029-1034
The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.
2.Short-term safety evaluation of Nirsevimab injection: a prospective study
Pengxiang ZHOU ; Linghui LI ; Wei ZHOU ; Meihua PIAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1057-1061
Objective:To evaluate the short-term safety of Nirsevimab injection for preventing respiratory syncytial virus infections in infants through a physician-nurse-pharmacist collaborative model.Methods:This prospective observational study enrolled infants receiving single-dose Nirsevimab at Peking University Third Hospital from September 2024 to August 2025. A multidisciplinary team comprising pediatricians, nurses, pharmacists, and obstetricians was established to develop standardized protocols for medication management, injection procedures, follow-up processes, and safety assessment forms. Descriptive statistics analyzed on-site observations within 30 minutes post-injection and all adverse events, with causality assessment conducted.Results:Among 331 participants [171 males (51.7%), 160 females (48.3%)], 225 (68.0%) received outpatient injections and 106 (32.0%) inpatient injections. Successful administration was achieved in 330 cases (99.7%), including 207 (62.7%) receiving 50 mg/vial and 123 (37.3%) receiving 100 mg/vial formulations; one child (3 years 11 months, 19.0 kg) received two 100 mg doses. During the 30-minute observation, 11 cases (3.3%) experienced adverse events, all presenting as injection site erythema following 100 mg/vial administration, with no systemic or serious adverse events observed. All symptoms resolved spontaneously within 30 minutes. Multidisciplinary review suggested potential associations with insufficient rewarming time, larger injection volumes, or post-injection compression pressure.Conclusion:Nirsevimab demonstrated favorable short-term safety profiles in Chinese infants following single-dose administration, with feasible multidisciplinary standardized protocols, though larger sample sizes and extended follow-up are warranted for monitoring medium-to-long-term safety and special populations.
3.Prognostic factors for endovascular treatment of acute anterior circulation vessel occlusion with large-core infarction
Dinglai LIN ; Han ZHENG ; Tingyu YI ; Zhinan PAN ; Xiufen ZHENG ; Shuyi LIU ; Meihua WU ; Yanmin WU
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(2):221-226
Objective To investigate the potential beneficial predictors for endovascular treatment(EVT)in case of acute anterior circulation large vessel occlusion with large-core infarction.Methods We made a retrospective inclusion of 92 patients with anterior circulation large vessel occlusion and core infarct volume ranging from 50 to 100 mL,who underwent EVT at Zhangzhou Municipal Hospital of Fujian Province from March 2018 to February 2021.All the patients were confirmed as anterior circulation large infarction and large infarct volume using computed tomography(CT),computed tomography angiography(CTA),and computed tomography perfusion(CTP)before EVT.All clinical and imaging data were collected to observe the postoperative recurrence rate,incidence of symptomatic intracranial hemorrhage(sICH),and functional prognosis 90 days.Then the patients were divided into favorable outcomes group(mRS≤3)and unfavorable outcomes group(mRS>3)based on Rankin scores 90 days post-stroke.Univariate and multivariate Logistic analysis were conducted to analyze factors influencing the patients'prognosis.By combining the results of multivariate analysis,we constructed receiver operating characteristic(ROC)curves and identified the cut-off value to evaluate the predictive value of age for post-vascular treatment prognosis.Results Among the included patients,the postoperative revascularization rate(mTIICI≥2b)was 95%(88 cases),the rate of favorable outcomes at 90 days postoperatively(mRS≤3)was 32.61%(30 cases),the incidence of sICH was 13%,and the mortality rate was 31.5%.Compared with the unfavorable outcomes group,the favorable outcomes group had a younger age and a higher proportion of males.Multivariate analysis indicated that older age was an independent risk factor for adverse outcomes following endovascular treatment(OR=4.97,95%CI:1.78-13.90,P=0.002).The ROC curve indicated that the area under the curve was maximized at the age of 72.5 years(AUC=0.763,95%CI:0.661-0.864,P<0.001).Its sensitivity and specificity was 0.565 and 0.833,respectively.Conclusion Age is an independent predictor of the prognosis of acute procirculatory large core stroke.Patients with large core infarction older than 72.5 years may not benefit from endovascular therapy,which needs to be confirmed by a multicenter large sample prospective randomized controlled trial.
4.Predicting value of intestinal fatty acid-binding protein in esophageal varices in patients with hepatitis B cirrhosis
Caijun HAN ; Zhengxie WU ; Yuan HUANG ; Xing JIN ; Meihua PIAO
Chinese Journal of Laboratory Medicine 2025;48(11):1446-1451
Objective:To explore the clinical predicting value of serum intestinal fatty acid-binding protein (I-FABP) in the development of esophageal varices (EV) in patients with chronic hepatitis B cirrhosis.Method:We used case-control study. A retrospective analysis was performed on the clinical data of 169 patients with hepatitis B cirrhosis who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023. EV diagnosis and grades were based on gastroscopy. Enzyme-linked immunosorbent assay was used to measure the serum level of I-FABP on admission. Spearman correlation analysis was used to investigate the correlation among variables. Contributing factors of EV were evaluated using univariate and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of I-FABP for EV presence.Results:The gastroscopy showed 59 patients without EV. The median of I-FABP in the EV Group was significantly higher than that in the no-EV Group [2.01 (1.39, 2.89) μg/L vs 0.96 (0.77, 1.91) μg/L], and the difference was statistically significant ( Z=5.585, P<0.001). I-FABP showed significant positive correlations between model for end-stage liver disease sore and Von Willebrand Factor Antigen/thrombocyte Ratio ( r=0.523, 0.328, both P<0.001). Multiple logistic regression analysis identified I-FABP as the independent factor contributing to the presence of EV ( OR=1.73, P=0.045). The area under the curve of I-FABP predicting EV was 0.76. The cut-off was 1.46 μg/L. Conclusion:I-FABP is a potential marker for the formation of EV in patients with hepatitis B cirrhosis, and its increased concentration is related to reduced hepatic reserve and portal hypertension.
5.Intratumoral injection of two dosage forms of paclitaxel nanoparticles combined with photothermal therapy for breast cancer.
Lina SUN ; Cuiling ZUO ; Baonan MA ; Xinxin LIU ; Yifei GUO ; Xiangtao WANG ; Meihua HAN
Chinese Herbal Medicines 2025;17(1):156-165
OBJECTIVE:
In order to enhance the efficacy of anti-breast cancer, paclitaxel nanoparticles (PTX NPs) and polypyrrole nanoparticles (PPy NPs) were combined with photothermal therapy and chemotherapy. At the same time, the two dosage forms of PTX NPs and PTX NPs gel were compared.
METHODS:
PTX NPs were prepared by self-assembly method, and then the cytotoxicity in vitro was investigated by Methyl thiazolyl tetrazolium (MTT) and other methods, and the efficacy and side effects in vivo were further investigated.
RESULTS:
The average hydrated diameter, PDI and electric potential of PTX NPs were (210.20 ± 1.57) nm, (0.081 ± 0.003) mV and (15.80 ± 0.35) mV, respectively. MTT results showed that the IC50 value of PTX NPs on 4 T1 cells was 0.490 μg/mL, while that of PTX injection was 1.737 μg/mL. The cell inhibitory effect of PTX NPs was about 3.5 times higher than that of PTX injection. The tumor inhibition rates of PTX NPs and gel were 48.64% and 56.79%, respectively. Together with local photothermal stimulation, the tumor inhibition rate of the PTX NPs reached 91.05%, surpassing that of the gel under the same conditions (48.98%), moreover, the organ index and H&E staining results of PTX NPs showed a decrease in toxicity.
CONCLUSION
This combination therapy can significantly enhance the effect of anti-breast cancer, and the synergistic effect of chemotherapy and light and heat provides a feasible and effective strategy for the treatment of tumor.
6.Predictive value of machine learning models based on CT imaging features for papillary thyroid carcinoma
Hanlin ZHU ; Bo FENG ; Haifeng ZHANG ; Meihua ZHANG ; Min TIAN ; Tong ZHANG ; Peiying WEI ; Zhijiang HAN
Chinese Journal of Endocrine Surgery 2025;19(1):68-73
Objective:To establish three machine learning prediction models based on CT imaging characteristics of papillary thyroid carcinoma (PTC) , and use SHAP (shapley additive explanations) analysis to investigate the contribution of each CT image features in the best model.Methods:CT imaging features in 426 cases of 440 PTCs confirmed pathologically from Jan. 2016 to Jan. 2021 at the affiliated Hangzhou First People’s Hospital of Westlake University Medical School were retrospectively analyzed. compared with 467 cases of 528 nodular goiter (NG) , evaluating the distribution of four CT characteristics: cookie bite sign, enhanced range of narrowing/blur (ERNB) , microcalcifications, and irregular shape. We split the data into 8∶2 ratio for training and testing sets, then constructed three machine learning models using XGBoost, RF, and SVM. Based on AUC, accuracy, F1 score, and other metrics, we selected the best model. Lastly, we used SHAP values to assess each CT feature’s contribution and positive/negative effects on the model.Results:Among 440 PTC and 528 NG nodules, CT features like cookie bite sign, ERNB, microcalcifications, and irregular shape occurred in 326 and 30 ( χ 2=483.05, P<0.001) , 363 and 106 ( χ 2=374.45, P<0.001) , 158 and 53 ( χ 2=94.24, P<0.001) , and 354 and 52 ( χ 2=491.34, P<0.001) nodules, respectively. The machine learning models built using XGBoost, RF, and SVM had AUC, accuracy, and F1 scores ranging from 0.884~0.925, 0.867~0.873, and 0.844~0.854 respectively on the training set. On the test set, the scores ranged from 0.869~0.923, 0.845~0.871, and 0.803~0.845. Among them, the XGBoost model demonstrated the highest diagnostic performance on the test set. Among the four CT features, irregular shape had the highest absolute SHAP value, positively contributing to PTC diagnosis. Conclusion:XGBoost model showed the highest PTC diagnostic performance. Irregular shape had the greatest positive impact on PTC diagnosis.
7.Predictive value of machine learning models based on CT imaging features for papillary thyroid carcinoma
Hanlin ZHU ; Bo FENG ; Haifeng ZHANG ; Meihua ZHANG ; Min TIAN ; Tong ZHANG ; Peiying WEI ; Zhijiang HAN
Chinese Journal of Endocrine Surgery 2025;19(1):68-73
Objective:To establish three machine learning prediction models based on CT imaging characteristics of papillary thyroid carcinoma (PTC) , and use SHAP (shapley additive explanations) analysis to investigate the contribution of each CT image features in the best model.Methods:CT imaging features in 426 cases of 440 PTCs confirmed pathologically from Jan. 2016 to Jan. 2021 at the affiliated Hangzhou First People’s Hospital of Westlake University Medical School were retrospectively analyzed. compared with 467 cases of 528 nodular goiter (NG) , evaluating the distribution of four CT characteristics: cookie bite sign, enhanced range of narrowing/blur (ERNB) , microcalcifications, and irregular shape. We split the data into 8∶2 ratio for training and testing sets, then constructed three machine learning models using XGBoost, RF, and SVM. Based on AUC, accuracy, F1 score, and other metrics, we selected the best model. Lastly, we used SHAP values to assess each CT feature’s contribution and positive/negative effects on the model.Results:Among 440 PTC and 528 NG nodules, CT features like cookie bite sign, ERNB, microcalcifications, and irregular shape occurred in 326 and 30 ( χ 2=483.05, P<0.001) , 363 and 106 ( χ 2=374.45, P<0.001) , 158 and 53 ( χ 2=94.24, P<0.001) , and 354 and 52 ( χ 2=491.34, P<0.001) nodules, respectively. The machine learning models built using XGBoost, RF, and SVM had AUC, accuracy, and F1 scores ranging from 0.884~0.925, 0.867~0.873, and 0.844~0.854 respectively on the training set. On the test set, the scores ranged from 0.869~0.923, 0.845~0.871, and 0.803~0.845. Among them, the XGBoost model demonstrated the highest diagnostic performance on the test set. Among the four CT features, irregular shape had the highest absolute SHAP value, positively contributing to PTC diagnosis. Conclusion:XGBoost model showed the highest PTC diagnostic performance. Irregular shape had the greatest positive impact on PTC diagnosis.
8.Prognostic factors for endovascular treatment of acute anterior circulation vessel occlusion with large-core infarction
Dinglai LIN ; Han ZHENG ; Tingyu YI ; Zhinan PAN ; Xiufen ZHENG ; Shuyi LIU ; Meihua WU ; Yanmin WU
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(2):221-226
Objective To investigate the potential beneficial predictors for endovascular treatment(EVT)in case of acute anterior circulation large vessel occlusion with large-core infarction.Methods We made a retrospective inclusion of 92 patients with anterior circulation large vessel occlusion and core infarct volume ranging from 50 to 100 mL,who underwent EVT at Zhangzhou Municipal Hospital of Fujian Province from March 2018 to February 2021.All the patients were confirmed as anterior circulation large infarction and large infarct volume using computed tomography(CT),computed tomography angiography(CTA),and computed tomography perfusion(CTP)before EVT.All clinical and imaging data were collected to observe the postoperative recurrence rate,incidence of symptomatic intracranial hemorrhage(sICH),and functional prognosis 90 days.Then the patients were divided into favorable outcomes group(mRS≤3)and unfavorable outcomes group(mRS>3)based on Rankin scores 90 days post-stroke.Univariate and multivariate Logistic analysis were conducted to analyze factors influencing the patients'prognosis.By combining the results of multivariate analysis,we constructed receiver operating characteristic(ROC)curves and identified the cut-off value to evaluate the predictive value of age for post-vascular treatment prognosis.Results Among the included patients,the postoperative revascularization rate(mTIICI≥2b)was 95%(88 cases),the rate of favorable outcomes at 90 days postoperatively(mRS≤3)was 32.61%(30 cases),the incidence of sICH was 13%,and the mortality rate was 31.5%.Compared with the unfavorable outcomes group,the favorable outcomes group had a younger age and a higher proportion of males.Multivariate analysis indicated that older age was an independent risk factor for adverse outcomes following endovascular treatment(OR=4.97,95%CI:1.78-13.90,P=0.002).The ROC curve indicated that the area under the curve was maximized at the age of 72.5 years(AUC=0.763,95%CI:0.661-0.864,P<0.001).Its sensitivity and specificity was 0.565 and 0.833,respectively.Conclusion Age is an independent predictor of the prognosis of acute procirculatory large core stroke.Patients with large core infarction older than 72.5 years may not benefit from endovascular therapy,which needs to be confirmed by a multicenter large sample prospective randomized controlled trial.
9.Predicting value of intestinal fatty acid-binding protein in esophageal varices in patients with hepatitis B cirrhosis
Caijun HAN ; Zhengxie WU ; Yuan HUANG ; Xing JIN ; Meihua PIAO
Chinese Journal of Laboratory Medicine 2025;48(11):1446-1451
Objective:To explore the clinical predicting value of serum intestinal fatty acid-binding protein (I-FABP) in the development of esophageal varices (EV) in patients with chronic hepatitis B cirrhosis.Method:We used case-control study. A retrospective analysis was performed on the clinical data of 169 patients with hepatitis B cirrhosis who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023. EV diagnosis and grades were based on gastroscopy. Enzyme-linked immunosorbent assay was used to measure the serum level of I-FABP on admission. Spearman correlation analysis was used to investigate the correlation among variables. Contributing factors of EV were evaluated using univariate and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of I-FABP for EV presence.Results:The gastroscopy showed 59 patients without EV. The median of I-FABP in the EV Group was significantly higher than that in the no-EV Group [2.01 (1.39, 2.89) μg/L vs 0.96 (0.77, 1.91) μg/L], and the difference was statistically significant ( Z=5.585, P<0.001). I-FABP showed significant positive correlations between model for end-stage liver disease sore and Von Willebrand Factor Antigen/thrombocyte Ratio ( r=0.523, 0.328, both P<0.001). Multiple logistic regression analysis identified I-FABP as the independent factor contributing to the presence of EV ( OR=1.73, P=0.045). The area under the curve of I-FABP predicting EV was 0.76. The cut-off was 1.46 μg/L. Conclusion:I-FABP is a potential marker for the formation of EV in patients with hepatitis B cirrhosis, and its increased concentration is related to reduced hepatic reserve and portal hypertension.
10.Interpretation of "Guidelines for prevention of respiratory syncytial virus infections in mothers and infants (2025 Edition)"
Pengxiang ZHOU ; Wei ZHOU ; Huixia YANG ; Meihua PIAO ; Yangyu ZHAO ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2025;28(12):1029-1034
The "Guidelines for prevention of respiratory syncytial virus (RSV) infection in mothers and infants (2025 Edition)" were developed by the Society of Perinatal Medicine, Chinese Medical Association. This guideline focuses on preventing RSV infections in maternal and neonatal populations, providing 15 evidence-based recommendations addressing eight clinical questions that integrate current best evidence with clinical expertise and patient preferences. The recommendations encompass non-pharmacological prevention, pharmacological prophylaxis, and vaccine strategies. This article provides a comprehensive interpretation of the guidelines, summarizes the current evidence status and practical limitations, and aims to facilitate better understanding and application of the recommendations among healthcare providers, thereby enhancing RSV infection prevention and control for maternal and neonatal populations in China.

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