1.Effect of Zishen Tongguan Formula on "Gut-prostate" Axis of Rats with Chronic Non-bacterial Prostatitis Based on 16S rDNA Sequencing
Xiran LI ; Mengjiao CHEN ; Kaiping ZOU ; Chenguang ZHAO ; Xingbin DAI ; Xiaoqing ZHANG ; Shun LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):63-71
ObjectiveBased on the theory of "gut-prostate" axis, this study explored the effects and mechanisms of Zishen Tongguan formula and Cinnamomi Cortex in the formula in treating rats with chronic non-bacterial prostatitis(CNP) by detecting the levels of inflammatory factors, and the composition and structure of intestinal flora in CNP rats. MethodsEight out of 42 SD rats were randomly selected as the normal group, and the remaining rats were injected with carrageenan to prepare the CNP model. After successful modeling, 32 rats were randomly divided into the model group, Ningmitai capsule group(0.50 g·kg-1), Zishen Tongguan formula group(2.00 g·kg-1), and the Phellodendri Chinensis Cortex-Anemarrhenae Rhizoma pair group(PCC-AR group, 2.00 g·kg-1), with 8 rats in each group. The administered groups were given the corresponding medicinal solution by gavage, and the normal and model groups were intragastrically administered with an equal volume of normal saline, once a day for 14 consecutive days. The prostate tissues of rats were collected and subjected to hematoxylin-eosin(HE) staining and Masson staining to observe the pathological changes of the tissues in each group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of related inflammatory factors in rat serum, and 16S rDNA sequencing was used to analyze the abundance and diversity changes of gut microbiota before and after administration, and species difference analysis was performed. ResultsAll the administered groups could alleviate the inflammatory symptoms of CNP rats, increase the expression levels of anti-inflammatory factors and decrease the expression levels of pro-inflammatory factors, with the most sIgnificant effect observed in the Zishen Tongguan formula group. Compared with the normal group, the expression levels of interleukin(IL)-8, hypersensitive C-reactive protein(hs-CRP), immunoglobulin(Ig)M, secretory IgA (sIgA), and inducible nitric oxide synthase(iNOS) were sIgnificantly increased in the model group(P<0.01). Compared with the model group, the expression levels of the above inflammatory factors in all administered groups were significantly reduced(P<0.01). When compared with the PCC-AR group, the Zishen Tongguan formula group showed a significant decrease in transforming growth factor(TGF)-β1 expression level(P<0.05) and a significant increase in IgM expression level(P<0.01). The results of gut microbiota analysis showed that, compared with the PCC-AR group, at the order level, the Zishen Tongguan formula group significantly reduced the relative abundance of conditional pathogens such as Bacteroidales, Acidaminococcales, Rhodospirillales, Clostridiales, and Elusimicrobiales(P<0.01). And at the genus level, the Zishen Tongguan formula group significantly decreased the relative abundance of pathogenic microbiota such as Lachnospira and Bacteroides(P<0.01) and significantly increased the relative abundances of beneficial microbiota such as Ruminococcus and Lactobacillus(P<0.01). ConclusionZishen Tongguan formula can reduce the level of harmful intestinal bacteria, increase the level of beneficial intestinal bacteria, down-regulate the expression of serum inflammatory factors, and the small amount of Cinnamomi Cortex in the formula may play a key role in the treatment of CNP with this formula.
2.Effect of Zishen Tongguan Formula on "Gut-prostate" Axis of Rats with Chronic Non-bacterial Prostatitis Based on 16S rDNA Sequencing
Xiran LI ; Mengjiao CHEN ; Kaiping ZOU ; Chenguang ZHAO ; Xingbin DAI ; Xiaoqing ZHANG ; Shun LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):63-71
ObjectiveBased on the theory of "gut-prostate" axis, this study explored the effects and mechanisms of Zishen Tongguan formula and Cinnamomi Cortex in the formula in treating rats with chronic non-bacterial prostatitis(CNP) by detecting the levels of inflammatory factors, and the composition and structure of intestinal flora in CNP rats. MethodsEight out of 42 SD rats were randomly selected as the normal group, and the remaining rats were injected with carrageenan to prepare the CNP model. After successful modeling, 32 rats were randomly divided into the model group, Ningmitai capsule group(0.50 g·kg-1), Zishen Tongguan formula group(2.00 g·kg-1), and the Phellodendri Chinensis Cortex-Anemarrhenae Rhizoma pair group(PCC-AR group, 2.00 g·kg-1), with 8 rats in each group. The administered groups were given the corresponding medicinal solution by gavage, and the normal and model groups were intragastrically administered with an equal volume of normal saline, once a day for 14 consecutive days. The prostate tissues of rats were collected and subjected to hematoxylin-eosin(HE) staining and Masson staining to observe the pathological changes of the tissues in each group. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of related inflammatory factors in rat serum, and 16S rDNA sequencing was used to analyze the abundance and diversity changes of gut microbiota before and after administration, and species difference analysis was performed. ResultsAll the administered groups could alleviate the inflammatory symptoms of CNP rats, increase the expression levels of anti-inflammatory factors and decrease the expression levels of pro-inflammatory factors, with the most sIgnificant effect observed in the Zishen Tongguan formula group. Compared with the normal group, the expression levels of interleukin(IL)-8, hypersensitive C-reactive protein(hs-CRP), immunoglobulin(Ig)M, secretory IgA (sIgA), and inducible nitric oxide synthase(iNOS) were sIgnificantly increased in the model group(P<0.01). Compared with the model group, the expression levels of the above inflammatory factors in all administered groups were significantly reduced(P<0.01). When compared with the PCC-AR group, the Zishen Tongguan formula group showed a significant decrease in transforming growth factor(TGF)-β1 expression level(P<0.05) and a significant increase in IgM expression level(P<0.01). The results of gut microbiota analysis showed that, compared with the PCC-AR group, at the order level, the Zishen Tongguan formula group significantly reduced the relative abundance of conditional pathogens such as Bacteroidales, Acidaminococcales, Rhodospirillales, Clostridiales, and Elusimicrobiales(P<0.01). And at the genus level, the Zishen Tongguan formula group significantly decreased the relative abundance of pathogenic microbiota such as Lachnospira and Bacteroides(P<0.01) and significantly increased the relative abundances of beneficial microbiota such as Ruminococcus and Lactobacillus(P<0.01). ConclusionZishen Tongguan formula can reduce the level of harmful intestinal bacteria, increase the level of beneficial intestinal bacteria, down-regulate the expression of serum inflammatory factors, and the small amount of Cinnamomi Cortex in the formula may play a key role in the treatment of CNP with this formula.
3.Predictive value of lactate/albumin ratio,interleukin-6 and CD4+T lymphocyte count in the short-term prognosis of severe pneumonia and sepsis
Zhiyu MIAO ; Lei ZHANG ; Xiaoyan LI ; Ruixia ZHANG ; Mengjiao ZHAO ; Yanqiu GAO
Journal of Xinxiang Medical College 2024;41(3):232-239
Objective To investigate the predictive value of lactate/albumin ratio(LAR),interleukin-6(IL-6)and CD4+T lymphocyte count in 28-day mortality in patients with severe pneumonia and sepsis.Methods A total of 73 patients with severe pneumonia and sepsis admitted to the Respiratory Intensive Care Unit(RICU)of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2022 to June 2023 were enrolled and divided into the survival group(n=43)and the death group(n=30)according to their 28-day outcomes.The clinical data of the patients were collected from their electronic medical records,including age,gender,comorbidities with hypertension,diabetes,and coronary artery heart disease(CHD),as well as sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,mean arterial pressure(MAP),confusion,uremia,respiratory rate,blood pressure,age ≥65 years(CURB-65)score,total bilirubin(Tbil),serum creatinine(Scr),platelet count(PLT),white blood cell(WBC)count,procalcitonin(PCT),and C-reactive protein(CRP)at admission to RICU.On the 1st,3rd,and 7th day after admission to RICU,the patients'arterial blood was drawn,and the lactate level was detected by a fully automated blood gas analyzer.The peripheral venous blood was drawn,and the serum albumin and IL-6 levels were detected by enzyme-linked immunosorbent assay,and the CD4+T lymphocyte subset count was measured by flow cytometry.The LAR of patients on the 1st,3rd and 7th day was calculated.The clinical data of the patients and the LAR,IL-6 level and CD4+T lymphocyte count on the 1st,3rd,and 7th day were compared between the two groups.The influencing factors of 28-day mortality in patients with severe pneumonia and sepsis were analyzed by logistic regression,and the predictive value of each influencing factor on the 28-day mortality in patients with severe pneumonia and sepsis was evaluated by the receiver operating characteristic(ROC)curve.Results There was no significant difference in gender,age,proportions of comorbidities with hypertension,diabetes and CHD,length of stay in RICU,and Tbil,MAP,PLT,Scr,WBC,PCT and CRP at admission to RICU(P>0.05).The APACHE Ⅱ and CURB-65 scores of the patients in the death group were significantly higher than those in the survival group(P<0.05).On the 1st,3rd and 7th day,the CD4+T lymphocyte count in the death group was significantly lower than that in the survival group,while the SOFA score was significantly higher than that in the survival group(P<0.05).On the first day,there was no significant difference in the LAR and IL-6 level be-tween the death group and the survival group(P>0.05).However,on the 3rd and 7th day,the LAR and IL-6 level in the death group were significantly higher than those in the survival group(P<0.05).The LAR,IL-6 level and SOFA score on the 3rd and 7th day in the survival group were significantly lower than those on the 1st day,and these indicators on the 7th day were sig-nificantly lower than those on the 3rd day(P<0.05);the CD4+T lymphocyte count on the 3rd and 7th day was significantly higher than that on the 1st day(P<0.05),while it showed no significant difference on the 7th and 3r day(P>0.05).The IL-6 level on the 7th day in the death group was significantly lower than that on the 1st and 3rd day(P<0.05),while there was no significant difference in IL-6 level on the 1st day compared with the 3r day(P>0.05);moreover,there was no significant difference in LAR,CD4+T lymphocyte count and SOFA score between each time point(P>0.05).Pearson correlation analy-sis showed that on the 3rd day,the LAR and IL-6 level were significantly positively correlated with the SOFA score in patients with severe pneumonia and sepsis(r=0.385,0.394;P<0.05).On the 7th day,the LAR and IL-6 level were also significantly positively correlated with the SOFA score(r=0.418,0.402;P<0.05).On the 3 rd and 7 th day,CD4+T lymphocyte count was significantly negatively correlated with the SOFA score(r=-0.451,-0.454;P<0.05).Logistic regression analysis showed that the APACHE Ⅱ score,LAR,IL-6 level and CD4+T lymphocyte count on the 3rd day,and the IL-6 level and CD4+T lym-phocyte count on the 7th day were the influencing factors for 28-day mortality in patients with severe pneumonia and sepsis(P<0.05).The ROC curve showed that the APACHE Ⅱ score,LAR,IL-6 level and CD4+T lymphocyte count on the 3rd day and the combination of the three,IL-6 level and CD4+T lymphocyte count on the 7th day and the combination of the two had certain predictive value for the 28-day mortality in patients with severe pneumonia and sepsis(P<0.05).The area under the ROC curve(AUC)of LAR,IL-6 level and CD4+T lymphocyte count on the 3rd day combined to predict 28-day mortality in patients with severe pneumonia and sepsis was 0.891,and the AUC of APACHE Ⅱ score for predicting 28-day mortality in pa-tients with severe pneumonia and sepsis was 0.769.The AUC values of LAR,IL-6 level and CD4+T lymphocyte count on the 3rd day for predicting 28-day mortality in patients with severe pneumonia and sepsis were 0.795,0.757 and 0.770,respective-ly,and the AUC values of IL-6 level and CD4+T lymphocyte count on the 7th day and their combination for predicting 28-day mortality in patients with severe pneumonia and sepsis were 0.743,0.802 and 0.888,respectively.Conclusion The 3-day LAR,IL-6 level and CD4+T lymphocyte count,and the 7-day IL-6 level and CD4+T lymphocyte count after admission are re-lated to the 28-day mortality in patients with severe pneumonia and sepsis.The combined LAR,IL-6 level and CD4+T lympho-cyte count on the 3rd day can better assess the severity and prognosis of patients.
4.Rapid Analysis of Components in Longshengzhi Capsules Based on UPLC-Q/TOF-MS Technology
Mengyi ZHAO ; Chenghao BI ; Mengjiao LI ; Zhengwei DONG ; Jiawei FAN ; Jinyue ZHANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(8):2144-2153
Objective To establish a rapid detection and identification method for the chemical components of Longshengzhi capsules based on UPLC-Q-TOF/MS.Method UPLC-Q/TOF-MS technology was used to analyze and identify the chemical components of Longshengzhi capsules.The chromatographic column was a Waters Acquity UPLC BEH C18 column(100mm×2.1mm,1.7 μm),and the mobile phase A was 0.1%formic acid water.The mobile phase B was a methanol acetonitrile(1∶1)solution containing 0.1%formic acid(B).The flow rate is 0.3mL/min,the column temperature is 40℃,and the injection volume is 2 μL.The ion source adopts the electric spray ion source.The data is collected in the positive and negative ion modes,and the collection range is m/z 50~1200.The identification and matching are carried out through UNIFI software combined with manual verification of chemical components.Result 87 chemical components were preliminarily and rapidly identified.Conclusion The established method can systematically and rapidly analyze the chemical components in Longsheng leeches,providing a basis for the study of medicinal substances and having important significance for the quality control of Longsheng leeches.
5.Pueraria Lobata Flowers Extract inhibits THP-1-derived foam cell formation by acti-vating PPARγ to upregulate the expression of ABCA1
Rongrong ZHU ; Mengjiao CHEN ; Zhenwang ZHAO ; Jiayi LIU ; Jianfeng WU ; Yufei WANG ; Min ZHANG
Chinese Journal of Arteriosclerosis 2024;32(5):395-401
Aim To explore the effect of Pueraria Lobata Flowers Extract(PFE)on lipid accumulation in mac-rophage-derived foam cells.Methods The concentration of PFE in THP-1-derived foam cells was screened by MTT,intracellular lipid accumulation was detected by oil red O staining and cholesterol detection kit,intracellular cholesterol ef-flux levels were detected by cholesterol efflux assay kit,RT-qPCR and Western blot were used to analyze mRNA and pro-tein expression.Results PFE significantly reduced lipid accumulation in THP-1-derived foam cells.PFE did not affect the mRNA expression of CD36,scavenger receptor-A Ⅰ(SR-A Ⅰ),sterol regulatory element-binding protein 2(SREBP2),3-hydroxy-3-methylglutaryl-CoA reductase(HMGCR),but it could upregulate the mRNA and protein expres-sion levels of ATP-binding cassette transporter A1(ABCA1)(P<0.05),and promote the intracellular cholesterol efflux of macrophage-derived foam cells(P<0.01).PFE could activate the activity of peroxisome proliferator-activated receptor y(PPARγ)(P<0.01)and upregulate the mRNA and protein expression levels of PPARγ(P<0.05).Compared with the PFE control group,the expression of PPARγ and ABCA1 proteins decreased and cholesterol efflux decreased after GW9662 treatment(all P<0.01).Conclusion PFE could significantly prevent the lipid accumulation in THP-1-derived foam cells and inhibit the formation of foam cells by upregulating ABCA1 expression and cholesterol efflux mediated by PPARγ.
6.Exploring of Transformation Rule of Saponins in Polygalae Radix Before and After Processing Based on Simulated Processing Technology
Mengjiao HE ; Ziming ZHUANG ; Yue XING ; Haoran LI ; Xuelan ZHANG ; Xin ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(24):169-176
ObjectiveTo investigate the transformation mechanism and content variation of saponins from Polygalae Radix before and after being boiled with licorice juice and water. MethodSimulated licorice juice boiled products and simulated water boiled products of onjisaponin B, onjisaponin Z, onjisaponin F, polygalasaponin ⅩⅩⅧ were prepared by simulated processing technology, and analyzed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry(UPLC-Q-Exactive Orbitrap/MS). Then the contents of onjisaponin B, onjisaponin Z, onjisaponin F, polygalasaponin ⅩⅩⅧ and tenuifolin in Polygalae Radix, licorice-boiled Polygalae Radix and water-boiled Polygalae Radix were determined by UPLC-triple quadrupole tandem mass spectrometry(UPLC-QQQ-MS/MS). ResultDuring the boiling process with licorice juice and water, onjisaponin B could be hydrolyzed to produce 4-methoxycinnamic acid, desacylsenegin Ⅲ, polygalasaponin ⅩⅩⅧ and tenuifolin, onjisaponin Z could be hydrolyzed to produce 3,4,5-trimethoxycinnamic acid, onjisaponin TF, polygalasaponin ⅩⅩⅧ and tenuifolin, onjisaponin F could be hydrolyzed to produce 3,4,5-trimethoxycinnamic acid, onjisaponin G, polygalasaponin ⅩⅩⅧ and tenuifolin, and polygalasaponin ⅩⅩⅧ was hydrolyzed to produce tenuifolin. After being boiled with licorice juice or water, the content of onjisaponin B decreased significantly(P<0.05, P<0.01), but the contents of onjisaponin Z, onjisaponin F, polygalasaponin ⅩⅩⅧ and tenuifolin increased significantly(P<0.05, P<0.01) in Polygalae Radix. Compared with the water-boiled products, the contents of onjisaponin Z and tenuifolin increased significantly(P<0.05, P<0.01), and the change of tenuifolin content was the most significant in the licorice-boiled products.However, there was no significant difference in the content of onjisaponin B, onjisaponin F and polygalasaponin ⅩⅩⅧ between the water-boiled products and the licorice-boiled products. ConclusionBeing boiled with licorice juice or water can hydrolyze onjisaponin B, onjisaponin Z, onjisaponin F and polygalasaponin ⅩⅩⅧ, and generate secondary glycosides and aglycones(organic acids) through deglycosylation, which leads to obvious changes in the contents of onjisaponins after Polygalae Radix being processed.It is inferred that licorice juice can promote the hydrolysis of some onjisaponins in Polygalae Radix to onjisaponin Z and tenuifolin.This study provides an experimental basis for revealing processing mechanism of Polygalae Radix.
7.Predictive value of lactate clearance rate combined with syndecan-1 in patients with septic shock and ARDS
Ruitao XU ; Shuangfeng LI ; Shuya HUANG ; Mengjiao ZHAO ; Yanqiu GAO
Chinese Journal of Emergency Medicine 2023;32(5):660-666
Objective:To observe the changes of lactate clearance rate (LCR) and serum polyligandosan-1 (SDC-1) in patients with septic shock complicated with acute respiratory distress syndrome (ARDS) and to evaluate its prognostic value.Methods:Patients with septic shock and ARDS who were admitted to the Respiratory Intensive Care Unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from February 2021 to April 2022 were selected as subjects. The patients were divided into the survival group and death group according to their 28-day survival status. General clinical data and related indicators of patients in the two groups were collected and compared. The related factors influencing the 28-day death of patients with septic shock and ARDS were screened, and receiver operating characteristic (ROC) curve was drawn to evaluate the individual and combined forecast value of LCR and SDC-1 for the prognosis of patients with septic shock and ARDS.Results:Compared with the survival group, sequential organ failure score (SOFA) and acute physiology and chronic health status score Ⅱ(APACHE Ⅱ) at admission to RICU, the levels of 24 h Lac, 6 h SDC-1, 24 h SDC-1 and 72 h SDC-1 in the death group increased significantly (all P< 0.05), and the levels of 6 h LCR, 24 h LCR, 6 h OI, 24 h OI and 72 h OI significantly decreased (all P<0.05). Spearman correlation analysis showed that SDC-1 at 6 h, 24 h and 72 h was significantly negatively correlated with OI at corresponding time points (all P<0.05), and LCR at 6 h and 24 h was significantly positively correlated with OI at corresponding time points (all P<0.05). Multivariate Logistic regression analysis showed that SOFA score, 24 h LCR, 24 h SDC-1 and 72 h SDC-1 were the risk factors of 28-d death in patients with septic shock and ARDS (all P<0.05). The areas under ROC curve of each related factor were SOFA score, 24 h LCR, 24 h SDC-1 and 72 h SDC-1, which could predict the prognosis (all P<0.05). 24 h LCR combined with 24 h SDC-1 had the maximum area under the curve (AUC=0.805, 95% CI: 0.691-0.920, with a sensitivity of 75.0% and a specificity of 74.4%). Conclusions:24 h LCR, 24 h SDC-1 and 72 h SDC-1 are the risk factors of the 28-day death of patients with septic shock and ARDS. 24 h LCR combined with 24 h SDC-1 can improve the test efficiency compared with the single indicator.
8.An optimal medicinal and edible Chinese herbal formula attenuates particulate matter-induced lung injury through its anti-oxidative, anti-inflammatory and anti-apoptosis activities.
Huan ZHANG ; Jun KANG ; Wuyan GUO ; Fujie WANG ; Mengjiao GUO ; Shanshan FENG ; Wuai ZHOU ; Jinnan LI ; Ayesha T TAHIR ; Shaoshan WANG ; Xinjun DU ; Hui ZHAO ; Weihua WANG ; Hong ZHU ; Bo ZHANG
Chinese Herbal Medicines 2023;15(3):407-420
OBJECTIVE:
Identifying novel strategies to prevent particulate matter (PM)-induced lung injury is crucial for the reduction of the morbidity of chronic respiratory diseases. The combined intervention represented by herbal formulae for simultaneously targeting multiple pathological processes can provide a more beneficial effect than the single intervention. The aim of this paper is therefore to design a safe and effective medicinal and edible Chinese herbs (MECHs) formula against PM-induced lung injury.
METHODS:
PM-induced oxidative stress, inflammatory response and apoptosis A549 cell model were used to screen anti-oxidant, anti-inflammatory and anti-apoptotic MECHs, respectively. A network pharmacology method was utilized to rationally design a novel herbal formula. Ultra performance liquid chromatography-mass spectrometer was utilized to assess the quality control of MECHs formula. The excretion of magnetic iron oxide nanospheres of the MECHs formula was estimated in zebrafish. The MECH formula against PM-induced lung injury was investigated with mice experiments.
RESULTS:
Five selected herbs were rationally designed to form a new MECH formula, including Citri Exocarpium Rubrum (Juhong), Lablab Semen Album (Baibiandou), Atractylodis Macrocephalae Rhizoma (Baizhu), Mori Folium (Sangye) and Polygonati Odorati Rhizoma (Yuzhu). The formula effectively promoted the magnetic iron oxide nanospheres excretion in zebrafish. The mid/high dose formula significantly prevented PM-induced lung damage in mice by enhancing the activity of SOD and GSH-Px, reducing the MDA and ROS level and attenuating the upregulation of pro-inflammatory cytokine (IL-6, IL-8, IL-1β and TNF-α), down regulating the protein expression of NF-κB, STAT3 and Caspase-3.
CONCLUSION
Our findings suggest that the effective MECHs formula will become a novel strategy for preventing PM-induced lung injury and provide a paradigm for the development of functional foods using MECHs.
9.Application of transbronchial needle aspiration in diagnosis of tuberculosis in children
Chao WANG ; Zhongxiao ZHANG ; Shuaishuai LIU ; Mengjiao ZHAO ; Juan QIU ; Chen MEN ; Xia LIU
Chinese Journal of Applied Clinical Pediatrics 2022;37(12):920-923
Objective:To investigate the application of transbronchial needle aspiration (TBNA) in the diagnosis of tuberculosis with mediastinal lymphadenopathy in children.Methods:A retrospective study was conducted on clinical data in 8 children of tuberculosis with mediastinal lymphadenopathy treated in the Center for Respiratory Intervention, Children′s Hospital Affiliated to Shandong University from March 2014 to July 2019.TBNA was performed after the mediastinal lymphadenopathy were diagnosed by chest enhanced CT and the final diagnosis was made.The diagnostic experience of TBNA was summarized.Results:Eight children with mediastinal lymphadenopathy included in this present study aged from 7 months to 8 years and 6 months (infants accounted for 75.0%), with a median age of 22.5 months.There were 3 males (37.5%) and 5 females (62.5%). The body mass was 8.5-39.0 kg, and the median body mass was 10.7 kg.The course of disease was 15-90 days, and the median number of days was 18.5 days.The clinical manifestations included cough in 8 cases, fever in 4 cases, wheezing in 1 case and laryngeal ringing in 1 case.Bronchoscopy and TBNA biopsy were performed.Cytology, etiology and pathology were examined after TBNA.A definite diagnosis could be made in 6 children, with a diagnosis rate of 75.0%.Among them, 4 cases were found with acid-fast bacilli in smear but pathological examination was negative; 1 case was pathologically conformed to the characteristics of tuberculosis infection but the smear was negative; the smear and pathology of 1 case were both suggestive of tuberculosis; 2 cases did not present etiological and histological evidence with TBNA.The diagnosis was made according to the positive acid-fast bacilli of alveolar lavage fluid smear.There were no complications during and after operation.Conclusions:TBNA is an important method to diagnose tuberculosis in children, which is effective, safe and has high clinical application value.
10.Establishment and validation of a nomogram model for predicting EGFR mutations in lung adenocarcinoma
Hongyue ZHAO ; Yexin SU ; Mengjiao WANG ; Peng FU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2022;42(10):577-582
Objective:To construct and validate a nomogram model based on clinical factors and PET/CT metabolic parameters of 18F-FDG for predicting epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma. Methods:From January 2014 to January 2019, 114 patients (59 males, 55 females, age (60.0±10.8) years) with lung adenocarcinoma in the First Affiliated Hospital of Harbin Medical University were retrospectively enrolled. Clinical data (smoking status, tumor location, clinical stage and carcinoembryonic antigen (CEA) level), 18F-FDG PET/CT metabolic parameters (SUV max, metabolic tumor volume (MTV) and total lesion glycolysis (TLG)) and EGFR mutation status were analyzed. Patients were divided into training group (80 cases) and validation group (34 cases). In the training group, univariate analyses (independent-sample t test, Wilcoxon rank sum test, χ2 test or Fisher′s exact probability method) were used for categorical variables. Variables that showed significant differences between EGFR mutation group and wild type group were selected. Variance inflation factors (VIF) were calculated and the collinearity variables were deleted, and a nomogram model of optimal logistic model was constructed based on Akaike information criterion (AIC). The effect of the model was evaluated by the concordance index (C-index), sensitivity, specificity, accuracy, calibration and decision curve analysis (DCA) in the training group and the validation group. Results:Among 114 patients, 56 were with EGFR mutations and 58 were with EGFR wild type. In the training group, there were significant differences in gender (male/female: 14/26 vs 25/15; χ2=6.05, P=0.014), smoking status (with/without smoking history: 4/36 vs 22/18; χ2=18.46, P<0.001) and SUV max (5.72(3.90, 8.32) vs 8.09(4.56, 12.55); W=1 045.50, P=0.018) between EGFR mutation group and wild type group. However, there were no significant differences in other factors ( t=-0.54, χ2 values: 0.20 and 0.20, W values: 921.50 and 983.00, all P>0.05). The VIF of gender, smoking status and SUV max were all less than 10, and the nomogram model with three factors showed the minimum AIC (90.06). In the training group, C-index value of the model was 0.798 (95% CI: 0.699-0.897), with the sensitivity of 85.0%(34/40), the specificity of 70.0%(28/40) and the accuracy of 77.5%(62/80). In the validation group, C-index value was 0.854(95% CI: 0.725-0.984), with the sensitivity of 13/16, the specificity of 14/18, and the accuracy of 79.4%(27/34). The calibration curve and the goodness of fit test showed good calibration, and DCA showed that the model could benefit patients clinically within a large risk threshold range (training group: 0-0.59, validation group: 0-0.65). Conclusion:The nomogram model based on gender, smoking status and SUV max can be used to easily predict EGFR mutation status in lung adenocarcinoma.

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