1.Construction and validation of prediction models for delayed encephalopathy after acute carbon monoxide poisoning based on machine learning
Yanwu YU ; Yan ZHANG ; Ding YUAN ; Huihui HAO ; Fang YANG ; Hongyi YAN ; Pin JIANG ; Mengnan GUO ; Zhigao XU ; Changhua SUN ; Gaiqin YAN ; Lu CHE ; Jianjun GUO ; Jihong CHEN ; Yan LI ; Yanxia GAO
Chinese Journal of Emergency Medicine 2025;34(10):1403-1409
Objective:s To investigate the risk factors for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) in patients with acute carbon monoxide poisoning (ACOP) and to develop predictive models based on machine learning algorithms.Methods:Patients with ACOP hospitalized at the First Affiliated Hospital of Zhengzhou University from August 2019 to October 2024 were included, with the occurrence of DEACMP as the outcome measure. The dataset was randomly divided into training and validation sets at a ratio of 7:3. Lasso regression was used to select features influencing the outcome in training sets. Nine machine learning models—including Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Support Vector Machine (SVM)—were constructed. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) calculated for each model. Calibration curves were used to assess accuracy, and decision curve analysis (DCA) was applied to evaluate clinical utility. The SHapley Additive exPlanations (SHAP) method was employed to visualize and interpret the best-performing model.Results:A total of 264 ACOP patients were included, of whom 54 (20.5%) developed DEACMP. Lasso regression identified eight key feature variables. Based on these factors, predictive models were constructed, showing good AUC stability across the nine machine learning models in both training (0.92–0.99) and validation sets (0.85–0.91). The RF model performed best, with an AUC of 0.99 in the training set and 0.90 in the validation set; its calibration curve and DCA curve also demonstrated excellent performance. SHAP analysis of the RF model revealed the importance ranking of factors from highest to lowest as follows: Glasgow Coma Scale (GCS) score, duration of coma, age, history of coronary heart disease, CK-MB level, monocyte count, diastolic blood pressure (DBP), and drinking history.Conclusions:The RF model exhibited the highest predictive performance for DEACMP occurrence in ACOP patients. The influencing factors, ranked in order of importance from highest to lowest, are as follows: GCS score, duration of coma, age, history of coronary heart disease, CK-MB level, monocyte count, DBP, and drinking history.
2.Analysis of the efficacy and safety of balloon-assisted enteroscopy for the diagnosis and treatment of Dieulafoy lesions of the small intestine (with video)
Donglin ZHAO ; Mengnan XU ; Zhimeng JIANG ; Jing ZHANG ; Yan YU ; Nianjun XIAO ; Bairong LI ; Chongxi FAN ; Shoubin NING ; Tao SUN
Chinese Journal of Digestive Endoscopy 2025;42(11):881-886
Objective:To evaluate the incidence, clinical features, factors affecting initial diagnosis, efficacy, and safety of therapy and prognosis of small intestinal Dieulafoy lesions (DL).Methods:Clinical data including clinical background, diagnosis, and treatment details of patients who were admitted to the Department of Gastroenterology, Air Force Medical Center, for suspected small bowel bleeding, diagnosed as having small bowel DL and treated with balloon-assisted enteroscopy (BAE) were retrospectively analyzed from November 2017 to March 2024.Results:Among 800 patients, 30 cases (3.75%, 30/800, 17 males and 13 females) were diagnosed as having small intestine DL with the mean age of 60.90 years. Clinical symptoms included melena (56.67%, 17/30), hematochezia (43.33%, 13/30), and hemodynamic instability (30.00%, 9/30). Active bleeding occurred in 23 (76.67%) patients. Comorbidities existed in 70.00% (21/30) and 33.33% (10/30) used long-term antithrombotic agents. Diagnosis was confirmed after a single BAE in 63.33% (19/30) and after multiple BAEs (mean 1.6 procedures) in 36.67% (11/30). Lesions were predominantly located at jejunal. All patients achieved successful treatment with a single BAE procedure. The median follow-up period was 12.25 months (range: 5.25-23.00 months). Five cases (16.67%) experienced recurrent bleeding, with one case transfered to surgical intervention. Two cases (6.67%) reported post-operative symptoms of dizziness and fatigue, which resolved after symptomatic management. Multivariate analysis showed that long-term oral anticoagulant therapy ( OR=0.06, 95% CI: 0.01-0.73) was an independent predictor of single-session diagnosis. Conclusion:Small intestinal DL is rare and challenging to diagnose. Antithrombotic therapy may facilitate the diagnosis of DL at the first BAE. Jejunal localization is common, and combined endoscopic therapy (including clipping) is effective and safe.
3.The world's first PD-1/VEGF bispecific antibody:ivonescimab
Caihong SUN ; Taotao HU ; Xingxing XIAO ; Mengnan YUAN ; Simin JIANG ; Yinqi CHEN ; Guodong RUAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(9):1290-1296
Ivonescimab is a humanized bispecific antibody targeting human vascular endothelial growth factor-A(VEGF-A)and programmed death protein-1(PD-1).It was approved by National Medi-cal Products Administration on May 24th,2024,and can be used in combination with pemetrexed and carboplatin for locally advanced or positive EG-FR gene mutation after treatment with epidermal growth factor receptor(EGFR)tyrosine kinase inhib-itor.This paper mainly introduces the research progress of the world's first PD-1/VEGF bispecific antibody ivonescimab,and summarizes the mecha-nism of action,pharmacokinetics,phase Ⅰ-Ⅲ clinical trials and drug safety.
4.The world's first PD-1/VEGF bispecific antibody:ivonescimab
Caihong SUN ; Taotao HU ; Xingxing XIAO ; Mengnan YUAN ; Simin JIANG ; Yinqi CHEN ; Guodong RUAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(9):1290-1296
Ivonescimab is a humanized bispecific antibody targeting human vascular endothelial growth factor-A(VEGF-A)and programmed death protein-1(PD-1).It was approved by National Medi-cal Products Administration on May 24th,2024,and can be used in combination with pemetrexed and carboplatin for locally advanced or positive EG-FR gene mutation after treatment with epidermal growth factor receptor(EGFR)tyrosine kinase inhib-itor.This paper mainly introduces the research progress of the world's first PD-1/VEGF bispecific antibody ivonescimab,and summarizes the mecha-nism of action,pharmacokinetics,phase Ⅰ-Ⅲ clinical trials and drug safety.
5.Analysis of the efficacy and safety of balloon-assisted enteroscopy for the diagnosis and treatment of Dieulafoy lesions of the small intestine (with video)
Donglin ZHAO ; Mengnan XU ; Zhimeng JIANG ; Jing ZHANG ; Yan YU ; Nianjun XIAO ; Bairong LI ; Chongxi FAN ; Shoubin NING ; Tao SUN
Chinese Journal of Digestive Endoscopy 2025;42(11):881-886
Objective:To evaluate the incidence, clinical features, factors affecting initial diagnosis, efficacy, and safety of therapy and prognosis of small intestinal Dieulafoy lesions (DL).Methods:Clinical data including clinical background, diagnosis, and treatment details of patients who were admitted to the Department of Gastroenterology, Air Force Medical Center, for suspected small bowel bleeding, diagnosed as having small bowel DL and treated with balloon-assisted enteroscopy (BAE) were retrospectively analyzed from November 2017 to March 2024.Results:Among 800 patients, 30 cases (3.75%, 30/800, 17 males and 13 females) were diagnosed as having small intestine DL with the mean age of 60.90 years. Clinical symptoms included melena (56.67%, 17/30), hematochezia (43.33%, 13/30), and hemodynamic instability (30.00%, 9/30). Active bleeding occurred in 23 (76.67%) patients. Comorbidities existed in 70.00% (21/30) and 33.33% (10/30) used long-term antithrombotic agents. Diagnosis was confirmed after a single BAE in 63.33% (19/30) and after multiple BAEs (mean 1.6 procedures) in 36.67% (11/30). Lesions were predominantly located at jejunal. All patients achieved successful treatment with a single BAE procedure. The median follow-up period was 12.25 months (range: 5.25-23.00 months). Five cases (16.67%) experienced recurrent bleeding, with one case transfered to surgical intervention. Two cases (6.67%) reported post-operative symptoms of dizziness and fatigue, which resolved after symptomatic management. Multivariate analysis showed that long-term oral anticoagulant therapy ( OR=0.06, 95% CI: 0.01-0.73) was an independent predictor of single-session diagnosis. Conclusion:Small intestinal DL is rare and challenging to diagnose. Antithrombotic therapy may facilitate the diagnosis of DL at the first BAE. Jejunal localization is common, and combined endoscopic therapy (including clipping) is effective and safe.
6.Construction and application of standard system for the preservation of pathogenic microorganism resources
Mengnan JIANG ; Xin LI ; Yuanyuan ZHAO ; Nailing SUN ; Kaiqi LIU ; Suwen LEI ; Qiang WEI
Chinese Journal of Epidemiology 2024;45(10):1441-1447
Standards are the technical support for economic activities and social development. The construction and standardization of the pathogenic microorganism preservation standard system is an important technical foundation for the high-quality development of preservation work. Establishing a pathogenic microorganism resource standard system is also important to the national biosafety standards. Through the standardization of pathogenic microbial resource preservation, we can ensure the effective management and sustainable utilization of pathogenic microbial resources, promote the transformation of resources, and serve as an important new element of new productivity to assist the innovative development of biosafety science and technology. This article elaborates and analyzes the establishment background, construction framework, standardization process, and application effects of the standard system for preserving pathogenic microbial resources, providing stronger support for further improving the standard system and promoting the standardization of pathogenic microbial resource preservation.
7.Association between preschoolers physical activity levels and parental sports concept and behavior
Chinese Journal of School Health 2024;45(7):1036-1039
Objective:
To analyze the impact of parental sports concept and behavior on physical activity in preschool children, so as to provide a foundation for future guidance on fostering childrens physical activity within the family context.
Methods:
From November to December 2020, a clustered convenience sampling method was employed to conduct surveys, and a total of 283 children were selectal from one kindergarten each in Beijing, Shenyang, and Xian. Participating children wore ActiGraph GT9X accelerometers continuously for one week to collect data on different intensity levels of physical activity. Physical Activity afterschool Questionnaire for Preschooler (P-PAQ) was utilized to assess parental sports concept and behavior. The gender differences in physical activity level and physical activity compliance rate were analyzed by using ttest, Mann-Whitney U test, and Chisquare test; and the relationship between parental exercise concepts and behaviors and physical activity of preschool children was analyzed using Spearman rank correlation analysis and multiple linear regression analysis.
Results:
Parental sports concept was significantly positively correlated with average daily moderatetovigorous physical activity (MVPA) and total physical activity (TPA) in children (r=0.12-0.16, P<0.05). Parental sports behavior was significantly positively correlated with childrens average daily TPA (r=0.25, P<0.05). Multiple linear regression revealed that parental sports concept was positively correlated with average daily MVPA and TPA in both boys and girls (B=0.65-0.83), while parental sports behavior only was positively correlated with boys average daily MVPA and TPA (B=0.24-0.25)(P<0.05).
Conclusions
Parental sports concept and behavior can impact physical activity levels in preschool children, exhibiting gender differences. Future guidance on physical activity in family upbringing should consider both parental sports concept and behavior, and pay attention to the influence of childrens gender.
8.Construction and application of the standard process of thirst management for patients undergoing endonasal transsphenoidal surgery for pituitary adenomas
Xuelian JIANG ; Ping LIU ; Siyi QIN ; Yuping GUO ; Mengnan LI
Chinese Journal of Modern Nursing 2023;29(1):57-61
Objective:To explore the construction and application of the standard process of thirst management for patients undergoing endonasal transsphenoidal surgery for pituitary adenomas.Methods:From June 2020 to October 2021, 160 patients with endonasal transsphenoidal surgery for pituitary adenomas who were admitted to the Neurosurgery Department of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) were selected by convenience sampling. The patients were randomly divided into test group and control group, 80 cases in each group. The control group implemented routine nursing to prevent postoperative thirst, while the test group established a standard process of thirst management and implemented thirst prevention and interventions according to the process. The thirst intensity, thirst pain and resting salivary flow rate between the two groups was compared.Results:The thirst intensity scores of patients in the test group at 2, 6 and 24 hours after operation were lower than those in the control group, with statistically significant differences ( Z=-8.696, -10.008, -4.305; P<0.01) . The score of thirst pain in the test group was lower than that in the control group, and the resting salivary flow rate at 6 and 24 hours after operation were higher than those in the control group, with statistically significant differences ( Z=-9.488, -4.124, -2.631; P<0.01) . Conclusions:The standard process of thirst management can reduce the postoperative thirst intensity of patients with pituitary adenomas surgery and improve their thirst feeling, which is worthy of clinical promotion.
9.Nucleic acid nanoassembly-enhanced RNA therapeutics and diagnosis.
Mengnan ZHAO ; Rujing WANG ; Kunmeng YANG ; Yuhong JIANG ; Yachen PENG ; Yuke LI ; Zhen ZHANG ; Jianxun DING ; Sanjun SHI
Acta Pharmaceutica Sinica B 2023;13(3):916-941
RNAs are involved in the crucial processes of disease progression and have emerged as powerful therapeutic targets and diagnostic biomarkers. However, efficient delivery of therapeutic RNA to the targeted location and precise detection of RNA markers remains challenging. Recently, more and more attention has been paid to applying nucleic acid nanoassemblies in diagnosing and treating. Due to the flexibility and deformability of nucleic acids, the nanoassemblies could be fabricated with different shapes and structures. With hybridization, nucleic acid nanoassemblies, including DNA and RNA nanostructures, can be applied to enhance RNA therapeutics and diagnosis. This review briefly introduces the construction and properties of different nucleic acid nanoassemblies and their applications for RNA therapy and diagnosis and makes further prospects for their development.
10.Interpretation for the health standard of technical requirements for evaluation of national standard strains of pathogenic microorganisms
Qiang WEI ; Mengnan JIANG ; Yuanyuan ZHAO
Chinese Journal of Experimental and Clinical Virology 2023;37(3):250-253
Technical requirements for evaluation of national standard strains of pathogenic microorganisms (WS/T 812—2022)have been implemented since May 1, 2023. This is one of the concrete and important measures to implement Biosafety Law of the People′s Republic of China, the National Health Commission of the pathogenic microorganisms of collection organization of the " 14th Five-Year" development plan and to improve the standard system of pathogenic resource preservation and biosafety in China. For the first time, this standard specifies a definition, four evaluation principles, five types of use, and three evaluation indicators of national standard strains of pathogenic microorganisms, and standardizing the evaluation technical procedures and certificate. After the implementation of the standard, it will strongly support the national needs for the evaluation and application of pathogenic microorganism standard strains, such as infectious disease prevention and control, food safety testing, and biometrics specification, gradually reduce the long-term dependence on foreign standard strains and other " bottleneck" problems, help national biosecurity and high level science and technology self-reliance while promoting the innovation and high-level development of biotechnology.


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