1.Effects of different dialysis modalities on survival rates in the oldest old patients and analysis of mortality-associated risk factors
Ying WANG ; Bin PAN ; Pengpeng YAN ; Chunping XU ; Jianghua CHEN ; Ping ZHANG
Chinese Journal of Nephrology 2025;41(11):825-832
Objective:To compare the differences of long-term survival rates between hemodialysis (HD) and peritoneal dialysis (PD) in the oldest old end-stage renal disease (ESRD) patients, and analyze the influencing factors of mortality.Methods:It was a retrospective cohort study. The clinical data from the oldest old patients (≥80 years old) who underwent HD or PD for the first time and maintained dialysis treatment for ≥3 months in the Zhejiang Dialysis Registration System from January 1, 2008 to December 31, 2021 were collected. The follow-up endpoint was until the patients' death or December 31, 2022. The propensity score matching method was used to match groups. Kaplan-Meier method and log-rank test were used to compare the differences of long-term survival rates between the two groups. Cox regression analysis was used to analyze the risk factors of mortality.Results:A total of 5 880 the oldest old dialysis patients were included in this study, with 5 363 patients in the initial HD group and 517 patients in the initial PD group. After matching, there were 517 patients in the HD group and 517 patients in the PD group. The median survival time of HD group before matching was 39.9 months, with 1-year, 3-year, and 5-year survival rates of 85.4%, 54.9%, and 30.0%, respectively. The median survival time of PD group was 32.9 months, with 1-year, 3-year, and 5-year survival rates of 82.5%, 47.1%, and 22.3%, respectively. After matching, the median survival time of HD group was 40.3 months, and the 1-year, 3-year, and 5-year survival rates were 86.1%, 57.8%, and 29.1%, respectively. The survival rate of PD group remained unchanged. The difference of 1-year survival rate between the two groups was not statistically significant, but the 2-year, 3-year, 4-year, 5-year, and overall survival rates in HD group were higher than those in PD group (Log‐rank test, χ2=4.897, P=0.027; χ2=9.693, P=0.002; χ2=10.194, P=0.001; χ2=7.868, P=0.005; χ2=12.510, P<0.001). Multivariate Cox regression analysis showed that HD (HD/PD, HR=0.794, 95% CI 0.669-0.943, P=0.009), increasing age ( HR=1.069, 95% CI 1.038-1.110, P<0.001), comorbidity with chronic obstructive pulmonary disease ( HR=1.510, 95% CI 1.065-2.139, P=0.021) and serum albumin <35 g/L ( HR=1.393, 95% CI 1.165-1.665, P<0.001) were independent correlated factors of mortality. Conclusions:There is no significant difference in the 1-year survival rate between HD and PD groups. The survival rate for more than 1 year in HD patients is higher than that in PD patients. HD is an independent protective factor of survival, and increasing age, comorbidities of chronic obstructive pulmonary disease, and serum albumin <35 g/L are independent risk factors affecting the survival in the oldest old dialysis patients.
2.Clinical and genetic characteristics of follicular lymphoma with bulky disease
Tianyuan XU ; Ruichi LI ; Rui SUN ; Nan WANG ; Shu CHENG ; Li WANG ; Pengpeng XU ; Weili ZHAO ; Zhong ZHENG
The Journal of Practical Medicine 2025;41(10):1502-1508
Objective To explore the characteristics and prognosis of follicular lymphoma(FL)with bulky disease under rituximab-based first-line treatment.Methods A retrospective analysis was conducted on 525 FL patients diagnosed between September 2009 and September 2021 who received rituximab as a first-line treat-ment[342 patients received rituximab combined with chemotherapy(R-chemo),183 patients received rituximab plus lenalidomide(R2)].The clinicopathologic characteristics,gene mutations,and prognosis of bulky FL patients were analyzed.Results Compared to non-bulky FL patients,bulky FL patients had a significantly higher proportion of lymph node≥5 sites,≥2 extranodal involvement,bone marrow involvement,elevated LDH,and a higher proportion in the high-risk group of FLIPI1 and FLIPI2.Gene sequencing revealed a significantly higher mutation rate of ZNF608 in bulky FL patients compared to non-bulky FL patients.In patients receiving R-chemo as the first-line treatment,there was no significant difference in progression-free survival(PFS)and overall survival(OS)between bulky and non-bulky FL patients.However,in patients treated with R2,the PFS and OS of bulky FL patients was significantly shorter.Conclusions Bulky FL patients compared to non-bulky FL patients have a significantly higher proportion of high-risk baseline characteristics.For bulky FL at diagnosis,chemo-free regimens require further exploration on the basis of R2.
3.Clinical and genetic characteristics of follicular lymphoma with bulky disease
Tianyuan XU ; Ruichi LI ; Rui SUN ; Nan WANG ; Shu CHENG ; Li WANG ; Pengpeng XU ; Weili ZHAO ; Zhong ZHENG
The Journal of Practical Medicine 2025;41(10):1502-1508
Objective To explore the characteristics and prognosis of follicular lymphoma(FL)with bulky disease under rituximab-based first-line treatment.Methods A retrospective analysis was conducted on 525 FL patients diagnosed between September 2009 and September 2021 who received rituximab as a first-line treat-ment[342 patients received rituximab combined with chemotherapy(R-chemo),183 patients received rituximab plus lenalidomide(R2)].The clinicopathologic characteristics,gene mutations,and prognosis of bulky FL patients were analyzed.Results Compared to non-bulky FL patients,bulky FL patients had a significantly higher proportion of lymph node≥5 sites,≥2 extranodal involvement,bone marrow involvement,elevated LDH,and a higher proportion in the high-risk group of FLIPI1 and FLIPI2.Gene sequencing revealed a significantly higher mutation rate of ZNF608 in bulky FL patients compared to non-bulky FL patients.In patients receiving R-chemo as the first-line treatment,there was no significant difference in progression-free survival(PFS)and overall survival(OS)between bulky and non-bulky FL patients.However,in patients treated with R2,the PFS and OS of bulky FL patients was significantly shorter.Conclusions Bulky FL patients compared to non-bulky FL patients have a significantly higher proportion of high-risk baseline characteristics.For bulky FL at diagnosis,chemo-free regimens require further exploration on the basis of R2.
4.Progress in the biological magnetoreception mechanisms of pigeon geomagnetic navigation
Yong ZHAO ; Fang WANG ; Pengpeng WU ; Changhong SHI
Chinese Journal of Comparative Medicine 2025;35(9):145-152
Homing pigeons and many other animals have exquisite geomagnetic sensing ability and can accurately find appropriate paths and directions during long-distance migration.Homing pigeons are the preferred animal model for studies of biological geomagnetic navigation.Despite substantial progress in research on bio-geomagnetic navigation over the past few decades,the biological mechanism is still unclear.In this paper,we review recent advancements in research on biological magnetoreception using homing pigeons.We focus on the magnetic sensing mechanisms of the magnetoreceptor models based on nanoscale ferromagnetic particles and the light-dependent radical pair model.Key directions for biological magnetoreception research are proposed.This review provides an improved theoretical basis for the study of geomagnetic navigation using homing pigeons as well as insight into the operating principles of the biological magnetic perception system.
5.Investigation on the species and pathogens of ticks in some cities of Liaoning Province
Fuxiao XIU ; He ZHAI ; Yao WANG ; Yu ZHAO ; Yuxiang YANG ; Pengpeng WANG ; Yu FENG
Chinese Journal of Zoonoses 2025;41(8):809-815
This study investigated the prevalence of canine ticks and the types of their carried pathogens in select cities of Liaon-ing Province,to provide a theoretical scientific basis for the prevention and control of ticks and tick-borne diseases.Canine ticks were collected from six cities in Liaoning Province(Shenyang,Dalian,Anshan,Chaoyang,Tieling,Dandong)and identified through a combination of morphological and molecular biology methods.PCR was used to detect five tick pathogens:Rickettsia,Borrelia burgdor-feri,Babesia,Pseudomonas aeruginosa,and Ehrlichia.Canine ticks were prevalent primarily in Liaoning Province from April to June.The collected ticks included 456 Haemaphysalis longicornis,70 Ixodes persulcatus,and 31 Rhicephalus sanguineus.Three tick borne pathogens,Ehrlichia,Borrelia burgdorferi,and Rickettsia,were detected,whereas no Babesia or Pseudomonas were detected.The to-tal detection rate of Ehrlichia(46.85%),which is significant difference with total detection rate of Borrelia burgdorferi(10.81%)(χ2=33.392,P<0.05),but insignificant difference with total detection rate of Rickettsia(34.23%)(χ2=3.370,P>0.05),Both Eh-rlichia and Rickettsia were distributed in the six cities.Haemaphysalis longicornis was the dominant tick species parasite on the surfaces of dogs in Liaoning Province.The main tick borne pathogens in dogs in Liaoning Province were Ehrlichia and Rickettsia.
6.The effect of adenoidectomy on the prognosis of children with refractory chronic sinusitis and adenoid hypertrophy
Lang XU ; Lu LIU ; Wei ZHANG ; Pengpeng WANG ; Xin NI
Chinese Archives of Otolaryngology-Head and Neck Surgery 2025;32(8):529-533,537
OBJECTIVE To analyze the distribution of the nasopharyngeal microbiota in children with refractory chronic sinusitis and adenoid hypertrophy using 16S rRNA next-generation high-throughput sequencing technology,and to compare the effects of adenoidectomy on the nasopharyngeal microbiota in such patients,with the aim of providing microbiological evidence for the clinical treatment of refractory chronic sinusitis with adenoid hypertrophy.METHODS Children diagnosed with chronic sinusitis with adenoid hypertrophy who visited Chengdu Women and Children's Central Hospital from January 2024 to March 2025 and whose symptoms were not controlled after drug treatment were selected.They were divided into a non-surgical group and a surgical group based on whether they underwent adenoidectomy.The VAS scores,Lund-Kennedy scores,and microbial community detection rates between the two groups were compared.RESULTS The final VAS scores and Lund-Kennedy scores for surgical group were both lower than those for non-surgical group,with statistically significant differences(tVAS score=3.491,P<0.001;tLund-Kennedy score=4.166,P<0.001).Comparisons of microbial α diversity analysis and β diversity at the phylum and genus levels between the two groups showed no statistically significant differences(tα diversity analysis=0.524,P=0.604;Rβ diversity at the phylum level=0.075,P=0.454;Rthe genus level=0.117,P=0.538).The dominant bacterial groups at the phylum level were the same in both groups,including Proteobacteria,Bacillales,Actinobacteria,Bacteroidetes,and Firmicutes,but the average relative abundance differed between the two groups.Species comparison analysis showed that at the phylum level,the abundance of Proteobacteria and Thermodesulfovibrio in surgical group was higher than that in non-surgical group;At the genus level,the abundance of the genus Moraxella was higher in non-surgical group than in surgical group,while the abundance of the genera Acidovorax,Stenotrophomonas,Delftia,Burkholderia,Caballeronia,Paraburkholderia,Lactobacillus,Devosia,norank_f_Muribaculaceae,Paracoccus,and Kocuria was lower in non-surgical group than in surgical group.CONCLUSION Children with refractory sinusitis and adenoid hypertrophy all have rich microbial communities in the nasopharynx.Adenoid surgery has no significant effect on the diversity of the nasopharyngeal microbial community.However,the composition of the microbial community has changed,and there are significant species differences,which may be related to the resolution of local obstruction after adenoidectomy and changes in the survival environment of the nasopharyngeal microbial community.
7.Effects of different dialysis modalities on survival rates in the oldest old patients and analysis of mortality-associated risk factors
Ying WANG ; Bin PAN ; Pengpeng YAN ; Chunping XU ; Jianghua CHEN ; Ping ZHANG
Chinese Journal of Nephrology 2025;41(11):825-832
Objective:To compare the differences of long-term survival rates between hemodialysis (HD) and peritoneal dialysis (PD) in the oldest old end-stage renal disease (ESRD) patients, and analyze the influencing factors of mortality.Methods:It was a retrospective cohort study. The clinical data from the oldest old patients (≥80 years old) who underwent HD or PD for the first time and maintained dialysis treatment for ≥3 months in the Zhejiang Dialysis Registration System from January 1, 2008 to December 31, 2021 were collected. The follow-up endpoint was until the patients' death or December 31, 2022. The propensity score matching method was used to match groups. Kaplan-Meier method and log-rank test were used to compare the differences of long-term survival rates between the two groups. Cox regression analysis was used to analyze the risk factors of mortality.Results:A total of 5 880 the oldest old dialysis patients were included in this study, with 5 363 patients in the initial HD group and 517 patients in the initial PD group. After matching, there were 517 patients in the HD group and 517 patients in the PD group. The median survival time of HD group before matching was 39.9 months, with 1-year, 3-year, and 5-year survival rates of 85.4%, 54.9%, and 30.0%, respectively. The median survival time of PD group was 32.9 months, with 1-year, 3-year, and 5-year survival rates of 82.5%, 47.1%, and 22.3%, respectively. After matching, the median survival time of HD group was 40.3 months, and the 1-year, 3-year, and 5-year survival rates were 86.1%, 57.8%, and 29.1%, respectively. The survival rate of PD group remained unchanged. The difference of 1-year survival rate between the two groups was not statistically significant, but the 2-year, 3-year, 4-year, 5-year, and overall survival rates in HD group were higher than those in PD group (Log‐rank test, χ2=4.897, P=0.027; χ2=9.693, P=0.002; χ2=10.194, P=0.001; χ2=7.868, P=0.005; χ2=12.510, P<0.001). Multivariate Cox regression analysis showed that HD (HD/PD, HR=0.794, 95% CI 0.669-0.943, P=0.009), increasing age ( HR=1.069, 95% CI 1.038-1.110, P<0.001), comorbidity with chronic obstructive pulmonary disease ( HR=1.510, 95% CI 1.065-2.139, P=0.021) and serum albumin <35 g/L ( HR=1.393, 95% CI 1.165-1.665, P<0.001) were independent correlated factors of mortality. Conclusions:There is no significant difference in the 1-year survival rate between HD and PD groups. The survival rate for more than 1 year in HD patients is higher than that in PD patients. HD is an independent protective factor of survival, and increasing age, comorbidities of chronic obstructive pulmonary disease, and serum albumin <35 g/L are independent risk factors affecting the survival in the oldest old dialysis patients.
8.Long-term protective efficacy of recombinant CHO cell-derived hepatitis B vaccine:A 26-year follow-up study in Zhengding county
Qiudong SU ; Zhiyong HAO ; Feng QIU ; Lili QIAO ; Huijuan JIA ; Shuang ZHANG ; Pengpeng YUAN ; Juan CHU ; Zhiyong ZHANG ; Junfang YAO ; Jinling WEI ; Yan WANG ; Peiqi ZHAO ; Yujiao LIU ; Zhao GAO ; Jingchen MA ; Feng WANG ; Haisong ZHOU
Chinese Journal of Experimental and Clinical Virology 2025;39(4):434-440
Objective:To evaluate the long-term protective efficacy of the recombinant Chinese hamster ovary cell-derived hepatitis B vaccine(CHO-HepB)26 years post-vaccination in the rural China.Methods:Zhengding county,Hebei province was designated as a rural monitoring site for CHO-HepB efficacy. Study participants included individuals born between 1997 and 1999 who had completed the three-dose CHO-HepB primary series without booster doses. A cross-sectional survey was conducted in late 2024 using random sampling. Demographic and vaccination history data were collected via questionnaires,and hepatitis B virus(HBV)serological markers were detected using chemiluminescence. Historical surveillance data were integrated to infer infection statuses of HBsAg-positive individuals and evaluate longitudinal trends in anti-HBs seropositivity and antibody titers.Results:Among 178 participants(mean time since vaccination:26.2 years),the seroprevalence rates were 0.6% for HBsAg(95% CI:0.0%-1.6%),64.6% for anti-HBs(95% CI:57.6%-71.6%),and 1.1% for anti-HBc(95% CI:0.0%-2.7%). Compared to the pre-vaccination baseline HBsAg positivity of 11.3% in children under 10 years of age,the estimated vaccine protection rate was 95%. Two notable cases were identified:one with concurrent HBsAg and anti-HBc positivity and one with anti-HBs and anti-HBc positivity,suggestive of transient HBV exposure(1999—2009)without chronicity. Natural immune boosting was inferred for the latter case based on anti-HBs titer dynamics. Longitudinal analysis of four prior cross-sectional surveys(2005,2009,2013,and 2017)revealed no significant upward trends in HBsAg and anti-HBc positivity(both P>0.05)over 26 years,while anti-HBs seropositivity declined significantly( P<0.05)from 6 to 26 years post-vaccination. Conclusion:The CHO-HepB vaccine demonstrates sustained immunological persistence and robust long-term protection up to 26 years post-immunization. Continued emphasis on rigorous implementation of mother-to-child transmission prevention strategies is critical for future hepatitis B control.
9.Clinicopathologic characteristics,gene mutation profile,and prognostic analysis of patients with adrenal diffuse large B-cell lymphoma
Jiayin HE ; Siyuan CHEN ; Qing SHI ; Muchen ZHANG ; Hongmei YI ; Lei DONG ; Ying QIAN ; Li WANG ; Shu CHENG ; Pengpeng XU ; Weili ZHAO
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(9):1194-1201
Objective·To analyze the clinicopathologic characteristics,gene mutation profile,and prognostic factors of patients with adrenal diffuse large B-cell lymphoma(DLBCL).Methods·From March 2002 to December 2022,a total of 105 patients with adrenal DLBCL admitted to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retrospectively analyzed for their clinicopathological data,survival outcomes,and prognostic factors.Patients'gene mutation profiles were evaluated by targeted sequencing of 152 lymphoma-related genes.Results·The median age of the patients was 62(15?82)years and the male-to-female ratio was 2.3∶1.Among them,63 patients(60.0%)were over 60 years old,22 patients(21.0%)had an Eastern Cooperative Oncology Group(ECOG)performance status of two or higher,87 patients(82.9%)were staged Ann Arbor Ⅲ?Ⅳ,92 patients(87.6%)had elevated serum lactate dehydrogenase(LDH)levels(above the upper limit of reference),84 patients(80.0%)had extranodal invasion in at least two organs,67 patients(63.8%)were of non-germinal center B-cell(non-GCB)origin,and 95 patients(90.5%)had an international prognosis index(IPI)scored over 2.With a median follow-up of 28.3(0.7?191.9)months,the estimated 2-year overall survival(OS)rate and progression-free survival(PFS)rate were 68.3%and 53.1%,respectively.The estimated 5-year OS rate and PFS rate were 52.6%and 44.0%,respectively.Among 93 patients who could be evaluated for clinical outcomes,62(66.7%)got a complete response(CR).Univariate analysis and multivariate Cox analysis revealed that age over 60 years was an adverse prognostic factor for PFS,and ECOG performance status of two or higher was an adverse prognostic factor for both OS and PFS.Targeted gene sequencing in 46 adrenal diffuse DLBCL patients showed high mutation frequencies in lysine methyltransferase 2D(KMT2D;n=17,37%),Pim-1 proto-oncogene,serine/threonine kinase(PIM1;n=17,37%),MYD88 innate immune signal transduction adaptor(MYD88;n=15,33%),CD79b molecule(CD79B;n=13,28%),and BTG anti-proliferation factor 2(BTG2;n=10,22%).Conclusion·Age over 60 years is an adverse prognostic factor for PFS,and ECOG performance status of two or higher is an adverse prognostic factor for both OS and PFS in patients with adrenal DLBCL.Patients exhibited high frequencies of KMT2D,PIM1,MYD88,CD79B,and BTG2 mutations,as well as an increased proportion of the MCD-like subtype.
10.Clinicopathologic characteristics,gene mutation profile,and prognostic analysis of diffuse large B-cell lymphoma with lung involvement
Siyuan CHEN ; Qing SHI ; Di FU ; Li WANG ; Shu CHENG ; Pengpeng XU ; Weili ZHAO
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(9):1214-1220
Objective·To investigate the clinicopathologic features,gene mutation profile,and real-world survival prognosis of diffuse large B-cell lymphoma(DLBCL)with pulmonary involvement.Methods·The clinical data of 110 patients with newly diagnosed,pathologically confirmed DLBCL and pulmonary involvement at Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,between August 2003 and December 2022 were retrospectively collected and analyzed.Evaluation of the efficacy of treatment,survival analyses,and univariate and multivariate analyses were performed in 88 patients who received a first-line regimen based on rituximab in combination with cyclophosphamide,doxorubicin/epirubicine,vincristine,and prednisone(R-CHOP).A total of 74 patients underwent targeted DNA sequencing of 55 lymphoma-related genes and were evaluated for mutations.Results·Among the 110 patients,72(65.5%)were>60 years old,52(47.3%)were female,92(83.6%)presented with Ann Arbor stage Ⅲ?Ⅳ,20(18.2%)had ECOG scores≥2,75(68.2%)had elevated lactate dehydrogenase(LDH)levels,79(71.8%)had≥2 extranodal involvements,32(31.4%)were classified as germinal center B-cell subtype,22(26.8%)were diagnosed with double expressor lymphoma,and 4(4.6%)with double-hit lymphoma.Among the patients treated with R-CHOP-based first-line regimens,the objective response rate(ORR)was 68.2%,the 5-year progression-free survival(PFS)rate was 43.7%,and the 5-year overall survival(OS)rate was 65.4%.Univariate analysis showed that elevated LDH and ECOG score≥2 were poor prognostic factors for PFS and OS,and mutations in PIM1 and CD79B were poor prognostic factors for PFS among high-frequency mutations.Multivariate analysis showed that elevated LDH was an independent adverse prognostic factor for PFS(HR=2.47,95%CI 1.28?4.77)and OS(HR=2.71,95%CI 1.21 ? 6.07).Targeted sequencing results showed that PIM1(25.7%),MYD88(24.3%),TP53(18.9%),CD79B(17.6%),KMT2D(17.6%),and TNFAIP3(16.2%)were the high-frequency mutations with mutation rates over 15%.Conclusion·Elevated LDH is an independent adverse prognostic factor for PFS and OS in DLBCL with pulmonary involvement.Mutations in PIM1,MYD88,TP53,CD79B,KMT2D,and TNFAIP3 are frequently observed in this population.

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