1.Current Status of Early Surgical Site Infection Following Prosthetic Implantation in Aesthetic and Reconstructive Surgery and Evaluation of Quality Control Improvement Outcomes
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Shujuan SHAN ; Qianyu LI ; Jingya WANG ; Xiaojun WANG ; Xiao LONG ; Xiao XU
Medical Journal of Peking Union Medical College Hospital 2026;17(4):1174-1180
To assess the current status of early surgical site infections following prosthetic implantation in plastic surgery across four provincial-level administrative regions in China, and to explore the effectiveness of standardized training for infection prevention and control. From January to May 2025, an online questionnaire survey was conducted to perform a baseline investigation in medical institutions performing plastic and aesthetic prosthetic implant surgeries in Chongqing, Shaanxi, Jiangxi, and Guizhou provinces. Data were collected on the volume of various types of prosthetic implant surgeries and the corresponding incidence of early surgical site infections. Improvement strategies for the prevention and control of early surgical site infections in prosthetic implant surgeries were jointly developed by the National Medical Quality Control Center for Plastic and Aesthetic Surgery and the National Medical Quality Control Center for Hospital Infection Management, followed by promotion and training. Subsequently, post-implementation data from June to October 2025 were collected from the above regions, and comparisons were made between pre- and post-implementation periods across different regions and surgical categories. A total of 209 medical institutions were included in the baseline period, with a questionnaire response rate of 99.52% and a total of 7475 prosthetic implantation surgeries. In the post-implementation period, 624 medical institutions were included, with a response rate of 96.00% and a total of 4813 surgeries. The combined proportion of breast prosthesis implantation and nasal/nasal base prosthesis implantation surgeries consistently exceeded 80% across all regions and periods. Regarding the distribution of infection cases, among different types of prosthetic implant surgeries, nasal/nasal base prostheses accounted for the highest proportion, with 57.50%(23/40) at baseline and 62.86% 22/35) post-implementation. The proportion of breast prosthesis infections decreased from 40.00%(16/40) at baseline to 17.14%(6/35) post-implementation. Across different regions, infection cases in Jiangxi (post-implementation)(100%), Guizhou[both baseline(100%) and post-implementation(100%)] were all concentrated in nasal/nasal base prostheses. Shaanxi reported four cases of chin prosthesis infections (22.22%) during the post-implementation period, and Chongqing reported three cases of metal-related infections(27.27%) during the post-implementation period. In terms of infection rates, Chongqing(0.55% Breast prostheses and nasal/nasal base prostheses currently represent the main types of implants used in prosthetic implantation surgeries. The improvement strategies implemented in this study were associated with decreased early surgical site infection rates in multiple regions, suggesting that these strategies provide clinical insights for the prevention and control of early infections following prosthetic implantation surgeries in China.
2.Multiparametric MRI to Predict Gleason Score Upgrading and Downgrading at Radical Prostatectomy Compared to Presurgical Biopsy
Jiahui ZHANG ; Lili XU ; Gumuyang ZHANG ; Daming ZHANG ; Xiaoxiao ZHANG ; Xin BAI ; Li CHEN ; Qianyu PENG ; Zhengyu JIN ; Hao SUN
Korean Journal of Radiology 2025;26(5):422-434
Objective:
This study investigated the value of multiparametric MRI (mpMRI) in predicting Gleason score (GS) upgrading and downgrading in radical prostatectomy (RP) compared with presurgical biopsy.
Materials and Methods:
Clinical and mpMRI data were retrospectively collected from 219 patients with prostate disease between January 2015 and December 2021. All patients underwent systematic prostate biopsy followed by RP. MpMRI included conventional diffusion-weighted and dynamic contrast-enhanced imaging. Multivariable logistic regression analysis was performed to analyze the factors associated with GS upgrading and downgrading after RP. Receiver operating characteristic curve analysis was used to estimate the area under the curve (AUC) to indicate the performance of the multivariable logistic regression models in predicting GS upgrade and downgrade after RP.
Results:
The GS after RP was upgraded, downgraded, and unchanged in 92, 43, and 84 patients, respectively. The AUCs of the clinical (percentage of positive biopsy cores [PBCs], time from biopsy to RP) and mpMRI models (prostate cancer [PCa] location, Prostate Imaging Reporting and Data System [PI-RADS] v2.1 score) for predicting GS upgrading after RP were 0.714 and 0.749, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, tPSA, PCa location, and PIRADS v2.1 score) was 0.816, which was larger than that of the clinical factors alone (P < 0.001). The AUCs of the clinical (age, percentage of PBCs, ratio of free/total PSA [F/T]) and mpMRI models (PCa diameter, PCa location, and PI-RADS v2.1 score) for predicting GS downgrading after RP were 0.749 and 0.835, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, F/T, PCa diameter, PCa location, and PI-RADS v2.1 score) was 0.883, which was larger than that of the clinical factors alone (P < 0.001).
Conclusion
Combining clinical factors and mpMRI findings can predict GS upgrade and downgrade after RP more accurately than using clinical factors alone.
3.Multiparametric MRI to Predict Gleason Score Upgrading and Downgrading at Radical Prostatectomy Compared to Presurgical Biopsy
Jiahui ZHANG ; Lili XU ; Gumuyang ZHANG ; Daming ZHANG ; Xiaoxiao ZHANG ; Xin BAI ; Li CHEN ; Qianyu PENG ; Zhengyu JIN ; Hao SUN
Korean Journal of Radiology 2025;26(5):422-434
Objective:
This study investigated the value of multiparametric MRI (mpMRI) in predicting Gleason score (GS) upgrading and downgrading in radical prostatectomy (RP) compared with presurgical biopsy.
Materials and Methods:
Clinical and mpMRI data were retrospectively collected from 219 patients with prostate disease between January 2015 and December 2021. All patients underwent systematic prostate biopsy followed by RP. MpMRI included conventional diffusion-weighted and dynamic contrast-enhanced imaging. Multivariable logistic regression analysis was performed to analyze the factors associated with GS upgrading and downgrading after RP. Receiver operating characteristic curve analysis was used to estimate the area under the curve (AUC) to indicate the performance of the multivariable logistic regression models in predicting GS upgrade and downgrade after RP.
Results:
The GS after RP was upgraded, downgraded, and unchanged in 92, 43, and 84 patients, respectively. The AUCs of the clinical (percentage of positive biopsy cores [PBCs], time from biopsy to RP) and mpMRI models (prostate cancer [PCa] location, Prostate Imaging Reporting and Data System [PI-RADS] v2.1 score) for predicting GS upgrading after RP were 0.714 and 0.749, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, tPSA, PCa location, and PIRADS v2.1 score) was 0.816, which was larger than that of the clinical factors alone (P < 0.001). The AUCs of the clinical (age, percentage of PBCs, ratio of free/total PSA [F/T]) and mpMRI models (PCa diameter, PCa location, and PI-RADS v2.1 score) for predicting GS downgrading after RP were 0.749 and 0.835, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, F/T, PCa diameter, PCa location, and PI-RADS v2.1 score) was 0.883, which was larger than that of the clinical factors alone (P < 0.001).
Conclusion
Combining clinical factors and mpMRI findings can predict GS upgrade and downgrade after RP more accurately than using clinical factors alone.
4.Multiparametric MRI to Predict Gleason Score Upgrading and Downgrading at Radical Prostatectomy Compared to Presurgical Biopsy
Jiahui ZHANG ; Lili XU ; Gumuyang ZHANG ; Daming ZHANG ; Xiaoxiao ZHANG ; Xin BAI ; Li CHEN ; Qianyu PENG ; Zhengyu JIN ; Hao SUN
Korean Journal of Radiology 2025;26(5):422-434
Objective:
This study investigated the value of multiparametric MRI (mpMRI) in predicting Gleason score (GS) upgrading and downgrading in radical prostatectomy (RP) compared with presurgical biopsy.
Materials and Methods:
Clinical and mpMRI data were retrospectively collected from 219 patients with prostate disease between January 2015 and December 2021. All patients underwent systematic prostate biopsy followed by RP. MpMRI included conventional diffusion-weighted and dynamic contrast-enhanced imaging. Multivariable logistic regression analysis was performed to analyze the factors associated with GS upgrading and downgrading after RP. Receiver operating characteristic curve analysis was used to estimate the area under the curve (AUC) to indicate the performance of the multivariable logistic regression models in predicting GS upgrade and downgrade after RP.
Results:
The GS after RP was upgraded, downgraded, and unchanged in 92, 43, and 84 patients, respectively. The AUCs of the clinical (percentage of positive biopsy cores [PBCs], time from biopsy to RP) and mpMRI models (prostate cancer [PCa] location, Prostate Imaging Reporting and Data System [PI-RADS] v2.1 score) for predicting GS upgrading after RP were 0.714 and 0.749, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, tPSA, PCa location, and PIRADS v2.1 score) was 0.816, which was larger than that of the clinical factors alone (P < 0.001). The AUCs of the clinical (age, percentage of PBCs, ratio of free/total PSA [F/T]) and mpMRI models (PCa diameter, PCa location, and PI-RADS v2.1 score) for predicting GS downgrading after RP were 0.749 and 0.835, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, F/T, PCa diameter, PCa location, and PI-RADS v2.1 score) was 0.883, which was larger than that of the clinical factors alone (P < 0.001).
Conclusion
Combining clinical factors and mpMRI findings can predict GS upgrade and downgrade after RP more accurately than using clinical factors alone.
5.Multiparametric MRI to Predict Gleason Score Upgrading and Downgrading at Radical Prostatectomy Compared to Presurgical Biopsy
Jiahui ZHANG ; Lili XU ; Gumuyang ZHANG ; Daming ZHANG ; Xiaoxiao ZHANG ; Xin BAI ; Li CHEN ; Qianyu PENG ; Zhengyu JIN ; Hao SUN
Korean Journal of Radiology 2025;26(5):422-434
Objective:
This study investigated the value of multiparametric MRI (mpMRI) in predicting Gleason score (GS) upgrading and downgrading in radical prostatectomy (RP) compared with presurgical biopsy.
Materials and Methods:
Clinical and mpMRI data were retrospectively collected from 219 patients with prostate disease between January 2015 and December 2021. All patients underwent systematic prostate biopsy followed by RP. MpMRI included conventional diffusion-weighted and dynamic contrast-enhanced imaging. Multivariable logistic regression analysis was performed to analyze the factors associated with GS upgrading and downgrading after RP. Receiver operating characteristic curve analysis was used to estimate the area under the curve (AUC) to indicate the performance of the multivariable logistic regression models in predicting GS upgrade and downgrade after RP.
Results:
The GS after RP was upgraded, downgraded, and unchanged in 92, 43, and 84 patients, respectively. The AUCs of the clinical (percentage of positive biopsy cores [PBCs], time from biopsy to RP) and mpMRI models (prostate cancer [PCa] location, Prostate Imaging Reporting and Data System [PI-RADS] v2.1 score) for predicting GS upgrading after RP were 0.714 and 0.749, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, tPSA, PCa location, and PIRADS v2.1 score) was 0.816, which was larger than that of the clinical factors alone (P < 0.001). The AUCs of the clinical (age, percentage of PBCs, ratio of free/total PSA [F/T]) and mpMRI models (PCa diameter, PCa location, and PI-RADS v2.1 score) for predicting GS downgrading after RP were 0.749 and 0.835, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, F/T, PCa diameter, PCa location, and PI-RADS v2.1 score) was 0.883, which was larger than that of the clinical factors alone (P < 0.001).
Conclusion
Combining clinical factors and mpMRI findings can predict GS upgrade and downgrade after RP more accurately than using clinical factors alone.
6.Multiparametric MRI to Predict Gleason Score Upgrading and Downgrading at Radical Prostatectomy Compared to Presurgical Biopsy
Jiahui ZHANG ; Lili XU ; Gumuyang ZHANG ; Daming ZHANG ; Xiaoxiao ZHANG ; Xin BAI ; Li CHEN ; Qianyu PENG ; Zhengyu JIN ; Hao SUN
Korean Journal of Radiology 2025;26(5):422-434
Objective:
This study investigated the value of multiparametric MRI (mpMRI) in predicting Gleason score (GS) upgrading and downgrading in radical prostatectomy (RP) compared with presurgical biopsy.
Materials and Methods:
Clinical and mpMRI data were retrospectively collected from 219 patients with prostate disease between January 2015 and December 2021. All patients underwent systematic prostate biopsy followed by RP. MpMRI included conventional diffusion-weighted and dynamic contrast-enhanced imaging. Multivariable logistic regression analysis was performed to analyze the factors associated with GS upgrading and downgrading after RP. Receiver operating characteristic curve analysis was used to estimate the area under the curve (AUC) to indicate the performance of the multivariable logistic regression models in predicting GS upgrade and downgrade after RP.
Results:
The GS after RP was upgraded, downgraded, and unchanged in 92, 43, and 84 patients, respectively. The AUCs of the clinical (percentage of positive biopsy cores [PBCs], time from biopsy to RP) and mpMRI models (prostate cancer [PCa] location, Prostate Imaging Reporting and Data System [PI-RADS] v2.1 score) for predicting GS upgrading after RP were 0.714 and 0.749, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, tPSA, PCa location, and PIRADS v2.1 score) was 0.816, which was larger than that of the clinical factors alone (P < 0.001). The AUCs of the clinical (age, percentage of PBCs, ratio of free/total PSA [F/T]) and mpMRI models (PCa diameter, PCa location, and PI-RADS v2.1 score) for predicting GS downgrading after RP were 0.749 and 0.835, respectively. The AUC of the combined diagnostic model (age, percentage of PBCs, F/T, PCa diameter, PCa location, and PI-RADS v2.1 score) was 0.883, which was larger than that of the clinical factors alone (P < 0.001).
Conclusion
Combining clinical factors and mpMRI findings can predict GS upgrade and downgrade after RP more accurately than using clinical factors alone.
7.Wenxia Changfu Formula inhibits NSCLC metastasis by halting TAMs-induced epithelial-mesenchymal transition via antagonisticallymodulating CCL18.
Qianyu BI ; Mengran WANG ; Li LUO ; Beiying ZHANG ; Siyuan LV ; Zengna WANG ; Xuming JI
Chinese Journal of Natural Medicines (English Ed.) 2025;23(7):838-847
Our previous research demonstrated that the Wenxia Changfu Formula (WCF), as a neoadjuvant therapy, inhibits M2 macrophage infiltration in the tumor microenvironment and prevents lung cancer metastasis. Given tumor-associated macrophages (TAMs) in epithelial-mesenchymal transition (EMT), this study investigated whether WCF impedes lung cancer metastasis by attenuating TAM-induced EMT in non-small cell lung cancer (NSCLC) cells. Utilizing a co-culture model treated with or without WCF, we observed that WCF downregulated cluster of differentiation 163 (CD163) expression in macrophages, reduced CCL18 levels in the conditioned medium, and inhibited the growth, invasion, and EMT of NSCLC cells induced by macrophage co-culture. Manipulation of CCL18 levels and Src overexpression in NSCLC cells revealed that WCF's effects are mediated through CCL18 and Src signaling. In vivo, WCF inhibited recombinant CCL18 (rCCL18)-induced tumor metastasis in nude mice by blocking Src signaling. These findings indicate that WCF inhibits NSCLC metastasis by impeding TAM-induced EMT via antagonistic modulation of CCL18, providing evidence for its potential development and clinical application in NSCLC patients.
Epithelial-Mesenchymal Transition/drug effects*
;
Carcinoma, Non-Small-Cell Lung/metabolism*
;
Humans
;
Animals
;
Lung Neoplasms/metabolism*
;
Chemokines, CC/antagonists & inhibitors*
;
Mice
;
Mice, Nude
;
Drugs, Chinese Herbal/administration & dosage*
;
Cell Line, Tumor
;
Neoplasm Metastasis
;
Tumor-Associated Macrophages/drug effects*
;
Mice, Inbred BALB C
;
Signal Transduction/drug effects*
8.Protective effect of Liraglutide inrats with diabetic kidney disease by regulating nuclear factor E2-related factor 2/glutathione peroxidase 4 ferroptosis signaling pathway
Dong LIANG ; Qianyu LIN ; Min YANG ; Mengjie LI ; Wenhua XING ; Ning YU ; Yunqi LIU ; Xiaomin ZHANG
Chinese Journal of Diabetes 2025;33(4):299-303
Objective To investigate the protective effect of Liraglutide in rats with diabetic kidney disease(DKD)by regulating the nuclear factor E2-related factor 2(Nrf2)/glutathione peroxidase 4(GPX4)ferroptosis signaling pathway.Methods Twelve male Sprague-Dawley(SD)rats were randomly divided into normal control(NC)group,DKD group,and Liraglutide treatment(Lir)group,with 4 rats in each group.The 24 hUAlb,TC,TG,LDL-C,serum creatinine(Scr),BUN,ferrous ion(Fe2+),the activity of glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)were detected in each group.Hematoxylin and eosin(HE),periodic acid-Schiff(PAS),and periodic acid-silver methenamine-Masson(PASM-Masson)staining were used to observe the pathological changes of the kidneys.Immunofluorescence was performed to detect the localization and expression of reactive oxygen species(ROS)in the renal tissue.The protein expressions of Nrf2 and GPX4 were detected by Western blot.Results Compared with the NC group,the levels of 24 hUAlb,Scr,BUN,TC,TG,LDL-C,MDA,ROS,and Fe2+were increased(P<0.05 or P<0.01),while the expressions of GSH-Px,Nrf2,and GPX4 proteins were decreased in the DKD group(P<0.01).Compared with the DKD group,the levels of 24 hUAlb,BUN,TC,TG,LDL-C,MDA,ROS,and Fe2+were decreased(P<0.05 or P<0.01),and the expressions of GSH-Px,Nrf2,and GPX4 proteins were increased in the Lir group(P<0.01).Conclusions Liraglutide may exert a protective effect in DKD by upregulating the Nrf2/GPX4 signaling pathway and inhibiting ferroptosis.
9.Effects of Qizhi Zhoufei Granules on Endoplasmic Reticulum Stress in Chronic Obstructive Pulmonary Disease Rats
Yi ZHANG ; Jinwei WU ; Qianyu JIANG ; Jintian LI ; Kunpeng ZHAO ; Xiaogang WU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(1):106-112
Objective To investigate the effects of Qizhi Zhoufei Granules on endoplasmic reticulum stress in rats with chronic obstructive pulmonary disease(COPD);To explore its mechanism.Methods COPD rat model was induced by lipopolysaccharide tracheal instillation and smoking.Totally 60 Wistar rats were divided into control group,model group,Bufei Huoxue Capsules group and Qizhi Zhoufei Granules low-,medium-and high-dosage groups using random number table method,with 10 rats in each group.Drug gavage intervention was carried out for the treatment group since the 29th day of modeling,and normal saline was given to the control group and model group for 28 d.Lung function tests were performed,HE staining was used to detect morphology of lung tissue,TUNEL staining was used to detect the degree of apoptosis in lung tissue,RT-qPCR and Western blot were used to detect the endoplasmic reticulum stress and apoptosis related molecular mRNA and protein expression in lung tissue.Results Compared with the control group,the lung function indexes of peak inspiratory flow(PIF),peak expiratory flow(PEF)and minute volume(MV)significantly decreased,and frequency of breathing(F)significantly increased in the model group(P<0.05);the structural damage of the lung tissue was obvious,the lung injury score and apoptosis rate significantly increased(P<0.05),the expressions of glucose regulated protein 78(GRP78),protein kinase R-like ER kinase(PERK),C/EBP-homologous protein(CHOP),Caspase-3 and Caspase-9 mRNA were increased(P<0.05),the protein expressions of GRP78,p-PERK,activating transcription factor 4(ATF4),CHOP,Caspase-3 and Caspase-9 were significantly increased(P<0.05).Compared with the model group,PIF,PEF and MV significantly increased in Qizhi Zhoufei Granules medium-and high-dosage groups and Bufei Huoxue Capsules group,and F significantly decreased(P<0.05);the damage in lung tissue was improved,and the lung injury score and cell apoptosis rate significantly decreased(P<0.05),the mRNA expressions of GRP78,PERK,CHOP,Caspase-3 and Caspase-9 in lung tissue decreased(P<0.05),and the protein expressions of GRP78,p-PERK,ATF4,CHOP,Caspase-3 and Caspase-9 decreased(P<0.05).Conclusion Qizhi Zhoufei Granules can prevent cell apoptosis and excessive damage by inhibiting the expression of endoplasmic reticulum stress related factors in COPD rats,thereby promoting unfolded protein response and improving endoplasmic reticulum folding ability,constraining endoplasmic reticulum stress state,and assisting in its regulation.
10.Analysis concepts of traditional Chinese medicine in the diagnosis and treatment of heat stroke
Li KONG ; Hao HAO ; Feihu ZHANG ; Yu WANG ; Wenqiang LI ; Tejin BA ; Qianyu BI
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2025;32(1):11-15
The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

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