1.Diagnostic value of blood lipids combined with blood routine parameters for pneumoconiosis and the construction of nomogram prediction model
Qu ZHOU ; Wei WANG ; Zimeng WANG ; Longchun MAO ; Juan HU ; Yuanyuan LI ; Junli YU ; Shangcheng XU ; Wenbing LIU
International Journal of Laboratory Medicine 2025;46(8):965-970,975
Objective To analyze the situation of blood lipid and blood routine parameters in patients with pneumoconiosis,and construct a column chart diagnostic model to explore their diagnostic value for pneumo-coniosis.Methods A total of 456 patients with pneumoconiosis admitted to the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College from January 2022 to January 2024 were selected as the pneu-moconiosis group,while 462 healthy subjects exposed to dust during the same period were chosen as the con-trol group.Serum lipids and blood routine parameters related to pneumoconiosis were measured and compared between two groups.Univariate and multivariate Logistic regression analyzes were conducted to examine ser-um lipids and blood routine parameters associated with pneumoconiosis.A risk prediction model was construc-ted using logistic regression in machine learning,and the diagnostic efficacy of the column chart diagnostic model was evaluated by calculating the C-index through receiver operating characteristic(ROC)curve and plotting the model calibration curve based on Hosmer Lemeshow goodness of fit.Decision curve analysis(DCA)was used to assess the clinical practicality of the column chart diagnostic model.Results The levels of serum high-density ester protein cholesterol(HDL-C),cholesterol(TC),red blood cell(RBC),hematocrit(HCT),hemoglobin concentration(HGB),lymphocyte number(LYM),and lymphocyte percentage(LYM%)in the pneumoconiosis group were lower than those in the control group(P<0.05).The levels of neutrophil-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune inflammation index(SII)were higher than those in the control group(P<0.05).Multivariate Logistic regression analysis showed that HDL-C,LYM%,PLR,and SII were independent influencing factors for pneumoconiosis(P<0.05).A column chart diagnostic model for the occurrence of pneumoconiosis was constructed using HDL-C,TC,LYM%,PLR,and SII as diagnostic factors.The ROC curve C-index of the diagnostic model was 0.84(95%CI:0.81-0.86),with sensitivity for diagnosing pneumoconiosis of 75.29%,specificity of 77.51%,posi-tive predictive value of 83.25%,and negative predictive value of 67.88%.Internal validation was conducted on the constructed column chart diagnostic model,with a validation set ROC curve C-index of 0.84(95%CI:0.80-0.87),sensitivity of 80.91%,specificity of 72.62%,positive diagnostic value of 79.46%,and negative diagnostic value of 74.39%.The calibration positive curve slope of the diagnostic model was close to 1,and in the fit test P>0.05.DCA analysis showed that the diagnostic model had clinical practical value for risk diag-nosis of pneumoconiosis.Conclusion HDL-C,TC,LYM%,PLR and SII are independent influencing factors for pneumoconiosis.A column chart diagnostic model for the occurrence of pneumoconiosis is successfully constructed based on machine learning principles,and it has been verified to have high diagnostic efficiency.
2.A preliminary exploration of reduced port laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF)
Wei PENG ; Qiankun SHAO ; Xinyu LIANG ; Shangcheng YAN ; Qiang CHEN ; Rui REN ; Mengchao SHENG ; Wenting XU ; Yuan TIAN ; Yongyou WU
Chinese Journal of Gastrointestinal Surgery 2024;27(10):1069-1074
Objective:This study aimed to share preliminary experiences of single-incision plus two ports laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF).Methods:Following the 6th edition of the Japanese Gastric Cancer Treatment Guidelines, proximal gastrectomy with lymphadenectomy was performed. Using a single-port approach, the esophagus was transected at least 2 cm above the tumor's upper margin with linear staplers. The stomach was then extracted through a periumbilical incision, and the proximal stomach was subsequently transected extracorporeally, while ensuring appropriate resection margins on both the greater and lesser curvatures. A single flap was created before returning the remnant stomach to the abdominal cavity and re-establishing pneumoperitoneum. The No.2 clip was used to grasp and elevate the esophageal stump. An incision was made at the right lower edge of the esophageal stump to guarantee that the esophageal lumen was open. The linear stapler was then inserted into the openings of the stomach and esophagus to perform a side overlap anastomosis with a length of 3 cm. Another barbed suture was used to close the common opening of the esophagus and the stomach, and the same barbed suture were used to suture the gastric wall to the lower edge of the muscle flap. The first barbed suture was then used to sequentially suture the proximal brim of the flap to the esophagus and the right brim of the flap to the right brim of the mucosal window. After completion of anastomosis, a drainage tube was inserted through the right upper port. This procedure was employed from November 2023 to March 2024 on five patients diagnosed with adenocarcinoma of the esophagogastric junction and upper stomach. The cohort consisted of three males and two females, with an age range of 62 to 75 years and a body mass index (BMI) of 13.7 to 24.2 kg/m2. All cases were preoperatively staged as T1-2N0M0, confirmed by endoscopic biopsy and enhanced CT scans of the chest, abdomen, and pelvis.Results:All five patients successfully underwent the surgery. The median surgery time was 180-325 minutes, with the intraoperative blood loss of 30-50 ml. The number of lymph nodes harvested ranged from 18 to 27. The time to first flatus, and restore liquid diet and was 2.0-5.0 and 1.0-3.0 days, respectively. The postoperative length of stay was 9.0-11.0 days. The pain scores on the Numeric Rating Scale (NRS). On the first day, the pain scores were 3.0 in two cases, 2.0 in two cases, and 1.0 in one case. On the second day, the pain scores were 2.0 in two cases and 1.0 in three cases. On the third day, the pain scores were 1.0 in four cases and 2.0 in one case. No short-term postoperative complications were observed, and there were no perioperative deaths.Conclusion:Single-incision plus two ports laparoscopic proximal gastrectomy with ROSF is safe and feasible.
3.Investigation and analysis of a cluster outbreak of Mycoplasma pneumoniae infection in a school
Shanghai Journal of Preventive Medicine 2024;36(8):741-745
ObjectiveTo investigate a cluster outbreak of Mycoplasma pneumoniae (MP) infection in a school in Shangcheng District, Hangzhou, and to provide references for the prevention and control of similar epidemics in the future. MethodsCases were defined and searched, and telephone follow-ups were conducted one by one for the searched cases. A questionnaire on the factors related to MP infection was designed to collect information, and the questionnaire was filled under the guidance of professionals from the centers for disease control and prevention (CDC). Throat swab samples from cases and their close contacts were collected for the detection of influenza virus, adenovirus and MP nucleic acids. ResultsA total of 28 cases were found in this outbreak, all of them were students from the same class, and the incidence rate of the students in the class was 68.29%, with an incidence rate of 66.67% (12/18) in male students and 69.57% (16/23) in female students. The main clinical manifestations were cough (26 cases, 92.86%) and fever (21 cases, 75.00%), with a median fever day of 5 days. A total of 20 cases (71.43%) had pneumonia, 13 cases (46.43%) were hospitalized, with a median hospitalization day of 5 days. There were no severe and fatal cases. The epidemic lasted for 42 days, and the cases were mainly concentrated between November 6 and November 20, with a total of 22 cases (78.57%). The investigation of infection factors showed that wearing a mask in public places with dense population out of school was a protective factor for MP infection (OR=0.27, 95%CI: 0.08‒0.94, P=0.040), and picky eating was a risk factor for MP infection (OR=8.60, 95%CI: 1.30‒56.75, P=0.036). Based on the comprehensive epidemiological history, clinical symptoms, and laboratory results of the cases, it is determined that the epidemic is a clustered outbreak of MP infection, with a high possibility of intra-class transmission caused by the first case of hospital infection. ConclusionThe incubation period of MP infection is long, the infectivity is strong, the illness is prolonged, and the mild hidden infection rate are relatively high. It is suggested that the inclusion criteria for suspected cases should be lowered to improve the sensitivity of surveillance during the epidemic management. Class suspension criteria should be made based on the length of the incubation period and the extent of the outbreak, and which should be at least longer than the average incubation period (2 weeks).
4.A preliminary exploration of reduced port laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF)
Wei PENG ; Qiankun SHAO ; Xinyu LIANG ; Shangcheng YAN ; Qiang CHEN ; Rui REN ; Mengchao SHENG ; Wenting XU ; Yuan TIAN ; Yongyou WU
Chinese Journal of Gastrointestinal Surgery 2024;27(10):1069-1074
Objective:This study aimed to share preliminary experiences of single-incision plus two ports laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF).Methods:Following the 6th edition of the Japanese Gastric Cancer Treatment Guidelines, proximal gastrectomy with lymphadenectomy was performed. Using a single-port approach, the esophagus was transected at least 2 cm above the tumor's upper margin with linear staplers. The stomach was then extracted through a periumbilical incision, and the proximal stomach was subsequently transected extracorporeally, while ensuring appropriate resection margins on both the greater and lesser curvatures. A single flap was created before returning the remnant stomach to the abdominal cavity and re-establishing pneumoperitoneum. The No.2 clip was used to grasp and elevate the esophageal stump. An incision was made at the right lower edge of the esophageal stump to guarantee that the esophageal lumen was open. The linear stapler was then inserted into the openings of the stomach and esophagus to perform a side overlap anastomosis with a length of 3 cm. Another barbed suture was used to close the common opening of the esophagus and the stomach, and the same barbed suture were used to suture the gastric wall to the lower edge of the muscle flap. The first barbed suture was then used to sequentially suture the proximal brim of the flap to the esophagus and the right brim of the flap to the right brim of the mucosal window. After completion of anastomosis, a drainage tube was inserted through the right upper port. This procedure was employed from November 2023 to March 2024 on five patients diagnosed with adenocarcinoma of the esophagogastric junction and upper stomach. The cohort consisted of three males and two females, with an age range of 62 to 75 years and a body mass index (BMI) of 13.7 to 24.2 kg/m2. All cases were preoperatively staged as T1-2N0M0, confirmed by endoscopic biopsy and enhanced CT scans of the chest, abdomen, and pelvis.Results:All five patients successfully underwent the surgery. The median surgery time was 180-325 minutes, with the intraoperative blood loss of 30-50 ml. The number of lymph nodes harvested ranged from 18 to 27. The time to first flatus, and restore liquid diet and was 2.0-5.0 and 1.0-3.0 days, respectively. The postoperative length of stay was 9.0-11.0 days. The pain scores on the Numeric Rating Scale (NRS). On the first day, the pain scores were 3.0 in two cases, 2.0 in two cases, and 1.0 in one case. On the second day, the pain scores were 2.0 in two cases and 1.0 in three cases. On the third day, the pain scores were 1.0 in four cases and 2.0 in one case. No short-term postoperative complications were observed, and there were no perioperative deaths.Conclusion:Single-incision plus two ports laparoscopic proximal gastrectomy with ROSF is safe and feasible.
5.Advances on pentraxin 3 in osteoporosis and fracture healing.
Jia-Jun LU ; Yan SUN ; Xuan ZHANG ; Qiao-Qi WANG ; Zhou-Yi XIANG ; Yi-Qing LING ; Pei-Jian TONG ; Tao-Tao XU
China Journal of Orthopaedics and Traumatology 2023;36(4):393-398
Pentaxin 3 (PTX3), as a multifunctional glycoprotein, plays an important role in regulating inflammatory response, promoting tissue repair, inducing ectopic calcification and maintaining bone homeostasis. The effect of PTX3 on bone mineral density (BMD) may be affected by many factors. In PTX3 knockout mice and osteoporosis (OP) patients, the deletion of PTX3 will lead to decrease of BMD. In Korean community "Dong-gu study", it was found that plasma PTX3 was negatively correlated with BMD of femoral neck in male elderly patients. In terms of bone related cells, PTX3 plays an important role in maintaining the phenotype and function of osteoblasts (OB) in OP state;for osteoclast (OC), PTX3 in inflammatory state could stimulate nuclear factor κ receptor activator of nuclear factor-κB ligand (RANKL) production and its combination with TNF-stimulated gene 6(TSG-6) could improve activity of osteoclasts and promote bone resorption;for mesenchymal stem cells (MSCs), PTX3 could promote osteogenic differentiation of MSCs through PI3K/Akt signaling pathway. In recent years, the role of PTX3 as a new bone metabolism regulator in OP and fracture healing has been gradually concerned by scholars. In OP patients, PTX3 regulates bone mass mainly by promoting bone regeneration. In the process of fracture healing, PTX3 promotes fracture healing by coordinating bone regeneration and bone resorption to maintain bone homeostasis. In view of the above biological characteristics, PTX3 is expected to become a new target for the diagnosis and treatment of OP and other age-related bone diseases and fracture healing.
Animals
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Male
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Mice
;
Bone Resorption/metabolism*
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Cell Differentiation
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Fracture Healing/genetics*
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Osteoblasts
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Osteoclasts
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Osteogenesis
;
Osteoporosis/genetics*
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Phosphatidylinositol 3-Kinases/pharmacology*
6.Gender differences in the prevalence and impact factors of hysterical tendencies in adolescents from three eastern Chinese provinces.
Qinglin CHENG ; Li XIE ; Yunkai HU ; Jinfeng HU ; Wei GAO ; Yongxiang LV ; Yong XU
Environmental Health and Preventive Medicine 2018;23(1):5-5
BACKGROUND:
Few studies have attempted to compare the differences in the prevalence and impact factors of hysterical tendencies (HTs) in adolescents. Thus, the aim of this study was to examine gender differences in the prevalence and impact factors of adolescents' HTs across three eastern Chinese provinces (Anhui, Jiangsu, and Zhejiang).
METHODS:
A multicenter, school-based, cross-sectional study was conducted in three provinces (Anhui, Jiangsu, and Zhejiang) in China in 2014. The sample included 10,131 middle-school students aged 13-18 years who were randomly selected using a multiphase, stratified, cluster sampling technique. A two-stage appraisal procedure was used to determine the adolescents' HTs. We also designed a multicenter, school-based, case control (1329 cases with 2661 control individuals) study to collect data on the common factors affecting this population using a common protocol and questionnaire.
RESULTS:
An overall positive rate of HTs among adolescents across the three eastern Chinese provinces studied was found at 13.1% (95% confidence interval (CI) 12.5-13.8%), at 14.5% (95% CI 13.3-15.7%) for females, and at 12.2% (95% CI 11.1-13.4%) for males. Gender-stratified, multiple conditional regression analyses revealed that superstitious beliefs pertaining to life, somatotype, teacher-student satisfaction, and family achievement orientation were significantly linked to HTs only in males, while left-behind adolescents, emotional and social adaptation, teacher-student support, family cohesion, and the Hospital Anxiety and Depression Scale - depression scores were significantly associated with female HTs only. The models indicated that of all the independent variables studied, family medical history was the strongest impact factor for both male HTs (adjusted matched odds ratio (amOR) = 2.92, 95% CI = 1.84-4.86) and female HTs (amOR = 2.74, 95% CI = 1.59-4.98).
CONCLUSIONS
HTs are prevalent among adolescents in the three eastern Chinese provinces studied. Gender differences in the prevalence and impact factors of HTs are significant in adolescents, and HTs seem to affect more females than males. Therefore, sex-specific intervention programs against HTs in adolescents should be considered to reduce HT prevalence in adolescents by modifying influential social, school, and family factors.
Adolescent
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Adolescent Behavior
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psychology
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China
;
epidemiology
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Cross-Sectional Studies
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Female
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Histrionic Personality Disorder
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epidemiology
;
psychology
;
Humans
;
Male
;
Prevalence
;
Risk Factors
;
Sex Factors
;
Students
;
psychology

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