1.Effect of Roxadustat and rHuEPO on novel inflammatory immune indices in non-dialysis diabetic nephropathy anemia patients
Zhouxia XIANG ; Dan PENG ; Dongfang ZHAO ; Meng HE ; Shunian GUO ; Shu RONG
Clinical Medicine of China 2025;41(2):127-132
Objective:To investigate the effects of Roxadustat and recombinant human erythropoietin (rHuEPO) on novel inflammatory immune indices in anemic patients with non-dialysis type 2 diabetes mellitus combined with chronic kidney disease (CKD).Methods:A retrospective case-control study was performed in this study. Patients with non-dialysis type 2 diabetes mellitus combined with CKD admitted to Shanghai First People's Hospital from December 2015 to December 2023 were selected. Among those patients, 252 cases were treated with rHuEPO (rHuEPO group) and 103 cases were treated with Roxadustat (Roxadustat group). Both group had a course of treatment over three months. The baseline data and novel inflammatory immunity indices, systemic immuno-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) were compared between the two groups of patients before and after 3 months of treatment.Results:The differences in gender, age, body mass index, systolic blood pressure, diastolic blood pressure, history of cardiovascular and cerebrovascular disease, history of hypertension, estimated glomerular filtration rate, and use of hypoglycemic, antihypertensive, and lipid-lowering medications were not statistically significant when compared between the two groups of patients (all P>0.05). Before treatment, the differences in NLR, PLR, SII, and LMR between the two groups were not statistically significant (all P>0.05); after 3 months of treatment, NLR, PLR, SII, and LMR were lower in both groups than before treatment [rHuEPO group: (2.3±0.8)% vs. (2.8±0.8)%, (83±33)% vs. (160±49)%, (2.3±0.8)% vs. (3.1±0.7)%, (476±227)% vs. (594±243)%, with t values of 9.25, 23. 20, 26.67, and 9.62, respectively, all P<0.001; Roxadustat group: (1.7±0.6)% versus (2.9±1.0)%, (72±30)% versus (162±47)%, (2.0±0.8)% versus (3.1±0.9)%, (408±151)% versus (605±267)%, with t values of 8. 38, 14.27, 8.62, and 5.97, respectively, all P<0.001], and NLR, PLR, and SII were lower in the Roxadustat group than in the rHuEPO group ( t=5.00, P<0.001, t=2.44, P=0.015, t=2.09, P=0.040). Conclusion:In patients with anemia in non-dialysis type 2 diabetes mellitus associated with CKD,Roxadustat had similar ability of reducing the level of novel inflammatory markers compared to rHuEPO.
2.Prediction of Lymphovascular Invasion in cN0 Breast Cancer Based on Multi-Parametric MRI Radiomics Features
Shunian LI ; Yiyan SHANG ; Yaxin GUO ; Jun LIAO ; Yunxia WANG ; Xiaodong LI ; Meiyun WANG ; Hongna TAN
Chinese Journal of Medical Imaging 2025;33(10):1035-1042
Purpose To investigate the value of intratumoral and peritumoral radiomics features based on multi-parametric MRI for preoperative prediction of lymphovascular invasion(LVI)in clinical lymph node-negative(cN0)breast cancer.Materials and Methods This retrospective study included 280 patients with pathologically confirmed breast cancer who underwent preoperative MRI at Henan Provincial People's Hospital from January 2017 to May 2021.Patients were randomly divided into a training cohort and a testing cohort.After Z-score normalization,feature selection was performed using Select K Best and least absolute shrinkage and selection operator regression.Random forest algorithms were used to construct intratumoral,peritumoral,and combined intratumoral-peritumoral radiomics models for LVI prediction.Model performance and clinical utility were evaluated using the area under the receiver operating characteristic curve(AUC),calibration curves and decision curve analysis.Results High Ki-67 expression(≥20%),axillary lymph node metastasis and positive diffusion weighted imaging(DWI)margin sign were more common in the LVI-positive group(χ2=5.959,18.316,20.554,all P<0.05).In the testing cohort,the AUC values of the dynamic contrast-enhanced(DCE)-Intra and DCE-Com models for predicting LVI status were higher than those of the DWI sequence,whereas the AUC value of the DWI-Peri model was higher than that of the DCE sequence.The DWI-DCE-Com model achieved AUCs of 0.836 and 0.818 in the training and testing cohorts,respectively,which surpassed the predictive performance of single-sequence intratumoral-peritumoral radiomics models(DWI-Com,DCE-Com).Decision curve analysis showed that the DWI-DCE-Com model provided greater net clinical benefit across a reasonable range of threshold probabilities.Conclusion Radiomics models based on multiparametric MRI features from intratumoral and peritumoral regions can effectively predict LVI status in cN0 breast cancer,offering valuable support for preoperative individualized treatment decision-making.
3.Prediction of Lymphovascular Invasion in cN0 Breast Cancer Based on Multi-Parametric MRI Radiomics Features
Shunian LI ; Yiyan SHANG ; Yaxin GUO ; Jun LIAO ; Yunxia WANG ; Xiaodong LI ; Meiyun WANG ; Hongna TAN
Chinese Journal of Medical Imaging 2025;33(10):1035-1042
Purpose To investigate the value of intratumoral and peritumoral radiomics features based on multi-parametric MRI for preoperative prediction of lymphovascular invasion(LVI)in clinical lymph node-negative(cN0)breast cancer.Materials and Methods This retrospective study included 280 patients with pathologically confirmed breast cancer who underwent preoperative MRI at Henan Provincial People's Hospital from January 2017 to May 2021.Patients were randomly divided into a training cohort and a testing cohort.After Z-score normalization,feature selection was performed using Select K Best and least absolute shrinkage and selection operator regression.Random forest algorithms were used to construct intratumoral,peritumoral,and combined intratumoral-peritumoral radiomics models for LVI prediction.Model performance and clinical utility were evaluated using the area under the receiver operating characteristic curve(AUC),calibration curves and decision curve analysis.Results High Ki-67 expression(≥20%),axillary lymph node metastasis and positive diffusion weighted imaging(DWI)margin sign were more common in the LVI-positive group(χ2=5.959,18.316,20.554,all P<0.05).In the testing cohort,the AUC values of the dynamic contrast-enhanced(DCE)-Intra and DCE-Com models for predicting LVI status were higher than those of the DWI sequence,whereas the AUC value of the DWI-Peri model was higher than that of the DCE sequence.The DWI-DCE-Com model achieved AUCs of 0.836 and 0.818 in the training and testing cohorts,respectively,which surpassed the predictive performance of single-sequence intratumoral-peritumoral radiomics models(DWI-Com,DCE-Com).Decision curve analysis showed that the DWI-DCE-Com model provided greater net clinical benefit across a reasonable range of threshold probabilities.Conclusion Radiomics models based on multiparametric MRI features from intratumoral and peritumoral regions can effectively predict LVI status in cN0 breast cancer,offering valuable support for preoperative individualized treatment decision-making.
4.Effect of Roxadustat and rHuEPO on novel inflammatory immune indices in non-dialysis diabetic nephropathy anemia patients
Zhouxia XIANG ; Dan PENG ; Dongfang ZHAO ; Meng HE ; Shunian GUO ; Shu RONG
Clinical Medicine of China 2025;41(2):127-132
Objective:To investigate the effects of Roxadustat and recombinant human erythropoietin (rHuEPO) on novel inflammatory immune indices in anemic patients with non-dialysis type 2 diabetes mellitus combined with chronic kidney disease (CKD).Methods:A retrospective case-control study was performed in this study. Patients with non-dialysis type 2 diabetes mellitus combined with CKD admitted to Shanghai First People's Hospital from December 2015 to December 2023 were selected. Among those patients, 252 cases were treated with rHuEPO (rHuEPO group) and 103 cases were treated with Roxadustat (Roxadustat group). Both group had a course of treatment over three months. The baseline data and novel inflammatory immunity indices, systemic immuno-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) were compared between the two groups of patients before and after 3 months of treatment.Results:The differences in gender, age, body mass index, systolic blood pressure, diastolic blood pressure, history of cardiovascular and cerebrovascular disease, history of hypertension, estimated glomerular filtration rate, and use of hypoglycemic, antihypertensive, and lipid-lowering medications were not statistically significant when compared between the two groups of patients (all P>0.05). Before treatment, the differences in NLR, PLR, SII, and LMR between the two groups were not statistically significant (all P>0.05); after 3 months of treatment, NLR, PLR, SII, and LMR were lower in both groups than before treatment [rHuEPO group: (2.3±0.8)% vs. (2.8±0.8)%, (83±33)% vs. (160±49)%, (2.3±0.8)% vs. (3.1±0.7)%, (476±227)% vs. (594±243)%, with t values of 9.25, 23. 20, 26.67, and 9.62, respectively, all P<0.001; Roxadustat group: (1.7±0.6)% versus (2.9±1.0)%, (72±30)% versus (162±47)%, (2.0±0.8)% versus (3.1±0.9)%, (408±151)% versus (605±267)%, with t values of 8. 38, 14.27, 8.62, and 5.97, respectively, all P<0.001], and NLR, PLR, and SII were lower in the Roxadustat group than in the rHuEPO group ( t=5.00, P<0.001, t=2.44, P=0.015, t=2.09, P=0.040). Conclusion:In patients with anemia in non-dialysis type 2 diabetes mellitus associated with CKD,Roxadustat had similar ability of reducing the level of novel inflammatory markers compared to rHuEPO.
5.Epidemiological analysis of pathogens causing bloodstream infections in department of hematology in Guangdong Province
Chuyue ZHUO ; Yingyi GUO ; Ningjing LIU ; Baomo LIU ; Shunian XIAO ; Yi ZHANG ; Xiaochun GUO ; Dongni LI ; Shuangyu TAN ; Nanhao HE ; Ying MAI ; Jing GUAN ; Chao ZHUO
Chinese Journal of Hematology 2020;41(12):996-1001
Objective:To evaluate the epidemiology of bacterial bloodstream infections in patients submitted to hematologic wards in southern China.Methods:A total of 50 teaching hospitals were involved based on the China Antimicrobial Resistance Surveillance System. The data of clinical isolates from blood samples were collected from January 1, 2019, to December 31, 2019. Antimicrobial susceptibility testing was conducted by the Kirby-Bauer automated systems, and the results were interpreted using the CLSI criteria.Results:The data of 1,618 strains isolated from hematologic wards in 2019 were analyzed, of which gram-negative bacilli and gram-positive cocci accounted for 71.8% and 28.2%, respectively. Of those, the five major species were most often isolated, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, coagulase-negative staphylococcus, and Streptococcus viridans. The prevalence rates of methicillin-resistant strains in Staphylococcus aureus and coagulase-negative staphylococcus were 19.7% and 80.6%, respectively. No gram-positive cocci were resistant to vancomycin, linezolid, and teicoplanin, and none of the enterococci were resistant to linezolid. The resistance rate of S. viridans to penicillin G was 6.9%, and those to ceftriaxone and cefotaxime were more than 25%. The resistance rate of E. coli and K. pneumoniae in Enterobacteriaceae was higher in children than that in adults. The resistance rate of K. pneumoniae to meropenem was 14.1%. The resistant rate of Enterobacter cloacae to carbapenem was more than 25%. P. aeruginosa was more sensitive to more antibiotics than 80%, but the resistance rate to meropenem in children was higher than that in adults (11.8% vs. 6.5%). The proportion of gram-positive cocci in the ICU and respiratory departments was higher than that in the hematology department. The detection rates of carbapenem-resistant E. coli and K. pneumoniae in the respiratory department were the lowest with 0.3% and 3.7%, respectively, while those of CRPA and CRAB in the hematology department were the lowest with 8.3% and 25.8%, respectively. The detection rate of all carbapenem-resistant organisms in the ICU was the highest among the three departments.Conclusion:The etiology and drug resistance of bacteria from blood samples in the hematology department are different from those in the ICU and respiratory departments. The proportions of K. pneumoniae, P. aeruginosa, E. cloacae, and S. viridans dominating in the department of Hematology were significantly higher than those in the ICU and respiratory departments in Guangdong region.
6.The clinical effects of Banxia Xiexin Decoction cured by gastric syndromes
Lili ZHU ; Xiaofeng ZHAO ; Hai GUO ; Shunian LI
The Journal of Practical Medicine 2015;(9):1546-1547
Objective To study the clinical effect of BanxiaXiexinDecoction on gastric symdrome. Methods 82 patients withgastric syndrome hospitalized in our hospital from April 2012 to April 2014 were randomized evenly into the control group and the observation group In the control group , the patients were treated with thebasic treatment using Western medicine while the observation group was treated with BanxiaXiexin decoction based on the basic treatment. Then , the two group were compared in terms curative effects. Results The total effective rate in the observation group was significantly higher than that of the control group (92.68%vs. 70.73%, P < 0.05), while the rate of complications in the treatment group was significantly lower than that in the control group (12.20 vs. 29.27%, P < 0.05). Conclusion Western medicine plus BanxiaXiexin Decoctionis effective in the treatment of gastric syndrome. It may be fast at improving the symptoms and good at preventing the relapse of disease.

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