1.Exploration of the mechanism of cognitive impairment induced by ketamine in mice based on metabolomics
Tingting LUO ; Xiaoxiao YAO ; Xinyi ZHAN ; Yiru MA ; Ting GAO ; Ying WEI
China Pharmacy 2025;36(12):1436-1441
OBJECTIVE To explore the potential mechanism of ketamine-induced cognitive impairment in mice based on metabolomics. METHODS Male C57BL/6 mice were randomly divided into control group and ketamine group (25 mg/kg), with 12 mice in each group. Each group of mice was intraperitoneally injected with normal saline or corresponding drugs, 4 times a day, for 10 consecutive days. On the last 2 days of drug administration, the cognitive behavior was evaluated by Y maze and novel object recognition test, and the histopathological changes in the prefrontal cortex (PFC) were observed. Ultra-high performance liquid chromatography-tandem mass spectrometry technology was used to analyze the changes of metabolites in PFC, screen for differential metabolites, and perform pathway enrichment analysis. RESULTS Compared with the control group, the morphology of PFC neurons in the ketamine group of mice was inconsistent. There were cavities around the nucleus, and the number of deeply stained cells increased. The mean optical density value of the Nissl staining positive area was significantly reduced, and the alternation rate and discrimination index were significantly reduced (P<0.05 or P<0.01). In the PFC tissue samples of mice of the two groups, there were a total of 114 differential metabolites, including 73 up-regulated and 41 down-regulated metabolites, including glutamine, succinic acid, ketoglutarate, and choline, etc. The differential metabolites mentioned above were mainly enriched in metabolism of alanine, aspartate and glutamate, metabolism of arginine and proline, γ aminobutyric acid synapses, pyrimidine metabolism, cholinergic synapses pathways, etc. CONCLUSIONS Ketamine can induce cognitive impairment in mice. Its neurotoxicity is related to abnormal synaptic transmission and energy metabolism, and neuroimmune regulation disorders.
2.Current status of book publishing in the field of biological weapons defense in China
Xuechun WANG ; Jiajun DU ; Xixiaoxue ZHANG ; Ting KAN ; Wenjun WU ; Yu MA ; Shanshan YANG ; Shengshu WANG ; Yao HE ; Miao LIU
Shanghai Journal of Preventive Medicine 2024;36(7):673-678
ObjectiveTo provide scientific support for the compilation of high-quality anti-nuclear, biological, and chemical (NBC) medical textbooks in China by retrieving books in the field of biological weapons defense in China, summarizing the publication time and distribution of publishing institutions, and categorizing content and key points of related books. MethodsRelevant subject terms in the field of biological weapons defense were searched through the official website of China National Digital Library and other websites, up until December 31, 2023, and were limited to books. Topic analysis was conducted on the introductions and contents of the books using the latent Dirichlet allocation (LDA) model. The number of topics was determined based on perplexity, and topics were identified according to the intertopic distance map, followed by a qualitative description of the core content of each topic. ResultsA total of 104 books were included in this study, among which four were identified as higher educational textbooks. The volume of publications increased during the periods 2002‒2004 and 2020‒2023. Research institutions accounted for the highest percentage of publishers (37.78%), and 56.67% of the publishers were military institutions. The study identified six topics: "distribution, defense, and response to biological weapons", "category, diagnosis, and treatment of biological warfare agents", "response to biological public health emergencies", "status of nuclear, biological, and chemical weapons internationally", "biosafety risk management and prevention and control", and "technologies and equipment related to biological hazard identification". ConclusionThere are few books in the field of biological weapons defense in China and the content is relatively outdated. In the future, the preparation of teaching materials should be aimed at practical emergency handling techniques for biological weapons, enhance the emphasis on biological weapons detection and biological warfare early warning, improve the fundamental theories at different training levels, and timely update the current research status in the field.
3.Influencing factors of immune-related thyroid dysfunction and overall survival in cancer patients treated with PD-1/PD-L1 inhibitors
Fengping LEI ; Juanchuan YAO ; Ting MA ; Haichen LI ; Wei CUI
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(6):967-974
[Objective] To investigate the influencing factors of immune-related thyroid dysfunction (irTD) treated with programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors and their impact on overall survival (OS) of cancer. [Methods] We enrolled 211 cancer patients treated with PD-1/PD-L1 inhibitors. Clinical differences between irTD groups were compared, and subgroup analysis was performed. Multifactor Logistic regression analysis was used to identify influencing factors of irTD, while survival analysis was used to explore the relationship between the occurrence of irTD and OS, and the log-rank test was used for comparison between groups. The multi-model COX regression analysis was used to evaluate the impact of irTD on OS. [Results] The incidence rate of irTD was 26.1%, with 13.3%, 10.0% and 2.8%, respectively for grade 1, grade 2, and grades 3-4, and the median time of occurrence was at week 9 (IQR: 5-25 weeks). Significant differences were observed between the irTD and non-irTD groups in terms of gender, smoking history, targeted therapy history, and baseline thyroid antibody status (P<0.05). In irTD patients, thyroglobulin antibody (TGAb) levels began to increase from week 3, remained above the baseline from week 6 to week 30, and then gradually declined to the baseline level after week 30. The change in thyroid microsomal antibody (TMAb) levels was less pronounced than that of TGAb. Subgroup analysis showed that patients with hyperthyroidism were younger at the time of initial immunotherapy than those with hypothyroidism (P<0.05) and had lower baseline TSH levels (P<0.05). Multifactor Logistic regression analysis revealed that patients with positive baseline thyroid antibodies had a 4.595-fold higher risk of developing irTD compared to those with negative antibodies (95% CI: 2.286-9.239, P<0.001). Survival analysis revealed that patients with irTD had a longer OS and the multi-model COX regression analysis revealed that after adjusting for factors such as age, gender, chemotherapy, tumor type and tumor metastasis status, patients with irTD had a significantly longer OS (HR=0.228, 95% CI: 0.079-0.656, P=0.006). [Conclusion] The severity of irTD was predominantly grades 1-2, with grades 3-4 being rare. Positive baseline thyroid antibodies were an independent risk factor for the development of irTD. Patients who develop irTD have a longer OS, which may be due to their stronger immune response.
4.Construction and validation of a risk prediction model for postoperative delirium in primary liver cancer patients aged 60 years or older
Yao MA ; Ting LI ; Qiushi ZHANG ; Ling HU ; Jie ZHENG
Journal of Clinical Hepatology 2024;40(9):1816-1821
Objective To construct a risk prediction model for postoperative delirium in elderly patients with primary liver cancer,and to validate its application value.Methods A retrospective analysis was performed for 175 elderly patients with primary liver cancer who were admitted to Tianyou Hospital Affiliated to Wuhan University of Science and Technology from March 2020 to January 2023.The incidence rate of postoperative delirium was recorded,and the univariate and multivariate regression analyses was performed for factors that may affect the onset of delirium.A prediction model was constructed,and the clinical application value of the prediction model was analyzed and validated.The independent-samples t test was used for comparison of continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups.The univariate and multivariate logistic regression analyses were performed for factors that may affect the onset of delirium in elderly patients with primary liver cancer,and the receiver operating characteristic(ROC)curve was used to investigate the value of the model in predicting the onset of delirium.Results Among the 175 elderly patients with primary liver cancer,41 experienced postoperative delirium,with an incidence rate of 23.43%.The univariate analysis showed that age,presence of more than two underlying diseases,Child-Pugh class of liver function,preoperative blood lactate,time of operation,preoperative hemoglobin,and preoperative serum albumin were associated with the onset of postoperative delirium(t=3.534,χ2=12.000,χ2=4.938,t=7.561,t=5.768,t=5.141,t=6.148,P<0.05).The multivariate logistic regression analysis of the factors with statistical significance in the univariate analysis showed that time of operation,preoperative hemoglobin,preoperative serum albumin,and age were included in the regression model(P<0.05),and they were independent risk factors for the onset of postoperative delirium in elderly patients with primary liver cancer.According to the results of the multivariate logistic regression analysis,a prediction model for postoperative delirium in elderly patients with primary liver cancer was constructed as follows:-2.222+3.678×time of operation-2.441×preoperative hemoglobin-3.904×preoperative serum albumin+1.807×age.The prediction performance of this model was analyzed,with an area under the ROC curve of 0.931(95%confidence interval:0.890-0.971,P<0.001)and an optimal cut-off value of-1.604(with a sensitivity of 87.80%and a specificity of 87.30%).A total of 56 elderly patients with primary liver cancer who underwent radical surgery in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from February 2023 to June 2023 were enrolled in a prospective study for model validation.According to the above risk prediction model,there were 14 patients in the high-risk group and 42 patients in the low-risk group,and the high-risk group had a significantly higher incidence rate of postoperative delirium than the low-risk group(71.43%vs 11.90%,χ2=16.056,P<0.05).Conclusion Age,time of operation,preoperative serum albumin,and preoperative hemoglobin are important influencing factors for the onset of postoperative delirium in elderly patients with primary liver cancer.The risk prediction model based on these factors has a good prediction performance,which holds promise for further in-depth research.
5.Current status of diagnosis and treatment of chronic lymphocytic leukemia in China: A national multicenter survey research.
Wei XU ; Shu Hua YI ; Ru FENG ; Xin WANG ; Jie JIN ; Jian Qing MI ; Kai Yang DING ; Wei YANG ; Ting NIU ; Shao Yuan WANG ; Ke Shu ZHOU ; Hong Ling PENG ; Liang HUANG ; Li Hong LIU ; Jun MA ; Jun LUO ; Li Ping SU ; Ou BAI ; Lin LIU ; Fei LI ; Peng Cheng HE ; Yun ZENG ; Da GAO ; Ming JIANG ; Ji Shi WANG ; Hong Xia YAO ; Lu Gui QIU ; Jian Yong LI
Chinese Journal of Hematology 2023;44(5):380-387
Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female
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Humans
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Male
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Aged
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Middle Aged
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Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy*
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Prognosis
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Lymphoma, B-Cell
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Immunohistochemistry
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Immunoglobulin Heavy Chains/therapeutic use*
6.CHESS endoscopic ruler in objective measurement of diameter of esophageal varices in liver cirrhosis and portal hypertension: a prospective multicenter study
Shengjuan HU ; Jianping HU ; Shaoqi YANG ; Xiaoguo LI ; Yanhong DENG ; Ruichun SHI ; Xiaoqin LI ; Hailong QI ; Qian SHEN ; Fang HE ; Jun ZHU ; Bin MA ; Xiaobing YU ; Jianyang GUO ; Yuehua YU ; Haijiang YONG ; Wentun YAO ; Ting YE ; Hua WANG ; Wenfu DONG ; Jianguo LIU ; Qiang WEI ; Jing TIAN ; Haoxiang HE ; Changhui HE ; Yifei HUANG ; Yang BU ; Xiaolong QI
Chinese Journal of Digestion 2023;43(3):193-198
Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.
7.In vitro study of dendritic cell derived exosomes transporting hepatitis D antigen induced specific cytotoxic T lymphocyte response
Ting YAO ; Mengjiao LYU ; Jinmei CHEN ; Yi ZHANG ; Siyuan MA ; Yongsheng YU ; Guoqing ZANG ; Xiaohua CHEN
Chinese Journal of Infectious Diseases 2022;40(4):234-240
Objective:To explore the effect and mechanism of dendritic cell derived exosomes (Dexs) loading ubiquitinated (Ub) hepatitis D antigen (HDAg) on activating specific cytotoxic T lymphocytes (CTL).Methods:Ub-S-HDAg-Dexs were co-cultured with dendritic cells (DC) which were from the femora of C57BL/6 mice for 48 h, then flow cytometry was used to detect the maturity of DC (CD86, CD80 and major histocompatibility complex (MHC) Ⅱ). The spleen-derived T lymphocytes from C57BL/6 mice were added in vitro to activate DC and co-cultivated for 72 h. The T cells were divided into Ub-S-HDAg-Dexs group (add 50 μg/mL Ub-S-HDAg-Dexs), Blank-Dexs group (add 50 μg/mL DC derived exosomes without plasmid transfection), Con-Dexs group (add 50 μg/mL DC derived exosomes transfected by cantrol plasmid), PBS group (add 50 μL/mL phosphate buffered saline), and Ub-S-HDAg-Dexs+ AG490 group (add 50 μg/mL Ub-S-HDAg-Dexs, DC and T lymphocytes stimulated by exosomes, and 50 μmol/L AG490 was also added to the cell mix). Flow cytometry was used to detect CD8 + T cells secreting interferon-gamma, non-radioactive lactate dehydrogenase release test to detect the killing activity of specific CTL. Real-time quantitative polymerase chain reaction (PCR) and Western blotting were used to detect the mRNA and protein expressions of JAK kinase (JAK) 2, GATA-binding protein 3 (GATA3), T-bet, signal transduction and activator of transcription (STAT) 1 and STAT4. Independent sample t test were used for statistical analysis. Results:The positive rates of the surface molecules CD80, CD86, MHCⅡof DC stimulated by Ub-S-HDAg-Dexs were 83.850%±0.219%、68.910%±0.134%、84.320%±0.445%, respectively.In the Ub-S-HDAg-Dexs group, the rate of CD8 + T cells secreting interferon-gamma was 6.420%±0.028%, which was higher than those of other groups, including PBS group, Blank-Dexs group, Con-Dexs group and Ub-S-HDAg-Dexs+ AG490 group ( t=90.78, 30.32, 63.06 and 85.42, respectively, all P<0.001). The cytotoxicity of T cells in the Ub-S-HDAg-Dexs group was 82.4%±3.9%, which was higher than those of other groups ( t=17.28, 9.74, 3.95 and 15.89, respectively, all P<0.050). The relative mRNA expressions of JAK2, T-bet, STAT1, STAT4 in Ub-S-HDAg-Dexs group were higher than those in other groups, including Con-Dexs group ( t=10.74, 32.34, 13.00 and 16.28, respectively, all P<0.001), Blank-Dexs group ( t=15.05, 21.51, 6.46 and 13.12, respectively, all P<0.050), PBS group ( t=21.83, 41.42, 7.30 and 17.50, respectively, all P<0.050), Ub-S-HDAg-Dexs+ AG490 group ( t=35.75, 20.69, 17.02 and 17.07, respectively, all P<0.001), and the differences were all statistically significant. The protein expressions of T-bet, STAT1, STAT4 in Ub-S-HDAg-Dexs group increased compared with those in PBS group ( t=346.70, 57.54 and 55.81, respectively, all P<0.001), with statistical significance. In the presence of AG490, the protein expressions of T-bet, STAT1 and STAT4 decreased compared with those in Ub-S-HDAg-Dexs group, and the differences were statistically significant ( t=355.40, 52.79 and 126.10, respectively, all P<0.001). Conclusions:Ubiquitinated HDAg transported by exosomes could effectively promote DC maturation, induce T lymphocyte differentiation, and generate specific CTL responses, which provides a new idea for the treatment of hepatitis D.
8.Efficacy and Mechanism of Yishen Shengjing Prescription in Treatment of Oligoasthenospermia
Yu-jie HU ; Yan-tong XU ; Jian GAO ; Cong CHEN ; Jia-lin LI ; Cai ZHANG ; Quan-tao MA ; Xiao-yao LIU ; Wei-ling WANG ; Ting WANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(11):93-101
ObjectiveWe aimed to investigate the efficacy and mechanism of Yishen Shengjing Prescription (YSP) in the treatment of oligoasthenospermia in rats. MethodThe oligoasthenospermia rat model was established by injection with cyclophosphamide (35 mg·kg-1·d-1) for 5 consecutive days. Rats were randomly assigned into control group (without treating with cyclophosphamide), model group, low- (YSP-L), medium- (YSP-M), and high- (YSP-H) dose (2.91, 5.83, and 11.66 g·kg-1, respectively) groups, Wuzi Yanzongwan (WYW, 1.03 g·kg-1) group, and L-carnitine (0.17 g·kg-1) group, with 8 rats in each group. After 28 days of drug intervention, the body weight, testicular weight, and testicular index of rats were recorded. The sperm quality in epididymis was detected by computer-assisted sperm analysis (CASA) system. Hematoxylin-eosin (HE) staining was employed for observation of testicular tissue morphology. The levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in testicular tissue were detected by colorimetry. The levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) in serum were determined by enzyme-linked immunosorbent assay(ELISA). TdT-mediated dUTP nick-end labeling (TUNEL) was employed to detect the apoptosis of testicular cells. The protein levels of B cell lymphoma-2(Bcl-2), Bax, and cleaved Caspase-3 in testicular tissue were detected by Western blot. ResultCompared with the control group, the model group showed decreased body weight, testicular weight and index, sperm concentration and motility (P<0.01) and increased testicular pathological score (P<0.01). Compared with the model group, the YSP-M, YSP-H, WYW, and L-carnitine groups showed increased body weight, testicular weight, testicular index, sperm concentration and motility and decreased testicular pathological score. After modeling, the SOD level decreased (P<0.01) while the MDA content increased (P<0.01) in the testicular tissue. YSP-H, WYW, and L-carnitine reversed the SOD and MDA level changes caused by modeling. Compared with the control group, the model group exhibited declined T level (P<0.01) and increased FSH and LH levels (P<0.01). Compared with the model group, YSP, WYW, and L-carnitine increased the T level (P<0.01) and decreased the LH level (P<0.05, P<0.01). The apoptosis rate of spermatogenic cells in the model group was higher than that in the control group (P<0.01), whereas YSP-M, WYW, and L-carnitine reversed such changes (P<0.01). The model group rats showed decreased expression of Bcl-2(P<0.05) and increased expression of Bax and cleaved Caspase-3 (P<0.05, P<0.01). Compared the model group, YSP-M, YSP-H, WYW, and L-carnitine up-regulated the Bcl-2 expression and down-regulated the cleaved Caspase-3 expression (P<0.05, P<0.01). ConclusionYSP improved the sperm quality of oligoasthenospermia model rats by regulating the antioxidant system and sex hormone levels and inhibiting the apoptosis of spermatogenic cells.
9.Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China.
Ran ZHANG ; Ting Li DONG ; Wen Li LIANG ; Zhao Bing CAO ; Zhen XIE ; Kang Mai LIU ; Fei YU ; Geng Feng FU ; Yu Qi ZHANG ; Guo Yong WANG ; Qiao Qin MA ; Shao Bin WU ; Yan LI ; Wei DONG ; Zhen JIANG ; Jie XU ; Zun You WU ; Jun YAO ; Pin Liang PAN ; Mao Feng QIU
Chinese Journal of Epidemiology 2022;43(4):523-527
Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.
China/epidemiology*
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Cities
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Drug Resistance
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Drug Resistance, Viral/genetics*
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Female
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Genotype
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HIV Infections/epidemiology*
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HIV Seropositivity/drug therapy*
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HIV-1/genetics*
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Homosexuality, Male
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Humans
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Male
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Phylogeny
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Reverse Transcriptase Inhibitors/therapeutic use*
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Sexual and Gender Minorities
10.Evaluation on measurement uncertainty of correction factors of fluconazole impurities determined by HPLC standard curve method
Ting XIAO ; Bufang MA ; Chen WANG ; Shangchen YAO ; Yanchun FENG ; Baoming NING
Journal of China Pharmaceutical University 2022;53(3):306-313
In this paper, the uncertainties of correction factors of fluconazole impurities determined by HPLC standard curve method were evaluated, and the main common factors affecting the accuracy of standard curve method were found, so as to improve the accuracy of the method.In this study, the corresponding fitting lines of fluconazole and its impurities A, B, C, D, F and I were established respectively, and the ratio of the slope of fitting lines of each impurity and its corresponding principal component was calculated as the correction factor of the impurity.Then on the basis of GUM method, the uncertainty of each impurity correction factor determined by standard curve method was evaluated according to the established uncertainty evaluation scheme of correction factor determination process.The correction factor and uncertainty of fluconazole impurities A, B, C, D, F and I were 1.068 ± 0.046, 0.102 ± 0.005, 0.0582 ± 0.0031, 1.382 ± 0.121, 0.802 ± 0.067 and 1.383 ± 0.119, respectively, and the coverage factor k was 2.Finally, the contribution rate of each uncertainty component was calculated.In the relative combined standard uncertainties urel(f) of fluconazole impurities A, B, C, D, F and I correction factors, the sum of contribution rate of slope uncertainty urel(K) of the linear equation of principal component and its impurity is more than 85%; in the slope uncertainties urel(K) of linear equation, the contribution rates of uncertainties of solution concentration in 8 of 12 data groups are more than 80%, and the contribution rates of uncertainties introduced by reference substance content in solution concentration are about 80%.It can be seen that the preparation of linear solution concentration is the most influential factor in the determination of impurity correction factor by standard curve method, followed by the linear fitting process.In the preparation process of linear solution concentration, the purity of reference substance is the most influential factor, followed by weighing and pipetting times.The conclusion can help the experimenters to better formulate experimental plans and ensure the accuracy of the results when doing similar work.

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