1.Mechanical thrombectomy vs.catheter-directed thrombolysis for acute inferior vena cava thrombosis:a prospective randomized trial
Lin MA ; Xuan TIAN ; Han ZHENG ; Jianlong LIU ; Yuedi YIN ; Lingyan WANG ; Jinyong LI ; Xiao LIU ; Mi ZHOU ; Run HUA
Chinese Journal of General Surgery 2025;34(6):1178-1187
Background and Aims:Acute inferior vena cava thrombosis(IVCT)commonly occurs secondary to inferior vena cava filter(VCF)implantation.If not promptly treated,it may lead to serious complications such as bilateral lower limb swelling and pulmonary embolism and can also reduce the likelihood of successful filter retrieval.Percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)are currently the main interventional treatments for IVCT,but comparative studies evaluating their efficacy and safety remain limited.This study was to conduct a prospective randomized controlled trial to compare the clinical efficacy and safety of AngioJet mechanical thrombectomy versus conventional CDT in the treatment of acute IVCT and to explore factors influencing filter retrieval rates,thereby providing evidence-based guidance for clinical decision-making.Methods:From January 2022 to December 2024,patients diagnosed with acute IVCT following VCF implantation were prospectively enrolled at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University.Patients were randomly assigned to either the CDT group(n=46)or the PMT group(n=48)according to the interventional procedure used.The two groups were compared in terms of filter retrieval rates,thrombus clearance outcomes,operative time,thrombolytic drug dosage,and incidence of complications.Logistic regression analysis was used to identify factors associated with primary filter retrieval.Results:A total of 94 patients were enrolled,with 46 in the CDT group and 48 in the PMT group.Compared to the CDT group,the PMT group demonstrated a significantly higher primary filter retrieval rate(77.1%vs.43.5%),grade Ⅲ thrombus clearance rate(70.8%vs.37.0%),and better postoperative thrombus scores.Additionally,the PMT group required lower urokinase doses and shorter thrombolysis duration(all P<0.05).The overall filter retrieval rate and 3-month IVC patency were similar between groups,both exceeding 93%.Regarding safety,the CDT group had a higher incidence of catheter-related infections and medical adhesive-related skin injury,while vagal reflex symptoms were more frequent in the PMT group.Logistic regression analysis identified thrombus clearance rate as an independent factor significantly associated with primary filter retrieval in the PMT group(OR=190.773,P<0.05).Conclusion:Compared to CDT,AngioJet mechanical thrombectomy combined with manual aspiration achieves higher thrombus clearance and primary filter retrieval rates in the treatment of acute IVCT while also reducing thrombolysis duration and drug dosage.However,attention should be paid to the increased risk of vagal reflex symptoms.There was no significant difference between the two groups in secondary filter retrieval rates or long-term IVC patency.The choice of intervention should be based on the patient's condition,timing of filter retrieval,and individualized clinical considerations.
2.Mechanical thrombectomy vs.catheter-directed thrombolysis for acute inferior vena cava thrombosis:a prospective randomized trial
Lin MA ; Xuan TIAN ; Han ZHENG ; Jianlong LIU ; Yuedi YIN ; Lingyan WANG ; Jinyong LI ; Xiao LIU ; Mi ZHOU ; Run HUA
Chinese Journal of General Surgery 2025;34(6):1178-1187
Background and Aims:Acute inferior vena cava thrombosis(IVCT)commonly occurs secondary to inferior vena cava filter(VCF)implantation.If not promptly treated,it may lead to serious complications such as bilateral lower limb swelling and pulmonary embolism and can also reduce the likelihood of successful filter retrieval.Percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)are currently the main interventional treatments for IVCT,but comparative studies evaluating their efficacy and safety remain limited.This study was to conduct a prospective randomized controlled trial to compare the clinical efficacy and safety of AngioJet mechanical thrombectomy versus conventional CDT in the treatment of acute IVCT and to explore factors influencing filter retrieval rates,thereby providing evidence-based guidance for clinical decision-making.Methods:From January 2022 to December 2024,patients diagnosed with acute IVCT following VCF implantation were prospectively enrolled at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University.Patients were randomly assigned to either the CDT group(n=46)or the PMT group(n=48)according to the interventional procedure used.The two groups were compared in terms of filter retrieval rates,thrombus clearance outcomes,operative time,thrombolytic drug dosage,and incidence of complications.Logistic regression analysis was used to identify factors associated with primary filter retrieval.Results:A total of 94 patients were enrolled,with 46 in the CDT group and 48 in the PMT group.Compared to the CDT group,the PMT group demonstrated a significantly higher primary filter retrieval rate(77.1%vs.43.5%),grade Ⅲ thrombus clearance rate(70.8%vs.37.0%),and better postoperative thrombus scores.Additionally,the PMT group required lower urokinase doses and shorter thrombolysis duration(all P<0.05).The overall filter retrieval rate and 3-month IVC patency were similar between groups,both exceeding 93%.Regarding safety,the CDT group had a higher incidence of catheter-related infections and medical adhesive-related skin injury,while vagal reflex symptoms were more frequent in the PMT group.Logistic regression analysis identified thrombus clearance rate as an independent factor significantly associated with primary filter retrieval in the PMT group(OR=190.773,P<0.05).Conclusion:Compared to CDT,AngioJet mechanical thrombectomy combined with manual aspiration achieves higher thrombus clearance and primary filter retrieval rates in the treatment of acute IVCT while also reducing thrombolysis duration and drug dosage.However,attention should be paid to the increased risk of vagal reflex symptoms.There was no significant difference between the two groups in secondary filter retrieval rates or long-term IVC patency.The choice of intervention should be based on the patient's condition,timing of filter retrieval,and individualized clinical considerations.
3.Mediating role of social belonging in the association between depression and fertility quality of life in infertile women
Xiaohuan SONG ; Guiying LUO ; Jieyu WANG ; Fei JIANG ; Yuedi JIA ; Mengli ZHU ; Danni WANG
Chinese Journal of Reproduction and Contraception 2024;44(3):291-295
Objective:To explore the relationship among depression, social belonging and fertility quality of life of infertile women, and to provide a theoretical basis for the development of effective measures to improve the quality of life of infertile women.Methods:From July 2022 to October 2022, a random sample of 400 patients treated for infertility in the Reproductive Assisting Centre of the First Hospital of Anhui Medical University were selected using a general basic questionnaire, the Depression Screening Self-Rating Scale (PHQ-9), the Social Attribution Measurement Questionnaire and the Fertility Quality of Life Scale quality of life questionnaire (FertiQoL) were administered. Spearman correlation was used to analyze the association between the variables, and mediating effects were examined by Bootstrap procedure and PROCESS software.Results:The 400 infertile women had a median depression score of 5, reaching a subclinical mild level of depression, a median score of 12 on the social belonging measure, and a median score of 62.87 on the FertiQoL. Social belonging was negatively correlated with depression ( r=-0.206, P<0.001); social belonging was positively correlated with FertiQoL ( r=0.267, P<0.001); and depression was negatively correlated with FertiQoL ( r=-0.428, P<0.001). Mediation analysis showed that after controlling for relevant variables, the indirect effect of depression on FertiQoL in infertile women was -0.069 0 (95% CI: -0.173 3--0.008 3), and the direct effect was -1.019 1 (95% CI: -1.436 3- -0.601 8), the mediating effect of FertiQoL through social belonging on depression in infertile women accounted for 6.34% of the total effect. Conclusion:Social belonging plays a partial mediating role in depression and FertiQoL among infertile women. Infertile women should be given timely attention to their psychological situation and given more social recognition and support to improve their FertiQoL.
4.Identification of Osteoarthritis Inflamm-Aging Biomarkers by Integrating Bioinformatic Analysis and Machine Learning Strategies and the Clinical Validation
Qiao ZHOU ; Jian LIU ; Yan ZHU ; Yuan WANG ; Guizhen WANG ; Yajun QI ; Yuedi HU
Journal of Sichuan University (Medical Sciences) 2024;55(2):279-289
Objective To identify inflamm-aging related biomarkers in osteoarthritis(OA).Methods Microarray gene profiles of young and aging OA patients were obtained from the Gene Expression Omnibus(GEO)database and aging-related genes(ARGs)were obtained from the Human Aging Genome Resource(HAGR)database.The differentially expressed genes of young OA and older OA patients were screened and then intersected with ARGs to obtain the aging-related genes of OA.Enrichment analysis was performed to reveal the potential mechanisms of aging-related markers in OA.Three machine learning methods were used to identify core senescence markers of OA and the receiver operating characteristic(ROC)curve was used to assess their diagnostic performance.Peripheral blood mononuclear cells were collected from clinical OA patients to verify the expression of senescence-associated secretory phenotype(SASP)factors and senescence markers.Results A total of 45 senescence-related markers were obtained,which were mainly involved in the regulation of cellular senescence,the cell cycle,inflammatory response,etc.Through the screening with the three machine learning methods,5 core senescence biomarkers,including FOXO3,MCL1,SIRT3,STAG1,and S100A13,were obtained.A total of 20 cases of normal controls and 40 cases of OA patients,including 20 cases in the young patient group and 20 in the elderly patient group,were enrolled.Compared with those of the young patient group,C-reactive protein(CRP),interleukin(IL)-6,and IL-1β levels increased and IL-4 levels decreased in the elderly OA patient group(P<0.01);FOXO3,MCL1,and SIRT3 mRNA expression decreased and STAG1 and S100A13 mRNA expression increased(P<0.01).Pearson correlation analysis demonstrated that the selected markers were associated with some indicators,including erythrocyte sedimentation rate(ESR),IL-1β,IL-4,CRP,and IL-6.The area under the ROC curve of the 5 core aging genes was always greater than 0.8 and the C-index of the calibration curve in the nomogram prediction model was 0.755,which suggested the good calibration ability of the model.Conclusion FOXO3,MCL1,SIRT3,STAG1,and S100A13 may serve as novel diagnostic biomolecular markers and potential therapeutic targets for OA inflamm-aging.
5.Mediating role of social belonging in the association between depression and fertility quality of life in infertile women
Xiaohuan SONG ; Guiying LUO ; Jieyu WANG ; Fei JIANG ; Yuedi JIA ; Mengli ZHU ; Danni WANG
Chinese Journal of Reproduction and Contraception 2024;44(3):291-295
Objective:To explore the relationship among depression, social belonging and fertility quality of life of infertile women, and to provide a theoretical basis for the development of effective measures to improve the quality of life of infertile women.Methods:From July 2022 to October 2022, a random sample of 400 patients treated for infertility in the Reproductive Assisting Centre of the First Hospital of Anhui Medical University were selected using a general basic questionnaire, the Depression Screening Self-Rating Scale (PHQ-9), the Social Attribution Measurement Questionnaire and the Fertility Quality of Life Scale quality of life questionnaire (FertiQoL) were administered. Spearman correlation was used to analyze the association between the variables, and mediating effects were examined by Bootstrap procedure and PROCESS software.Results:The 400 infertile women had a median depression score of 5, reaching a subclinical mild level of depression, a median score of 12 on the social belonging measure, and a median score of 62.87 on the FertiQoL. Social belonging was negatively correlated with depression ( r=-0.206, P<0.001); social belonging was positively correlated with FertiQoL ( r=0.267, P<0.001); and depression was negatively correlated with FertiQoL ( r=-0.428, P<0.001). Mediation analysis showed that after controlling for relevant variables, the indirect effect of depression on FertiQoL in infertile women was -0.069 0 (95% CI: -0.173 3--0.008 3), and the direct effect was -1.019 1 (95% CI: -1.436 3- -0.601 8), the mediating effect of FertiQoL through social belonging on depression in infertile women accounted for 6.34% of the total effect. Conclusion:Social belonging plays a partial mediating role in depression and FertiQoL among infertile women. Infertile women should be given timely attention to their psychological situation and given more social recognition and support to improve their FertiQoL.
6.Physicochemical properties, molecular structure, antioxidant activity, and biological function of extracellular melanin from Ascosphaera apis.
Zhi LI ; Hui HENG ; Qiqian QIN ; Lanchun CHEN ; Yuedi WANG ; Zeyang ZHOU
Journal of Zhejiang University. Science. B 2022;23(5):365-381
Ascosphaera apis spores containing a dark-colored pigment infect honeybee larvae, resulting in a large-scale collapse of the bee colony due to chalkbrood disease. However, little is known about the pigment or whether it plays a role in bee infection caused by A. apis. In this study, the pigment was isolated by alkali extraction, acid hydrolysis, and repeated precipitation. Ultraviolet (UV) analysis revealed that the pigment had a color value of 273, a maximum absorption peak at 195 nm, and a high alkaline solubility (7.67%) and acid precipitability. Further chemical structure analysis of the pigment, including elemental composition, Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy, mass spectrometry, and nuclear magnetic resonance (NMR), proved that it was a eumelanin with a typical indole structure. The molecular formula of melanin is C10H6O4N2, and its molecular weight is 409 Da. Melanin has hydroxyl, carboxyl, amino, and phenolic groups that can potentially chelate to metal ions. Antioxidant function analyses showed that A. apis melanin had a high scavenging activity against superoxide, hydroxyl, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals, and a high reducing ability to Fe3+. Indirect immunofluorescence assay (IFA), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) analyses showed that A. apis melanin was located on the spore wall. The spore wall localization, antioxidant activity, and metal ion chelating properties of fungal melanin have been suggested to contribute to spore pathogenicity. However, further infection experiments showed that melanin-deficient spores did not reduce the mortality of bee larvae, indicating that melanin does not increase the virulence of A. apis spores. This study is the first report on melanin produced by A. apis, providing an important background reference for further study on its role in A. apis.
Animals
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Antioxidants/pharmacology*
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Larva
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Melanins
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Molecular Structure
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Onygenales
7.BiTE-T:Anovel gene-editing T cell for solid tumor therapy
WANG Yuedi ; LUO Feifei ; CHU Yiwei
Chinese Journal of Cancer Biotherapy 2019;26(7):725-729
Gene-engineered T cells, represented by chimeric antigen receptor T cells (CAR-T cells), have achieved great success in hematological tumors, and gradually been applied in the clinical treatment of tumors. In 2017, two CD19-CAR products for hematological tumors were consecutively approved for marketing in America, and have shown powerful anti-tumor efficacy in non-solid tumor treatment. However, CAR-T cell therapy didn’t achieve expectant therapeutic efficacy in solid tumors due to complicated tumor microenvironment and restriction of surface tumor antigen. In addition, the cytotoxicity caused by off-target effects is more troublesome. To address these hurdles, more and more researchers have begun to explore new gene-edited T cells for solid tumor treatment, among which bispecific T cell engager T cell (BiTE T) has shown high anti-tumor efficacy in vitro evaluation and in vivo animal models and thus has attracted great attention. This review mainly discusses the current difficulties confronted by solid tumor treatment and the principles, characteristics and advantages of BiTE-T cell preparation.

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