1.Data Spaces in Medicine and Health: Technologies, Applications, and Challenges.
Wan-Fei HU ; Si-Zhu WU ; Qing QIAN
Chinese Medical Sciences Journal 2025;40(1):18-28
Data space, as an innovative data management and sharing model, is emerging in the medical and health sectors. This study expounds on the conceptual connotation of data space and delineates its key technologies, including distributed data storage, standardization and interoperability of data sharing, data security and privacy protection, data analysis and mining, and data space assessment. By analyzing the real-world cases of data spaces within medicine and health, this study compares the similarities and differences across various dimensions such as purpose, architecture, data interoperability, and privacy protection. Meanwhile, data spaces in these fields are challenged by the limited computing resources, the complexities of data integration, and the need for optimized algorithms. Additionally, legal and ethical issues such as unclear data ownership, undefined usage rights, risks associated with privacy protection need to be addressed. The study notes organizational and management difficulties, calling for enhancements in governance framework, data sharing mechanisms, and value assessment systems. In the future, technological innovation, sound regulations, and optimized management will help the development of the medical and health data space. These developments will enable the secure and efficient utilization of data, propelling the medical industry into an era characterized by precision, intelligence, and personalization.
Humans
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Computer Security
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Information Dissemination
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Data Management
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Information Storage and Retrieval
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Data Mining
2.Complications among patients undergoing orthopedic surgery after infection with the SARS-CoV-2 Omicron strain and a preliminary nomogram for predicting patient outcomes.
Liang ZHANG ; Wen-Long GOU ; Ke-Yu LUO ; Jun ZHU ; Yi-Bo GAN ; Xiang YIN ; Jun-Gang PU ; Huai-Jian JIN ; Xian-Qing ZHANG ; Wan-Fei WU ; Zi-Ming WANG ; Yao-Yao LIU ; Yang LI ; Peng LIU
Chinese Journal of Traumatology 2025;28(6):445-453
PURPOSE:
The rate of complications among patients undergoing surgery has increased due to infection with SARS-CoV-2 and other variants of concern. However, Omicron has shown decreased pathogenicity, raising questions about the risk of postoperative complications among patients who are infected with this variant. This study aimed to investigate complications and related factors among patients with recent Omicron infection prior to undergoing orthopedic surgery.
METHODS:
A historical control study was conducted. Data were collected from all patients who underwent surgery during 2 distinct periods: (1) between Dec 12, 2022 and Jan 31, 2023 (COVID-19 positive group), (2) between Dec 12, 2021 and Jan 31, 2022 (COVID-19 negative control group). The patients were at least 18 years old. Patients who received conservative treatment after admission or had high-risk diseases or special circumstances (use of anticoagulants before surgery) were excluded from the study. The study outcomes were the total complication rate and related factors. Binary logistic regression analysis was used to identify related factors, and odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the impact of COVID-19 infection on complications.
RESULTS:
In the analysis, a total of 847 patients who underwent surgery were included, with 275 of these patients testing positive for COVID-19 and 572 testing negative. The COVID-19-positive group had a significantly higher rate of total complications (11.27%) than the control group (4.90%, p < 0.001). After adjusting for relevant factors, the OR was 3.08 (95% CI: 1.45-6.53). Patients who were diagnosed with COVID-19 at 3-4 weeks (OR = 0.20 (95% CI: 0.06-0.59), p = 0.005), 5-6 weeks (OR = 0.16 (95% CI: 0.04-0.59), p = 0.010), or ≥7 weeks (OR = 0.26 (95% CI: 0.06-1.02), p = 0.069) prior to surgery had a lower risk of complications than those who were diagnosed at 0-2 weeks prior to surgery. Seven factors (age, indications for surgery, time of operation, time of COVID-19 diagnosis prior to surgery, C-reactive protein levels, alanine transaminase levels, and aspartate aminotransferase levels) were found to be associated with complications; thus, these factors were used to create a nomogram.
CONCLUSION
Omicron continues to be a significant factor in the incidence of postoperative complications among patients undergoing orthopedic surgery. By identifying the factors associated with these complications, we can determine the optimal surgical timing, provide more accurate prognostic information, and offer appropriate consultation for orthopedic surgery patients who have been infected with Omicron.
Humans
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COVID-19/complications*
;
Male
;
Female
;
Middle Aged
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Postoperative Complications/epidemiology*
;
SARS-CoV-2
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Orthopedic Procedures/adverse effects*
;
Aged
;
Nomograms
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Adult
;
Retrospective Studies
;
Risk Factors
3.Hippocampal Extracellular Matrix Protein Laminin β1 Regulates Neuropathic Pain and Pain-Related Cognitive Impairment.
Ying-Chun LI ; Pei-Yang LIU ; Hai-Tao LI ; Shuai WANG ; Yun-Xin SHI ; Zhen-Zhen LI ; Wen-Guang CHU ; Xia LI ; Wan-Neng LIU ; Xing-Xing ZHENG ; Fei WANG ; Wen-Juan HAN ; Jie ZHANG ; Sheng-Xi WU ; Rou-Gang XIE ; Ceng LUO
Neuroscience Bulletin 2025;41(12):2127-2147
Patients suffering from nerve injury often experience exacerbated pain responses and complain of memory deficits. The dorsal hippocampus (dHPC), a well-defined region responsible for learning and memory, displays maladaptive plasticity upon injury, which is assumed to underlie pain hypersensitivity and cognitive deficits. However, much attention has thus far been paid to intracellular mechanisms of plasticity rather than extracellular alterations that might trigger and facilitate intracellular changes. Emerging evidence has shown that nerve injury alters the microarchitecture of the extracellular matrix (ECM) and decreases ECM rigidity in the dHPC. Despite this, it remains elusive which element of the ECM in the dHPC is affected and how it contributes to neuropathic pain and comorbid cognitive deficits. Laminin, a key element of the ECM, consists of α-, β-, and γ-chains and has been implicated in several pathophysiological processes. Here, we showed that peripheral nerve injury downregulates laminin β1 (LAMB1) in the dHPC. Silencing of hippocampal LAMB1 exacerbates pain sensitivity and induces cognitive dysfunction. Further mechanistic analysis revealed that loss of hippocampal LAMB1 causes dysregulated Src/NR2A signaling cascades via interaction with integrin β1, leading to decreased Ca2+ levels in pyramidal neurons, which in turn orchestrates structural and functional plasticity and eventually results in exaggerated pain responses and cognitive deficits. In this study, we shed new light on the functional capability of hippocampal ECM LAMB1 in the modulation of neuropathic pain and comorbid cognitive deficits, and reveal a mechanism that conveys extracellular alterations to intracellular plasticity. Moreover, we identified hippocampal LAMB1/integrin β1 signaling as a potential therapeutic target for the treatment of neuropathic pain and related memory loss.
Animals
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Laminin/genetics*
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Hippocampus/metabolism*
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Neuralgia/metabolism*
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Cognitive Dysfunction/etiology*
;
Male
;
Peripheral Nerve Injuries/metabolism*
;
Extracellular Matrix/metabolism*
;
Integrin beta1/metabolism*
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Pyramidal Cells/metabolism*
;
Signal Transduction
4.Analysis of risk factors for early failure of simple taper retentive implants.
Xu ZHANG ; Zengxuan WAN ; Shibo WEI ; Fei YU ; Ning CAO ; Liangwei CAO ; Hao WU ; Shuigen GUO ; Hongwu WEI
West China Journal of Stomatology 2025;43(6):780-788
OBJECTIVES:
To explore the related risk factors of early failure of simple taper retentive implants, and to provide theoretical guidance for clinical work.
METHODS:
Collect cases of patients who visited the Department of Stomatology of the Fourth Affiliated Hospital of Nanchang University from January 2021 to June 2024, received simple taper retentive implants, and had complete medical records. Taking the implants as the unit, analyze the influence of patient-related factors (gender, age, smoking history, hypertension history, diabetes history), implant-related factors (implant length, implant diameter, implant surface treatment), and surgical-related factors (implant site, implant timing, simultaneous maxillary sinus floor elevation, simultaneous bone augmentation) on the early failure of implants. Univariate analysis and multivariate analysis were adopted to explore the potential risk factors for early failure of simple taper retentive implants.
RESULTS:
A total of 3,533 simple taper retentive from 1,681 patients were included during the study period. Among them, 53 implants from 49 patients experienced early failure, with an early failure rate of 2.9% at the patient le-vel and 1.5% at the implant level. Multivariate analysis revealed that smoking (OR=2.148, P=0.021), the anterior mandibular region (OR=3.669, P=0.006), and the posterior maxillary region (OR=2.191, P=0.033) were risk factors for early failure of simple taper retentive implants. In the univariate analysis, simultaneous maxillary sinus floor elevation had a higher risk of early failure, but this effects was no longer significant in the multivariate analysis (P>0.05).
CONCLUSIONS
Smoking, the anterior mandibular region, and the posterior maxillary region are risk factors for the early failure of simple taper retentive implants, and could be comprehensively considered in the preoperative treatment plan.
Humans
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Risk Factors
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Male
;
Female
;
Middle Aged
;
Dental Implants
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Adult
;
Smoking/adverse effects*
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Dental Restoration Failure
;
Aged
5. MW-9, a chalcones derivative bearing heterocyclic moieties, ameliorates ulcerative colitis via regulating MAPK signaling pathway
Zhao WU ; Nan-Ting ZOU ; Chun-Fei ZHANG ; Hao-Hong ZHANG ; Qing-Yan MO ; Ze-Wei MAO ; Chun-Ping WAN ; Ming-Qian JU ; Chun-Ping WAN ; Xing-Cai XU
Chinese Pharmacological Bulletin 2024;40(3):514-520
Aim To investigate the therapeutic effect of the MW-9 on ulcerative colitis(UC)and reveal the underlying mechanism, so as to provide a scientific guidance for the MW-9 treatment of UC. Methods The model of lipopolysaccharide(LPS)-stimulated RAW264.7 macrophage cells was established. The effect of MW-9 on RAW264.7 cells viability was detected by MTT assay. The levels of nitric oxide(NO)in RAW264.7 macrophages were measured by Griess assay. Cell supernatants and serum levels of inflammatory cytokines containing IL-6, TNF-α and IL-1β were determined by ELISA kits. Dextran sulfate sodium(DSS)-induced UC model in mice was established and body weight of mice in each group was measured. The histopathological damage degree of colonic tissue was assessed by HE staining. The protein expression of p-p38, p-ERK1/2 and p-JNK was detected by Western blot. Results MW-9 intervention significantly inhibited NO release in RAW264.7 macrophages with IC50 of 20.47 mg·L-1 and decreased the overproduction of inflammatory factors IL-6, IL-1β and TNF-α(P<0.05). MW-9 had no cytotoxicity at the concentrations below 6 mg·L-1. After MW-9 treatment, mouse body weight was gradually reduced, and the serum IL-6, IL-1β and TNF-α levels were significantly down-regulated. Compared with the model group, MW-9 significantly decreased the expression of p-p38 and p-ERK1/2 protein. Conclusions MW-9 has significant anti-inflammatory activities both in vitro and in vivo, and its underlying mechanism for the treatment of UC may be associated with the inhibition of MAPK signaling pathway.
6.Wnt-mediated HDAC5 Regulation during Endothelial Differentiation of iPS Cells
Qi-Kai TANG ; Yu-Qing WANG ; Fei-Yu ZHANG ; Hao-Peng WU ; Wan-Yi ZHANG ; Tao LI
Chinese Journal of Biochemistry and Molecular Biology 2024;40(6):838-847
HDAC(histone deacetylase)is a class of epigenetic modifying enzymes that can deacetylate proteins by altering the acetylation status of histones in the nucleus,regulating promoter activation levels,and thereby affecting downstream gene expression.However,expression changes of HDACs during endo-thelial differentiation are still unclear.This study used a three-stage method to induce human induced pluripotent stem cells(hiPSCs)to differentiate into endothelial cells,and qRT-PCR was used to detect the expression changes of class I HDAC(HDAC1,2)and class Ⅱ HDAC(HDAC4,5)genes.It was found that HDAC5 exhibits significant expression changes during endothelial differentiation.It is downreg-ulated by 90%during the mesodermal differentiation stage(P<0.01),upregulated by 3.7-fold during the vascular precursor stage(P<0.01),and subsequently downregulated by 70%during the late stage of endothelial differentiation(P<0.01).Immunoblotting experiments further confirmed that HDAC5 under-goes periodic expression changes during endothelial differentiation.Mechanistic studies have shown that HDAC5 downregulation during the differentiation stage of the mesoderm is mediated by Wnt signaling.CHIR99021 treatment and overexpression of Wnt3a can activate the Wnt signaling pathway,leading to HDAC5 downregulation.Inhibiting the Wnt signaling pathway through IWP-2 promotes the recovery of HDAC5 expression.In addition,it was found that HDAC5 is mainly localized in the nucleus,and IWP-2 restores HDAC5 expression,but it remains in the cytoplasm.Further research suggests that downregu-lation of HDAC5 during mesodermal differentiation may contribute to the expression of the mesodermal marker BraT.Treatment with the HDAC inhibitor BML210 can promote early mesodermal differentiation,interfere with endothelial differentiation of vascular precursor cells,and enhance late-stage endothelial differentiation.In conclusion,HDAC5 displays a stage-specific expression during endothelial differentia-tion,and Wnt signaling activation is the main mechanism regulating the downregulation of HDAC5 during the mesoderm stage.
7.Mechanism of Kechuanting granules in suppressing IL-33/ILC2s and pathogenic T cells to intervene in allergic airway inflammation
Nan-Ting ZOU ; Zhao WU ; Xiao-Dong YAN ; Chun-Fei ZHANG ; Hao-Hong ZHANG ; Qing-Yan MO ; Ming-Qian JU ; Jin-Zhu XU ; Chun-Ping WAN
Chinese Pharmacological Bulletin 2024;40(7):1350-1357
Aim To investigate the mechanisms of Ke-chuanting granules(KCT)inhibiting the IL-33/ILC2s pathway and pathogenic T cells to intervene in allergic airway inflammation.Methods Network pharmacolo-gy was utilized to analyze the potential targets and mechanisms of KCT-treated asthma.Allergic asthma models were induced in mice using OVA.Lung histo-pathology was conducted to observe injury changes.ELISA and quantitative PCR were utilized to measure key inflammatory factors and their mRNA expression levels in Th2-type asthma.Western blot was used to detect the phosphorylation levels of relevant proteins in the MAPK pathway.Flow cytometry was performed to evaluate the proportions of ILC2s,Th1,Th 17,Th2 and Treg cells.Results Network pharmacology iden-tified 227 main active components and 143 key targets of KCT in treating asthma,primarily enriched in signa-ling pathways such as MAPK and IL-17.Further vali-dation experiments demonstrated that KCT significantly alleviated lung inflammatory injury in asthmatic mice,reduced the number of B cells,production of I L-4,TNF-α and TGF-β,downregulated JNK phosphoryla-tion levels in lung tissue,as well as mRNA levels of Il-33,Bcl11b,Rorα,Tcf-7,Jun,Mapk3 and Mapk14.KCT intervention reduced the numbers of ILC2s and Th 17 cells in lungs and spleens of mice,and inhibited Th2 cell infiltration in lungs.Conclusions KCT ex-hibits therapeutic effects on allergic airway inflamma-tion in asthma,closely associated with the inhibition of the IL-33/ILC2s pathway,pathogenic T cell subsets,and JNK-MAPK signaling pathway.
8.Application of single-port thoracoscopic surgery for non-small cell lung cancer in the elderly
Zhi-Qiang WU ; Yong-Qiang WEI ; Hong-Li WAN ; Xiao-Fei ZENG ; Hong WANG ; Xian-Bo WANG
Journal of Regional Anatomy and Operative Surgery 2024;33(12):1089-1092
Objective To investigate the clinical efficacy and safety of single-port thoracoscopic surgery for elderly patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 93 patients with NSCLC who underwent thoracoscopic lobectomy or segmentectomy was collected,the patients were divided into uniportal operation group(40 cases,received single-port thoracoscopic surgery)and single-operation port operation group(53 cases,received single-operation port thoracoscopic surgery)according to the operation methods.The operation time,the amount of blood loss,the number of lymph node dissection,chest drainage volume 3 days after surgery,duration of indwelling drainage tube,postoperative hospital stay,visual analogue scale(VAS)score of postoperative pain,and incidence of postoperative complications of patients between the two groups were compared.The cumulative survival rate between the two groups was compared.Results The operation were successfully completed in both groups.There was no statistically significant difference in terms of operation time,the amount of blood loss,the number of lymph node dissection,chest drainage volume 3 days after surgery,duration of indwelling drainage tube,or postoperative hospital stay of patients between the two groups(P>0.05).There was significant difference in VAS score of postoperative pain of patients between the two groups(P<0.05).There was no early death within 1 months after surgery in both groups.There was no significant difference in the incidence of complications between the two groups(P>0.05).After 4 to 30 months of follow-up,there was no significant difference in the cumulative survival rate between the two groups(P>0.05).Conclusion Single-port thoracoscopic lobectomy or segmentectomy for elderly patients with NSCLC has high safety and feasibility,with less trauma,faster recovery and less postoperative pain.
9.Application practice of 6S management of delicate instruments in central supply sterilization depart-ment
Wei WAN ; Fei WU ; Huangquan JIANG ; Dongxia RAO
Modern Hospital 2024;24(9):1373-1376,1380
Objective Analysis of the application effect after using 6S management of delicate instruments in Central Supply Sterilization Department.Methods 6S management's preliminary stage from December 2022 to December 2023,then created a departmental 6S management team and organized a mobilization meeting.Formulated specific implementation steps for 6S management,accepted on-site inspection of 6S management quality by the nursing department and self inspection of Central Supply Sterilization Department quarterly,compared the qualification rate of all instruments packaging and sterille goods supply quarterly,and the timely supply rate of emergency reprocessing instruments,the difference before and after 6S management was statistically significant(P<0.05).Results The on-site inspection of 6S management quality by the nursing department found that the"seiton"in the first quarter,the"safety"of manual cleaning of employees in the second quarter,the"seiso"in the third quarter,the"safety"of on-site interview in the fourth quarter,and the quality of 6S management in the auxiliary area were quali-fied were unqualified.The qualification rate of all instruments packaging were higher than before using 6S management in the first,second,third,fourth quarters(P<0.05),and the qualification rate of sterille goods supply were higher than before using 6S management in the first,second,fourth quarters(P<0.05),and the timely supply rate of emergency reprocessing instru-ments were higher than before using 6S management in the second,third,fourth quarters(P<0.05).Conclusion 6S manage-ment can improved the key link quality and identified various problems of delicate instrument management in Central Supply Steri-lization Department,among which seiri,seiton,seiso,seiketsu is the focus of daily management.
10.Observation on the therapeutic effect of mostly angular bone resection,first carpometacarpal joint arthroplasty combined with ligament reconstruction and tendon tamponade in the treatment of first carpometacarpal joint osteoarthritis
Ao WANG ; Fei WU ; Feng LIU ; Yue YANG ; Longbiao WAN ; Wei CHEN
Journal of Clinical Surgery 2024;32(10):1078-1081
Objective To evaluate the effectiveness of treatment for osteoarthritis of the first carpometacarpal joint.Methods From June 2019 to June 2022,15 patients with osteoarthritis of the first carpometacarpal joint underwent a combined procedure of trapezium excision,first carpometacarpal joint arthroplasty,ligament reconstruction,and tendon interposition.Surgical efficacy was assessed using X-rays,thumb joint range of motion,grip strength,pinch strength,and pain rating(VAS).Results 9 months postoperative follow-up revealed significant pain reduction,increased thumb range of motion,enhanced grip and pinch strength,with an overall surgical excellence rate of 86.7%.Conclusion Trapeziecotomy arthroplasty with ligament reconstruction and tendon tamponade demonstrates significant efficacy in treating osteoarthritis of the first carpometacarpal joint,effectively alleviating pain,improving thumb mobility,and enhancing hand strength.The method is simple and effective.

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