1.Impact of Antibody Immune Response and Immune Cells on Osteoporosis and Fractures
Kangkang OU ; Jiarui CHEN ; Jichong ZHU ; Weiming TAN ; Cheng WEI ; Guiyu LI ; Yingying QIN ; Chong LIU
Clinics in Orthopedic Surgery 2025;17(3):530-545
Background:
The immune system plays a critical role in the development and progression of osteoporosis and fractures. However, the causal relationships between antibody immune responses, immune cells, and these bone conditions remain unclear. This study aimed to explore these relationships using Mendelian randomization (MR) analysis.
Methods:
We collected complete blood count data from patients with fractures and healthy individuals and analyzed their differences. Then, we conducted a 2-sample, 2-step MR analysis to investigate the causal effects of antibody immune responses on osteoporosis and fractures, using inverse-variance weighted (IVW) as the primary method. We also explored whether immune cells mediate the pathway between antibodies and osteoporosis or fractures. Finally, we analyzed the functions and expression levels of key genes involved.
Results:
Overall, the fracture group exhibited increased white blood cell count, absolute neutrophil count, absolute monocyte count, platelet count, and their respective proportions, while absolute lymphocyte count, absolute eosinophil count, absolute basophil count, red blood cell count, and their proportions were decreased. We identified 44 causal relationships between antibodies and osteoporosis or fractures, with 7 supported by multiple MR methods, and 5 showing odds ratios significantly deviating from 1 in the IVW analysis. Epstein-Barr virus-related antibodies had a notable impact on osteoporosis and fractures. The human leukocyte antigen (HLA) gene family, particularly HLA-DPB1, emerged as a significant risk factor. However, immune cells were not found to mediate these effects.
Conclusions
This study elucidated the causal relationships between antibody immune responses, immune cells, and osteoporosis or fractures. The HLA gene family plays a crucial role in the interaction between antibodies and these bone conditions, with HLA-DPB1 identified as a key risk gene. Immune cells do not serve as mediators in this process. These findings provide valuable insights for future research.
2.Impact of Antibody Immune Response and Immune Cells on Osteoporosis and Fractures
Kangkang OU ; Jiarui CHEN ; Jichong ZHU ; Weiming TAN ; Cheng WEI ; Guiyu LI ; Yingying QIN ; Chong LIU
Clinics in Orthopedic Surgery 2025;17(3):530-545
Background:
The immune system plays a critical role in the development and progression of osteoporosis and fractures. However, the causal relationships between antibody immune responses, immune cells, and these bone conditions remain unclear. This study aimed to explore these relationships using Mendelian randomization (MR) analysis.
Methods:
We collected complete blood count data from patients with fractures and healthy individuals and analyzed their differences. Then, we conducted a 2-sample, 2-step MR analysis to investigate the causal effects of antibody immune responses on osteoporosis and fractures, using inverse-variance weighted (IVW) as the primary method. We also explored whether immune cells mediate the pathway between antibodies and osteoporosis or fractures. Finally, we analyzed the functions and expression levels of key genes involved.
Results:
Overall, the fracture group exhibited increased white blood cell count, absolute neutrophil count, absolute monocyte count, platelet count, and their respective proportions, while absolute lymphocyte count, absolute eosinophil count, absolute basophil count, red blood cell count, and their proportions were decreased. We identified 44 causal relationships between antibodies and osteoporosis or fractures, with 7 supported by multiple MR methods, and 5 showing odds ratios significantly deviating from 1 in the IVW analysis. Epstein-Barr virus-related antibodies had a notable impact on osteoporosis and fractures. The human leukocyte antigen (HLA) gene family, particularly HLA-DPB1, emerged as a significant risk factor. However, immune cells were not found to mediate these effects.
Conclusions
This study elucidated the causal relationships between antibody immune responses, immune cells, and osteoporosis or fractures. The HLA gene family plays a crucial role in the interaction between antibodies and these bone conditions, with HLA-DPB1 identified as a key risk gene. Immune cells do not serve as mediators in this process. These findings provide valuable insights for future research.
3.Impact of Antibody Immune Response and Immune Cells on Osteoporosis and Fractures
Kangkang OU ; Jiarui CHEN ; Jichong ZHU ; Weiming TAN ; Cheng WEI ; Guiyu LI ; Yingying QIN ; Chong LIU
Clinics in Orthopedic Surgery 2025;17(3):530-545
Background:
The immune system plays a critical role in the development and progression of osteoporosis and fractures. However, the causal relationships between antibody immune responses, immune cells, and these bone conditions remain unclear. This study aimed to explore these relationships using Mendelian randomization (MR) analysis.
Methods:
We collected complete blood count data from patients with fractures and healthy individuals and analyzed their differences. Then, we conducted a 2-sample, 2-step MR analysis to investigate the causal effects of antibody immune responses on osteoporosis and fractures, using inverse-variance weighted (IVW) as the primary method. We also explored whether immune cells mediate the pathway between antibodies and osteoporosis or fractures. Finally, we analyzed the functions and expression levels of key genes involved.
Results:
Overall, the fracture group exhibited increased white blood cell count, absolute neutrophil count, absolute monocyte count, platelet count, and their respective proportions, while absolute lymphocyte count, absolute eosinophil count, absolute basophil count, red blood cell count, and their proportions were decreased. We identified 44 causal relationships between antibodies and osteoporosis or fractures, with 7 supported by multiple MR methods, and 5 showing odds ratios significantly deviating from 1 in the IVW analysis. Epstein-Barr virus-related antibodies had a notable impact on osteoporosis and fractures. The human leukocyte antigen (HLA) gene family, particularly HLA-DPB1, emerged as a significant risk factor. However, immune cells were not found to mediate these effects.
Conclusions
This study elucidated the causal relationships between antibody immune responses, immune cells, and osteoporosis or fractures. The HLA gene family plays a crucial role in the interaction between antibodies and these bone conditions, with HLA-DPB1 identified as a key risk gene. Immune cells do not serve as mediators in this process. These findings provide valuable insights for future research.
4.Impact of Antibody Immune Response and Immune Cells on Osteoporosis and Fractures
Kangkang OU ; Jiarui CHEN ; Jichong ZHU ; Weiming TAN ; Cheng WEI ; Guiyu LI ; Yingying QIN ; Chong LIU
Clinics in Orthopedic Surgery 2025;17(3):530-545
Background:
The immune system plays a critical role in the development and progression of osteoporosis and fractures. However, the causal relationships between antibody immune responses, immune cells, and these bone conditions remain unclear. This study aimed to explore these relationships using Mendelian randomization (MR) analysis.
Methods:
We collected complete blood count data from patients with fractures and healthy individuals and analyzed their differences. Then, we conducted a 2-sample, 2-step MR analysis to investigate the causal effects of antibody immune responses on osteoporosis and fractures, using inverse-variance weighted (IVW) as the primary method. We also explored whether immune cells mediate the pathway between antibodies and osteoporosis or fractures. Finally, we analyzed the functions and expression levels of key genes involved.
Results:
Overall, the fracture group exhibited increased white blood cell count, absolute neutrophil count, absolute monocyte count, platelet count, and their respective proportions, while absolute lymphocyte count, absolute eosinophil count, absolute basophil count, red blood cell count, and their proportions were decreased. We identified 44 causal relationships between antibodies and osteoporosis or fractures, with 7 supported by multiple MR methods, and 5 showing odds ratios significantly deviating from 1 in the IVW analysis. Epstein-Barr virus-related antibodies had a notable impact on osteoporosis and fractures. The human leukocyte antigen (HLA) gene family, particularly HLA-DPB1, emerged as a significant risk factor. However, immune cells were not found to mediate these effects.
Conclusions
This study elucidated the causal relationships between antibody immune responses, immune cells, and osteoporosis or fractures. The HLA gene family plays a crucial role in the interaction between antibodies and these bone conditions, with HLA-DPB1 identified as a key risk gene. Immune cells do not serve as mediators in this process. These findings provide valuable insights for future research.
5.Extension and Application Strategy of Four Examinations of Traditional Chinese Medicine in Chronic Kidney Disease
Zhengxin LIU ; Qin SONG ; Yining HE ; Xiaofan YIN ; Tianyang QIAN ; Weiming HE
Journal of Traditional Chinese Medicine 2025;66(13):1327-1332
Traditional four examinations of traditional Chinese medicine (TCM) are based on the symptoms and signs of patients, which are the advantages of TCM but also have shortcomings. Chronic kidney disease has the characteristics of insidiousness, long-term, deficiency and variability during its onset, which are difficult to be intervened in time based on only symptoms, therefore it is necessary to extend the application of the four examinations in the diagnosis and treatment process of chronic kidney disease. Based on the background of the continuous development of TCM syndrome differentiation techniques, this article proposed the extension and application strategies of the traditional four examinations in chronic kidney disease, including the incorporation of microscopic syndrome differentiation to identify the causes of kidney disease and prevent symptom deterioration; the utilization of accurate examination information enhanced by artificial intelligence for controlling development of existing disease; the integration of disease differentiation and syndrome differentiation to summarize clinical rules towards using constant to measure variation; and the establishment of a kidney disease database for the storage of four examinations information to prevent recurrence after recovery. The four above extension and application strategies can be used to achieve the long-term management and treatment effects of timely and early diagnosis, dynamic observation of the condition, accurate application of intervention, and strengthened prognosis assessment in the diagnosis and treatment of chronic kidney disease, and expand the advantages of TCM in the prevention and treatment of chronic kidney disease.
6.Impact of Wenyang lishui formula on ventricular remodeling in rats with pulmonary hypertension-induced right heart failure
Sijian FENG ; Yan HUANG ; Aimin XING ; Mei YUAN ; Yafang LIU ; Weiming WANG
China Pharmacy 2025;36(20):2531-2536
OBJECTIVE To discuss the impact of Wenyang lishui formula on ventricular remodeling in rats with pulmonary hypertension-induced right heart failure (RHF) based on the Hippo/Yes-associated protein (YAP) signaling pathway. METHODS Ten rats were randomly selected as the control group. The remaining 63 rats were given a single intraperitoneal injection of monocrotaline to establish the pulmonary hypertension-induced RHF model. The 50 rats that successfully underwent the model establishment were randomly divided into the RHF group, low-dose group of Wenyang lishui formula (4.25 g/kg), high-dose group of the Wenyang lishui formula (17.00 g/kg), furosemide group (20 mg/kg), and high-dose group of Wenyang lishui formula+ Hippo/YAP signaling pathway activator group (17.00 g/kg of Δ Wenyang lishui formula+16 mg/kg of PY-60), with 10 rats in each group. The rats in each group were given the corresponding drug solution or normal saline by gavage or/andtail vein injection, once a day, for 4 consecutive weeks. During the experiment, the general conditions of the rats in each group were observed; after the last administration, the right ventricular diameter, right atrial diameter, end-diastolic volume, pulmonary artery blood flow acceleration time (PAAT) and its ratio to ejection time (ET) (PAAT/ET), pulmonary artery pressure and its ratio to pulmonary arterial flow velocity (pulmonary artery pressure/velocity) were measured. The plasma levels of brain natriuretic peptide and angiotensin Ⅱ (Ang Ⅱ) were detected. The pathological changes of the right ventricular tissue were observed, and the collagen volume fraction, the phosphorylation levels of the large tumor suppressor 1/2 (LATS1/2) and YAP, and the protein expression of the transcriptional coactivator of PDZ-binding motif (TAZ) were also detected. RESULTS Compared with the RHF group, the rats in Wenyang lishui formula low-dose and high-dose groups showed improved hair color, movement, diet, and mental state. The atrophy of right ventricular myocardial cells, the increase of inflammatory cells, collagen deposition, and hypertrophy of myocardial fibers were significantly alleviated. The right ventricular internal diameter, right atrial internal diameter, end-diastolic volume, pulmonary artery pressure, pulmonary artery pressure/velocity, the plasma levels of brain natriuretic peptide and AngⅡ , collagen volume fraction, the phosphorylation level of YAP and protein expression of TAZ were significantly decreased, while the PAAT, PAAT/ET and the phosphorylation level of LATS1/2 were significantly increased (P<0.05). PY-60 could significantly reverse the improvement effects of high-dose Wenyang lishui formula on the above quantitative indicators (P< 0.05). CONCLUSIONS Wenyang lishui formula can restore the right heart function of pulmonary hypertension-induced RHF rats, reduce their pulmonary artery pressure, alleviate the pathological changes in their cardiac tissues, and the above effects may be related to the activation of Hippo expression and the inhibition of YAP phosphorylation.
7.Efficacy and safety of using an enteral immunonutrition formula in the enhanced recovery after surgery protocol for Chinese patients with gastrointestinal cancers undergoing surgery: A randomized, open-label, multicenter trial (healing trial).
Jianchun YU ; Gang XIAO ; Yanbing ZHOU ; Yingjiang YE ; Han LIANG ; Guole LIN ; Qi AN ; Xiaodong LIU ; Bin LIANG ; Baogui WANG ; Weiming KANG ; Tao YU ; Yulong TIAN ; Chao WANG ; Xiaona WANG
Chinese Medical Journal 2025;138(21):2847-2849
8.Torso Simulation Research on Electromagnetic Compatibility of Implantable Neurostimulator.
Qifei LI ; Weiming WANG ; Weiqiang ZHANG ; Linzhi DAI ; Jiawei LIU
Chinese Journal of Medical Instrumentation 2025;49(2):212-218
In the YY 0989.3-2023 standard, clause 27.106 specifies the protection test against electromagnetic interference, but it only briefly describes the test level for electromagnetic exposure, and does not detail the parameters of the torso. This study aims to explore the internal field distribution for different torso parameters under electromagnetic exposure, and explore the patterns of field distribution through modeling and simulation. The results indicate that the parameters of the torso significantly affect the internal field distribution. The findings of this study provide a basis and reference for the electromagnetic compatibility test for implantable neurostimulator products.
Electromagnetic Fields
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Implantable Neurostimulators
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Computer Simulation
9.Development and validation of clinical prediction model for post-treatment recurrence in high-risk non-muscle invasive bladder cancer after BCG intravesical instillation
Haitao WANG ; Weiming LUO ; Jian CHEN ; Jian ZHANG ; Qiang RAN ; Jing XU ; Junhao JIN ; Yangkun AO ; Yapeng WANG ; Junying ZHANG ; Qiubo XIE ; Weihua LAN ; Qiuli LIU
Journal of Army Medical University 2025;47(9):959-968
Objective To investigate the factors influencing the efficacy of intravesical Bacille Calmette-Guérin(BCG)instillation after transurethral resection of bladder tumor(TURBT)in patients with intermediate-and high-risk non-muscle invasive bladder cancer(NMIBC),and to construct a prediction model for recurrence after BCG treatment.Methods A retrospective cohort study was conducted on the subjected patients diagnosed with intermediate-and high-risk NMIBC undergoing TURBT followed by standard BCG instillation.The 110 patients treated in Department of Urology of Army Medical Center of PLA from January 2018 to December 2023 were assigned into a training set,while the 52 patients treated at Department of Urology of General Hospital of Central Theater Command from January 2015 to December 2020 were into an external validation set.A total of 17 variables were included and analyzed.Univariate and multivariate Cox regression analyses were performed to identify factors associated with recurrence after BCG instillation,and nomograms were plotted to predict 1-year,3-year,and 5-year recurrence-free survival(RFS).Calibration curve,decision curve analysis(DCA),and receiver operating characteristic(ROC)curve analysis were conducted for internal and external validation to evaluate the predictive performance and clinical utility of the model.Results In the training set,26 patients(23.64%)experienced recurrence during the follow-up period,with a median RFS of 32.00(18.00~50.50)months.Univariate Cox regression analysis suggested that platelet count,eosinophil to lymphocyte ratio(ELR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),systemic immune inflammation(SII)index,and neutrophil-monocyte to lymphocyte ratio(NMLR),pathological T1 stage(pT1)tumor and hemoglobin,albumin,lymphocyte,and platelet(HALP)score were potential factors influencing recurrence after BCG instillation.Multivariate Cox regression analysis identified high HALP score(HR=0.185,95%CI:0.046~0.736,P=0.017)as an independent protective factor,while high ELR(HR=3.599,95%CI:1.505~8.608,P=0.004)and pT1 stage(HR=3.240,95%CI:1.191~8.818,P=0.021)were independent risk factors for recurrence.Based on this,a nomogram prediction model was constructed.The calibration curves demonstrated good agreement between predicted and actual 1-,3-,and 5-year recurrence risks.Decision curve analysis indicated clinical utility across a wide threshold probability range.In the training set,the model showed strong predictive performance for 1-(AUC=0.842),3-(AUC=0.847),and 5-year(AUC=0.887)recurrence risks,which was further validated in the external cohort.Conclusion Higher HALP score prior to BCG instillation therapy is a protective factor against tumor recurrence,while higher ELR and pT1 stage are risk factors.Our nomogram prediction model based on HALP score,ELR and pathological T stage,can identify individuals at high risk of recurrence after BCG instillation therapy.
10.Efficacy and prognostic factors of second transurethral resection for non-muscle-invasive bladder cancer
Yangkun AO ; Weiming LUO ; Qiang RAN ; Haitao WANG ; Jian ZHANG ; Yapeng WANG ; Ze WANG ; Jing XU ; Jun ZHANG ; Zhenzhen CHEN ; Weihua LAN ; Qiuli LIU ; Jun JIANG
Journal of Army Medical University 2025;47(16):1923-1930
Objective To investigate risk factors for residual lesions after initial transurethral resection of bladder tumors(TURBT)and risk factors for tumor recurrence after second TURBT in patients with non-muscle-invasive bladder cancer(NMIBC)in order to provide reference for clinical management.Methods A case-control study design was adopted to include 120 NMIBC patients who underwent initial TURBT and then second surgery within 2~8 weeks in our department from January 2017 to January 2025.Based on the presence of residual lesions after the initial TURBT or not,the patients were divided into a residual lesion group(n=34)and a non-residual lesion group(n=86).Chi-square test and multivariate logistic regression analysis were performed to identify potential risk factors for residual lesions following the initial TURBT.Univariate and multivariate Cox regression models were used to analyze potential risk factors for tumor recurrence after the second TURBT.Results The residual lesion rate after initial TURBT was 28.33%.Chi-square test analysis revealed that tumor stage T1(Chi-square=5.756,P=0.016)and broad tumor base(Chi-square=4.331,P=0.037)were factors influencing residual lesions after initial TURBT.Multivariate logistic regression analysis identified tumor stage T1(OR=3.047,95%CI:1.128~8.226,P=0.028)as an independent risk factor for residual lesions after initial TURBT.The tumor recurrence rate after second TURBT was 17.5%.Multivariate Cox regression analysis identified tumor stage T1(OR=4.258,95%CI:1.248~14.532,P=0.021),intravesical chemotherapy instillation after second TURBT(OR=3.539,95%CI:1.284~9.752,P=0.015),history of urinary system tumors(OR=3.002,95%CI:1.145~7.873,P=0.025)and high platelet-to-lymphocyte(PLR)ratio(OR=2.798,95%CI:1.115~7.023,P=0.028)as independent risk factors for tumor recurrence after second TURBT.Conclusion Tumor stage T1 and broad tumor base are risk factors for residual lesions after initial TURBT,while tumor stage T1,intravesical chemotherapy instillation after second TURBT,history of urinary system tumors and high PLR ratio are risk factors for tumor recurrence after second TURBT.Comprehensive analysis on above 4 indicators can effectively assess the risk of tumor recurrence in NMIBC patients following second TURBT,and timely early medical intervention is beneficial for improving patient outcomes.

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