1.Palpitations, Shortness of Breath, Weakness in Limbs, Edema, and Dyspnea: A Rare Inflammatory Myopathy with Positive Aniti-mitochondrial Antibodies and Cardiac Involvement
Chunsu LIANG ; Xuchang ZHANG ; Ning ZHANG ; Lin KANG ; Xiaohong LIU ; Jiaqi YU ; Yingxian LIU ; Lin QIAO ; Yanli YANG ; Xiaoyi ZHAO ; Ruijie ZHAO ; Na NIU ; Xuelian YAN
Medical Journal of Peking Union Medical College Hospital 2025;16(1):248-255
This article presents a case study of a patient who visited the Geriatric Department of Peking Union Medical College Hospital due to "palpitations, shortness of breath for more than 2 years, limb weakness for 6 months, edema, and nocturnal dyspnea for 2 months". The patient exhibited decreased muscle strength in the limbs and involvement of swallowing and respiratory muscles, alongside complications of heart failure and various arrhythmias which were predominantly atrial. Laboratory tests revealed the presence of multiple autoantibodies and notably anti-mitochondrial antibodies. Following a comprehensive multidisciplinary evaluation, the patient was diagnosed with anti-mitochondrial antibody-associated inflammatory myopathy. Treatment involved a combination of glucocorticoids and immunosuppressants, along with resistance exercises for muscle strength and rehabilitation training for lung function, resulting in significant improvement of clinical symptoms. The case underscores the importance of collaborative multidisciplinary approaches in diagnosing and treating rare diseases in elderly patients, where careful consideration of clinical manifestations and subtle abnormal clinical data can lead to effective interventions.
2.Impact of Sarcopenia on Long-term Outcomes in Elderly Inpatients with Type 2 Diabetes Mellitus: A Prospective Cohort Study
Ning ZHANG ; Xiaohong LIU ; Lin KANG ; Wei CHEN ; Xuan QU ; Minglei ZHU ; Xiaohong SUN
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1348-1355
To investigate the collective influence of sarcopenia on the extended prognosis of hospitalized elderly individuals with type 2 diabetes mellitus(T2DM). Patients with T2DM aged 65 years and older, who were admitted to the Geriatrics Department of Peking Union Medical College Hospital between January 2017 and January 2021, were consecutively enrolled in the study. The presence of sarcopenia was evaluated based on the diagnostic criteria established by the Asian Working Group for Sarcopenia(AWGS) in 2014. Additionally, assessments were made on the patients' comorbidities, functional status, nutritional status, and geriatric syndromes. Follow-up was conducted through outpatient visits and telephone calls to monitor outcomes such as severe disability, rehospitalization, and all-cause mortality. Cox regression analysis was performed to investigate the impact of concurrent sarcopenia on the long-term prognosis of hospitalized elderly individuals with T2DM. A total of 244 elderly inpatients with T2DM who met specific criteria were included in the study, comprising 110 males(45.1%) and 134 females(54.9%), with ages ranging from 65 to 93 years and a median age of 74 years. Sarcopenia was observed in 25.4%(62/244) of patients. Over a follow-up period of three to seven years(median 5.6 years), elderly T2DM patients with sarcopenia exhibited significantly higher rates of severe disability, rehospitalization, and all-cause death compared to those without sarcopenia(all The prevalence of sarcopenia is notably high among hospitalized elderly patients with T2DM, greatly affecting their long-term prognosis. It is imperative for clinicians to prioritize screening and implement interventions for sarcopenia in elderly T2DM patients to improve their quality of life and overall prognosis.
3.Cronkhite-Canada Syndrome Combined with Asymptomatic Novel Coronavirus Infection: A Case Report
Ning ZHANG ; Chenhao YANG ; Liangrui ZHOU ; Xiaohong SUN ; Xiaohong LIU ; Lin KANG ; Ji LI ; Hailong LI
Medical Journal of Peking Union Medical College Hospital 2024;15(2):406-412
This article presents a case study of a patient who had Cronkhite-Canada syndrome in combination with an asymptomatic novel coronavirus infection. The patient exhibited clinical symptoms of loss of appetite, hair and nail loss, and skin pigmentation. Digestive endoscopy revealed widespread and varying-sized polypoid changes in the mucosa of the stomach, duodenum, and colon. During the course of the illness, the patient tested positive for novel coronavirus nucleic acid. Treatment with moderate doses of prednisone resulted in the patient's hair regrowth and decreased skin hypopigmentation. The article provides a summary of the patient's diagnosis and treatment and a review of relevant literature, with the aim of enhancing clinicians' understanding of the disease.
4.A Bibliometric Analysis of the Development of Global Research on Geriatric Interdisciplinary Team From 2000 to 2023
Ning ZHANG ; Mu HE ; Xiangyu ZHANG ; Lin KANG ; Xiaohong SUN ; Xiaohong LIU ; Xuan QU ; Minglei ZHU
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1107-1116
To examine the global research trends and emerging focal points in the field ofgeriatric interdisciplinary team (GIT) from 2000 to 2023, so as to offer insights and reference for related research in China. English literature related to GIT published from January 1, 2000 to December 31, 2023 were searched in the Web of Science database. The literature information was extracted using VOSviewer 1.6.18 software to create a cooperation network diagram highlighting high-producing countries/regions and research institutions, as well as a high-frequency keyword table. CiteSpace 6.1.R6 software was used to analyze the co-occurrence and clustering of authors, research institutions, countries/regions, etc., and the "bibliometrix" package of R was used to analyze the characteristics of high-frequency keywords in the literature. A total of 965 GIT-related documents including 921 original articles and 44 reviews were gathered. There was a noticeable rise in annual publications over time. The United States led in publication quantity (357 articles, 37.0%) and total citations (8656). The University of Michigan was highlighted as the top research institution with 27 articles (2.8%). Author Johan Flamaing from the University of Leuven in Belgium had the highest output with 12 articles (1.2%) and the highest co-citation frequency(163 times). The In the last two decades, research on GIT has garnered significant attention within the discipline. Developed countries, particularly the United States, have taken a leading role in this field. Presently, GIT research is centered on conducting comprehensive geriatric assessments and implementing corresponding interventions for elderly patients with frailty and hip fractures. Additionally, research is focused on GIT interventions for addressing potentially inappropriate medication use and preventing falls in the elderly, as well as managing elderly patients with tumors, dementia, and delirium. The exploration of interventions remains a key area of interest in current research. In the future, there is potential for conducting more high-quality qualitative research related to GIT interventions for elderly patients receiving long-term care or home care, as well as for enhancing geriatric medicine teaching in GIT.
5.A Case of Older Patient with Right Vocal Cord Paralysis Caused by Herpes Simplex Virus Infection Using Comprehensive Intervention by a Geriatric Interdisciplinary Team
Xiu GAO ; Kanghao ZHOU ; Ning ZHANG ; Yunlong LI ; Lin KANG ; Xiaohong LIU ; Xiaoyi ZHAO
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1146-1151
This article presents a case report of right vocal cord paralysis resulting from herpes simplex virus infection in an older adult. The patient initially presented with fever, blisters on the lips and right cheek, followed by the gradual onset of hoarseness and difficulty in swallowing. Laryngoscopy revealed fixation of the right vocal cord while the left vocal cord exhibited normal movement. A high level of herpes simplex virus type 1 IgM antibody was detected during the disease progression. Treatment involving mid-dose glucocorticoid and methylcobalamin neurotrophic therapy, swallowing and vocal rehabilitation training, as well as enteral nutrition support, led to alleviation of hoarseness and improved ability to drink water in small sips. Follow-up laryngoscopy indicated partial restoration of movement in the right vocal cord. The article not only outlines the diagnosis and treatment of this case but also reviews relevant literature to broaden clinicians' knowledge of viral-induced vocal cord paralysis in the elderly. It also emphasizes the importance of a geriatric interdisciplinary team in managing complex diseases in older patients.
6.Impact of Sarcopenia on Long-term Outcomes in Elderly Inpatients with Type 2 Diabetes Mellitus: A Prospective Cohort Study
Ning ZHANG ; Xiaohong LIU ; Lin KANG ; Wei CHEN ; Xuan QU ; Minglei ZHU ; Xiaohong SUN
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1348-1355
To investigate the collective influence of sarcopenia on the extended prognosis of hospitalized elderly individuals with type 2 diabetes mellitus(T2DM). Patients with T2DM aged 65 years and older, who were admitted to the Geriatrics Department of Peking Union Medical College Hospital between January 2017 and January 2021, were consecutively enrolled in the study. The presence of sarcopenia was evaluated based on the diagnostic criteria established by the Asian Working Group for Sarcopenia(AWGS) in 2014. Additionally, assessments were made on the patients' comorbidities, functional status, nutritional status, and geriatric syndromes. Follow-up was conducted through outpatient visits and telephone calls to monitor outcomes such as severe disability, rehospitalization, and all-cause mortality. Cox regression analysis was performed to investigate the impact of concurrent sarcopenia on the long-term prognosis of hospitalized elderly individuals with T2DM. A total of 244 elderly inpatients with T2DM who met specific criteria were included in the study, comprising 110 males(45.1%) and 134 females(54.9%), with ages ranging from 65 to 93 years and a median age of 74 years. Sarcopenia was observed in 25.4%(62/244) of patients. Over a follow-up period of three to seven years(median 5.6 years), elderly T2DM patients with sarcopenia exhibited significantly higher rates of severe disability, rehospitalization, and all-cause death compared to those without sarcopenia(all The prevalence of sarcopenia is notably high among hospitalized elderly patients with T2DM, greatly affecting their long-term prognosis. It is imperative for clinicians to prioritize screening and implement interventions for sarcopenia in elderly T2DM patients to improve their quality of life and overall prognosis.
7.Construction of the Whole Process Management Model of Hospice and Palliative Care Outpatient Clinic
Yaoxin ZENG ; Xiaohong NING ; Ying ZHENG ; Zhiyuan ZHANG ; Yiyou WANG ; Yu ZHANG ; Qian KANG
Acta Academiae Medicinae Sinicae 2024;46(2):210-216
Objective To construct a scientific and practical management model of the hospice and pal-liative care outpatient clinic and provide a reference for the operation and development of the outpatient clin-ic.Methods The basic framework of the whole process management model of hospice and palliative care outpa-tient clinic was determined preliminarily by literature analysis,qualitative interviews and experts group meet-ings.Two rounds of consultation were conducted among 18 experts in hospice and palliative care and medical-nursing combined outpatient service by the Delphi method.Results The questionnaire response rates of the two rounds of expert consultation were both 100%and the authority coefficients of the two rounds of expert consultation were 0.88 and 0.91,respectively.Finally,the whole process management model of hospice and palliative care out-patient clinic was constructed,which was composed of three first-level indicators including staff composition,work structure and effect evaluation,5 second-level indicators and 62 third-level indicators.Conclusion The construc-ted whole process management model is scientific,innovative and continuous,which can provide a reference for the operation and development of the hospice and palliative care outpatient clinic.
8.Mechanism of LINC01410 promoting proliferation and migration in esophageal squamous cell carcinoma
Fei CAO ; Wenhao YU ; Xiaonan TANG ; Zidong MA ; Tingmin CHANG ; Yabin GONG ; Mingjuan LIAO ; Xiaohong KANG
China Oncology 2024;34(8):753-762
Background and purpose:Long non-coding RNA(lncRNA)LINC01410,with a length of 647 bp,participates in a variety of tumor biological processes.However,the role and mechanism of LINC01410 involved in esophageal squamous cell carcinoma(ESCC)remain unclear.This study aimed to explore the potential mechanism of LINC01410 promoting ESCC proliferation and invasion,to provide a potential prognostic indicator and therapeutic target for individuals with ESCC.Methods:Gene Expression Profiling Interactive Analysis 2(GEPIA2)databases were used to analyze the expression of LINC01410 and overall survival in esophageal squamous cell carcinoma data set in the Cancer Genome Atlas(TCGA).Gene Set Enrichment Analysis(GSEA)was performed to identify the underlying signaling pathways involved in the biological effects of LINC01410 in ESCC.A total of 62 pairs of ESCC tissues and paracancerous tissues from ESCC patients who underwent radical surgery in the Department of Thoracic Surgery at the First Affiliated Hospital of Xinxiang Medical College and the First People's Hospital of Pingdingshan City from January 2020 to December 2021 were collected.This project has been approved by the Hospital Ethics Committee(First Affiliated Hospital of Xinxiang Medical College,No.2018036;First People's Hospital of Pingdingshan City,No.2019-018).The expression of LINC01410 in ESCC tissues was detected by real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR).We transfected EC109 cells with LV-NC or LV-over/LINC01410 and EC9706 cells with shRNA-NC or shRNA-LINC01410.Stable transfected cells(EC109/NC,EC109/OE,EC9706/NC and EC9706/KD)were selected in primary cell culture medium containing puromycin.The expression of LINC01410 was detected by RTFQ-PCR.The impact of LINC01410 on ESCC cell proliferation was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)and colony formation assays.The effect of LINC01410 on ESCC cell invasion was detected by transwell migration assay.T cell factor/lymphoid enhancer factor 1(TCF/LEF1)luciferase reporter assay was performed to validate the effect of LINC01410 on the activity of canonical Wnt/β-catenin signaling pathway.The expressions of Wnt/β-catenin and epithelial-mesenchymal transition(EMT)signal pathway related proteins in ESCC cells were detected by Western blot.Results:By analyzing the LINC01410 expression from ESCC samples in TCGA by GEPIA2,we found LINC01410 was consistently increased in ESCC tumors compared with normal tissues(P<0.05),and high LINC01410 expression was associated with poorer overall survival(OS).RTFQ-PCR assay showed that expressions of LINC01410 were higher in esophageal cancer tissues and esophageal cancer cells(EC109 and EC9706)than in precancerous tissues and HEEC cells(P<0.05).The expression level of LINC01410 was significantly correlated with invasion range,lymph node metastasis and TNM stage in ESCC patients(P<0.01).LINC01410 expression was also upregulated in EC109/OE,however the expression of LINC01410 in EC9706/KD was decreased(P<0.01).MTT assay showed overexpression of LINC01410 increased the viability of EC109 cells,while knockdown of LINC01410 decreased the viability of EC9706 cells(P<0.01).Colony formation assay indicated that overexpression of LINC01410 enhanced the clonogenic ability of ESCC cells,while knockdown of LINC01410 reduced colony formation(P<0.01).Transwell migration assay showed that LINC01410 overexpression drastically increased the number of migratory cells,while silencing of LINC01410 suppressed the migration in EC9706 cells(P<0.01).GSEA revealed that Wnt/β-catenin and EMT pathways were significantly enriched in ESCC samples with a high level of LINC01410.TCF/LEF1 luciferase reporter assay showed higher levels of Wnt-dependent activities were observed in EC109/OE cells,whereas silenced LINC01410 in EC9706 cells led to contrary results(P<0.01).Western blot analysis showed that overexpression of LINC01410 in EC109 cell significantly increased the expression levels of N-cadherin,β-catenin,cyclin D1,c-Myc and decreased E-cadherin expression,while knockdown LINC01410 resulted in opposite results.Conclusion:LINC01410 promotes proliferation and metastasis of ESCC,which might be caused by activation of Wnt/β-catenin and EMT signaling pathways.
9.Multicenter evaluation of the diagnostic efficacy of jaundice color card for neonatal hyperbilirubinemia
Guochang XUE ; Huali ZHANG ; Xuexing DING ; Fu XIONG ; Yanhong LIU ; Hui PENG ; Changlin WANG ; Yi ZHAO ; Huili YAN ; Mingxing REN ; Chaoying MA ; Hanming LU ; Yanli LI ; Ruifeng MENG ; Lingjun XIE ; Na CHEN ; Xiufang CHENG ; Jiaojiao WANG ; Xiaohong XIN ; Ruifen WANG ; Qi JIANG ; Yong ZHANG ; Guijuan LIANG ; Yuanzheng LI ; Jianing KANG ; Huimin ZHANG ; Yinying ZHANG ; Yuan YUAN ; Yawen LI ; Yinglin SU ; Junping LIU ; Shengjie DUAN ; Qingsheng LIU ; Jing WEI
Chinese Journal of Pediatrics 2024;62(6):535-541
Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).
10.Correlation between early serum markers and AISA grading in patients with acute spinal cord injury
Yueguang WANG ; Xiaohong MU ; Shengyuan JIANG ; Bowen DENG ; Ximei KANG ; Jianguang SU
Chinese Journal of Tissue Engineering Research 2024;28(34):5494-5499
BACKGROUND:At present,there are some limitations in evaluating the severity of acute spinal cord injury,and a rapid and accurate evaluation method is urgently needed. OBJECTIVE:To analyze the correlation between the expression levels of serum oxidative stress and nerve injury indexes and the severity of the disease in patients with acute spinal cord injury. METHODS:A total of 65 patients were included in the study from August 2020 to May 2022,including 32 patients in the experimental group(acute spinal cord injury)and 33 patients in the control group(simple spinal fracture).American Spinal Injury Association(ASIA)Impairment Scale and neurological function score were evaluated within 8 hours of admission.Meanwhile,serum levels of superoxide dismutase,malondialdehyde,glutathione,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase were detected and compared between the two groups.The correlation between the expression levels of the above serological indicators in serum and ASIA impairment grade and AISA neural function score was analyzed. RESULTS AND CONCLUSION:The average serum levels of superoxide dismutase and glutathione in the experimental group were significantly lower than those of the control group(P<0.001),while the average serum levels of malondialdehyde,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase in the experimental group were higher than those of the control group(P<0.01).The serum levels of superoxide dismutase and glutathione in the experimental group were positively correlated with the damage grade of AISA(r=0.862 4,0.849 3,P<0.01),while the serum levels of malondialdehyde,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase were negatively correlated with the damage grade of AISA(r=-0.866 1,-0.638 1,-0.746 6,P<0.001),and the serum level of nitric oxide was not significantly correlated with the damage grade of AISA(r=-0.177 5,P>0.05).The serum level of glutathione in the experimental group was positively correlated with AISA sensory function scores(r=0.569 9,P<0.001),while the serum levels of malondialdehyde,glial fibrillary acidic protein and neuron-specific enolase were negatively correlated with AISA sensory function scores(r=-0.574 1,-0.099 2,-0.708 6,P<0.05),and the serum levels of superoxide dismutase and nitric oxide were not significantly correlated with AISA sensory function scores(r=0.230 8,-0.376 2,P>0.05).The serum levels of superoxide dismutase and glutathione in the experimental group were positively correlated with ASIA motor function scores(r=0.380,0.524 7,P<0.05);the serum levels of malondialdehyde,glial fibrillary acidic protein and neuron-specific enolase were negatively correlated with AISA motor function scores(r=-0.577 9,-0.452 2,-0.662 8,P<0.05);and the level of nitric oxide had no significant correlation with AISA motor function scores(r=-0.049 7,P>0.05).To conclude,the serum levels of superoxide dismutase,malondialdehyde,glutathione,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase in serum of patients with acute spinal cord injury are significantly correlated with ASIA impairment grade and ASIA neural function score,which could be used as biomarkers for early clinical assessment of disease severity.

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