1.Related factors of retinopathy in elderly patients with type 2 diabetes mellitus and analysis of discriminant efficiency
Journal of Public Health and Preventive Medicine 2026;37(2):162-165
Objective To analyze the related factors of retinopathy in elderly patients with type 2 diabetes mellitus (T2DM) and explore the discriminant efficiency. Methods A retrospective analysis was conducted on 314 elderly patients with T2DM who were treated in Beijing Aerospace General Hospital between April 2022 and April 2025. The related factors of retinopathy in elderly patients with T2DM were explored by logistic regression analysis. ROC curve was drawn to analyze the discriminant efficiency of related factors. Results Compared with the patients in the non-concurrent group, the patients in the concurrent group had a longer course of diabetes mellitus, a higher level of glycosylated hemoglobin (HbA1c), and higher proportions of diabetic peripheral neuropathy, hypertension history, high myopia history and smoking history (P<0.05). After logistic regression analysis, the course of diabetes mellitus, HbA1c, diabetic peripheral neuropathy, history of hypertension and history of high myopia were found to be related factors of retinopathy in elderly patients with T2DM (P<0.05). Based on the above related factors, a model was established for ROC curve analysis, and it was found that the area under the curve was 0.935, with sensitivity, specificity, and 95%CI being 0.867, 0.916, and 0.890-0.979, respectively. Conclusion Course of diabetes mellitus, HbA1c, diabetic peripheral neuropathy, history of hypertension, and history of high myopia are related factors of retinopathy in elderly patients with T2DM. These related factors demonstrate good discriminant efficiency on retinopathy in elderly patients with T2DM.
2.Effects of human umbilical cord blood platelet-rich plasma,mononuclear cells,and mesenchymal stem cells in repairing thin endometrium in rats
Yanli MU ; Anchun HU ; Wenchi XU ; Panpan CHEN ; Hao CHEN ; Shuyun ZHAO ; Guanyou HUANG ; Xiaojuan CHEN
Chinese Journal of Tissue Engineering Research 2026;30(1):78-92
BACKGROUND:Research has found that human umbilical cord blood platelet rich plasma and human umbilical cord blood derived mesenchymal stem cells have certain therapeutic effects on thin endometrium.However,there are currently no reports on the study of human umbilical cord blood mononuclear cells on thin endometrium,and there is a lack of relevant research comparing the three.OBJECTIVE:To explore the effects and mechanisms of human umbilical cord blood platelet rich plasma,monocytes,and mesenchymal stem cells in repairing thin endometrium in rats.METHODS:Sixty female SPF grade SD rats were randomly divided into sham operation group,model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group,with 12 rats in each group.The sham operation group received 0.5 mL physiological saline injection into the uterine horn,followed by 0.5 mL of PBS infusion after 5 minutes;The model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group were injected with 0.5 mL of 95%ethanol by volume.After 5 minutes,the remaining ethanol was aspirated and washed twice with physiological saline.Then,0.5 mL of PBS,human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells(1×107 cells/mL),and human umbilical cord blood derived mesenchymal stem cells(1×107 cells/mL)were perfused separately.During the third normal estrus cycle after reperfusion,organs,tissues and serum were collected for testing of relevant indicators.RESULTS AND CONCLUSION:(1)The macroscopic view of uterine tissue,hematoxylin eosin staining and Masson staining results:the sham operation group had intact structure,moderate endometrial thickness,and clear vascular structure.Compared with the sham operation group,the model group showed uterine atrophy,incomplete structure,significantly reduced endometrial thickness and glandular quantity,disordered vascular structure,and increased fibrosis.Compared with the model group,after treatment with human umbilical cord blood derivatives,the size,structure,and endometrial thickness of the uterus were restored(all P<0.01),and fibrosis was reduced,with the most significant recovery observed in the human umbilical cord blood mononuclear cell group.The increase in glandular quantity was most significant in the human umbilical cord blood platelet rich plasma group(P<0.000 1).(2)The immunohistochemistry and immunofluorescence results of uterine tissue showed that compared with the sham operation group,the expression levels of cell proliferation related indicators such as keratin 9 and vimentin,endometrial receptivity related indicators such as leukemia inhibitory factor and integrin αyβ3,platelet endothelial cell adhesion molecule,basic fibroblast growth factor,and vascular endothelial growth factor were all reduced in the model group(all P<0.05).Compared with the model group,the above indicators were significantly increased after treatment with human umbilical cord blood derivatives.Comparison of human umbilical cord blood derivatives among groups showed that keratin 9 and vascular endothelial growth factor protein:human umbilical cord blood mononuclear cell group>human umbilical cord blood derived mesenchymal stem cell group>human umbilical cord blood platelet rich plasma group;Wave shaped protein and leukemia inhibitory factor protein:human umbilical cord blood derived mesenchymal stem cell group>human umbilical cord blood mononuclear cell group>human umbilical cord blood platelet rich plasma group;Integrin αyβ3 protein:human umbilical cord blood platelet rich plasma group>human umbilical cord blood derived mesenchymal stem cell group>human umbilical cord blood mononuclear cell group;Platelet endothelial cell adhesion molecule protein:human umbilical cord blood platelet rich plasma group>human umbilical cord blood mononuclear cell group>human umbilical cord blood derived mesenchymal stem cell group;Basic fibroblast growth factor protein:human umbilical cord blood mononuclear cell group>human umbilical cord blood platelet rich plasma group>human umbilical cord blood derived mesenchymal stem cell group.(3)Western blot analysis showed that compared with the sham operation group,the protein levels of interleukin-6,interleukin-1β,and tumor necrosis factor alpha in the model group were significantly increased(all P<0.001),and their expression levels decreased after treatment(all P<0.05).(4)ELISA assay showed that compared with the sham operation group,the model group had lower levels of anti Mullerian hormone,estradiol,and progesterone,and increased levels of follicle stimulating hormone and luteinizing hormone(except for luteinizing hormone,all P<0.05).After treatment,there was a certain degree of recovery in the levels of sex hormones and anti Mullerian hormones.(5)Fertility experiments showed that compared with the sham operation group,the model group had an increase in conception time and a significant decrease in litter size(all P<0.05).After treatment with human umbilical cord blood derivatives,the litter size of all three groups increased(P<0.05),and no significant differences were found between the groups.This study preliminarily reveals that human umbilical cord blood mononuclear cells have a certain therapeutic effect on thin endometrium,and human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells,and human umbilical cord blood derived mesenchymal stem cells have different advantages and differences in improving endometrial regeneration function,endometrial receptivity,angiogenesis,inflammation regulation,and improving pregnancy outcomes in thin endometrium.
3.Effects of human umbilical cord blood platelet-rich plasma,mononuclear cells,and mesenchymal stem cells in repairing thin endometrium in rats
Yanli MU ; Anchun HU ; Wenchi XU ; Panpan CHEN ; Hao CHEN ; Shuyun ZHAO ; Guanyou HUANG ; Xiaojuan CHEN
Chinese Journal of Tissue Engineering Research 2026;30(1):78-92
BACKGROUND:Research has found that human umbilical cord blood platelet rich plasma and human umbilical cord blood derived mesenchymal stem cells have certain therapeutic effects on thin endometrium.However,there are currently no reports on the study of human umbilical cord blood mononuclear cells on thin endometrium,and there is a lack of relevant research comparing the three.OBJECTIVE:To explore the effects and mechanisms of human umbilical cord blood platelet rich plasma,monocytes,and mesenchymal stem cells in repairing thin endometrium in rats.METHODS:Sixty female SPF grade SD rats were randomly divided into sham operation group,model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group,with 12 rats in each group.The sham operation group received 0.5 mL physiological saline injection into the uterine horn,followed by 0.5 mL of PBS infusion after 5 minutes;The model group,human umbilical cord blood platelet rich plasma group,human umbilical cord blood mononuclear cell group,and human umbilical cord blood derived mesenchymal stem cell group were injected with 0.5 mL of 95%ethanol by volume.After 5 minutes,the remaining ethanol was aspirated and washed twice with physiological saline.Then,0.5 mL of PBS,human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells(1×107 cells/mL),and human umbilical cord blood derived mesenchymal stem cells(1×107 cells/mL)were perfused separately.During the third normal estrus cycle after reperfusion,organs,tissues and serum were collected for testing of relevant indicators.RESULTS AND CONCLUSION:(1)The macroscopic view of uterine tissue,hematoxylin eosin staining and Masson staining results:the sham operation group had intact structure,moderate endometrial thickness,and clear vascular structure.Compared with the sham operation group,the model group showed uterine atrophy,incomplete structure,significantly reduced endometrial thickness and glandular quantity,disordered vascular structure,and increased fibrosis.Compared with the model group,after treatment with human umbilical cord blood derivatives,the size,structure,and endometrial thickness of the uterus were restored(all P<0.01),and fibrosis was reduced,with the most significant recovery observed in the human umbilical cord blood mononuclear cell group.The increase in glandular quantity was most significant in the human umbilical cord blood platelet rich plasma group(P<0.000 1).(2)The immunohistochemistry and immunofluorescence results of uterine tissue showed that compared with the sham operation group,the expression levels of cell proliferation related indicators such as keratin 9 and vimentin,endometrial receptivity related indicators such as leukemia inhibitory factor and integrin αyβ3,platelet endothelial cell adhesion molecule,basic fibroblast growth factor,and vascular endothelial growth factor were all reduced in the model group(all P<0.05).Compared with the model group,the above indicators were significantly increased after treatment with human umbilical cord blood derivatives.Comparison of human umbilical cord blood derivatives among groups showed that keratin 9 and vascular endothelial growth factor protein:human umbilical cord blood mononuclear cell group>human umbilical cord blood derived mesenchymal stem cell group>human umbilical cord blood platelet rich plasma group;Wave shaped protein and leukemia inhibitory factor protein:human umbilical cord blood derived mesenchymal stem cell group>human umbilical cord blood mononuclear cell group>human umbilical cord blood platelet rich plasma group;Integrin αyβ3 protein:human umbilical cord blood platelet rich plasma group>human umbilical cord blood derived mesenchymal stem cell group>human umbilical cord blood mononuclear cell group;Platelet endothelial cell adhesion molecule protein:human umbilical cord blood platelet rich plasma group>human umbilical cord blood mononuclear cell group>human umbilical cord blood derived mesenchymal stem cell group;Basic fibroblast growth factor protein:human umbilical cord blood mononuclear cell group>human umbilical cord blood platelet rich plasma group>human umbilical cord blood derived mesenchymal stem cell group.(3)Western blot analysis showed that compared with the sham operation group,the protein levels of interleukin-6,interleukin-1β,and tumor necrosis factor alpha in the model group were significantly increased(all P<0.001),and their expression levels decreased after treatment(all P<0.05).(4)ELISA assay showed that compared with the sham operation group,the model group had lower levels of anti Mullerian hormone,estradiol,and progesterone,and increased levels of follicle stimulating hormone and luteinizing hormone(except for luteinizing hormone,all P<0.05).After treatment,there was a certain degree of recovery in the levels of sex hormones and anti Mullerian hormones.(5)Fertility experiments showed that compared with the sham operation group,the model group had an increase in conception time and a significant decrease in litter size(all P<0.05).After treatment with human umbilical cord blood derivatives,the litter size of all three groups increased(P<0.05),and no significant differences were found between the groups.This study preliminarily reveals that human umbilical cord blood mononuclear cells have a certain therapeutic effect on thin endometrium,and human umbilical cord blood platelet rich plasma,human umbilical cord blood mononuclear cells,and human umbilical cord blood derived mesenchymal stem cells have different advantages and differences in improving endometrial regeneration function,endometrial receptivity,angiogenesis,inflammation regulation,and improving pregnancy outcomes in thin endometrium.
4.Mechanism of Wenyang jieyu granules regulating NLRP3/ASC/Caspase-1 pathway on antidepressant effect in rats
Shuang MENG ; Jie ZHAO ; Xinxin WANG ; Dandan TAN ; Xiaorong ZHOU ; Huimin SUN ; Xiaojuan MA ; Zhenyu FENG
China Pharmacy 2026;37(11):1440-1446
OBJECTIVE To explore the antidepressant mechanism of Wenyang jieyu granules (WYJYG) via the NOD-like receptor thermal protein domain associated protein 3 (NLRP3)/apoptosis-associated speck-like protein containing a CARD (ASC)/Caspase-1 pathway. METHODS A rat model of depression was established by chronic unpredictable mild stress combined with single-housing for 42 consecutive days.The experiment set up blank group, model group, MCC950 (NLRP3 inflammasome inhibitor) group (10 mg/kg), fluoxetine group (positive control,2.08 mg/kg),low-dose WYJYG(3.78 g/kg) and high-dose WYJYG group (7.56 g/kg),with 10 rats in each group. From the 22nd day of the experiment, rats in the fluoxetine group, low-dose and high-dose WYJYG groups were intragastrically administered with the corresponding drugs and intraperitoneally injected with an equal volume of normal saline. Rats in the MCC950 group were intraperitoneally injected with MCC950 at the corresponding concentration and intragastrically administered with an equal volume of distilled water. Rats in the blank group and model group were given an equal volume of distilled water by gavage and an equal volume of normal saline by intraperitoneal injection. All interventions were performed once a day for 21 consecutive days. Behavioral tests were conducted once a week. After the last administration, the contents of ASC, ionized calcium binding adaptor molecule 1 (Iba1), interleukin-1β (IL-1β), and IL-18 in hippocampal tissues were detected. The protein expressions of NLRP3, cluster of differentiation 68 (CD68), Caspase-1, B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein were determined, and neuronal apoptosis was observed. RESULTS After the last administration, compared with the model group, the open-field activity time was significantly prolonged ( P <0.05), and the latency to feed in a novel environment was significantly shortened ( P <0.05) in rats of the high-dose WYJYG group. In hippocampal tissue, the contents of ASC, Iba1, IL-1β, and IL-18, as well as the protein expression levels of NLRP3, Caspase-1, and CD68, and the positive rate of neuronal apoptosis were all significantly decreased/downregulated ( P <0.05). Bcl-2 protein expression was significantly upregulated ( P <0.05), and the density of neuronal apoptosis-positive cells was significantly reduced ( P <0.05). CONCLUSIONS WYJYG play on antidepressant role by inhibiting the NLRP3/ASC/Caspase-1 pathway, reducing microglia-mediated neuroinflammation, and inhibiting hippocampal neurons apoptosis.
5.Effect and mechanisms of highly active umbilical cord mesenchymal stem cells on aging spleen in elderly tree shrews
Li YE ; Chuan TIAN ; Xiaojuan ZHAO ; Mengdie CHEN ; Qianqian YE ; Qiang LI ; Zhuyin LIAO ; Ye LI ; Xiangqing ZHU ; Guangping RUAN ; Zhixu HE ; Liping SHU ; Xinghua PAN
Chinese Journal of Tissue Engineering Research 2025;29(19):4000-4010
BACKGROUND:Spleen has the functions of blood storage,hematopoiesis,and immunity.With the increase of age,the structural degeneration and functional decline of spleen lead to the impairment of immune system function,thus accelerating the aging process of the body.The treatment of spleen aging in tree shrews with highly active umbilical cord mesenchymal stem cells has not been reported. OBJECTIVE:To explore the intervention effect and mechanism of highly active umbilical cord mesenchymal stem cells on spleen aging in tree shrews. METHODS:Highly active umbilical cord mesenchymal stem cells were isolated,cultured,and obtained from the umbilical cord tissue of newborn tree shrews by caesarean section.The differentiation abilities of adipogenesis,osteogenesis,and chondrogenesis were detected by three-line differentiation kit.Cell cycle and surface markers were detected by flow cytometry.The second generation of highly active umbilical cord mesenchymal stem cells were transfected with Genechem Green Fluorescent Protein with infection complex values of 100,120,140,160,180,and 200,respectively,to screen the best transfection conditions.After transfection,the fourth generation of highly active umbilical cord mesenchymal stem cells was injected into the tail vein of tree shrews in the elderly treatment group.The young control group and the aged model group were not given special treatment.After 4 months of treatment,the spleen tissue was taken and the structure of the spleen was observed by hematoxylin-eosin staining.β-Galactosidase staining was used to detect the activity of aging-related galactosidase.Immunohistochemical staining was used to detect the expression levels of p21 and p53 proteins.Ki67 and PCNA immunofluorescence staining was used to detect cell proliferation activity.Immunofluorescence staining was used to detect the expression levels of spleen autophagy protein molecules Beclin 1 and APG5L/ATG5.Reactive oxygen species fluorescence staining was used to detect the content of reactive oxygen species in spleen tissue.CD3 immunofluorescence staining was used to detect the change of the proportion of total T lymphocytes.The secretion levels of interleukin 1β and transforming growth factor β1 in spleen were detected by enzyme linked immunosorbent assay.The distribution of highly active umbilical cord mesenchymal stem cells labeled with green fluorescent protein in spleen tissue was observed by DAPI double staining of nucleus. RESULTS AND CONCLUSION:(1)Highly active umbilical cord mesenchymal stem cells grew in a short spindle shape with fish-like growth,with a large proportion of G0/G1 phase,and had the potential to differentiate into adipogenesis,osteogenesis,and chondrogenesis.(2)Multiplicity of infection=140 and transfection for 72 hours were the best conditions for labeling tree shrews highly active umbilical cord mesenchymal stem cells with Genechem Green Fluorescent Protein.(3)Compared with the aged model group,in the aged treatment group,the spleen tissue cells of tree shrews were arranged closely,and the area of white pulp was increased(P<0.01);the boundary between red pulp and white pulp was clear;the proportion of germinal centers did not show statistically significant difference(P>0.05).The activity level of galactosidase related to spleen tissue aging was decreased(P<0.001),and the expression levels of aging protein molecules p21 and p53 were down-regulated(P<0.001).The expression levels of proliferation-related molecules Ki67 and PCNA were up-regulated(P<0.001,P<0.05);expression levels of autophagy-related molecules Beclin 1 and APG5L/ATG5 were up-regulated(P<0.001),and the content of reactive oxygen species decreased(P<0.001),and the proportion of CD3+T cells increased(P<0.05).The secretion level of interleukin 1β in the aging-related secretion phenotype decreased(P<0.001);no significant difference was found in transforming growth factor β1 level(P>0.05).Compared with the young control group,the above indexes were significantly different in the elderly treatment group(P<0.05).(4)Green fluorescent cells labeled with green fluorescent protein were observed in spleen tissue of tree shrews the elderly treatment group by frozen tissue section observation.The results show that intravenous infusion of highly active umbilical cord mesenchymal stem cells can migrate to spleen tissue,inhibit the production of reactive oxygen species,down-regulate the expression of aging-related proteins,induce autophagy,promote cell proliferation,reduce chronic inflammation,and then improve the structure and function of spleen tissue.
6.Overview of Chinese Pharmacopoeia 2025 Edition Volume Ⅲ
CAO Yan ; ZHAO Xiong ; WANG Xiaojuan ; CHEN Huiyi ; LI Huiyi
Drug Standards of China 2025;26(1):028-033
“Chinese Pharmacopoeia” is the legal basis for drug development, production, operation, use and management in China, and the Chinese Pharmacopoeia 2025 Edition is going to be issued and implemented. This article introduces the revision and amendment situations, analyzes the characteristics of the new edition of the Pharmacopoeia and the future development direction of national standards for better understanding and implementation of the latest edition of pharmacopoeia.
7.Relationship between c-myc gene rearrangement and clinical characteristics, PET-CT imaging features and prognosis of patients with diffuse large B-cell lymphoma
Xiaojuan ZHANG ; Jialin LI ; Tong ZHAO ; Ling YUAN
Cancer Research and Clinic 2025;37(3):190-197
Objective:To investigate the correlation between c-myc gene rearrangement and clinical characteristics, 18F-deoxyglucose (FDG) PET-CT imaging features and prognosis of patients with diffuse large B-cell lymphoma (DLBCL). Methods:A retrospective cohort study was conducted. A total of 152 patients with DLBCL confirmed by pathology and underwent 18F-FDG PET-CT examination one week before treatment at Shanxi Province Cancer Hospital from September 2010 to December 2022 were selected, and their clinical data and PET-CT imaging data were collected. Fluorescence in situ hybridization (FISH) method was used to detect c-myc gene rearrangement in tumor tissues. The clinical characteristics and PET-CT imaging features between patients with and without c-myc gene rearrangement were compared. Kaplan-Meier method was used to plot the progression-free survival (PFS) and overall survival (OS) curves of patients, and log-rank test was used for inter group comparison. Univariate and multivariate Cox proportional hazards models were used to analyze the factors affecting the prognosis of DLBCL patients. Results:Among the 152 patients, there were 85 males (55.9%) and 67 females (44.1%); the age was (58±15) years old (range: 25-81 years old); 22 cases (14.5%) had c-myc gene rearrangement (including 7 cases of double hit), while the remaining 130 cases (85.5%) did not have c-myc gene rearrangement. There were statistically significant differences in the compositions of patients with different treatment plans, National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) scores, elevated lactate dehydrogenase (LDH) levels, positive bcl-6 protein, 18F-FDG PET-CT parameters, metabolic tumor volume (MTV) ≥ 256.04 cm 3, total lesion glycolysis (TLG) ≥ 2 292.34 g between patients with and without c-myc gene rearrangement (all P < 0.05); there were no statistically significant differences in the compositions of patients with different genders, age, tumor involvement range, Ann Arbor staging, immunophenotyping, bone marrow invasion, hepatitis B virus infection, CD10 protein, MUM1 protein, bcl-2 protein, and other 18F-FDG PET-CT imaging parameters (all P > 0.05). The MTV [(727±268) cm 3vs. (314±33) cm 3] and TLG [(8 965±1 868) g vs. (5 341±627) g] of patients with c-myc gene rearrangement were higher than those of patients without c-myc gene rearrangement, and the differences were statistically significant ( t values were 3.07 and 2.19, respectively, and P values were 0.003 and 0.035, respectively); there was no statistically significant difference in the maximum standardized uptake value, average standardized uptake value, tumor maximum standardized uptake value-to-blood maximum standardized uptake value ratio (TBR), and tumor maximum standardized uptake value-to-liver maximum standardized uptake value ratio between patients with and without c-myc gene rearrangement (all P > 0.05). The median follow-up period was 79.5 months (range: 6-153 months). The PFS and OS of patients with c-myc gene rearrangement were worse than those of patients without c-myc gene rearrangement, and the differences were statistically significant (both P < 0.001). Univariate Cox regression analysis showed that Ann Arbor staging, NCCN-IPI score, LDH level, c-myc gene rearrangement, MTV, TLG, and TBR were all associated with poor PFS and OS in DLBCL patients (all P < 0.05); multivariate Cox regression analysis showed that the presence of c-myc gene rearrangement was an independent risk factor for PFS (with vs. without, HR = 3.362, 95% CI: 1.825-6.193, P < 0.001) and OS (with vs. without, HR = 4.441, 95% CI: 2.226-8.857, P < 0.001) in DLBCL patients, and NCCN-IPI score (≥ 4 points vs. 0-3 points, HR = 2.439, 95% CI: 1.086-5.495, P = 0.031) and MTV (≥ 256.04 cm 3vs. <256.04 cm 3, HR = 2.439, 95% CI: 1.021-5.814, P = 0.045) were independent risk factors for PFS. Conclusions:DLBCL patients with c-myc gene rearrangement have high tumor burden, late clinical stage and poor prognosis. The rearrangement of c-myc gene may be a predictive factor for disease progression and death in DLBCL patients.
8.Clinical features and prognosis of patients with primary sclerosing cholangitis:An analysis of 107 cases
Tongtong MENG ; Weijia DUAN ; Xinyu LI ; Junqi NIU ; Huiguo DING ; Ying HAN ; Wen XIE ; Lu ZHOU ; Bangmao WANG ; Liping GUO ; Jie LI ; Bei JIA ; Lingyi ZHANG ; Liang WANG ; Xiaoqian XU ; Yu WANG ; Xiaojuan OU ; Xinyan ZHAO ; Hong YOU ; Jidong JIA ; Yuanyuan KONG
Journal of Clinical Hepatology 2025;41(7):1337-1343
Objective To describe the clinical features of patients with primary sclerosing cholangitis(PSC)in China based on a nationwide multicenter patient cohort,and to investigate the risk factors for prognosis.Methods A retrospective cohort study was conducted among the patients with a confirmed diagnosis of PSC based on the electronic medical record system of seven grade A tertiary hospitals across the country,and related data were extracted.The Mann-Whitney U test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to estimate liver transplant-free survival,and the log-rank test was used for comparison of survival rate between PSC patients with different features.The Cox regression model was used to identify independent risk factors for the prognosis of PSC patients and the interactions between key factors.Results A total of 107 patients were enrolled,among whom 55.6%(55/99)had large-duct PSC and 29.0%(31/107)had comorbidity with inflammatory bowel disease(IBD).The positivity rate of anti-neutrophil cytoplasmic antibody(ANCA)was 32.9%(24/73),and 50.0%(40/80)of the patients had an increase in IgG/IgM.The median symptom-to-diagnosis interval was 1 year(<1-4.0),and 38.3%(41/107)of the patients had progressed to decompensated cirrhosis at the time of diagnosis.The median liver transplant-free survival time was 114 months(95%confidence interval[CI]:62-166),with a 5-year survival rate of 65.7%.The multivariate analysis showed that an increase in total bile acid(TBA)(hazard ratio[HR]=1.006,95%CI:1.002-1.010,P=0.001)and a prolonged symptom-to-diagnosis interval(HR=1.252,95%CI:1.059-1.480,P=0.009)were independent risk factors for prognosis.The interaction analysis showed that compared with the female patients with TBA<50 μmol/L,both male and female patients with TBA≥50 μmol/L had a significant increase in the risk of liver transplantation or death(male:HR=16.563,95%CI:2.103-130.449,P<0.001;female:HR=17.009,95%CI:2.113-136.934,P<0.001),and compared with the patients with an age of<45 years and a TBA level of<50 μmol/L,the patients with an age of≥45 years and a TBA level of≥50 μmol/L had a significant increase in the risk of liver transplantation or death(HR=10.729,95%CI:1.325-86.859,P=0.026).Compared with the female patients with an symptom-to-diagnosis interval of≤2 years,the male patients with a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.825,95%CI:1.725-13.644,P=0.003),and compared with the patients with an age of<45 years and a symptom-to-diagnosis interval of≤2 years,the patients with an age of<45 years and a symptom-to-diagnosis interval of>2 years had an increased risk of liver transplantation or death(HR=4.983,95%CI:1.366-18.173,P=0.015).Conclusion Compared with the reports from Western countries,large-duct PSC is also the main type of PSC in China,but with a relatively low proportion,and there is also a relatively low proportion of patients with IBD or positive ANCA.An increase in TBA and a prolonged symptom-to-diagnosis interval are independent risk factors for prognosis,with significant interactions with age and sex.This suggests that early screening and intervention should be enhanced to improve prognosis.
9.Evaluation on the Efficacy and Advantages and Mechanisms of TCM in Preventing and Treating"Inflammation-cancer Transformation"of Colorectal Adenoma-colorectal Cancer
Xiaojuan TANG ; Yuan REN ; Min HE ; Liang ZHAO ; Yuan LYU ; Yongmin LI ; Jing HUANG ; Yongheng HE
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(2):20-24
Colorectal adenoma is a definite precancerous lesion,and the"inflammation-cancer transformation"is a key pathological link in the process of colorectal adenoma-cancer evolution.Under the guidance of the theory of"preventive treatment of diseases"in TCM,prevention before disease onset and preventing the development of the occurred disease has become the consensus and the important subject of clinical research to block the"inflammation-cancer transformation"and prevent the precancerous lesions of colorectal cancer.This article discussed the effectiveness of TCM in preventing and treating the"inflammation-cancer transformation"from different aspects.Its advantages are reflected in improving the symptoms of TCM and improving the quality of life,etc.Its mechanism may be related to inhibiting the activation of cancer-promoting signals,regulating inflammation,maintaining intestinal microbial homeostasis,and protecting the intestinal barrier.By explaining the pathogenesis of adenoma-cancer transformation in TCM,this article discussed the efficacy and advantages of TCM to block"inflammation-cancer transformation",analyzed its intervention targets and pathways,providing references for the intervention of TCM in the management of precancerous lesions of colorectal cancer and the synergistic prevention and treatment of traditional Chinese and Western medicine.
10.MRI radiomics combined with ResNet101 deep learning for differentiating lumbar spine brucella spondylitis and spinal metastases
Yupu LI ; Pengfei ZHAO ; Xiaojuan ZHANG ; Zhaojing ZHANG ; Ziyi WANG ; Pengfei QIAO
Chinese Journal of Medical Imaging Technology 2025;41(6):958-962
Objective To observe the value of MRI radiomics combined with ResNet101 deep learning for differentiating lumbar spine brucella spondylitis(BS)and spinal metastases(SM).Methods Seventy-one cases of lumbar spine BS and the same amount of lumbar spine SM patients were retrospectively enrolled in training set,while 33 cases of lumbar spine BS and the same amount of lumbar spine SM patients were enrolled in test set.Clinical features were screened with univariate and multivariate logistic analysis,and a clinical model(Mclinic)was constructed.ROI of lesions were drawn on lumbar sagittal T 2WI,then radiomics features were extracted to construct a radiomics model(Mradiomics).ResNet101 deep learning was integrated with radiomics,then deep learning radiomics features were extracted to construct deep learning radiomics model(MDL+R).Finally a combined model(Mcombined)was constructed through combining clinical features and deep learning radiomics features.The efficacy of the above models for differentiating BS and SM were analyzed.Results Significant differences of patients' age and proportion of fever and accessory involvement were found between BS and SM patients in training and test sets(all P<0.05),and univariate and multivariate logistic analysis showed the latter two were clinical features(both P<0.001).The area under the curve(AUC)of Mclinic for differentiating lumbar spine BS and SM was 0.794 and 0.773 in training set and test set,of Mradiomics was 0.895 and 0.791,of MDL+R was 0.926 and 0.882,while of Mcombined was 0.967 and 0.906,respectively.AUC of Mcombined was the highest in training set(all P<0.05),while in test set,AUC of Mcombined was significantly higher than that of Mclinic and Mradiomics(both P<0.05).Conclusion MRI radiomics combined with ResNet101 deep learning was helpful for differentiating lumbar spine BS and SM.Combining with clinical data could improve its diagnostic efficacy.


Result Analysis
Print
Save
E-mail