1.Construction and Application Evaluation of an Integrated Traditional Chinese and Western Medicine Risk Prediction Model for Readmission in Patients with Stable Angina of Coronary Heart Disease:A Prospective Study Based on Real-World Clinical Data
Wenjie HAN ; Mingjun ZHU ; Xinlu WANG ; Rui YU ; Guangcao PENG ; Qifei ZHAO ; Jianru WANG ; Shanshan NIE ; Yongxia WANG ; Jingjing WEI
Journal of Traditional Chinese Medicine 2025;66(6):604-611
ObjectiveBy exploring the influencing factors of readmission in patients with stable angina of coronary heart disease (CHD) based on real-world clinical data, to establish a risk prediction model of integrated traditional Chinese and western medicine, in order to provide a basis for early identification of high-risk populations and reducing readmission rates. MethodsA prospective clinical study was conducted involving patients with stable angina pectoris of CHD, who were divided into a training set and a validation set at a 7∶3 ratio. General information, traditional Chinese medicine (TCM)-related data, and laboratory test results were uniformly collected. After a one-year follow-up, patients were classified into a readmission group and a non-readmission group based on whether they were readmitted. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for readmission. A risk prediction model of integrated traditional Chinese and western medicine was constructed and visualized using a nomogram. The model was validated and evaluated in terms of discrimination, calibration, and clinical decision curve analysis. ResultsA total of 682 patients were included, with 477 in the training set and 205 in the validation set, among whom 89 patients were readmitted. Multivariate logistic regression analysis identified heart failure history [OR = 6.93, 95% CI (1.58, 30.45)], wiry pulse [OR = 2.58, 95% CI (1.42, 4.72)], weak pulse [OR = 3.97, 95% CI (2.06, 7.67)], teeth-marked tongue [OR = 4.38, 95% CI (2.32, 8.27)], blood stasis constitution [OR = 2.17, 95% CI (1.06, 4.44)], phlegm-stasis mutual syndrome [OR = 3.64, 95% CI (1.87, 7.09)], and elevated non-high-density lipoprotein cholesterol [OR = 1.30, 95% CI (1.01, 1.69)] as influencing factors of readmission. These factors were used as predictors to construct a nomogram-based risk prediction model for readmission in patients with stable angina. The model demonstrated moderate predictive capability, with an area under the receiver operating characteristic curve (AUC) of 0.818 [95% CI (0.781, 0.852)] in the training set and 0.816 [95% CI (0.779, 0.850)] in the validation set. The Hosmer-Lemeshow test showed good calibration (χ² = 4.55, P = 0.80), and the model's predictive ability was stable. When the threshold probability exceeded 5%, the clinical net benefit of using the model to predict readmission risk was significantly higher than intervening in all patients. ConclusionHistory of heart failure, teeth-marked tongue, weak pulse, wiry pulse, phlegm-stasis mutual syndrome, blood stasis constitution, and non-high-density lipoprotein cholesterol are influencing factors for readmission in patients with stable angina of CHD. A clinical prediction model was developed based on these factors, which showed good discrimination, calibration, and clinical utility, providing a scientific basis for predicting readmission events in patients with stable angina.
2.Improvement effects and mechanism of total secondary ginsenosides on hypertrophic changes in cardiomyocytes
Bin LI ; Jia LI ; Zhongjie YUAN ; Mingjun ZHU ; Shiyang XIE ; Yuan GAO ; Rui YU ; Xinlu WANG
China Pharmacy 2025;36(12):1430-1435
OBJECTIVE To investigate the ameliorative effects and potential mechanism of total secondary ginsenosides (TSG) on hypertrophic changes of primary cardiomyocytes stimulated by angiotensin Ⅱ (Ang Ⅱ). METHODS Primary cardiomyocytes were isolated from the hearts of neonatal SD rats and divided into the following groups: control group, AngⅡ group (2 µmol/L), TSG group (7.5 µg/mL), PFK-015 group [6-phosphofructo-2-kinase/fructose-2, 6-bisphosphatase 3 (PFKFB3) inhibitor, 10 nmol/L], and TSG+PFK-015 group (TSG 7.5 µg/mL+PFK-015 10 nmol/L). The surface area, protein synthesis, energy metabolism-related indicators [free fatty acid (FFA), coenzyme A (CoA), acetyl coenzyme A (acetyl-CoA)], and the expressions of glycolysis-related factors [hypoxia-inducible factor 1α (HIF-1α), glucose transporter protein 4 (GLUT-4), lactate dehydrogenase A (LDHA), pyruvate dehydrogenase kinase 1 (PDK1) and PFKFB3] in primary cardiomyocytes of each group were measured. RESULTS Compared with the control group, the surface area of primary cardiomyocytes and protein synthesis were significantly increased, the content of FFA, protein and mRNA expressions of HIF-1α, LDHA, PDK1 and PFKFB3 were significantly increased or up-regulated in the AngⅡ group, while the contents of CoA and acetyl-CoA, the protein and mRNA expressions of GLUT-4 were significantly decreased or down-regulated (P<0.05). Compared with the AngⅡ group, both TSG group and PFK-015 group showed significant improvements in these indexes, with the TSG+PFK-015 group generally demonstrating superior effects compared to either treatment alone (P<0.05). CONCLUSIONS TSG can reduce the surface area of AngⅡ-induced primary cardiomyocytes, decrease protein synthesis, and inhibit their hypertrophic changes. These effects may be related to improving energy metabolism and the inhibition of glycolysis activity.
3.Hemolysis rates of three red blood cell components at the end of storage: a 5-year retrospective study
Zhenping LU ; Fufa LIU ; Meiyan KANG ; Xianbin WU ; Yanting WANG ; Xing LONG ; Xinlu QIU ; Jin LI
Chinese Journal of Blood Transfusion 2025;38(6):828-832
Objective: To evaluate the suitability of the existing hemolysis rate standards for locally processed red blood cell components by retrospectively analyzing 5-year hemolysis rate data at the end of storage. Methods: A total of 720 blood samples of three types of red blood cell components from our blood station from January 2019 to December 2023 were collected. Parameters included hemoglobin concentration (Hb), hematocrit (Hct), and free hemoglobin concentration (fHb). Hemolysis rate were taken as the control standard of 0.8% in accordance with the national standard. The hemolysis rates were compared against the national standard threshold of 0.8% (GB18469-2012), and annual trends of the detection parameters were observed. Results: The hemolysis rates (x-+s,%) of leukocyte-depleted whole blood at the end of storage were (0.038±0.023 8) in 2019, (0.049±0.039 5) in 2020, (0.043±0.040 7) in 2021, (0.049±0.030 7) in 2022, and (0.058±0.054 8) in 2023, respectively; The hemolysis rates (x-+s" />,%) of leukocyte-depleted suspended red blood cells at the end of storage were (0.093±0.050 2) in 2019, (0.086±0.049 5) in 2020, (0.123±0.072 3) in 2021, (0.122±0.052 1) in 2022, and (0.106±0.058 6) in 2023, respectively; The hemolysis rates (x-+s,%) of washed red blood cells at the end of storage were (0.127±0.038 2) in 2019, (0.150±0.066 5) in 2020, (0.121±0.052 2) in 2021, (0.124±0.038 9) in 2022, and (0.128±0.044 3) in 2023, respectively. Conclusion: Hemolysis rates at the end of blood storage of three red blood cell components were significantly lower than the limits specified in Quality Requirements for Whole Blood and Components (GB18469-2012), as well as standards from the EU, AABB and the United States. The results demonstrate excellent product quality control. A regional internal control standard of <0.2% is proposed for hemolysis rates at the end of storage.
4.Analysis of blood turbidity and collateral disease
Baogeng HUAI ; Xiaoyue SHEN ; Yun QIAO ; Yingjuan CAO ; Dieshan LIU ; Xinlu WANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(6):779-784
Blood turbidity and collateral disease are closely related to each other as the important component parts of the theoretical system of modern traditional Chinese medicine (TCM). The former focuses on blood and the latter on blood vessels and collaterals. By integrating these two theories, a theoretical basis for TCM syndrome differentiation and treatment of modern diseases can be provided. This article summarizes the correlation of origin, concept, treatment method and representative drugs of two theories, and points out that both blood turbidity and collateral disease prospers and develops through the integration of TCM classical theory and modern medical achievements. Theoretically, blood turbidity is the cause of collateral disease, and collateral disease is the result of aggravated blood turbidity. In many metabolic diseases, blood turbidity and collateral disease actually correspond to the main features of the early and late stages of the same disease, respectively. In treatment, clearing blood turbidity is consistent with dredging collaterals. When clearing blood turbidity, it is necessary to dredge the collaterals, and when dredging the collaterals, it is necessary to clear the blood turbidity. In terms of prescription and medication, Huazhuo Xingxue Decoction is the representative prescription of blood turbidity, which can be combined with Ramulus Cinnamomi, Sichuan lovage rhizome, earthworm, and other dredging collateral drugs. The representative prescription for collateral disease is Tongxinluo Capsule, which can be combined with lotus leaf, Fructus Crataegi, cassia seed, and other turbid-clearing drugs to enhance the curative effect.
5.Regulation of Signaling Pathways Related to Myocardial Infarction by Traditional Chinese Medicine: A Review
Wenjun WU ; Chidao ZHANG ; Jingjing WEI ; Xue LI ; Bin LI ; Xinlu WANG ; Mingjun ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):321-330
The pathological changes of myocardial infarction (MI) are mainly characterized by progressive myocardial ischemic necrosis, decline in cardiac diastolic function, thinning of the ventricular wall, and enlargement of the ventricles. The clinical manifestations include myocardial ischemia, heart failure, arrhythmia, shock, and even sudden cardiac death, rendering MI one of the most perilous cardiovascular diseases. Currently, the clinical treatment for MI primarily involves interventional procedures and drug therapy. However, due to their significant side effects and high complication rates associated with these treatments, they fail to ensure a satisfactory quality of life and long-term prognosis for patients. On the other hand, traditional Chinese medicine has demonstrated remarkable potential in improving patient prognosis while reducing side effects. Research has elucidated that various signaling pathways such as nuclear transcription factor-κB (NF-κB), adenosine 5̒-monophosphate-activated protein kinase (AMPK), transforming growth factor-β (TGF-β)/Smads, mitogen-activated protein kinase (MAPK), Wnt/β-catenin (β-catenin), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B(Akt) play crucial roles in regulating the occurrence and development of MI. Effectively modulating these signaling pathways through its therapeutic interventions, traditional Chinese medicine can enhance MI management by inhibiting apoptosis, providing anti-inflammatory properties, alleviating oxidative stress levels, and resisting myocardial ischemia. Due to its notable efficacy and favorable safety, it has become an area of focus in clinical practice.
6.Correlation between gut microbiota and diffuse large B-cell lymphoma based on Mendelian randomization
Juan LIU ; Mingliang CHEN ; Liping HUANG ; Wei YIN ; Xinlu LIN ; Yanqiu LI ; Xin WANG
Chongqing Medicine 2025;54(3):652-658
Objective To investigate the causal relationship between gut microbiota and diffuse large B-cell lymphoma(DLBCL).Methods Employed a two-sample bidirectional Mendelian randomization approach,using summary statistics from genome-wide association studies(GWAS)to extract single nucleotide polymor-phisms(SNPs)associated with exposure and outcome as instrumental variables.Exposure instrumental varia-bles(P<1×10-5)and outcome instrumental variables(P<5×10-8)were selected based on the P-values of SNPs.Three different Mendelian randomization methods were used to analyze the relationship between gut microbiota and DLBCL,with sensitivity analyses including heterogeneity,pleiotropy,and leave-one-out tests.Results Bilophila(OR=2.043,95%CI:1.279-3.264),Coprobacter(OR=1.371,95%CI:1.035-1.816),Eubacterium eligens group(OR=1.996,95%CI:1.291-3.087)increased the risk of DLBCL.Alistipes(OR=0.588,95%CI:0.359-0.963),Eubacterium eligens group(OR=1.996,95%CI:1.291-3.087),Slackia(OR=0.688,95%CI:0.479-0.988)reduced the risk of DLBCL.Reverse Mendelian randomization a-nalysis failed to reveal any evidence of a causal relationship between DLBCL and the six gut microbiota.Con-clusion There is a causal association between gut microbiota and DLBCL.
7.Analysis of sleep status and impact factor of patients in clinical trials of antineoplastic drugs
Lingjun LI ; Weiying ZHANG ; Wenjin WANG ; Xiuyue YANG ; Yuting HU ; Jing WANG ; Xinlu YAN
Chinese Journal of Practical Nursing 2024;40(29):2279-2284
Objective:To explore the sleep status and impact factor analysis of patients in clinical trials of antineoplastic drugs, and provide a basis for improving the sleep status and impact analysis of patients in clinical trials of antineoplastic drugs.Methods:From April to May 2023, 107 oncology patients in the Phase I Clinical Trial Ward of the Affiliated East Hospital of Tongji University were selected as the research objects by convenient sampling method. The general information questionnaire, Pittsburgh Sleep Quality Index Scale (PSQI), Numeric rating scale (NRS), Generalized Anxiety Disorder Scale (GAD-7) and Depression Self-Ration Tool Scale (PHQ-9). Multivariate Logistic regression analysis methods were used to carry out a cross-sectional investigation and the relevant factors affecting patients′sleep.Results:Totally 103 questionnaires were effectively collected. The 103 patients′ age ranged from 20 to 75 years old, including 61 males and 42 females. 47.57% (49/103) patients in clinical trials of antineoplastic drugs had abnormal sleep. The average score of patients (PSQI) (7.66 ± 3.93) was higher than the average score of the domestic norm (3.88 ± 2.52), and there was significant statistical difference ( t = 9.76, P<0.01). Logistic regression analysis showed that pain ( OR = 3.004, 95% CI 1.135-7.948, P<0.05) and trial cycle ( OR = 0.432, 95% CI 0.191-0.978, P<0.05) were significant risk factors for abnormal sleep quality. Conclusions:The incidence of abnormal sleep quality in patients of clinical trials of antineoplastic drugs is high, but the sleep quality is poor. The factors that affect the sleep quality of patients in clinical trials of antineoplastic drugs are mainly related to the patient′s trial cycle and cancer pain. According to these characteristics, individualized programs should be developed to improve the sleep quality of patients with advanced cancer, so as to improve the quality of life of patients with advanced cancer.
8.MRI for differential diagnosis of ovarian granulosa cell tumor and ovarian thecoma-fibroma
Xinlu ZHANG ; Wenwei TANG ; Hailei GU ; Zhongfu TIAN ; Yao YAO ; Zebo HUANG ; Lili WANG
Chinese Journal of Interventional Imaging and Therapy 2024;21(5):289-293
Objective To observe the value of MRI for differential diagnosis of ovarian granulosa cell tumor(OGCT)and ovarian thecoma-fibroma(OTF).Methods Data of 37 females with OGCT(OGCT group)and 74 with OTF(OTF group)were retrospectively analyzed.MRI parameters were compared between groups.Multiple logistic regression analysis was performed,and the efficacy of each parameter alone and their combination for distinguishing OGCT and OTF were observed.Results Significant differences of cystic-solid classification,degree of cystic changes,the maximum diameter of cyst area of lesions,T2WI signal,enhancement degree and apparent diffusion coefficient(ADC)of the solid part of lesions,presence of honeycomb sign/cheese sign,presence of tumor blood vessels and bleeding were found between groups(all P<0.05).Degree of cystic changes,ADC and presence of honeycomb sign/cheese sign were impact factors of MRI for distinguishing OGCT and OTF.The area under the curve(AUC)of the above three for distinguishing OGCT and OTF was 0.834,0.868 and 0.744,respectively,and of the combination was 0.934,greater than any alone(all P<0.05).Conclusion MRI features such as degree of cystic changes,ADC and presence of honeycomb sign/cheese sign were helpful for distinguishing OGCT and OTF.
9.Application value of 18F-D3FSP PET/CT in patients with cognitive impairment of varying degrees
Sihao LIANG ; Anqi LI ; Ruiyue ZHAO ; Jingwen LI ; Peng HOU ; Shuang XIONG ; Zhuohua WU ; Xiang CHEN ; Yuying HUANG ; Tengfei GUO ; Xinlu WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2024;44(5):260-265
Objective:To explore the effectiveness of 18F-deuterated-Florbetapir (D3FSP) PET/CT imaging in detecting β-amyloid (Aβ) deposition in the brain and its correlation with plasma biomarkers. Methods:A retrospective analysis was conducted on 79 patients (32 males, 47 females; age(66±7)years) who underwent 18F-D3FSP PET/CT imaging from June 2022 to November 2023 at the First Affiliated Hospital, Guangzhou Medical University, as a part of the Greater Bay Area Healthy Aging Brain Longitudinal Cohort Study (GHABS). Based on the Alzheimer′s Disease Neuroimaging Initiative cohort standard protocol, patients were categorized into cognitively unimpaired (CU) group, mild cognitive impairment (MCI) group, and Alzheimer′s disease (AD) group. Brain regions were segmented using the AW workstation and the SUV ratio (SUVR) was calculated with the cerebellum as the reference region. One-way analysis of variance, Bonferroni correction and Pearson correlation analysis were used to analyze data. The ROC curve analysis was used to analyze the cut-off value and the diagnostic efficacy of SUVR. Results:There were 48, 15 and 16 cases in CU, MCI and AD groups respectively. During the transition from CU to MCI and then to AD, there was a rising trend in SUVR ( F values: 11.15-22.38, all P<0.001) across the whole brain and various brain regions (bilateral frontal lobes, bilateral anterior cingulate gyrus, bilateral precuneus, bilateral parietal lobes, bilateral lateral temporal lobes, and bilateral occipital lobes). SUVRs of the right anterior cingulate gyrus and bilateral precuneus were different between the CU and MCI groups (all P<0.017), and those of bilateral frontal lobes, right precuneus, bilateral parietal lobes, bilateral lateral temporal lobes, and bilateral occipital lobes were different between the MCI and AD groups (all P<0.017). SUVRs of brain regions were negatively correlated with cognitive scale scores ( r values: from -0.57 to -0.37, all P<0.001), and were positively correlated with plasma phosphorylated tau181 (p-tau181, r values: 0.50-0.61, all P<0.001). The ROC curve analysis suggested that the cut-off value of SUVR in the precuneus for distinguishing CU from AD was 1.20, with the AUC, sensitivity, specificity and accuracy of 0.85, 12/16, 91.7%(44/48)and 87.5%(56/64), respectively. Conclusion:18F-D3FSP PET/CT imaging has good clinical application value in assessing the deposition sites and the extent of Aβ in the brain, which is related to clinical cognition and plasma p-tau181 level.
10.Application of 18F-AlF-P16-093 PET combined with multiparametric MRI in the diagnosis of primary prostate cancer lesions: a head-to-head comparative study based on needle biopsy pathology
Miao KE ; Jinhui LIU ; Shaonan ZHONG ; Jing ZHANG ; Mingzhao LI ; Di GU ; Ruiyue ZHAO ; Xinlu WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2024;44(9):533-538
Objective:To evaluate the diagnostic efficacy of the novel prostate specific membrane antigen (PSMA)-targeted PET imaging agent 18F-AlF-P16-093 in combination with multiparametric MRI (mpMRI) for prostate cancer (PCa), and to explore its application in guiding transperineal puncture biopsy. Methods:A retrospective analysis was conducted on the clinical and pathological data of 36 patients diagnosed as PCa (age: 68-76 years) who underwent 18F-AlF-P16-093 PET/CT and mpMRI examinations at the First Affiliated Hospital of Guangzhou Medical University from August 2023 to March 2024. The entire prostate was divided into 12 regions based on biopsy localization. Imaging evaluations were performed using PET/CT and mpMRI at the lesion level, with biopsy pathology as the gold standard. The correlations between mpMRI scores, PET/CT scores and pathological diagnosis results were evaluated by Phi coefficient analysis. Diagnostic efficacy was assessed by ROC curve analysis. Logistic regression was used to determine the impact of bleeding on image interpretation. Results:18F-AlF-P16-093 PET/CT showed a moderate positive correlation with pathological diagnosis result ( Phi=0.415, P<0.001), which was superior to mpMRI ( Phi=0.338, P<0.001). The diagnostic efficacy of PET single-modality model was superior to mpMRI in all indicators. The combination of 18F-AlF-P16-093 PET/CT with mpMRI significantly improved diagnostic specificity and positive predictive value, with the diagnostic specificity of the PET+ T 2 weighted imaging (WI)+ diffusion WI (DWI) and PET+ T 2WI+ DWI+ apparent diffusion coefficient (ADC) combinations exceeding 90%, and the positive predictive value exceeding 80%. Bleeding did not significantly affect the diagnosis of PCa by mpMRI and PET/CT (odds ratio ( OR): 0.463-0.785, all P>0.05). Conclusion:18F-AlF-P16-093 PET/CT is superior to mpMRI in the detection and diagnostic efficacy of PCa lesions, and the combination of 18F-AlF-P16-093 PET with mpMRI can further improve diagnostic specificity and positive predictive value, which is of guiding significance for targeted prostate biopsy.


Result Analysis
Print
Save
E-mail