1.Epidemiological characteristics and influencing factors of latent tuberculosis infection among detainees in eastern China
Xinru FEI ; Peng LU ; Jingxian NING ; Yuchen PAN ; Limei ZHU ; Qiao LIU ; Hongxi ZHOU
Shanghai Journal of Preventive Medicine 2026;38(4):280-283
ObjectiveTo analyze the epidemiological characteristics of latent tuberculosis infection (LTBI) among newly detained populations in eastern China, to identify high-risk groups, and to provide a scientific basis for formulating tuberculosis prevention and control strategies in the prison system. MethodsA cross-sectional study was conducted among the newly admitted detainees in two prisons in eastern China in 2022. Data on demographic characteristics, behavioral risk factors and previous disease history of the research subjects were collected through a structured questionnaire survey. The LTBI status of the detainees was determined using the QuantiFERON-TB Gold In-Tube (QFT-GIT) method. Lasso regression was used to screen variables, followed by multivariate logistic regression analysis to investigate the influencing factors of LTBI. ResultsA total of 305 detainees were included in the study. The median age of detainees was 35 (31, 43) years. The study population was predominantly male (67.21%), of Han ethnicity (95.41%), had a junior or senior high school education (59.34%), and was unemployed (31.80%). A history of smoking was reported by 52.79% of participants, while 57.70% reported no alcohol consumption. The majority had no history of hypertension (85.90%), diabetes mellitus (93.77%), human immunodeficiency virus (HIV) infection (97.38%), familial genetic diseases (95.08%), surgery or trauma (73.77%), drug use (92.79%), or hepatitis (93.77%). The LTBI rate was 14.75%. After comparing the demographic characteristics of LTBI and non-infected groups, it was found that smoking history (χ2=7.40, P=0.025), drug use history (χ2=5.49, P=0.019), and HIV infection (χ2=8.12, P=0.004) were statistically correlated with LTBI infection. The results of multivariate logistic regression analyses showed that smoking [adjusted odds ratio (aOR)=4.08, 95%CI: 1.60‒10.42, P=0.003], HIV infection (aOR=11.57, 95%CI: 2.50‒53.51, P=0.002) and drug use (aOR=3.04, 95%CI: 1.02‒9.09, P=0.046) were risk factors for LTBI. ConclusionThe LTBI rate among newly detainees in two prisons in eastern China is slightly lower than that among long-term detainees. Early screening and intervention should be implemented for newly detainees, with particular attention focused on high-risk groups such as those with a history of smoking, HIV infection, or drug use.
2.Effects of Electrothermal Acupuncture on the HIF-1α/S1P/S1PR3 Pathway and Macrophage Polarization in Epididymal White Adipose Tissue of Obese Model Mice
Xiaobo GE ; Yuanyuan LI ; Jiangyan WEI ; Limin NIE ; Xin YANG ; Quan MIAO ; Mina WANG ; Yawei XI ; Luopeng ZHAO ; Yine SONG ; Xinru SUN ; Lu LIU ; Bin LI
Journal of Traditional Chinese Medicine 2026;67(20):2227-2235
ObjectiveTo investigate the mechanism underlying the weight loss effect of electrothermal acupuncture (ETA) in diet-induced obese (DIO) model mice based on the hypoxia-inducible factor-1α (HIF-1α)/sphingosine-1-phosphate (S1P)sphingosine-1-phosphate receptor 3 (S1PR3) signaling pathway-mediated macrophage polarization. MethodsAn obesity mouse model was established by continuously feeding at a high-fat diet (HFD) for 8 weeks. Twenty successfully modeled obese mice were randomly divided into a model group and an electrothermal acupuncture (ETA) group with 10 mice per group, both of which continued to receive the HFD till week 12. Another 10 mice were assigned to the normal group and fed a standard chow diet continuously for 12 weeks. Starting from week 9 of the experiment, mice in the ETA group received electrothermal acupuncture stimulation at Zhongwan (CV12), bilateral Tianshu (ST25), and bilateral Zusanli (ST36) for 30 minutes per session, with the instrument current set at (40±0.5)mA and a constant temperature of (40±0.5)℃. Mice in the normal group and the model group were restrained in the same manner for 30 minutes without acupuncture. All interventions were performed once every other day for a total of 4 weeks. Ten hours after the final intervention, the body weight, waist circumference, and body length of mice in each group were measured, and Lee's index was calculated. Serum biochemical analysis was performed to assess fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine (Cr). Serum leptin (LEP) and adiponectin (ADPN) levels, as well as sphingosine-1-phosphate (S1P) levels in epididymal white adipose tissue (eWAT), were detected by ELISA. Histomorphological changes in eWAT were monitored via HE staining. Flow cytometry was used to analyze macrophage subtype-related indexes in eWAT, including the total proportion of macrophages, the proportion of M1 macrophages, the proportion of M2 macrophages, and the M1/M2 ratio. Antibody array technology was used to determine the levels of differentially expressed inflammatory factors in eWAT between the model and blank groups, as well as between the ETA and model groups. Western blot and qPCR were used to detect the protein and mRNA expression levels of HIF-1α and S1PR3 in the eWAT, respectively. ResultsCompared to the normal group, the model group showed significantly increased body weight, Lee's index, waist circumference, and FBG, TC, TG, HDL-C, LDL-C, AST, and ALT levels, upgraded LEP and S1P levels, decreased ADPN level and ADPN/LEP ratio, elevated proportion of M1 macrophages and the M1/M2 ratio, reduced proportion of M2 macrophages, and upregulated protein and mRNA expression levels of HIF-1α and S1PR3 (P<0.05 or P<0.01). With the exception of HDL-C, all the abovementioned indicators in the ETA group were significantly improved compared to the model group (P<0.05 or P<0.01). Analysis of differentially expressed inflammatory cytokines revealed that, compared to the normal group, the levels of interleukin-1β (IL-1β), interferon-γ (IFN-γ), interleukin-6 (IL-6), and interleukin-12p70 (IL-12p70) in the eWAT of the model group were elevated; conversely, the levels of interleukin-17 (IL-17), interleukin-5 (IL-5), IL-6, and interleukin-23 (IL-23) in the eWAT of the ETA group decreased compared to the model group (P<0.05 or P<0.01). ConclusionETA exerts a weight-reducing effect in obese model mice, and the mechanism may involve inhibition of the HIF-1α/S1P/S1PR3 signaling pathway activation, which shifts macrophage polarization from the M1 to M2 phenotype, thereby alleviating chronic inflammation.
3.Randomized Controlled Study of Baoshen Prescription in Treating Stage Ⅳ Diabetic Nephropathy in Patients with Syndromes of Qi-Yin Deficiency and Kidney Collateral Stasis and Obstruction
Yiting QIU ; Shuangshuang HONG ; Zhiqiu LIU ; Xinru SUN ; Yuefen WANG ; Mengchao LIU ; Wenjing ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):124-131
ObjectiveTo evaluate the clinical efficacy and safety of Baoshen prescription in the treatment of stage Ⅳ diabetic nephropathy (DN) in the patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction, and to explore the mechanism of this prescription delaying the disease progression. MethodsA randomized, controlled, double-blind, multicenter clinical trial was conducted, in which 94 stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction were randomly assigned into Baoshen prescription and control groups (47 cases). The treatment lasted for 12 weeks. The primary efficacy indicators were mainly renal function indexes, including urine albumin-to-creatinine ratio (UACR), 24-hour urine total protein (24 h-UTP), serum creatinine (SCr), and estimated glomerular filtration rate (eGFR). The secondary efficacy indicators were metabolic memory of hyperglycemia, podocyte epithelial-to-mesenchymal transdifferentiation-related indexes, and TCM syndrome score. ResultsAfter 12 weeks of treatment, the Baoshen prescription group showed lowered levels of advanced glycation end products (lgAGEs), connective tissue growth factor (CTGF), type Ⅳ collagen (Col-Ⅳ), receptor of AGEs (RAGE), urinary fibroblast-specific protein-1 (FSP-1), UACR, 24 h-UTP, and glycated hemoglobin (HbAlc) (P<0.05), and an upward trend of miR-21 mRNA. The control group showed elevated levels of SCr and UREA and lowered levels of urinary FSP-1, eGFR, and HbAlc (P<0.05). After treatment, the Baoshen prescription group had lower levels of lgAGEs, CTGF, urinary FSP-1, SCr, UACR, and 24 h-UTP and higher levels of Col-Ⅳ and eGFR than the control group (P<0.05). In addition, the Baoshen prescription group showed statistically significant differences in SCr, eGFR, UACR, and 24 h-UTP before and after treatment (P<0.05). ConclusionBaoshen prescription can effectively improve the renal function, reduce the urinary protein level, and alleviate clinical symptoms in stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction. The mechanism may be related to the metabolic memory of hyperglycemia and epithelial-to-mesenchymal transdifferentiation of podocytes.
4.Analysis of Dengue virus nucleic acid testing screening among blood donors in Xishuangbanna Dai Autonomous Prefecture, China
Xinru LIU ; Shaofang LU ; Ying YAN ; Jing DONG ; Ji WU ; Jie MA ; Le CHANG ; Huimin JI ; Huizhen SUN ; Mingwen DENG ; Xiaoqian GAO ; Lunan WANG
Chinese Journal of Blood Transfusion 2025;38(12):1662-1668
Objective: To investigate the prevalence of Dengue virus (DENV) infection among voluntary blood donors in Xishuangbanna Dai Autonomous Prefecture, and to evaluate the necessity of implementing nucleic acid testing (NAT) for blood donors during the rainy season (May-October). Methods: Prior to initiating donor screening, the Xishuangbanna Central Blood Center conducted in-house validation of reagent performance and participated in external quality assessment (EQA) organized by the National Center for Clinical Laboratories (NCCL). During the surveillance period (August-October 2024), a total of 2 919 donor samples were screened using a 6-sample mini-pool NAT strategy. Daily internal quality controls were recorded. Samples that tested positive in pooled screening were deconvoluted and retested in duplicate; only those reactive in both replicate wells were sent to the NCCL for confirmatory testing. At NCCL, samples underwent re-testing using five domestic NAT reagents, as well as serological assays for NS1 antigen and DENV-specific IgG/IgM. Confirmed positive samples were further characterized by serotyping, envelope (E) gene sequencing, and phylogenetic analysis using the maximum likelihood method. Results: The DENV NAT reagent demonstrated consistent detection of 40 copies/mL controls in individual donor (ID)-NAT test (mean CT: 35.61±0.40). During the 63-day quality control monitoring, DENV detection remained stable (mean CT: 22.53±0.72). The center achieved full marks in EQA assessments for 2023 and 2024. Three reactive pools were identified in initial screening, and subsequent individual testing confirmed three DENV RNA-positive donors (sample numbers: 2401, 2402, and 2403). The confirmatory test results from NCCL were: all five NAT platforms consistently detected DENV RNA in the three samples; for serological tests, 2 samples (2402, 2403) were positive for NS1 antigen, while all three samples were negative for both IgG and IgM antibodies. DENV serotyping reagents identified DENV-2 in all cases, which were further confirmed as DENV-2 Genotype Ⅱ-Cosmopolitan by E gene sequencing. Phylogenetic analysis indicated that samples 2401 and 2402 clustered with Southeast Asian strains (Thailand/MZ636802.1, Laos/PQ775621.1), while sample 2403 closely matched a previously reported local Yunnan strain (PV544686.1). Conclusion: DENV-2 infection was detected among blood donors in Xishuangbanna during the rainy season, indicating concurrent risks of imported and local transmission. We recommend implementing pooled NAT screening for blood donors in high-risk areas during dengue epidemic seasons, along with strengthened laboratory quality control, to enhance blood safety.
5.Research progress of repetitive transcranial magnetic stimulation in regulating neural electrical activity in early Alzheimer′s disease
Xinru LI ; Ruru WANG ; Zhipeng LIU ; Tao YIN ; Xin WANG
International Journal of Biomedical Engineering 2025;48(3):288-294
Alzheimer′s disease (AD) is a degenerative disorder of the central nervous system. In the early stages of AD, i.e. when cognitive impairment is mild or absent but biomarkers are present, patients show abnormal neuroelectric activity. Repetitive transcranial magnetic stimulation (rTMS) is an important method of non-invasively regulating neuroelectric activity in the brain. It does so by inducing microcurrents to change the membrane potential of nerve cells in the brain based on electromagnetic induction. In this review, the characteristics of neuroelectric activity of AD patients and AD model mice in the early stage of AD were mainly introduced, and the regulation of rTMS on the neuroelectric activity of early AD was discussed.
6.Association of Arterial Elasticity with Left Ventricular Structure and Function
Zhiran LIU ; Bin CHEN ; Xinru XU
Journal of Medical Research 2025;54(9):79-85
Objective To investigate the association between brachial-ankle pulse wave velocity(baPWV)and left ventricular structure and function.Methods A total of 4864 participants who completed baPWV and transthoracic echocardiography from January 2010 to December 2021 were included.The participants were divided into three groups based on baPWV:Group T1:baPWV<14m/s;Group T2:14m/s≤baPWV<18m/s;Group T3:baPWV ≥18m/s.Multivariable Logistic regression and linear regression was used to examine the correlation between baPWV and interventricular septal thickness(IVS),left ventricular posterior wall thickness(LVPW),left ventricular end diastolic diameter(LVEDd),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),and the presence of mitral e'/a'<1.Results Increased baPWV was significantly associated with thickening of IVS(β=0.095,95%CI:0.007-0.182),thickening of LVPW(β=0.145,95%CI:0.056-0.233),and mitral e'/a'<1(OR=2.200,95%CI:1.608-3.010)(P<0.05).It was negatively correlated with LVEDd(β=-0.048,95%CI:-0.075--0.021)and showed no significant associa-tion with LVMI and LVEF(P>0.05).Stratified analysis indicated that systolic blood pressure and baPWV had an interaction effect on LVEDd and mitral e'/a'<1(P<0.05).Conclusion BaPWV is associated with left ventricular remodeling and diastolic function.The correlation between baPWV and LVPW and LVEDd is stronger in groups with normal systolic blood pressure.In contrast,the correlation with mitral e'/a'<1 is more prominent in groups with elevated systolic blood pressure.
7.Theoretical Exploration on Zang-Fu Organ Differentiation and Treatment of Chronic Eczema with Traditional Chinese Medicine from the Perspective of Physique-Qi-Spirit Trinity Life View
Yan LUO ; Xinru WANG ; Li'na WANG ; Limin LIU ; Xiaodan RAO ; Xingxian HUANG ; Yuanyuan ZHUO
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(8):2064-2069
Chronic eczema is clinically characterized by pruritus and skin lesions such as macules,exudation,desquamation,and lichenification.Traditional Chinese medicine(TCM)typically attributes its pathogenesis to wind,dampness,and heat pathogens,and TCM treatment for chronic eczema focused on dispelling wind,eliminating dampness,and clearing heat.However,there were fewer reports about the treatment of accompanying emotional changes and sleep disturbances in chronic eczema patients.This paper integrated the physique-qi-spirit trinity life view with zang-fu organ differentiation,and proposed that the disorder of spleen transportation and transformation contributed to the pathological foundation of chronic eczema,while the dysfunction of heart and liver was the factor that significantly influenced disease progression after analyzing the clinical features of chronic eczema.For the treatment of chronic eczema,the establishment of strategies should consider clinical characteristics,duration of disease,and skin lesion patterns.The combination of physique-qi-spirit regulation with heart-liver-spleen treatment approaches aims to alleviate clinical symptoms,improve quality of life,and enhance therapeutic efficacy for chronic eczema patients.
8.Mechanism of Congrong Zonggan Capsules in Improving Neuroinflammation and Cognitive Impairment in 5×FAD Mice Based on NF-κB/NLRP3 Signaling Pathway
Yanru ZHOU ; Xinru GU ; Yuru LIU ; Shun ZHANG ; Yaozhong LYU ; Zhenzhong WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):130-138
ObjectiveTo investigate the effects of Congrong Zonggan capsules (CRZG) on cognitive impairment in the Alzheimer's disease (AD) model of mice and its related mechanisms. MethodsSPF grade 4-week-old 5×FAD mice were divided into a model group, low-dose CRZG (0.819 g·kg-1) and high-dose CRZG (1.638 g·kg-1) groups, and Donepezilepezil hydrochloride group (2 mg·kg-1), with eight mice in each group. Eight C57 mice with the same background were set as the normal group. After one week of adaptive feeding, mice were orally administered continuously for six months. On the 5th month of drug administration, Y maze, new object recognition, and Morris water maze tests were conducted separately. After administration, mouse brain tissue was taken, and the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in brain tissue were detected by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence (IF) was used to detect the expression of small glial cell markers Iba1, astrocyte markers GFAP, and amyloid protein 1-42 (Aβ1-42) in the hippocampus of the brain tissue. The hematoxylin-eosin (HE) staining was used to detect pathological changes in the hippocampus of brain tissue. Western blot was used to detect the expression of nuclear factor-κB (NF-κB) p65, NOD-like receptor protein 3 (NLRP3), cleaved Caspase-1, apoptosis-associated speck-like protein containing a CARD (ASC), and other proteins in the brain tissue. ResultsCompared with those in the normal group, the mice in the model group had obvious cognitive impairment. The spontaneous alternation rate of the Y maze was decreased, and the discrimination index of novel object recognition was decreased significantly (P<0.01). The escape latency in the water maze was shortened significantly (P<0.01). The contents of IL-6 and TNF-α in brain tissue were increased. The fluorescence levels of Iba1 and Aβ1-42 in the hippocampus were significantly increased (P<0.01). There was a significant increase in neuronal lesions, neuronal atrophy, loose arrangement of tissue structure, and abnormal erythrocyte aggregation in the hippocampus. The protein expressions of p-NF-κB p65/NF-κB p65, cleaved Caspase-1, ASC, IL-6, and IL-1β were significantly increased (P<0.05, P<0.01). Compared with the model group, the spontaneous alternation rate and discrimination index of the high-dose CRZG group were increased significantly (P<0.01), and the escape latency was shortened significantly (P<0.05, P<0.01). The content of IL-6 decreased in the brain, and that of TNF-α dropped significantly (P<0.01). The expression of Iba1 protein and Aβ1-42 in the hippocampus decreased significantly (P<0.05, P<0.01). The hippocampal neurons were densely arranged, and the pyramidal nuclei were clear and centered. The abnormal aggregation of red blood cells was alleviated. The value of p-NF-κB/NF-κB proteins and the expression of ASC, cleaved Caspase-1, IL-6, and IL-1β were significantly decreased (P<0.05, P<0.01). ConclusionCRZG can effectively improve cognitive impairment in 5×FAD mice with Alzheimer's disease, and its mechanism may be related to the regulation of the NF-κB/NLRP3 pathway to reduce the abnormal activation of microglia and inhibit neuroinflammation.
9.Clinical presentation and treatment outcomes of 24 adult patients with thrombotic thrombocytopenic purpura
Xinru LI ; Fengmei WANG ; Xiaoliang ZHANG ; Bicheng LIU
Chinese Journal of Nephrology 2025;41(8):579-586
Objective:To investigate the clinical features, treatment strategies and prognosis of adult thrombotic thrombocytopenic purpura (TTP) patients and improve the clinicians' understanding of TTP.Methods:It was a case series analysis study. The clinical data of TTP patients admitted to ZhongDa Hospital affiliated to Southeast University from August 2013 to November 2024 were retrospectively collected. The clinical manifestations, laboratory tests, treatment methods and prognosis of TTP patients were analyzed. Kaplan-Meier method and multivariate Cox proportional hazards regression model were utilized to assess the association between rituximab treatment and survival outcomes.Results:The study included 24 TTP patients, with age of (58.38±15.03) years (21 to 87 years), 14 females (58.33%) and 10 males (41.67%). The first symptoms were often neurological abnormalities (lethargy, coma, sudden glossolalia or unconsciousness (10 patients, 41.67%). Five patients (20.83%) had the quinary syndrome, including fever, microangiopathic hemolytic anemia, thrombocytopenia, renal insufficiency and neurological symptoms, and 13 patients (54.17%) had the triad syndrome, including neurological syndromes, microangiopathic hemolytic anemia and thrombocytopenia. Twenty-three patients (95.83%) had anemia. Twenty patients (83.33%) presented with neurological abnormalities, among which 10 patients died of neurological events. Renal insufficiency occurred in 14 patients (58.33%). Nine patients (37.50%) presented with large areas of skin ecchymosis. Except for 1 patient complicating with lung adenocarcinoma and 1 patients complicating with bone metastasis tumor, the other patients had no active tumors. All 24 patients had PLASMIC scores ≥ 4 points, of which 11 patients (45.83%) had PLASMIC scores ≥ 6 points. Fourteen patients (58.33%) received the treatment for plasma exchange, and 7 patients (29.17%) did not undergo plasma exchange and received component transfusion and glucocorticoids therapy with poor prognosis due to rapid disease progression, old age or severe disease. Furthermore, 3 patients (12.50%) were only treated with component transfusion and glucocorticoids therapy for economic reasons, and died shortly after hospital discharge. Eight patients received plasma exchange, glucocorticoids combined with rituximab, of which one died, four survived, and three were lost to follow-up. Finally, fifteen patients (62.50%) died, 4 patients survived, and 5 patients were lost to follow-up (still alive before hospital discharge). Kaplan-Meier survival analysis demonstrated that mortality in the rituximab group was significantly lower than that in the non-rituximab group (Log-rank test, χ2=13.185, P<0.001). Multivariate Cox proportional hazards regression analysis further confirmed that no receiving rituximab was an independent correlated factor of death ( HR=10.453, 95% CI 1.309-83.436, P=0.027). Conclusions:TTP usually starts with neurological symptoms, and can affect multiple systems. The patients with neurological abnormalities have a poor prognosis. The patients with TTP have a rapid disease progression and a high mortality rate. Rapid identification and timely treatment are crucial for improving the prognosis of TTP. Combining rituximab based on plasma exchange and glucocorticoids may reduce mortality of TTP patients.
10.The Current Status and Prospects of the Application of Digital Technology in the Field of Pharmacovigilance of Rare Diseases
Ying CAO ; Xinru LIU ; Shengfeng WANG ; Lin ZHUO
JOURNAL OF RARE DISEASES 2025;4(1):22-29
To summarize the current status in the application of digital and intelligent technologies in the field of pharmacovigilance and to provide reference to the selection and development of methods for pharmacovigilance of rare diseases. Searched five major databases-CNKI, WANFANG, VIP, PubMed, and Embase, selected and the data of application of digital technology in the field of drug vigilance for rare diseases, extracted relevant information and conducted a systematic review. The application of digital technology in drug surveillance has not yet been used in the special field of rare diseases. Relevant case studies are insufficient. Two major challenges need to be addressed. One is the insufficient data sources and the other is technical limitations. Based on the characteristics of drugs for rare diseases, this paper identifies data sources and intelligent technologies suitable for the field of drug vigilance for rare disease, proposes direction for potential development in the future, and makes targeted suggestions.

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