1.Clinical analysis of 11 cases of pediatric protein-losing gastroenteropathy manifested as chronic diarrhea
Jianyun HAO ; Xuemei ZHONG ; Youzhe GONG ; Huijuan NING ; Yanfei CHEN
Chinese Journal of General Practitioners 2025;24(9):1143-1147
A retrospective analysis was conducted on the clinical data of 11 children with Protein-Losing Gastrointestinal Disease (PLG) presented with chronic diarrhea who were admitted to the Capital Institute of Pediatrics Affiliated to Capital Medical University from 2018 to 2025. The data included etiology, laboratory test results, endoscopic and imaging findings, treatment regimens, and prognosis. Among them, there were 6 males and 5 females, with a median age of 7.8 (1.6, 12.0) months, and 9 cases ≤1 year. The etiologies were intestinal lymphangiectasia ( n=5), infection-related enteritis ( n=2), Crohn′s disease ( n=1), eosinophilic gastroenteritis ( n=1), and unknown ( n=2). Clinical manifestations were characterized by chronic diarrhea ( n=11), hypoalbuminemia ( n=11), and immune dysfunction ( n=8). Gastrointestinal endoscopy was performed in 9 cases, and diagnosis was confirmed by endoscopic pathology in 8 cases. Among the 5 cases of intestinal lymphangiectasia, only 3 were confirmed by 99Tc-labeled human serum albumin ( 99Tc m-HSA) radionuclide imaging. Five cases of lymphangiectasia were treated with a high medium-chain triglyceride diet, 2 infectious cases were treated with antibacterial agens, and 3 immune diseases received immunomodulators. Ten cases were cured and discharged, while 1 child died of sepsis after intestinal malrotation surgery. It is suggested that childhood PLG mostly occurs in infancy, with intestinal lymphangiectasia as the main etiology. Endoscopic pathology is the main diagnostic method, and with the combination of nutritional and immunomodulatory therapy, the prognosis is good for most of PLG patients.
2.Clinical characteristics of monogenic and non-monogenic early-onset inflammatory bowel disease
Youzhe GONG ; Yanfei CHEN ; Fuping WANG ; Jiao WANG ; Li MENG ; Xi HE ; Xuemei ZHONG
Chinese Journal of Inflammatory Bowel Diseases 2025;09(2):143-148
Objective:To compare the clinical characteristics of monogenic and non-monogenic early-onset inflammatory bowel disease (EO-IBD) in children and to explore the necessity of genetic analysis in EO-IBD research.Methods:A retrospective analysis of clinical data was conducted on 73 children diagnosed with EO-IBD at the Children's Hospital affiliated with Capital Institute of Pediatrics between January 2017 and December 2023. Genetic analysis was performed utilizing next-generation sequencing technology, with patients stratified into monogenic and non-monogenic groups based on the presence or absence of pathogenic mutations. Subsequently, a comparative analysis of clinical characteristics was conducted between these two cohorts of EO-IBD patients.Results:Among the 73 EO-IBD cases, 27 (37%) were diagnosed as monogenic IBD, and 46 (63%) as non-monogenic IBD. Compared to the non-monogenic group, the monogenic group had an earlier age of onset [1 (0.2, 3.0) months vs. 15 (4.1, 51.3) months, P < 0.001], with a higher incidence within the first month of life (70.4% vs. 13.0%, P < 0.001). Monogenic IBD cases were more likely to present with Crohn's disease (CD) phenotypes (88.9% vs. 52.2%, P = 0.003) and colonic involvement (L2) (91.7% vs. 62.5%, P < 0.001), but were less likely to present with non-penetrating, non-stricturing (B1) disease (87.5% vs. 95.8%, P = 0.019). Children in the monogenic group were more prone to severe malnutrition (74.1% vs. 21.3%, P < 0.001), perianal abscesses (40.7% vs. 8.7%, P < 0.001), perianal tags (22.2% vs. 0%, P = 0.004), fever (74.1% vs. 23.9%, P < 0.001), oral ulcers (44.4% vs. 6.5%, P < 0.001), and skin lesions (33.3% vs. 2.2%, P < 0.001). Regarding treatment, the monogenic group had higher usage of thalidomide (88.9% vs. 54.3%, P = 0.002) and hematopoietic stem cell transplantation (HSCT) (37.0% vs. 0, P < 0.001) and a higher mortality rate (22.2% vs. 2.2%, P = 0.017) . Conclusions:For children with IBD presenting at an early age, especially within the first month of life, and showing symptoms like fever, oral ulcers, skin lesions, severe malnutrition, and perianal disease, monogenic IBD should be considered. Genetic testing results can aid in guiding treatment decisions.
3.Clinical characteristics of monogenic and non-monogenic early-onset inflammatory bowel disease
Youzhe GONG ; Yanfei CHEN ; Fuping WANG ; Jiao WANG ; Li MENG ; Xi HE ; Xuemei ZHONG
Chinese Journal of Inflammatory Bowel Diseases 2025;09(2):143-148
Objective:To compare the clinical characteristics of monogenic and non-monogenic early-onset inflammatory bowel disease (EO-IBD) in children and to explore the necessity of genetic analysis in EO-IBD research.Methods:A retrospective analysis of clinical data was conducted on 73 children diagnosed with EO-IBD at the Children's Hospital affiliated with Capital Institute of Pediatrics between January 2017 and December 2023. Genetic analysis was performed utilizing next-generation sequencing technology, with patients stratified into monogenic and non-monogenic groups based on the presence or absence of pathogenic mutations. Subsequently, a comparative analysis of clinical characteristics was conducted between these two cohorts of EO-IBD patients.Results:Among the 73 EO-IBD cases, 27 (37%) were diagnosed as monogenic IBD, and 46 (63%) as non-monogenic IBD. Compared to the non-monogenic group, the monogenic group had an earlier age of onset [1 (0.2, 3.0) months vs. 15 (4.1, 51.3) months, P < 0.001], with a higher incidence within the first month of life (70.4% vs. 13.0%, P < 0.001). Monogenic IBD cases were more likely to present with Crohn's disease (CD) phenotypes (88.9% vs. 52.2%, P = 0.003) and colonic involvement (L2) (91.7% vs. 62.5%, P < 0.001), but were less likely to present with non-penetrating, non-stricturing (B1) disease (87.5% vs. 95.8%, P = 0.019). Children in the monogenic group were more prone to severe malnutrition (74.1% vs. 21.3%, P < 0.001), perianal abscesses (40.7% vs. 8.7%, P < 0.001), perianal tags (22.2% vs. 0%, P = 0.004), fever (74.1% vs. 23.9%, P < 0.001), oral ulcers (44.4% vs. 6.5%, P < 0.001), and skin lesions (33.3% vs. 2.2%, P < 0.001). Regarding treatment, the monogenic group had higher usage of thalidomide (88.9% vs. 54.3%, P = 0.002) and hematopoietic stem cell transplantation (HSCT) (37.0% vs. 0, P < 0.001) and a higher mortality rate (22.2% vs. 2.2%, P = 0.017) . Conclusions:For children with IBD presenting at an early age, especially within the first month of life, and showing symptoms like fever, oral ulcers, skin lesions, severe malnutrition, and perianal disease, monogenic IBD should be considered. Genetic testing results can aid in guiding treatment decisions.
4.Clinical analysis of 11 cases of pediatric protein-losing gastroenteropathy manifested as chronic diarrhea
Jianyun HAO ; Xuemei ZHONG ; Youzhe GONG ; Huijuan NING ; Yanfei CHEN
Chinese Journal of General Practitioners 2025;24(9):1143-1147
A retrospective analysis was conducted on the clinical data of 11 children with Protein-Losing Gastrointestinal Disease (PLG) presented with chronic diarrhea who were admitted to the Capital Institute of Pediatrics Affiliated to Capital Medical University from 2018 to 2025. The data included etiology, laboratory test results, endoscopic and imaging findings, treatment regimens, and prognosis. Among them, there were 6 males and 5 females, with a median age of 7.8 (1.6, 12.0) months, and 9 cases ≤1 year. The etiologies were intestinal lymphangiectasia ( n=5), infection-related enteritis ( n=2), Crohn′s disease ( n=1), eosinophilic gastroenteritis ( n=1), and unknown ( n=2). Clinical manifestations were characterized by chronic diarrhea ( n=11), hypoalbuminemia ( n=11), and immune dysfunction ( n=8). Gastrointestinal endoscopy was performed in 9 cases, and diagnosis was confirmed by endoscopic pathology in 8 cases. Among the 5 cases of intestinal lymphangiectasia, only 3 were confirmed by 99Tc-labeled human serum albumin ( 99Tc m-HSA) radionuclide imaging. Five cases of lymphangiectasia were treated with a high medium-chain triglyceride diet, 2 infectious cases were treated with antibacterial agens, and 3 immune diseases received immunomodulators. Ten cases were cured and discharged, while 1 child died of sepsis after intestinal malrotation surgery. It is suggested that childhood PLG mostly occurs in infancy, with intestinal lymphangiectasia as the main etiology. Endoscopic pathology is the main diagnostic method, and with the combination of nutritional and immunomodulatory therapy, the prognosis is good for most of PLG patients.
5.Research on isokinetic strength characteristics of waist and abdominal flexor and extensor muscles of fighter pilots
Han CAI ; Lihong WU ; Zhigang CHEN ; Wei YUAN ; Jianrong LI ; Jiangwei CHENG ; Yanfei GONG
Chinese Journal of Aerospace Medicine 2024;35(2):97-102
Objective:To provide theoretical basis for strength and endurance training of waist and abdominal muscles and prevention of waist injuries in fighter pilots by exploring the muscle strength and work characteristics of the waist and abdominal flexor and extensor muscles in fighter pilots.Methods:Sixty male fighter pilots who were qualified for flight in aeromedical assessment, aged 24-46 years old, were randomly selected and divided into 24-30, 31-40, 41-46 years group. The Isomed2000 isokinetic dynamometer system was applied to measure the muscle strength and work performance of the abdominal and lumbar flexors and extensors of the fighter pilots with the angular velocities of 60°/s and 180°/s. The flexion and extension muscle peak torque, relative peak torque, flexion-extension ratio, and endurance ratio were compared among different age groups of pilots.Results:At the same angular velocity, the peak torque and relative peak torque of the lumbar and abdominal extensor muscles in fighter pilots were greater than those of the flexor muscles, with statistically significant differences ( t=7.01-9.13, all P<0.001). The peak torque and relative peak torque of the lumbar and abdominal flexor and extensor muscles significantly decreased with increasing test angular velocity ( t=13.63-17.25, all P<0.001). Under the angular velocity of 60°/s, there were no significant differences in the peak torque and relative peak torque of the flexor muscles among different age groups (both P>0.05); there were significant differences in the peak torque and relative peak torque of extensor muscles ( F=5.31, 6.61, P=0.008, 0.003) and 41-46 years groups were lower than the other 2 groups ( P=0.019, 0.003, 0.002, 0.004). Under an angular velocity of 180°/s, there were significant differences in the peak torque and relative peak torque of the waist and abdominal flexor and extensor muscles among different age groups ( F=3.82, 3.47, 3.83, 5.49, P=0.028, 0.043, 0.027, 0.008); the relative peak torque of the abdominal and lumbar flexor and extensor muscles in the 24-30 years group was higher than that in the 41-46 years group ( P=0.032, 0.006). The peak torque and the relative peak torque of the abdominal and lumbar flexor muscles in 31-40 years group were higher than those in 41-46 years group ( P=0.008, 0.013). The low qualification rate of peak torque ratio indicated the imbalance between flexor and extensor muscles and the poor endurance of abdominal and lumbar flexor and extensor muscles than that of flexor muscles. There was no statistically significant difference in the endurance ratio of the abdominal and lumbar flexor and extensor muscles among different age groups ( P>0.05). Conclusions:The balance between flexor and extensor muscles of waist and abdominal muscles should be paid more in fighter pilot′s fitness training. For the pilots older than 40 the training targeted to slow the muscles decline is necessary.
6.Research on isokinetic strength characteristics of waist and abdominal flexor and extensor muscles of fighter pilots
Han CAI ; Lihong WU ; Zhigang CHEN ; Wei YUAN ; Jianrong LI ; Jiangwei CHENG ; Yanfei GONG
Chinese Journal of Aerospace Medicine 2024;35(2):97-102
Objective:To provide theoretical basis for strength and endurance training of waist and abdominal muscles and prevention of waist injuries in fighter pilots by exploring the muscle strength and work characteristics of the waist and abdominal flexor and extensor muscles in fighter pilots.Methods:Sixty male fighter pilots who were qualified for flight in aeromedical assessment, aged 24-46 years old, were randomly selected and divided into 24-30, 31-40, 41-46 years group. The Isomed2000 isokinetic dynamometer system was applied to measure the muscle strength and work performance of the abdominal and lumbar flexors and extensors of the fighter pilots with the angular velocities of 60°/s and 180°/s. The flexion and extension muscle peak torque, relative peak torque, flexion-extension ratio, and endurance ratio were compared among different age groups of pilots.Results:At the same angular velocity, the peak torque and relative peak torque of the lumbar and abdominal extensor muscles in fighter pilots were greater than those of the flexor muscles, with statistically significant differences ( t=7.01-9.13, all P<0.001). The peak torque and relative peak torque of the lumbar and abdominal flexor and extensor muscles significantly decreased with increasing test angular velocity ( t=13.63-17.25, all P<0.001). Under the angular velocity of 60°/s, there were no significant differences in the peak torque and relative peak torque of the flexor muscles among different age groups (both P>0.05); there were significant differences in the peak torque and relative peak torque of extensor muscles ( F=5.31, 6.61, P=0.008, 0.003) and 41-46 years groups were lower than the other 2 groups ( P=0.019, 0.003, 0.002, 0.004). Under an angular velocity of 180°/s, there were significant differences in the peak torque and relative peak torque of the waist and abdominal flexor and extensor muscles among different age groups ( F=3.82, 3.47, 3.83, 5.49, P=0.028, 0.043, 0.027, 0.008); the relative peak torque of the abdominal and lumbar flexor and extensor muscles in the 24-30 years group was higher than that in the 41-46 years group ( P=0.032, 0.006). The peak torque and the relative peak torque of the abdominal and lumbar flexor muscles in 31-40 years group were higher than those in 41-46 years group ( P=0.008, 0.013). The low qualification rate of peak torque ratio indicated the imbalance between flexor and extensor muscles and the poor endurance of abdominal and lumbar flexor and extensor muscles than that of flexor muscles. There was no statistically significant difference in the endurance ratio of the abdominal and lumbar flexor and extensor muscles among different age groups ( P>0.05). Conclusions:The balance between flexor and extensor muscles of waist and abdominal muscles should be paid more in fighter pilot′s fitness training. For the pilots older than 40 the training targeted to slow the muscles decline is necessary.
7.Diagnostic values of integrated evidence chain, Roussel Uclaf Causality Assessment Method, and Structured Expert Opinion Process method for drug-induced liver injury
Tingting HE ; Qingsheng LIANG ; Liping WANG ; Longxin LIANG ; Xiaohan LI ; Yanfei CUI ; Jing JING ; Zhaofang BAI ; Man GONG ; Ruilin WANG
Journal of Clinical Hepatology 2022;38(1):141-147
Objective To investigate the clinical applicability and different characteristics of three commonly used diagnostic methods for drug-induced liver injury from the two aspects of liver injury induced by Western medicine and liver injury induced by traditional Chinese medicine. Methods A prospective cohort study was performed for 289 hospitalized patients with acute drug-induced liver injury who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2015 to December 2020 and did not receive integrated traditional Chinese and Western medicine therapy, among whom 187 patients had herb-induced liver injury and 102 had Western medicine-induced liver injury. The 289 patients were diagnosed by the integrated evidence chain (IEC), Roussel Uclaf Causality Assessment Method (RUCAM), and the Structured Expert Opinion Process (SEOP) method, and related data at acute onset were collected, including general information, latency period, detailed medication, and laboratory markers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase, alkaline phosphatase, and total bilirubin. A statistical analysis was performed to investigate the consistency between IEC, RUCAM, and SEOP in the diagnosis of Western medicine-induced liver injury and herb-induced liver injury and their own applicability. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data; the chi-square was used for comparison of categorical data. Results The hepatocellular type was the main type of clinical liver injury in both Western medicine-induced liver injury and herb-induced liver injury, accounting for 81.4% and 74.3%, respectively, and laboratory examination showed higher levels of ALT and AST. Western medicine-induced liver injury cases were diagnosed by IEC, RUCAM, and SEOP, with a clinical diagnosis rate of 65.7%, 100%, and 63.7%, respectively, and the constituent ratio of Western medicine-induced liver injury was 23.2%, 35.3%, and 22.5%, respectively. Herb-induced liver injury cases were diagnosed by these three methods, with a clinical diagnosis rate of 47.6%, 100%, and 29.9%, respectively, and the constituent ratio of herb-induced liver injury was 30.8%, 64.7%, and 19.4%, respectively. The consistency test of the three diagnostic methods showed that in the diagnosis of Western medicine-induced liver injury cases, there was good consistency between IEC and SEOP (Kappa=0.785, P < 0.05), while there was poor consistency between RUCAM and IEC (Kappa=0.149, P > 0.05) and between RUCAM and SEOP (Kappa=0.117, P > 0.05); in the diagnosis of herb-induced liver injury cases, there was poor consistency between RUCAM and SEOP (Kappa=0.066, P > 0.05), while there was good consistency between RUCAM and IEC (Kappa=0.026, P < 0.05) and between IEC and SEOP (Kappa=0.437, P < 0.05). Conclusion The IEC method shows good applicability for both Western medicine-induced liver injury and herb-induced liver injury, and there is good consistency between IEC and SEOP in the diagnosis of Western medicine-induced liver injury cases, while there is a relatively low level of consistency between IEC and SEOP in the diagnosis of herb-induced liver injury. There is poor consistency between RUCAM and the other two methods. In the clinical diagnosis of Western medicine-induced liver injury, IEC, RUCAM, and SEOP should be used in combination to accurately judge the causal relationship between drugs and liver injury.
8.Study on the HPLC Fingerprint of Anemone raddeana
Yanfei ZHANG ; Zhimeng LI ; Lili ZHAO ; Jiyu GONG ; Guangzhi CAI
China Pharmacy 2016;27(3):399-401
OBJECTIVE:To establish the HPLC fingerprint for Anemone raddeana. METHODS:HPLC was performed on the column of Phemomenex Gemini C18 with mobile phase of 0.1%phosphoric acid-acetonitrile(gradient elution)at a flow rate of 1 ml/min,the detection wavelength was 206 nm,the column temperature was 30℃,and the injection volume was 20μl. With the refer-ence of raddeanin A,13 batches of A. raddeana were analyzed,chromatographic fingerprint similarity evaluation system software was conducted for similarity analysis,and SPSS 13.0 was conducted for cluster analysis. RESULTS:There were 11 common peaks in the 13 batches of A. raddeana with similarity of higher than 0.90. According to the verification,the fingerprint and control fin-gerprint shows good consistency. The drugs in Huadian,Jiaohe, Tiangang,Shulan,Tonghua and Fusong of Jilin and Shangzhi of Heilongjiang were regarded as category 1,and in Harbin,Yabuli town and Yimianpo of Heilongjiang,Qingyuan of Liaoning,Ji-nan of Shandong were category 2. CONCLUSIONS:The established fingerprint can provide reference for the identification and quality evaluation of A. raddeana.
9.The correlation between TLR2 gene -597T/C polymorphism and primary ANCA associated small vasculitis of Han population in Guangxi
Suzhen WEI ; Chao XUE ; Yunhua LIAO ; Yanfei LAI ; Chunxiang WU ; Linlin HE ; Aimei GONG
The Journal of Practical Medicine 2016;32(7):1092-1096
Objective To investigate the correlation between Toll-like receptor2 (TLR2) gene promoter region -597T/C polymorphism and primary ANCA associated small vasculitis (AAV) in Guangxi Han people. Methods A case contrastive control study was adopted in the study. Patients with AAV (patients group, n=110) and healthy people (control group, n = 200) were recruited. Associated serum indexes were detected and polymorphisms of TLR2 gene promoter 597T/C were analyzed by polymerase chain restricted fragment length polymorphisms (PCR-RFLP). Results (1)Three TLR2-597T/C genotypes were discovered in 110 AAV patients, namely, TT, TC and CC, with the frequency of 54.55%,40.00% and 5.45% respectively. And the frequencies of allele T and C were 74.55% and 25.45%. In control group, the genotype frequencies of TT, TC and CC were 56.00%,40.50% and 3.50%, with 76.25% of allele T and 23.75% of allele C. No significant differences were found in neither genotype distribution nor allele frequencies between the patients group and control group ( P > 0 . 05 ) . ( 2 ) Significant differences were found in the incidence of proteinuria rate and the hemoglobin (P< 0.05)in AAV patients. (3)There was no significant difference between AI and CI in TT, TC and CC genotype in AAV patients. Conclusions Polymorphism of TLR2-597T/C may be correlated with the incidence of proteinuria and the level of hemoglobin, while no obvious correlation with the genetic susceptibility of ANCA in vasculitis patients of Guangxi Han people.
10.Contents Determination of Rosin Acid in Rheumatoid Arthritis Tablet by HPLC-MS/MS
Jianlong YANG ; Yanli QU ; Tongtong XU ; Xiao XING ; Yanfei ZHANG ; Jiyu GONG
China Pharmacy 2015;(30):4299-4300,4301
OBJECTIVE:To establish a method for the content determination of rosin acid in Rheumatoid arthritis tablet. METH-ODS:HPLC was performed on the column of ZORBAX SB-C18 with mobile phase of acetonitrile-0.1% formic acid(82∶18,V/V) at flow rate of 1.0 ml/min ,detection wavelength was 241 nm ,column temperature was 30 ℃ and volume injection was 10 μl. MS/MS column was ZORBAX SB-C18 with mobile phase of acetonitrile-0.1% formic acid(80∶20,V/V)at flow rate of 0.2 ml/min;column temperature was 30 ℃;volume injection was 0.5 μl. Ionization mode was ESI+,atomization gas pressure was 25 psi,gas flow as 8.0 L/min,capillary voltage was 4 000 V,capillary outlet voltage was 120 V,precursor ion was 303 m/z,scan range was 50-500 m/z and the gas temperature was 350 ℃. RESULTS:The linear range of rosin acid was 2.5-100.0 μg/ml. RSDs of preci-sion,stability and reproducibility tests were lower than 2.0%,recoveries was 96.75%-98.11%(RSD=0.53%,n=6). CONCLU-SIONS:The method is simple,accurate and reproducible,and suitable for the content determination of rosin acid in Rheumatoid arthritis tablet.

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