1.Association Between the Coexistence of Chronic Non-communicable Diseases and Quality of Life in Middle-aged and Elderly People Living with HIV/AIDS
Yao ZHANG ; Chi ZHANG ; Cong LIU ; Haidan ZHONG ; Peishan DU ; Quanmin LI ; Linghua LI ; Jing GU
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(1):161-171
ObjectiveTo investigate the prevalence rate of chronic non-communicable diseases (NCDs) and the association with quality of life in middle-aged and elderly patients with HIV/AIDS. MethodsThis cross-sectional study surveyed 432 patients with HIV/AIDS (aged≥45 years) in the Infectious Disease Center in Guangzhou Eighth People’s Hospital of Guangzhou Medical University, and 366 participants were included in the analysis after quality control. A questionnaire and the EuroQol 5-Dimensional 3-level version (EQ-5D-3L) were used to investigate NCDs and quality of life and Tobit regression model was used to estimate the association between chronic diseases and quality of life. ResultsAmong the 366 participants, 29(7.9%) had cardiovascular disease, 45(12.3%) had hypertension, 122(33.3%) had hyperglycemia, 151(41.3%)had hyperlipidemia,7(1.9%) had cancer, 17 (4.6%) had chronic kidney disease, 38 (10.4%) had chronic liver disease, 21(5.7%) had musculoskeletal disorders, and 253(69.1%) suffered from at least one type of chronic diseases. The median (lower and upper quartiles) of EQ-5D utility index was 1.000(0.964~1.000). Multivariate Tobit regression results of the total population showed that cancer [ba=-0.08,95%CI (-0.15,-0.01),P=0.036], chronic kidney disease [ba=-0.07, 95%CI (-0.12,-0.02),P=0.006], musculoskeletal disease [ba=-0.09, 95%CI (-0.13, -0.05),P<0.001], and ≥3 types of chronic diseases[ba=-0.05, 95%CI(-0.08,-0.01),P=0.013] were negatively correlated with EQ-5D utility index. The stratified analysis results of different CD4+T cell levels showed that hypertension [ba=-0.07, 95%CI (-0.12, -0.02), P=0.007], chronic kidney disease [ba=-0.10,95%CI (-0.18,-0.03), P=0.006], musculoskeletal disease [ba=-0.15, 95%CI (-0.22,-0.07), P<0.001] and ≥3 types of chronic diseases [ba=-0.09, 95%CI (-0.09, -0.01), P<0.001] were negatively correlated with EQ-5D utility index in the group with CD4≤500 (cells/μL), whereas cancer[ba=-0.11, 95%CI (-0.20,-0.01), P=0.031] was negatively correlated with EQ-5D utility index in the group with CD4>500(cells/μL). ConclusionsThe prevalence rate of chronic non-communicable diseases in middle-aged and elderly patients with HIV/AIDS is relatively high. The classification of NCDs such as cancer or chronic kidney disease or other chronic diseases and the numbers of NCDs categories are negatively correlated with quality of life. However,this association varies among patients with HIV/AIDS of different CD4+T cell levels. It is suggested that we should try to prevent and identify NCDs at an early stage, strengthen linkages and integration of health services for AIDS and chronic NCDs, and jointly manage and control AIDS with chronic diseases to improve the quality of life among people living with HIV/AIDS.
2.Influencing factors and clinical treatment of severe complications after unilateral pneumonectomy in treating tuberculous destroyed lung
Xiao LI ; Ning WANG ; Lei BAO ; Zhiqiang WU ; Gang LI ; Cong CAI ; Yijie SONG ; Dan LI ; Banggui WU ; Liangshuang JIANG ; Xiaojun YAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(05):626-633
Objective To evaluate the surgical efficacy of unilateral pneumonectomy for the treatment of tuberculous destroyed lung, analyze the causes of severe postoperative complications, and explore clinical management strategies. Methods A retrospective analysis was conducted on the clinical data of patients with tuberculous destroyed lung who underwent unilateral pneumonectomy at the Public Health Clinical Center of Chengdu from 2017 to 2023. Postoperative severe complications were statistically analyzed. Patients were divided into a non-severe complication group and a severe-complication group, and the causes, management, and outcomes of complications were analyzed. Results A total of 134 patients were included, comprising 69 males and 65 females, with a mean age of 17-73 (40.43±12.69) years. There were 93 patients undergoing left pneumonectomy and 41 patients undergoing right pneumonectomy. Preoperative sputum smear was positive in 35 patients, all of which converted to negative postoperatively. There were 58 patients with hemoptysis preoperatively, and none experienced hemoptysis postoperatively. Postoperative incisional infection occurred in 8 (5.97%) patients, and postoperative pulmonary infection in 26 (19.40%) patients. Severe postoperative complications occurred in 17 (12.69%) patients, including empyema in 9 (6.72%) patients, bronchopleural fistula with empyema in 1 (0.75%) patient, severe pneumonia in 3 (2.24%) patients, postpneumonectomy syndrome in 1 (0.75%) patient, chylothorax in 1 (0.75%) patient, ketoacidosis in 1 (0.75%) patient, and heart failure with severe pneumonia in 1 (0.75%) patient. Perioperative mortality occurred in 2 (1.49%) patients, both of whom underwent right pneumonectomy. Multivariate logistic regression analysis revealed that a history of ipsilateral thoracic surgery, concomitant Aspergillus infection, and greater blood loss were independent risk factors for severe complications following unilateral pneumonectomy for tuberculous destroyed lung (P<0.05). Conclusion Unilateral pneumonectomy for patients with tuberculous destroyed lung can significantly improve the clinical cure rate, sputum conversion rate, and hemoptysis cessation rate. However, there is a certain risk of severe perioperative complications and mortality, requiring thorough perioperative management and appropriate management of postoperative complications.
3.Single-cell Protein Localization Method Based on Class Perception Graph Convolutional Network
Hao-Yang TANG ; Xin-Yue YAO ; Meng-Meng WANG ; Si-Cong YANG
Progress in Biochemistry and Biophysics 2025;52(9):2417-2427
ObjectiveThis study proposes a novel single-cell protein localization method based on a class perception graph convolutional network (CP-GCN) to overcome several critical challenges in protein microscopic image analysis, including the scarcity of cell-level annotations, inadequate feature extraction, and the difficulty in achieving precise protein localization within individual cells. The methodology involves multiple innovative components designed to enhance both feature extraction and localization accuracy. MethodsFirst, a class perception module (CPM) is developed to effectively capture and distinguish semantic features across different subcellular categories, enabling more discriminative feature representation. Building upon this, the CP-GCN network is designed to explore global features of subcellular proteins in multicellular environments. This network incorporates a category feature-aware module to extract protein semantic features aligned with label dimensions and establishes a subcellular relationship mining module to model correlations between different subcellular structures. By doing so, it generates co-occurrence embedding features that encode spatial and contextual relationships among subcellular locations, thereby improving feature representation. To further refine localization, a multi-scale feature analysis approach is employed using the K-means clustering algorithm, which classifies multi-scale features within each subcellular category and generates multi-cell class activation maps (CAMs). These CAMs highlight discriminative regions associated with specific subcellular locations, facilitating more accurate protein localization. Additionally, a pseudo-label generation strategy is introduced to address the lack of annotated single-cell data. This strategy segments multicellular images into single-cell images and assigns reliable pseudo-labels based on the CAM-predicted regions, ensuring high-quality training data for single-cell analysis. Under a transfer learning framework, the model is trained to achieve precise single-cell-level protein localization, leveraging both the extracted features and pseudo-labels for robust performance. ResultsExperimental validation on multiple single-cell test datasets demonstrates that the proposed method significantly outperforms existing approaches in terms of robustness and localization accuracy. Specifically, on the Kaggle 2021 dataset, the method achieves superior mean average precision (mAP) metrics across 18 subcellular categories, highlighting its effectiveness in diverse protein localization tasks. Visualization of the generated CAM results further confirms the model’s capability to accurately localize subcellular proteins within individual cells, even in complex multicellular environments. ConclusionThe integration of the CP-GCN network with a pseudo-labeling strategy enables the proposed method to effectively capture heterogeneous cellular features in protein images and achieve precise single-cell protein localization. This advancement not only addresses key limitations in current protein image analysis but also provides a scalable and accurate solution for subcellular protein studies, with potential applications in biomedical research and diagnostic imaging. The success of this method underscores the importance of combining advanced deep learning architectures with innovative training strategies to overcome data scarcity and improve localization performance in biological image analysis. Future work could explore the extension of this framework to other types of microscopic imaging and its application in large-scale protein interaction studies.
4.Research progress of cathepsins in neurodegenerative diseases
Sitong YAO ; Weiqi XU ; Shuyan CONG
Journal of China Medical University 2024;53(11):1036-1042,1050
Cathepsins,the most abundant hydrolases in lysosomes,are responsible for the degradation of various substrates.Increasing evidence suggests that cathepsins play important roles in neurodegenerative diseases.Cathepsins affect the progression of diseases by regu-lating the aggregation of abnormal proteins(e.g.α-synuclein,amyloid β-protein,huntington).Abnormal expression levels and activity and gene mutations of cathepsin B,D,and L in the nervous system can lead to the occurrence and development of neurodegenerative diseases.This review summarizes the research progress on cathepsins in neurodegenerative diseases in recent years,with a view to providing a basis for the early diagnosis and treatment of these diseases.
5.Analysis on risk factors and prognosis of cerebral venous sinus thrombosis with early-onset seizures
Sitong YAO ; Weiqi XU ; Shuyan CONG
Chinese Journal of Cerebrovascular Diseases 2024;21(6):369-377
Objective To analyze the risk factors and the prognosis in patients with cerebral venous sinus thrombosis(CVST)accompanied by early-onset seizures.Methods A retrospective study was conducted on 163 patients with CVST admitted to the Department of Neurology and Neurosurgery of Shengjing Hospital of China Medical University during August 2011 to November 2022 as the study subjects.Based on whether they had concurrent seizures within 14 days after diagnosis CVST,the patients were divided into the early-onset seizures group(42 cases)and the non-early-onset seizure group(121 cases).Clinical data were collected,including general clinical data,imaging data,laboratory test results,and treatment plans,etc.The general clinical data involves gender,age,suspected etiology(infection[such as mastoiditis,otitis media,sinusitis,etc.],oral contraceptives/estrogen,pregnancy/puerperium,anemia and other factors that can lead to changes in blood composition,hyperhomocysteinemia),clinical manifestations(including headache,dizziness,disturbance of consciousness,nausea and vomiting,limb numbness,hemiplegia,tinnitus,aphasia,diplopia,mental abnormalities,unresponsiveness,isolated intracranial hypertension[papilledema],etc.).Imaging data includes involved venous sinus location,multiple venous sinuses(involving ≥ 2 venous sinuses)and intracranial changes(intracranial hemorrhage,venous cerebral infarction,subarachnoid hemorrhage).All patients were tested for D-dimer on the second day of admission.Patients with intracranial hypertension were examined with spinal puncture and measured cerebrospinal fluid pressure,with elevated cerebrospinal fluid pressure defined as the pressure>180mmH2O.The patients were followed up by telephone 2 months after discharge,and the modified Rankin scale(mRS)was used to assess the prognosis of the patients(mRS score ≤2 points as good prognosis,mRS score>2 points as poor prognosis).The mortality rate of patients was measured.The clinical data,imaging data,laboratory test results,treatment and follow-up results of the two groups were compared.The correlation variables with P<0.05 in the univariate analysis were included in the multivariate Logistic regression model to analyze the independent risk factors of CVST accompanied by early-onset seizures.Results(1)Compared with the non-early-onset seizure group,the proportion of pregnant/puerperal females in the early-onset seizure group was higher(33.3%vs.13.2%,P=0.004),the proportion of patients with hemiplegia was higher(23.8%vs.6.6%,P=0.005),and the proportion of patients with CVST imaging combined with intracranial hemorrhage was higher(40.5%vs.13.2%,P<0.01),with all the differences were statistically significant.There was no significant difference in other baseline clinical data between the two groups(all P>0.05).(2)Further multivariate Logistic regression analysis showed that pregnancy/puerperium(OR,4.854,95%CI 1.917-12.290,P=0.001),hemiplegia(OR,3.871,95%CI 1.246-12.028,P=0.019)and intracranial hemorrhage(OR,5.005,95%CI 2.038-12.288,P<0.01)were independent risk factors for CVST with early-onset seizures.(3)There were 3 patients(7.1%)in the early-onset seizure group and 6 patients(5.0%)in the non-early-onset seizure group dead,and there was no significant difference in the proportion of death between the two groups(P=0.887).The proportion of patients with good prognosis in the early-onset seizure group was lower than that in the non-early-onset epilepsy group(81.0%vs.92.6%),and the difference between the groups was statistically significant(P=0.043).Among the patients treated with anticoagulation alone,the good prognosis rate of non-early-onset seizures group(99/106,93.4%)was higher than that of the early-onset seizure group(32/40,80.0%),and the difference was statistically significant(P=0.029).Conclusions For CVST patients,especially females during pregnancy or postpartum period,clinical manifestations accompanied by hemiplegia,and with intracranial hemorrhage on imaging,the risk of seizures within 14 days of the diagnosis of CVST should be vigilant.The prognosis of CVST patients with early-onset seizures is worse than that of patients without early-onset seizures.
6.Clinical characteristics and prognostic analysis of 34 patients with primary thyroid lymphoma
Lei YANG ; Lijie ZENG ; Jin YE ; Liqiang WEI ; Jia CONG ; Xin LI ; Na YAO ; Jing YANG ; Henan WANG ; Liwei LYU ; Yiping WU ; Liang WANG
Chinese Journal of Hematology 2024;45(5):495-499
Objective:To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary thyroid lymphoma (PTL) .Methods:A retrospective analysis was conducted on the clinical and pathological data of 34 newly diagnosed PTL patients admitted to Beijing Tongren Hospital from September 2010 to February 2023. The Kaplan-Meier survival curve and Log-rank test were used for survival analysis, and the Cox regression model was applied for univariate analysis of prognostic factors.Results:All 34 PTL patients presented with cervical mass as the initial clinical manifestation. There were 9 males and 25 females. The pathological diagnosis was diffuse large B-cell lymphoma (DLBCL) in 29 patients and mucosa-associated lymphoid tissue (MALT) lymphoma in 5 patients. Among the DLBCL patients, 6 had B symptoms, 17 had an Eastern Cooperative Oncology Group (ECOG) score of ≥2, the Ann Arbor staging was stage Ⅰ-Ⅱ in 21 cases and stage Ⅲ-Ⅳ in 8 cases, the tumor diameter was ≥10 cm in 4 cases, and 14 had concurrent Hashimoto thyroiditis; 27 cases received chemotherapy, with 21 cases achieving complete remission (CR), 2 cases partial remission (PR), and 6 cases of disease progression; the 5-year progression-free survival and overall survival rates were 78.9% and 77.4%, respectively; univariate survival analysis showed that B symptoms, tumor diameter ≥10 cm, and Ann Arbor stage Ⅲ-Ⅳ were significant factors affecting patient prognosis ( P<0.05). MALT lymphoma patients were all in stages Ⅰ-Ⅱ, had an ECOG score of 0-1, and were without B symptoms. All patients underwent surgical resection, with 4 cases achieving CR and 1 case PR. Conclusion:PTL is more common in females with concurrent Hashimoto thyroiditis, with the majority of pathological types being B-cell lymphoma. The main treatment is chemotherapy, supplemented by radiotherapy and surgery, and the prognosis is relatively favorable.
7.Progress on the mechanism of cartilage damage induced by T-2 toxin in Kashin-Beck disease
Cong YAO ; Shuichu HAO ; Chun ZHANG ; Jun DONG ; Yumeng JIA ; Xiong GUO
Chinese Journal of Endemiology 2024;43(5):421-424
Kashin-Beck disease (KBD) is an endemic and degenerative osteoarthropathy that can cause damage to the endochondral ossification of the limbs during development. The etiology is still unclear. In recent years, scholars at home and abroad have studied the mechanism of T-2 toxin and its metabolites causing KBD cartilage damage from the perspectives of immunotoxicity, oxidative stress, inflammatory response, cell apoptosis, etc., mainly including transforming growth factor-β receptor (TGF-βRs) signaling pathway, immune regulatory factor, inflammatory factor IL-1β and apoptosis enzyme activating factor 1 (APAF1), which promote the progression of KBD by inducing human chondrocyte injury, inhibiting matrix synthesis and accelerating cellular catabolism. This article reviews the research progress on the immunotoxicity of T-2 toxin and its toxic effects on KBD cartilage injury at the molecular level, in order to provide a scientific basis for prevention and treatment of KBD.
8.Novel antibacterial drug target against Gram-negative bacteria: lipopolysaccharide transport protein LptDE and its inhibitors
Yue LI ; Guo-qing LI ; Yuan-yuan TIAN ; Cong-ran LI ; Xin-yi YANG ; Kai-hu YAO ; Xue-fu YOU
Acta Pharmaceutica Sinica 2024;59(2):279-288
The outer membrane composed predominantly of lipopolysaccharide (LPS) is an essential biological barrier for most Gram-negative (G-) bacteria. Lipopolysaccharide transport protein (Lpt) complex LptDE is responsible for the critical final stage of LPS transport and outer membrane assembly. The structure and function of LptDE are highly conserved in most G- bacteria but absent in mammalian cells, and thus LptDE complex is regarded as an attractive antibacterial target. In recent 10 years, the deciphering of the three-dimensional structure of LptDE protein facilities the drug discovery based on such "non
9.Diagnostic value of pulmonary embolism volumein identifying mild-to-high-risk acute pulmonary embolism based on quantitative CT
Yan'e YAO ; Yansong LI ; Xionghui WANG ; Xiaoqi HUANG ; Tao REN ; Jun FENG ; Youmin GUO ; Cong SHEN
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(1):126-132
Objective To investigate the value of computer-assisted quantification of pulmonary embolism volume(PEV)in identifying mild-to-high-risk acute pulmonary embolism(APE).Methods We retrospectively enrolled 143 patients with suspected APE confirmed by computed tomography pulmonary angiography(CTPA)at Yan'an University Affiliated Hospital from January 2017 to December 2020.According to the 2018 Chinese Guidelines for Diagnosis,Treatment and Prevention of Pulmonary Thromboembolism,all the patients were divided into low-risk group(n=88)and mild-to-high-risk group(n=55).We collected the patients'basic demographic data,clinical manifestations,and serum levels of N-terminal-B type natriuretic peptide precursor(NT-proBNP)and D-dimer.Based on CTPA images,the degree of pulmonary thromboembolism was artificially evaluated to obtain the pulmonary artery occlusion index(PAOI).The thrombus was segmented using the pulmonary embolism detection tool based on digital lung,and PEV was calculated.We compared the differences in clinical and laboratory indicators and PAOI and PEV between the two risk groups.We analyzed the value of PAOI and PEV in identifying mild-to-high-risk APE using receiver operating characteristic(ROC)curves,and used Logistic regression analysis to identify independent risk factors in predicting mild-to-high-risk APE.Different models were established.Results Compared with the low-risk group,APE patients in the mild-to-high-risk group were older(P<0.05),had lower diastolic blood pressure(P<0.05),higher levels of D-dimer and NT-proBNP(P<0.05),lower levels of platelet count,arterial oxygen partial pressure and arterial carbon dioxide partial pressure(P<0.05),and higher levels of PAOI and PEV(P<0.001).ROC curve analysis showed that the area under the curve for PEV in identifying mild-to-high-risk APE was 0.809(95%CI:0.734-0.884),while that for PAOI was 0.753(95%CI:0.667-0.839).Logistic regression analysis showed that PEV and NT-proBNP were independent risk factors for mild-to-high-risk APE(P<0.05).Conclusion PEV and NT-proBNP are independent risk factors for mild-to-high-risk APE.
10.Protective effect of quercetin mediated ferroptosis pathway on hypertonic stimulation induced dry eye cell model
Jia-Di WANG ; Bai-Ping AN ; Yue LIU ; Cong-Hong CAO ; Bei-Ting ZONG ; Jing YAO
The Chinese Journal of Clinical Pharmacology 2024;40(4):529-533
Objective To investigate the effect of quercetin on HCE-2 injury of human corneal epithelial cells induced by high osmotic pressure and its mechanism.Methods HCE-2 cells were randomly divided into control group(normal osmotic pressure),model group(high osmotic pressure),experimental-L group(high osmotic pressure+31.25 pg·mL-1 quercetin),experimental-M group(high osmotic pressure+62.50 μg·mL-1 quercetin),experimental-H group(high osmotic pressure+125.00 μg·mL-1 quercetin),erastin group(high osmotic pressure+125.00 μg·mL-1 quercetin+30.00 μmol·L-1 iron death inducer erastin).Cell survival rate was detected by cell counting kit 8;reactive oxygen species(ROS)levels was detected by C11-BODIPY 581/591 probe staining;glutathione(GSH)and malondialdehyde(MDA)levels were determined by kit method;the expression levels of glutathione peroxidase 4(GPX4),dihydrolactate dehydrogenase(DHODH)and ferroptosis suppressor protein 1(FSP1)were detected by real-time quantitative polymerase chain reaction and Western blot.Results The cell survival rates of control group,model group,experimental-H group and erastin group were(100.00±3.97)%,(50.05±5.83)%,(86.35±7.35)%and(58.32±4.66)%,respectively;ROS levels were 1.00±0.09,2.45±0.16,1.19±0.05 and 2.09±0.30,respectively;GPX4 protein levels were 1.09±0.11,0.34±0.03,0.91±0.12 and 0.30±0.04,respectively;FSP1 protein levels were 0.92±0.06,0.25±0.03,0.89±0.07 and 0.39±0.07,respectively;DHODH protein levels were 0.89±0.11,0.31±0.04,0.86±0.11,0.41±0.04,respectively.Compared with model group,the above indexes in control group were statistically significant(all P<0.05);the differences between experimental-H group and model group were statistically significant(all P<0.05);the above indexes in erastin group were significantly different from those in experimental-H group(all P<0.05).Conclusion Quercetin can ameliorate HCE-2 cell damage induced by high osmotic pressure by inhibiting iron death pathway.

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