1.Establishment of an immunoprecipitation-inductively coupled plasma mass spectrometry for detecting serum non-ceruloplasmin-bound copper and its clinical application
Junxia WU ; Yiru XU ; Qiang LU ; Yaping FANG ; Jianjian DONG ; Chenchen XU ; Zhichao HE
Chinese Journal of Laboratory Medicine 2025;48(9):1215-1221
Objective:To establish a method for detecting serum non-ceruloplasmin-bound copper (NCC) by immunoprecipitation-inductively coupled plasma mass spectrometry (IP-ICP-MS) and evaluate its clinical application.Methods:Methodological evaluation research. Immunoprecipitation was first used to separate serum ceruloplasmin, followed by detection of serum NCC levels using ICP-MS. Two levels of quality control serum were reconstituted to determine the limit of detection (LOD), limit of quantitation (LOQ), accuracy, and precision of the self-developed method. The serum samples of 131 healthy individuals (healthy group) and 69 first-time diagnosed Wilson′s disease (WD) patients(WD group) from November 2023 to June 2024 in the Affiliated Hospital of Institute of Neurology, Anhui University of Traditional Chinese Medicine were collected. Using self-developed method detected the serum NCC levels, established the healthy reference intervals, and NCC levels between the two groups were compared using the Mann-Whitney U test. Results:The calibration curve exhibited excellent lineary across the concentration range of 1.562 to 300.000 μg/L, as demonstrated by coefficient of determination ( R2) of 0.999. The self-developed NCC method exhibited that the LOD was 0.99 μg/L, the LOQ was 3.29 μg/L, the accuracy (spike and recovery experience) was 87.67%?106.27%, and the intra-batch and inter-batch imprecision expressed as coefficient of variation ( CV) was 2.8%?7.3%, and the healthy reference range was 34.31-71.79 μg/L. The serum NCC levels in the WD group were 102.39 (74.38, 144.04) μg/L, which was significantly higher than those in healthy group (51.45±10.34) μg/L ( Z=?7.967, P<0.01). Conclusions:The established IP-ICP-MS method for detecting serum NCC meets the required analytical performance criteria. It is simply operative, highly sensitive, and provides accurate and reliable results, which could be used for clinical detection.
2.Advanced research progress and clinical hotspots of bipolar disorder in the past decade
Yiru FANG ; Zuowei WANG ; Jun CHEN
Chinese Journal of Psychiatry 2025;58(2):87-93
Bipolar disorder (BD) is a heterogeneous group of diseases caused by multiple factors such as biology, psychology, and society. So far, there is a lack of specific biological markers for recognizing and diagnosing BD, and unmet clinical needs for diagnosis and treatment are widespread. This article summarizes changes in the diagnosis name and the progress of research in disease classification, epidemiology, etiology and pathogenesis, clinical diagnosis, evaluation, and treatment of BD in the past decade in China and the world. It also discusses hot topics such as precision medicine, diagnostic biomarkers, and digital healthcare for BD, and proposes thoughts on future clinical practice and scientific research in BD.
3.Analysis of the Causes of Subject Screening Failures in Clinical Trials of Antineoplastic Drugs and Protocol Nerfing Indicators
Shuopeng JIA ; Hailan MA ; Huiyao HUANG ; Jingxiao ZHU ; Anqi YU ; Yiru HOU ; Yu TANG ; Hong FANG ; Ning LI
Herald of Medicine 2025;44(3):497-502
Objective To analyze the reasons for the failure of subject screening in clinical trials of antineoplastic drugs and the impact of natriuretic criteria on the entry of subjects into clinical trials,to explore the strategies to improve the suc-cessful enrolment of screened subjects,and to provide reference bases for research institutes and sponsors in the formulation of na-triuretic criteria.Methods This study selected data from 40 drug clinical trials conducted at the Drug Clinical Trial Research Center of the Cancer Hospital of the Chinese Academy of Medical Sciences from January 1,2016,to June 30,2022.It statistically described the collected data on the frequency and percentage composition of screening failures among participants and the inclu-sion and exclusion criteria in the protocols.Results A total of 425 subjects were screened out of 40 clinical trial programmers covering 8 tumor types,with the majority being<65 years of age(333,78.4%),of which the most important reasons included vol-untary withdrawal(71,16.7%),tumor metastasis(52,12.2%),failure to recover from treatment of pre-existing disease(38,8.9%),failure of bone marrow function(19,4.5%),and non-compliant liver function(15,3.5%).Among the nadir indicators,the age of the subjects(100%),ECOG score(97.5%),bone marrow function(ANC:95.0%,PLT:97.5%,HB:97.5%),liver function(T-BiL:95.0%,ALT:87.5%,AST:95.0%),renal function(CR:80.0%),and viral screening(HIV:80.0%,HBV:70.0%,HCV:62.5%)were relatively stringent.Conclusion The main reasons for subject screening failure in clinical trials in oncology in our hospital are voluntary withdrawal,brain metastasis,and failure of their biochemical test standards,which are close-ly related to the setting of clinical trial nadir criteria.Therefore,an in-depth understanding of subjects'characteristics,accurate set-ting of appropriate nadir criteria,continuous improvement of trial design,and strengthening of communication with subjects to pro-vide more relevant information will help to improve the screening success rate of clinical trials.
4.Research progress on the neuroinflammation mechanisms in bipolar disorder
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(1):107-112
Bipolar disorder(BD)is a chronic,recurrent mental illness characterized by extreme fluctuations in mood and state,clinically manifested as recurrent or alternating manic,depressive,and mixed episodes.The pathogenesis is complex and remains unknown,with neuroinflammation considered as a key factor in its development.In-depth research not only helps to understand the etiology,but also provides direction for the development of new therapeutic targets.This paper reviews recent studies on neuroinflammation in BD,discusses changes in peripheral and central inflammation and associated biomarkers,explores the underlying mechanisms of pathogenesis,and briefly describes the mechanisms and potential of mood stabilizers and new therapeutic drugs in anti-inflammatory effect,aiming to suggest possible future research directions.
5.Analysis of the Causes of Subject Screening Failures in Clinical Trials of Antineoplastic Drugs and Protocol Nerfing Indicators
Shuopeng JIA ; Hailan MA ; Huiyao HUANG ; Jingxiao ZHU ; Anqi YU ; Yiru HOU ; Yu TANG ; Hong FANG ; Ning LI
Herald of Medicine 2025;44(3):497-502
Objective To analyze the reasons for the failure of subject screening in clinical trials of antineoplastic drugs and the impact of natriuretic criteria on the entry of subjects into clinical trials,to explore the strategies to improve the suc-cessful enrolment of screened subjects,and to provide reference bases for research institutes and sponsors in the formulation of na-triuretic criteria.Methods This study selected data from 40 drug clinical trials conducted at the Drug Clinical Trial Research Center of the Cancer Hospital of the Chinese Academy of Medical Sciences from January 1,2016,to June 30,2022.It statistically described the collected data on the frequency and percentage composition of screening failures among participants and the inclu-sion and exclusion criteria in the protocols.Results A total of 425 subjects were screened out of 40 clinical trial programmers covering 8 tumor types,with the majority being<65 years of age(333,78.4%),of which the most important reasons included vol-untary withdrawal(71,16.7%),tumor metastasis(52,12.2%),failure to recover from treatment of pre-existing disease(38,8.9%),failure of bone marrow function(19,4.5%),and non-compliant liver function(15,3.5%).Among the nadir indicators,the age of the subjects(100%),ECOG score(97.5%),bone marrow function(ANC:95.0%,PLT:97.5%,HB:97.5%),liver function(T-BiL:95.0%,ALT:87.5%,AST:95.0%),renal function(CR:80.0%),and viral screening(HIV:80.0%,HBV:70.0%,HCV:62.5%)were relatively stringent.Conclusion The main reasons for subject screening failure in clinical trials in oncology in our hospital are voluntary withdrawal,brain metastasis,and failure of their biochemical test standards,which are close-ly related to the setting of clinical trial nadir criteria.Therefore,an in-depth understanding of subjects'characteristics,accurate set-ting of appropriate nadir criteria,continuous improvement of trial design,and strengthening of communication with subjects to pro-vide more relevant information will help to improve the screening success rate of clinical trials.
6.Research progress on the neuroinflammation mechanisms in bipolar disorder
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(1):107-112
Bipolar disorder(BD)is a chronic,recurrent mental illness characterized by extreme fluctuations in mood and state,clinically manifested as recurrent or alternating manic,depressive,and mixed episodes.The pathogenesis is complex and remains unknown,with neuroinflammation considered as a key factor in its development.In-depth research not only helps to understand the etiology,but also provides direction for the development of new therapeutic targets.This paper reviews recent studies on neuroinflammation in BD,discusses changes in peripheral and central inflammation and associated biomarkers,explores the underlying mechanisms of pathogenesis,and briefly describes the mechanisms and potential of mood stabilizers and new therapeutic drugs in anti-inflammatory effect,aiming to suggest possible future research directions.
7.Establishment of an immunoprecipitation-inductively coupled plasma mass spectrometry for detecting serum non-ceruloplasmin-bound copper and its clinical application
Junxia WU ; Yiru XU ; Qiang LU ; Yaping FANG ; Jianjian DONG ; Chenchen XU ; Zhichao HE
Chinese Journal of Laboratory Medicine 2025;48(9):1215-1221
Objective:To establish a method for detecting serum non-ceruloplasmin-bound copper (NCC) by immunoprecipitation-inductively coupled plasma mass spectrometry (IP-ICP-MS) and evaluate its clinical application.Methods:Methodological evaluation research. Immunoprecipitation was first used to separate serum ceruloplasmin, followed by detection of serum NCC levels using ICP-MS. Two levels of quality control serum were reconstituted to determine the limit of detection (LOD), limit of quantitation (LOQ), accuracy, and precision of the self-developed method. The serum samples of 131 healthy individuals (healthy group) and 69 first-time diagnosed Wilson′s disease (WD) patients(WD group) from November 2023 to June 2024 in the Affiliated Hospital of Institute of Neurology, Anhui University of Traditional Chinese Medicine were collected. Using self-developed method detected the serum NCC levels, established the healthy reference intervals, and NCC levels between the two groups were compared using the Mann-Whitney U test. Results:The calibration curve exhibited excellent lineary across the concentration range of 1.562 to 300.000 μg/L, as demonstrated by coefficient of determination ( R2) of 0.999. The self-developed NCC method exhibited that the LOD was 0.99 μg/L, the LOQ was 3.29 μg/L, the accuracy (spike and recovery experience) was 87.67%?106.27%, and the intra-batch and inter-batch imprecision expressed as coefficient of variation ( CV) was 2.8%?7.3%, and the healthy reference range was 34.31-71.79 μg/L. The serum NCC levels in the WD group were 102.39 (74.38, 144.04) μg/L, which was significantly higher than those in healthy group (51.45±10.34) μg/L ( Z=?7.967, P<0.01). Conclusions:The established IP-ICP-MS method for detecting serum NCC meets the required analytical performance criteria. It is simply operative, highly sensitive, and provides accurate and reliable results, which could be used for clinical detection.
8.Advanced research progress and clinical hotspots of bipolar disorder in the past decade
Yiru FANG ; Zuowei WANG ; Jun CHEN
Chinese Journal of Psychiatry 2025;58(2):87-93
Bipolar disorder (BD) is a heterogeneous group of diseases caused by multiple factors such as biology, psychology, and society. So far, there is a lack of specific biological markers for recognizing and diagnosing BD, and unmet clinical needs for diagnosis and treatment are widespread. This article summarizes changes in the diagnosis name and the progress of research in disease classification, epidemiology, etiology and pathogenesis, clinical diagnosis, evaluation, and treatment of BD in the past decade in China and the world. It also discusses hot topics such as precision medicine, diagnostic biomarkers, and digital healthcare for BD, and proposes thoughts on future clinical practice and scientific research in BD.
9.Comparison of the validity of different self-rated tools for identifying (Hypo-) manic episodes mixed features: based on Date from the Second Phase of the National Bipolar Mania Clinical Pathway Survey
Zuowei WANG ; Yuncheng ZHU ; Chuangxin WU ; Guiyun XU ; Miao PAN ; Zhiyu CHEN ; Xiaohong LI ; Wenfei LI ; Zhian JIAO ; Mingli LI ; Yong ZHANG ; Jingxu CHEN ; Xiuzhe CHEN ; Na LI ; Jing SUN ; Jian ZHANG ; Shaohua HU ; Haishan WU ; Zhaoyu GAN ; Yan QIN ; Yumei WANG ; Yantao MA ; Xiaoping WANG ; Yiru FANG
Chinese Journal of Psychiatry 2024;57(7):426-432
Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.
10.Evaluation of circadian rhythms in depression by using actigraphy:a systematic review and meta-analysis
Chenyin SUN ; Baichuan WU ; Huifeng ZHANG ; Yiru FANG ; Daihui PENG
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(5):606-616
Objective·To systematically review the effectiveness of actigraphy on the evaluation of circadian rhythm characteristics in patients with depression.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,PsycINFO,CNKI,WanFang Data,and Chinese biomedical literature database(CBM),from the inception of each database to May 5th,2023.Case control studies that used actigraphy to evaluate circadian rhythms in patients with depression and compared them with healthy controls were collected.Literature was screened according to the inclusion and exclusion criteria,and the quality of the included literature was evaluated by using the Newcastle-Ottawa Scale.The meta-analysis was performed by using RevMan 5.4 software.Results·A total of 9 articles were included,including 390 patients with depression and 288 healthy controls.The meta-analysis showed that the MESOR(midline statistic of rhythm)(SMD=-0.29,95%CI-0.51 ?-0.07,P=0.009)of the circadian cosine function in patients with depression was lower than that in healthy controls;sleep onset(MD=33.06,95%CI 14.90 ? 51.23,P=0.000)and sleep offset(MD=53.80,95%CI 22.38 ? 85.23,P=0.000)were later in patients with depression than those in healthy controls;no statistical difference was found in the activity level of the most active 10 hours(SMD=-0.26,95%CI-0.52 ? 0.01,P=0.060)between patients with depression and healthy controls,although there was a trend for lower activity in patients with depression;no statistical difference was found in the acrophase(MD=25.33,95%CI-12.41 ? 63.06,P=0.190)of the circadian cosine function between patients with depression and healthy controls;no clear statistical significance of the difference was found in the amplitude(SMD=-0.14,95%CI-0.42 ? 0.14,P=0.340)and the activity level of the least active 5 hours(SMD=0.31,95%CI-0.10 ? 0.71,P=0.140)between patients with depression and healthy controls.Conclusion·Actigraphy can reflect circadian rhythm disruption in patients with depression to some extent,but the limited number of included studies and inconsistencies in the study populations and methodologies have affected the quality and results of the analyses.More high-quality clinical trials are needed to provide evidence.

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