1.Mortality, morbidity, and care practices for 1750 very low birth weight infants, 2016-2021
Yang HE ; Meng ZHANG ; Jun TANG ; Wanxiu LIU ; Yong HU ; Jing SHI ; Hua WANG ; Tao XIONG ; Li ZHANG ; Junjie YING ; Dezhi MU
Chinese Medical Journal 2024;137(20):2452-2460
Background::Very low birth weight (VLBW) infants are the key populations in neonatology, wherein morbidity and mortality remain major challenges. The study aimed to analyze the clinical characteristics of VLBW infants.Methods::A retrospective cohort study was conducted in West China Second Hospital between January 2016 and December 2021. Neonates with a birth weight of <1500 g were included. Mortality, care practices, and major morbidities were analyzed, and compared with those of previous 7 years (2009-2015).Results::Of the total 1750 VLBW, 1386 were infants born with birth weight between 1000-1499 g and 364 infants were born with weight below 1000 g; 42.9% (751/1750) required delivery room resuscitation; 53.9% (943/1750) received non-invasive ventilation only; 38.2% (669/1750) received invasive ventilation; 1517 VLBW infants received complete treatment. Among them, 60.1% (912/1517) of neonates had neonatal respiratory distress syndrome (NRDS), 28.7% (436/1517) had bronchopulmonary dysplasia (BPD), 22.0% (334/1517) had apnea, 11.1% (169/1517) had culture-confirmed sepsis, 8.4% (128/1517) had pulmonary hemorrhage, 7.6% (116/1517) had severe intraventricular hemorrhage (IVH)/periventricular leukomalacia (PVL), 5.7% (87/1517) had necrotizing enterocolitis (NEC), and 2.0% (31/1517) had severe retinopathy of prematurity. The total and in-hospital mortality rates were 9.7% (169/1750) and 3.0% (45/1517), respectively. The top three diagnoses of death among those who had received complete treatment were sepsis, NRDS, and NEC. In 2009-2015, 1146 VLBW were enrolled and 895 infants received complete treatment. The proportions of apnea, IVH, and IVH stage ≥3/PVL, were higher in 2009-2015 compared with those in 2016-2021, while the proportions of NRDS and BPD were characterized by significant increases in 2016-2021. The total and in-hospital mortality rates were 16.7% (191/1146) and 5.6% (50/895) respectively in 2009-2015.Conclusion::Among VLBW infants born in 2016-2021, the total and in-hospital mortality rates were lower than those of neonates born in 2009-2015. Incidences of NRDS and BPD increased in 2016-2021, which affected the survival rates and long-term prognosis of VLBW.
2.Application of virus load testing in HIV antibody screening positive but western blot negative samples
Chinese Journal of Experimental and Clinical Virology 2024;38(4):464-467
Objective:To explore the application of viral load (VL) testing in human immunodeficiency virus (HIV) antibody screening positive but western blot (WB) negative samples, provide scientific basis for laboratory diagnosis of such populations.Methods:For the HIV antibody retest samples from the initial screening laboratory of Zaozhuang City Center for Disease Control and Prevention from 2021 to 2023, as well as samples from the voluntary counseling and testing at outpatient clinic of our unit that showed a negative WB test result, VL and CD4 + T lymphocyte counts were tested. Four weeks later, the patients were followed up and blood samples were collected by the current district (city) Center for Disease Control and Prevention, and sent to the confirmation laboratory for confirming testing. Results:Among the thirty-two patients, there were fifteen cases with target not detected (TND) by using VL. After four weeks, the follow-up results were all negative. There was one case with a VL test result of 20-5 000 copies/ml, and after four weeks, the follow-up result was positive. There were sixteen cases with a VL test result of >5 000 copies/ml. After four weeks, the follow-up results were all positive. Person correlation analysis was conducted between the log value of VL and CD4 + T lymphocyte count, and the result showed a certain degree of negative correlation ( r=-0.63, P=0.006). Conclusions:VL testing can assist in distinguishing patients with positive HIV antibody screening and negative WB results, and VL testing and WB testing should complement each other, combined with CD4 + T lymphocyte count and epidemiological history to make a diagnosis.
3.Mechanism of long non-coding RNA SATB2-AS1 inhibiting progression of lung adenocarcinoma
Bo-Wei QIAO ; Yong ZHANG ; Ming-Tao LI ; Yan LI
Journal of Regional Anatomy and Operative Surgery 2024;33(10):876-882
Objective To investigate the effect of long non-coding RNA(lncRNA)antisense transcript of SATB2 protein(SATB2-AS1)on the biological function of lung adenocarcinoma cells and its mechanism.Methods Tumor tissues and adjacent tissues from 25 patients with lung adenocarcinoma were collected to detect the expression of SATB2-AS1.Then,the overexpression vector of lncRNA SATB2-AS1(pcDNA-SATB2-AS1)and shRNA or shRNA of IGF2BP2(sh-SATB2-AS1;sh-IGF2BP2)and/or shRNA of SLC7A11(sh-SLC7A11)were transfected into lung adenocarcinoma cell A549.RIP assay was used to estimate the binding of IGF2BP2 protein to SATB2-AS1 or SLC7A11 mRNA,respectively;CCK-8 and Transwell assay were used to detect the proliferation and invasion ability of lung adenocarcinoma cells;RT-qPCR and Western blot assay were used to detect gene expression and protein expression,respectively.Results Compared with adjacent tissues and human bronchial epithelial cell BEAS-2B,the expression of SATB2-AS1 was significantly down-regulated in tumor tissues of patients with lung adenocarcinoma and lung adenocarcinoma cells(P<0.01).Overexpression of SATB2-AS1 significantly inhibited the proliferation and invasion of A549 cells,while silencing SATB2-AS1 significantly promoted the cell proliferation and invasion(P<0.05).Moreover,overexpression of SATB2-AS1 significantly reduced Fe2+concentration,reactive oxygen species(ROS)level,and malondialdehyde(MDA)content in A549 cells(P<0.01),and increased glutathione(GSH)content,the expression of SLC7A11 and GPX4 which were the key proteins of ferroptosis(P<0.01).Meanwhile,SATB2-AS1 significantly promoted IGF2BP2 protein binding to SLC7A11 mRNA by binding to IGF2BP2 protein,and reduced the stability of SLC7A11 mRNA(P<0.01).Silencing SLC7A11 significantly reversed the effects of silencing SATB2-AS1 on A549 cells.Conclusion LncRNA SATB2-AS1 destabilizes SLC7A11 mRNA by recruiting IGF2BP2 protein,induces the ferroptosis of lung adenocarcinoma cells,inhibits the cell proliferation and invasion,and thus inhibits the progression of lung adenocarcinoma.
4.Clinical Features and Prognosis of Patients with Primary Extranodal Diffuse Large B-Cell Lymphoma
Si YI ; Xia LI ; Huan TAO ; Hong-Bing MA ; Jie JI ; Yu WU ; Ting NIU ; Yong-Qian JIA
Journal of Experimental Hematology 2024;32(6):1711-1718
Objective:To investigate the clinical features,gene mutation profile,efficacy and prognostic factors of primary extranodal diffuse large B-cell lymphoma(EN-DLBCL).Methods:A retrospective analysis was performed for 382 patients with primary EN-DLBCL with complete clinical data who were treated in West China Hospital from January 2013 to January 2023,and their clinical characteristics,gene mutation profile,efficacy and prognostic factors were analyzed.Results:The median age of the 382 patients with EN-DLBCL was 56 (18-89 )years old.The male-to-female ratio was 1.12∶1,and the most common primary sites were gastrointestinal tract (31.7%),Wechsler ring (19. 1%)and breast gland (7.1%).A total of 51 gene mutations were fund,and the most common frequencies of gene mutations were TP53 (32.5%),MYD88 (32.5%),and CD79B (30.0%).The median follow-up was 63 months,and the 5-year progression-free survival (PFS)rate was 74.5% and the 5-year overall survival (OS)rate was 89.6%. The adverse factors on PFS were as follows:>1 extranodal sites involvement (P<0.001),P53≥50%(P<0.001),hyper double expression(hDEL)of C-myc>50%/Bcl-2>70%(P<0.001).The adverse factors affecting the OS of patients were as follows:>1 extranodal sites involvement (P<0.001),P53≥50%(P<0.001),hDEL(P<0.001). Chemotherapy combined with local radiotherapy could improve PFS (P=0.041)and OS (P=0.003),while R-CHOP+X (molecule agents as BTKi、HDACi、Lenalidomide)failed to show a significant difference in PFS (P=0.075)and OS (P=0.767 ).Among the 40 patients who underwent next-generation sequencing at high risk,there was no significant in PFS (P=0.849)and OS (P=0.500)of patients with positive MYD88 and/or CD79B mutations (MCD subtype)treated with BTKi and patients with negative MYD88 and CD79B mutations.Conclusion:Primary EN-DLBCL can involve multiple organs or tissue sites.TP53,MYD88,and CD79B are the most common gene mutations.The efficacy of BTKi in patients with positive MCD subtypes at intermediate and high risk is not inferior to that in MCD-negative control patients.
5.Effects of xanthohumol on proliferation and apoptosis of thyroid cancer cells B-CPAP through the Notch signaling pathway
Jun QI ; Yong SUN ; Yuan-Peng ZHANG ; Bin LU ; Tao LI ; Yan-Tao ZHANG
Chinese Journal of Current Advances in General Surgery 2024;27(4):282-285
Objective:Xanthohumol is a kind of isoamyl olefinic flavonoid natural compounds,which have antitumor activity and impact on a variety of cell signaling pathways,The objective of this study was to explore the effects of xanthohumol on proliferation and apoptosis of thyroid cancer cells B-CPAP through the Notch signaling pathway.Methods:B-CPAP cells were cultivated in vitro,Xanthohumol was divided into control group(0 μ mol/L),low dose group(10 μ mol/L),middle dose group(20 μ mol/L),high dose group(40 μ mol/L)according to the different concentrations,The logarithmic growth cells were cultivated with different concentrations of xanthohumol intervention,application of MTT colorimetry in the detection of proliferation inhibition rates of B-CPAP cells.B-CPAP cells morphological changes were observed by using fluorescence microscope after appli-cation of Hoechst 33258 dyeing.B-CPAP cells apoptosis were detected by Annexin V-FITC/PI flow cytometry.Notch signaling pathway related proteins were determined?by?Western blotting.Re-sults:MTT showed that low dose group,middle dose group and high dose group,respectively pro-cessing after 24h,48h,72h,proliferation inhibition rates of the three groups were statistical?signifi-cance(F=189.34,131.73,124.51,P<0.05);Respectively treated after 24h,48h,72h,proliferation in-hibition rates of xanthohumol increased over time in the same group,The differences were statisti-cally significant(F=204.51,169.64,183.15,P<0.05).B-CPAP cells of high dose group appeared ob-viously apoptosis morphological changes compared with the control group through Hoechst33258 dying.Flow cytometry showed apoptosis rates of concrol group,low dose group and high dose group compared were statistical?significance(F=1235.54,P<0.05).Apoptosis rate was higher in the high-dose group.Western blotting showed that Notch1,Treatment was performed for 72h,Hes1,Bcl-2 expression were significantly decreased in low dose group,middle dose group and high dose group compared with the control group(F=203.22,161.52,224.78),while cleaved caspase-3 ex-pression significantly increased(F=463.27),the differences were statistically significant(P<0.05).Conclusions:Xanthohumol inhibits B-CPAP cells proliferation and induces cells apoptosis maybe through the Notch signaling pathway.
6.Prevalence of pre-diabetes and its association with overweight and obesity in an adult health check-up population
Qinchuan HOU ; Li XIANG ; Huiwang ZHANG ; Beibei ZHANG ; Dongyu LI ; Tao YONG ; Yuping LIU ; Ping SHUAI
Chinese Journal of Health Management 2024;18(5):347-353
Objective:To analyze the current prevalence of pre-diabetes (PDM) and its relationship with overweight and obesity in an adult health check-up population.Methods:This study was a cross-sectional and retrospective cohort study and was applied using whole-cluster random sampling method. A total of 491 379 adults who underwent health check-ups at the Health Management Centre of Sichuan Provincial People′s Hospital from January 2017 to July 2023 were selected to analyze the epidemiological characteristics of PDM and overweight-obesity, as well as the trend of change over time. A retrospective cohort study was conducted on 19 001 of the subjects who underwent≥3 health check-ups and did not have diabetes and PDM at baseline, and the relationships between body mass index, waist circumference and the risk for developing PDM were analyzed using Cox proportional risk regression models. And the dose-response relationship between body mass index, waist circumference and the risk for developing PDM was analyzed using restricted cubic spline regression (RCS).Results:Of the 491 379 cases included in the cross-sectional study, 275 084 were male and 216 295 were female, 163 158 cases were under 40 years old, and 328 221 cases were 40 years old and above; the total prevalence of PDM was 19.41% in 2017-2023, with an overall increasing trend. Of the 19 001 people included in the cohort study, a total of 2 487 (13.09%) new cases of PDM were identified at the end of follow-up. After adjusting for confounding factors, overweight ( HR=1.150, 95% CI: 1.047-1.263), obesity ( HR=1.335, 95% CI: 1.149-1.552) and abdominal obesity ( HR=1.218, 95% CI: 1.105-1.342) were risk factors for PDM. The risk of PDM rised with the increase of body mass index (>22.9 kg/m 2, Pnon-linear=0.973) and waist circumference (>80 cm, Pnon-linear=0.830), with a linear dose-response mode. In different gender and age groups, it was found the greater the body mass index (>24.1 kg/m 2 for men,>21.5 kg/m 2 for women;>23.3 kg/m 2 for age≥40 years,>24.1 kg/m 2 for age<40 years) and waist circumference (>85 cm for men, >73 cm for women; >82 cm for age ≥40 years, >85 cm for age <40 years), the higher the risk of PDM. Conclusions:The prevalence of PDM is on the rise in the adult health check-up population. To prevent PDM, it is necessary to control the body mass index and waist circumference to a lower level than the overweight and obesity standards.
7.Association of cardiometabolic index with severity of coronary artery stenosis and prognosis in patients with acute myocardial infarction
Kaiyang WANG ; Hongmei LAI ; Jing TAO ; Jiahui YONG ; Guoqing LI ; Yining YANG
Chinese Journal of Endocrinology and Metabolism 2024;40(8):647-653
Objective:To explore the correlation between cardiometabolic index(CMI) and the severity of coronary artery stenosis and long-term prognosis in patients with acute myocardial infarction(AMI).Methods:A total of 712 patients with AMI who were admitted to the Xinjiang Uygur Autonomous Region People′s Hospital from January 2018 to December 2019 were included as the subjects. According to the tertile of CMI, the subjects were divided into high, medium, and low value groups. Gensini score was used to quantitatively assess the degree of coronary artery stenosis. The endpoint event was defined as the occurrence of major cardiovascular adverse events(MACEs). Spearman correlation analysis was conduceted to explore the correlation between CMI and Gensini score. Multivariate Cox regression was utilized to analyze the independent influencing factors of MACEs. A restricted cubic spline plot was employed to analyze the nonlinear relationship between CMI and the risk of MACEs. Kaplan- Meier curve was used to analyze survival differences between groups. Subgroup analysis was performed to evaluate the consistency of the predictive value of CMI for MACEs. Results:Spearman correlation analysis showed that CMI was positively correlated with Gensini score( r=0.13, P<0.001). After adjusting for confounding, multivariate Cox regression analysis showed that CMI was an independent risk factor for MACEs( HR=1.709, 95% CI 1.052-2.778, P=0.031). The restricted cubic spline analysis revealed an L-shaped nonlinear effect relationship between CMI and MACEs risk( P=0.024). Kaplan- Meier survival curve analysis demonstrated that the cumulative incidence of MACEs in AMI patients increased significantly with the increase of CMI( P<0.05). Subgroup analysis indicated that CMI independently predicted the occurrence of MACEs across different subgroups, and had higher predictive value in patients with normal lipids and normal body weight. Conclusion:CMI is closely associated with the severity of coronary stenosis in AMI patients, and is an independent predictor of the risk of long-term MACEs.
8.Insulin resistance caused by iatrogenic hyperinsulinemia in type 1 diabetes
Shuang LI ; Jingfei LIU ; Yang CHEN ; Yong GU ; Tao YANG
Chinese Journal of Endocrinology and Metabolism 2024;40(9):811-816
Type 1 diabetes is characterized by an absolute deficiency of insulin. Exogenous insulin replacement therapy is a crucial treatment approach for type 1 diabetes. However, the non-physiological insulin administration can lead to iatrogenic hyperinsulinemia, exacerbate peripheral insulin resistance, and subsequently increase the risk of various complications. Emerging insulin infusion technologies, lifestyle interventions, and medications such as metformin are increasingly being utilized in type 1 diabetes management to lower plasma insulin levels and improve patient outcomes.
9.Establishment of a predictive scoring model and preventive measures for bladder neck contracture after laparoscopic enucleation of the prostate with urethra preservation
Zu-Pan LI ; Jiang GU ; Yong-Chun ZHANG ; Qing-Tao YANG ; Miao LIU
National Journal of Andrology 2024;30(1):32-39
Objective:To establish a predictive scoring model for bladder neck contracture(BNC)after laparoscopic enuclea-tion of the prostate with preservation of the urethra(Madigan surgery)and explore the preventive measures against this postoperative complication.Methods:We included 362 cases of BPH treated by laparoscopic Madigan surgery from January 2019 to March 2022(45 with and 317 without postoperative BNC)in the training group and another 120 cases treated the same way in the verification group,collected the clinical data on the patients and evaluated the results of surgery.Using the least absolute shrinkage and selection operator(LASSO)and multivariate logistic regression,we analyzed the risk factors for postoperative BNC and constructed a predictive scoring model for evaluation of the factors.Results:Compared with the baseline,the IPSS,quality of life(QOL)score and postvoid residual urine volume(PVR)were significantly decreased(P<0.05)while the maximum urinary flow rate(Qmax)remarkably in-creased(P<0.05)in the BPH patients at 3 months after surgery.Eight non-zero characteristic predictors were identified by LASSO regression analysis.Multivariate logistic regression analysis showed that short clinical experience of the surgeon,concurrent prostatitis,bladder rinse solution temperature<34℃,catheter blockage,urethral balloon injection volume>40 ml and postoperative constipation were independent risk factors for postoperative BNC(P<0.05).The best cut-off value was 2.36 points in both the training and the verification groups.The results of evaluation exhibited a high discriminability of the predictive scoring model.Conclusion:Laparo-scopic Madigan surgery is a safe and effective method for the treatment of BPH.Short clinical experience of the surgeon,concurrent prostatitis,bladder rinse solution temperature<34℃,catheter blockage,water injected into the urethral balloon>40 ml and postop-erative constipation were independent risk factors for postoperative BNC.The predictive scoring model constructed in this study has a good discriminability and is simple and feasible,contributive to the prediction of postoperative BNC in BPH patients undergoing laparo-scopic Madigan surgery.
10.Comprehensive therapy of traditional Chinese medicine for erectile dysfunction with damp-heat stasis:A clinical observation of 103 cases
Jun-Chao YAO ; Bao-Jun JU ; Xiao LI ; Lu-Yu LI ; Miao-Miao MA ; Yong-Tao ZHANG
National Journal of Andrology 2024;30(3):233-240
Objective:To assess the clinical effect and safety of comprehensive therapy of traditional Chinese medicine(TCM)in the treatment of erectile dysfunction(ED)with damp-heat stasis.Methods:We selected 108 cases of ED with damp-heat stasis meeting the inclusion criteria and treated with tadalafil(the control group,n=54)or tadalafil+comprehensive TCM therapy(the trial group,n=54)in the First Affiliated Hospital of Henan University of Chinese Medicine in the same period.After 8 weeks of treatment,we recorded the patients'scores on IIEF-5,TCM syndrome,erectile quality(EQS),9-Item Patient Health Questionnaire(PHQ-9)and Generalized Anxiety Scale 7(GAD-7).At 16 weeks of our study,we collected the efficacy parameters,safety indicators and adverse reactions by telephone follow-up and compared the data obtained between the two groups of patients.Results:Totally,103 of the patients completed the study,51 in the control and 52 in the trial group.Compared with the baseline,the IIEF-5 and EQS scores were both markedly increased after 8 weeks of treatment in the trial group(12.35±3.00 vs 18.36±2.82,P<0.05;39.5[30.25-43]vs 67.5[54.5-76.75],P<0.05)and the control(11.96±2.79 vs 15.88±3.86,P<0.05;38.0[29-42]vs 56[49-64],P<0.05),even more significantly in the former than in the latter(P<0.05);the TCM syndrome and GAD-7 scores were remarkably decreased in the trial(9.5[8-12]vs 4.0[2.25-5],P<0.05;5[2.25-6.75]vs 2.5[1-4.75],P<0.05)and the control group(10.0[8-12]vs 5.0[3-6],P<0.05;5.0[3-6]vs 4.0[2-5],P<0.05),even more signif-icantly in the former than in the latter(P<0.05),so were the PHQ-9 scores(P<0.05),but with no statistically significant differ-ence between the two groups(P>0.05).The IIEF-5 scores of the two groups remained significantly higher than the baseline during the follow-up(P<0.05),even higher in the trial than in the control group(17.04±2.60 vs 14.16±3.34,P<0.05).No obvious abnormal safety indicators or adverse events were observed during the study.Conclusion:Comprehensive TCM therapy combined with tadalafil is superior to tadalafil alone in the treatment of ED with damp-heat stasis,and has a better long-term efficacy and a higher safety.

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