1.Visual observation of primary sensory nerve conduction pathways in rats by anterograde tracing with adeno-associated virus
Guanggeng WU ; Ge LI ; Rui KUANG ; Yuanshan ZENG ; Zhaowei ZHU ; Bo HE
Chinese Journal of Microsurgery 2024;47(6):647-654
Objective:To discover a novel and intuitive anterograde tracing method for observing the course of sensory nerve fibers in dorsal root ganglia (DRG).Methods:From July 2022 to August 2023, studies were conducted in the Department of Plastic Surgery of the First Affiliated Hospital of Sun Yat-sen University. Three healthy 1-month old female SD rats, weighed approximately 180-220 g, were randomly selected. An adeno-associated virus carrying a neuron-specific promoter and red fluorescent protein (AAV- syp-mCherry) was prepared. The virus was injected into the spinal roots outside L 4-L 6 DRG through sterile surgery. After 1 month of breeding, L 4-L 6 spinal cord tissue of immunofluorescent staining of the side injected with viral tracer, DRG, sciatic nerve, and plantar skin of the SD rats were collected for immunofluorescent staining of neurofilament protein (NF) and microtubule associated protein 2 (MAP2). Distribution characteristics of AAV-positive nerve fibers were observed using a confocal microscope by average optical density (AOD) . Results:One month after injection of the viral tracer, red markers were visible in the dorsal horn of the L 4-L 6 spinal cord (AOD=0.5419±0.0245), DRG (AOD=0.4917±0.0087), sciatic nerve (AOD=0.6237±0.0634), dermis of plantar skin and skin appendages on the injected side (AOD=0.4943±0.0165). The red fluorescent clusters were found co-labeled with NF-positive nerve fibers or MAP2-positive neurons, it suggested that AAV- syp-mCherry could be transported anterogradely within sensory axons to distant target organs (skin) and offered a long-term image. Conclusion:The anterograde tracing method by adeno-associated virus can effectively show the complete trace of the central and peripheral processes of primary sensory neurons, and can serve as an effective methodology in observation of the pathways of peripheral sensory nerve fibers.
2.Application of remote fundus image reading training in improving the diagnostic ability of ophthalmologists in Xinjiang Uygur Autonomous Region
Xufeng ZHAO ; Xiuyan MA ; Xuejing LI ; Li QIN ; Lina SUO ; Wenping MA ; Shihao LI ; Jiaxing CHEN ; Yaxin YANG ; Xinxia LI ; Tao XIE ; Juan LI ; Yuanshan XIONG ; Zhiyong WU ; Zhihuai CHANG ; Mowen FANG ; Ting WANG ; Hong LIU ; Pengju MA ; Pengpeng LIU ; Jing RAN ; Di YANG ; Changle XUE ; Zhen XIE ; Zhao FAN ; Yang WANG ; Peng LEI ; Qingjiang HUANG ; Bing LI ; Shi FENG ; Zhangwanyu WEI ; Yishuang MAO ; Weihong YU ; Linjun ZHANG
Chinese Journal of Ocular Fundus Diseases 2024;40(12):941-946
Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.
3.Visual observation of primary sensory nerve conduction pathways in rats by anterograde tracing with adeno-associated virus
Guanggeng WU ; Ge LI ; Rui KUANG ; Yuanshan ZENG ; Zhaowei ZHU ; Bo HE
Chinese Journal of Microsurgery 2024;47(6):647-654
Objective:To discover a novel and intuitive anterograde tracing method for observing the course of sensory nerve fibers in dorsal root ganglia (DRG).Methods:From July 2022 to August 2023, studies were conducted in the Department of Plastic Surgery of the First Affiliated Hospital of Sun Yat-sen University. Three healthy 1-month old female SD rats, weighed approximately 180-220 g, were randomly selected. An adeno-associated virus carrying a neuron-specific promoter and red fluorescent protein (AAV- syp-mCherry) was prepared. The virus was injected into the spinal roots outside L 4-L 6 DRG through sterile surgery. After 1 month of breeding, L 4-L 6 spinal cord tissue of immunofluorescent staining of the side injected with viral tracer, DRG, sciatic nerve, and plantar skin of the SD rats were collected for immunofluorescent staining of neurofilament protein (NF) and microtubule associated protein 2 (MAP2). Distribution characteristics of AAV-positive nerve fibers were observed using a confocal microscope by average optical density (AOD) . Results:One month after injection of the viral tracer, red markers were visible in the dorsal horn of the L 4-L 6 spinal cord (AOD=0.5419±0.0245), DRG (AOD=0.4917±0.0087), sciatic nerve (AOD=0.6237±0.0634), dermis of plantar skin and skin appendages on the injected side (AOD=0.4943±0.0165). The red fluorescent clusters were found co-labeled with NF-positive nerve fibers or MAP2-positive neurons, it suggested that AAV- syp-mCherry could be transported anterogradely within sensory axons to distant target organs (skin) and offered a long-term image. Conclusion:The anterograde tracing method by adeno-associated virus can effectively show the complete trace of the central and peripheral processes of primary sensory neurons, and can serve as an effective methodology in observation of the pathways of peripheral sensory nerve fibers.
4.Application of remote fundus image reading training in improving the diagnostic ability of ophthalmologists in Xinjiang Uygur Autonomous Region
Xufeng ZHAO ; Xiuyan MA ; Xuejing LI ; Li QIN ; Lina SUO ; Wenping MA ; Shihao LI ; Jiaxing CHEN ; Yaxin YANG ; Xinxia LI ; Tao XIE ; Juan LI ; Yuanshan XIONG ; Zhiyong WU ; Zhihuai CHANG ; Mowen FANG ; Ting WANG ; Hong LIU ; Pengju MA ; Pengpeng LIU ; Jing RAN ; Di YANG ; Changle XUE ; Zhen XIE ; Zhao FAN ; Yang WANG ; Peng LEI ; Qingjiang HUANG ; Bing LI ; Shi FENG ; Zhangwanyu WEI ; Yishuang MAO ; Weihong YU ; Linjun ZHANG
Chinese Journal of Ocular Fundus Diseases 2024;40(12):941-946
Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.
5.Meta-analysis of perioperative results and safety of percutaneous nephrostomy and retrograde ureteral stenting in the treatment of acute obstructive upper urinary tract infection
Gang WU ; Xidong WANG ; Yuanshan CUI ; Jitao WU
Chinese Journal of Urology 2023;44(2):128-133
Objective:To compare the perioperative outcomes and safety of percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS) in the treatment of acute obstructive upper urinary tract infection.Methods:A comprehensive search was performed on the MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials to identify relevant literatures. The retrieval period was from the establishment of the database to August 2022. Inclusion criteria: ①Randomized controlled trial (RCT) of PCN and RUS in the treatment of acute obstructive upper urinary tract infection; ②Studies provided accurate data for analysis, including the total number of subjects and the results of each index; ③The full text of the study was available, and different literatures published in the same cohort were included in the newly published data. ④The observation indexes included the time for the recovery of body temperature, creatinine, leukocyte, operation, radiation exposure, postoperative fever, postoperative pain, and the incidence of postoperative fistulotomy or stent displacement. Exclusion criteria: ①non-RCT study; ②unable to obtain the full text. Two researchers independently screened the literature and evaluated the literature quality, and all the statistical data were analyzed by RevMan5.3 software.Results:Seven trials enrolled 727 patients were included in the meta-analysis, 412 in the PCN group and 315 in the RUS group included. Meta-analysis revealed that the advantages of PCN were lower incidence of postoperative hematuria ( OR=0.54, 95% CI 0.30-0.99, P=0.040) and lower incidence of insertion failure ( OR=0.42, 95% CI 0.21-0.81, P=0.010), but the fluoroscopy time of RUS group was shorter than that of PCN group ( MD=0.31, 95% CI 0.14-0.48, P<0.01). Moreover, there was no significant difference in time to normalization of temperature, time to normalization of creatinine, time to normalization of WBC, operative time, postoperative fever, postoperative pain, postoperative nephrostomy tube or stent slippage rate between the two surgical methods( P>0.05). Conclusions:The radiation exposure time of PCN was longer than that of RUS, but the incidence of postoperative hematuria and catheterization failure was lower than that of RUS.
6.Shanghai expert consensus on remote verification system of blood distribution in medical institutions
Zhanshan ZHA ; Mi JIANG ; Yuanshan LU ; Qingqing MA ; Baohua QIAN ; Ruiming RONG ; Chaohui TANG ; Xiaofeng TANG ; Jiang WU ; Rong XIA ; Tongyu ZHANG ; Xi ZHANG ; Rong ZHOU ; Zhengrong ZOU
Chinese Journal of Blood Transfusion 2022;35(8):783-785
In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.
7.Development and practice of national first-class undergraduate course "bioengineering equipment".
Yuanshan WANG ; Kun NIU ; Feng CHENG ; Zheming WU ; Jianmiao XU ; Xiaofei SONG ; Yuguo ZHENG
Chinese Journal of Biotechnology 2022;38(12):4797-4807
As a strategic emerging industry of China, the biotechnology industry develops rapidly in recent years, which significantly increased the demand for creative and capable talents. As a core curriculum of bioengineering specialty, biotechnology equipment plays an important role in fostering such talents. To address the problems in biotechnology equipment course teaching such as limited equipment availability, limited engineering practice, and lack of learning motivations, curriculum reform and optimization were performed based on curriculum resource development, virtual reality-physical combined engineering training, and boosting learning motivations. The optimized teaching contents focus on fostering morality, intelligence, and creative practice abilities by connecting new requirements of social development, introducing new progress in biotechnology research, as well as new practices in research and development (R & D). Measures such as teaching methods innovation, assessment and evaluation methods optimization, cutting-edge R & D progress, diverse resources integration, and online-offline combined teaching, were developed to boost the learning motivation and foster the innovation competence of students. By above exploration and practice, the practice and innovation competence of students were significantly enhanced.
Humans
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Students
;
Learning
;
Curriculum
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Bioengineering
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Biomedical Engineering
8.Role of Transcutaneous Electrical Nerve Stimulation in Treating Children With Overactive Bladder From Pooled Analysis of 8 Randomized Controlled Trials
Huanqin CUI ; Yi YAO ; Zhunan XU ; Zhenli GAO ; Jitao WU ; Zhongbao ZHOU ; Yuanshan CUI
International Neurourology Journal 2020;24(1):84-94
Purpose:
Transcutaneous electrical neural stimulation (TENS), as a non-invasive modality, has been clinically used as an alternative treatment for children with overactive bladder (OAB). We conducted a pooled analysis to explore the effect of TENS on OAB.
Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-analysis guideline was followed in this study. The MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases, as well as the reference lists of the retrieved studies, were used to find trials relevant for assessing the use of TENS to treat OAB.
Results:
Of the 246 records identified, 8 publications were analyzed in our study. Our analysis found that TENS resulted in a greater decrease of wet days/wk, daily voiding frequency, daily incontinence episodes, and daily number of voids than was observed in the control group. Furthermore, TENS-treated patients showed similar visual analogue scale (VAS) scores to patients in the control group, demonstrating that the application of TENS did not increase patients’ discomfort and pain. TENS had a relative advantage in the number of partial responses, but no clear differences were found in frequency of no response or a full response compared to the control group. In urodynamic testing, TENS led to obvious improvements in average voided volume and maximum voided volume in children with OAB.
Conclusions
TENS had a remarkable effect on the improvement of urodynamic indexes and objective OAB symptoms without a significant increase in VAS scores for children with OAB.
9.Development and application of in-situ microscopy in on-line monitoring of cell biomass.
Yuanshan WANG ; Wenhui HAO ; Zheming WU ; Kun NIU ; Meihua GONG
Chinese Journal of Biotechnology 2019;35(9):1607-1618
With the rapid development of modern biotechnology, fermentation process is increasingly important in industrial production. To guarantee the stability of products, fermentation process should be elaborately monitored and controlled. Biomass is an important parameter for on-line monitoring in bioprocesses because biomass can reflect cell growth in a bioreactor directly. In-situ microscope, a non-invasive and image-analysis based technology, can real-time monitor cells in biological process. This review summarizes the development and application of in-situ microscopy in biomass monitoring.
Biomass
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Bioreactors
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Biotechnology
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Fermentation
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Microscopy
10.Efficacy and Adverse Events Associated With Use of OnabotulinumtoxinA for Treatment of Neurogenic Detrusor Overactivity: A Meta-Analysis.
Hejia YUAN ; Yuanshan CUI ; Jitao WU ; Peng PENG ; Xujie SUN ; Zhenli GAO
International Neurourology Journal 2017;21(1):53-61
PURPOSE: OnabotulinumtoxinA is used widely for the treatment of neurogenic detrusor overactivity. We conducted a systematic review and meta-analysis to assess its efficacy and safety for neurogenic detrusor overactivity treatment. METHODS: A systematic literature review was performed to identify all published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for neurogenic detrusor overactivity treatment. MEDLINE, Embase, and the CENTRAL were employed. Reference lists of retrieved studies were reviewed carefully. RESULTS: Six publications involving 871 patients, which compared onabotulinumtoxinA with a placebo were analyzed. Efficacy of onabotulinumtoxinA treatment was shown as a reduction of the mean number of urinary incontinence episodes per day (mean difference, -1.41; 95% confidence interval [CI], -1.70 to -1.12; P<0.00001), maximum cystometric capacity (135.48; 95% CI, 118.22–152.75; P<0.00001), and maximum detrusor pressure (-32.98; 95% CI, -37.33 to -28.62; P<0.00001). Assessment of adverse events revealed that complications due to onabotulinumtoxinA injection were localized primarily to the urinary tract. CONCLUSIONS: This meta-analysis suggests that onabotulinumtoxinA is an effective treatment for neurogenic detrusor overactivity with localized advent events.
Humans
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Urinary Incontinence
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Urinary Tract

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