1.Analysis of Inpatient Mortality Cases in a Tertiary General Hospital in Beijing Based on Diagnosis-related Groups
Yufei ZHANG ; Jiong ZHOU ; Xiaojun MA ; Xiaoran WANG
Medical Journal of Peking Union Medical College Hospital 2025;16(3):697-702
To analyze inpatient mortality cases in a tertiary general hospital in Beijing based on diagnosis-related groups (DRG), with the aim of providing references for healthcare quality management. We retrospectively collected DRG data of hospitalized patients admitted to a tertiary general hospital in Beijing from January 1, 2015, to December 31, 2023. Mortality cases were analyzed according to mortality risk stratification, with a focus on the temporal trends, departmental distribution, and DRG composition of low/medium-low mortality risk cases. Among 927 304 DRG-classified hospitalizations, 2346 cases resulted in death (stratified into 130 low-risk, 209 medium-low-risk, 411 medium-high-risk, and 1596 high-risk cases), yielding an overall mortality rate of 0.25%. The mortality rates were 0.02% (130/680 939) in the low-risk group and 0.16% (209/130 449) in the medium-low-risk group. From 2015 to 2023, the mortality rate showed a significant downward trend ( Critical care units accounted for the highest proportion of mortality cases, with surgical patients having complications/comorbidities representing the major DRG-related factors for low/medium-low-risk deaths. Hospitals should prioritize these findings by identifying areas for improvement, implementing multidisciplinary case reviews, and strengthening patient safety measures.
2.Comparative study on the selectivity differences of 18F-TFQC and 18F-DPA-714 for TSPO gene polymorphisms and their PET imaging in rat neuroinflammation models
Hongxing SU ; Yufei MA ; Qingyu LIN ; Zhequan FU ; Xinyan GAO ; Pengcheng MA ; Dai SHI ; Zonghua LUO ; Dengfeng CHENG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(8):458-463
Objective:To explore the binding characteristics of N, N-diethyl-2-(2-(4-(2- 18F-fluoroethoxy)phenyl)-5, 7-dimethylpyrazolo[1, 5-a]pyrimidin-3-yl)acetamide ( 18F-DPA-714) and ( R)- N-sec-butyl- N-methyl-4-(3-( 18F-trifluoromethyl)phenyl)quinazoline-2-carboxamide ( 18F-TFQC) to the single nucleotide polymorphisms of the 18×10 3 translocator protein (TSPO), and to evaluate the imaging efficacy and feasibility of those 2 molecular probes in neuroinflammation rat models. Methods:To test the selectivity of 18F-DPA-714 and 18F-TFQC for TSPO polymorphisms, the wild-type (high-affinity binding, HAB) and mutant (low-affinity binding, LAB) sequences of the human TSPO gene were transfected into 293T cells respectively. A competitive inhibition assay was carried out with N-methyl- N-(1-methylpropyl)-1-(2-chlorophenyl)-3-isoquinoline carboxamide (PK11195) as an inhibitor to determine the binding affinities of 2 probes to TSPO polymorphisms. Rat neuroinflammation models ( n=6) were established using lipopolysaccharide. Three days after modeling, small animal PET/CT imaging was performed using 18F-DPA-714 and 18F-TFQC, respectively, to observe and compare the uptake of the tracers, and the ratio of SUV mean of the right striatum to SUV mean of the left striatum (SUVR) was calculated. After the imaging, the expression and distribution of microglia and TSPO were detected by tissue immunofluorescence. Repeated-measures analysis of variance was used to analyze the SUVR data of different groups. Results:The inhibition constants ( Ki) of 18F-TFQC on 293T-LAB and 293T-HAB cells were 23.51 and 14.60 nmol/L, respectively, with a Ki LAB/ Ki HAB ratio of 1.61, indicating low sensitivity to TSPO single nucleotide polymorphisms. The Ki of 18F-DPA-714 for binding to 293T-LAB and 293T-HAB cells were 45.23 and 6.47 nmol/L, respectively, with a Ki LAB/ Ki HAB ratio of 6.99. Small animal PET/CT imaging demonstrated that specifically uptake of both probes could be found in neuroinflammatory lesions. The overall SUVR of 18F-DPA-714 in the lesions within 60minutes was slightly higher than that of 18F-TFQC, but no significant difference was observed ( F values: inter-group 0.40, time effect 0.30, cross-effect 0.03; all P>0.05). Conclusions:Compared with 18F-DPA-714, 18F-TFQC is less sensitive to TSPO gene polymorphisms, thus being more suitable for clinical application and promotion. It holds promise for the early identification of neuroinflammation and the efficacy monitoring of anti-inflammatory drug treatments.
3.Analysis of the levels and food source of cadmium exposure by dietary pathway among middle-aged and elderly populations in cadmium-contaminated areas of China
Xiaochen WANG ; Yi ZHANG ; Xiaojie DONG ; Ruiting HAO ; Xiu YE ; Wenli ZHANG ; Ying ZHU ; Ailing LIU ; Yuan WEI ; Bing WU ; Yufei LUO ; Changzi WU ; Yanning MA ; Zhengxiong YANG ; Yuebin LYU ; Gangqiang DING ; Dongqun XU ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2025;59(5):597-603
Objective:To evaluate the levels and source of cadmium exposure by dietary pathway among middle-aged and elderly people ≥40 in cadmium-contaminated areas of China.Methods:A total of 7 193 people aged 40-89 years from four typical cadmium-contaminated areas in China were selected as the study subjects. Food Frequency Questionnaire (FFQ), Total Diet Study (TDS) and a 3-day-24-hour dietary recall survey were conducted. Dietary cadmium intake and food sources through dietary pathways were assessed based on cadmium content in foods, consumption amounts and intake frequencies.Results:The mean age of the participants was 63.39±12.21 years, with 50.05% being males. The average monthly dietary cadmium intake was 7.39 μg/(kg·BW). Staple foods and vegetables were the primary sources of dietary cadmium intake, accounting for 57.51% and 32.48%, respectively. The monthly dietary cadmium intake in all surveyed regions did not exceed the Provisional Tolerable Monthly Intake (PTMI) recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA).Conclusion:The monthly dietary cadmium intake among middle-aged and elderly people in cadmium-contaminated areas of China is relatively low, with the risk remaining at an acceptable level. Staple foods and vegetables are the most significant contributors to dietary cadmium intake.
4.Recombinant yeast-cell microcapsules carrying the DNA vaccine against enterotoxigenic Escherichia coli.
Xiafang ZHAO ; Lihong DU ; Baoxia MA ; Shaona JIA ; Yufei LIU ; Yufei ZHU ; Xiaotao MA ; Xiaojun YANG ; Kun XU
Chinese Journal of Biotechnology 2025;41(6):2388-2404
The enterotoxigenic Escherichia coli (ETEC) infection is a major factor restricting the development of animal husbandry. However, the abuse of antibiotics will lead to the antibiotic residues and emergence of antibiotic-resistant bacteria. The existing vaccines face challenges in stimulating intestinal immunity, demonstrating limited prevention effects. Therefore, it is indispensable to develop a new vaccine that is safe and suitable as a feed additive to activate intestinal immunity. This study constructed yeast-cell microcapsules (YCM) carrying the DNA vaccine against ETEC by genetic engineering. Furthermore, animal experiments were carried out to explore the regulatory effects of feeding YCM on the intestinal immune system and intestinal microbiota. Saccharomyces cerevisiae was selected as the oral delivery vehicle (microcapsules) of the DNA vaccine. The codon-optimized nucleic acid sequence of K88, the main antigen of mammal-derived ETEC, was synthesized, and the yeast shuttle vector containing the corresponding DNA vaccine expression cassette was constructed by DNA recombination. The recombinant strain of YCM was prepared by transforming JMY1. Additionally, the characteristics of the YCM strain and its feasibility as an oral vaccine were comprehensively evaluated by the fluorescence reporter assay, gastrointestinal fluid tolerance assay, intestinal epithelial cell adhesion assay, intestinal retention assessment, antiserum detection, and intestinal microbiota detection. The experimental results showed that the DNA vaccine expression cassette was expressed in mammals, and the recombinant strain of YCM could tolerate up to 8 hours of gastrointestinal fluid digestion and had good adhesion to intestinal epithelial cells. The results of mouse feeding experiments indicated that the recombinant strain of YCM could stay in the intestinal tract for at least two weeks, and the DNA vaccine expression cassette carried by YCM entered the intestinal immune system and triggered an immune response to induce the production of specific antibodies. Moreover, feeding YCM recombinant bacteria also improved the abundance of gut microbiota in mice, demonstrating a positive effect in regulating intestinal flora. In summary, we prepared the recombinant strain of YCM carrying the DNA vaccine against ETEC and comprehensively evaluated its characteristics and feasibility as an oral vaccine. Feeding the recombinant YCM could induce specific immune responses and regulate intestinal microbiota. The findings provide a reference for the immunoprevention of ETEC-related animal diseases.
Animals
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Enterotoxigenic Escherichia coli/genetics*
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Saccharomyces cerevisiae/metabolism*
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Vaccines, DNA/genetics*
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Mice
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Escherichia coli Infections/immunology*
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Escherichia coli Vaccines/genetics*
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Capsules
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Mice, Inbred BALB C
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Female
5.A qualitative study on influencing factors of physical activity behavior change in lung cancer patients based on health action process approach theory
Huxing CAO ; Yufei LI ; Junjun CAO ; Qiaoqiao MA ; Lili HOU
Journal of Clinical Medicine in Practice 2025;29(14):125-130
Objective To explore the influencing factors of physical activity behavior change in lung cancer patients and provide a basis for developing targeted intervention programs.Methods A descriptive qualitative research method was employed.Using purposive sampling,18 lung cancer pa-tients and 10 healthcare professionals were selected for semi-structured interviews from October to De-cember 2023.The health action process approach(HAPA)theory was used as the framework,and directed content analysis was applied to analyze the data.Results The barriers to physical activity behavior change in lung cancer patients were distilled into six themes:insufficient risk perception,negative outcome expectations,self-doubt and behavior avoidance tendencies,challenges in persist-ence and risk of interruption,lack of behavioral intention and demand,and absence of action and coping plans.The facilitating factors were divided into six themes:perception of the potential hazards of insufficient physical activity,perception of the health benefits of physical activity,cultivation and development of self-efficacy,stimulation of motivation for activity,formulation of differentiated activity plans,and formulation of adaptive coping plans.Conclusion Physical activity behavior in lung cancer patients is influenced by multiple factors.Targeted intervention strategies can be developed based on the HAPA theory to promote physical activity behavior change and improve physical activity levels.
6.Multivariate Functional Mixed Model and Application
Yufei MA ; Chunxia LI ; Tao ZHANG
Chinese Journal of Health Statistics 2025;42(4):491-495
Objective To introduce the fundamental principles of the multivariate functional mixed model(MFMM)and provide a methodological basis for interpreting the principal components derived from dimension reduction of multivariate functional data.Methods The MFMM models the mean function,auto-covariance function,and cross-covariance function within functions non-parametrically,clearly separating the shared latent processes common to all indicators from the specific latent processes unique to each indicator.In the case study,data from colorectal cancer patients at the Yunnan Cancer Hospital are used to extract the common and specific principal components of longitudinal carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)within 12 months post-surgery using MFMM,coupled with interpretation through a random survival forest prediction model.Results The MFMM identified 2 shared principal components for CEA and CA125,5 specific components for CEA,and 5 specific components for CA125.The random survival forest prediction model constructed based on these extracted components showed higher prediction accuracy than the baseline model.Furthermore,variable importance analysis revealed that the first specific component of CEA was the most important predictive variable after clinical baseline variables,while the importance of CA125 specific components was lower than that of CEA,consistent with the current consensus on colorectal cancer.Conclusion MFMM effectively manages the correlations among multiple longitudinal indicators and their changes over time,capturing the shared and specific processes of multiple longitudinal measurement indicators as they evolve.This enhances the model's interpretability and offers theoretical and practical advantages.
7.Effect of Yijinjing on Muscle Strength and Chronic Inflammation in Elderly Patients with Sarcopenia
Tao ZHANG ; Tianyi MA ; Li LUO ; Shuting LIU ; Yufei CHU ; Guoqiang LIANG ; Lei FANG ; Guodong ZHANG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(3):399-404
OBJECTIVE To observe the clinical efficacy of Yijinjing in the treatment of elderly sarcopenia and its effect on chro-nic inflammatory response in patients,and to explore the Yijinjing exercise prescription suitable for elderly patients with sarcopenia.METHODS A total of 120 elderly patients with sarcopenia admitted to the Department of Rehabilitation Medicine,Suzhou Hospital of Traditional Chinese Medicine from September 2022 to September 2024 were selected and randomly divided into a control group and a Yijinjing group,with 60 cases in each group.The control group received health education and dietary guidance,and the Yijinjing group received Yijinjing exercises on the basis of the intervention of the control group.The changes in skeletal muscle mass,upper and lower limb muscle strength,muscle thickness,muscle cross-sectional area,physical fitness and chronic inflammation level were observed in the two groups before and after the intervention.RESULTS After intervention,the skeletal muscle mass,grip strength,30 s sit-stand test times,rectus femoris thickness and cross-sectional area,vastus intermedius thickness,and physical fit-ness assessment of the patients in the Yijinjing group were significantly increased compared with those before treatment(P<0.05),and the indicators after intervention were higher than those in the control group(P<0.05);the serum TNF-α and IL-18 levels in the Yi-jinjing group were significantly decreased compared with those before treatment(P<0.05),and the indicators after intervention were lower than those in the control group(P<0.05);there was no statistically significant change in the biceps brachii thickness and serum IL-6 level in the Yijinjing group compared with those before treatment(P>0.05);there was no significant correlation between the bi-ceps brachii thickness and grip strength after Yijinjing intervention,r=0.139 8,P>0.05;there was a significant negative correlation between the TNF-α level and grip strength after Yijinjing intervention,r=-0.313 8,P<0.05.CONCLUSION Yijinjing exercises can improve muscle mass and strength in elderly patients with sarcopenia,and improve the physical fitness of patients,which may be related to improving the chronic inflammatory state of the body.
8.Effects of Pulsatilla powder on intestinal flora and tryptophan metabolism in co-lon of piglets with diarrhea
Shuo FENG ; Lifang ZHANG ; Yufei XIE ; Shengming JIANG ; Liting CAO ; Shicheng BI ; Qi MA
Chinese Journal of Veterinary Science 2025;45(3):568-579
This study aims to investigate the effects of Pulsatilla powder(PP)on colonic intestinal flora and tryptophan metabolism in piglets with diarrhea.Twenty-four weaned piglets were ran-domly divided into the normal control group,model group,self-healing group,and PP group.The model of piglet diarrhea was established by the compound factor of external evil+internal injury+epi-demic virus,and treated with PP.During the modeling period,the body weight,mental status and fecal patterns of piglets were monitored daily.After the experiment,the colon tissues were collect-ed for histopathological observation,and the inflammatory factors IL-1β and IL-6 in the colon tis-sue was detected by ELISA,16S rRNA was used to analyze colonic intestinal flora and RT-qPCR was used to determine the expression of genes related to tryptophan metabolism in the colon.The results showed that,compared with the model group,PP significantly improved the pathological status of the colon in piglets with diarrhea,with elevated body mass and a significant increase in goblet cells(P<0.05);and significantly reduced the levels of IL-1β and IL-6 in the colon of diar-rhea piglets(P<0.05).The results of intestinal flora showed that PP increased the abundance of Firmicutes(P<0.01),Spirochaeota(P<0.01)and Lactobacillus(P<0.05),reduced the abun-dance of Bacteroidota(P<0.05)、Prevotella_NK3B31_group(P<0.05)and Clostridium_sensu_stricto 1(P<0.01).Meanwhile,PP significantly reduced the expression level of TPH1 mRNA(P<0.05),increased the expression levels of AhR(P<0.05)and IL-22 mRNA in the co-lon of diarrhea piglets.These results indicates that PP may alleviate diarrhea in piglets by regula-ting colonic intestinal flora and genes related to intestinal tryptophan metabolism.This study pro-vides data support for the subsequent investigation of piglet diarrhea prevention and treatment.
9.Analysis of the levels and food source of cadmium exposure by dietary pathway among middle-aged and elderly populations in cadmium-contaminated areas of China
Xiaochen WANG ; Yi ZHANG ; Xiaojie DONG ; Ruiting HAO ; Xiu YE ; Wenli ZHANG ; Ying ZHU ; Ailing LIU ; Yuan WEI ; Bing WU ; Yufei LUO ; Changzi WU ; Yanning MA ; Zhengxiong YANG ; Yuebin LYU ; Gangqiang DING ; Dongqun XU ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2025;59(5):597-603
Objective:To evaluate the levels and source of cadmium exposure by dietary pathway among middle-aged and elderly people ≥40 in cadmium-contaminated areas of China.Methods:A total of 7 193 people aged 40-89 years from four typical cadmium-contaminated areas in China were selected as the study subjects. Food Frequency Questionnaire (FFQ), Total Diet Study (TDS) and a 3-day-24-hour dietary recall survey were conducted. Dietary cadmium intake and food sources through dietary pathways were assessed based on cadmium content in foods, consumption amounts and intake frequencies.Results:The mean age of the participants was 63.39±12.21 years, with 50.05% being males. The average monthly dietary cadmium intake was 7.39 μg/(kg·BW). Staple foods and vegetables were the primary sources of dietary cadmium intake, accounting for 57.51% and 32.48%, respectively. The monthly dietary cadmium intake in all surveyed regions did not exceed the Provisional Tolerable Monthly Intake (PTMI) recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA).Conclusion:The monthly dietary cadmium intake among middle-aged and elderly people in cadmium-contaminated areas of China is relatively low, with the risk remaining at an acceptable level. Staple foods and vegetables are the most significant contributors to dietary cadmium intake.
10.Multivariate Functional Mixed Model and Application
Yufei MA ; Chunxia LI ; Tao ZHANG
Chinese Journal of Health Statistics 2025;42(4):491-495
Objective To introduce the fundamental principles of the multivariate functional mixed model(MFMM)and provide a methodological basis for interpreting the principal components derived from dimension reduction of multivariate functional data.Methods The MFMM models the mean function,auto-covariance function,and cross-covariance function within functions non-parametrically,clearly separating the shared latent processes common to all indicators from the specific latent processes unique to each indicator.In the case study,data from colorectal cancer patients at the Yunnan Cancer Hospital are used to extract the common and specific principal components of longitudinal carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)within 12 months post-surgery using MFMM,coupled with interpretation through a random survival forest prediction model.Results The MFMM identified 2 shared principal components for CEA and CA125,5 specific components for CEA,and 5 specific components for CA125.The random survival forest prediction model constructed based on these extracted components showed higher prediction accuracy than the baseline model.Furthermore,variable importance analysis revealed that the first specific component of CEA was the most important predictive variable after clinical baseline variables,while the importance of CA125 specific components was lower than that of CEA,consistent with the current consensus on colorectal cancer.Conclusion MFMM effectively manages the correlations among multiple longitudinal indicators and their changes over time,capturing the shared and specific processes of multiple longitudinal measurement indicators as they evolve.This enhances the model's interpretability and offers theoretical and practical advantages.

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