1.Development and validation of the “Questionnaires on the Knowledge, Attitudes, and Practices of College Students in Response to Public Health Emergencies”
Hong JIANG ; Shuli MA ; Yufeng ZHANG ; Yue ZHAO ; Xinling YANG
China Occupational Medicine 2025;52(1):33-39
Objective To develop the "Questionnaires on the Knowledge, Attitudes, and Practices of College Students in Response to Public Health Emergencies" and validate its reliability and validity. Methods The initial questionnaire was developed according to literature review, expert consultations, and one-on-one interviews with students and educators. A total of 43 college students were selected as the pre-test subjects using the convenience sampling method. The final version of the questionnaire was developed using item analysis and expert consultations. A total of 682 college students were selected as the validation subjects using the cluster sampling method. The exploratory factor analysis and confirmatory factor analysis were used to assess the reliability and validity of the questionnaire. Results The final version of the questionnaire consisted of three dimensions: knowledge, practice, and attitude, with 5, 10, 7 items, respectively. The KMO test value for the questionnaire was 0.804, with Bartlett′s test of sphericity showing a chi-square value of 2 000.557 (P<0.01). The content validity index for each item ranged from 0.894 to 1.000, with the overall content validity index for the questionnaire being 0.966 and 0.973. The exploratory factor analysis identified three common factors, with a cumulative variance contribution rate of 54.1%. The result of confirmatory factor analysis showed good model fit, with model fit index, comparative fit index, normed fit index, incremental fit index, Tucker-Lewis Index, root mean square error of approximation of 2.960, 0.930, 0.940, 0.930, 0.950 and 0.070, respectively. The Cronbach's α coefficient for the questionnaire was 0.772, split-half reliability was 0.604, and test-retest reliability was 0.905. Conclusion The "Questionnaires on the Knowledge, Attitudes, and Practices of College Students in Response to Public Health Emergencies" demonstrates good reliability, and it is suitable for widespread application.
2.Mechanism Investigation of Qi-invigorating and Blood-activating Drug Combination in Yitangkang Compound Against Diabetic Cardiomyopathy Using Multimodal Research Approach
Chenghao YU ; Tingting LI ; Mingbo ZHANG ; Honghe XIAO ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):94-106
ObjectiveThrough multimodal research methods including medication rule mining, network pharmacology, molecular docking and dynamics simulation, and in vivo animal experiments, this study aims to speculate and verify the core composition (Ginseng Radix et Rhizoma Rubra-Salviae Miltiorrhizae Radix et Rhizoma-Notoginseng Radix et Rhizoma) and efficacy (Qi-invigorating and blood-activating) of the drug combination in Yitangkang Compound for improving diabetic cardiomyopathy (DCM), investigate the interaction relationship and binding strength between core active ingredients of the drug combination and key signaling pathway targets, and further explore the mechanism by which the Qi-invigorating and blood-activating drug combination regulates the calcium signaling pathway to improve cardiac function in DCM rats. MethodsThe Ancient and Modern Medical Cases Cloud Platform was used to construct a DCM prescription database, and the "Analysis Method" module of the platform was applied to mine and summarize medication rules, thereby determining the core composition of the Qi-invigorating and blood-activating drug combination in Yitangkang. Drug-active ingredient-signaling pathway-core target-disease analysis and visualization were conducted by combining network pharmacology with the Traditional Chinese Medicine System Pharmacology Platform (TCMSP) database, SwissTargetPrediction platform, GeneCards database, MetaScape database, CytoScape software, etc. Then, molecular docking was performed via the CB-Dock2 platform, and molecular dynamics simulation of the high-binding-strength docking complexes was carried out by Gromacs software. Finally, in vivo animal experiments were carried out. Twenty-eight Sprague Dawley (SD) rats meeting the research criteria were divided into a normal group, a model group, a drug combination group (3.3 g·kg-1), and a Yitangkang group (20 g·kg-1). A type 2 diabetes mellitus (T2DM) rat model was established by high-fat diet feeding combined with intraperitoneal injection of streptozotocin (STZ), followed by continuous feeding for eight weeks until the DCM model was successfully established. During this period, the traditional Chinese medicine (TCM) compound and drug combination were administered for prevention and treatment intervention. Meanwhile, changes in blood glucose, body weight, and heart index of each group were monitored. Cardiac function was assessed by echocardiography, and electrophysiological signals were detected by an electrocardiogram. The heart tissue was observed for pathological changes by hematoxylin-eosin (HE) and Masson staining, and the expression of L-type calcium channel (CACNA1C), calmodulin (CALM1), calcium/calmodulin-dependent protein kinase Ⅱδ (CAMK2D), and neuronal nitric oxide synthase (NOS1) proteins in the calcium signaling pathway of myocardial tissue was detected by Western blot. ResultsIn 62 DCM prescriptions, Ginseng Radix et Rhizoma Rubra, Salviae Miltiorrhizae Radix et Rhizoma, and Notoginseng Radix et Rhizoma were used most frequently. Their meridian tropism mainly involved the spleen, heart, and lung, and their sweet and warm properties were prominent. The drugs for tonifying or blood-activating and stasis-resolving ranked top. In association rule analysis, (Ginseng Radix et Rhizoma Rubra, Salviae Miltiorrhizae Radix et Rhizoma)-Notoginseng Radix et Rhizoma had the highest lift. Network pharmacology obtained 75 active ingredients of the drug combination, 714 drug combination action targets, 2 702 disease targets, and 286 intersection targets. Protein-protein interaction (PPI) network predicted nine interaction component-targets (nine active ingredients and four calcium signaling pathway target genes). Molecular docking showed the four complexes with the lowest binding energy were 2f3z-ginsenoside Re, 1cll-quercetin, 9blh-(6S)-6-(hydroxymethyl)-1,6-dimethyl-8,9-dihydro-7H-naphtho[8,7-g]benzofuran-10,11-dione, and 5vv0-miltionone Ⅱ. Dynamics simulation showed the CALM1-quercetin complex had the strongest binding affinity. The animal experiment results revealed that compared with the normal group, the model group showed significant changes in blood glucose, body weight, myocardial tissue morphology, heart index, cardiac function, electrophysiological indexes, and the expression levels of CACNA1C, CALM1, CAMK2D, and NOS1 proteins (P<0.05, P<0.01). Compared with the model group, the Yitangkang group had a certain improvement effect on the above indexes (P<0.05, P<0.01). Compared with the Yitangkang group, the drug combination group showed no significant difference in improving myocardial tissue morphology, heart index, cardiac function, electrophysiological indexes, and the expression of CACNA1C, CALM1, CAMK2D, and NOS1 proteins, except for blood glucose and body weight. ConclusionGinseng Radix et Rhizoma Rubra, Salviae Miltiorrhizae Radix et Rhizoma, and Notoginseng Radix et Rhizoma are the core Qi-invigorating and blood-activating drug combination in Yitangkang Compound. They have a good preventive and therapeutic effect on STZ-induced DCM in rats, and their mechanism of action may be related to the regulation of the calcium signaling pathway.
3.Application of the plasmatrix in alveolar ridge preservation
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(3):161-168
After tooth extraction, significant absorption occurs in the soft and hard tissues of the alveolar ridge. The goal of alveolar ridge preservation is to maintain the volume and shape of the alveolar ridge's soft and hard tissues as much as possible so as to provide suitable conditions for implant placement. Currently, there are challenges in classifying the socket for alveolar ridge preservation, such as the difficulty in directly guiding the selection of graft materials and clinical procedures and the insufficient space for particle xenograft maintenance, resulting in poor bone regeneration. Plasmatrix is an autologous blood derivative that effectively enhances tissue regeneration. This article introduced the characteristics of soft and hard tissue defects after tooth extraction and the primary applications of plasmatrix for alveolar ridge preservation (liquid plasmatrix, solid plasmatrix membrane/plug, and plasmatrix bone blocks) as well as the proposed methods for the reclassification of sockets for alveolar ridge preservation based on soft and hard tissue defects at the extraction site to facilitate the creation of clinical recommendations. The proposed classifications are as follows: Class I, extraction socket without bone defect, with or without soft tissue defect; Class Ⅱ, extraction socket with bone defect, both sides with bone wall defect less than 50%, with or without soft tissue defect; Class Ⅲ, extraction socket with bone tissue defect, at least one side with bone wall defect greater than 50%, with or without soft tissue defect. For the Class I socket, a solid plasmatrix membrane or plug is inserted, followed by injection of liquid plasmatrix, using a double-layer solid plasmatrix membrane for socket closure; for the ClassⅡ socket, plasmatrix bone blocks are inserted, followed by injection of liquid plasmatrix and secondary solidification, using absorbable collagen membrane and double-layer solid plasmatrix membrane for socket closure; for the ClassⅢ socket, tenting screws are used to maintain height, followed by implantation of plasmatrix bone blocks, injection of liquid plasmatrix and secondary solidification, using absorbable collagen membrane and double-layer solid plasmatrix membrane for socket closure. The aim of this article is to provide comprehensive knowledge of plasmatrix for oral clinicians to serve as a reference to simplify the clinical decision-making process and procedures for alveolar ridge preservation.
4.Application status and prospect of Indocyanine green in radical prostatectomy
Yufeng ZHANG ; Hongchen SONG ; Boyu YANG ; Mingjun SHI ; Peiqian YANG ; Zhengguo JI
International Journal of Surgery 2024;51(2):129-133
Prostate cancer is a common malignant tumor in male genitourinary system, and radical prostatectomy is one of the important methods to treat prostate cancer. Indocyanine green is a non-radioactive, water-soluble compound, which can help identify anatomical structures and visualize blood vessels through near-infrared fluorescence. The role and injection techniques of Indocyanine green in radical prostatectomy in sentinel lymph node identification, pelvic lymph node dissection and neurovascular bundle preservation are reviewed, so as to provide a reference for improving the surgical effect, reducing the difficulty of surgery, and prolonging the survival period of patients, and evaluate the potential research field of this technology in the future.
5.Correlation of KRAS Gene 3'UTR Polymorphisms with Cervical Cancer and Cervical Intraepithelial Neoplasia in Chinese Han Population in Yunnan Province
Ni GUO ; Cheng ZHANG ; Chao HONG ; Weipeng LIU ; Yufeng YAO ; Zhiling YAN
Journal of Kunming Medical University 2024;45(2):14-22
Objective To investigate the correlation between rs712 and rs7973450 located at the 3'UTR region of the KRAS gene and the risk of cervical cancer(CC)and cervical intraepithelial neoplasia(CIN)in Chinese Han population in Yunnan province.Methods A total of 2405 individuals(461 subjects with CIN,961 subjects with CC and 983 healthy controls)were enrolled.The SNPs were genotyped used TaqMan assay and the correlation of these SNPs with CIN and CC was analyzed.Results The A allele of rs7973450 might be a protective factor for the occurrence of CIN(P = 0.004,OR= 0.651,95%CI 0.487~0.871)and CC(P = 7.00×10-4,OR= 0.667,95%CI 0.529~0.844).There was no significant difference in allelic and genotypic distribution of rs712 among CIN,CC and Control groups(P>0.017).The haplotype assay showed thatrs712A-rs7973450G was associated with increased risk of CIN(P = 4.00×10-4;OR= 1.714,95%CI 1.269~2.314)and CC(P = 3.84×10-5,OR= 1.667,95%CI 1.305~2.131).While haplotype rs712A-rs7973450A was associated with a lower risk of CC(P = 0.012,OR= 0.790,95%CI 0.658~0.950).Conclusion The A allele of rs7973450 in 3'UTR of KRAS gene might be the protective factor for the occurrence of CIN and CC in a Chinese Han population in Yunnan province.
6.Analysis of clinical and pathological characteristics of drug-induced live injury based on hepatotoxicity injury patterns
Honghai XU ; Shiwei ZHU ; Hui ZHANG ; Yufeng GAO ; Hua WANG
Chinese Journal of Clinical and Experimental Pathology 2024;40(2):172-178
Purpose To explore the clinical and pathologi-cal features and the relationships between pathological features and drugs of patients with drug-induced liver injury(DILI)based on the hepatotoxicity injury patterns.Methods The clin-ical data,laboratory indicators,drugs,and liver biopsy of 50 cases of DILI were collected,the expression of CK19 was detec-ted by immunohistochemistry EnVision two-step method,and the reticular scaffold of liver tissue was displayed by Reticular fiber staining.Results Among the 50 patients with DILI,there were 29 cases of hepatocellular DILI,11 cases of cholestatic DILI,and 10 cases of mixed DILI,respectively,with the hepatocellu-lar DILI accounting for the highest proportion(58%).7 catego-ries of drugs induced DILI,with herbal ranking first(52%).Different types of drugs could cause different types of DILI,with herbal induced 17 cases hepatocellular DILI(58.62%)and an-ti-infectious and anticancer drugs induced all 3 cases cholestatic DILI(27.27%).Different types of DILI displayed various pathological characteristics.Hepatocellular congestion,feathery degeneration,and small bile duct thrombosis primarily occur in cholestasis and mixed DILI,while bridging necrosis,sub-large and large necrosis were mainly seen in hepatocellular DILI.Conclusion Based on hepatotoxicity injury patterns,DILI ex-hibits a variety of clinical and pathological characteristics,and there is some relationship between pathological characteristics and drugs.Liver puncture pathological biopsy plays an important role in improving the diagnosis and treatment of DILI.
7.Efficacy of tele-rehabilitation program for preschool children with functional articulation disorders
Yufeng JIA ; Yang LI ; Shuang ZHANG ; Shuzhi GAO ; Jingyun GAO ; Shuang LI
Chinese Journal of Child Health Care 2024;32(2):223-227
【Objective】 To observe the effect of tele-rehabilitation program on the articulation resolution of preschool children with functional articulation disorders (FAD), so as to provide reference for the clinical application of tele-rehabilitation in this context. 【Methods】 A total of 66 preschool children diagnosed with FAD in the outpatient department of Child Rehabilitation, Tangshan Maternal and Child Health Hospital from March 2022 to March 2023 were selected into this study, and were divided into tele-rehabilitation group (n=32) and control group (n=34) by random number table method. The control group received daily family rehabilitation guidance, while the tele-rehabilitation group underwent a tele-rehabilitation program lasting for 3 months. All children were assessed using the Chinese phonological ability evaluation lexicon before and 3 months after the treatment. 【Results】 After 3 months of treatment, both the tele-rehabilitation group and the control group showed significant improvements in articulation resolution compared to before treatment (t=12.165、12.986, P<0.05). Notably, the tele-rehabilitation group exhibited significantly greater improvement than the control group (t=2.138, P<0.05). Within the tele-rehabilitation group, children were further divided into three subgroups based on the severity of their dysphonia: mild, moderate, and severe. After 3 months of treatment, the articulation resolution of the mild and moderate groups improved significantly compared to before treatment (Z=2.226, 31.900, P<0.05), whereas no statistically significant improvement was observed in the severe group compared to before treatment (Z=1.857, P>0.05). 【Conclusion】 Tele-rehabilitation program effectively improves articulation resolution in preschool children with FAD, especially for mild to moderate preschool children with FAD.
8.The evaluation of alpha-fetoprotein response on efficacy and prognosis in targeted therapy combined with immunotherapy for intermediate-to-advanced hepatocellular carcinoma: a multicenter clinical study
Kongying LIN ; Qingjing CHEN ; Luobin GUO ; Yun YANG ; Yufeng CHEN ; Jianxi ZHANG ; Fuqun WEI ; Hui ZHANG ; Zhiqing CHENG ; Yuntong LI ; Congren WANG ; Yabin JIANG ; Kecan LIN ; Weiping ZHOU ; Yongyi ZENG
Chinese Journal of Digestive Surgery 2024;23(2):248-256
Objective:To investigate the evaluation efficacy and predictive prognostic value of alpha-fetoprotein (AFP) response in tyrosine kinase inhibitors (TKIs) in combination with PD-1 inhibitors (α-PD-1) for intermediate-to-advanced hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 205 patients with intermediate-to-advanced HCC who were admitted to 9 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from March 2020 to July 2022 were collected. There were 178 males and 27 females, aged (52±12)years. Based on AFP response at 6-8 weeks after treatment, patients were divided into the AFP response group (AFP level decreased by ≥50% compared to baseline) and the AFP no response group (AFP level decreased by <50% compared to baseline). Observation indicators: (1) AFP response evaluation of anti-tumor efficacy; (2) comparison of patient prognosis; (3) analysis of factors affecting patient prognosis. Measurement data with normal distrubution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range) and M( Q1, Q3). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curve and calculate survival rate, and the Log-Rank test was used for survival analysis. The COX proportional risk model was used for univariate analysis and the COX stepwise regression model was used for multivariate analysis. Results:(1) AFP response evaluation of anti-tumor efficacy. Before treatment, all 205 patients were positive of AFP, with a baseline AFP level of 1 560(219,3 400)μg/L. All 205 patients were treated with TKIs in combination with α-PD-1, and the AFP level was 776(66,2 000)μg/L after 6 to 8 weeks of treatment. Of the 205 patients, 88 cases were classified as AFP response and 117 cases were classified as AFP no response. According to the response evaluation criteria in solid tumors version 1.1, the objective response rate (ORR) and disease control rate (DCR) were 42.05%(37/88) and 94.32%(83/88) in patients of the AFP response group and 16.24% (19/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=16.846, 25.950, P<0.05). According to the modified response evaluation criteria in solid tumors, the ORR and DCR were 69.32% (61/88) and 94.32% (83/88) in patients of the AFP response group and 33.33% (39/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=26.030, 25.950, P<0.05). (2) Comparison of patient prognosis. All 205 patients were followed up for 12.4(range, 2.4-34.0)months after treatment. The median progression free survival time and total survival time were 5.5 months and 17.8 months, respectively. The 1-year, 2-year progression free survival rates were 20.8% and 7.2%, and the 1-year, 2-year overall survival rates were 68.7% and 31.5%, respectively. The median progression free survival time, 1-year and 2-year progression free survival rates were 9.7 months, 39.6% and 14.2% in patients of the AFP response group and 3.7 months, 7.8% and 2.0% in patients of the AFP no response group, showing a significant difference in progression free survival between them ( χ2=43.154, P<0.05). The median overall survival time, 1-year and 2-year overall survival rates were not reached, 85.2% and 56.3% in patients of the AFP response group and 14.6 months, 56.3% and 14.5% in patients of the AFP no response group, showing a significant difference in overall survival between them ( χ2=33.899, P<0.05). (3) Analysis of factors affecting patient prognosis. Results of multivariate analysis showed that invasion of large blood vessels, extrahepatic metastasis, combined hepatic artery intervention therapy, and AFP response were independent factors influencing progression free survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio=1.474, 1.584, 0.631, 0.367, 95% confidence interval as 1.069-2.033, 1.159-2.167, 0.446-0.893, 0.261-0.516, P<0.05), and Eastern Cooperative Oncology Group score, invasion of large blood vessels, extrahepatic metastasis, and AFP response were independent factors influencing overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio= 1.347, 1.914, 1.673, 0.312, 95% confidence interval as 1.041-1.742, 1.293-2.833, 1.141-2.454, 0.197-0.492, P<0.05). Conclusions:AFP response at 6-8 weeks after treatment can effectively evaluate anti-tumor efficacy of TKIs in combination with α-PD-1 for intermediate-to-advanced HCC. AFP response is the independent factor influencing progression free survival and overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1.
9.Application of case-based learning based on the clinical case library of stomatology in standardized residency training for comprehensive stomatology
Ming WANG ; Haiyang LI ; Yufeng ZHANG ; Qinhua WANG ; Weiwen QIAN ; Xiaotian JIANG ; Conghua LI
Chinese Journal of Medical Education Research 2024;23(3):424-428
Objective:To investigate the application effect of case-based learning (CBL) based on the clinical case library of stomatology in standardized residency training for comprehensive stomatology.Methods:A total of 52 residents in Department of Stomatology, Chongqing Medical University, were given CBL teaching based on the clinical case library of comprehensive stomatology, and a questionnaire survey was performed to evaluate the teaching effect. Theoretical and skill assessments were performed before and after CBL teaching, and a comparative analysis was performed. SPSS 19.0 software was used for the t-test. Results:The questionnaire survey showed that CBL teaching based on the clinical case library of stomatology effectively improved the ability of independent learning [92.31% (48/52)], the interest in learning [88.46% (46/52)], and the ability for case diagnosis and the accuracy of investigation and judgment [94.23% (49/52)]. This method helped with the mastery and understanding of the theoretical knowledge in stomatology [96.15% (50/52)] and improved the abilities for expression and communication [84.62% (44/52)] and the ability to find and solve problems [94.23% (49/52)]. It also helped to stimulate the interest in scientific research and teaching [82.69% (43/52)] and create an active classroom atmosphere [82.69% (43/52)]. Among these residents, 94.23% (49/52) liked CBL teaching, and 88.64% (46/52) thought the setting of the case library was reasonable. After the application of CBL teaching, there were significant increases in theoretical score [from (66.74±4.25) points to (81.44±7.16) points] and skill examination score [from (64.00±3.14) points to (81.96±7.50) points].Conclusions:CBL teaching based on the case library of stomatology has a good teaching effect in the standardized residency training for comprehensive stomatology and can not only improve the theoretical and skill assessments of residents, but also improve their learning interest and clinical thinking ability.
10.Real world analysis of third-line treatment with anlotinib in combination with radiotherapy for extensive-stage small-cell lung cancer
Yufeng ZONG ; Xin ZHANG ; Yao TAN ; Haifeng WANG
Chinese Journal of Radiation Oncology 2024;33(1):13-18
Objective:To investigate the clinical efficacy and safety of anlotinib combined with radiotherapy as a third-line treatment regimen for extensive stage small-cell lung cancer (ES-SCLC) in a real-world background.Methods:Forty ES-SCLC patients enrolled in a single center of Affiliated Cancer Hospital of Xinjiang Medical University in China between November 2018 and July 2021 were treated with radiotherapy added on anlotinib as a third-line treatment regimen. Overall survival (OS), progression-free survival (PFS), safety, and quality of life were analyzed, and the survival status was statistically analyzed using Kaplan-Meier method.Results:Among the 40 patients, partial remission, stable disease, and progressive disease was confirmed in 7, 24 and 9 patients, respectively. The obtained objective remission rate (ORR) was 18%, the disease control rate (DCR) was 78%, and median PFS and median OS were 4.5 months and 9 months, respectively. The most common adverse reactions included fatigue (28%), bleeding (20%), anorexia (13%), and hand-foot syndrome (8%). Most of them were grade 1-2 in severity, 4 cases were documented as ≥grade 3, and no grade 5 toxicity was recorded.Conclusions:In the real world, radiotherapy added on anlotinib as a third-line regimen can prolong PFS and OS of the ES-SCLC patients, and the adverse reactions are generally tolerated. This combination treatment regimen is worthy of further investigation.


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