1.Relationship between psychological abuse and neglect and suicidal ideation in left-behind adolescents: the mediating role of negative affect and the moderating role of different stages of adolescence
Lu PAN ; Yuhang WU ; Yuqin SONG ; Cen LIN ; Yu CEN ; Jiarui SHAO ; Cailin XIE ; Mengqin DAI ; Qiuyue FAN ; Lei TANG ; Jiaming LUO
Sichuan Mental Health 2025;38(4):374-380
BackgroundPrevious studies have identified a close relationship among psychological neglect and abuse, negative affect, different stages of adolescence, and suicidal ideation. However, the mechanisms underlying the impact of psychological abuse and neglect on suicidal ideation among left-behind adolescents remain unclear, and this field of research is still in its relative infancy. ObjectiveTo explore the relationship between psychological neglect/abuse and suicidal ideation among left-behind adolescents, as well as the mediating role of negative affect and the moderating effect of different stages of adolescence, so as to provide insights for preventing and intervening suicidal ideation in this population. MethodsFrom November 2021 to May 2022, a cluster random sampling technique was utilized to select 2 309 left-behind adolescents in western China. Assessments were conducted using the Child Psychological Abuse and Neglect Scale (CPANS), the Positive and Negative Suicide Ideation (PANSI) and the Positive and Negative Affect Schedule for Children (PANAS-C). Spearman correlation coefficients were calculated across all samples, and Process 4.1 was employed to test the mediating role of negative affect and the moderating role of different stages of adolescence in the pathway linking psychological abuse/neglect to suicidal ideation. ResultsA total of 2 119 left-behind adolescents (mean age: 14.94±1.20 years) completed the study, with males comprising 51.34% (1 088/2 119) and females 48.66% (1 031/2 119).Among left-behind adolescents, scores on CPANS psychological neglect subscale showed positive correlations with both psychological abuse subscale scores and PANAS-C negative affect subscale scores (r=0.446, 0.496, P<0.01). Additionally, CPANS psychological neglect and psychological abuse subscale scores were also positively correlated with PANSI scores (r=0.487, 0.508, P<0.01). Furthermore, PANAS-C negative affect subscale scores demonstrated a positive correlation with PANSI scores (r=0.499, P<0.01). Negative affect partially mediated the relationship between psychological abuse/psychological neglect and suicidal ideation, with effect sizes of 0.166 (95% CI: 0.141~0.191) and 0.131 (95% CI: 0.112~0.152). Different stages of adolescence moderated the latter part (negative emotion → suicidal ideation) of the indirect mediation path from psychological neglect to suicidal ideation through negative affect (β=-0.066, P<0.01). ConclusionBoth psychological neglect and psychological abuse may influence suicidal ideation among left-behind adolescents via negative affect. Moreover, different stages of adolescence may moderate the indirect path from psychological neglect to suicide ideation through negative affect.
2.Chinese expert consensus on the evaluation of allergen-specific immunotherapy outcomes(Wuhan, 2025).
Yuqin DENG ; Xi LUO ; Zhuofu LIU ; Shuguang SUN ; Jing YE ; Tiansheng WANG ; Jianjun CHEN ; Meiping LU ; Yin YAO ; Ying WANG ; Wei ZHOU ; Bei LIU ; Qingxiang ZENG ; Yuanteng XU ; Qintai YANG ; Yucheng YANG ; Feng LIU ; Chengli XU ; Yanan SUN ; Haiyu HONG ; Haibo YE ; Liqiang ZHANG ; Fenghong CHEN ; Huabin LI ; Hongtian WANG ; Yuncheng LI ; Wenlong LIU ; Yu XU ; Hongfei LOU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(11):1075-1085
Allergen-specific immunotherapy(AIT) remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis(AR). Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group(CRRCG) convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans
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Allergens/immunology*
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China
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Consensus
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Desensitization, Immunologic
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Immunoglobulin E
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Quality of Life
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Rhinitis, Allergic/therapy*
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Treatment Outcome
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East Asian People
3.Analyzing the occupational health literacy level and its influencing factors among six key occupational populations in the Jiulongpo District, Chongqing City
Yu LUO ; Shimin DENG ; Yuqin WEN
China Occupational Medicine 2025;52(1):66-70
Objective To evaluate the occupational health literacy (OHL) level and its influencing factors among individuals of six key industries from Jiulongpo District, Chongqing City. Methods A total of 2 022 frontline workers from six key industries in the Jiulongpo District of Chongqing City were selected as the research subjects using a cluster sampling method. The OHL level of the workers were assessed using the Occupational Health Literacy Questionnaire of National Key Populations. Results The overall OHL level among the 2 022 frontline workers was 51.43%. The OHL level in the four dimensions of basic knowledge of occupational health protection, healthy work practices and behaviors, legal knowledge of occupational health, and basic skills of occupational health protection were 81.45%, 56.08%, 43.42%, and 37.59%, respectively. The OHL levels of the six key industries from high to low were electrical machinery and equipment manufacturing, healthcare, education, express delivery/food delivery, transportation, and environmental hygiene, accounted for 91.43%, 61.98%, 52.64%, 40.58%, 36.70% and 31.15% (P<0.01). The results of logistic regression analysis showed that population of Han had higher OHL level than ethnic minorities (P<0.01), married individuals had lower OHL level than unmarried individuals (P<0.05), individuals with college education or above had higher OHL level than those with junior high school education or below (P<0.01), and higher personal monthly income was associated with higher OHL levels (all P<0.05). The OHL levels of workers of environmental hygiene, transportation, education, express delivery/food delivery, and healthcare were lower than those in electrical machinery and equipment manufacturing (all P<0.01). Conclusion The OHL level among occupational populations in the six key industries in Jiulongpo District, Chongqing City, needs to be further improved. And the OHL monitoring and intervention should be focused on the occupational population of express delivery/food delivery industry, transportation, environmental hygiene, and occupational population with low income, low educated, and ethnic minorities.
4.Mechanism of Huangqi Chifengtang in Treating Atherosclerosis Based on 16S rRNA Sequencing and Metabolomics
Yuqin LIANG ; Jiaqi FU ; Yunhe SHI ; Fang LU ; Donghua YU ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):94-103
ObjectiveTo investigate the mechanism of action of Huangqi Chifengtang (HQCFT) on rats with atherosclerosis (AS) by regulating the gut microbiota and their metabolites. MethodsA rat model of AS was induced through high-fat diet feeding and vitamin D3 injection, and the modeling lasted for 12 weeks. Fifty eight-week-old male SD rats were randomly divided into five groups: A blank group, a model group, a group receiving a low dose of HQCFT at 1.53 g·kg-1 (HQCFT-L group), a group receiving a high dose of HQCFT at 3.06 g·kg-1 (HQCFT-H group), and a group receiving atorvastatin calcium tablets at 1.8 mg·kg-1 (Ato group), with 10 rats in each group. Oral gavage administration started on the day after model establishment, once daily for four weeks. The efficacy of HQCFT was verified using aortic hematoxylin-eosin (HE) staining and determination of lipid levels and hemorrheology. The real-time polymerase chain reaction (Real-time PCR) was used for detecting inflammatory factor levels in the aorta, high-throughput sequencing for analyzing the gut microbiota composition in intestinal contents, targeted metabolomics for detecting short-chain fatty acid (SCFA) levels, and non-targeted metabolomics for identifying metabolomic profiles of intestinal contents. ResultsCompared with that in the blank group, the aortic tissue of rats in the model group showed significant AS lesions, including endothelial damage, inflammatory infiltration, and formation of fibrous plaques and calcified foci. Moreover, serum triacylglycerol (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels were significantly elevated (P<0.05), while high-density lipoprotein cholesterol (HDL-C) levels were significantly reduced (P<0.05). Significant increases were observed in whole blood viscosity, plasma viscosity, and the mRNA expression levels of NOD-like receptor pyrin domain containing 3 (NLRP3), Caspase-1, interleukin (IL)-β, IL-6, and tumor necrosis factor-α (TNF-α) in aortic tissue (P<0.05). Additionally, gut microbiota composition, SCFA levels, and metabolomic profiles were significantly altered. Compared with those in the model group, serum TC, TG, and LDL-C levels, as well as the whole blood viscosity and plasma viscosity, were significantly reduced in all groups treated with HQCFT (P<0.05). Significant decreases were observed in NLRP3 mRNA expression levels in all groups treated with HQCFT, Caspase-1, IL-β, and IL-6 mRNA expression levels in the HQCFT-H group, and TNF-α mRNA expression levels in the HQCFT-L group (P<0.05). HQCFT reversed the increase in the F/B ratio and dialled back the decrease in the relative abundance of Blautia and the increase in that of Desulfovibrio. HQCFT promoted the production of acetic acid, valeric acid, and propionic acid. Non-targeted metabolomics identified 39 differential metabolites, which were mainly enriched in metabolic pathways such as arachidonic acid metabolism and primary bile acid biosynthesis. ConclusionThe mechanism by which HQCFT ameliorates AS injury may be related to the improvement of dyslipidemia and body inflammatory responses by altering gut microbiota composition, promoting SCFA production, and regulating the levels of metabolites in intestinal contents.
5.Mechanism of Huangqi Chifengtang in Treating Atherosclerosis Based on 16S rRNA Sequencing and Metabolomics
Yuqin LIANG ; Jiaqi FU ; Yunhe SHI ; Fang LU ; Donghua YU ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):94-103
ObjectiveTo investigate the mechanism of action of Huangqi Chifengtang (HQCFT) on rats with atherosclerosis (AS) by regulating the gut microbiota and their metabolites. MethodsA rat model of AS was induced through high-fat diet feeding and vitamin D3 injection, and the modeling lasted for 12 weeks. Fifty eight-week-old male SD rats were randomly divided into five groups: A blank group, a model group, a group receiving a low dose of HQCFT at 1.53 g·kg-1 (HQCFT-L group), a group receiving a high dose of HQCFT at 3.06 g·kg-1 (HQCFT-H group), and a group receiving atorvastatin calcium tablets at 1.8 mg·kg-1 (Ato group), with 10 rats in each group. Oral gavage administration started on the day after model establishment, once daily for four weeks. The efficacy of HQCFT was verified using aortic hematoxylin-eosin (HE) staining and determination of lipid levels and hemorrheology. The real-time polymerase chain reaction (Real-time PCR) was used for detecting inflammatory factor levels in the aorta, high-throughput sequencing for analyzing the gut microbiota composition in intestinal contents, targeted metabolomics for detecting short-chain fatty acid (SCFA) levels, and non-targeted metabolomics for identifying metabolomic profiles of intestinal contents. ResultsCompared with that in the blank group, the aortic tissue of rats in the model group showed significant AS lesions, including endothelial damage, inflammatory infiltration, and formation of fibrous plaques and calcified foci. Moreover, serum triacylglycerol (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels were significantly elevated (P<0.05), while high-density lipoprotein cholesterol (HDL-C) levels were significantly reduced (P<0.05). Significant increases were observed in whole blood viscosity, plasma viscosity, and the mRNA expression levels of NOD-like receptor pyrin domain containing 3 (NLRP3), Caspase-1, interleukin (IL)-β, IL-6, and tumor necrosis factor-α (TNF-α) in aortic tissue (P<0.05). Additionally, gut microbiota composition, SCFA levels, and metabolomic profiles were significantly altered. Compared with those in the model group, serum TC, TG, and LDL-C levels, as well as the whole blood viscosity and plasma viscosity, were significantly reduced in all groups treated with HQCFT (P<0.05). Significant decreases were observed in NLRP3 mRNA expression levels in all groups treated with HQCFT, Caspase-1, IL-β, and IL-6 mRNA expression levels in the HQCFT-H group, and TNF-α mRNA expression levels in the HQCFT-L group (P<0.05). HQCFT reversed the increase in the F/B ratio and dialled back the decrease in the relative abundance of Blautia and the increase in that of Desulfovibrio. HQCFT promoted the production of acetic acid, valeric acid, and propionic acid. Non-targeted metabolomics identified 39 differential metabolites, which were mainly enriched in metabolic pathways such as arachidonic acid metabolism and primary bile acid biosynthesis. ConclusionThe mechanism by which HQCFT ameliorates AS injury may be related to the improvement of dyslipidemia and body inflammatory responses by altering gut microbiota composition, promoting SCFA production, and regulating the levels of metabolites in intestinal contents.
6.Role of PPAR signaling pathway related genes in acute gouty arthritis
Yuqin LI ; Hui ZHANG ; Dan WANG ; Jing LIU ; Chengxiu YU ; Guohua YUAN
Chinese Journal of Immunology 2025;41(1):163-168
Objective:To investigate the role of mRNA expression in the pathogenesis of gout by analyzing the difference of gene expression in peripheral blood mononuclear cells(PBMCs)among acute gouty(AG),intermittent gouty(IG)and health con-trols(HC).Methods:AG patients,IG patients and HC were enrolled in this study.RNA-seq and bioinformatics techniques were used to observe the differences of mRNA expression in PBMCs of different groups,and to explore the genes and signaling pathways as-sociated with gout attack.GO and KEGG databases were used to investigate the biological functions of differentially expressed genes and the relationship between genes and signaling pathways.Genes involved in the KEGG enriched PPAR signaling pathway(CYP27A1,ACSL1,CD36,PPARG,ANGPTL4,PLIN2)were validated in PBMCs from 35 patients with AG,35 patients with IG,and 35 normal healthy subjects using real-time PCR.Results:Compared with HC group,there were 222 significant differential genes in AG group,including 193 up-regulated genes and 29 down-regulated genes.GO analysis showed that the genes differentially ex-pressed in AG group were mainly enriched in the regulation of multicellular biological processes such as inflammation,trauma,and stress response and immune response regulation compared with HC group.However,KEGG analysis showed that the up-regulated genes in AG group were enriched in"Toll-like receptor signaling pathway""complement and coagulation cascades""PPAR signaling pathway""lipid and atherosclerosis""osteoclast differentiation""cytokine-cytokine receptor interaction""chemokine signaling path-way""IL-17 signaling pathway",and"cholesterol metabolism"compared with HC group.The results of PCR validation of related genes in the PPAR signaling pathway showed that the expression levels of ACSL1,CD36,PPARG,and PLIN2 in the AG group were higher than those in the control group(P<0.05),and the expression levels of CYP27A1 and ANGPTL4 in the AG group were not dif-ferent from those in the HC group(P>0.05).Conclusion:PPAR signaling pathway may be involved in the pathogenesis of AG,of which ACSL1,CD36,PPARG,and PLIN2 may be used as potential therapeutic targets for acute gouty arthritis;CYP27A1 and ANG-PTL4 may not be associated with the pathogenesis of AG.
7.Association analysis on BRCA gene functional domain mutations and prognosis in patients with ovarian epithelial carcinoma and fallopian tube carcinoma
Mingrui ZHAO ; Yuqin YANG ; Liang YU ; Lin ZHANG ; Qianjing CHANG ; Wenjun CHENG
Chinese Journal of Obstetrics and Gynecology 2025;60(5):372-382
Objective:To analyze the characteristics of BRCA gene mutations in patients with ovarian epithelial carcinoma and fallopian tube carcinoma, and to investigate the impact of mutations in the functional domains of the BRCA genes on the prognosis of patients.Methods:This research collected a total of 273 patients diagnosed with primary ovarian epithelial carcinoma or fallopian tube carcinoma by pathological examination at the First Affiliated Hospital of Nanjing Medical University between January 2009 and December 2023.Data on their BRCA gene mutation status, clinicopathological data, and follow-up information were collected. A retrospective analysis was conducted to evaluate the association between BRCA gene mutations and patients' prognosis, including progression free survival (PFS) and overall survival (OS) time.Results:Among the 273 patients with ovarian or fallopian tube carcinoma, 101 cases (37.0%, 101/273) were positive for BRCA gene mutations (BRCA-positive group), while 172 cases (63.0%, 172/273) were negative for BRCA gene mutations (BRCA-negative group). (1) Clinicopathological characteristics: compared with the BRCA-negative group, the BRCA-positive group had a younger age at diagnosis, lower proportion of postmenopausal status, and lower recurrence rate (all P<0.05). Additionally, the BRCA-positive group showed a higher prevalence of family history of gynecological malignancies and a higher rate of no visible residual disease (R0) resection, all with statistical significance (all P<0.05). (2) Characteristics of BRCA gene mutations: among the 101 BRCA-positive patients, 74 cases (27.1%, 74/273) had BRCA1 gene mutations, 26 cases (9.5%, 26/273) had BRCA2 gene mutations, and 1 case (0.4%, 1/273) had indeterminate mutation records. According to the American College of Medical Genetics and Genomics (ACMG) 2015 guideline, mutations of uncertain significance accounted for 22.8% (23/101), likely pathogenic mutations accounted for 10.9% (11/101), and pathogenic mutations accounted for 59.4% (60/101), with 5.9% (6/101) unclassifiable. BRCA1 and BRCA2 genes have three (RING, DBD, BRCT) and two (RAD51-BD, DBD) major functional domains, respectively. Among the 89 BRCA-positive patients with detailed domain mutation data, the overall domain mutation rate was 40.4% (36/89), distributed as follows: DBD 14.6% (13/89), BRCT 12.4% (11/89), RING 4.5% (4/89), and RAD51-BD 9.0% (8/89). (3) Association between BRCA gene functional domain mutations and prognosis: among 77 patients with advanced stage (Ⅲ-Ⅳ) ovarian epithelial carcinoma in the BRCA-positive group with functional domain mutation data, the median PFS time was significantly longer in the 31 patients with domain mutations compared to the 46 patients with non-domain mutations (not reached during the follow-up period, vs 26.0 months; P=0.035). However, there was no significant difference in median OS time between the two groups (not reached during the follow-up period, vs 67.0 months; P=0.513). Median PFS time was longer in 13 patients with mutations in the DBD functional domain than that in 64 patients with mutations outside the DBD functional domain (not reached during the follow-up period, vs 28.0 months; P=0.042), whereas there was no significant difference in the comparison of median OS time between the two groups (not reached during the follow-up period, vs 67.0 months; P=0.321). (4) Association between BRCA gene functional domain mutations and efficacy of poly adenosine diphosphate ribose polymerase inhibitor (PARPi) maintenance therapy: among 51 advanced stage ovarian epithelial carcinoma patients who received PARPi maintenance therapy in the BRCA-positive group, 20 patients with domain mutations demonstrated significantly longer median PFS time compared to 31 patients with non-domain mutations (not reached during the follow-up period, vs 31.0 months; P=0.039). However, no significant difference was observed in median OS time between the two groups (not reached during the follow-up period, vs 53.0 months; P=0.178). PARPi maintenance therapy was more effective in the 9 patients with mutations in the DBD functional domain than that in the 42 patients with mutations located outside the DBD structural domain, with significant differences observed in both median PFS time (both not reached during the follow-up period; P=0.007) and median OS time (both not reached during the follow-up period; P=0.037). In contrast, patients with mutations in the BRCT or RAD51-BD domains showed no significant differences in either median PFS or OS time compared to patients with mutations outside these domains (all P>0.05). Conclusions:Patients with ovarian epithelial carcinoma and fallopian tube carcinoma who harbor BRCA functional domain mutations exhibit significantly longer median PFS time compared to those with non-domain mutations. Moreover, among patients received PARPi maintenance therapy, those with mutations in the DBD domain have a better median PFS and OS time benefit.
8.Expert consensus on intraoperative repositioning for patients with spine fracture and dislocation (version 2025)
Dongmei BIAN ; Ke SUN ; Ningbo CHEN ; Caixia BAI ; Miao WANG ; Yafeng QIAO ; Fei WANG ; Hong WANG ; Feng TIAN ; Mei YAN ; Meng BAI ; Linjuan ZHANG ; Liyan ZHAO ; Yaqing CUI ; Xue JIANG ; Leling FENG ; Ning NING ; Junqin DING ; Lan WEI ; Yonghua ZHAI ; Yu ZENG ; Zengmei ZHANG ; Jiqun HE ; Fenggui BIE ; Hong CHEN ; Zengyan WANG ; Li LI ; Li ZHANG ; Yaying ZHOU ; Bing SHAO ; Ying WANG ; Caixia XIE ; Yanfeng YAO ; Jingjing AN ; Wen SHI ; Xiongtao LIU ; Xiaoyan AN ; Ning NAN ; Lan LI ; Xiaohui GOU ; Qiaomei LI ; Xiuting WU ; Yuqin ZHANG ; Jing LIU ; Fusen XIANG ; Xu XU ; Na MEI ; Jiao ZHOU ; Shan FAN ; Qian WANG ; Shuixia LI
Chinese Journal of Trauma 2025;41(2):138-147
Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.
9.Expert consensus on intraoperative repositioning for patients with spine fracture and dislocation (version 2025)
Dongmei BIAN ; Ke SUN ; Ningbo CHEN ; Caixia BAI ; Miao WANG ; Yafeng QIAO ; Fei WANG ; Hong WANG ; Feng TIAN ; Mei YAN ; Meng BAI ; Linjuan ZHANG ; Liyan ZHAO ; Yaqing CUI ; Xue JIANG ; Leling FENG ; Ning NING ; Junqin DING ; Lan WEI ; Yonghua ZHAI ; Yu ZENG ; Zengmei ZHANG ; Jiqun HE ; Fenggui BIE ; Hong CHEN ; Zengyan WANG ; Li LI ; Li ZHANG ; Yaying ZHOU ; Bing SHAO ; Ying WANG ; Caixia XIE ; Yanfeng YAO ; Jingjing AN ; Wen SHI ; Xiongtao LIU ; Xiaoyan AN ; Ning NAN ; Lan LI ; Xiaohui GOU ; Qiaomei LI ; Xiuting WU ; Yuqin ZHANG ; Jing LIU ; Fusen XIANG ; Xu XU ; Na MEI ; Jiao ZHOU ; Shan FAN ; Qian WANG ; Shuixia LI
Chinese Journal of Trauma 2025;41(2):138-147
Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.
10.Association analysis on BRCA gene functional domain mutations and prognosis in patients with ovarian epithelial carcinoma and fallopian tube carcinoma
Mingrui ZHAO ; Yuqin YANG ; Liang YU ; Lin ZHANG ; Qianjing CHANG ; Wenjun CHENG
Chinese Journal of Obstetrics and Gynecology 2025;60(5):372-382
Objective:To analyze the characteristics of BRCA gene mutations in patients with ovarian epithelial carcinoma and fallopian tube carcinoma, and to investigate the impact of mutations in the functional domains of the BRCA genes on the prognosis of patients.Methods:This research collected a total of 273 patients diagnosed with primary ovarian epithelial carcinoma or fallopian tube carcinoma by pathological examination at the First Affiliated Hospital of Nanjing Medical University between January 2009 and December 2023.Data on their BRCA gene mutation status, clinicopathological data, and follow-up information were collected. A retrospective analysis was conducted to evaluate the association between BRCA gene mutations and patients' prognosis, including progression free survival (PFS) and overall survival (OS) time.Results:Among the 273 patients with ovarian or fallopian tube carcinoma, 101 cases (37.0%, 101/273) were positive for BRCA gene mutations (BRCA-positive group), while 172 cases (63.0%, 172/273) were negative for BRCA gene mutations (BRCA-negative group). (1) Clinicopathological characteristics: compared with the BRCA-negative group, the BRCA-positive group had a younger age at diagnosis, lower proportion of postmenopausal status, and lower recurrence rate (all P<0.05). Additionally, the BRCA-positive group showed a higher prevalence of family history of gynecological malignancies and a higher rate of no visible residual disease (R0) resection, all with statistical significance (all P<0.05). (2) Characteristics of BRCA gene mutations: among the 101 BRCA-positive patients, 74 cases (27.1%, 74/273) had BRCA1 gene mutations, 26 cases (9.5%, 26/273) had BRCA2 gene mutations, and 1 case (0.4%, 1/273) had indeterminate mutation records. According to the American College of Medical Genetics and Genomics (ACMG) 2015 guideline, mutations of uncertain significance accounted for 22.8% (23/101), likely pathogenic mutations accounted for 10.9% (11/101), and pathogenic mutations accounted for 59.4% (60/101), with 5.9% (6/101) unclassifiable. BRCA1 and BRCA2 genes have three (RING, DBD, BRCT) and two (RAD51-BD, DBD) major functional domains, respectively. Among the 89 BRCA-positive patients with detailed domain mutation data, the overall domain mutation rate was 40.4% (36/89), distributed as follows: DBD 14.6% (13/89), BRCT 12.4% (11/89), RING 4.5% (4/89), and RAD51-BD 9.0% (8/89). (3) Association between BRCA gene functional domain mutations and prognosis: among 77 patients with advanced stage (Ⅲ-Ⅳ) ovarian epithelial carcinoma in the BRCA-positive group with functional domain mutation data, the median PFS time was significantly longer in the 31 patients with domain mutations compared to the 46 patients with non-domain mutations (not reached during the follow-up period, vs 26.0 months; P=0.035). However, there was no significant difference in median OS time between the two groups (not reached during the follow-up period, vs 67.0 months; P=0.513). Median PFS time was longer in 13 patients with mutations in the DBD functional domain than that in 64 patients with mutations outside the DBD functional domain (not reached during the follow-up period, vs 28.0 months; P=0.042), whereas there was no significant difference in the comparison of median OS time between the two groups (not reached during the follow-up period, vs 67.0 months; P=0.321). (4) Association between BRCA gene functional domain mutations and efficacy of poly adenosine diphosphate ribose polymerase inhibitor (PARPi) maintenance therapy: among 51 advanced stage ovarian epithelial carcinoma patients who received PARPi maintenance therapy in the BRCA-positive group, 20 patients with domain mutations demonstrated significantly longer median PFS time compared to 31 patients with non-domain mutations (not reached during the follow-up period, vs 31.0 months; P=0.039). However, no significant difference was observed in median OS time between the two groups (not reached during the follow-up period, vs 53.0 months; P=0.178). PARPi maintenance therapy was more effective in the 9 patients with mutations in the DBD functional domain than that in the 42 patients with mutations located outside the DBD structural domain, with significant differences observed in both median PFS time (both not reached during the follow-up period; P=0.007) and median OS time (both not reached during the follow-up period; P=0.037). In contrast, patients with mutations in the BRCT or RAD51-BD domains showed no significant differences in either median PFS or OS time compared to patients with mutations outside these domains (all P>0.05). Conclusions:Patients with ovarian epithelial carcinoma and fallopian tube carcinoma who harbor BRCA functional domain mutations exhibit significantly longer median PFS time compared to those with non-domain mutations. Moreover, among patients received PARPi maintenance therapy, those with mutations in the DBD domain have a better median PFS and OS time benefit.

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