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.The targeting relationship and function of miR-199b-3p and CRIM1 in gastric cancer cells
Qinxi WANG ; Jiong ZHANG ; Kangming CHE
Chinese Journal of General Surgery 2024;33(10):1679-1687
Background and Aims:Studies have shown that miR-199b-3p is downregulated in gastric cancer tissues,while cysteine-rich transmembrane BMP regulator 1(CRIM1)is upregulated in these tissues.However,the role and mechanism of miR-199b-3p in the biological behavior of gastric cancer cells are still unclear,as is its potential association with CRIM1.Therefore,this study was conducted to investigate whether there is an interaction between miR-199b-3p and CRIM1 and how they affect the function of gastric cancer cells. Methods:qRT-PCR and immunohistochemistry were used to detect the expression levels of miR-199b-3p and CRIM1 in gastric cancer tissues and adjacent non-cancerous tissues.Gastric cancer MGC803 cells were used to assess changes in cell proliferation,invasion/migration abilities,and apoptosis rates after overexpression of miR-199b-3p(using miR-199b-3p mimics)or knockdown of CRIM1(using si-CRIM1).Bioinformatics analysis was used to predict the targeting relationship between miR-199b-3p and CRIM1,which was further validated by dual-luciferase reporter assay and confirmed through Western blot analysis. Results:The results of qRT-PCR indicated that,compared to adjacent non-cancerous tissues,miR-199b-3p expression was significantly lower in gastric cancer tissues,while CRIM1 expression was higher(both P<0.05).Immunohistochemistry results demonstrated positive expression of CRIM1 in cancerous tissues,while it was negative in non-cancerous tissues.Overexpression of miR-199b-3p or CRIM1 knockdown resulted in decreased proliferation and invasion/migration abilities of MGC803 cells,along with increased apoptosis rates(all P<0.05).Bioinformatics prediction and dual-luciferase reporter assays confirmed that CRIM1 is a target of miR-199b-3p.Western blot analysis showed that CRIM1 expression was significantly reduced after transfection with miR-199b-3p mimics(P<0.05). Conclusion:CRIM1 is a target gene of miR-199b-3p,which can inhibit the proliferation,invasion,and migration of gastric cancer cells while promoting apoptosis by targeting and regulating CRIM1 activity.The miR-199b-3p/CRIM1 pathway may serve as a potential therapeutic target for gastric cancer.
3.Seroepidemiological survey of Lyme disease in Urumqi City,Xinjiang,China
Li YANG ; Zi-Yi ZHANG ; Tong-Tong SHAO ; Xin-Ting LI ; Rong-Jiong ZHENG ; Shi-Yi WANG ; Yuan-Zhi WANG ; Qin HAO ; Xiao-Bo LU
Chinese Journal of Zoonoses 2024;40(4):334-339
The prevalence of Lyme disease in endogenous populations in Urumqi,Xinjiang was investigated.In total,795 serum samples were collected from residents of three townships in the surrounding area of Urumqi City from 2022 to 2023,which included 383 from Lucaogou Town,145 from Shuixigou Town,and,267 from Tori Township.Serum levels of IgG and IgM antibodies were screened with an enzyme linked immunosorbent assay(ELISA)and confirmed by western blot(WB)analysis.Clinical data of WB-positive indi-viduals were collected and comprehensive analysis was con-ducted for case diagnosis.The chi square test was used for statistical analysis of the results and the P<0.05 was consid-ered statistically significant.In total,110(13.84%)of 795 samples were positive.The positivity rates was higher in females than males[16.26%(73/449)vs.10.69%(37/346),x2=5.076,P=0.024],while there was no significant difference among age groups(x2=2.569,P=0.766).The positivity rates for serum antibodies in Shuixigou Town,Lucaogou Town,and Tuoli Township were 17.98%(48/267),14.48%(21/145),and 10.70%(41/383),respectively,with a significantly higher rate in Tuoli Township than Lucaogou Town(x2=7.041,P=0.008).Of 110 individuals who were initially positive for IgG and IgM antibodies with the ELISA,82(10.31%)were con-firmed positive by WB analysis.In total,20(2.52%)patients were diagnosed with Lyme disease based on clinical manifesta-tions.Lyme disease is epidemic among the population in Urumqi,as the infection rate is higher than the national average.Hence,continued surveillance is recommended for prevention of Lyme disease.
4.Diagnostic performance of PI-RADS v2.1 for clinically significant prostate cancer in the peripheral,transitional and multiple zones
Xiao-Jun DENG ; Hao-Cheng ZHANG ; Jiong ZHANG ; Yu-Hang QIAN ; Mei-Mei TAO ; Chun-Mei LIAO ; Miao-Wen LIN ; Gen-Qiang LANG
National Journal of Andrology 2024;30(11):982-986
Objective:To evaluate the diagnostic performance of the Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)for clinically significant prostate cancer(CSPCa)in the peripheral zone(PZ),transitional zone(TZ)and multiple zones(MZs).Methods:We retrospectively studied the clinical data on 108 patients undergoing multiparametric magnetic resonance imaging(mpMRI)and transperineal prostate biopsy in our hospital from January 2021 to January 2023.Using PI-RADS v2.1,we ex-amined the MR images of the patients with suspected PCa,compared the PI-RADS v2.1 scores with the results of prostate biopsy,and analyzed the correlation of the PI-RADS v2.1 scores with CSPCa.We calculated the area under the receiver operating characteristic(ROC)curve(AUC),and described the diagnostic performance of PI-RADS v2.1 for CSPCa in the PZ,TZ and MZs.Results:Transperineal prostate puncture biopsy was successfully completed in all the patients,which revealed 66(61.11%)cases of CSPCa with Gleason score(GS)7-10.Suspected CSPCa was observed in 45(95.74%)of the 47 PZ lesions,8(47.06%)of the 17 TZ le-sions,and 40(90.91%)of the 44 MZ lesions.The PZ,TZ and MZ lesions diagnosed by PI-RADS v2.1 were significantly correlated with CSPCa(r=0.492,P<0.001).The AUCs of PI-RADS v2.1 for PZ,TZ and MZs were 0.644,0.732 and 0.811,with specificities of 66.8%,57.6%and 62.1%,and sensitivities of 57.2%,78.4%and 93.2%,respectively.The negative predictive values were 46.5%,85.7%and 79.2%,and the positive predictive values 76.2%,43.4%and 84.8%,respectively.Conclusion:The PI-RADS v2.1 score has a high diagnostic value for CSPCa in the PZ,TZ and MZs,with the best performance for that in the MZs.
5.Emerging role of Jumonji domain-containing protein D3 in inflammatory diseases
Li XIANG ; Chen RU-YI ; Shi JIN-JIN ; Li CHANG-YUN ; Liu YAN-JUN ; Gao CHANG ; Gao MING-RONG ; Zhang SHUN ; Lu JIAN-FEI ; Cao JIA-FENG ; Yang GUAN-JUN ; Chen JIONG
Journal of Pharmaceutical Analysis 2024;14(9):1282-1300
Jumonji domain-containing protein D3(JMJD3)is a 2-oxoglutarate-dependent dioxygenase that specif-ically removes transcriptional repression marks di-and tri-methylated groups from lysine 27 on histone 3(H3K27me2/3).The erasure of these marks leads to the activation of some associated genes,thereby influencing various biological processes,such as development,differentiation,and immune response.However,comprehensive descriptions regarding the relationship between JMJD3 and inflammation are lacking.Here,we provide a comprehensive overview of JMJD3,including its structure,functions,and involvement in inflammatory pathways.In addition,we summarize the evidence supporting JMJD3's role in several inflammatory diseases,as well as the potential therapeutic applications of JMJD3 inhibitors.Additionally,we also discuss the challenges and opportunities associated with investigating the functions of JMJD3 and developing targeted inhibitors and propose feasible solutions to provide valuable insights into the functional exploration and discovery of potential drugs targeting JMJD3 for inflammatory diseases.
6.The Construction Status and Development Trend of Smart Hospital in China
Da YUAN ; Congpu ZHAO ; Pujue ZHU ; Jieshi ZHANG ; Zheng CHEN ; Jiong ZHOU ; Xiaojun MA ; Hua PENG
Journal of Medical Informatics 2024;45(7):33-36
Purpose/Significance To expound the development status,difficulties and challenges of smart hospital in China,so as to pro-vide references for the subsequent related research.Method/Process By using the methods of bibliometrics and literature review,the definition of smart hospital is summarized and feasible suggestions on the construction of smart hospital are put forward.Result/Conclusion Smart hospital in China has initially established a"trinity"structural framework of smart healthcare,smart service and smart management,playing a positive role in improving patient satisfaction and promoting high-quality development of hospitals.It is necessary for the government,hospitals,social capital and other multi-party cooperation to jointly promote the construction of smart hospital in China and better protect people's health.
7.A multi-center epidemiological study on pneumococcal meningitis in children from 2019 to 2020
Cai-Yun WANG ; Hong-Mei XU ; Gang LIU ; Jing LIU ; Hui YU ; Bi-Quan CHEN ; Guo ZHENG ; Min SHU ; Li-Jun DU ; Zhi-Wei XU ; Li-Su HUANG ; Hai-Bo LI ; Dong WANG ; Song-Ting BAI ; Qing-Wen SHAN ; Chun-Hui ZHU ; Jian-Mei TIAN ; Jian-Hua HAO ; Ai-Wei LIN ; Dao-Jiong LIN ; Jin-Zhun WU ; Xin-Hua ZHANG ; Qing CAO ; Zhong-Bin TAO ; Yuan CHEN ; Guo-Long ZHU ; Ping XUE ; Zheng-Zhen TANG ; Xue-Wen SU ; Zheng-Hai QU ; Shi-Yong ZHAO ; Lin PANG ; Hui-Ling DENG ; Sai-Nan SHU ; Ying-Hu CHEN
Chinese Journal of Contemporary Pediatrics 2024;26(2):131-138
Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]
8.Factors influencing the occurrence of small for gestational age at different degrees
Yi-Min ZHANG ; Shu-Ming SHAO ; Chen YU ; Xiao-Rui ZHANG ; Zheng LIU ; Yang-Yang LI ; Jiong QIN
Chinese Journal of Contemporary Pediatrics 2024;26(3):262-268
Objective To investigate the factors influencing the occurrence of small for gestational age(SGA)at different degrees and provide a basis for early identification of severe SGA cases.Methods Neonatal and maternal prenatal information were retrospectively collected from January 2018 to December 2022 at Peking University People's Hospital.The neonates were divided into three groups:severe SGA group(birth weight below the 3rd percentile for gestational age and sex),mild SGA group(birth weight ≥3rd percentile and<10th percentile),and non-SGA group(birth weight ≥10th percentile).An ordered multinomial logistic regression model was used to analyze the factors influencing the occurrence of SGA at different degrees.Results A total of 14 821 neonates were included,including 258 cases(1.74%)in the severe SGA group,902 cases(6.09%)in the mild SGA group,and 13 661 cases(92.17%)in the non-SGA group.The proportions of preterm births and stillbirths were higher in the severe SGA group compared to the mild SGA and non-SGA groups(P<0.0125).The proportion of neonatal asphyxia was higher in both the severe SGA and mild SGA groups compared to the non-SGA group(P<0.0125).Ordered multinomial logistic regression analysis showed that maternal pre-pregnancy underweight(OR=1.838),maternal pre-pregnancy obesity(OR=3.024),in vitro fertilization-embryo transfer(OR=2.649),preeclampsia(OR=1.743),connective tissue disease during pregnancy(OR=1.795),nuchal cord(OR=1.213),oligohydramnios(OR=1.848),and intrauterine growth restriction(OR=27.691)were all associated with a higher risk of severe SGA(P<0.05).Maternal parity as a multipara(OR=0.457)was associated with a lower likelihood of severe SGA(P<0.05).Conclusions Maternal pre-pregnancy underweight,maternal pre-pregnancy obesity,in vitro fertilization-embryo transfer,preeclampsia,connective tissue disease during pregnancy,oligohydramnios,nuchal cord,and intrauterine growth restriction are closely related to the occurrence of more severe SGA.Maternal parity as a multipara acts as a protective factor against the occurrence of severe SGA.[Chinese Journal of Contemporary Pediatrics,2024,26(3):262-268]
9.Risk factors and survival of EBV-infected aplastic anemia patients after haploid allogeneic hematopoietic stem cell transplantation
Xin-He ZHANG ; Jia FENG ; Zheng-Wei TAN ; Yue-Chao ZHAO ; Hui-Jin HU ; Jun-Fa CHEN ; Li-Qiang WU ; Qing-Hong YU ; Di-Jiong WU ; Bao-Dong YE ; Wen-Bin LIU
Chinese Journal of Infection Control 2024;23(10):1228-1235
Objective To analyze the risk factors and survival status of Epstein-Barr virus(EBV)infection in pa-tients with aplastic anemia(AA)after haploid allogeneic hematopoietic stem cell transplantation(Haplo-HSCT).Methods Clinical data of 78 AA patients who underwent Haplo-HSCT in the hematology department of a hospital from January 1,2019 to October 31,2022 were analyzed retrospectively.The occurrence and onset time of EBV viremia,EBV-related diseases(EBV diseases),and post-transplant lymphoproliferative disorders(PTLD)were ob-served,risk factors and survival status were analyzed.Results Among the 78 patients,38 were males and 40 were females,with a median age of 33(9-56)years old;53 patients experienced EBV reactivation,with a total inci-dence of 67.9%,and the median time for EBV reactivation was 33(13,416)days after transplantation.Among pa-tients with EBV reactivation,49 cases(62.8%)were simple EBV viremia,2 cases(2.6%)were possible EBV di-seases,and 2 cases(2.6%)were already confirmed EBV diseases(PTLD).Univariate analysis showed that age 1<40 years old at the time of transplantation,umbilical cord blood infusion,occurrence of acute graft-versus-host disease(aGVHD)after transplantation,and concurrent cytomegalovirus(CMV)infection were independent risk fac-tors for EBV reactivation in AA patients after Haplo-HSCT.Multivariate analysis showed that concurrent CMV in-fection was an independent risk factor for EBV reactivation in A A patients after Haplo-HSCT(P=0.048).Ritu-ximab intervention before stem cell reinfusion was a factor affecting the duration of EBV reactivation(P<0.05).The mortality of EBV viremia,EBV diseases,and PTLD alone were 8.2%,50.0%,and 100%,respectively.The 2-year overall survival rate of patients with and without EBV reactivation were 85.3%,and 90.7%,respectively,difference was not statistically significant(P=0.897).However,patients treated with rituximab had 2-year lower survival rate than those who did not use it,with a statistically significant difference(P=0.046).Conclusion EBV reactivation is one of the serious complications in AA patients after Haplo-HSCT,which affects the prognosis and survival of patients.
10.Research Hotspots on Systemic Lupus Erythematosus in Pregnancy Based on Bibliometrics
Shuming SHAO ; Yimin ZHANG ; Xiaorui ZHANG ; Jie LIU ; Chaomei ZENG ; Jiong QIN
Acta Academiae Medicinae Sinicae 2024;46(5):685-691
Objective To explore the research hotspots on systemic lupus erythematosus(SLE)in pregnancy based on the bibliometric analysis of the related articles published from 2018 to 2023 and provide di-rections for the future research in this field.Methods PubMed,Web of Science,and Embase were searched for the articles on SLE in pregnancy that were published from January 1,2018 to December 31,2023.VOSviewer was used to visualize the high-frequency keywords in the selected articles.Results A total of 266 articles were selected,from which 25 high-frequency keywords were extracted.The bibliometric analysis showed that the available studies about SLE in pregnancy mainly focused on maternal complications,maternal and fetal outcomes,and medica-tions.The studies were limited regarding the predictors,autoimmunity,immunotherapy,and long-term outcomes of offspring.Conclusion Maternal complications,maternal and fetal outcomes,and medications are currently hotspots in the research on SLE in pregnancy,while predictors,autoimmunity,immunotherapy,and long-term outcomes of offspring may become future research directions.

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