1.The expression levels of serum SAA and Presepsin in patients with colorectal cancer after laparoscopic surgery and their predictive value for early anastomotic leakage
Xinxia PENG ; Fuxia YIN ; Zhisheng YAN
China Journal of Endoscopy 2025;31(10):7-14
Objective To investigate the levels of serum soluble CD14 subtype(Presepsin)and serum amyloid protein A(SAA)in patients with colorectal cancer after laparoscopic surgery,and their predictive value for early anastomotic leakage.Methods From October 2021 to April 2024,126 patients with laparoscopic colorectal cancer were divided into the non-anastomotic leakage group(control group,n=103)and the anastomotic leakage group(observation group,n=23)based on whether anastomotic leakage occurred within 3 days after the operation.Clinical information was collected from both groups and compared between groups.Enzyme linked immunosorbent assay(ELISA)was applied to detect the postoperative serum levels of Presepsin and SAA in two groups.Pearson method was applied to investigate the correlation between postoperative serum levels of Presepsin and SAA in patients with colorectal cancer after laparoscopic surgery.The multivariate Logistic regression model was applied to analyze the key factors influencing the occurrence of anastomotic leakage in the early postoperative period in patients with colorectal cancer after laparoscopic surgery.The receiver operating characteristic curve(ROC curve)was applied to evaluate the predictive value of serum Presepsin and SAA levels for early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.Results Compared with the control group,the proportion of patients with tumours≥7 cm from the anus was significantly reduced and intraoperative bleeding was significantly increased in the observation group,the differences were statistically significant(P<0.05).The postoperative levels of serum Presepsin and SAA in the observation group were obviously higher than those in the control group,the differences were statistically significant(P<0.05).There was an obvious positive correlation between serum levels of Presepsin and SAA in patients with colorectal cancer after laparoscopic surgery(r=0.749,P=0.016).Serum Presepsin levels higher than 389.23 pg/mL and SAA expression levels higher than 25.10 mg/L were independent risk factors for the occurrence of early anastomotic leakage after surgery in patients with colorectal cancer after laparoscopic surgery.A tumor distance from the anus of≥7 cm was a protective factor.The area under the curve(AUC)of serum Presepsin and SAA alone and in combination for detecting early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery was 0.834(95%CI:0.757~0.894),0.801(95%CI:0.720~0.866),and 0.897(95%CI:0.830~0.944).The combined detection was superior to the separate detection of Presepsin and SAA(Zcombination-Presepsin=2.085,Zcombination-SAA=2.010,both P<0.05).Conclusion Serum levels of Presepsin and SAA are elevated in patients with colorectal cancer after laparoscopic surgery,and their combined detection has high predictive value for early anastomotic leakage.
2.The expression levels of serum SAA and Presepsin in patients with colorectal cancer after laparoscopic surgery and their predictive value for early anastomotic leakage
Xinxia PENG ; Fuxia YIN ; Zhisheng YAN
China Journal of Endoscopy 2025;31(10):7-14
Objective To investigate the levels of serum soluble CD14 subtype(Presepsin)and serum amyloid protein A(SAA)in patients with colorectal cancer after laparoscopic surgery,and their predictive value for early anastomotic leakage.Methods From October 2021 to April 2024,126 patients with laparoscopic colorectal cancer were divided into the non-anastomotic leakage group(control group,n=103)and the anastomotic leakage group(observation group,n=23)based on whether anastomotic leakage occurred within 3 days after the operation.Clinical information was collected from both groups and compared between groups.Enzyme linked immunosorbent assay(ELISA)was applied to detect the postoperative serum levels of Presepsin and SAA in two groups.Pearson method was applied to investigate the correlation between postoperative serum levels of Presepsin and SAA in patients with colorectal cancer after laparoscopic surgery.The multivariate Logistic regression model was applied to analyze the key factors influencing the occurrence of anastomotic leakage in the early postoperative period in patients with colorectal cancer after laparoscopic surgery.The receiver operating characteristic curve(ROC curve)was applied to evaluate the predictive value of serum Presepsin and SAA levels for early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.Results Compared with the control group,the proportion of patients with tumours≥7 cm from the anus was significantly reduced and intraoperative bleeding was significantly increased in the observation group,the differences were statistically significant(P<0.05).The postoperative levels of serum Presepsin and SAA in the observation group were obviously higher than those in the control group,the differences were statistically significant(P<0.05).There was an obvious positive correlation between serum levels of Presepsin and SAA in patients with colorectal cancer after laparoscopic surgery(r=0.749,P=0.016).Serum Presepsin levels higher than 389.23 pg/mL and SAA expression levels higher than 25.10 mg/L were independent risk factors for the occurrence of early anastomotic leakage after surgery in patients with colorectal cancer after laparoscopic surgery.A tumor distance from the anus of≥7 cm was a protective factor.The area under the curve(AUC)of serum Presepsin and SAA alone and in combination for detecting early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery was 0.834(95%CI:0.757~0.894),0.801(95%CI:0.720~0.866),and 0.897(95%CI:0.830~0.944).The combined detection was superior to the separate detection of Presepsin and SAA(Zcombination-Presepsin=2.085,Zcombination-SAA=2.010,both P<0.05).Conclusion Serum levels of Presepsin and SAA are elevated in patients with colorectal cancer after laparoscopic surgery,and their combined detection has high predictive value for early anastomotic leakage.
3.Epidemic Characteristics and Survival Trends of Upper Gastrointestinal Cancer in Fujian Cancer Registration Areas from 2011 to 2020
Yongying HUANG ; Zhisheng XIANG ; Jingyu MA ; Yongtian LIN ; Yeying WEN ; Yan ZHOU
China Cancer 2024;33(11):886-893
[Purpose]To analyze the epidemic characteristics and survival trends of upper gas-trointestinal cancer in Fujian cancer registration areas from 2011 to 2020.[Methods]Cancer regi-stration data in Fujian Province was collected to calculate the crude incidence and mortality rate,age-standardized incidence/mortality rates by Chinese standard population(ASIRC,ASMRC)and by world standard population(ASIRW,ASMRW)and cumulative rate of 0~74 years old of upper gastrointestinal cancer(including esophageal and gastric cancers)as well as the corresponding temporal trends from 2011 to 2020.Using the Joinpoint software to calculate the annual percent-age change(APC)and average annual percentage change(AAPC)to analyze the trends.The data were divided into two time periods(2011-2015 and 2016-2020)to compare the 5-year relative survival rates of upper gastrointestinal cancer.[Results]From 2011 to 2020,there were 26 286 new cases of upper gastrointestinal cancer in Fujian cancer registration areas,accounting for 20.28%of all malignant tumors.The incidence rate,ASIRC and ASIRW of upper gastrointestinal cancer was 56.52/105,42.55/105,and 42.75/105,respectively,and the cumulative incidence rate(0~74 years old)was 5.32%.Incidence of upper gastrointestinal cancer was higher in men than that in women.The incidence of upper gastrointestinal cancer showed an decreasing trend from 2011 to 2020,with an AAPC of ASIRC of-4.7%(95%CI:-6.6%~-2.9%).There were 11 680 new cases of esophageal cancer in Fujian cancer registration areas,the crude incidence,ASIRC,ASIRW and cumulative incidence(0~74 years old)of esophageal cancer were 25.12/105,18.67/105,18.97/105,and 2.32%,respectively.There were 14 606 gastric cancer new cases in Fujian cancer registration areas during 2011-2020,the crude mortality,ASMRC,ASIRW and cumulative mortality(0~74 years old)of gastric cancer were 31.41/105,23.88/105,23.78/105,and 3.00%,respectively.There were 20 133 upper gastrointestinal cancer deaths during 2011-2020 in Fujian cancer registration areas,accounting for 26.05%of all cancer deaths.The crude mortality,ASMRC and ASMRW of upper gastrointestinal cancer was 43.29/105,31.95/105,and 31.89/105,respectively,the cumu-lative mortality rate(0~74 years old)was 3.84%.The mortality of upper gastrointestinal cancer was higher in men than that in women.The mortality rate of upper gastrointestinal cancer showed a trend of first increase and then decrease,with an APC of 3.5%(95%CI:-0.5%~11.3%)from 2011 to 2014 and-5.2%(95%CI:-8.4%~3.7%)from 2014 to 2020.There were 9 643 deaths of esophageal cancer during 2011-2020 in Fujian cancer registration areas.The crude mortality,ASMRC,ASMRW and cumulative mortality rate(0~74 years old)of esophageal cancer was 20.74/105,15.20/105,15.35/105,and 1.83%,respectively.There were 10 490 deaths of gastric cancer dur-ing 2011-2020 in Fujian cancer registration areas.The crude mortality,ASMRC,ASMRW and cumulative mortality rate(0~74 years old)of gastric cancer was 22.56/105,16.75/105,16.54/105,and 2.00%,respectively.The 5-year relative survival rate for upper gastrointestinal cancer patients during 2011-2015 and 2016-2020 were 24.74%(95%CI:23.92%~25.56%)and 25.49%(95%CI:24.65%~26.34%),respectively.The 5-year relative survival rate for esophageal cancer patients during 2011-2015 and 2016-2020 were 17.15%(95%CI:16.10%~18.22%)and 18.72%(95%CI:17.59%~19.88%),respectively.The 5-year relative survival rate for gastric cancer patients during 2011-2015 and 2016-2020 were 30.90%(95%CI:29.71%~32.10%)and 30.76%(95%CI:29.56%~31.97%),respectively.There was a decreasing trend in 5-year survival of upper gastroin-testinal patients with increasing age,with lower survival rate in patients over 65 years old.[Con-clusion]The incidence and mortality of upper gastrointestinal cancer in Fujian cancer registration areas showed an overall decreasing trend,and the 5-year relative survival rate improved slightly,while the disease burden of upper gastrointestinal cancer remains heavy.Incidence and mortality of upper gastrointestinal cancer of men were higher than those of women,and the elderly patients with upper gastrointestinal cancer had a poorer prognosis.Fujian should pay close attention to the prevention and control of gastric cancer among key groups,and strengthen its comprehensive pre-vention and control ability of upper gastrointestinal cancer.
4.Result Analysis of Rural Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancer in Fujian Province from 2013 to 2022
Yongtian LIN ; Jingyu MA ; Zhisheng XIANG ; Yongying HUANG ; Yeying WEN ; Yan ZHOU
China Cancer 2024;33(11):908-914
[Purpose]To analyze the preliminary screening and follow-up results of the early diag-nosis and treatment program for upper gastrointestinal cancer in rural areas of Fujian Province from 2013 to 2022.[Methods]Screening data from the early diagnosis and treatment program for upper gastrointestinal cancer in Fujian Province from 2013 to 2022 were collected and organized.The positive case detection rate,early diagnosis rate,and treatment rate of the screening population were calculated.SPSS 22.0 software was used to test the trend Chi-square test of the annual changes in detection rate,early diagnosis rate and treatment rate.The Chi-square test was used to compare the detection rate and early diagnosis rate between different groups.[Results]From 2013 to 2022,a total of 26 823 screenings and follow-ups were completed in Fujian Province,with de-tection rate,early diagnosis rate,and treatment rate of 1.41%,56.20%,and 92.61%,respec-tively.The early diagnosis rate showed an increasing trend from 2013 to 2022(P<0.05).The initial screening detected rate and early diagnosis rate were 1.38%and 55.59%,respectively,while fol-low-up detection rate and early diagnosis rate were 5.36%and 75.00%.The detection rates for esophagus,cardia,and stomach cases were 0.70%,0.15%,and 0.58%,respectively,with early diagnosis rates of 64.86%,53.66%,and 46.41%,respectively.The differences in detection rates and early diagnosis rates for each site were statistically significant(all P<0.05).[Conclusion]With the development of early diagnosis and treatment of upper gastrointestinal cancer in rural areas of Fujian Province and the improvement of residents'awareness of cancer prevention,the detection rate and early diagnosis rate of upper gastrointestinal cancer in Fujian Province have been im-proved,which plays an important role in improving the survival rate of patients.
5.Research on the enrollment status of students in Master's Degree Program in Pediatrics in China and the countermeasures
Mingyue WEN ; Xin JIN ; Jinzhong JIA ; Zhisheng LIANG ; Yuexin LI ; Rui ZHU ; Mengquan LIU ; Qi YAN ; Mengting ZHANG ; Zhiqiang WANG
Chinese Journal of Medical Education Research 2024;23(9):1197-1202
Objective:To investigate the enrollment scale and distribution of Master's Degree in Pediatrics programs in China, and to provide a reference for promoting pediatric education and disciplinary development.Methods:Data on colleges and universities authorized to award Master's Degree in Pediatrics in 2023 were collected, sorted, and analyzed for the number, structure, distribution, and enrollment scale and direction of these institutions using descriptive statistics.Results:Among the 117 clinical medicine academic master's degree programs in China, 72 enroll pediatric academic master's degree candidates, with an enrollment of 260 students. Among the 120 master's degree programs in clinical medicine, 104 enroll professional master's degree candidates, enrolling 1 195 students. Enrollment is mainly concentrated in East China, "non-double first-class" colleges and universities, medical colleges and universities with subject level B, and enrollment is carried out in the direction of secondary disciplines.Conclusions:The number of colleges and universities authorized to award Master's Degree in Pediatrics was small, and the distribution of these colleges and universities was unbalanced. The enrollment scale was small and the orientation of Professional Master's Degree was not reasonable. Some colleges and universities were authorized to award Master's Degree in Pediatrics, but did not enroll any students. It is suggested to increase the number of colleges and universities authorized to award Master's Degree in Pediatrics and strengthen the staffing of pediatric departments. The aim is to expand the enrollment scale of candidates for Master's Degree in Pediatrics, improving the differential training of candidates for Academic Master's Degree and Professional Master's Degree, and attach importance to the construction of pediatrics.
6.Novel discovery of schisandrin A regulating the interplay of autophagy and apoptosis in oligoasthenospermia by targeting SCF/c-kit and TRPV1 via biosensors.
Lijuan MA ; Boyi LI ; Jinchen MA ; Chunyuan WU ; Nan LI ; Kailin ZHOU ; Yun YAN ; Mingshuang LI ; Xiaoyan HU ; Hao YAN ; Qi WANG ; Yanfei ZHENG ; Zhisheng WU
Acta Pharmaceutica Sinica B 2023;13(6):2765-2777
Oligoasthenospermia is the primary cause of infertility. However, there are still enormous challenges in the screening of critical candidates and targets of oligoasthenospermia owing to its complex mechanism. In this study, stem cell factor (SCF), c-kit, and transient receptor potential vanilloid 1 (TRPV1) biosensors were successfully established and applied to studying apoptosis and autophagy mechanisms. Interestingly, the detection limit reached 2.787 × 10-15 g/L, and the quantitative limit reached 1.0 × 10-13 g/L. Furthermore, biosensors were used to investigate the interplay between autophagy and apoptosis. Schisandrin A is an excellent candidate to form a system with c-kit similar to SCF/c-kit with a detection constant (KD) of 5.701 × 10-11 mol/L, whereas it had no affinity for SCF. In addition, it also inhibited autophagy in oligoasthenospermia through antagonizing TRPV1 with a KD of up to 4.181 × 10-10 mol/L. In addition, in vivo and in vitro experiments were highly consistent with the biosensor. In summary, high-potency schisandrin A and two potential targets were identified, through which schisandrin A could reverse the apoptosis caused by excessive autophagy during oligoasthenospermia. Our study provides promising insights into the discovery of effective compounds and potential targets via a well-established in vitro-in vivo strategy.
7.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Wong Wing-kin GARY ; Yanxia HE ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2023;38(1):20-30
China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
8.Recommendations for prescription review of commonly used anti-seizure medications in treatment of children with epilepsy
Qianqian QIN ; Qian DING ; Xiaoling LIU ; Heping CAI ; Zebin CHEN ; Lina HAO ; Liang HUANG ; Yuntao JIA ; Lingyan JIAN ; Zhong LI ; Hua LIANG ; Maochang LIU ; Qinghong LU ; Xiaolan MO ; Jing MIAO ; Yanli REN ; Huajun SUN ; Yanyan SUN ; Jing XU ; Meixing YAN ; Li YANG ; Shengnan ZHANG ; Shunguo ZHANG ; Xin ZHAO ; Jie DENG ; Fang FANG ; Li GAO ; Hong HAN ; Shaoping HUANG ; Li JIANG ; Baomin LI ; Jianmin LIANG ; Jianxiang LIAO ; Zhisheng LIU ; Rong LUO ; Jing PENG ; Dan SUN ; Hua WANG ; Ye WU ; Jian YANG ; Yuqin ZHANG ; Jianmin ZHONG ; Shuizhen ZHOU ; Liping ZOU ; Yuwu JIANG ; Xiaoling WANG
Chinese Journal of Applied Clinical Pediatrics 2023;38(10):740-748
Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.
9.Expert consensus on the diagnosis, treatment and prevention of monkeypox in children
Rongmeng JIANG ; Yuejie ZHENG ; Lei ZHOU ; Luzhao FENG ; Lin MA ; Baoping XU ; Hongmei XU ; Wei LIU ; Zhengde XIE ; Jikui DENG ; Lijuan XIONG ; Wanjun LUO ; Zhisheng LIU ; Sainan SHU ; Jianshe WANG ; Yi JIANG ; Yunxiao SHANG ; Miao LIU ; Liwei GAO ; Zhuang WEI ; Guanghua LIU ; Gang LIU ; Wei XIANG ; Yuxia CUI ; Gen LU ; Min LU ; Xiaoxia LU ; Runming JIN ; Yan BAI ; Leping YE ; Dongchi ZHAO ; Adong SHEN ; Xiang MA ; Qinghua LU ; Fengxia XUE ; Jianbo SHAO ; Tianyou WANG ; Zhengyan ZHAO ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(13):964-973
Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.
10.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition)
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Kwok-keung Daniel NG ; Wing-kin Gary WONG ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(14):1053-1065
Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

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