1.A Single-cell Transcriptomic Study of Wenyang Jiedu Granules in Alleviating Influenza Virus Pneumonia by Suppressing Interferon Responses and Apoptotic Pathways in AT1 Cells
Jingyan XIN ; Shengle QIN ; Taoyu CHEN ; Yuntao LIU ; Xiaolu WANG ; Chaofeng LIANG ; Zhongde ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):76-85
ObjectiveTo investigate the molecular mechanisms by which Wenyang Jiedu granules (WYJD) alleviate influenza A virus (IAV)-induced pneumonia based on single-cell transcriptome sequencing. MethodsThirty female BALB/c mice were randomly divided into a blank control group (Control), IAV group, and WYJD low-, medium-, and high-dose groups (WYJD-L, WYJD-M, WYJD-H; 2.925, 5.85, 11.7 g·kg-1, n=6). Except for the Control group, all other groups were intranasally inoculated with IAV subtype H1N1 (A/PR/8/34) to establish an infection model. Two hours after modeling, drug administration was initiated and continued for 5 consecutive days, with daily monitoring of body weight and general condition. On day 6, mice were sacrificed and samples were collected. Lung index was calculated, and histopathological examination of lung tissue was performed. Lung tissues from the Control, IAV, and WYJD-H groups were subjected to single-cell transcriptome sequencing (n=3), focusing on type I alveolar epithelial cells (AT1) to analyze changes in gene expression and signaling pathways. Western blot was used to detect the expression changes of relevant proteins to validate the single-cell sequencing results. ResultsCompared with the Control group, the IAV group exhibited significantly decreased body weight (P<0.05) and significantly increased lung index (P<0.05). Compared with the IAV group, all WYJD-treated groups exhibited significantly increased body weight (P<0.01) and significantly decreased lung index (P<0.01). Single-cell sequencing analysis revealed that WYJD inhibited overactivation of interferon and inflammatory signaling pathways in AT1 cells after IAV infection, including interferon-γ response, interferon-α response, tumor necrosis factor-α/nuclear factor-κB (TNF-α/NF-κB), and interleukin-6/Janus kinase/signal transducer and activator of transcription 3 (IL-6/JAK/STAT3) pathways. Compared with the Control group, the number of AT1 cells in the IAV group showed a decreasing trend. Compared with the IAV group, the WYJD-H group showed an increasing trend, although neither difference was statistically significant. Further analysis of AT1 cell subpopulation gene expression showed that, compared with the Control group, the IAV group exhibited increased expression of pro-apoptotic genes FAS cell surface death receptor (FAS) and cyclin-dependent kinase inhibitor 1A (CDKN1A), a significant increase in tumor protein p53 (Tp53) expression (P<0.05), and significant decreases in expression of the AT1 marker gene advanced glycosylation end-product-specific receptor (AGER) and membrane structural gene caveolin1 (CAV1) (P<0.05, P<0.01). Compared with the IAV group, the WYJD-H group showed significantly decreased expression of FAS, CDKN1A, and Tp53 (P<0.05, P<0.01), and significantly increased expression of AGER and CAV1 (P<0.05, P<0.01). Regarding interferon response-related genes, compared with the Control group, the IAV group showed increased expression of interferon-stimulated gene 15 (ISG15), interferon-induced protein with tetratricopeptide repeats 3 (IFIT3), signal transducer and activator of transcription 2 (STAT2), bone marrow stromal cell antigen 2 (BST2), and C-X-C motif chemokine ligand 10 (CXCL10), with a significant increase in 2′,5′-oligoadenylate synthetase-like protein 1 (OASL1) (P<0.05). Compared with the IAV group, the WYJD-H group showed significantly decreased expression of all the above genes, with highly significant differences for ISG15, IFIT3, STAT2, BST2, and OASL1 (P<0.01), and a significant difference for CXCL10 (P<0.05). Among inflammation-related genes, compared with the Control group, the IAV group showed significantly increased expression of intercellular adhesion molecule 1 (ICAM1), tumor necrosis factor alpha-induced protein 3 (TNFAIP3), keratin 8 (KRT8), tumor necrosis factor receptor superfamily member 1A (TNFRSF1A), and TNFRSF1B (P<0.01), and increased expression of NFKBIA, a negative regulator of NF-κB (P<0.05). Compared with the IAV group, the WYJD-H group showed significantly decreased expression of KRT8 and TNFRSF1B (P<0.05), while ICAM1, NFKBIA, TNFAIP3, and TNFRSF1A showed decreasing trends without statistical significance. Western blot validation showed that, compared with the Control group, protein expression levels of ISG15, FAS, p53, and phosphorylated p65 (p-p65) in lung tissue of the IAV group were significantly increased (P<0.05, P<0.01). Compared with the IAV group, the WYJD-H group showed significantly decreased expression of these proteins (P<0.05, P<0.01). ConclusionWYJD may alleviate viral pneumonia by targeting gene expression in AT1 cells, inhibiting overactivated interferon and inflammatory signaling pathways after IAV infection, and downregulating pro-apoptotic signaling, thereby reducing alveolar epithelial injury.
2.CT layered localization and clinical effect of acupuncture on lumbar disc herniation.
Yong YANG ; Li ZHANG ; Shoufang LIU ; Youlong ZHOU ; Quanliang WANG ; Jian LIU
Chinese Acupuncture & Moxibustion 2025;45(6):757-760
OBJECTIVE:
To explore the relationship between the effect of acupuncture and layered localization of computed tomography (CT) in treatment of lumbar disc herniation.
METHODS:
Based on the CT layered localization, the herniated lumbar discs were positioned in 5 layers, A, B, C, D and E among 300 patients with lumbar disc herniation. Combined with the horizontal and the frontal planes, the three-dimensional location was formed. Acupuncture was delivered at acupoints including bilateral Shenshu (BL23), Dachangshu (BL25), and Huantiao (GB30), Weizhong (BL40) on the affected side. One intervention of acupuncture was 30 min, once daily; 1 course of treatment was composed of 10 interventions and 2 courses were required. Before and after treatment, Japanese orthopaedic association (JOA) score was recorded, and the effect was evaluated. The curative effect was classified and compared with the CT layered localization.
RESULTS:
Of 300 patients, 226 cases were effective and the effective rate was 75.33%. The JOA scores of all patients, and in the effective group and the non-effective group were higher compared with the scores before treatment (P<0.05). With the layered localization considered, acupuncture was more effective on the cases positioned in C layer. Regarding the horizontal plane, the effect was better on the cases with zone 1 and zone 1-2 involved. In terms of the grade of frontal plane, acupuncture was more effective on the cases graded Ⅰ and Ⅱ.
CONCLUSION
The clinical effect of acupuncture on lumbar disc herniation is related with the layer and the horizontal zone of herniated disc positioned, as well as to the grade of the frontal plane.
Humans
;
Acupuncture Therapy
;
Intervertebral Disc Displacement/diagnostic imaging*
;
Male
;
Female
;
Middle Aged
;
Adult
;
Tomography, X-Ray Computed
;
Lumbar Vertebrae/diagnostic imaging*
;
Acupuncture Points
;
Aged
;
Young Adult
;
Treatment Outcome
3.Characteristics of traditional Chinese medicine syndromes in patients with Chikungunya hemorrhagic fever:a cross-sectional study
Shiying LU ; Danwen ZHENG ; Xintian HONG ; Yuping LIU ; Guangzong LI ; Zhifeng HONG ; Jinghua YANG ; Yan ZHANG ; Banghan DING ; Yuntao LIU ; Yuanyuan WANG ; Xin YIN ; Jingwei SHUI ; Xiaofei FAN ; Hai LAN ; Zhongde ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1531-1539
Objective To explore the traditional Chinese medicine(TCM)syndrome characteristics of patients with Chikungunya hemorrhagic fever and to provide empirical data to support the application of TCM in diagnosing and treating Chikungunya hemorrhagic fever.Methods A cross-sectional survey was conducted to collect clinical data(sex,age,days since onset,and comorbidity underlying disease conditions)and TCM with four-examination information(symptoms,tongue manifestations,and pulse manifestations)from 255 patients with Chikungunya hemorrhagic fever who visited Lecong Hospital of Shunde,Foshan,the Third People's Hospital of Shunde District of Foshan,Shunde Hospital of Southern Medical University Affiliated Chencun Hospital between July 23 and July 29,2025.Factor and cluster analyses were used to summarize TCM syndrome characteristics and analyze core pathogenesis in conjunction with clinical features.Results Among the 255 patients with Chikungunya hemorrhagic fever,131 were male and 124 were female,with a age of(49.05±17.93)years and a disease duration of(3.26±1.78)days.Among the four types of examination information in TCM,35 items exhibited a frequency exceeding 10%.The most prevalent symptoms were arthralgia(180 patients,70.59%),exanthem(153 patients,60.00%),fatigue(99 patients,38.82%),anhidrosis(98 patients,38.43%),pruritus(96 patients,37.65%),and fever(92 patients,36.08%).Tongue and pulse manifestations were primarily white fur(155 patients,60.78%),pink tongue(111 patients,43.53%),slippery pulse(143 patients,56.08%),and greasy fur(134 patients,52.53%).Patients with disease onset≤3 d had a higher incidence of arthralgia,fatigue,fever,aversion to cold,generalized muscle pain,aversion to wind,insomnia,headache,sweating,low-grade fever,poor appetite,loose stool,hyperhidrosis,and red tongue than those with disease onset≥4 d(P<0.05).Patients with disease onset≥4 d had a higher incidence of pink tongue and thick fur than those with disease onset≤3 d(P<0.05).The syndrome elements in patients with Chikungunya hemorrhagic fever predominantly manifested on the defensive exterior,with involvement of the sinew-bone joints,skin-muscle,and spleen.Pathogenic factors were primarily characterized by external winds,dampness,and heat.Factor and cluster analysis result indicated three TCM pathogenesis progression patterns:imbalance of the defensive exterior with wind-dampness conflict and heat transformation;dampness-heat flowing into muscles and meridians causing joint obstruction and qi blood stasis;and dampness-heat congelation resulting in qi mechanism obstruction,consumption of body fluids,and infiltration of the skin.Conclusion Patients with Chikungunya hemorrhagic fever primarily present with fever,joint pain,and rashes.In TCM,this condition falls under the category of"dampness-warmth"syndrome.Its etiology is attributed to pathogens,with transmission occurring through mosquito bites.The core pathogenesis of TCM is the invasion of the defensive exterior and dampness-toxic heat accumulation.The therapeutic principles focus on clearing heat pathogens,resolving dampness pathogens,dispersing wind pathogens,and promoting the resolution of rashes.
4.Characteristics of traditional Chinese medicine syndromes in patients with Chikungunya hemorrhagic fever:a cross-sectional study
Shiying LU ; Danwen ZHENG ; Xintian HONG ; Yuping LIU ; Guangzong LI ; Zhifeng HONG ; Jinghua YANG ; Yan ZHANG ; Banghan DING ; Yuntao LIU ; Yuanyuan WANG ; Xin YIN ; Jingwei SHUI ; Xiaofei FAN ; Hai LAN ; Zhongde ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1531-1539
Objective To explore the traditional Chinese medicine(TCM)syndrome characteristics of patients with Chikungunya hemorrhagic fever and to provide empirical data to support the application of TCM in diagnosing and treating Chikungunya hemorrhagic fever.Methods A cross-sectional survey was conducted to collect clinical data(sex,age,days since onset,and comorbidity underlying disease conditions)and TCM with four-examination information(symptoms,tongue manifestations,and pulse manifestations)from 255 patients with Chikungunya hemorrhagic fever who visited Lecong Hospital of Shunde,Foshan,the Third People's Hospital of Shunde District of Foshan,Shunde Hospital of Southern Medical University Affiliated Chencun Hospital between July 23 and July 29,2025.Factor and cluster analyses were used to summarize TCM syndrome characteristics and analyze core pathogenesis in conjunction with clinical features.Results Among the 255 patients with Chikungunya hemorrhagic fever,131 were male and 124 were female,with a age of(49.05±17.93)years and a disease duration of(3.26±1.78)days.Among the four types of examination information in TCM,35 items exhibited a frequency exceeding 10%.The most prevalent symptoms were arthralgia(180 patients,70.59%),exanthem(153 patients,60.00%),fatigue(99 patients,38.82%),anhidrosis(98 patients,38.43%),pruritus(96 patients,37.65%),and fever(92 patients,36.08%).Tongue and pulse manifestations were primarily white fur(155 patients,60.78%),pink tongue(111 patients,43.53%),slippery pulse(143 patients,56.08%),and greasy fur(134 patients,52.53%).Patients with disease onset≤3 d had a higher incidence of arthralgia,fatigue,fever,aversion to cold,generalized muscle pain,aversion to wind,insomnia,headache,sweating,low-grade fever,poor appetite,loose stool,hyperhidrosis,and red tongue than those with disease onset≥4 d(P<0.05).Patients with disease onset≥4 d had a higher incidence of pink tongue and thick fur than those with disease onset≤3 d(P<0.05).The syndrome elements in patients with Chikungunya hemorrhagic fever predominantly manifested on the defensive exterior,with involvement of the sinew-bone joints,skin-muscle,and spleen.Pathogenic factors were primarily characterized by external winds,dampness,and heat.Factor and cluster analysis result indicated three TCM pathogenesis progression patterns:imbalance of the defensive exterior with wind-dampness conflict and heat transformation;dampness-heat flowing into muscles and meridians causing joint obstruction and qi blood stasis;and dampness-heat congelation resulting in qi mechanism obstruction,consumption of body fluids,and infiltration of the skin.Conclusion Patients with Chikungunya hemorrhagic fever primarily present with fever,joint pain,and rashes.In TCM,this condition falls under the category of"dampness-warmth"syndrome.Its etiology is attributed to pathogens,with transmission occurring through mosquito bites.The core pathogenesis of TCM is the invasion of the defensive exterior and dampness-toxic heat accumulation.The therapeutic principles focus on clearing heat pathogens,resolving dampness pathogens,dispersing wind pathogens,and promoting the resolution of rashes.
5.Relationship between inflammatory factor levels with metabolism,verbal fluency and information processing function in hospitalized schizophrenia patients
Cong WANG ; Cuizhen ZHU ; Xueying ZHANG ; Hua GAO ; Zhongde PAN ; Jian CHENG ; Deying YANG ; Mingming ZHENG ; Xulai ZHANG
Sichuan Mental Health 2024;37(4):323-329
Background Schizophrenic patients have metabolic disorders,impaired language and information processing function.Inflammatory factors may play an important role in the occurrence and development of schizophrenia.Objective To explore the relationship of the inflammatory factor levels with metabolic levels,language fluency and information processing function in patients with schizophrenia,so as to provide references for clinical understanding of the neuropathological mechanisms of schizophrenia.Methods A total of 96 patients with schizophrenia were included in the study group,who were hospitalized in the Fourth People's Hospital of Hefei from January 2021 to December 2022 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)and Mini-International Neuropsychiatric Interview(MINI)6.0.Meanwhile,population who underwent physical examination at the same hospital were included in the control group(n=42).A high-sensitivity multi factor electrochemiluminescence analyzer was used to detect the levels of inflammatory factors IL-4,IL-5,IL-7,IL-8,IL-10 and IL-13.A fully automated biochemical analyzer was used to detect the levels of metabolic indicators such as fasting blood glucose,triglycerides,high-density lipoprotein,apolipoprotein A,creatinine and urea nitrogen.Verbal fluency and information processing function of all participants were assessed by using Verbal Fluency Test(VFT)and Stroop Color Word Test(SCWT).Results There were statistically significant differences in the levels of IL-4,IL-5,IL-7,IL-8,IL-10,IL-13 and IL-15 between the study group and the control group(P<0.05).There were statistically significant differences in BMI,waist circumference,fasting blood glucose,triglycerides,high-density lipoprotein,urea nitrogen,apolipoprotein A and creatinine levels between the two groups(P<0.05).The differences in the correct number of household appliances,animals,fruits,vegetables,names starting with"water"and"self"in VFT between the two groups were statistically significant(P<0.05).The differences in point reaction time,character reaction time and character color reaction time in SCWT between the two groups were statistically significant(P<0.05).Correlation analysis showed that except for creatinine levels,the levels of IL-4 and IL-5 in patients with schizophrenia were correlated with other indicators(P<0.05).IL-7 levels were correlated with creatinine levels,household appliances,animals,fruits,correct number of names starting with"water"in VFT,point reaction time and word reaction time in SCWT(P<0.05).IL-8 levels were correlated with triglyceride levels,household appliances,animals,fruits,vegetables,correct number of names starting with"water"and"self"in VFT and word reaction time in SCWT(P<0.05).Except for creatinine levels and the correct number of names starting with"self",IL-10 levels were correlated with all other indicators(P<0.05).Except for creatinine and urea nitrogen levels,IL-13 levels were correlated with other indicators(P<0.05).Conclusion The levels of inflammatory factors in patients with schizophrenia may be related to their metabolic levels,language fluency and information processing function.
6.Correlations of miR-203a-3p and PHOX2B expression in glioma tissues with clinical features and prognosis
Qi ZHANG ; Jia HU ; Hui LI ; Jin WANG ; Zhongde LI ; Zhiyuan HU
The Journal of Practical Medicine 2024;40(10):1382-1388
Objective To investigate the correlations microRNA-203a-3p(miR-203a-3p)and paired allographic box protein 2B(PHOX2B)expression levels in glioma tissues with clinical features and prognosis.Methods Ninety-six glioma patients admitted to our hospital from June 2017 to April 2020 were included in the study.The resected glioma tissues and corresponding paracancerous tissues from the patients were collected intraop-eratively.qRT-PCR and immunohistochemistry were conducted to detect the expression of miR-203a-3p and PHOX2B mRNA in glioma tissues and paracancerous groups.Pearson's method was used to analyze the correlation between miR-203a-3p and PHOX2B mRNA.Kaplan-Meier survival curves were used to analyze the correlations of miR-203a-3p and PHOX2B mRNA with the prognosis of glioma patients.COX regression was used to analyze the risk factors affecting the prognosis of glioma patients.Results The miR-203a-3p level and positive expression rate of glioma tissues were significantly lower than that of paracancerous tissues(P<0.05),and the PHOX2B mRNA level and positive expression rate were significantly higher than that of paracancerous tissues(P<0.05).By Pearson correlation analysis,the miR-203a-3p and PHOX2B mRNA levels of glioma patients were negatively correlated(P<0.05).miR-203a-3p and PHOX2B were associated with KPS score,tumor tissue necrosis,and WHO grading(P<0.05).Kaplan-Meier curve analysis yielded the results that the survival rate of the miR-203a-3p highly expressed group was significantly higher than that of the lowly expressed group(P<0.05),and the survival rate of the PHOX2B mRNA highly expressed group was significantly lower than that of the lowly expressed group(P<0.05).COX regression analysis showed that miR-203a-3p,PHOX2B mRNA,tumor tissue necrosis,and WHO grading were the risk factors affecting the prognosis of glioma patients(P<0.05).Conclusion The expression level of miR-203a-3p is obviously reduced and the expression level of PHOX2B mRNA is obviously increased in glioma,both showing close correlation with clinical characteristics and prognosis.
7.Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study
Danwen ZHENG ; Heng WENG ; Yuntao LIU ; Xin YIN ; Jun ZHANG ; Jian ZHANG ; Luming CHEN ; Yuanshen ZHOU ; Jing ZENG ; Yan CAI ; Wanxin WEN ; Qinghua ZHANG ; Lanting TAO ; Liangsheng SUN ; Tianjin CAI ; Weiliang WANG ; Shubin CAI ; Xindong QIN ; Xiaofeng LIN ; Xiaohua XU ; Haimei ZOU ; Qiaoli HUA ; Peipei LU ; Jingnan LIN ; Kaiyuan ZHANG ; Aihua OU ; Jiqiang LI ; Fang YAN ; Xu ZOU ; Lin LIN ; Banghan DING ; Jianwen GUO ; Tiehe QIN ; Yimin LI ; Xiangdong GUAN ; Xiaoneng MO ; Zhongde ZHANG
Chinese Journal of Emergency Medicine 2021;30(10):1220-1228
Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.
8.Application of the pathological classification of "CCCG-WT-2016" (2019 revision) for treatment of Wilms tumors
Qiao HE ; TouEn Kenneth CHANG ; Wanwan CHEN ; Jing MA ; Ping SHEN ; Jiefeng CHEN ; Xiaoting JIN ; Zhongde ZHANG ; Minzhi YIN
Chinese Journal of Pathology 2020;49(4):324-328
Objective:To describe our experiences in application of the 2019 revision of "CCCG-WT-2016" for the diagnosis of Wilms tumors.Methods:Ninety-one cases of Wilms tumor diagnosed at Shanghai Children′s Medical Center from January 2015 to December 2018 were collected. All cases were reviewed by two senior pathologists, including one from China and the other from Singapore, according to the 2019 revision of "CCCG-WT-2016."Results:The specimens were obtained by core biopsy ( n=21), primary nephrectomy ( n=41), post-chemotherapy nephrectomy/resection ( n=18), or biopsy/resection of metastatic/relapse/post-chemotherapy metastatic lesion(s) ( n=11). The specimens of core biopsy and primary nephrectomy ( n=62) all had favorable histology.Twelve post-chemotherapy nephrectomy cases were subdivided into three risk groups: low risk ( n=0), intermediate risk ( n=10) and high risk ( n=2). Six post-chemotherapy resection cases were subdivided into 3 risk groups:low risk ( n=0), intermediate risk ( n=5) and high risk ( n=1). The remaining 11 cases were comprised of metastatic, relapse, and post-chemotherapy metastatic lesions. The concordance rate of the two senior pathologists was 100%(91/91). Conclusions:The 2019 revision of "CCCG-WT-2016" is clearly written and easy to use. It can serve as the basis of accurate classification for clinical treatment.
9.Clinicopathological characteristics of NTRK-rearranged mesenchymal tumors in childhood
Minzhi YIN ; Jing MA ; Qiao HE ; Ping SHEN ; Jiefeng CHEN ; Xiaoting JIN ; Zhongde ZHANG ; Hong Chik KUICK ; Huiyi CHEN ; Ng Eileen Hui Qi ; Jet Sze AW ; Chang Kenneth Tou En
Chinese Journal of Pathology 2020;49(7):675-680
Objective:To investigate the clinical and pathological features of pediatric NTRK-rearranged tumors.Methods:Four NTRK-rearranged soft tissue tumors and one renal tumor at Shanghai Children′s Medical Center, Shanghai Jiaotong University and Singapore KK Women′s and Children′s Hospital from January 2017 to September 2019 were identified. Pan-TRK immunohistochemistry, and the ALK and ETV6 gene break-apart fluorescence in situ hybridizations (FISH) were performed. NTRK gene rearrangement was detected using sequencing-based methods.Results:There were 3 males and 2 females in this study. The patients were between 3 months and 13 years of age. Histologically, the tumors were infiltrative spindle cell tumors with variable accompanying inflammatory cells. Immunohistochemistry showed positive reactivity for pan-TRK in all tumors, with nuclear staining for NTRK3 fusion, and cytoplasmic staining for NTRK1 fusion. The molecular testing revealed NTRK gene fusions (one each of TPM3-NTRK1, ETV6-NTRK3 and DCTN1-NTRK1, and two cases of LMNA-NTRK1). Two patients were receiving larotrectinib. The others were are well without disease, with follow-up durations of 9 to 29 months.Conclusions:NTRK-rearranged mesenchymal tumors from soft tissue sites and kidney are identified. A novel DCTN1-NTRK1 fusion is described. Pan-TRK immunohistochemistry is useful for diagnosis. NTRK-targeted therapy may be an option for unresectable, recurrent or metastatic cases.
10.Clinical characteristics of patients with dengue fever accompanied by platelet count reduction and analysis of their traditional Chinese medicine syndrome and treatment
Xiaolan QIN ; Yuntao LIU ; Jiechao ZHENG ; Yuemin ZHANG ; Wanyin TANG ; Zhongde ZHANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2019;26(4):429-432
Objective To analyze the clinical features of patients with dengue fever (DF) accompanied by platelet count (PLT) reduction and their characteristics of traditional Chinese medicine (TCM) syndrome differentiation and treatment. Methods The clinical data of 1 570 patients with confirmed diagnosis of DF collected from the Information Management System (HIS) of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (TCM) from January 2013 to December 2017 were retrospective analyzed. According to the patients accompanied by platelet (PLT) reduction or not, they were divided into DF accompanied by PLT reduction group (1 211 cases) and non-PLT reduction group (359 cases); according to whether the cooling blood and dissipating blood stasis TCM (composed of red peony, peony bark, rehmannia root, salvia miltiorrhiza, rhinoceros horn, etc.) was used or not in TCM syndrome differentiation prescription, they were divided into cooling blood and dissipating blood stasis group (492 cases) and non-cooling blood and dissipating blood stasis group (719 cases). The differences in clinical characteristics, laboratory indicators, TCM syndrome differentiation and prescription characteristics in DF accompanied by PLT reduction group and non-PLT reduction group were compared and analyzed; the differences in changes of white cell counts (WBC) and PLT levels before and after treatment between cooling blood and dissipating blood stasis group and non-cooling blood and dissipate blood stasis group were compared and analyzed. Results The proportions of rash, hemorrhage, WBC reduction and aspartate transaminase (AST) elevation in DF accompanied by PLT reduction group were significantly higher than those in non-PLT reduction group [rash: 61.4% (744/1 211) vs. 14.8% (53/359), hemorrhage: 7.3% (89/1 211) vs. 1.1% (4/359), WBC reduction: 88.2% (1 068/1 211) vs. 60.4% (217/359), AST increased: 41.0% (497/1 211) vs. 29.5% (106/359)]; the PLT and WBC in the DF accompanied by PLT reduction group were significantly lower than those in the non-PLT reduction group [PLT (×109/L): 74.2±27.5 vs. 166.6±42.8, WBC (×109/L): 2.1±1.6 vs. 6.4±3.7, both P < 0.05], and AST in the DF accompanied by PLT reduction group were significantly higher than those in the non-PLT reduction group (U/L: 69.6±34.1 vs. 52.6±26.1, P < 0.05). The common syndrome of TCM syndrome differentiation in DF accompanied by PLT reduction group and non-PLT reduction group was mainly Wei-Qi syndrome [425 cases (35.1%) and 147 cases (40.9%) respectively]; Yinqiao powder was the main TCM prescription in the two groups [132 cases (10.9%) and 46 cases (12.8%) respectively]. In the comparisons between the cooling blood and dissipate blood stasis group and non-cooling blood and dissipate blood stasis group, there were no statistically significant differences in the proportion of combining use of drugs for increasing WBC and PLT and the levels of WBC and PLT after treatment (all P > 0.05). After treatment, the WBC, PLT levels and the proportions of above indexes returned to normal in the cooling blood and dissipate blood stasis group were significantly higher than those in the non- cooling blood and dissipate blood stasis group [WBC(×109/L): 4.5±3.1 vs. 3.2±2.4, proportion of WBC returned to normal: 42.7% (210/492) vs. 33.1% (238/719); PLT (×109/L): 85.9±26.2 vs. 79.3±24.8, proportion of PLT returned to normal: 41.1% (202/492) vs. 27.5% (198/719), all P < 0.05]. Conclusions The symptoms of skin rash and bleeding are more common in patients with DF accompanied by PLT reduction. The syndrome differentiation of TCM for this disease is mostly based on the combined disorders of Wei (defence) and Qi, both Qi and blood burning and blood stasis associated with toxin. Cooling blood and dissipating blood stasis may help the recovery of WBC and PLT in these patients, which is of great significance in reducing severity of dengue fever (such as bleeding).

Result Analysis
Print
Save
E-mail