1.Influencing factors for calcium salt deposition in patients with alveolar echinococcosis
Zitong XIONG ; Zhiyi LIN ; Yanxin HUANG ; Fuzhong FANG ; Zhengzhan WU ; Zirui XIN ; Chunxia HU ; Jiayu ZHOU ; Yuan YAO ; Hongwei ZHANG
Journal of Clinical Hepatology 2026;42(2):372-379
ObjectiveTo investigate the imaging features of calcium salt deposition and serological markers in patients with alveolar echinococcosis through a retrospective analysis, as well as independent risk factors for the degree of calcium salt deposition in lesions, and to provide a basis for assessing disease process. MethodsA retrospective analysis was performed for the imaging and clinical data of 107 patients with alveolar echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from December 2023 to June 2025, and according to the volume of calcium salt deposition, they were divided into non-deposition group with 16 patients, mild deposition group with 52 patients, moderate deposition group with 16 patients, and severe deposition group with 23 patients. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups, and the χ2 test or Fisher’s exact test was used for comparison of categorical data between groups. The four groups were further combined into the low deposition group (no/mild deposition) and the high deposition group (moderate/severe deposition). A binary logistic regression analysis was used to investigate the independent influencing factors for calcium salt deposition, and a predictive model was established. The receiver operating characteristic (ROC) curve was used to assess the predictive performance of the model, and the Bootstrap method was used for internal validation. ResultsThere were significant differences between the four groups in sex distribution, involvement of other sites, white blood cell count, lymphocyte percentage, fibrinogen, uric acid, sodium ion, chloride ion, and calcium ion (all P<0.05). The univariate analysis showed that there were significant differences between the four groups in sex, involvement of other sites, white blood cell count, lymphocyte percentage, fibrinogen, alanine aminotransferase, albumin, creatinine, uric acid, sodium ion, chloride ion, and calcium ion (all P<0.1). The multi-collinearity diagnosis showed that the VIF values for all continuous variables ranged from 1.104 to 1.760, suggesting that collinearity did not affect modeling. An ordinal logistic regression model was established based on sex, involvement of other sites, calcium ion, lymphocyte percentage, and uric acid. The multivariate analysis showed that lymphocyte percentage (odds ratio [OR]=1.106, 95% confidence interval [CI]: 1.041 — 1.174, P=0.001) and blood calcium level (OR=0.005, 95%CI: 0.000 —0.230, P=0.007) were independent influencing factors for the degree of calcium salt deposition. The regression equation was established as Logit(P)=8.231 + 0.100 × lymphocyte percentage -5.344 × calcium ion. The ROC curve analysis showed that the model had an area under the ROC curve of 0.716, with a Youden index of 0.353, a sensitivity of 1.000, and a specificity of 0.353. The Hosmer-Lemeshow test showed that the model had poor calibration (χ2=20.688, P=0.008). The Bootstrap method with 1000 repeated samples showed that the estimated values of lymphocyte percentage (OR=1.106, 95%CI: 1.049 — 1.186, P=0.002) and calcium ion (OR=0.005, 95%CI: 0.000 — 0.214, P=0.010) were consistent with the original model, and the confidence intervals did not include 1, which further supported the reliability of the model. ConclusionBoth lymphocyte percentage and blood calcium level are independent influencing factors for calcium salt deposition in alveolar echinococcosis, and the degree of calcium salt deposition in alveolar echinococcosis lesions increases with the reduction in blood calcium level and the increase in lymphocyte percentage.
2.The Philosophy and Practical Pathway of "Dao (道)-Shen (神)-Formula" in Traditional Chinese Medicine
Lesong ZHANG ; Jun LI ; Zhaorui CUI ; Xiao XIA ; Zirui WANG
Journal of Traditional Chinese Medicine 2026;67(9):921-925
By tracing back to the classical literature of traditional Chinese medicine (TCM), this paper proposes a TCM philosophy integrating "dao (道)-shen(神)-formula" as a unified whole. It systematically elaborates the formula-constructing thought that "the monarch drug follows dao, and the formula carries dao", analyzes shen (spirit/ life vitality) from the perspectives of its substance, manifestation and function, and explains the pivotal role of shen in connecting dao and formula. Taking Treatise on Cold Damage and Miscellaneous Diseases (《伤寒杂病论》) as an example, the paper explores how the "dao-shen-formula" union is implemented in classics. Based on the Inner Canon of Yellow Emperor (《黄帝内经》), the paper articulates a practical pathway for the "dao-shen-formula" union, namely "observing shen to differentiate the mechanism → restoring dao to regulate shen → achieving harmony of shen and restoration of dao", thereby transforming abstract concepts into operable and verifiable practical approaches. It is hoped that this study will provide theoretical foundation and practical guidance for the shift from treating diseases to treating the person, and from correcting deviations to restoring dao in TCM.
3.The Philosophy and Practical Pathway of "Dao (道)-Shen (神)-Formula" in Traditional Chinese Medicine
Lesong ZHANG ; Jun LI ; Zhaorui CUI ; Xiao XIA ; Zirui WANG
Journal of Traditional Chinese Medicine 2026;67(9):921-925
By tracing back to the classical literature of traditional Chinese medicine (TCM), this paper proposes a TCM philosophy integrating "dao (道)-shen(神)-formula" as a unified whole. It systematically elaborates the formula-constructing thought that "the monarch drug follows dao, and the formula carries dao", analyzes shen (spirit/ life vitality) from the perspectives of its substance, manifestation and function, and explains the pivotal role of shen in connecting dao and formula. Taking Treatise on Cold Damage and Miscellaneous Diseases (《伤寒杂病论》) as an example, the paper explores how the "dao-shen-formula" union is implemented in classics. Based on the Inner Canon of Yellow Emperor (《黄帝内经》), the paper articulates a practical pathway for the "dao-shen-formula" union, namely "observing shen to differentiate the mechanism → restoring dao to regulate shen → achieving harmony of shen and restoration of dao", thereby transforming abstract concepts into operable and verifiable practical approaches. It is hoped that this study will provide theoretical foundation and practical guidance for the shift from treating diseases to treating the person, and from correcting deviations to restoring dao in TCM.
4.Monte Carlo study of transmission X-ray tubes in kilovoltage radiotherapy
Yikai WU ; Zhongyu QI ; Li TAO ; Hui ZHANG ; Zeeshan MUHAMMAD ; Zirui YE ; Yankui CHANG ; Xi PEI ; Xu GEORGE
Chinese Journal of Medical Physics 2025;42(7):863-871
Transmission X-ray tubes are relatively new devices characterized by portability,suitability for miniaturization,and low requirements for shielding,making them ideal radiation sources for kilovoltage X-ray therapy.However,their application in radiotherapy remains underexplored.An electron target model of a transmission X-ray tube is developed using the Monte Carlo toolkit TOPAS 3.8.1.The study investigates the effect of tungsten target thickness on X-ray output efficiency,finding that a tube voltage of 50 kV and a tungsten thickness of 1.4 μm yields the highest emission efficiency.Based on the energy spectrum at this optimal efficiency,polynomial fitting approach is applied to determine the corresponding aluminum filter thickness for mean energies ranging from 20 keV to 35 keV,achieving a mean fitting error of 0.91%.Next,the study simulates dose deposition in a water phantom for spectra with different mean energies and various source-to-surface distances,and plots percent-depth-dose curves,relative normalized dose-depth curves,and relative normalized dose histograms under each treatment condition.Finally,the simulated results are compared with experimental data from the intraoperative radiotherapy system Intrabeam and the superficial X-ray therapy unit SRT-100,obtaining average relative errors of 3.71%and 4.38%,respectively.These findings provide a theoretical foundation for further optimization of transmission X-ray tubes in kilovoltage radiotherapy.
5.Monte Carlo study of transmission X-ray tubes in kilovoltage radiotherapy
Yikai WU ; Zhongyu QI ; Li TAO ; Hui ZHANG ; Zeeshan MUHAMMAD ; Zirui YE ; Yankui CHANG ; Xi PEI ; Xu GEORGE
Chinese Journal of Medical Physics 2025;42(7):863-871
Transmission X-ray tubes are relatively new devices characterized by portability,suitability for miniaturization,and low requirements for shielding,making them ideal radiation sources for kilovoltage X-ray therapy.However,their application in radiotherapy remains underexplored.An electron target model of a transmission X-ray tube is developed using the Monte Carlo toolkit TOPAS 3.8.1.The study investigates the effect of tungsten target thickness on X-ray output efficiency,finding that a tube voltage of 50 kV and a tungsten thickness of 1.4 μm yields the highest emission efficiency.Based on the energy spectrum at this optimal efficiency,polynomial fitting approach is applied to determine the corresponding aluminum filter thickness for mean energies ranging from 20 keV to 35 keV,achieving a mean fitting error of 0.91%.Next,the study simulates dose deposition in a water phantom for spectra with different mean energies and various source-to-surface distances,and plots percent-depth-dose curves,relative normalized dose-depth curves,and relative normalized dose histograms under each treatment condition.Finally,the simulated results are compared with experimental data from the intraoperative radiotherapy system Intrabeam and the superficial X-ray therapy unit SRT-100,obtaining average relative errors of 3.71%and 4.38%,respectively.These findings provide a theoretical foundation for further optimization of transmission X-ray tubes in kilovoltage radiotherapy.
6.Clinical Application Effects of Preloaded Snare Technique in Patients With Risk of Occluder Displacement During Percutaneous Atrial Septal Defect Closure
Gang HAN ; Zirui SUN ; Yan HAN ; Lele BEN ; Yuanhao ZHANG ; Weizhen XING ; Saifei WANG ; Yu HAN
Chinese Circulation Journal 2025;40(7):703-707
Objectives:To analyze the clinical application effect of the preloaded snare technique in patients with risk of atrial septal occluder migration during percutaneous atrial septal defect(ASD)occlusion.Methods:The clinical data of 24 patients with secundum ASD who underwent preloaded snare-assisted transcatheter closure in Fuwai Central China Cardiovascular Hospital between December 2022 and August 2024 were retrospectively analyzed.The preprocedural echocardiography revealed that all patients presented with large secundum ASD or insufficient margins,indicating potential risk of device migration during percutaneous ASD occlusion.Consequently,preloaded snare technique was applied for ASD closure.Postprocedural evaluations were conducted to assess device stability(migration or shedding),residual shunt,pericardial effusion,and new-onset arrhythmia during the procedure,immediately after intervention,and at 1-month follow-up.Results:Among 24 patients,there were 4 males,with an average age of(37.88±13.18)years and an average weight of(59.70±10.78)kg.Twenty-two cases underwent successful interventional closure.Two cases occurred atrial septal occluder migration during the procedure,both were successfully retrieved using the preloaded snare and subsequently scheduled for surgical repair.Postprocedural electrocardiograms and echocardiograms(obtained immediately and at 1-month follow-up)demonstrated no device migration,residual shunt,occluder dislodgement,pericardial effusion,or new-onset arrhythmias.Conclusions:The preloaded snare technique can reduce the risk of atrial septal occluder migration and shedding,simplify the process of retrieving the occluder,enhance the safety of the intervention,and avoid emergency surgical intervention in high-risk populations.
7.Comorbidity of abnormal spinal curvature and screening myopia among primary and middle school students
WANG Zirui ; ZHANG Xiang ; LIU Yu ; ZHOU Xiaoxiao
Journal of Preventive Medicine 2025;37(4):336-340
Objective:
To investigate the comorbidity of abnormal spinal curvature and screening myopia among primary and middle school students in Taizhou City, Zhejiang Province, so as to provide the reference for the prevention and control of abnormal spinal curvature and myopia among children and adolescents.
Methods:
Students from nine counties (cities, districts) in Taizhou City were selected using a stratified cluster random sampling method. Basic information, sleep, physical activity, diet, electronic device usage, frequency of seat changes, after class study, reading and writing posture, and eye-use habits were collected through questionnaire surveys. Abnormal spinal curvature was screened according to the Technical Guidelines for the Prevention and Control of Abnormal Spinal Curvature in Children and Adolescents. Myopia was screened based on Specification for Screening of Refractive Error in Primary and Middle School Students (WS/T 663—2020). The influencing factors for the comorbidity of abnormal spinal curvature and screening myopia were analyzed using a multivariable logistic regression model.
Results:
A total of 13 596 students were surveyed, including 7 423 males (54.60%) and 6 173 females (45.40%). The average age was (13.45±2.59) years. The prevanlece of the comorbidity of abnormal spinal curvature and screening myopia, was 2.90% (394 cases). Multivariable logistic regression analysis showed that students who used computers for <1 hour in the past 7 days (not use as the reference, OR=1.312, 95%CI: 1.023-1.684), after class study for ≥3 hours in the past 7 days (OR=1.513, 95%CI: 1.068-2.143), and frequently/always read books or watched screens under direct sunlight (OR=1.604, 95%CI: 1.018-2.526) had a higher risk of the comorbidity of abnormal spinal curvature and screening myopia. In contrast, the students who slept for >9 h/d (OR=0.638, 95%CI: 0.411-0.991), engaged in outdoor activities for ≥3 h/d in the past 7 days (OR=0.645, 95%CI: 0.427-0.975), and changed seats once per month or more (OR=0.740, 95%CI: 0.573-0.955) had a lower risk of the comorbidity of abnormal spinal curvature and screening myopia.
Conclusion
The comorbidity of abnormal spinal curvature and screening myopia among primary and middle school students is mainly influenced by sleep, physical activity, electronic device use, frequency of seat changes, after class study and eye-use habits.
8.In Vitro and Animal Studies of Human Natural Killer Cell-Derived Exosomes for the Treatment of Otitis Media.
Zirui ZHAO ; Liqin WANG ; Zhen GUO ; Kanglun JIANG ; Jianghong XU ; Yilai SHU ; Christina Y XU ; Jianning ZHANG ; Yunfeng WANG ; Geng-Lin LI
Neuroscience Bulletin 2025;41(10):1792-1804
Otitis media is an infection of the middle ear mainly caused by bacteria, and current treatments rely heavily on antibiotics. However, the emergence of antibiotic-resistant bacterial strains seriously affects their efficacy. In our study, we found that extracellular vesicles (EVs) derived from human natural killer cells (NKs) inhibit the proliferation of both standard and levofloxacin (LVX)-resistant strains of Staphylococcus aureus in a dose-dependent manner. Moreover, compared to LVX, EVs were more effective at reducing effusion and rescuing hearing thresholds in animal models. For LVX-sensitive strains, EVs were significantly more effective in terms of curative time but not curative rate. For LVX-resistant strains, EVs were significantly more effective in terms of both curative rate and curative time when applied alone or applied jointly with LVX. In summary, we found that NK EVs are highly effective in treating otitis media, providing an alternative approach for treating this common disease.
Killer Cells, Natural/metabolism*
;
Exosomes/metabolism*
;
Animals
;
Humans
;
Otitis Media/therapy*
;
Staphylococcus aureus/drug effects*
;
Disease Models, Animal
;
Anti-Bacterial Agents/pharmacology*
;
Levofloxacin/pharmacology*
9.The relationship between D-loop region single nucleotide polymorphism and copy number of mitochondrial DNA with the risk of developing dermatomyositis
Zirui Tan ; Jingjing Zhang ; Yuanyuan Jia ; Chenxing Peng ; Yufe Zhao
Acta Universitatis Medicinalis Anhui 2025;60(1):130-135
Objective :
To explore the relationship between single nucleotide polymorphisms ( SNPs) in D-loop region of mitochondrial DNA ( mtDNA) and mtDNA copy number and the risk of dermatomyositis ( DM) ,and its in- fluencing factors.
Methods :
74 patients with DM and 92 healthy controls were included in the study. Genomic DNA was extracted from peripheral blood and the target fragment of mtDNA D-loop region was amplified by PCR technique,and the products were subsequently sequenced.Serum levels of ROS were assessed using a high-sensi- tivity reactive oxygen species detection kit.The expression levels of cytokines,interleukin ( IL) -5,IL-13,inter- feron-γ ( IFN-γ) ,IL-2,IL-6,IL-10,tumor necrosis factor-α ( TNF-α) and IL-4 were measured using Flow Fluo- rescence Immunmicrobeads Assay.Wilcoxon rank-sum test was used to assess the potential correlation between cy- tokines and SNPs associated with DM risk.The relative copy number of mtDNA was measured using quantitative re- al-time polymerase chain reaction ( qPCR) analysis.
Results :
Two SNPs ( 16304T / C,16519T / C) were found to be associated with the risk of developing DM,and alleles 16304C ( χ2 = 4. 937,P = 0. 026) and 16519C ( χ2 = 4. 405,P = 0. 036) in the mitochondrial D-loop region were confirmed to be associated with DM development risk. The DM risk-associated allele 16304C was significantly associated with lower IL-4 expression ( P = 0. 016) .The mtDNA copy number was significantly higher in DM patients than in controls ( P <0. 001) .
Conclusion
Mitochondrial D-loop SNPs can be potential biomarkers for DM risk,and SNPs may be involved in DM by influencing cytokines.DM shows high expression of mtDNA copy number,and the increase in mtDNA copy number may lead to mitochondrial dysfunction,which triggers the pathogenesis of DM.
10.Expression and significance of α7 nicotinic acetylcholine receptor on thymic T follicular helper cells in myasthenia gravis
Meng WANG ; Menghao YANG ; Xinzheng CUI ; Zirui SUN ; Chenshuo SHI ; Zhiwen ZHANG ; Lixiang ZHENG ; Qingyong ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(12):1771-1776
Objective To investigate the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in thymic T follicular helper cells (TFH) and its significance in patients with myasthenia gravis (MG). Methods Fifteen MG patients who underwent surgical treatment at the Myasthenia Gravis Comprehensive Diagnosis and Treatment Center of Henan Provincial People’s Hospital from June 2022 to June 2023 were selected as a MG group, including 7 males and 8 females, aged 12-30 years. Twelve patients who underwent partial thymectomy to optimize surgical field exposure during cardiac surgery at Fuwai Central China Cardiovascular Hospital from June 2022 to June 2023 were selected as a control group, including 5 males and 7 females aged 20-35 years. Thymus single cell suspension was obtained by grinding the thymus tissue, and flow cytometry was used to detect the expression of α7nAChR in TFH cells. The thymus cell suspension was purified using density gradient centrifugation, followed by immunomagnetic bead separation to obtain CD4+T cells. CXCR5 antibody and coupled magnetic beads were added to isolate TFH cells. Real-time fluorescent polymerase chain reaction and Western blotting were performed to further investigate the expression of α7nAChR in TFH cells. Results Compared with the control group, the proportion of thymic TFH cells in the MG group was significantly increased (P<0.05), along with significantly decreased mRNA and protein expression levels of α7nAChR within these cells (P<0.01). Conclusion The findings suggest that there is a reduced expression of α7nAChR within thymic TFH cells in MG patients, leading to weakened immunosuppressive function which may indirectly contribute to disease onset and progression.


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