1.Research progress on occupational health of interventional radiation workers
Junfang MA ; Fang ZHANG ; Wei CUI
Chinese Journal of Radiological Health 2025;34(2):297-302
With the rapid development of interventional radiology technology, the occupational health risk of interventional radiation workers has attracted increasing attention. This paper reviews recent studies on hematological changes, DNA damage and molecular-level changes, cancer, eye lens, and other health impairments among interventional radiation workers. The aim is to provide an overview of the current research progress as well as a scientific basis for the implementation of targeted protective measures to improve the occupational health level of interventional radiology workers.
2.Clinical analysis of patients with cardiopulmonary resuscitation in emergency department and establishment of prediction model of restoration of spontaneous circulation in hospital
Junfang LIU ; Xiaoxia DUAN ; Zhiqin MA ; Haoxue FU ; Bo WU ; Qi WANG
Chinese Critical Care Medicine 2024;36(1):40-43
Objective:To screen the independent influencing factors of restoration of spontaneous circulation (ROSC) in patients after cardiopulmonary resuscitation (CPR) and establish a predictive model, and explore its clinical value.Methods:A retrospective case control study was conducted. The clinical data of cardiac arrest patients admitted to the emergency department of Tangdu Hospital of Air Force Military Medical University and received CPR from January to July 2023 were analyzed, including general information, blood biochemical indicators, main cause of cardiac arrest, whether it was defibrillation rhythm, duration from admission to CPR, and whether ROSC was achieved. The clinical data between the patients whether achieved ROSC or not were compared. The binary multivariate Logistic regression analysis was used to screen the independent influencing factors of ROSC in in-hospital CPR patients. According to the above influencing factors, the ROSC prediction model was established, and the receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of the model for ROSC.Results:A total of 235 patients who received CPR in the emergency department were enrolled, including 153 cases (65.11%) of in-hospital CPR and 82 cases (34.89%) of out-of-hospital CPR. The ROSC ratio was 30.21% (71/235). Among all patients, the majority were aged 61-80 years [40.43% (95/235)], and cardiogenic disease was the main cause of cardiac arrest [32.77% (77/235)]. Among 153 patients with in-hospital CPR, 89 were non-ROSC and 64 were ROSC with ROSC rate of 41.83%. Compared with the non-ROSC group, the patients in the ROSC group had lower blood lactic acid (Lac), N-terminal pro-brain natriuretic peptide (NT-proBNP), Lac/albumin (Alb) ratio (LAR), and ratio of non-defibrillation rhythm [Lac (mmol/L): 5.50 (2.33, 9.65) vs. 7.10 (3.50, 13.35), NT-proBNP (μg/L): 0.87 (0.20, 8.68) vs. 3.00 (0.58, 20.17), LAR: 0.14 (0.07, 0.29) vs. 0.19 (0.10, 0.43), non-defibrillation rhythm ratio: 68.75% (44/64) vs. 93.26% (83/89)], higher actual base excess (ABE) and Alb [ABE (mmol/L): -3.95 (-12.75, 0.23) vs. -7.50 (-13.50, -3.35), Alb (g/L): 38.13±7.03 vs. 34.09±7.81], and shorter duration from admission to CPR [hours: 3.25 (1.00, 14.00) vs. 8.00 (2.00, 27.50)], the differences were statistically significant (all P < 0.05). Binary multivariate Logistic regression analysis showed that LAR [odds ratio ( OR) = 0.037, 95% confidence interval (95% CI) was 0.005-0.287], non-defibrillation rhythm ( OR = 0.145, 95% CI was 0.049-0.426), and duration from admission to CPR ( OR = 0.984, 95% CI was 0.972-0.997) were independent influencing factors for ROSC in hospitalized CPR patients (all P < 0.05). Based on the above influencing factors, a ROSC prediction model was constructed through regression analysis results. The ROC curve analysis showed that the area under the ROC curve (AUC) for predicting ROSC in in-hospital CPR patients was 0.757 (95% CI was 0.680-0.834), Yoden index was 0.429, sensitivity was 76.6%, and specificity was 66.3%. Conclusions:LAR, non-defibrillation rhythm and duration from admission to CPR were independent influencing factors for ROSC in patients with in-hospital CPR. The ROSC prediction model established based on the above influencing factors has a good predictive value for ROSC of CPR patients in hospital, and can guide clinicians to evaluate the prognosis of patients through relevant indicators as early as possible.
3.Early warning value and model construction of laboratory indexes of patients with hemorrhagic fever with renal syndrome to severe patients
Xiaoxia DUAN ; Junfang LIU ; Qinqin YANG ; Jie LIU ; Bo WU ; Zhiqin MA ; Haoxue FU ; Qi WANG
Chinese Journal of Emergency Medicine 2024;33(7):1006-1010
Objective:To analyze the early warning value of laboratory examination on admission of patients with hemorrhagic fever with renal syndrome to critically ill patients.Meetods:In this study, a retrospective case-control study was used to analyze the clinical data and laboratory examination results of patients with hemorrhagic fever with renal syndrome admitted to the emergency department of Tangdu Hospital of Air Force Medical University from January 2021 to January 2022. According to the patient's laboratory indexes and clinical symptoms, the patients were divided into mild, moderate, severe and critical groups. The general data of the two groups were compared, and the independent risk factors of critically ill patients were screened by multi-factor logistic regression analysis, the predictive model of severe HFRS patients was constructed, and the ROC curve was drawn. .Results:Of the 164 patients with HFRS, 50 were in the severe group and 114 in the mild group. The serum levels of WBC, AST, ALT, Cr, BUN, DD and PCT in the severe group were higher than those in the mild group, while the levels of PLT, ALB and PTA in the severe group were lower than those in the mild group. Multiple logistic regression analysis showed that WBC, PLT and PCT were independent influencing factors for the progression of critically ill patients. The predictive model of severe HFRS was established as follows: logit (P) = -0.321 + 0.040 WBC (×10 9/L) -0.045 PLT (×10 9/L) + 0.086 PCT(ng/mL). The early warning ef?cacy of WBC, PLT, And PCT for severe HFRS was further analyzed. The area under the ROC curve (area under curve, AUC) was 0.779, 0.842, 0.862, and the optimal threshold was 10.435×109/L, 41.5 ×109/Land 2.97 ng/mL, respectively. The AUC of joint detection is 0.900, the sensitivity is 88.0%, and the speci?city is 82.5%, which is better than that of a single laboratory. . Conclusions:HFRS laboratory indexes have certain clinical signi?cance for the identi?cation of critically ill patients, in which serum WBC, PLT and PCT indexes are the risk factors of severe HFRS, which provides a theoretical basis for clinical diagnosis, treatment and prognosis of severe HFRS patients.
4.Clinical characteristics and genetic analysis of a case of autosomal dominant mental retardation-42 caused by GNB1 gene mutation
Daoqi MEI ; Yuan WANG ; Junfang SUO ; Miao LIU ; Ang MA ; Yiran ZHAO ; Qiuping HE
Chinese Journal of Neurology 2024;57(5):473-480
Objective:To summarize the clinical phenotype and genetic characteristics of a case of autosomal dominant mental retardation-42 (MRD42) caused by GNB1 gene mutation. Methods:The clinical and genetic data of a case of MRD42 caused by a GNB1 gene missense mutation diagnosed in the Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University in March 2023 were retrospectively analyzed. The child was followed-up, the child′s data were summarized, and related literature was reviewed. Results:The patient is a 6-month-old female infant, who was admitted to hospital because of "developmental delay for 3 months, intermittent convulsions for 1 month". The clinical manifestations included generalized tonic-clonic seizures, focal seizures, intellectual disability, delayed language and motor development. Long-term video electroencephalogram showed slightly slower background activity, bilateral occipital spike and wave discharges, multispike and wave complexes during sleep. Three focal onset seizures were captured. Cranial magnetic resonance imaging suggested that the subarachnoid space of the bilateral frontotemporal areas was slightly wide. Chromosome karyotype and copy number variation analysis showed no abnormality. The results of whole exon sequencing showed a de novo heterozygous missense mutation in the GNB1 gene [NM_002074:c.155(exon5)G>A;p.Arg52Gln], which had not been reported. The seizure was effectively controlled by function rehabilitation training and anti-epileptic drug therapy. Conclusions:MRD42 is a rare autosomal dominant disorder caused by mutation in the GNB1 gene. The clinical manifestations include infantile-onset seizures, mental retardation, speech and motor development delay, etc. The de novo heterozygous missense mutation in the GNB1 gene c.155G>A(p.Arg52Gln) is the genetic cause of the proband.
5.Effect of ultra-early nursing intervention on postoperative cognitive impairment in patients with cerebral hemorrhage
Junfang MA ; Yanyan MENG ; Haihong LIU ; Hua DENG ; Xiaohong CHEN ; Yixuan ZHAI
Chinese Journal of Modern Nursing 2022;28(21):2921-2925
Objective:To explore the effect of ultra-early nursing intervention on postoperative cognitive behavior and prognosis of patients with cerebral hemorrhage.Methods:Using the convenient sampling method, a total of 82 patients with cerebral hemorrhage who were admitted to the First Affiliated Hospital of Zhengzhou University from March 2019 to January 2021 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 41 cases in each group. Both groups received surgical treatment. The control group received routine nursing, while the observation group received ultra-early nursing intervention on the basis of routine nursing when vital signs were stable 48 hours after operation. The differences in neurological function (National Institutes of Health Stroke Scale, NIHSS) , cognitive function (Loewenstein Occupational Therapy Cognitive Assessment, LOTCA) and activity of daily living scores were compared between the two groups at 48 hours and 1 month after operation.Results:The NIHSS score at 1 month after surgery in both groups was lower than that at 48 hours after surgery and the NIHSS score at 1 month after surgery in observation group was lower than that in control group ( P<0.05) . The LOTCA dimension scores of the two groups at 1 month after operation were higher than those at 48 hours after operation and the LOTCA dimension scores of the observation group at 1 month after operation were higher than those of the control group ( P<0.05) . The activity of daily living scores of the two groups at 1 month after operation were higher than those at 48 hours after operation and the activity of daily living score of the observation group at 1 month after operation was higher than that of the control group , the differences were statistically significant ( P<0.05) . Conclusions:Ultra-early nursing intervention can effectively promote the recovery of postoperative neurological function and cognitive function in patients with cerebral hemorrhage and improve the activity of daily living of patients.
6.Identification of TCF3-ZNF384 fusion by transcriptome sequencing in B cell acute lymphoblastic leukemia and its laboratory and clinical characteristics.
Qisheng WU ; Fang WANG ; Junfang YANG ; Xue CHEN ; Xiaoli MA ; Panxiang CAO ; Yang ZHANG ; Daijing NIE ; Jiaqi CHEN ; Xiaosu ZHOU ; Jiancheng FANG ; Mingyue LIU ; Min ZHANG ; Ping WU ; Tong WANG ; Hongxing LIU
Chinese Journal of Medical Genetics 2021;38(4):351-354
OBJECTIVE:
To detect fusion gene with pathological significance in a patient with refractory and relapsed acute B cell lymphoblastic leukemia (B-ALL) and to explore its laboratory and clinical characteristics.
METHODS:
Transcriptome sequencing was used to detect potential fusion transcripts. Other laboratory results and clinical data of the patient were also analyzed.
RESULTS:
The patient was found to harbor TCF3 exon 17-ZNF384 exon 7 in-frame fusion transcript. The minimal residual disease (MRD) has remained positive after multiple chemotherapy protocols including CD19-, CD22- targeted chimeric antigen receptor T cells immunotherapy. The patient eventually achieved complete remission and sustained MRD negativity after allogeneic hemopoietic stem cell transplantation (allo-HSCT).
CONCLUSION
Transcriptome sequencing can effectively detect potential fusion genes with clinical significance in leukemia. TCF3-ZNF384 positive B-ALL has unique laboratory and clinical characteristics, may not well respond to chemotherapy and immunotherapy, and is more likely to relapse. Timely allo-HSCT treatment may help such patients to achieve long-term disease-free survival. TCF3-ZNF384 positive B-ALL is not uncommon in pediatric patients but has not been effectively identified.
B-Lymphocytes
;
Basic Helix-Loop-Helix Transcription Factors/genetics*
;
Child
;
Hematopoietic Stem Cell Transplantation
;
Humans
;
Laboratories
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy*
;
Trans-Activators/genetics*
;
Transcriptome
7.Correlation between nutritional status and mental sub-health among Chinese adolescents
MA Yuanyuan,WU Huipan, YIN Xiaojian,CHEN Jun,CAO Junfang
Chinese Journal of School Health 2021;42(1):28-31
Objective:
To explore the correlation between different nutritional status and mental sub-health of Chinese adolescents, and provide reference for improving the physical and mental health of Chinese adolescents.
Methods:
A total of 16 545 adolescents (13-22 years old) were selected by random overall sampling method in six major administrative regions in China.The psychological part of the Multidimensional Sub-health Questionnaire of Adolescents (MSQA) was used for mental sub-health test.Chi-square test and Logistic regression analysis were used to analyze and compare the relationship between different nutritional status and mental sub-health.
Results:
The overall detection rate of mental sub-health status in the adolescents with normal BMI group was 18.5%, while those in the lean, overweight and obese groups were 22.3%, 38.7%, and 44.7%, respectively, which were significantly different from those in the normal BMI group(χ2=478.68,P<0.05).After adjusted for gender and age, the Logistic regression model showed that compared with those with normal BMI, those who were thin (OR=1.19, 95%CI=1.09-1.30), overweight (OR=2.76, 95%CI=2.47-3.09) and obese(OR=3.43, 95%CI=2.83-4.15) had increased risk of mental sub-health.
Conclusion
The nutritional status of Chinese adolescents in significantly related to mental sub-heatlh,hose who are underweight, overweight and obese have significantly higher risks of mental sub-health than those who are normal.Improvement of nutritional status of adolescents is beneficial to healthy adolescent development.
8.Effect of body mass index on the assisted reproductive outcome of frozen-thawed embryo transfer in patients with polycystic ovary syndrome
Yinfeng ZHANG ; Haining LUO ; Rui SHI ; Yaojia ZHANG ; Xiaomei TAI ; Xinyu HU ; Junfang MA ; Xinyan WANG ; Yunshan ZHANG ; Pengpeng QU
Chinese Journal of Obstetrics and Gynecology 2021;56(4):257-263
Objective:To investigate the effect of body mass index (BMI) on clinical pregnancy and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) during frozen-thawed embryo transfer.Methods:A total of 650 patients with PCOS who received routine in vitro fertilization or intracytoplasmic sperm injection treatment for frozen-thawed embryo transfer from June 2014 to June 2019 in Tianjin Central Hospital of Gynecology Obstetrics were retrospectively analyzed. According to BMI, PCOS patients were divided into group A (18.5≤BMI<23 kg/m 2, n=253), group B (23≤BMI<25 kg/m 2, n=167), and group C (BMI≥25 kg/m 2, n=230). The general information, clinical pregnancy outcomes, pregnancy complications, the incidence of macrosomia and low-birth-weight infants were compared in the three groups, and the influencing factors of neonatal birth weight were analyzed. Results:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate all showed downward trend with the increase of BMI, but the differences were not statistically significant (all P>0.05). The live birth rate in group C [47.0% (108/230)] was significantly lower than those in groups A and B, with statistical significance ( χ2 =7.43, P=0.024). The late miscarriage rate was higher in group C [9.4% (13/139)] than in groups A and B ( χ2 =7.66, P=0.022). The birth rates of macrosomia in groups B [22.2% (16/72)] and group C [21.1% (16/76)] were significantly higher than that in group A, and the difference was statistically significant ( χ2 =14.15, P=0.001). There was no statistically significant difference in the incidence of gestational diabetes between the three groups ( χ2 =3.81, P=0.149). The incidence of hypertension disorders complicating pregnancy increased with the increase of BMI, and the difference was not statistically significant ( P>0.05). Regression analysis showed that macrosomia was significantly associated with maternal pre-pregnancy BMI and gestational weeks, and the risk of macrosomia increased by 15% (95% CI: 3%-28%) for every increase in maternal BMI. Conclusions:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of PCOS patients in frozen-thawed embryo transfer cycles show downward trend with the increase of BMI. Obese patients with PCOS have a significant increase in late miscarriage rate and a significant decrease in live birth rate. The incidence of hypertension disorders complicating pregnancy in PCOS patients in the obese group has an increasing trend, and the birth rate of macrosomia has increased significantly. Therefore, it is recommended that obese women with PCOS lose weight scientifically before pregnancy to improve pregnancy and neonatal outcomes.
9.Multimodal imaging analysis of congenital optic disc pit
Xinrui QIAO ; Nalei ZHOU ; Jingxue MA ; Junfang SHI ; Li DAI ; Ying LIU ; Yihang LI ; Jinxin SHI ; Jianbin AN
Chinese Journal of Experimental Ophthalmology 2021;39(11):989-996
Objective:To analyze the characteristics of eyes with congenital optic disc pits (ODPs) through multimodal imaging.Methods:A cross-sectional study was conducted.Thirty-eight patients (38 eyes) diagnosed with congenital ODPs in the Second Hospital of Hebei Medical University from January 2009 to January 2020 were enrolled.A comprehensive summary analysis of the imaging results including fundus photography, spectral domain-optical coherence tomography (SD-OCT), infrared imaging, fundus autofluorescence (FAF), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) was performed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The Second Hospital of Hebei Medical University (No.2021-P011). Written informed consent was obtained from each subject prior to any medical examination.Results:Among the 38 eyes, there were 32 eyes with ODPs located in or below the temporal side of optic disc, 4 eyes with ODPs located above the temporal side of optic disc, and 2 eyes with ODPs located at the center of optic disc, which were round or quasi-circular pale depression, and dark red eminences with clear or unclear boundaries between milk spots were found in 29 eyes with optical-disc macular degeneration (ODP-M) by fundus photography.SD-OCT examination showed that the structure of lamina cribrosa in the lesion area in all ODPs patients was incomplete, which presented a dark area with no tissue reflection, and the fissure led to the deep optic nerve.Fluid was found in the outer nuclear layer in all ODP-M patients, and there were 27 eyes with fluid in the inner nuclear layer, 13 eyes in the ganglion cell layer, and 4 eyes under the inner limiting membrane.Among the 29 eyes with ODP-M, there were 21 eyes with retinoschisis in outer layer, 27 eyes with neuroepithelial detachment.In the 27 eyes with neuroepithelial detachment, spot-like high reflection and reduced or disappeared ellipsoid band reflectance were seen above the neuroepithelium in 18 eyes.In infrared images, there were circular or quasi-circular low-reflection areas in the temporal side of the optic disc, and the lesion of ODP-M eyes presented low-reflection areas.FAF examination showed that in 27 eyes with ODP-M, there was a hypofluorescent region at the posterior pole consistent with the lesion range, among which, there was a granular or sheet-like hyperfluorescence at the center of the hypofluorescent region in 18 eyes.FFA showed that the optic disc depression in the arterial phase of patients was in a localized hypofluorescence state.During the venous phase, fluorescein dye extravasation along the temporal side of the optic disc could be found.A strong fluorescent arc with unclear boundaries at the temporal edge of the optic disc was formed in the late stage of angiography.Among the 29 eyes with ODP-M, the area of the macular lesion showed hyperfluorescence during the late stage of angiography in 27 eyes with neuroepithelial detachment, and no extension of dye toward the macula was found.ICGA showed that the optic disc depression of ODPs patients presented a localized hypofluorescence, and the lesion showed hyperfluorescence in 27 of the 29 ODP-M eyes with neuroepithelial detachment.Conclusions:Multimodal imaging can be helpful to realize the early diagnosis, etiology analysis of ODPs and make treatment plan.
10.Analysis of anxiety and depression in patients undergoing radiotherapy during COVID-19 epidemic period
Jiabin MA ; Hongnan ZHEN ; Hui GUAN ; Zhikai LIU ; Jing SHEN ; Wenhui WANG ; Zheng MIAO ; Junfang YAN ; Qingyu MENG ; Ke HU ; Fuquan ZHANG
Chinese Journal of Radiation Oncology 2020;29(8):615-618
Objective:To investigate the anxiety and depression of cancer patients undergoing radiotherapy during the epidemic of COVID-19.Methods:By using self-rating anxiety scale and self-rating depression scale, a cross-sectional survey was conducted during the COVID-19 epidemic period.Results:During the COVID-19 epidemic period, the incidence of anxiety and depression in cancer patients undergoing radiotherapy was 15.8% and 27.7% respectively, of which 12.9% suffered from both anxiety and depression. The average scores of anxiety and depression were 49.4(25/76) and 46.4(25/83), respectively, which were higher than those of the domestic norm. Age is a contributing factor for anxiety, and patients living in urban are more likely to experience depression.Conclusions:The prevalence of anxiety and depression of cancer patients undergoing radiotherapy are higher than healthy people during the COVID-19 outbreak. We should pay more attention to the psychological states of the cancer patients.


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