1.Level of vitamin D in children with cholestatic liver disease and its clinical features
Ziyun GUO ; Lina DU ; Xiaoxuan XIE ; Yan YANG
Journal of Clinical Hepatology 2025;41(1):99-103
ObjectiveTo investigate vitamin D level in children with cholestatic liver disease, and to provide a theoretical basis for vitamin D supplementation therapy in children with this disease. MethodsA total of 116 children with cholestatic liver disease who attended Department of Traditional Chinese Medicine, Beijing Children’s Hospital, Capital Medical University, for the first time from January 2022 to January 2024 were enrolled and divided into groups for comparison based on sex, age, vitamin D supplementation dose, course of the disease, and etiology. The data on the serum level of 25-hydroxyvitamin D (25-OH-D) and related biochemical parameters were collected to assess the correlation between vitamin D level and biochemical parameters. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups, and the Spearman rank correlation test was used for correlation analysis. ResultsAmong the 116 children, 76 (65.5%) had vitamin D deficiency or insufficiency. The children with vitamin D deficiency or insufficiency accounted for 65.7% (46/70) among boys and 65.2% (30/46) among girls, with no significant difference between boys and girls (χ2=0.003, P=0.956). The children with vitamin D deficiency or insufficiency accounted for 83.3% (25/30) among the children who had never received vitamin D supplementation, 58.7% (27/46) among the children with a daily supplementation dose of 500 IU, 64.3% (18/28) among the children with a daily supplementation dose of 700 IU, and 50.0% (6/12) among the children with a daily supplementation dose of>700 IU, and there was no significant difference between these groups (χ2=6.460, P=0.091). Comparison between the groups with different etiologies showed that the children with vitamin D deficiency or insufficiency accounted for 57.7% (15/26) in the infectious disease group, 66.7% (10/15) in the inherited metabolic disease group, 66.7% (6/9) in the drug-induced liver injury group, 100.0% (8/8) in the group with abnormal structure of the biliary system, and 63.8% (37/58) in the group with unknown etiology, and there was no significant difference between these groups (χ2=5.304, P=0.252). Comparison between the groups with different courses of the disease showed that the children with vitamin D deficiency or insufficiency accounted for 78.4% (29/37) in the<1 month group, 54.3% (25/46) in the 1 — 3 months group, 53.3% (8/15) in the 3 — 6 months group, and 77.8% (14/18) in the>6 months group, with no significant difference between these groups (χ2=7.432, P=0.059). Comparison between different age groups showed that compared with the infant group, the children group had a significantly higher proportion of children with vitamin D deficiency or insufficiency (χ2=9.504, P=0.018). The correlation analysis showed that serum aspartate aminotransferase and alanine aminotransferase had no significant correlation with 25-OH-D (P>0.05); serum alkaline phosphatase (ALP) (r=-0.286, P=0.002), gamma-glutamyl transpeptidase (GGT) (r=-0.248, P=0.007), total bilirubin (TBil) (r=-0.353, P<0.001), direct bilirubin (DBil) (r=-0.299, P=0.001), and total bile acid (r=-0.236, P=0.011) were negatively correlated with 25-OH-D, while serum calcium (r=0.263, P=0.004) and phosphorus (r=0.385, P<0.001) were positively correlated with 25-OH-D. ConclusionMost children with cholestatic liver disease have vitamin D deficiency or insufficiency, and the increase in serum ALP, GGT, TBil, DBil or total bile acid and the reduction in calcium or phosphorus may suggest vitamin D deficiency or insufficiency.
2.LIU Fengbin's Experience in Treating Autoimmune Liver Disease with the Method of Nourishing Yin and Removing Stasis Based on Stage
Xiling YANG ; Qiuhong YONG ; Chaoyuan HUANG ; Lina ZHAO ; Yiyuan ZHENG ; Chong PENG ; Kunhai ZHUANG ;
Journal of Traditional Chinese Medicine 2025;66(7):674-679
This paper summarizes Professor LIU Fengbin's clinical experience in treating autoimmune liver disease (AILD) using the method of nourishing yin and removing stasis based on stage differentiation. He believes that the pathogenesis of AILD generally involves both deficiency in essence and excess in manifestation, with essence deficiency often presenting as liver and kidney yin deficiency, which may progress to spleen deficiency and yang deficiency over time. The excess manifestation commonly includes qi stagnation, blood stasis, damp-heat, and phlegm toxicity. Clinically, he advocates for the treatment principle of nourishing yin and removing stasis. On the foundation of nourishing liver and kidney yin, different pathological factors causing stasis are eliminated according to their nature. Treatment is also tailored to different stages of AILD. In the early and asymptomatic stages, liver qi stagnation and spleen deficiency are prominent, warranting a therapeutic approach of soothing the liver, regulating qi and strengthening the spleen. The modified Chaishao Qizhi Decoction (柴芍气滞汤) is used. During the symptomatic stage, pathogenic factors become more pronounced, often accompanied by a significant deficiency of vital qi, with damp-heat, water retention, and phlegm toxicity as key pathological features. The treatment should focus on strengthening the spleen and dispelling dampness, using modified Sijunzi Decoction (四君子汤) combined with Yinchen Wuling Powder (茵陈五苓散). In the liver function decompensation stage, vital qi is severely deficient while pathogenic factors persist, with damp-heat, phlegm toxicity, and blood stasis obstructing the liver collaterals. Treatment should focus on nourishing blood, softening the liver, strengthening the spleen, and resolving stasis, using the modified Ruangan Yangxue Decoction (软肝养血汤). Throughout the treatment process, emphasis is placed on tonifying the liver and kidneys while protecting yin fluids.
3.Impact of childhood maltreatment and sleep quality on depressive symptoms among middle school students
Chinese Journal of School Health 2025;46(1):73-77
Objective:
To explore the impact of sleep quality, experience of childhood maltreatment, and their interaction on depressive symptoms among middle school students, so as to provide the reference for early intervention of depressive symptoms among middle school students.
Methods:
From September to December 2023, a questionnaire survey was conducted among 1 231 students from two secondary schools in Harbin, Heilongjiang Province by a convenient sampling method. The survey included general demographic information, Childhood Trauma Questionnaire Short Form, Pittsburgh Sleep Quality Index and Short Version of Center for Epidemiological Studies Depression Scale. The Chi square test was used to analyze the differences in depressive symptom, sleep quality and childhood maltreatment among students with different demographic characteristics. Correlation analysis was conducted using Logistic regression, and interaction analysis was performed by both additive and multiplicative interaction models.
Results:
The detection rate of depressive symptoms among middle school students was 22.7%, and the rate for high school students (35.2%) was significantly higher than that for middle school students (17.0%) ( χ 2=50.35, P <0.01). The detection rates of depressive symptoms among middle school students with a history of childhood maltreatment and poor sleep quality were 45.8% and 44.0%, respectively. Multivariate Logistic regression analysis showed that compared to students without a history of childhood maltreatment, students with a history of childhood maltreatment had a higher risk of depressive symptoms ( OR =4.49,95% CI =3.31~ 6.09 , P <0.01);students with poor sleep quality had a higher risk of depressive symptoms than students with good sleep quality ( OR = 5.99,95% CI =4.37~8.22, P <0.01).The interaction results showed that the presence of childhood maltreatment and poor sleep quality had an additive interaction on the occurrence of depression in middle school students. Compared with students without childhood maltreatment and having good sleep quality, students with childhood maltreatment and poor sleep quality had a 22.49 times higher risk of developing depression ( OR =22.49,95% CI =14.22~35.59, P <0.01).
Conclusion
Depressive symptoms among middle school students are associated with childhood maltreatment and poor sleep quality, and there is an additive interaction between childhood maltreatment and poor sleep quality on the impact of depressive symptoms.
4.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
5.Role of apical sodium-dependent bile acid transporter in hepatobiliary diseases
Xiaoxuan XIE ; Lina DU ; Ziyun GUO ; Yan YANG
Journal of Clinical Hepatology 2024;40(1):199-203
Apical sodium-dependent bile acid transporter (ASBT) is a key transporter responsible for intestinal reabsorption of bile acid and plays an important role in maintaining bile acid and cholesterol homeostasis, and its expression is regulated by various factors including transcription factors, nuclear receptors, and intestinal microflora. The abnormal expression and function of ASBT can lead to disorders in the metabolism of bile acid and cholesterol, causing a variety of hepatobiliary diseases. At present, ASBT has attracted wide attention as a therapeutic target. This article elaborates on the biological characteristics and expression regulation mechanism of ASBT and reviews the role of ASBT in hepatobiliary diseases, in order to provide a new direction for the treatment of related diseases.
6.Remyelination Regulated by microRNAs in Neurodegenerative Diseases: A Review
Manjing LI ; Qi LI ; Qingsen RAN ; Kunni CHEN ; Xinke DU ; Lina YANG ; Chunxia NIE ; Qing YANG ; Yujie LI ; Ying CHEN ; Yajie WANG ; Xiaogang WENG ; Weiyan CAI ; Xiaoxin ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):223-231
Demyelination of the central nervous system often occurs in neurodegenerative diseases, such as multiple sclerosis (MS). The myelin sheath, a layer of myelin membrane wrapping the axon, plays a role in the rapid conduction and metabolic coupling of impulses for neurons. The exposure of the axon will lead to axonal degeneratio, and further neuronal degeneration, which is the main cause of dysfunction and even disability in patients with demyelinating neurodegenerative diseases. In addition to the demyelination of mature myelin sheath, remyelination disorder is also one of the major reasons leading to the development of the diseases. The myelin sheath is composed of oligodendrocytes (OLs) derived from oligodendrocyte progenitor cells (OPCs) which are differentiated from neural stem cells (NSCs). The process of myelin regeneration, i.e., remyelination, is the differentiation of NSCs into OLs. Recent studies have shown that this process is regulated by a variety of genes. MicroRNAs, as important regulators of neurodegenerative diseases, form a complex regulatory network in the process of myelin regeneration. This review summarizes the main molecular pathways of myelin regeneration and microRNAs involved in this process and classifies the mechanisms and targets. This review is expected to provide a theoretical reference for the future research on the treatment of demyelinating diseases by targeting the regulation of microRNAs.
7.The molecular epidemiological characteristics of the gastroenteritis outbreaks caused by norovirusin Hainan Province,2020-2022
Yunting ZENG ; Haiyun CHEN ; Dandan LI ; Yanhui YANG ; Miao JIN ; Qiong HUANG ; Lei CUI ; Zhengfan PAN ; Lina REN ; Xiaojie YU
Acta Universitatis Medicinalis Anhui 2024;59(2):336-343
Objective To understand the molecular epidemiological characteristics of Norovirus outbreaks and the genome evolution of Norovirus epidemic strains in Hainan Province from 2020 to 2022.Methods The information and samples have been collected from the norovirus outbreaks from 2020 to 2022.Norovirus was detected by using the real-time PCR in these samples,then the detected sequences were amplified the analyzed.The Norovirus se-quences of 8 strains had been amplified and analyzed.Results From 2020 to 2022,39 gastroenteritis outbreaks were reported,and 25 outbreaks caused by Norovirus which mainly occurred in childcare institutions and schools(20/25,80%).The Norovirus outbreaks were mainly concentrated in counties around Haikou(northeast),which including Ding'an(5 cases),Wenchang(4 cases),Chengmai(4 cases),and Lingao(3 cases);following by western regions which included Baisha(2 cases),Ledong(2 cases),and Dongfang(3 cases).1 case was in Wanning in the southeast.Among individuals aged 2-17,the positive proportion of Norovirus in males was higher than that in females.Among individuals aged over 55,the proportion of Norovirus positive in females was higher than that in males.The gender of positive samples among individuals aged 18-40 was related to their profession.According to RT-PCR typing and sequencing,GⅡ group Norovirus were classified in13 outbreaks.There were 4 genotypes detected.GⅡ.2[P1 6]was the main epidemic strain with 60%(9/13),and the other three genotypes were GⅡ.4 Sydney[P31](15.4%,2/13)GⅡ.4 Sydney[P16](7.7%,1/13)and GⅡ.3[P12](7.7%,1/13).Further genic analysis of 8 Norovirus strains showed that all of them were still in the same branch as the previ-ous strain,and all exhibited a certain amount of amino acid variation.Conclusion Norovirus is the main pathogen of gastroenteritis outbreaks in Hainan province,and the main epidemic strain is GⅡ.2[P16].It is necessary to continue to strengthen the monitoring that provides scientific evidence for the prevention and control of norovirus out-breaks in Hainan region.
8.The differential diagnostic value of left ventricular segmental myocardial strain in cardiac amyloidosis and non-obstructive hypertrophic cardiomyopathy
Yang LIU ; Fangmin MENG ; Nianwei ZHOU ; Lina LUAN ; Cuizhen PAN ; Xianhong SHU
Chinese Journal of Clinical Medicine 2024;31(6):889-897
Objective To explore the difference of the left ventricular global longitudinal strain (GLS) and the segment strains between cardiac amyloidosis (CA) and non-obstructive hypertrophic cardiomyopathy (HCM). Methods Twenty patients with immunoglobulin light chain cardiac amyloidosis (AL-CA) as CA group and 20 patients with non-obstructive HCM selected as controls (HCM group) were enrolled from January 2016 to April 2022 in Zhongshan Hospital, Fudan University. All patients underwent two-dimensional speckle tracking echocardiography (2D-STE). The left ventricle GLS and the segmental strains were calculated. The values of these strains to distinguish AL-CA from HCM were analyzed by receiver operating characteristic (ROC) curves and logistic regression analysis. Results In the CA group, the GLS parameters (3P, 4Ch, 2Ch, 3Ch), as well as the left ventricle segmental strains (MID-ANT/LAT, MID-INF/SEPT, BASAL-ANT/LAT, BASAL-INF/SEPT, MID-ANT, MID-INF, BASAL-ANT, BASAL-INF, MID-INF/LAT, BASAL-ANT/SEPT, and BASAL-INF/LAT) were all lower than those in the HCM group (P<0.01). ROC results showed that GLS(4Ch), GLS(2Ch), GLS(3Ch), GLS(3P), BASAL-ANT/LAT, BASAL-INF/SEPT, BASAL-ANT, BASAL-INF, BASAL-ANT/SEPT and BASAL-INF/LAT had good efficacy in distinguishing AL-CA from HCM. Logistic regression analysis showed that BASAL-ANT/LAT was an independent factor in distinguishing AL-CA from HCM (P<0.01). The consistency of test results was good. Conclusions The left ventricular segmental myocardial strains show good efficacy in distinguishing AL-CA from HCM, and BASAL-ANT/LAT has highest application value.
9.Research progress in the treatment of maxillary transverse deficiency with combined orthodontic-orthognathic approach
Yang WANG ; Xiaozhou MA ; Lina ZHANG ; Shujun DONG
Chinese Journal of Stomatology 2024;59(7):726-731
In combined orthodontic-orthognathic treatment, the maxillary palatine suture is closed in most patients with insufficient maxillary width, and bony expansion of the maxilla cannot be achieved by dental expansion or rapid palatal expansion (RPE) which causes buccal inclination of the maxillary posterior teeth leading to unstable results. Therefore, segmental LeFort Ⅰ osteotomy and surgically assisted RPE are often used in clinical practice. In recent years, with the application of implant anchorage technology, implant anchorage assisted RPE has been gradually applied in orthognathic treatment. This article reviewed the indications, contraindications, complications, efficacy and long-term stability in different treatment approaches including segmental LeFort Ⅰ osteotomy, surgically assisted RPE and implant-supported maxillary skeletal expansion.
10.Clinical analysis of 13 cases of pediatric membranous duodenal stenosis treated with endoscopic radial incision (with video)
Xiaoxia REN ; Hongbin YANG ; Kuku GE ; Hanhua ZHANG ; Huanyu LIU ; Pan WANG ; Lina SUN ; Pinghong ZHOU ; Ying FANG
Chinese Journal of Digestive Endoscopy 2024;41(1):58-64
Objective:To explore the efficacy and safety of endoscopic radial incision (ERI) for congenital membranous duodenal stenosis (MDS).Methods:The clinical data of 13 children with MDS receiving ERI in the Department of Gastroenterology of Xi'an Children's Hospital from May 2017 to December 2021 were reviewed and analyzed. The perioperative management, surgical procedures, postoperative complications and follow-up were summarized.Results:There were 5 boys and 8 girls with a median disease duration of 8 (2-20) months, and the median age of diagnosis was 13 months (5-30 months). The septum of 10 cases (10/13) was located in the descending part of the duodenum, and that of 3 cases (3/13) in the horizontal part. The papilla of 1 case (1/13) opened on the septum, that of 3 cases (3/13) within 5 cm of the mouth side of the septum, and that of 9 cases (9/13) within 5 cm of the anal side of the septum. The median diameter of the septal aperture was 3 mm (2-6 mm). All 13 children successfully underwent ERI with a median operation time of 20 min (15-32 min). The average surgical incision was 3 strokes (2-4 strokes), and the endoscope with outer diameter 9.9 mm could pass stenosis after ERI. The median incision diameter was 10 mm (10-12 mm). All patients achieved relief of clinical symptoms after ERI. One patient (1/13) suffered from the postoperative delayed bleeding, which was stopped by endoscopic titanium clamping. No intestinal perforation or duodenal papilla injury occurred, and median postoperative hospital stay was 6 days (5-10 days). The upper gastrointestinal angiogram and gastroscopy were repeated 3 months after ERI, and the median diameter of stenosis was 12 mm (10-15 mm), which was significantly dilated compared with before. The mean body weight increase at 1 month after ERI was 1.20 kg (0.50-1.80 kg), and the mean body weight increase at 3 months was 3.50 kg (2.50-4.00 kg), which reached the normal body weight of the same age.Conclusion:ERI is safe and effective for the treatment of MDS in children, and shows good clinical application and promotion value.


Result Analysis
Print
Save
E-mail