1.The chain mediating role of social support and resilience in the relationship between symptom burden and psychological distress among lung cancer patients in the diagnostic phase
Congyu YIN ; Jina LI ; Man YE ; Yingxia LI ; Wei LI ; Lu KANG ; Yayi ZHANG ; Lingzhi HUANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(06):798-804
Objective To investigate the current status of symptom burden and psychological distress among lung cancer patients in the diagnostic phase, and to explore the chain mediating role of social support and resilience between symptom burden and psychological distress. Methods The patients with lung cancer in the diagnostic phase who were treated in the Department of Thoracic Surgery of the Second Xiangya Hospital of Central South University from October 2022 to June 2023 were investigated by a general information questionnaire using the MD Anderson Symptom Inventory, the Social Support Rating Scale, the Connor-Davidson Resilience Scale, and the Distress Thermometer. The chain mediating role of social support and resilience between symptom burden and psychological distress was analyzed. Results A total of 413 lung cancer patients were enrolled, including 173 males and 240 females, aged (54.69±10.82) years. The detection rate of psychological distress among lung cancer patients in the diagnostic phase was 48.18%, and the average score was (3.84±2.50) points. Psychological distress was positively correlated with symptom burden (P<0.01), and negatively correlated with social support and resilience (P<0.01). The mediating effect of resilience between symptom burden and psychological distress was significant. The chain mediating effect of social support and resilience between symptom burden and psychological distress was also significant. Conclusion Lung cancer patients in the diagnostic phase have a high detection rate of psychological distress. Symptom burden can directly impact psychological distress, and can affect psychological distress through the indirect path of resilience as well as the chain mediating path between social support and resilience among lung cancer patients in the diagnostic phase.
2.Levels of serum PRDX1 and PTEN and their relationship with liver function and disease activity in patients with autoimmune liver disease
Qing LI ; Luyan ZHOU ; Zhi TAN ; Lingzhi LIU
International Journal of Laboratory Medicine 2024;45(14):1682-1686
Objective To explore the relationship between the levels of peroxidoredoxin(PRDX)1 and chromosome 10 deletion phosphatase-tensin homologous gene(PTEN)and liver function and disease activity in patients with autoimmune liver disease.Methods A total of 83 patients with autoimmune liver disease ad-mitted to the hospital from January 2021 to December 2022 were selected as the study objects.According to the disease activity at admission,they were divided into active group(37 cases)and remission group(46 ca-ses).Clinical data and serum PRDX1 and PTEN levels of the two groups were analyzed.At the same time,Child-Pugh classification of liver function was performed,and the patients were grouped.A total of 100 health-y volunteers who underwent physical examination during the same period were selected as the control group.Multivariate Logistic regression was used to analyze the influencing factors of disease activity in patients with autoimmune liver disease,and the evaluation value of serum PRDX1 and PTEN levels on disease activity in pa-tients with autoimmune liver disease after treatment was analyzed by receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Compared with the grade A group,there were no significant differences in serum PRDX1 and PTEN levels in the grade B group(P>0.05),while serum PRDX1 level was increased and PTEN level was decreased in the grade C group(P<0.05).Compared with the grade B group,the serum PRDX1 level was increased and PTEN level was decreased in the grade C group(P<0.05).Com-pared with the control group,there were no significant differences in serum PRDX1 and PTEN levels in the re-mission group(P>0.05),while the serum PRDX1 level was increased and PTEN level was decreased in the active group(P<0.05).Compared with the remission group,the level of serum PRDX1 was increased and the level of PTEN was decreased in the active group(P<0.05).The AUC of serum PRDX1 and PTEN for evalu-ating the disease activity in autoimmune liver disease patients was 0.750 and 0.854,respectively,and the AUC of the combined detection of serum PRDX1 and PTEN was 0.916.The proportion of patients with hepatic dis-comfort and cirrhosis in the active stage group was higher than that in the remission stage group(P<0.05).Multivariate Logistic stepwise regression analysis results showed that hepatic discomfort(OR=3.487,95%CI:1.534-7.927),cirrhosis(OR=4.289,95%CI:1.744-10.545),PRDX1 ≥5.22 ng/mL(OR=5.068,95%CI:1.951-13.164),PTEN≤0.31 pg/mL(OR=5.387,95%CI:2.099-13.829)were risk factors for disease activity of autoimmune liver disease(P<0.05).Conclusion The increase of serum PRDX1 level and the decrease of serum PTEN level are closely related to liver function and disease activity in patients with au-toimmune liver disease,and they have certain clinical evaluation value in patients with autoimmune liver dis-ease.
3.Comparison of Methods between Soiled Bedding Sentinels and Exhaust Air Dust PCR for Health Monitoring of Rodent Laboratory Animals
Lingzhi YU ; Xiaofeng WEI ; Ming LI ; Zhihao KONG
Laboratory Animal and Comparative Medicine 2024;44(3):321-327
The microbiological quality of laboratory animals is crucial for the validity and reproducibility of scientific research data,as well as human health and animal welfare.Currently,individual ventilation cages(IVC)have become the mainstream feeding system for rodent laboratory animals.The most commonly used pathogen monitoring method for this feeding system is soiled bedding sentinels(SBS).This method monitors the microbial carrying status of mouse colony through indirect contact and delayed feedback.It can effectively monitor pathogens transmitted via the fecal-oral route,such as mouse hepatitis virus and reovirus.However,this method has difficulty detecting pathogens mainly transmitted through aerosols or direct contact,such as Sendai virus and Pasteurella pneumotropica.The exhaust air dust(EAD)-PCR monitoring method involves swab sampling in the IVC exhaust ducts to monitor the corresponding racks of the ducts;swab sampling before the prefiltration of the host to monitor the entire IVC rack;and EAD collection device sampling to monitor all racks connected to the same host.Different IVC manufacturers have developed corresponding EAD collection devices for their respective IVC systems,making operations convenient and standardization easy.Compared with the SBS method,the EAD-PCR method significantly improves detection rate and timeliness,with the fastest detection possible after one week of exposure.It can serve as a supplement or replacement for the SBS method.Currently,increasing evidence supports that EAD-PCR testing is a more reliable,sensitive,and cost-effective monitoring method,and is more beneficial to animal welfare.This article reviews the application progress of these two methods for monitoring pathogens,analyzes the existing limitations of the EAD-PCR method,and proposes solutions based on its implementation in our laboratory and examination units.The EAD-PCR method helps reduce the number of live sentinel animals used in pathogen monitoring,in order to better maintain the"3Rs"principle of laboratory animal welfare.
4.Health outcomes of electronic cigarettes
Xinmeng LI ; Lingzhi YUAN ; Fen WANG
Chinese Medical Journal 2024;137(16):1903-1911
The usage of electronic cigarettes (e-cigarettes) sparked an outbreak of unidentified vaping-related lung disease in the US during late 2019. With e-cigarettes becoming more and more popular, smokers have more options other than conventional cigarettes. Under these circumstances, a comprehensive evaluation of the general safety of new tobacco and tobacco-related products, represented by e-cigarettes, to human health is necessary. In this review, we summarize the current research on potential negative impacts of e-cigarette exposure on human health. In particular, studies detailing the relationship between e-cigarettes and the digestive system are summarized, with mechanisms mainly including hepatic metabolic dysfunction, impaired gut barrier, and worsened outcomes of inflammatory bowel disease (IBD). Although believed to be safer than traditional cigarettes, e-cigarettes exert adverse effects on systemic health and induce the development of multiple diseases including asthma, cardiovascular disease, and IBD. Moreover, nicotine-containing e-cigarettes have a negative impact on the childhood development and increase the risk of arterial stiffness compared to the non-nicotine e-cigarettes. However, non-nicotine e-cigarette components have detrimental effects including promoting liver damage and metabolic disorders.
5.Analysis on correlation between systemic inflammatory indicators with severity of disease condition and cognitive dysfunction in patients with schizophrenia
Ping LI ; Xingxiao HUANG ; Yezi ZHANG ; Lingzhi WANG
Chongqing Medicine 2024;53(20):3120-3124
Objective To analyze the value of systemic inflammatory indicators in diagnosing schizo-phrenia and their correlation with disease condition severity and cognitive dysfunction.Methods A total of 47 patients with schizophrenia visited and treated in this hospital from October 2021 to March 2023 were selected as the study subjects,and 47 healthy volunteers during the same period served as the control group.The morn-ing fasting venous blood was collected in all research subjects,and the blood routine and biochemical indicators were measured.The SII,SIRI,NHR and LHR were calculated.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of SII,SIRI,NHR and LHR in the patients with schizophrenia.The correlation adopted the Pearson correlation analysis.Results The levels of SII,SIRI,NHR and LHR in the schizophrenia group were significantly increased compared with the control group,and the difference was statistically significant(P<0.05).The ROC curve analysis demonstrated that the area under the curve(AUC)of SII,SIRI,NHR and LHR detection alone in diagnosing schizophrenia were 0.683,0.686,0.774 and 0.766 respectively.AUC of their combination detection was 0.886.SII was positively correlated with the gen-eral symptoms and the positive and negative symptom scale(PANSS)total score,and negatively correlated with the spatial structure,linguistic function and delayed memory(P<0.05);SIRI was positively correlated with the negative symptoms,general symptom and PANSS total score,and negatively correlated with the im-mediate memory,spatial structure,linguistic function,attention;NHR was positively correlated with the nega-tive symptoms,positive symptoms,general symptoms and PANSS total score,and negatively correlated with immediate memory,linguistic function,attention and delayed memory(P<0.05).LHR was positively corre-lated with the positive symptoms,general symptoms and PANSS total score,and negatively correlated with the spatial structure,linguistic function,attention and delayed memory(P<0.05).Conclusion SII,SIRI,NHR and LHR combined detection has higher diagnostic value for the patients with schizophrenia.Further-more,the SII,SIRI,NHR and LHR levels are closely correlated with the disease condition severity and cogni-tive function impairment degree.
6.Expression Levels and Regulation of Selenoprotein Genes in Patients With Coronavirus Disease 2019
Jing LI ; Rongqiang ZHANG ; Lingzhi ZHANG ; Yan QI ; Jie HAO ; Aoyue HE ; Xu ZHAO ; Xiuqin LI
Acta Academiae Medicinae Sinicae 2024;46(3):316-323
Objective To investigate the expression levels of selenoprotein genes in the patients with coronavirus disease 2019(COVID-19)and the possible regulatory mechanisms.Methods The dataset GSE177477 was obtained from the Gene Expression Omnibus,consisting of a symptomatic group(n=11),an asymptomatic group(n=18),and a healthy control group(n=18).The dataset was preprocessed to screen the differentially expressed genes(DEG)related to COVID-19,and gene ontology functional annotation and Kyoto encyclopedia of genes and genomes enrichment analysis were performed for the DEGs.The protein-protein interaction network of DEGs was established,and multivariate Logistic regression was employed to analyze the effects of selenoprotein genes on the presence/absence of symptoms in the patients with COVID-19.Results Compared with the healthy control,the symptomatic COVID-19 patients presented up-regulated expression of GPX1,GPX4,GPX6,DIO2,TXNRD1,SELENOF,SELENOK,SELENOS,SELENOT,and SELENOW and down-regulated ex-pression of TXNRD2 and SELENON(all P<0.05).The asymptomatic patients showcased up-regulated expres-sion of GPX2,SELENOI,SELENOO,SELENOS,SELENOT,and SELENOW and down-regulated expression of SELP(all P<0.05).The results of multivariate Logistic regression analysis showed that the abnormally high expression of GPX1(OR=0.067,95%CI=0.005-0.904,P=0.042)and SELENON(OR=56.663,95%CI=3.114-856.999,P=0.006)was the risk factor for symptomatic COVID-19,and the abnormally high expres-sion of SELP was a risk factor for asymptomatic COVID-19(OR=15.000,95%CI=2.537-88.701,P=0.003).Conclusions Selenoprotein genes with differential expression are involved in the regulation of COVID-19 development.The findings provide a new reference for the prevention and treatment of COVID-19.
7.Effectiveness of pneumatic compression therapy combined with infrared irradiation in preventing lower extremity deep vein thrombosis in critically ill patients
Lingzhi LAI ; Tingting CHEN ; Yaling BAI ; Huangen LI
Chinese Journal of Medical Physics 2024;41(11):1415-1420
Objective To explore the preventive effect of pneumatic compression therapy combined with infrared irradiation against lower extremity deep vein thrombosis(DVT)in critically ill patients.Methods A total of 150 critically ill patients from January 2021 to January 2023 in the Intensive Care Unit,Quanzhou First Hospital Affiliated to Fujian Medical University were selected and divided into control group and observation group,with 75 cases in each group.The control group patients were treated with conventional rehabilitation measures combined with the boot-type intermittent pneumatic compression therapy device for intermittent inflation and compression therapy,while the observation group patients received the bioinformatic feedback infrared therapy besides the treatment in control group.The incidence of DVT,the average time for swelling and pain reduction,the average time for swelling and pain disappearance,total hospitalization time,the hemodynamic indexes of the lower extremities,coagulation indexes,D-dimer,the recurrence rate of swelling and pain,satisfaction with the rehabilitation,and therapeutic efficacy were recorded.Results After 3 months of discharge,the rate of post-discharge swelling and pain recurrence in observation group was 2.67%(2/75),obviously lower than 10.66%(8/75)in control group(P<0.05).After 14 days of intervention,the lower extremity deep vein blood flow velocity and peak blood velocity of the two groups increased significantly as compared with those before intervention(P<0.05),and those were greater in observation group than in control group(P<0.05).After 14 days of intervention,the coagulation indexes(PT,TT,FIB)and D-dimer level were significantly lower or shorter in both groups as compared with those before intervention(P<0.05);and observation group had shorter PT and TT,and lower levels of FIB and D-dimer than control group(P<0.05).The average time for swelling and pain reduction,the average time for swelling and pain disappearance,and the total hospitalization time were shorter and the incidence of DVT was obviously lower in observation group as compared with control group(P<0.05).The overall response rates of 14-day intervention in observation group vs control group were 97.33%(73/75)vs 88.00%(66/75)(P<0.05).At the discharge,the satisfaction rates in observation group vs control group were 96.00%vs 85.34%(P<0.05).Conclusion The combination of bioinformatic feedback infrared therapy and boot-type intermittent pneumatic compression therapy device for intermittent inflation and compression therapy can shorten the average time for swelling and pain reduction,the average time for swelling and pain disappearance and the total hospitalization time,enhance the hemodynamics of the lower extremities,improve the coagulation function and D-dimer level,and improve the satisfaction with the rehabilitation and clinical efficacy,worthy of clinical promotion.
8.Galangin inhibits the pyroptosis of macrophages mediated by NOD-like receptor proteins 3
Lingzhi SHEN ; Li LI ; Zhouxin YANG ; Dongyang GUO ; Changqin CHEN ; Jing YAN
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(1):28-33
Objective To investigate the effect of Galangin on pyroptosis of bone marrow derived macrophages(BMDMs).Methods BMDMs were cultured in vitro and divided into blank control group,model group and Galangin group with different concentrations.Lipopolysaccharide(LPS)and adenosine triphosphate(ATP)were used to construct the pyroptosis model.The effect of different concentrations of Galangin on the proliferation of BMDMs was detected by cell counting Kit-8(CCK-8).The level of cysteinyl aspartate specific proteinase-1 p10 subunit(caspase-1 p10),interleukin-1β(IL-1β)in supernatant and intracellular nucleotide NOD-like receptor protein 3(NLRP3)were detected by Western blotting.IL-1β in supernatant was detected by enzyme-linked immunosorbent assay(ELISA).The cell death was observed by propidium iodide(PI)staining.High-throughput sequencing was used to compare the gene expression in the model group and Galangin groups at 20 μmol/L.Results There was no statistically significant difference between the 5,10,20,40,60,80 μmol/L Galangin groups on the proliferation level of BMDMs(all P>0.05),indicating that no significant effect of Galangin at 5,10,20,40,60,80 μmol/L was observed on the proliferation of BMDMs.So we selected Galangin at 5,10,20 μmol/L and treatment for 1,2 and 4 hours as the effects of different concentrations and time on the pyroptosis of BMDMs.Compared with blank control group,the expression of caspase-1 p10 and mature IL-1β protein and IL-1β in supernatant in model group were significantly increased(all P<0.05).Compared with model group,the expression of caspase-1 p10 and mature IL-1β protein and IL-1β in supernatant of Galangin at 5,10 and 20 μmol/L were significantly decreased[IL-1β protein expression(gray value):0.155±0.006,0.113±0.006,0.111±0.007 vs.1.000±0.000,caspase-1 p10 protein expression(gray value):0.207±0.044,0.160±0.008,0.082±0.008 vs.1.000±0.000,IL-1β(μg/L):99.80±10.36,85.21±8.78,26.53±4.56 vs.494.10±35.47,all P<0.05].There was no significant difference between the different concentration groups(all P>0.05),but with the extension of treatment time of Galangin,the inhibitory effect was enhanced.The inhibitory effect of Galangin at 20 μmol/L for 4 hours was the most obvious[IL-1β protein expression(gray value):0.186±0.004 vs.1.000±0.000,caspase-1 p10 protein expression(gray value):0.247±0.009 vs.1.000±0.000,IL-1β(μg/L):173.80±10.56 vs.653.80±76.02,all P<0.05].Treatment with 20 μmol/L Galangin for 4 hours could reduce the number of pyroptotic cell deaths(number of view:23.00±3.61 vs.67.67±15.63,P<0.05)and inhibited the expression of NLRP3 protein(gray value:0.178±0.025 vs.0.406±0.066,P<0.05).High-throughput sequencing showed that,compared with the model group,Galangin down-regulated the genes of Nlrp3,Nod2,IL-1β and up-regulated genes of Skp2(also known as Fbxl1),Fbxl20,Fbxl4,Fbxo32 and Fbxw7.Conclusion Galangin inhibited pyroptosis mediated by NLRP3 inflammasome in macrophages.
9.Safety of tocilizumab combined with traditional antirheumatic drugs in the treatment of systemic juve-nile idiopathic arthritis
Mengmeng WANG ; Zhidan FAN ; Lingzhi QIU ; Yong ZHANG ; Wenjing LI ; Haiguo YU
Chinese Journal of Rheumatology 2024;28(5):321-326
Objective:To investigate the safety of tocilizumab (TCZ) in the treatment of children with systemic juvenile idiopathic arthritis (sJIA).Methods:Data of children aged 2 to 18 years with the diagnosis of sJIA and treated with TCZ from June 1, 2017 to June 30, 2022 at our hospital were retrospectively collected. The clinical medication characteristics, incidence, severity and outcome of adverse drug reactions (ADR) were statistically analyzed. Univariate and multivariate analysis were used to analyze the risk factors of TCZ-induced ADR. Univariate comparison between groups were compared to the measured data followed by t test for normal distribution, and the counting data were paired with Chi-square test. Binary logistic regression analysis was used for multivariate analysis. Results:A total of 83 eligible children were enrolled. The age at TCZ initiation was (8.5±3.7) years old. Most of the children received oral glucocorticoid (86.8%) and/or methotrexate (72.3%) prior to TCZ treatment. The mean time of TCZ duration was (1.2±0.9) years, the total TCZ exposure was 92.70 patient years. Fifty-five (66.3%) children reported 123 ADR, with a rate of 132.69/100 patient years. Forty-two (50.6%) children reported 103 general ADR, with a rate of 111.11/100 patient years. Eighteen (21.7%) children reported 20 serious ADR, with a rate of 21.57/100 patient years. The results of univariate analysis showed that the dosage of glucocorticoid in ADR group was higher than that in non-ADR group [(0.76±0.50) mg·kg -1·d -1vs. (0.52±0.41) mg·kg -1·d -1, t=2.27, P=0.026], and the difference was statistically significant. However, there were no significant differences in gender [(male 23, female 32) cases vs. (male 9, female 19) cases, χ2=0.73, P=0.392], age at TCZ initiation [(8.5±3.8) years old vs. (9.0±3.1) years old, t=-0.65, P=0.516], duration of TCZ treatment [(1.24±1.00) years vs. (1.05±0.90) years, t=0.87, P=0.385], methotrexate doses weekly [(8.0±5.2) mg/m 2vs. (7.6±5.1) mg/m 2, t=0.39, P=0.696], and history of drug or food allergy (11 cases vs. 5 cases, χ2=0.06, P=0.815) between the two groups. The results of binary logistic regression analysis showed that the combined use of oral glucocorticoids was an independent risk factor for TCZ-induced ADR [ OR (95% CI) =3.05 (1.11, 8.36), P=0.030]. The risk of ADR was 3.05 times higher in the combined daily dose of glucocorticoids ≥0.76 mg/kg prednisone equivalent than that of < 0.76 mg/kg. Common general ADR to TCZ include infections (38.83/100 patient years) and abnormalities in laboratory parameters (37.76/100 patient years) such as elevated glutamic-pyrupiane transaminase (18.34/100 patient years), dyslipidemia (12.94/100 patient years), and hemocytopenia (5.39/100 patient years). The serious ADR included serious infection (9.71/100 patient years) and serious infusion reaction(7.55/100 patient years). All ADR were improved after drug withdrawal or symptomatic treatment, and no deaths occurred. Conclusion:TCZ has a good safety profile in the treatment of sJIA. Serious infections and severe infusion reactions often lead to discontinuation of the drug. The combination of glucocorticoids≥0.76 mg/kg prednisone equivalent is an independent risk factor for TCZ-induced ADR. Monitoring should be strengthened during the application of TCZ, and ADR should be detected and treated as early as possible to reduce the risk of medication related adverse reactions.
10.Stepwise intensive rehabilitation can effectively improve the pulmonary and diaphragmatic functioning of persons with serious chronic obstructive pulmonary disease
Yanping FU ; Jinzhu WANG ; Shuyan LI ; Juanhong CHEN ; Lingzhi JIANG ; Huiping YAO ; Xiangming YE
Chinese Journal of Physical Medicine and Rehabilitation 2024;46(11):1004-1010
Objective:To document the impact of information-based, stepwise, intensive rehabilitation therapy on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:Eighty such patients in an intensive care unit (ICU) were randomly divided into a control group and an observation group, each of 40. The control group received routine ICU rehabilitation, while the observation group underwent information-based, step-wise ICU rehabilitation. Upon admission to and discharge from the ICU, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, and diaphragm functioning were compared between the two groups. The duration of mechanical ventilation, the incidence of ventilator-associated pneumonia (VAP), length of stay in the ICU, incidence of delirium, and the incidence of deep vein thrombosis (DVT) were also recorded. The number of patients readmitted to the ICU after discharge, and the 28-day hospital mortality rate were recorded as well.Results:Significant improvement was observed in both groups in terms of their lung and diaphragm functioning, as well as in the rehabilitation- and hospital-related indicators. At discharge, significantly greater improvements were observed in the observation group compared with the control group in terms of their average FEV1, FVC, FEV1/FVC, inspiratory and expiratory diaphragm thickness, and diaphragm thickening rate. The average duration of mechanical ventilation and of rehabilitation interruptions was significantly less in the observation group. And incidents of accidental extubation, VAP, delirium and DVT were significantly fewer in the observation group as well. Their ICU stays tended to be significantly shorter without any significant difference between the two groups in the 28-day hospital mortality rate. The control group spent significantly less time in their daily rehabilitation sessions, with the result that significantly fewer of them achieved a grading of 2 or better on the mMRC respiratory questionnaire.Conclusion:Information-based stepwise intensive rehabilitation treatment can effectively improve the pulmonary and diaphragmatic function of AECOPD patients admitted to an ICU, shorten their mechanical ventilation time and the length of their ICU stay, and lower their incidence of VAP and DVT during hospitalization.

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