1.Establishment and validation of a nomograph model for prediction of bronchopulmonary dysplasia in very low birth weight infants born earlier than 32 weeks
Hui WU ; Xue AO ; Fengdong WANG ; Lin ZENG ; Meihua PIAO ; Xiaomei TONG ; Tongyan HAN
Chinese Journal of Perinatal Medicine 2023;26(5):366-374
Objective:To investigate the risk factors of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants with gestational age ≤32 weeks within 28 days after birth and to establish and validate the nomogram model for BPD prediction.Methods:We retrospectively chose VLBW infants with gestational age ≤32 weeks who survived to postmenstrual age (PMA) 36 weeks and were admitted to the neonatal intensive care unit of Peking University Third Hospital from January 2016 to April 2020 as the training cohort. BPD was diagnosed in accordance with the 2018 criteria. The clinical data of these infants were collected, and the risk factors of BPD were analyzed by Chi-square test, Mann-Whitney U test, and multivariate logistic regression, and a nomogram model was established. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the predictive performance. Decision curve analysis (DCA) was constructed for differentiation evaluation, and the calibration chart and Hosmer-Lemeshow goodness of fit test were used for the calibration evaluation. Bootstrap was used for internal validation. VLBW infants with gestational age ≤32 weeks survived to PMA 36 weeks and admitted to Hebei Chengde Maternal and Child Health Hospital from October 2017 to February 2022 were included as the validation cohort. ROC curve and calibration plot were conducted in the validation cohort for external validation. Results:Of the 467 premature infants included in the training cohort, 104 were in the BPD group; of the 101 patients in the external validation cohort, 16 were in the BPD group. Multivariate logistic regression analysis showed that low birth weight ( OR=0.03, 95% CI: 0.01-0.13), nosocomial pneumonia ( OR=2.40, 95% CI: 1.41-4.09), late-onset sepsis ( OR=2.18, 95% CI: 1.18-4.02), and prolonged duration of endotracheal intubation ( OR=1.61, 95% CI: 1.26-2.04) were risk factors for BPD in these groups of infants (all P<0.05). According to the multivariate logistic regression analysis results, a nomogram model for predicting BPD risk was established. The AUC of the training cohort was 0.827 (95% CI: 0.783-0.872), and the ideal cut-off value for predicted probability was 0.206, with a sensitivity of 0.788 (95% CI: 0.697-0.862) and specificity of 0.744 (95% CI: 0.696-0.788). The AUC of the validation cohort was 0.951 (95% CI:0.904-0.999). Taking the prediction probability of 0.206 as the high-risk threshold, the sensitivity and specificity corresponding to this value were 0.812 (95% CI: 0.537-0.950) and 0.882 (95% CI: 0.790-0.939). The Hosmer-Lemeshow goodness-of-fit test in the training and validation cohort showed a good fit ( P>0.05). DCA results showed a high net benefit of clinical intervention in very preterm infants when the threshold probability was 5%~80% for the training cohort. Conclusion:Low birth weight, nosocomial pneumonia, late-onset sepsis, and prolonged tracheal intubation duration are risk factors for BPD. The established nomogram model has a certain value in predicting the risk of BPD in VLBW less than 32 weeks.
2.Retrospective analysis and mining of data from 10 840 patients undergoing non-invasive prenatal screening.
Fang CHEN ; Meihua TAN ; Yanwen XU ; Bin ZHU ; Jia LI ; Kun LIN ; Mingqiao CHEN ; Lina ZENG
Chinese Journal of Medical Genetics 2020;37(10):1074-1078
OBJECTIVE:
To retrospectively analyze non-invasive prenatal screening (NIPS) data from two centers.
METHODS:
The NIPS results of 10 840 samples were analyzed, including 21/18/13 trisomies (T21/T18/T13), sex chromosome and other autosomal aneuploidies, and copy number variants (CNVs). The maternal age, gestational week, body mass index and concentration of free fetal DNA (cffDNA) were also analyzed.
RESULTS:
The average gestational age of the 10 840 pregnant women was (32.34±5.04) year old, and the average gestational week for NIPS was (17.60±3.55) week. The overall false positive rate for T21/T18/T13 was 0.11%, sensitivity was 100%, specificity was 99.89%, and positive predictive value was 81.5%. The positive predictive values for sex chromosome and other autosomal aneuploidies and CNVs were 56.67%, 11.76% and 83.33%, respectively. The incidence of T21/T18 in the elder women (35 years or elder) was 2.12 times(P<0.01) and 1.81 times (P> 0.05) that of young women. cffDNA was in proportion to gestational week (r = 0.207) and in inverse proportion to body mass index (r = -0.177). It has increased slowly before 15 weeks of gestation and thereafter at a rate of 0.5% per week after the 16th week.
CONCLUSION
The performance of NIPS in this study is by large close to the reported in the literature, and the results can provide a reference for further study.
3.Finding Analysis of Medical Device Manufacturer Audit in Suzhou Industrial Park for the Last Three Years.
Xiaoming QIAN ; Meihua NI ; Zeng LU
Chinese Journal of Medical Instrumentation 2020;44(4):353-358
OBJECTIVE:
Common findings are to be found from 144 different type of medical device manufacturers' audit reports which are from Jan. 2017 to Jun. 2019. Advise is to be provided for medical device manufacturers on continual improvement.
METHODS:
Classify and analyze the on-site audit findings from different type of medical device manufacturers.
RESULTS:
The frequency of findings from chapter production management, buildings and facilities, quality control are comparatively high.
CONCLUSIONS
The key to improve the quality management system is to cultivate the staff sense of continual improvement of quality system, improve the staff ability of finding and solving problems, encourage staff participation in quality system, fit the quality system on product realization.
Industry
;
Quality Control
;
Time Factors
4.Epidemiological characteristics of product-related injuries among children in Changshan County
Ming ZHAO ; Jieming ZHONG ; Jiafu DUAN ; Zhengfu WU ; Lihua GUO ; Hongxia ZENG ; Meihua FU ; Wenfeng LIU ; Sheng LIU ; Min YU
Journal of Preventive Medicine 2019;31(8):765-770
Objective:
To understand the epidemiological characteristics of product-related injuries among children in Changshan County from 2011 to 2017 and to provide evidence for targeted intervention.
Methods:
The surveillance data of product-related injuries among children aged below 18 years from 2011 to 2017 was collected from three sentinel hospitals in Changshan County. The characteristics of product-related injuries among children were analyzed,especially those injuries caused by furniture,stationery and sporting goods,commodities and toys.
Results:
A total of 5 111 product-related injury cases among children were reported,accounting for 13.49% of product-related injury cases of all age. There were 3 138 boys and 1 973 girls,accounting for 61.40% and 38.60%. There were 2 973 cases less than 10 years old,accounting for 58.17%. The main causes of product-related injuries were road traffic injury(49.46%),blunt(16.02%),stab/cut(12.39%)and fall(10.37%). The main categories of products included transportation equipments(not including motor vehicles,36.83%),motor vehicles(17.82%),furniture(12.23%),stationery and sporting goods(8.45%),commodities(4.89%)and toys(3.25%). Stab/cut(53.01%)was the main cause of commodities related injuries;blunt was the main cause of furniture,stationery and sporting goods and toys. The stationery and sporting goods related injuries occurred mainly in schools/public places(64.57%)and sports venues(18.48%)when engaging in sports(54.13%);furniture,commodities and toys related injuries injured cases occurred at home when engaging in leisure activities. Commodities mainly resulted in sharp/bite/open wound(51.50%);furniture,stationery and sporting goods and toys mainly resulted in bruises. Most cases were injured in head,slight and allowed home after treated.
Conclusion
The product-related injuries among children in Changshan County are more boys. The products mainly involve transportation equipments(not including motor vehicles),motor vehicles,furniture,stationery and sporting goods,commodities and toys,with emphasis on the latter four categories in the prevention of product-related child injury.
5.Changes of T cell immune mechanism in patients with acute exacerbation of chronic obstructive pulmonary disease
Wen ZENG ; Wen QIN ; Dachun HU ; Meihua LI ; Shurong TANG
Chongqing Medicine 2018;47(17):2298-2302
Objective To investigate the changes of T lymphocyte immune balance in the patients with COPD.Methods Forty-eightpatients with AECOPD from January 2015 to December 2016 in this hospital were selected as study group and 30 healthy subjects as control.T cells and cytokines in peripheral blood were detected by flow cytometry and ELISA,respectively.The levels of them were compared between the two groups.The correlations of them and principal components were analyzed among the two groups.Results (1) CD8+T cells in the study group decreased [23.8%(17.5%,30.1%) vs.28.2%(23.8%,31.5%),P<0.05],TregandTh17increased[8.5%(8.3%,9.0%) vs.5.6%(4.9%,6.1%),P<0.01;2.9%(2.8%,3.0%) vs.1.2%(1.2%,1.4%),P<0.01],respectively.(2)In the study group,IL-12 [54.97 pg/mL(31.20,161.59) pg/mL],IL-22 [17.70 pg/mL(15.60,35.99) pg/mL],IL-23[120.28 pg/mL(82.97,169.27) pg/mL],IL-23R [0.15 pg/mL(0.15,0.71)pg/mL]and TNF-α[1 000 pg/mL(1 000,1 000)pg/mL] were higher than that of the control group[31.20 pg/mL(31.20,56.23)pg/mL,15.60 pg/mL(15.60,15.60)pg/mL,78.10 pg/mL(78.10,99.08)pg/mL,0.15 pg/mL(0.15,0.15)pg/mL,722.16 pg/mL(494.25,941.44)pg/mL,P<0.05].(3)Correlation analysis showed that there was a negative correlation between Th17 and Treg (r=-0.883,P<0.01) in the study group (r=-0.883,P<0.01),and IL-22 was positively correlated with IL-23 (r=0.340,P<0.05).In the control group,there was a negative correlation between CD4+T cells and CD8+ T cells,Th17 and CD3+ T cells,Th17 and CD8+T cells (r was-0.578,-0.393 and-0.569,respectively,P<0.05),and a positive correlation between Th17 and Treg,IL-23 and CD4+T cells,TNF-α and DNT(r=0.403,0.440 and 0.392,respectively.(4) There were 5 main components among each group,but the variable factors differed in the study group from the controls,as that:Th17/Treg,Th17,Treg vs.CD4+ T/CD8+ T cells,CD4+ T cells,CD8+ T cells and CD4+T/CD8+T cells,CD8+ T cells vs.Th17/Treg,Treg and CD4+ T cells,CD3+ T cells vs.IL-12,IL-23R andIL-12,IL-23R vs.CD3+ T cells and IL-23,IL-22 vs.TNF-α,DNT.Conclusion The increasing immune function of Th17 cells with IL-22 and IL-23 may be involved in the pathological mechanism of COPD,which accompanied with the weakened toxicity of CD8+T cells and regulation of DNT.
6.Inhibition of Potentilla fruticosa extracts on α-amylase, α-glucosidase and aldose reductase
Meihua LI ; Weiqing WANG ; Yang ZENG ; Fengxia GUO ; Peiying YAN ; Jinping LI
Journal of China Pharmaceutical University 2018;49(4):470-475
This study measured the in vitro inhibitory effects of α-amylase(AM), α-glycosidase(AG)and aldose reductase(AR)extraction from Potentilla fruticosa in three solvents: water extract(WE)and 95% methanol extraction of petroleum ether part(MEP), 95% methanol extraction of ethyl acetate part(MEE)and 95% methanol extraction of water part(MEW)through α-amylase inhibitors(AMI), α-glycosidase inhibitors(AGI)and aldose reductase inhibitors(ARI)activity screening models. In vivo effects of different solvents from Potentilla fruticosa on impaired glucose tolerance of mice were also measured. Among them, WE, MEP and MEE exhibited against AMI activity with IC50 values of 0. 432, 1. 193 and 0. 507 mg/mL, respectively. Three solvents against AGI activity with IC50 values of 0. 164, 0. 768 and 0. 466 mg/mL, respectively. Three solvents against ARI activity with IC50 values of 0. 742, 2. 158 and 1. 098 mg/mL, respectively. The study suggests that Potentilla fruticosa in water extract and 95% methanol extraction of ethyl acetate part demonstrated a stronger inhibitory effect on AM, AG and AR. Meanwhile, Potentilla fruticosa in water extract and 95% methanol extraction of ethyl acetate part can be significantly decreased the postprandial blood glucose in mice.
7.Effects of Pim-1 inhibitor on mouse model of inflammatory bowel disease induced by TNBS
Rong OU ; Yueming SHEN ; Ya ZENG ; Lingzhi ZOU ; Na JIANG ; Meihua XU
Journal of Central South University(Medical Sciences) 2018;43(5):481-489
Objective:To explore the role of Pim-1 in the pathology of inflammatory bowel disease and the potential effect of Pim-1 inhibitor on treating such disease.Methods:Forty-five BALB/c mice were randomly divided into 5 groups (n=9):A normal control group,a inflammatory bowel disease group,two different dose of Pim-1 inhibitor treatment groups,and steroidhormone treatment group.The model of inflammatory bowel disease was induced by intracolonic administration of 2,4,6-trinitrobenzenestdfonic acid (TNBS) and ethanol mixture.Mice were treated with Pim-1 inhibitor [intraperitoneal inject,5 or 10 mg/(kg.d)] for 5 days and prednisone (intragastric administration,0.1 mg/d) for 5 days.The DAI,colon length,gross score and pathological grade were evaluated.The expressions ofT cell master transcription factors T-box expressed in T cells (T-bet),GATA binding protein 3 (GATA-3),RA orphan receptorγ (RORyt)and forkhead box P3 (Foxp3) were measured by Real-time PCR and Western blot,respectively.Results:Pim-1 inhibitor and prednisone showed therapeutic effect on acute TNBS colitis in vivo.GATA3 and RORγt were significantly up-regulated in acute TNBS colitis (P<0.05).In contrast,the expression of Foxp3 was suppressed in the inflammatory bowel disease group,whereas it did not cause any significant change in T-bet expression (P>0.05).Administration of Pim-1 inhibitor and prednisone resulted in suppression of GATA3,RORγt expression,and the increase of Foxp3 expression (P<0.05).Administration of Pim-1 inhibitor and prednisone resulted in inhibition of T-bet mRNA expression (P<0.05),but only prednisone could inhibit T-bet protein expression (P>0.05).Conclusion:Pim-1 inhibitor significantly suppresses Th2-and Th17-type immune responses.Furthermore,Pim-1 inhibitor could induce T-cell differentiation towards a Treg phenotype.Pim-1 inhibitor has therapeutic effect on acute TNBS colitis.
8.Efficacy analysis of ketamine on the patients with depression of modified electric convulsive therapy
Fengmei MEI ; Wei YUE ; Qiong ZENG ; Shanshan WU ; Xiaoning GAO ; Meihua ZHU
The Journal of Clinical Anesthesiology 2017;33(9):864-867
Objective To observe the effects of ketamine on the patients with depression re-ceiving modified electric conulsive therapy (MECT).Methods Sixty patients with depression were randomly divided into ketamine group and propofol group (n =30 each group).Atropine 0.5-1.0 mg, propofol 1.0 mg/kg or ketamine 0.8 mg/kg i.v.were given before MECT,Scoline 0.7-1.0 mg/kg i. v.was given after the eyelash reflex disappeared.Hamilton Depression Rating Scale (HAMD)was completed after the 2 nd ,4 th and 6 th MECT,the time of convulsion,twitch index,energy percentage, respiratory recovery time and adverse reactions were recorded.Results The total score of HAMD was significantly decreased with the increasing times of MECT in both groups,compared with propo-fol group,ketamine group's HAMD total score decreased faster,especially after the 4th MECT,the score decreased significantly in ketamine group (P <0.05).The time of convulsion,twitch index,en-ergy percentage, respiratory recovery time, adverse reactions all had no statistical significance between the two groups.Conclusion Compered with propofol,ketamine,as an anesthetic of MECT, can effectively lower the score of HAMD.
9.VCA-IgA and Rta-IgG joint detection diagnosis and effectiveness of nasopharyngeal carcinoma
Cuiyun WU ; Meihua QIU ; Xiaoling ZENG ; Haiying DU ; Min YAO ; Yixin CHEN
Chinese Journal of Laboratory Medicine 2016;39(8):609-612
Objective To investigate the clinical efficacy of combined detection of VCA-IgA and Rta-IgG in the diagnosis of nasopharyngeal carcinoma.Methods From May 2013 to November 2014, 3 913 serum samples(male 2 367,female 1 546) from healthy people who had health examination in our medical center were collected and 169 serum samples(male 118,female 51) were collected from the patients who were diagnosed as nasopharyngeal carcinoma by pathological biopsy.Serum samples in two groups were detected by EBV RTA-IgG, VCA-IgA assay ( ELISA ) respectively.SPSS17.0 statistical software and receiver operating characteristic curve ( ROC) were applied to data analysis.Results The Rta-IgG positive rates of EB virus were 93.5%in NPC group (158/169) and 2.4%(93/3 913) in healthy group;while the VCA-IgA positive rates were 79.3%in NPC group ( 134/169 ) and 8.9% ( 349/3 913 ) in healthy group. The sensitivity(χ2 =14.49,P<0.05) and specificity(χ2 =157.15,P<0.05) of Rta-IgG in the diagnosis of nasopharyngeal carcinoma were significantly better than that of VCA-IgA. Using VCA-IgA/Rta-IgG combined detection analysis, not only failed to effectively improve the diagnosis of nasopharyngeal cancer, but to reduce the detection sensitivity to 72.8%( 123/169 ) , compared with Rta-IgG detection only. Conclusions Rta-IgG is significantly better than that of VCA-IgA.There was no significant improvement in the clinical diagnostic efficacy of nasopharyngeal carcinoma using VCA-IgA/Rta-IgG combined detection mode.
10.The effects of ethanol on the hippocampal neural tissue development and kainite receptor expression in young mouse
Juan ZHAO ; Feng XIONG ; Meihua BAO ; Yuqian ZHANG ; Shaohong ZHOU ; Jie ZENG ; Guangyi LI ; Jianming LI
Chinese Journal of Nervous and Mental Diseases 2016;42(5):257-261
Objectives To investigate the effects of ethanol on neural development and kainate receptor expression in young mice. Methods Fetal alcohol spectrum disorder model was established by administration of 20% ethanol solu?tion to 7-day-old Kunming mice and control animals received physiological saline (The number of treatment and control were 80 and 40, respectively ). Body weight and general biological features were observed every day. Morris water maze was used to test learning and memory ability. Fluoro-Jade B was used to examine neural cells 24 hours after treatment in additional thirty 7-day-old Kunming mice which were further divided into two groups:a treatment group receiving 20%ethanol solution (n=15) and a control group receiving physiological saline (n=15). The development of neural cells and expression levels of kainite receptors were examined by using immunofluorescence staining. Results The body weight was significantly lighter in treatment group than in control group(control:21.13 ± 1.72g,treatment:13.96 ± 2.98g,P<0.05). Morris test showed that model group had longer latency than control group to find hidden platform(control:21.05± 5.31s,treatment:34.15±3.26s,P<0.05). Spatial probe test revealed that the number of passing through the platform were significantly smaller in model group than in control group(control:2.70 ± 1.25 times,treatment:0.93 ± 0.80 times,P<0.05). Astrocyte development anomaly was evident after ethanol treatment for 7 days. The expression levels of kainite re?ceptor GluR-6 and KA2 were up-regulated in the CA region of the hippocampus after ethanol treatment for 7 days. Con?clusion Kainite receptor GluR-6 and KA2 in CA region of the hippocampus may contribute to ethanol-induced hippo?campal neural development anomaly.


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