1.Magnifying endoscopy combined with narrow-band imaging,acetate-indigo rouge staining combined with multi-slice spiral CT in the diagnosis of early gastric cancer and precancerous lesions and clinical significance
Liang YANG ; Zhihua FENG ; Weiling MA ; Weifeng MA ; Shuai CHEN ; Lixia ZHANG ; Jihai WU
China Journal of Endoscopy 2024;30(2):9-16
Objective To analyze the diagnostic efficacy and clinical significance of magnifying endoscopy combined with narrow-band imaging(ME-NBI),acetate-indigo rouge staining and multi-slice spiral CT for early gastric cancer and precancerous lesions.Methods 202 patients with suspected early gastric cancer and precancerous lesions from February 2019 to March 2022 were regarded as the subjects of this study,all the patients underwent ME-NBI,acetate-indigo rouge staining,and multi-slice spiral CT examination;The diagnostic value of different examination methods for early gastric cancer and precancerous lesions was analyzed using the receiver operator characteristic curve(ROC curve),using the pathological results of gastric cancer as the gold standard,the diagnostic value of ME-NBI,acetate-indigo rouge staining combined with multi-slice spiral CT and their combination in early gastric cancer and precancerous lesions was analyzed using a four grid table.Results The image quality of ME-NBI and acetate-indigo rouge staining combined examinations was significantly higher than that of their respective independent examinations(P<0.05).There was significant difference in the degree of differentiation in the clinical features of patients with early gastric cancer and precancerous lesions(P<0.05).The area under the curve(AUC)of ME-NBI for the diagnosis of early gastric cancer and precancerous lesions was 0.853,the accuracy was 85.64%,the sensitivity was 88.37%,and the specificity was 83.62%.The AUC of acetate-indigo rouge staining for the diagnosis of early gastric cancer and precancerous lesions was 0.814,the accuracy was 81.68%,the sensitivity was 83.72%,and the specificity was 80.17%.The AUC of multi-slice spiral CT for the diagnosis of early gastric cancer and precancerous lesions was 0.804,with an accuracy of 80.69%,a sensitivity of 82.56%,and a specificity of 79.31%.And the AUC of the three methods combined to diagnose early gastric cancer and precancerous lesions was 0.893,with an accuracy of 89.60%,a sensitivity of 93.02%,and a specificity of 87.07%.Conclusion ME-NBI,acetate-indigo rouge staining combined with multi-slice spiral CT has high diagnostic efficacy in early gastric cancer and precancerous lesions,and can be used in clinical practice.
2.Metabolic profile analysis on urine of workers with occupational nickel exposure
Zuofei XIE ; Anping MA ; Wenjie ZHANG ; Lin ZHONG ; Jingjing QIU ; Zuokan LIN ; Yi SUN ; Weihui WANG ; Zhanhong YANG ; Liuqing ZHAO ; Yiru QIN ; Weifeng RONG
China Occupational Medicine 2024;51(5):488-495
Objective To analyze differential metabolites (DMs) in the urine of workers with occupational nickel exposure using non-targeted metabolomics, and to screen differential metabolic pathways. Methods A total of 30 nickel exposed workers were selected as the exposure group, and 30 administrative staff from the same factory were selected as the control group using the judgment sampling method. Urine samples of the individuals from the two groups were collected. The ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry and non-targeted metabolomics were used to detect and identify metabolites. The differential metabolic profiles were compared between workers of the two groups, and key differential metabolic pathways and potential biomarkers were screened. The association of DMs and urinary nickel level were evaluated by Spearman correlation coefficients. The sensitivity and specificity of biomarkers were assessed by receiver operating characteristic (ROC) curve analysis. Results A total of 418 metabolites were identified in the urine of worker in the exposure and control groups. The result of principal component analysis and orthogonal partial least squares analysis showed that there were 128 DMs in the urine of workers in the exposure group compared with the control group. These DMs were mainly enriched in glutathione metabolism, carnitine synthesis, and amino acid and nucleotide metabolism pathways, including glycine and serine metabolism. The result of correlation analysis and ROC curve analysis revealed that 4-methylcatechol, 4-vinylphenol sulfate, 2-hydroxyphenylacetone sulfate, 2-dodecylbenzenesulfonic acid, and decylbenzenesulfonic acid could be the potential biomarkers for nickel exposure (all area under the ROC curve >0.800). Conclusion There were significant differences in the urinary metabolic profiles of workers with occupational nickel exposure. The five DMs including 4-methylcatechol, 4-vinylphenol sulfate, 2-hydroxyphenylacetone sulfate, 2-dodecylbenzenesulfonic acid, and decylbenzenesulfonic acid. These DMs could be potential biomarkers of occupational nickel exposure.
3.Advances in rapid detection methods of biotoxins in blood
Wenjie ZHANG ; Yiru QIN ; Zuofei XIE ; Anping MA ; Jingjing QIU ; Zuokan LIN ; Jiaheng HE ; Zhanhong YANG ; Weifeng RONG ; Banghua WU
China Occupational Medicine 2024;51(5):575-580
Biotoxins, which include bacterial, fungal, marine, plant, and animal toxins, are widespread in living and occupational environments, posing potential threats to human health. Rapid detection of biotoxins in blood is crucial for preventing health hazards and enabling timely disease diagnosis and treatment. Biosensors and immunoassay technologies have critical advantages in the rapid detection of biotoxins in blood. Common biosensors, such as surface plasmon resonance biosensors and fluorescent biosensors, enhance sensitivity and reduce detection limits through signal amplification. Common immunoassay methods, such as colloidal gold immunochromatography, fluorescence immunochromatography, and chemiluminescence immunoassay, improve detection efficacy and sensitivity through specific antibody-antigen binding and nanotechnology. However, current rapid detection technologies of bitoxins in blood face challenges such as matrix interference and insufficient specificity, and they fall short in high-throughput detection of multiple toxins simultaneously. Future developments should focus on improving sample pretreatment, innovating signal amplification methods, enhancing specificity on recognition of elements, and designing portable detection devices and high-throughput platforms for simultaneous toxin analysis. These advancements aim to improve the sensitivity and reliability of detection methods, providing more accurate and convenient solutions for biotoxin detection in blood.
4.An Empirical Study on the Use of Diagnosis Related Group Tools for Grouping Adjustments in Large Public Hospitals
Guojie ZHANG ; Xutong TAN ; Zhiling CAI ; Qiang XU ; Weifeng XU ; Yihang CHEN ; Yating WANG ; Jinhan LIU ; Zheng CHEN ; Jiong ZHOU ; Xiaojun MA
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1052-1058
To analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources. We retrospectively collected DRG data from two surgical departments in a large public hospital in Beijing from 2017 to 2023. When the case mix index (CMI) of the two surgical departments declined, interventions such as performance appraisal, department education, and hospital publicity were promptly adopted. The changesin CMI values were observed and the trends in disease group weights, time consumption index, cost consumption index, and mortality rate in low-risk groups were analyzed. After the interventions, in surgical department Ⅰ, the proportion of patients with lower-weight diseases, such as major thyroid surgery (KD1), significantly decreased, while that of patients with higher-weight diseases, such as colorectal malignancy surgery (GB2) and pancreatic malignancy surgery (HB1), significantly increased. In surgical department Ⅱ, the proportion of patients with lower-weight diseases, such as chemotherapy (RE1), decreased markedly, while that of patients with higher-weight diseases, including major surgery for malignancy of kidney, ureter, and bladder (LA1), adrenal gland surgery (KC1), surgery for kidney/ureter/bladder except for major malignancy surgery (LB1), and male genital organ malignancy surgery (MA1), increased significantly. Both surgical departments achieved the goal of increasing their CMI values. In terms of efficiency, cost, and quality indicators, the time consumption index and cost consumption index of the two surgical departments were significantly lower than 1, and the mortality rate in low-risk groups was 0. Based on actual conditions and development goals, large public hospitals can achieve improvements in CMI values and optimization of disease group structures through reasonable interventions, thereby enhancing medical efficiency and rational utilization of resources.
5.Effect of PCSK9 inhibitors on inflammation levels and ventricular remodeling after PCI in ST-elevation acute myocardial infarction
Weifeng ZHANG ; Hailong MA ; Jinling ZHANG
The Journal of Practical Medicine 2024;40(15):2142-2147
Objective To investigate the effect of PCSK9 inhibitors on the level of inflammation and ven-tricular remodeling after PCI in ST-elevation acute myocardial infarction.Methods A total of 220 patients with acute ST-segment elevation myocardial infarction who received percutaneous coronary artery intervention in the Emergency Center of Qingdao Central Hospital from April 2021 to July 2023 were randomly divided into two groups,110 patients in the control group were treated with conventional treatment,and 110 patients in the PCSK9i group were treated with PCSK9 inhibitors on the basis of conventional treatment.Compared before and after treatment left ventricular endsystolic diameter(LVESD)and left ventricular ejection fraction(LVEF)and triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC).C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factor α(TNF-α).The incidence of major adverse cardiovascular events(MACE)(including myocardial infarction,recurrence of heart failure,malignant arrhythmia,and cardiovascular death)was compared.Results After 6 months of treatment and follow-up,LVEDD(mm),LVESD(mm),TG(mmol/L),TC(mmol/L),LDL-C(mmol/L),CRP(mg/L),TNF-α(pg/mL)and JL-6(ng/mL)after PCSK9i treatment were significantly lower than those in the control group,and the difference was statistically significant[(51.32±5.84)vs.(54.43±2.91);(34.88±2.69)vs.(36.96±3.19);(1.41±0.61)vs.(2.13±1.26);(3.53±1.06)vs.(3.98±0.93);(0.95±0.36)vs.(1.79±0.27);(5.18±1.92)vs.(7.69±2.61);(36.43±9.41)vs.(57.79±14.43);(17.4±0.68)vs.(28.55±8.92),All P<0.01],and the LVEF(%)and HDL-C(mmol/L)in the PCSK9i group were higher than patients in the control group,and the difference was statistically significant[(46.69±3.63)vs.(41.34±3.42),P<0.05,(1.35±0.29)vs.(1.29±0.27),P<0.01].The incidence of MACE events in the PCSK9i group was obviously lower than patients in the control group(5.2%vs.13.6%,P<0.05).Conclusion The application of PCSK9 inhibitors after PCI in patients with ST-segment elevation acute myocardial infarction can better reduce blood lipids,stabilize coronary plaque,reduce local and circula-tory inflammatory responses after myocardial infarction,improve ventricular adverse remodeling after myocardial infarction,inhibit ventricular remodeling,and reduce the total incidence of MACE,worthing promoting use.
6.E3 ubiquitin ligase SPOP regulates RLR signaling pathway and inhibits enterovirus 71 replication
Xinyu YANG ; Lichao ZANG ; Yang PENG ; Lijuan JIANG ; Jinhong MA ; Weifeng SHI ; Wei ZHOU
Chinese Journal of Microbiology and Immunology 2024;44(8):706-712
Objective:To investigate the role of speckle-type POZ(pox virus and zinc finger protein) protein (SPOP) in enterovirus 71 (EV71) infection.Methods:Immunoprecipitation analysis was employed to examine the impact of SPOP on the ubiquitin level of EV71 non-structural protein 2A protease (2A pro), while the phosphorylation level of IFR3 protein was assessed through Western blot. Cells were either overexpressed or knockdown of SPOP, followed by infection with EV71. RT-qPCR was utilized to analyze the transcription level of IFN-β, and the transcription level and protein level of EV71 structural protein VP1 were determined using RT-qPCR and Western blot, respectively. Results:The inhibition of EV71 infection in RD cells was observed following transfection with HA-SPOP. Additionally, it was found that the ubiquitin level of EV71-2A pro increased in a gradient-dependent manner. Subsequent transfection with shSPOP plasmid for endogenous SPOP knockdown resulted in a dose-dependent decrease in the levels of melanoma differentiation-associated gene 5 (MDA5), mitochondrial antiviral signaling (MAVS), and p-IRF3. Conversely, transfection with HA-SPOP plasmid led to a dose-dependent increase in the levels of MDA5, MAVS, and p-IRF3. The expression of SPOP, whether high or low, had an impact on the expression of IFN-β in cells. Additionally, the levels of VP1 mRNA or protein were found to be inhibited or increased. Conclusions:SPOP plays a role in increasing the ubiquitination level of EV71-2A pro, which in turn promotes the phosphorylation level of IRF3 and secretion of IFN-β. This effect is achieved by inhibiting the cleavage of 2A pro against key molecules MAVS and MDA5 in the RLR signaling pathway, ultimately leading to the inhibition of EV71 replication.
7.Determination of four organotin compounds in human whole blood by high performance liquid chromatography-inductively coupled plasma-mass spectrometry
Anping MA ; Banghua WU ; Ming DONG ; Xiaolin RUAN ; Jingjing QIU ; Weifeng RONG ; Jiaheng HE
China Occupational Medicine 2023;50(6):712-716
{L-End}Objective To establish a method for the simultaneous determination of dimethyltin (DMT), trimethyltin (TMT), diethyltin (DET), and triethyltin (TET) in human whole blood using high performance liquid chromatography-inductively coupled plasma-mass spectrometry (ICP-MS). {L-End}Methods The 1.0 mL of blood was added with 4.0 mL 65% aqueous solution (containing 6% acetic acid), extracted and separated by C4 column (150 mm×3 mm×3 μm) using a mobile phase of methanol and 4% acetic acid aqueous solution (containing 0.25 mmol/L tropolone) at a volume ratio of 35∶65, and detected by ICP-MS. {L-End}Results The linear range of DMT, TMT, DET, and TET was 30.60-550.80, 29.00-522.00, 46.10-829.80, and 34.05-612.90 μg/L, respectively. All correlation coefficients were 0.999. The detection limit of DMT, TMT, DET and TET was 21.40, 20.30, 32.27 and 23.80 μg/L, respectively. The recovery rate was 81.9%-104.9%. The within-run and between-run relative standard deviation was 1.6%-6.9% and 0.1%-10.0%, respectively. The samples can be stored at -20 ℃ and 4 ℃ for at least three days. {L-End}Conclusion This method can be used for trace analysis of DMT, TMT, DET, and TET in whole blood.
8.Low-frequency whole-body resonance stimulation can improve the balance and walking of hemiplegic stroke survivors
Feixiang MA ; Wanlang LI ; Yingling ZHU ; Tingting LIU ; Rui WANG ; Guiping CAO ; Weifeng XU
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(9):776-780
Objective:To observe any effect of low-frequency whole body resonant stimulation on the ba-lance and walking ability of hemiplegic stroke survivors.Methods:Sixty-six stroke survivors with hemiplegia were randomly divided into a low-frequency resonance training group, a high-frequency vibration training group and a control group, each of 22. All received routine exercise training at individualized intensities. All three groups underwent five 1-minute cycles of 7Hz, 15Hz or 1Hz stimulation twice a day, five days a week for eight weeks. Before and after the intervention, balance and walking ability were evaluated using the Berg Balance Scale, the timed up and go test and a 10m walking test. Step length, step frequency and step speed were also measured.Results:There were no significant differences among the three groups before the training. Afterward, significant improvement was observed in all of the groups in terms of all of the measurements. The average results of the low-frequency resonance training group were at that point significantly better than the other two groups′ averages, while the high-frequency vibration training group′s results were superior to those of the control group.Conclusion:Resonance training at 7Hz is the most effective in improving the balance and walking ability of stroke survivors with hemiplegia.
9.Prognostic differences between type Ⅰ and type Ⅱ renal papillary cell carcinoma
Wenjie YANG ; Jie DONG ; Lin MA ; Zhigang JI ; Weifeng XU
Journal of Modern Urology 2023;28(3):227-231
【Objective】 To analyze the clinical characteristics and prognostic differences between type Ⅰ and type Ⅱ papillary renal cell carcinoma (PRCC), and identify the prognosis-related independent predictors. 【Methods】 A total of 143 PRCC patients treated during Jan.2012 and Dec.2019 were involved, including 91 type Ⅰ patients and 52 type Ⅱ patients. The prognostic factors were analyzed with univariate and multivariate Cox regression analysis. The differences in cancer-specific survival (CSS) between the two groups were analyzed with Kaplan-Meier method and log-rank test. 【Results】 The patients’ age was 53.41±13.50 years. After a mean follow-up of 63.27±26.20 months, 14 patients died, and the overall CSS was 90.2%. The prognosis of type Ⅰ patients was better than type Ⅱ patients (94.5% vs. 82.7%, P=0.020). Cox regression suggested that PRCC subtype and stage were significantly associated with prognosis. There was no difference in prognosis between type Ⅰ and type Ⅱ patients in T1/T2 subgroup (P>0.05). However, in T3/T4 subgroup, type Ⅰ patients had a significant better prognosis than type Ⅱ patients (P=0.023), while the above trends were not observed in G1/G2 and G3/G4 subgroups (P>0.05). 【Conclusion】 PRCC subtype and stage are independent prognostic predictors. The impact of PRCC subtype on prognosis is mainly manifested in the subgroup of patients with T3 or higher stage.
10.Imbalance of lymphoid cells in peripheral blood maintains the immunosuppression and promotes the development of lung adenocarcinoma.
Hui GUO ; Lichao ZANG ; Xinyu YANG ; Yumin WU ; Jinhong MA ; Weifeng SHI
Chinese Journal of Cellular and Molecular Immunology 2023;39(8):729-736
Objectives Objectives To investigate how the imbalance of innate lymphoid cells (ILCs)in the peripheral blood of patients with lung adenocarcinoma affects the balance of downstream mononuclear macrophages and T helper (Th) cells, and to identify the impact of the imbalance of ILCs on the immune status and prognosis of lung adenocarcinoma. Methods The peripheral blood of 20 patients with lung adenocarcinoma and normal controls were collected. The percentage of ILCs, mononuclear macrophages and T lymphocyte in peripheral blood were analyzed by flow cytometry. The characteristic cytokine secretion levels of various types of immune cells in peripheral blood were detected by real-time fluorescence quantitative PCR. Results Compared with the normal controls, the proportion of M2 mononuclear macrophages, ILC1 and ILC2 in patients with lung adenocarcinoma was up-regulated, while the proportion of M1 mononuclear macrophages, CD4+ T and CD8+ T was down-regulated. The mRNA expression of related cytokines of M1 mononuclear macrophages and ILC1 were decreased; while the mRNA expression of related cytokines of M2 mononuclear macrophages and ILC2 were increased. Along with the decreased CD4+T cells-associated cytokine T-bet mRNA expression, and the increased GATA3 mRNA expression. Moreover, the expression of PD-1 in CD8+ T cells was also up-regulated. Conclusion The imbalance of ILCs in peripheral blood of patients with lung adenocarcinoma promotes the imbalance of mononuclear macrophages and Th cells, which altogether maintains the immunosuppression in patients with lung adenocarcinoma, and promotes the development of lung adenocarcinoma.
Humans
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Lymphocytes
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Immunity, Innate
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CD8-Positive T-Lymphocytes
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Cytokines/metabolism*
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Adenocarcinoma of Lung
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Immunosuppression Therapy
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RNA, Messenger

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