1.Performance of four simplified screening methods of elevated blood pressure among children and adolescents
LI Kunkun, TIAN Wei, TAO Mengmeng, CAO Wenjun
Chinese Journal of School Health 2024;45(2):277-282
Objective:
To evaluate the performance of four simplified screening methods of elevated blood pressure commonly used among children and adolescents according to Chinese guidelines for prevention and treatment of hypertension (revised in 2018), so as to provide a reference for the early detection of the elevated blood pressure among children and adolescents.
Methods:
Stratified cluster random sampling method was used to monitor the physical fitness of 5 211 children and adolescents in a city of Shanxi Province from October to November 2021. Chinese guidelines for prevention and treatment of hypertension was considered as gold standard, and sensitivity, specificity, area under the curve (AUC) and Kappa value were calculated to evaluate the screening effectiveness of formula method, height specific method, age group specific method, sex and age specific method for screening elevated blood pressure.
Results:
The detection rates of elevated blood pressure among children and adolescents screened by gold standard, formula method, height specific method,age group specific method, sex and age specific method were 21.9%, 24.0%, 21.1%, 24.5% and 20.2%, respectively. There was no significant difference between prevalence of elevated blood pressure screened by formula method, sex and age specific method and gold standard( χ 2=1.21, 1.41, P >0.05), whereas height specific method and age group specific method had significant differences with gold standard ( χ 2=20.39, 67.09, P <0.05). AUC was the largest for height specific method [0.94(95% CI =0.93-0.95)], and the smallest for age group specific method [0.87(95% CI = 0.86 -0.88)]. The Kappa values of height specific method (0.89) and sex and age specific method (0.89) were both greater than 0.85 , which were more consistent with the screening effectiveness of gold standard. When comparing by sex, age and body mass index (BMI), the screening effectivenesses were consistent with the overall in boys, 6-11 years and normal body weight groups, while the screening effectivenesses were different in girls, 12-17 years, overweight and obese groups. The AUC (0.87), Kappa value (0.71) and sensitivity (82.33%) of age group specific method were the lowest and the screening effectiveness was the worst.
Conclusion
Height specific method is more effective and can be used for early identification and self detection of blood pressure abnormalities among children and adolescents.
2.Pharmacokinetic study of the complication of Ephedra sinica and Prunus armeniaca in bronchial asthma model rats
Linlin CHEN ; Jingen XIE ; Xuecheng FAN ; Qian RAO ; Tianyi YANG ; Jiayu TIAN ; Xiong XIAO ; Wenjun GAO ; Wenhong LI
China Pharmacy 2024;35(13):1588-1593
OBJECTIVE To study the pharmacokinetic changes in the plasma and cerebrospinal fluid of bronchial asthma model rats after the complication of Ephedra sinica and Prunus armeniaca. METHODS SD male rats were randomly divided into blank group, model group, E. sinica group (12 g/kg, calculated by raw drug, similarly hereinafter), P. armeniaca group (6 g/kg) and E. sinica-P. armeniaca drug-pair group (12 g/kg of E. sinica+6 g/kg of P. armeniaca), with 6 rats in each group. Except for the blank group, the bronchial asthma model was induced by spraying rats in each group with an equal volume mixture of 2% acetylcholine chloride and 0.4% histamine phosphate, once a day, for 7 d. One hour before modeling every time, rats in each group were gavaged with the corresponding drug/normal saline, once a day, for 7 d. After the final administration and provocation of asthma, blood and cerebrospinal fluid collection were performed at different time points. The plasma and cerebrospinal fluid samples were pre-treated (with geranylgeranyl as the internal standard), and the mass concentrations of ephedrine/pseudoephedrine, methyl ephedrine and amygdalin in both samples were determined by liquid chromatography-tandem mass spectrometry. DAS 2.0 pharmacokinetic software was used to determine the main pharmacokinetic parameters through the non-atrial chamber model and to compare the changes of the pharmacokinetic parameters before and after the combination of the two drugs. RESULTS Compared with E. sinica group, cmax and AUC0-21.33 h (or AUC0-10.67 h) of ephedrine/pseudoephedrine and methyl ephedrine in the plasma and cerebrospinal fluid of rats were significantly reduced in E. sinica-P. armeniaca drug-pair group, while CLZ/F and VZ/F were significantly increased (P<0.05 or P<0.01); tmax of methyl ephedrine in the cerebrospinal fluid was significantly shortened (P< 0.05).Compared with P. armeniaca group, the t1/2 of amygdalin in the plasma of rats in E. sinica-P. armeniaca drug-pair group was significantly shortened, and CLZ/F was significantly increased (P<0.01); the tmax of bitter amygdalin in the cerebrospinal fluid was significantly shortened, and the AUC0-10.67 h, CLZ/F, and VZ/F were significantly increased (P<0.01). CONCLUSIONS The combination of E. sinica and P. armeniaca accelerates the absorption and elimination of ephedra alkaloids, thus reducing the accumulation of ephedra alkaloids in the bronchial asthma model rats.
3.Research progress of positive pressure bio-protective equipment for high-level biosafety laboratories in China
Tian MA ; Wenjun HE ; Yalan WANG ; Yuanyuan GUO ; Weifang HAN ; Peipei LIU ; Guizhen WU
Chinese Journal of Experimental and Clinical Virology 2024;38(2):217-223
Positive pressure bio-protective equipment is a key protective equipment for high-level biosafety laboratories, which provides comprehensive protection for professionals working in pathogenic microorganisms or other biological contamination environments. This paper summarizes the development status of positive pressure bio-protective equipment at home and abroad, analyzes the existing problems of the current positive pressure bio-protective equipment, and puts forward suggestions, to provide reference for the development and application of positive pressure bio-protective equipment in our country.
4.Pathway analysis of self-disclosure to posttraumatic growth in patients after cervical cancer surgery
Min LIU ; Ying GUO ; Yaning ZHOU ; Wenjun ZHANG ; Xueqi TIAN ; Fuli ZHAO
Chinese Journal of Practical Nursing 2024;40(19):1470-1476
Objective:To investigate the pathway of self-disclosure to posttraumatic growth in patients after cervical cancer surgery, and to provide reference for improving the level of posttraumatic growth in patients.Methods:A convenient sampling method was used to investigate 300 patients with cervical cancer after surgery in Shandong Provincial Hospital Affiliated to Shandong First Medical University from June to November 2022 by using general data questionnaire, Distress Disclosure Index (DDI), Connor-Davidson Resilience Scale (CD-RISC), the Shortened Chinese Version of the Family Resilience Assessment Scale (FRAS-C) and the Posttraumatic Growth Inventory (PTGI) in a cross-section study.Results:A total of 290 valid questionnaires were collected, with an effective recovery rate of 96.7%. The patients were aged 23-70(48.13 ± 10.39) years. The scores of self-disclosure, resilience, family resilience and posttraumatic growth were (46.41 ± 9.82), (67.06 ± 14.63), (108.18 ± 11.06) and (58.24 ± 17.86) respectively. The results of pathway analysis showed that self-disclosure could not only directly predict posttraumatic growth, but also indirectly predict posttraumatic growth through the mediating role of resilience and family resilience, and the chain mediating role of resilience and family resilience, respectively. The direct effect of self-disclosure on posttraumatic growth was 0.236(95% CI 0.138-0.335), and the chain mediating effect of family resilience and resilience between self-disclosure and posttraumatic growth was 0.036(95% CI 0.018-0.060). Conclusions:Medical staff should not only consider the direct influence of self-disclosure on posttraumatic growth, but also pay attention to improve the resilience and family flexibility of patients after cervical cancer surgery, so as to promote their posttraumatic growth.
5.Analysis of stability evaluation of output dose of linear accelerator VitalBeam based on machine performance check
Jianlin WANG ; Tian ZHANG ; Wenjun ZHANG ; Qiang HU
China Medical Equipment 2024;21(6):209-213
To analyze the long-term stability of the output dose of the medical linear accelerator VitalBeam based on Mechanical Performance Check(MPC)system.500 daily self-test data of the medical linear accelerator VitalBeam from January 2021 to December 2023 were collected,and the change trend and stability status of dose output deviation were analyzed.Through MPC detection and data analysis,the 6MV X-Ray in radiation dose output change was(0.53±0.85)%,the ray uniformity change was(0.54±0.15)%,and the ray center offset change was(0.15±0.07)mm,all of which were within the allowable range of error.The 6 MV photon beam dose output of the medical linear accelerator is stable and reliable,which meets the needs of clinical treatment,and the MPC detection can be used for the daily inspection and quality control of the accelerator.
6.Research progress on lidocaine intravenous infusion for promotion of early postoperative recovery
Bin TIAN ; Ruijuan LIU ; Wenjie ZHANG ; Yumin WU ; Wenjun YAN
Journal of Clinical Medicine in Practice 2024;28(5):130-134
The quality of recovery after surgery not only affects patient's satisfaction degree, but also affects patient's prognosis. With the goal of promoting early recovery, the potential advantages of amide local anesthetic lidocaine in perioperative intravenous application have attracted much attention. Intravenous infusion of lidocaine has many benefits, such as analgesia, anti-inflammatory, anti-tumor, and organ protection, and can effectively improve patient's prognosis. This study reviewed the current status of lidocaine in clinical intravenous application, explored its advantages in promoting patient's recovery, and briefly described the relevant mechanisms and safety of its application in the perioperative period.
7.The effects of occupational noise exposure on glycated hemoglobin and prediabetes
Xiayun DAI ; Wenjun YIN ; Jichao LI ; Ling ZHANG ; Tian XU ; Xiaoli SHEN ; Qunyan LI ; Shenglan ZHOU ; Guilin YI ; Zhiwei PAN ; Zhenlong CHEN
China Occupational Medicine 2023;50(3):274-278
Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.
8.Construction of a prediction model for lung cancer combined with chronic obstructive pulmonary disease by combining CT imaging features with clinical features and evaluation of its efficacy
Taohu ZHOU ; Wenting TU ; Xiuxiu ZHOU ; Wenjun HUANG ; Tian LIU ; Yan FENG ; Hanxiao ZHANG ; Yun WANG ; Yu GUAN ; Xin′ang JIANG ; Peng DONG ; Shiyuan LIU ; Li FAN
Chinese Journal of Radiology 2023;57(8):889-896
Objective:To assess the effectiveness of a model created using clinical features and preoperative chest CT imaging features in predicting the chronic obstructive pulmonary disease (COPD) among patients diagnosed with lung cancer.Methods:A retrospective analysis was conducted on clinical (age, gender, smoking history, smoking index, etc.) and imaging (lesion size, location, density, lobulation sign, etc.) data from 444 lung cancer patients confirmed by pathology at the Second Affiliated Hospital of Naval Medical University between June 2014 and March 2021. These patients were randomly divided into a training set (310 patients) and an internal test set (134 patients) using a 7∶3 ratio through the random function in Python. Based on the results of pulmonary function tests, the patients were further categorized into two groups: lung cancer combined with COPD and lung cancer non-COPD. Initially, univariate analysis was performed to identify statistically significant differences in clinical characteristics between the two groups. The variables showing significance were then included in the logistic regression analysis to determine the independent factors predicting lung cancer combined with COPD, thereby constructing the clinical model. The image features underwent a filtering process using the minimum absolute value convergence and selection operator. The reliability of these features was assessed through leave-P groups-out cross-validation repeated five times. Subsequently, a radiological model was developed. Finally, a combined model was established by combining the radiological signature with the clinical features. Receiver operating characteristic (ROC) curves and decision curve analysis (DCA) curves were plotted to evaluate the predictive capability and clinical applicability of the model. The area under the curve (AUC) for each model in predicting lung cancer combined with COPD was compared using the DeLong test.Results:In the training set, there were 182 cases in the lung cancer combined with COPD group and 128 cases in the lung cancer non-COPD group. The combined model demonstrated an AUC of 0.89 for predicting lung cancer combined with COPD, while the clinical model achieved an AUC of 0.82 and the radiological model had an AUC of 0.85. In the test set, there were 78 cases in the lung cancer combined with COPD group and 56 cases in the lung cancer non-COPD group. The combined model yielded an AUC of 0.85 for predicting lung cancer combined with COPD, compared to 0.77 for the clinical model and 0.83 for the radiological model. The difference in AUC between the radiological model and the clinical model was not statistically significant ( Z=1.40, P=0.163). However, there were statistically significant differences in the AUC values between the combined model and the clinical model ( Z=-4.01, P=0.010), as well as between the combined model and the radiological model ( Z=-2.57, P<0.001). DCA showed the maximum net benifit of the combined model. Conclusion:The developed synthetic diagnostic combined model, incorporating both radiological signature and clinical features, demonstrates the ability to predict COPD in patients with lung cancer.
9.Clinical application of minimal invasive liposuction system in lumbar abdominal liposuction
Muyi FENG ; Wenjun OUYANG ; Meng DENG ; Meibang XU ; Meng ZHANG ; Fang LIU ; Hao CHENG ; Kai TIAN
Chinese Journal of Medical Aesthetics and Cosmetology 2023;29(5):373-376
Objective:To investigate the clinical application and surgical effect of minimal invasive liposuction system (MILS) in lumbar abdominal liposuction.Methods:From July 2019 to March 2021, 985 patients were selected for lumbar and abdominal liposuction. Local anesthesia and intravenous anesthesia were used in all operations. The preoperative design and intraoperative procedures were carried out according to the requirements of MILS method. An average of 2 425 ml fat was aspirated, and the average operation time was 142.4 min.Results:After 3-18 (average 3.85 months) months of follow-up, 857 patients (87% of the patients) were discharged on the day of operation. The waist line curve of the patients was clear and the bulge of the upper and lower abdomen was significantly reduced. The satisfactory rate was 93.5%, and the incidence of complications was 2.8%. No severe complication occurred.Conclusions:MILS is a safe and effective method to perform the waist and abdominal liposuction scientifically and finely. The MILS method makes the lumbar abdominal liposuction standardized, reduces unnecessary procedure, shortens the liposuction learning curve, reduces the occurrence of complications, and achieves the best aesthetic effect.
10.Fanconi anemia gene-associated germline predisposition in aplastic anemia and hematologic malignancies.
Daijing NIE ; Jing ZHANG ; Fang WANG ; Xvxin LI ; Lili LIU ; Wei ZHANG ; Panxiang CAO ; Xue CHEN ; Yang ZHANG ; Jiaqi CHEN ; Xiaoli MA ; Xiaosu ZHOU ; Qisheng WU ; Ming LIU ; Mingyue LIU ; Wenjun TIAN ; Hongxing LIU
Frontiers of Medicine 2022;16(3):459-466
Whether Fanconi anemia (FA) heterozygotes are predisposed to bone marrow failure and hematologic neoplasm is a crucial but unsettled issue in cancer prevention and family consulting. We retrospectively analyzed rare possibly significant variations (PSVs) in the five most obligated FA genes, BRCA2, FANCA, FANCC, FANCD2, and FANCG, in 788 patients with aplastic anemia (AA) and hematologic malignancy. Sixty-eight variants were identified in 66 patients (8.38%). FANCA was the most frequently mutated gene (n = 29), followed by BRCA2 (n = 20). Compared with that of the ExAC East Asian dataset, the overall frequency of rare PSVs was higher in our cohort (P = 0.016). BRCA2 PSVs showed higher frequency in acute lymphocytic leukemia (P = 0.038), and FANCA PSVs were significantly enriched in AA and AML subgroups (P = 0.020; P = 0.008). FA-PSV-positive MDS/AML patients had a higher tumor mutation burden, higher rate of cytogenetic abnormalities, less epigenetic regulation, and fewer spliceosome gene mutations than those of FA-PSV-negative MDS/AML patients (P = 0.024, P = 0.029, P = 0.024, and P = 0.013). The overall PSV enrichment in our cohort suggests that heterozygous mutations of FA genes contribute to hematopoietic failure and leukemogenesis.
Anemia, Aplastic/genetics*
;
Epigenesis, Genetic
;
Fanconi Anemia/genetics*
;
Germ Cells
;
Hematologic Neoplasms/genetics*
;
Humans
;
Leukemia, Myeloid, Acute/genetics*
;
Retrospective Studies


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