1.The early prediction of umbilical cord blood S100β protein and lactate combined with amplitude integrated electroencephalogram in small for gestational age preterm infants with brain injury
Junlong CHEN ; Xiaoli WANG ; Xiaoling YANG ; Xuewen SU ; Fuhua JIA ; Shuli WU
International Journal of Pediatrics 2024;51(1):64-68
Objective:To explore the early predictive value of umbilical cord blood S100β protein and lactate combined with amplitude integrated electroencephalogram(aEEG)in small for gestational age(SGA)preterm infants with brain injury.Methods:One hundred and six cases of SGA preterm infants were enrolled in this study in Neonatology Department of Inner Mongolia People's Hospital from January 2019 to December 2021. Umbilical cord blood serum S100β protein and lactate at birth of All SGA preterm infants were tested,and aEEG was monitored at 6h and 72 h after birth,corrected gestational age of 32 weeks and 37 weeks. According to the diagnostic criteria of brain injury in preterm infants,SGA preterm infants were divided into brain injury group(45 cases)and non-brain injury group(61 cases),and compared the differences of S100β protein,lactate and the designated time aEEG between the two groups.SGA preterm infants with brain injury were further divided into symmetrical group(28 cases)and non-symmetrical group(15 cases). The differences of umbilical cord blood S100β protein and lactate level between the two groups were compared,and the diagnostic value in different types of SGA preterm infants with brain injury was also compared.Results:SGA preterm infants in the brain injury group had significantly higher levels of umbilical cord blood S100β protein[(0.826±0.218)μg/L vs(0.397±0.196)μg/L, t=8.316, P<0.05]and lactate[(8.5±1.3)mmol/L vs(3.8±0.9)mmol/L, t=3.281, P<0.05]than those in non-brain injury group.Symmetric SGA group had higher level of S100β protein than the asymmetric SGA group[(0.924±0.205)μg/L vs(0.438±0.196)μg/L, t=5.734, P<0.05].But there was no statistically significant difference in lactate levels[(5.6±1.4)mmol/L vs(3.9±1.2)mmol/L, t=0.932, P>0.05]between symmetric SGA group and asymmetric SGA group. The abnormal rates of aEEG in brain injury group and non-brain injury group were respectively 100%(45/45)vs 22.95%(14/61)at 6 h after birth,95.56%(43/45)vs 16.39%(10/61)at 72 h after birth,62.22%(28/45)vs 6.56%(4/61)at 32 weeks of corrected gestational age,22.22%(10/45)vs 3.28%(2/61)at 37 weeks of corrected gestational age. The abnormal rate of brain injury group was higher than the non-brain injury group in the same nodal time,and the differences were statistically significant( χ 2 value respectively 62.292,64.913,38.074,9.257,all P<0.05). Conclusion:There were significant value in umbilical cord blood S100β protein,lactate level and aEEG monitoring in the early diagnosis in preterm infants SGA with brain injury. The combination of the three might be more helpful for the early diagnosis and timely treatment of brain injury in SGA preterm infants.
2.The impact of non-HDL-C level on major adverse cardiovascular and cerebrovascular events and all-cause mortality after revascularization
Xuewen WANG ; Shihe LIU ; Xu HAN ; Qian LIU ; Shuohua CHEN ; Xiujuan ZHAO ; Lu LI ; Shouling WU ; Yuntao WU
Chinese Journal of Cardiology 2024;52(6):667-675
Objective:To investigate the impact of non-high-density lipoprotein cholesterol (non-HDL-C) level on major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause mortality in the Kailuan Study cohort undergoing revascularization.Methods:This is a prospective cohort study, with participants from the Kailuan Study cohort who participated in physical examinations from 2006 to 2020 and received revascularization therapy for the first time. According to the level of non-HDL-C, the study subjects were divided into 3 groups:<2.6 mmol/L group, 2.6-<3.4 mmol/L group, and≥3.4 mmol/L group. Annual follow-up was performed, and the endpoint events were MACCE and all-cause mortality. Cox proportional regression model was implemented to estimate the impact on MACCE and all-cause mortality associated with the different non-HDL-C groups. The partial distributed risk model was used to analyze the impact of different non-HDL-C levels on MACCE event subtypes, and death was regarded as a competitive event. The restricted cubic spline regression model was used to explore the dose-response relationship between non-HDL-C level and all-cause mortality, MACCE and its subtypes.Results:A total of 2 252 subjects were enrolled in the study, including 2 019 males (89.65%), aged (62.8±8.3) years, the follow-up time was 5.72 (3.18, 8.46) years. There were 384 cases(17.05%) of MACCE and 157 cases(6.97%) of all-cause mortality. Compared with patients with non-HDL-C≥3.4 mmol/L, patients with non-HDL-C<2.6 mmol/L were associated with a 38% reduced risk of MACCE after revascularization [ HR=0.62(95% CI: 0.48-0.80)]. Every 1 mmol/L decrease in non-HDL-C was associated with a 20% reduction in the risk of MACCE [ HR=0.80(95% CI: 0.73-0.88)]. The results of restricted cubic spline also showed that non-HDL-C levels after revascularization therapy were positively correlated with MACCE events (overall association P<0.001, non-linear association P=0.808). For all-cause mortality, compared to the non-HDL-C≥3.4 mmol/L group, the HR for all-cause mortality after revascularization in non-HDL-C<2.6 mmol/L group was 0.67(95% CI: 0.46-1.01). Every 1 mmol/L decrease in non-HDL-C was associated with a 15% reduction in the risk of all-cause mortality [ HR=0.85(95% CI: 0.73-0.99)]. The restricted cubic spline results showed a linear association between non-HDL-C levels after revascularization therapy and the risk of all-cause mortality (overall association P=0.039, non-linear association P=0.174). Conclusion:The decrease in non-HDL-C levels after revascularization were significantly associated with a reduced risk of MACCE and all-cause mortality.
3.Clinical efficacy of IDH1 mutation in temozolomide chemotherapy for glioma patients and its impact on immune cytokines and prognosis
Xuewen ZHANG ; Yu WANG ; Jie WU ; Chen WANG
Chinese Journal of Immunology 2024;40(11):2373-2379
Objective:To study clinical efficacy of isocitrate dehydrogenase 1(IDH1)mutation on temozolomide chemotherapy for glioma patients and its impact on immune cytokines and prognosis.Methods:A total of 134 patients with glioma who underwent surgical resection and were confirmed by pathology in Dushu Lake Hospital Affiliated to Soochow University from October 2021 to October 2022 were selected as research subjects.IDH1 mutation status was measured by direct sequencing method,and IDH1 expres-sion rate in glioma tissue was determined by immunohistochemistry.All patients with brain glioma were treated with temozolomide chemotherapy.Effects of IDH1 mutation on clinical efficacy,immune cytokines(IFN-γ,IL-2,IL-4,IL-10)and prognosis of glioma were analyzed.Results:Seventy-nine cases out of 134 cases of glioma tissue had IDH1 mutations,mostly at R132,with a mutation rate of 58.96%,significantly higher than normal brain tissue(χ2=48.066,P<0.05).Immunohistochemistry showed strong positive expression of IDH1 in 56 out of 134 glioma tissues.Proportion of WHO grade Ⅳ in IDH1 mutant group was lower than IDHI wild type group[11.39%(9/79)vs 63.64%(35/55),Z=41.020,P<0.05].Proportion of low differentiation in IDH1 mutant group was higher than IDHI wild type group[50.63%(40/79)vs 20.00%(11/55),χ2=12.907,P<0.05].Total effective rate in IDH1 mutant group was higher than IDH1 wild type group[91.14%(72/79)vs 76.36%(42/55),χ2=5.575,P<0.05],IFN-γ and IL-2 levels were higher than IDH1 wild type group[(28.98±3.25)pg/ml vs(20.15±2.54)pg/ml,(33.42±4.25)pg/ml vs(25.23±3.52)pg/ml,t=16.870,11.750,P<0.05],IL-4 and IL-10 levels were lower than IDH1 wild type group[(7.90±1.02)pg/ml vs(12.38±1.66)pg/ml,(8.79±1.00)pg/ml vs(15.26±1.23)pg/ml,t=19.330,33.500,P<0.05].IDH1 mutation was positively correlated with IFN-γ and IL-2 levels after temozolo-mide chemotherapy(r=0.845,0.772,P<0.05),and negatively correlated with IL-4 and IL-10 levels after temozolomide chemotherapy(r=-0.786,-0.685,P<0.05).Survival rate after chemotherapy in IDH1 mutant group was higher than IDH1 wild type group[89.87%(71/79)vs 72.70%(40/55),Log Rank test χ2=5.208,P<0.05].Cox regression analysis found that WHO grade Ⅲ(RR=1.342),poorly differentiated(RR=1.783),IFN-γ(RR=1.808),IL-2(RR=2.112),IL-4(RR=2.342),IL-10(RR=1.342)as risk factors,temozolo-mide chemotherapy efficacy(RR=0.653),IDH1 mutation(RR=0.895)as protective factors affect prognosis of temozolomide chemo-therapy in glioma patients(P<0.05).Conclusion:IDH1 mutation is related to disease grade and differentiation degree of glioma patients,and can affect efficacy of temozolomide chemotherapy and expressions of immune cytokines,which is a protective factor for prognosis and survival after temozolomide chemotherapy.
4.Diagnostic value of CT density features of the fat around pericoronary artery combined with ECG on the severity of disease condition in CHD patients
Jinwen LIU ; Xuewen LI ; Shan WU ; Yayun ZHANG ; Zhijun ZHANG
China Medical Equipment 2024;21(9):47-52
Objective:To investigate the diagnostic value of density features of computed tomography(CT)of the fat around pericoronary artery of dual-source computer tomography angiography(CTA)combined with electrocardiogram(ECG)on the severity of disease condition in patients with coronary heart disease(CHD).Methods:A total of 120 CHD patients who admitted to Shanxi Bethune Hospital from March 2021 to March 2023 were selected,and they were grouped according to the New York Heart Association(NYHA).Among of them,86 cases at grade Ⅱ-Ⅲ were divided into grade Ⅱ-Ⅲ group,and 34 cases at grade Ⅳ were divided into grade Ⅳ group.A dual-source CT was used to detect the densities of different coronary branches of Pericardial Adipose Tissue(PCAT)of average coronary artery of proximal left anterior descending artery(pLAD),mid left anterior descending artery(mLAD),proximal left circumflex artery(pLCX),proximal right coronary artery(pRCA),mid right coronary artery(mRCA)and distal right coronary artery(dRCA)of all patients,and ECG was used to detect and record the value of QRS voltage,QRS time limit value and QTc interval of patients.The mean PCAT densities of pLAD,mLAD,pLCX,pRCA,mRCA and Drca,and the QRS voltage and QRS time limit,as well as QTc interval between the two groups were observed and compared.The receiver operating characteristics(ROC)curve was used to analyze the efficacies of the above indicators in single diagnosis and combined diagnosis for the severity of disease condition of CHD patients.Results:The mean PCAT density of pLAD,mLAD,pLCX,pRCA,mRCA,mRCA and dRCA,and QRS time limit and QTc interval of patients in grade Ⅱ-Ⅲ group were significantly lower than those in grade Ⅳ group,with statistically significant difference(t=58.681,5.097,5.902,13.513,P<0.05),respectively.The area under curve(AUC)values of ROC curves of ECG and CT density of the fat around pericoronary artery of CTA were larger than 0.5 for the severity of disease condition in CHD patients,and the highest AUC value of combined diagnosis was 0.966.The results of Pearson linear correlation analysis showed that there were correlations among mean PCAT density,QRS voltage,QRS time limit and QTc interval,and there were significantly negative correlations between QRS voltage and mean PCAT density,between QRS time limit and QTc interval(r=-0.754,-0.280,-0.452,P<0.05),and there were significantly positive correlations among mean PCAT density,QRS time limit,QTc interval and the severity of the disease condition of CHD patients(r=0.983,0.435,0.547,P<0.05),respectively.There was a significantly negative correlation between QRS voltage and severity of disease condition of CHD patients(r=-0.776,P<0.05).Conclusion:The combination of CT density features of the fat around pericoronary artery of coronary artery CTA and ECG QRS wave group detection is helpful to the diagnosis for the severity of disease condition of CHD patients,which can improve the accuracy of diagnosis and has a certain of application value.
5.Environmental exposure to perchlorate, nitrate, and thiocyanate in relation to chronic kidney disease in the general US population, NHANES 2005-2016.
Wei LI ; Hong WU ; Xuewen XU ; Yange ZHANG
Chinese Medical Journal 2023;136(13):1573-1582
BACKGROUND:
Few studies have explored the impact of perchlorate, nitrate, and thiocyanate (PNT) on kidney function. This study aimed to evaluate the association of urinary levels of PNT with renal function as well as the prevalence of chronic kidney disease (CKD) among the general population in the United States.
METHODS:
This analysis included data from 13,373 adults (≥20 years) from the National Health and Nutrition Examination Survey 2005 to 2016. We used multivariable linear and logistic regression, to explore the associations of urinary PNT with kidney function. Restricted cubic splines were used to assess the potentially non-linear relationships between PNT exposure and outcomes.
RESULTS:
After traditional creatinine adjustment, perchlorate (P-traditional) was positively associated with estimated glomerular filtration rate (eGFR) (adjusted β: 2.75; 95% confidence interval [CI]: 2.25 to 3.26; P < 0.001), and negatively associated with urinary albumin-to-creatinine ratio (ACR) (adjusted β: -0.05; 95% CI: -0.07 to -0.02; P = 0.001) in adjusted models. After both traditional and covariate-adjusted creatinine adjustment, urinary nitrate and thiocyanate were positively associated with eGFR (all P values <0.05), and negatively associated with ACR (all P values <0.05); higher nitrate or thiocyanate was associated with a lower risk of CKD (all P values <0.001). Moreover, there were L-shaped non-linear associations between nitrate, thiocyanate, and outcomes. In the adjusted models, for quartiles of PNT, statistically significant dose-response associations were observed in most relationships. Most results were consistent in the stratified and sensitivity analyses.
CONCLUSIONS
Exposures to PNT might be associated with kidney function, indicating a potential beneficial effect of environmental PNT exposure (especially nitrate and thiocyanate) on the human kidney.
Adult
;
Humans
;
United States/epidemiology*
;
Nitrates/adverse effects*
;
Nutrition Surveys
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Thiocyanates/urine*
;
Perchlorates/urine*
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Creatinine
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Environmental Exposure
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Renal Insufficiency, Chronic/epidemiology*
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Logistic Models
6.Early effectiveness of a new minimally invasive plate in treatment of varus-type ankle arthritis.
Xuewen WANG ; Heng LI ; Xiaofeng GONG ; Liangpeng LAI ; Wenjing LI ; Yan WANG ; Hui DU ; Ying LI ; Ning SUN ; Yong WU
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(7):776-781
OBJECTIVE:
To evaluate the early effectiveness of a new minimally invasive plate in the treatment of varus-type ankle arthritis.
METHODS:
A clinical data of 15 patients with varus-type ankle arthritis who met the selection criteria between March 2021 and October 2021 were retrospectively analyzed. All the patients were treated with medial open-wedge supramalleolar osteotomy and fibular osteotomy. The osteotomies were fixed with the new minimally invasive plate. There were 7 males and 8 females with an average age of 49.8 years (range, 16-71 years). The causes of ankle arthritis included post-fracture deformity in 1 case, sprain in 8 cases, and acquired clubfoot in 1 case; and 5 cases were without obvious factors. The disease duration ranged from 1 to 12 years, with an average of 4.1 years. Comparisons were made between pre-operation and the last follow-up in the Takakura staging, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, foot function index (FFI), visual analogue scale (VAS) score, tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and talar tilt (TT).
RESULTS:
All incisions healed by first intention. All patients were followed up 7-18 months (mean, 12.8 months). At last follow-up, the AOFAS ankle-hindfoot score, FFI, VAS score, and Takakura staging significantly improved when compared with the preoperative ones ( P<0.05). X-ray films showed that the osteotomy healed at 3 months after operation. At last follow-up, TAS significantly increased and TT decreased when compared with the preoperative ones ( P<0.05), and the difference in TLS between pre- and post-operation was not significant ( P>0.05). Complications included 1 case of intraoperative screw breakage and 2 cases of nerve injury of the affected foot. None of the patients complained of significant discomfort at the plate placement during follow-up, and no loosening of the internal fixator occurred. Eleven patients were very satisfied with the effeectiveness, while 4 were relatively satisfied.
CONCLUSION
The new minimally invasive plate for the varus-type ankle arthritis has good early effectiveness in relieving ankle pain, correcting deformity, improving limb alignment and ankle function, and reducing the incidence of postoperative incisional complications.
Female
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Humans
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Male
;
Middle Aged
;
Ankle
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Ankle Joint/surgery*
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Osteoarthritis/surgery*
;
Retrospective Studies
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Tibia/surgery*
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Treatment Outcome
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Adolescent
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Young Adult
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Adult
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Aged
7.Effects of 12-week Liu Zi Jue Qigong-based breathing training on the curvature and range of motion of the thoracic and lumbar spines
Fanyuan JIN ; Yanbing LIU ; Xuewen WU ; Mengyue SHI ; Shuaiyu YING ; Haonan CHEN ; Xiaodong WANG
Journal of Acupuncture and Tuina Science 2023;21(1):27-33
Objective: To evaluate the effects of Liu Zi Jue Qigong (LQG)-based breathing training on the curvature and range of motion (ROM) of the thoracic and lumbar spines in different positions. Methods: Forty-seven college students were selected as subjects and randomly divided into an observation group and a control group. In the observation group, 27 subjects received regular LQG-based breathing training for 12 weeks, while 20 subjects in the control group did not receive any intervention. The spine measuring instrument Spinal Mouse was adopted to detect the curvature and ROM of the thoracic and lumbar spines. Results: In the observation group, the changes in the curvatures of thoracic spine in the upright and forward-bending positions showed statistical significance after LQG exercise (P<0.05), while there was no notable difference in the control group. The comparison of ROM of the thoracic spine from the upright position to the forward-bending and load-bearing positions showed statistically significant difference in the observation group (P<0.05), while there was no significant difference in the control group. There was no significant difference in the lumbar curvature and ROM in the two groups after LQG exercise. Conclusion: LQG-based breathing training improves the curvature and ROM of the thoracic spine.
8.Construction of a chimeric antigen receptor CAR THP -1 cell line targeting HER2
Yizhao Chen ; Lihua Liu ; Xiangling Zhu ; Huihui Wang ; Xuming Wu ; Xuewen Tan ; Yilong Fang ; Haifeng Jiang ; Zhen Xu ; Wei Wei ; Jiajie Tu
Acta Universitatis Medicinalis Anhui 2023;58(3):352-357
Objective:
To obtain chimeric antigen receptor macrophages ( CAR-M) targeting HER2 stably transfected.
Methods :
CAR lentivirus vector targeting HER2 was constructed and infected with human monocytic leukemia cell line (THP-1) .CAR THP-1 cells with green fluorescent labeling were selected by sorting flow cytometry and continued to be cultured in vitro.The CAR THP-1 cells targeting HER2 were co-cultured with the endometrial cancer cell line Ishikawa with negative and positive HER2 expression,and their targeted phagocytosis of CAR-M to HER2 positive tumor cells was detected by imaging flow cytometry ,and the targeted phagocytosis efficiency of CAR-M to HER2 positive tumor cells was detected by flow cytometry.
Results :
CAR lentivirus infection with THP- 1 cells was less efficient ; After co-culture with cancer cells,flow cytometry and imaging flow cytometry showed that CAR THP-1 cells had enhanced phagocytosis of HER2 positive Ishikawa cells compared with the empty body group (P<0. 01) .
Conclusion
In this experiment,CAR THP-1 cell line targeting HER2 was established by constructing CAR lentivirus vector and transfecting THP-1 cells ,and it was proved that CAR THP-1 could phagocytize HER2 positive Ishikawa cells through specific targeting.
9.Research progress in aging rodent models
Xuechan LI ; Le HAN ; Xuewen WANG ; Lijun LIU ; Jianjun WU ; Jing WANG
Acta Laboratorium Animalis Scientia Sinica 2023;31(12):1605-1609
Aging is a process of degenerative change that occurs as a result of time-related accumulation,associated with age-related diseases.Understanding the causes and mechanisms of aging and finding drugs that can effectively delay aging and prevent and cure age-related diseases currently present a great challenge for humans.Aging animal models thus represent an important tool in aging research,and various aging animal models have been created using different aging mechanisms.These different models having specific advantages and disadvantages,making them suitable for different research purposes.This review considers aging rodent models to provide information for aging research.
10.Application of high resolution computed tomography image assisted classification model of middle ear diseases based on 3D-convolutional neural network.
Ri SU ; Jian SONG ; Zheng WANG ; Shuang MAO ; Yitao MAO ; Xuewen WU ; Muzhou HOU
Journal of Central South University(Medical Sciences) 2022;47(8):1037-1048
OBJECTIVES:
Chronic suppurative otitis media (CSOM) and middle ear cholesteatoma (MEC) are the 2 most common chronic middle ear diseases. In the process of diagnosis and treatment, the 2 diseases are prone to misdiagnosis and missed diagnosis due to their similar clinical manifestations. High resolution computed tomography (HRCT) can clearly display the fine anatomical structure of the temporal bone, accurately reflect the middle ear lesions and the extent of the lesions, and has advantages in the differential diagnosis of chronic middle ear diseases. This study aims to develop a deep learning model for automatic information extraction and classification diagnosis of chronic middle ear diseases based on temporal bone HRCT image data to improve the classification and diagnosis efficiency of chronic middle ear diseases in clinical practice and reduce the occurrence of missed diagnosis and misdiagnosis.
METHODS:
The clinical records and temporal bone HRCT imaging data for patients with chronic middle ear diseases hospitalized in the Department of Otorhinolaryngology, Xiangya Hospital from January 2018 to October 2020 were retrospectively collected. The patient's medical records were independently reviewed by 2 experienced otorhinolaryngologist and the final diagnosis was reached a consensus. A total of 499 patients (998 ears) were enrolled in this study. The 998 ears were divided into 3 groups: an MEC group (108 ears), a CSOM group (622 ears), and a normal group (268 ears). The Gaussian noise with different variances was used to amplify the samples of the dataset to offset the imbalance in the number of samples between groups. The sample size of the amplified experimental dataset was 1 806 ears. In the study, 75% (1 355) samples were randomly selected for training, 10% (180) samples for validation, and the remaining 15% (271) samples for testing and evaluating the model performance. The overall design for the model was a serial structure, and the deep learning model with 3 different functions was set up. The first model was the regional recommendation network algorithm, which searched the middle ear image from the whole HRCT image, and then cut and saved the image. The second model was image contrast convolutional neural network (CNN) based on twin network structure, which searched the images matching the key layers of HRCT images from the cut images, and constructed 3D data blocks. The third model was based on 3D-CNN operation, which was used for the final classification and diagnosis of the 3D data block construction, and gave the final prediction probability.
RESULTS:
The special level search network based on twin network structure showed an average AUC of 0.939 on 10 special levels. The overall accuracy of the classification network based on 3D-CNN was 96.5%, the overall recall rate was 96.4%, and the average AUC under the 3 classifications was 0.983. The recall rates of CSOM cases and MEC cases were 93.7% and 97.4%, respectively. In the subsequent comparison experiments, the average accuracy of some classical CNN was 79.3%, and the average recall rate was 87.6%. The precision rate and the recall rate of the deep learning network constructed in this study were about 17.2% and 8.8% higher than those of the common CNN.
CONCLUSIONS
The deep learning network model proposed in this study can automatically extract 3D data blocks containing middle ear features from the HRCT image data of patients' temporal bone, which can reduce the overall size of the data while preserve the relationship between corresponding images, and further use 3D-CNN for classification and diagnosis of CSOM and MEC. The design of this model is well fitting to the continuous characteristics of HRCT data, and the experimental results show high precision and adaptability, which is better than the current common CNN methods.
Algorithms
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Ear Diseases
;
Humans
;
Neural Networks, Computer
;
Retrospective Studies
;
Tomography, X-Ray Computed/methods*


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