1.A prediction model for high-risk cardiovascular disease among residents aged 35 to 75 years
ZHOU Guoying ; XING Lili ; SU Ying ; LIU Hongjie ; LIU He ; WANG Di ; XUE Jinfeng ; DAI Wei ; WANG Jing ; YANG Xinghua
Journal of Preventive Medicine 2025;37(1):12-16
Objective:
To establish a prediction model for high-risk cardiovascular disease (CVD) among residents aged 35 to 75 years, so as to provide the basis for improving CVD prevention and control measures.
Methods:
Permanent residents aged 35 to 75 years were selected from Dongcheng District, Beijing Municipality using the stratified random sampling method from 2018 to 2023. Demographic information, lifestyle, waist circumference and blood biochemical indicators were collected through questionnaire surveys, physical examinations and laboratory tests. Influencing factors for high-risk CVD among residents aged 35 to 75 years were identified using a multivariable logistic regression model, and a prediction model for high-risk CVD was established. The predictive effect was evaluated using the receiver operating characteristic (ROC) curve.
Results:
A total of 6 968 individuals were surveyed, including 2 821 males (40.49%) and 4 147 females (59.51%), and had a mean age of (59.92±9.33) years. There were 1 155 high-risk CVD population, with a detection rate of 16.58%. Multivariable logistic regression analysis showed that gender, age, smoking, central obesity, systolic blood pressure, fasting blood glucose, triglyceride and low-density lipoprotein cholesterol were influencing factors for high-risk CVD among residents aged 35 to 75 years (all P<0.05). The area under the ROC curve of the established prediction model was 0.849 (95%CI: 0.834-0.863), with a sensitivity of 0.693 and a specificity of 0.863, indicating good discrimination.
Conclusion
The model constructed by eight factors including demographic characteristics, lifestyle and blood biochemical indicators has good predictive value for high-risk CVD among residents aged 35 to 75 years.
2.Characteristics of Emergency Health Systems Guidance Based on AGREE-HS
Danping ZHENG ; Wei YANG ; Nannan SHI ; Dongfeng WEI ; An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Zhaoshuai YAN ; Weixuan BAI ; Xinghua XIANG ; Yaxin TIAN ; Mengyu LIU ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):137-148
This study used the Appraisal of Guidelines Research & Evaluation-Health Systems (AGREE-HS) to demonstratively compare 34 global coronavirus disease-2019 (COVID-19) health systems guidance documents (HSGs) and 6 World Health Organization (WHO) standard HSGs. The comparison involved topic, participants, methods, recommendations, and implementability, with the aim of exploring the characteristics of emergency HSGs. The results showed that the emergency HSGs had an overall average score of 49%, with topic having the highest score, recommendations having the second highest score, and participants having the lowest score. The standard HSGs had an overall average score of 79%, with high scores in all items. The emergency HSGs had lower scores in participants, methods, recommendations, and implementability than the standard HSGs (P<0.001), while the COVID-19 emergency HSGs developed by the WHO had higher score in topic than the standard HSGs (P<0.05). Compared with those released by countries, the COVID-19 emergency HSG developed by the WHO showed superiority in all items and overall scores (P=0.000 2). This indicates that emergency HSGs, represented by the COVID-19 emergency HSG, place equal emphasis on topic and recommendations as standard HSGs but have low requirements in terms of expert participation, evidence support, and comprehensive consideration in the time- and resource-limited context. They have the characteristics of prominent topics, clear purposes, orientation to demand, keeping up with the latest evidence, flexible adjustment, and timeliness, emphasizing immediate implementation effects, weakening long-term effects, and focusing on comprehensive benefits. Additionally, developers, types, and report completeness are important influencing factors.
3.Characteristics of Developing Methods for Emergency Health Systems Guidance Based on AGREE-HS
Danping ZHENG ; Wei YANG ; Dongfeng WEI ; Nannan SHI ; Lin TONG ; An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Weixuan BAI ; Xinghua XIANG ; Mengyu LIU ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):149-156
The scientific rigor and efficacy of methodologies employed in drafting emergency health systems guidance documents (HSGs) are paramount in guaranteeing the quality, reliability, and applicability of HSGs. According to the Appraisal of Guidelines for Research and Evaluation- Health Systems (AGREE-HS), we demonstratively assessed both global coronavirus disease-2019 (COVID-19) emergency HSGs and World Health Organization (WHO) standard HSGs to uncover the core attributes of methods employed in the development of emergency HSGs. Our evaluation findings revealed that across the five assessment items of AGREE-HS, methods in the 34 emergency HSGs evaluated ranked third, trailing behind topic and recommendations. Notably, criterion 2 (the best available and most contextually relevant evidence is considered) received the highest score, whereas criterion 5 (evidence of cost and cost-effectiveness of the potential options is described) scored the lowest. Compared with the WHO standard HSGs, the COVID-19 emergency HSGs exhibited low scores in methods (P<0.05), which was reflected in nine criteria (P<0.05), especially in criteria 1 (systematic and transparent methods are used to identify and review the evidence) and 9 (systematic and transparent methods are used to agree upon the final recommendations). Among the COVID-19 emergency HSGs, that developed by the WHO achieved higher scores in eight out of all nine criteria, excluding criterion 8 (P<0.05). The clinically relevant emergency HSGs had higher scores in the criteria 3 (the evidence base is current) and 8 (the rationale behind the recommendations is clear) than other types of emergency HSGs. Collectively, the methodology for developing emergency HSGs, represented by the COVID-19 emergency HSG, underscores evidence orientation and integrates expert consensus. It is characterized by adaptable evidence synthesis strategies, streamlined evidence review protocols, and contextual relevance, all of which are influenced by external, internal, and implementation-specific factors.
4.Discussion on the Evidence Value of Textbooks in the Formulation of Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Allergic Rhinitis
Cuifang LIU ; Dongfeng WEI ; Wei YANG ; Feibiao XIE ; Danping ZHENG ; Xinghua XIANG ; Mengyu LIU
Journal of Traditional Chinese Medicine 2024;65(4):368-375
ObjectiveTo explore the feasibility and rationality of applying relevant diagnostic and treatment programmes from textbooks as evidence in traditional Chinese medicine (TCM) diagnosis and treatment guidelines, using allergic rhinitis as an example. MethodsTextbooks published from October 1949 to December 2022, as well as TCM diagnosis and treatment guidelines published until December 2022 on allergic rhinitis were searched, and the contents of diagnosis and treatment related to allergic rhinitis were extracted. The similarities and differences between textbooks in different periods, between textbooks in different versions, and between textbooks and guidelines were compared and analyzed. ResultsA total of 12 national planning textbooks on TCM otolaryngology and 4 Chinese medicine diagnosis and treatment guidelines on allergic rhinitis from 1975 to 2021 were included. The evolution of diagnostic and treatment programmes was shown by the textbooks in different periods. Since 2003, syndrome of latent heat in lung channel has been added in the published textbook, and TCM featured therapies, such as nasal packing, intranasal spray were enriched, as well as the contents related to prevention and prognosis. The main syndromes included lung qi deficiency and cold, spleen qi deficiency, kidney yang deficiency, and latent heat in lung meridian. The most common recommended prescriptions were Wenfei Zhiliu Pill (温肺止流丹), Yupingfeng Powder (玉屏风散) and Cangerzi Powder (苍耳子散); Buzhong Yiqi Decoction (补中益气汤), Shenling Baizhu Powder (参苓白术散); Shenqi Pill (肾气丸) or Zhenwu Decoction (真武汤); Xinyi Qingfei Decoction (辛夷清肺饮). A comparison of different versions of textbooks showed that the classification of syndromes was consistent, while the formulas were slightly different. The comparison between different versions of the current textbooks and the guidelines showed that the recommended prescriptions of the textbooks had more Cangerzi Powder, Xiaoqinglong Decoction (小青龙汤), Zhenwu Decoction, etc., while TCM featured therapies such as nose blowing, smelling, nasal plugging, nasal washing were enriched, and information on formula modification, prevention and adjustment, prognosis were also added, which can supplement the corresponding evidence for the guidelines. ConclusionTextbooks could serve as a strong supplement for the evidence-based development of TCM clinical guidelines. However, there is still a need for further research on the quality assessment system of textbook evidence to improve the credibility of its applicability of the guidelines evidence.
5.The treatment strategies and progresses in upper lip rejuvenation
Weihao SONG ; Yongjie WANG ; Xinghua YANG
Chinese Journal of Plastic Surgery 2024;40(10):1137-1141
The upper lip is a fundamental component of facial aesthetics, playing a crucial role in facial attraction and emotional expression. The aging of the upper lip is primarily attributed to the absorption of the bony supporting structure and the atrophy of the soft tissue. Currently, upper lip rejuvenation techniques mainly include lip lifting, filling treatments, and complementary skin resurfacing. This review outlines various treatment strategies and highlights recent advancements in upper lip rejuvenation, concluding that tailored treatment plans can be developed for varying degrees of aging. Comprehensive approaches can lead to satisfactory outcomes in lip rejuvenation.
6.Advances in Gene Therapy Delivery Systems:Promising Prospects for the Treatment of Inherited Retinal Diseases
Yang ZHAI ; Zixuan SU ; Xinghua WANG
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2024;53(3):414-419
Inherited retinal disease encompasses a range of congenital retinal neurodegenerative conditions,characterized by symptoms such as night blindness,progressive visual field defect,vision loss,and even blindness.The main cause of the disease is gene mutation.Through gene therapy,that is the application of exogenous nucleotides to replace or silence the disease-causing genes in the genetically defective cells,so that the cells can express the correct protein and restore the function of cells.Therefore,it is possible to cure the disease.The immune-privileged status of the eye makes it an ideal organ for gene thera-py.However,successful gene therapy requires delivery systems that can carry therapeutic nucleotides into the cells.This review focuses on the progress and challenges of gene therapy delivery systems for inherited retinal diseases,including viral and non-vi-ral vectors.
7.The treatment strategies and progresses in upper lip rejuvenation
Weihao SONG ; Yongjie WANG ; Xinghua YANG
Chinese Journal of Plastic Surgery 2024;40(10):1137-1141
The upper lip is a fundamental component of facial aesthetics, playing a crucial role in facial attraction and emotional expression. The aging of the upper lip is primarily attributed to the absorption of the bony supporting structure and the atrophy of the soft tissue. Currently, upper lip rejuvenation techniques mainly include lip lifting, filling treatments, and complementary skin resurfacing. This review outlines various treatment strategies and highlights recent advancements in upper lip rejuvenation, concluding that tailored treatment plans can be developed for varying degrees of aging. Comprehensive approaches can lead to satisfactory outcomes in lip rejuvenation.
8.The relationship between gene mutation in the pre-C region of hepatitis B virus and acute-on-chronic liver failure associated with hepatitis B
Xinghua CUI ; Yi YANG ; Ting SUN ; Junfei DONG
Journal of Chinese Physician 2024;26(10):1540-1543
Objective:To explore the relationship between gene mutation in the pre-C region of hepatitis B virus (HBV) and acute-on-chronic liver failure (ACLF) associated with hepatitis B.Methods:Fifty-eight patients with chronic hepatitis B (CHB) admitted to the General Hospital of Northern Theater Command of the Chinese People′s Liberation Army from May 2020 to May 2023 were selected as the CHB group, 51 patients with chronic hepatitis B liver cirrhosis (CHB-LC) were selected as the CHB-LC group, and 52 patients with hepatitis B-related acute-on-chronic liver failure were selected as the ACLF group. The clinicopathological data of the three groups were collected for retrospective analysis. Peripheral serum HBV DNA of the three groups was collected. The pre-C region genes of HBV in the three groups were amplified by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR), and then gene sequencing was performed. The variation at position 1896 of the pre-C region gene of HBV in the three groups was recorded. The general data, hepatitis B e antigen (HBeAg), HBV DNA quantification, triglycerides (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and gene mutation in the pre-C region of the three groups were observed and compared. Logistic regression analysis was performed on the related influencing factors of the onset of hepatitis B-related ACLF.Results:There were no statistically significant differences in gender, age, disease course, body mass index (BMI), TG, TC, and BUN among the three groups (all P>0.05), and there were statistically significant differences in HBeAg, HBV DNA quantification, ALT, and AST among the three groups (all P<0.05). The HBV DNA quantification, ALT, and AST in the ACLF group were higher than those in the CHB group and the CHB-LC group (all P<0.05). The mutation rate at position 1896 of the pre-C region gene of HBV in the ACLF group was higher than that in the CHB group and the CHB-LC group (all P<0.05); The results of logistic multivariate regression analysis showed that HBV DNA quantification, ALT, and gene mutation in the pre-C region were independent influencing factors for the onset of hepatitis B-related ACLF ( OR=1.042, 1.570, 1.413, P<0.05). Conclusions:The variation at position 1896 of the pre-C region gene of HBV is common in patients with HBV infection at different disease courses. The incidence of its variation shows a gradually increasing trend in CHB, CHB-LC, and ACLF. Elevated HBV DNA and ALT and gene mutation in the pre-C region of HBV are independent risk factors for the occurrence of hepatitis B-related ACLF. The progress of the disease in such patients requires clinical attention.
9.A Novel Melanin-Targeted 18F-PFPN Positron Emission Tomography Imaging for Diagnosing Ocular and Orbital Melanoma
Yiyan WANG ; Xinghua WANG ; Jie ZHANG ; Xiao ZHANG ; Yang CHENG ; Fagang JIANG
Korean Journal of Radiology 2024;25(8):742-748
Objective:
18F-N-(2-(Diethylamino)ethyl)-5-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy) picolinamide ( 18F-PFPN) is a novel positron emission tomography (PET) probe designed to specifically targets melanin. This study aimed to evaluate the diagnostic feasibility of 18F-PFPN in patients with ocular or orbital melanoma.
Materials and Methods:
Three patients with pathologically confirmed ocular or orbital melanoma (one male, two females; age 41–59 years) were retrospectively reviewed. Each patient underwent comprehensive 18F-PFPN and 18F-fluorodeoxyglucose ( 18F-FDG) PET scans. The maximum standardized uptake value (SUV max) of the lesion and the interference caused by background tissue were compared between 18F-PFPN and 18F-FDG PET imaging. In addition, the effect of intrinsic pigments in the uvea and retina on the interpretation of the results was examined. The contralateral non-tumorous eye of each patient served as a control.
Results:
All primary tumors (3/3) were detected using 18F-PFPN PET, while only two primary tumors were detected using 18F-FDG PET. Within each lesion, the SUV max of 18F-PFPN was 2.6 to 8.3 times higher than that of 18F-FDG. Regarding the quality of PET imaging, the physiological uptake of 18F-FDG PET in the brain and periocular tissues limited the imaging of tumors. However, 18F-PFPN PET minimized this interference. Notably, intrinsic pigments in the uvea and retina did not cause abnormal concentrations of 18F-PFPN, as no anomalous uptake of 18F-PFPN was detected in the healthy contralateral eyes.
Conclusion
Compared to 18F-FDG, 18F-PFPN demonstrated higher detection rates for ocular and orbital melanomas with minimal interference from surrounding tissues. This suggests that 18F-PFPN could be a promising clinical diagnostic tool for distinguishing malignant melanoma from benign pigmentation in ocular and orbital melanomas.
10.Constructing a Syndrome Differentiation Model by Combining Latent Structure Analysis of Association Rules: An Example of Kidney Yang Deficiency Syndrome in Primary Osteoporosis
Beibei LI ; Jing WANG ; Xinghua XIANG ; Wenyuan XU ; Weiguo BAI ; Mengyu LIU ; Yukun LI ; Xiaokun WU ; Yongjun WANG ; Wei YANG
Journal of Traditional Chinese Medicine 2023;64(24):2522-2531
ObjectiveTo construct a quantitative differentiation model of traditional Chinese medicine (TCM) syndromes by taking primary osteoporosis (POP) with kidney yang deficiency syndrome as an example, and to provide methodological reference for the standardization of syndrome differentiation. MethodsHigh-frequency clinical features of POP were screened by descriptive statistical analysis, and strong association features of POP were obtained by association rule algorithm. On this basis, a latent structure (latent tree) model was established through latent structure analysis, and the implicit and explicit variables (features) related to POP with kidney yang deficiency syndrome were comprehensively clustered, and the clustering results were interpreted by the indexes of mutual information and cumulative information coverage, to explore the primary and secondary symptoms, and to deduce the categories of POP with kidney yang deficiency syndrome based on the probability of the features appearing in the various latent categories. Based on the categories, the clinical feature scores and identification thresholds were calculated, and the syndrome differentiation model of POP with kidney yang deficiency was initially constructed by combining the comprehensive judgment rules. Finally, the results of TCM professionals' judgment were used as the gold standard to further evaluate the effectiveness of the model in assisting the syndrome differentiation. ResultsThe 32 features strongly associated with POP were obtained, and the Bayes information critedon score of the further constructed latent tree model was -15291.93. Based on the mutual information and the cumulative information coverage, the main symptoms of POP with kidney yang deficiency syndrome were bone weakness, fatigue, pale tongue, clear urine, frequent nocturnal urination, cold limbs, thin pulse, white coating, and secondary symptoms were weakness, loss of libido, loose stool, frequent urination, lumbar and knee weakness, and fear of cold. From the probability of the occurrence of each clinical feature in different latent categories of POP with kidney yang deficiency syndrome, the state was introduced as S0 category (none/mild kidney yang syndrome)/ S1 category (moderate kidney yang syndrome)/ S2 category (severe kidney yang syndrome). Optimizing the preliminary rules of state identification and refining the state of S1 category, the results showed that among 970 patients with POP, there were 520 patients having no/mild kidney yang deficiency syndrome, 224 patients with moderate to mild kidney yang deficiency syndrome, 81 patients with moderate to severe kidney yang deficiency syndrome, and 145 patients with severe kidney yang deficiency syndrome. During the evaluation and validation process, the correct rate of the model assessment index was 0.8835, while the sensitivity was 0.7181, and the specificity was 0.9437. ConclusionCombined with the latent structure analysis of the association rule, the syndrome differentiation model for POP with kidney yang deficiency could be constructed, and the model shows a good quantitative identification effect, which can provide methodological supports for clinicians to improve the efficiency and accuracy of TCM diagnosis.


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