1.Application of left echography in the diagnosis of false ventricular aneurysm and mural thrombus
Yanling XUE ; Xiaojing MA ; Shurui XIE ; Juan XIA ; Yafeng HE ; Zhengchun YU
Journal of Chinese Physician 2024;26(10):1460-1463
Objective:To evaluate the value of left echography (LVO) in the diagnosis of false ventricular aneurysm complicated with mural thrombus.Methods:The clinical data of 10 patients with suspected pseudoventricular aneurysm examined by thoracic echocardiography (TTE) in Wuhan Asian Heart Hospital from January 2018 to March 2024 were retrospectively analyzed. All patients underwent LVO examination to further diagnose pseudoventricular tumor and whether it was complicated with mural thrombosis. Computed tomography angiography (CTA) or cardiac magnetic resonance (CMR) examination was used as the gold standard to analyze the diagnostic value of LVO in the diagnosis of pseudoventricular tumor.Results:Among the 10 suspected pseudoventricular tumors examined by TTE, LVO detected 6 cases of left ventricular pseudoaneurysm and 1 case of right ventricular pseudoaneurysm; CTA confirmed that 6 cases of left ventricular pseudoaneurysm detected by LVO were correctly diagnosed, 1 case of right ventricular pseudoaneurysm was misdiagnosed, CMR diagnosed right ventricular diverticula, LVO diagnosis accuracy was 6/7, and 4 cases of thrombi were detected. The detection rate was 4/4. The maximum transverse diameter of the tumor body of the communicating mouth/false ventricular aneurysm was 0.46±0.04. 1 patient underwent coronary artery bypass grafting and resection of false ventricular aneurysm. 1 patient underwent coronary artery interventional stent surgery; 4 routine conservative drug treatment, follow-up observation; One case of right ventricular diverticulum did not require special treatment.Conclusions:LVO contrast agent can clearly show the tumor body and location, measure the tumor entrance and size, and show mural thrombus. It is the first choice for the identification of false ventricular tumor. The diverticula was similar to the image of false ventricular aneurysm, and the sensitivity and specificity of right ventricular wall motion were higher in CMR than in LVO.
2.Liver function injury in patients with omicron variant COVID-19 and its influencing factors
Feng DING ; Zelu MENG ; Yina MENG ; Jiangang WANG ; Lingling YING ; Xiaoqing XIE ; Yafeng YU ; Yida YANG ; Huajiang SHEN
Chinese Journal of Clinical Infectious Diseases 2023;16(5):360-366
Objective:To analyze the incidence of liver function injury in patients infected with 2019-nCoV omicron variant and its influencing factors.Methods:The clinical data and laboratory findings of 897 COVID-19 patients infected with omicron variant in Zhejiang province from February 23 to July 14, 2022 were retrospectively analyzed. Patients were divide into liver function injury group ( n=243) and non-liver function injury group ( n=654) based on liver function indicators. The clinical characteristics and laboratory tests were compared between the two groups, and influencing factors of liver function injury were analyzed. SPSS 26.0 statistical software was used for data analysis. Results:The incidence of liver injury in this series was 27.09% (243/897). The median age of patients in liver injury group was older, the body mass index (BMI) was higher( Z=-6.237 and -2.166, both P<0.05), the proportions of patients with hypertension and diabetes, and with severe clinical classification were higher ( χ2=17.087, 27.509 and 12.945, all P<0.01) ; the proportion of vaccinated patients was lower ( χ2=17.766, P<0.01) than those in non-liver injury group. The levels of platelet, hemoglobin, albumin and potassium in liver injury group were lower than those in non-liver injury group ( Z=-4.631, -2.368, -10.593 and -2.141, all P<0.05), while serum ALT, AST, γ-GT, urea nitrogen, glucose and hs-CRP levels were higher than those in the non-liver injury group ( Z=-7.451, -8.663, -4.410, -3.824, -3.278 and -3.884, all P<0.01). Multivariate Logistic regression analysis showed that age ( OR=2.580, 95% CI 1.429-4.657, P=0.002), history of diabetes ( OR=3.650, 95% CI 1.698-7.849, P=0.001), and decreased hemoglobin ( OR=1.993, 95% CI 1.066-3.726, P=0.031) and increased hs-CRP ( OR=1.797, 95% CI 1.283-2.517, P=0.001) were risk factors associated with liver function injury, while vaccination ( OR=0.499, 95% CI 0.312-0.798, P=0.004) was the protective factor for liver function. Conclusion:Liver function injury is frequently observed in COVID-19 patients infected with omicron variant, which is linked to age, underlying disease, and elevated inflammatory markers; while vaccination can lower the risk of liver injury in infected patients.
3.Construction of prognostic risk model of autophagy related genes in lung adenocarcinoma based on TGGA database
Xueqin Wang ; Yafeng Liu ; Jing Wu ; Jiawei Zhou ; Yingru Xing ; Xin Zhang ; Danting Li ; Jun Xie ; Xuansheng Ding ; Dong Hu
Acta Universitatis Medicinalis Anhui 2022;57(4):528-533
Objective:
A prognostic risk model for lung adenocarcinoma patients was established based on the cancer genome atlas(TCGA) database to explore the prognostic performance of autophagy related gene risk model for lung adenocarcinoma patients and its correlation with immune microenvironment.
Methods:
Clinical information and transcriptome data of lung adenocarcinoma patients were downloaded and extracted from TCGA database,and 232 autophagy-related genes were screened from the human autophagy database.cox regression analysis was used to screen out four autophagy genes independently associated with prognosis.The prognostic prediction model of lung adenocarcinoma was constructed by risk score ,and the performance of prediction model was evaluated by ROC curve.The relationship between risk scores and tumor immune microenvironment was explored using ESTIMATE ( estimation of stromal and immune cells in malignant tumour tissues using expression data) and CIBERSORT algo- rithms.
Results:
Thirty differentially expressed autophagy-related genes were identified in lung adenocarcinoma, of which four autophagy genes (BIRC5,ERO1A,ITGB4,NLRC4 ) could predict the prognosis of the patients. Grouped by risk score,the Kaplan-Meier analysis demonstrated that the survival rate of high-risk group was signifi- cantly lower than that of low-risk group(P<0. 000 1) .The ROC curve proved the accuracy of the model in predic- ting the prognosis of lung adenocarcinoma ( AUC = 0. 757 ) .The ESTIMATE and CIBERSORT analyses revealed that the risk scoring model was associated with multiple immune cells and immune infiltrates in the tumor microenvi- ronment.
Conclusion
Compared with clinical data,the autophagy gene prognostic risk model can better predict the prognosis of patients with lung adenocarcinoma.In the high-risk group,CD4 + memory quiescent cells can im- prove prognosis in lung adenocarcinoma patients.
4.Establishment and validation of risk prediction model for bone metastasis of NSCLC
Chunxiao Hu ; Yafeng Liu ; Yixin Su ; Jianqiang Guo ; Wenting Zhang ; Xueqin Wang ; Jun Xie ; Wanfa Hu ; Jing Wu ; Yingru Xing ; Dong Hu ; Xuansheng Ding
Acta Universitatis Medicinalis Anhui 2022;57(5):832-836
Objective:
To construct nomogram to predict the risk of bone metastasis in patients with non-small cell lung cancer(NSCLC).
Methods:
The clinical data of NSCLC patients diagnosed in the hospital were retrospectively analyzed, including the occurrence of bone metastasis, age, gender, pathological type, smoking status, PS score, TN stage, metastasis of other sites before bone metastasis, carcinoembryonic antigen(CEA) level, alpha fetoprotein(AFP) level, serum calcium(Ca2+), serum phosphorus(P), alkaline phosphatase(ALP) level, which were determined by univariate and multivariate logistic regression analysis. Receiver operating characteristic curve(ROC) and decision curve analysis were used, DCA was used to verify the accuracy and clinical benefit of the model, and nomogram was used to visualize the model.
Results:
Area under the ROC curve(AUC) showed that in the modeling group(n=138) and the validation group(n=92), the AUC value predicted by combined indicators(age, gender, pathological type, CEA, ALP)(modeling group=0.792, validation group=0.629) was higher than that predicted by single indicator.
Conclusion
The prediction model constructed in this study has good effect and can provide reference for clinical screening of high-risk patients with bone metastasis of NSCLC.
5.Surveillance of the point mutation associated with macrolides resistance to Treponema pallidum
Yongjian XIAO ; Shuangquan LIU ; Yafeng XIE ; Zhuoran LIU
The Journal of Practical Medicine 2017;33(15):2580-2583
Objective To investigate the prevalence of A2058G or A2059G mutation within 23S rRNA in Treponema pallidum (Tp) from primary syphilis patients chancre samples. Methods Simple PCR was used to screen the positive samples containing Tp DNA. Nested PCR was adopted to amplify the region of the Tp 23S rRNA and the purified amplicons were digested by restriction endonuclease MboⅡand Bsa I respectively and sequenced. Results 39 qualified samples were obtained from 43 chancre samples and all of them were found harboring the A2058G mutation, whereas the A2059G was not detected. Conclusion High frequency of the A2058G mutation within 23S rRNA implicated in macrolide resistance emerges in the circulating Tp in Hengyang. Therefore, macro-lide antibiotics such as azithromycin should be cautiously used as an optional therapy for syphilis.
6.Imaging diagnosis of hepatobiliary cystadenoma
Chinese Journal of Digestive Surgery 2014;13(3):223-226
Hepatobiliary cystadenoma is a rare tumor which has malignant potential.The clinical symptoms of hepatobiliary cystadenoma were non-specific.The features of computed tomography (CT) and magnetic resonance imaging (MRI) were helpful for the diagnosis of this disease.The imaging data of 4 patients with hepatobiliary cystadenoma who were admitted to the second People's Hospital of Wuxi from February 2010 to February 2013 were retrospectively analyzed.Cystic lesions,divisions and nodules on the wall are the features of CT and MRI of hepatobiliary cystadenoma.Enhanced CT and MRI are important for preoperative diagnosis of hepatobiliary cystadenoma.
7.Establishment of biotin-streptavidin time-resolved fluoroimmunoassay method for the measurement of heparanase
Bao ZHU ; Guoqiang XIE ; Hualong XIAO ; Biao HUANG ; Kejing SHAO ; Yafeng XU ; Yi ZHANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2014;34(4):308-311
Objective To establish a novel TRFIA for the measurement of heparanase (HPA) in serum samples,and investigate its clinical application.Methods The micro-pore plate wells were first coated with partially recombinant murine anti-human HPA monoclonal antibody.Biotin-labeled recombinant HPA protein was then used to compete with HPA in serum samples,and the prepared europium (III)-labeled streptavidin (Eu3+-SA) was used as signal readout for establishing the BSA-TRFIA assay.Using this assay,the serum HPA levels in healthy subjects (n=32) and tumor patients (n=54) were measured.The results of BSA-TRFIA were compared with those of ELISA.Two-sample t test (or t' test),and linear correlation analysis were used to analyze the data.Results The sensitivity of BSA-TRFIA for measuring HPA was 0.33 ug/L.The CV values for intra-batch and inter-batch were 5.29% and 7.54%,respectively.The average recovery rate was 105.5%.The standard curve range was 0-1 000 ug/L.The serum HPA level measured by the BSA-TRFIA method in healthy subjects was (2.03_+ 1.47) Iug/L.In tumor patients,the HPA level was significantly higher:(22.13_+7.38) ug/L (t'=19.388,P
8.Effect of Dachengqi decoction on pancreas aquaporin 1 in rats with acute necrotizing pancreatitis
Yafeng CHEN ; Dianxu FENG ; Teng CHEN ; Jiyun TIAN ; Jinkun XIE ; Haoran SHI ; Jingzhe ZHANG ; Feng HAN
Chinese Journal of Pancreatology 2012;12(1):40-44
Objective To detect the expression of aquaporin 1 in pancreas of rats with acute necrotizing pancreatitis (ANP) and to study the effect of Dachengqi decoction on it.MethodsOne hundred and sixty male SD rats were randomly divided into control group ( C group,n =32 ),ANP group ( n =32),Dexamethasone group (De group,n =32),Acetazolamide group (A group,n =32) and Dachengqi decoction group (DD group,n =32).ANP model was induced by retrograde injection of 5% sodium taurocholate into the biliary and pancreatic duct.Rats in De group received dexamethasone (4 mg/kg) intravenously after ANP induction; while rats in A group received 1 ml acetazolamide via gastric lavage 2 h before ANP induction; rats in DD group received 2 ml Dachengqi decoction via gastric lavage 48,24,2h before ANP induction; rats in C group received laparotomy.Eight rats in each group were sacrificed at 3 h,6 h,12 h and 18h after induction of ANP models.Quantity of ascites and levels of serum amylases were measured.Pathological changes in pancreas tissue were detected by HE and electron microscope.Capillary permeability in pancreas tissue was detected by Evans Blue (EB) extravasations method.AQP1 expression in pancreas tissue was detected by real-time PCR and Western blotting.ResultsLevels of serum amylase in ANP group was significantly higher,and the pancreatic injuries were obvious ; the levels of serum amylase in De group and DD group was lower than that in ANP group,and the pancreatic injuries were attenuated.The levels of serum amylase in A group were higher than that in ANP group,and the pancreatic.injuries were more severe than that in ANP group.Six hours after ANP induction,the levels of EB in pancreas were (13.44 ±2.56),(126.35 ± 14.80),(86.31 ± 14.46),( 108.99 ± 15.07 ),(78.29 ± 16.85 ) mg/L In C group,ANP group,De group,A group and DD group,and the expression of AQP1 mRNA in pancreatic tissue was ( 170.07 ± 22.48 ) %,( 83.93 ± 8.98 ) %,( 117.09 ±10.70 ) %,( 69.00 ± 8.98 ) %,( 112.82 ± 11.79 ) % ; and the expression of AQP1 protein was 0.23 ± 0.06,0.10 ±0.02,0.32 ±0.03,0.13 ±0.02,0.45 ±0.04.The content of EB in ANP group was higher than that in C group,while the expression of AQP1 mRNA and protein in ANP group was significantly lower than that in C group (P < 0.05 ).The content of EB in De group and DD group was significantly lower than that in ANP group,while the expression of AQP1 mRNA and protein was significantly higher than that in ANP group (P < 0.05).ConclusionsAQP1 plays an important role in the pathogenesis of capillary endothelial barrier dysfunction in rats with ANP.Dachengqi Decoction can attenuate pancreatic injuries of rats by regulating the expression of AQP1.
9.Overview in etiology and pathogenesis of hyperlipidemic severe acute pancreatitis
Jinkun XIE ; Yafeng CHEN ; Dianxu FENG
International Journal of Surgery 2012;39(6):416-420
Hyperlipidemia aggravates the pancreatitic injury in the course of severe acute pancreatitis.At present,the research on the pathogenesis has attracted wide attention though it has still not been fully clarified.In many theories of pathogenesis which explained the hyperlipidemic severe acute pancreatitis,the toxic effect of free fatty acids,the theory of accelerated activation of trypsinogen and the theory of pancreatic microcirculation disturbance were the dominant hypothesis.In recent years,concerns have also been raised over the theory of intestinal bacterial.translocation and the theory of calcium overload of pancreatic acinar cells.In this article,the author will review the recent advances in the pathogenesis of hyperlipidemic severe acute pancreatitis.
10.Role of Aquaporin 1 on capillary endothelial barrier dysfunction of intestine in rat with experimental acute necrotizing pancreatitis
Yafeng CHEN ; Dianxu FENG ; Jiyan TIAN ; Teng CHEN ; Peihao YIN ; Jinkan XIE ; Wen FENG ; Junkang GUI
Chinese Journal of General Surgery 2012;27(7):576-581
Objective To study the effect of aquaporin 1 on intestinal capillary endothelial barrier in rats with experimental acute necrotizing pancreatitis (ANP).Methods In this study,160 male Sprague-Dawley rats were randomly divided into five groups:Control group ( n =32),ANP group (n =32),NS group,Dexamethasone group,and Acetazolamide group.Eight rats in each group were sacrificed at 3,6,12 and 18 h after induction of experimental models.Volume of ascites and levels of serum amylases were deternined at each time point.Pathological changes in intestine tissues were observed under electron microscope after HE staining.Capillary permeeabilities in intestine tissues were detected by Evans blue (EB) extravasation experiment.The mRNA and protein expressions of AQP1 in intestine tissue were determined by real-time PCR and Western blotting,respectively.Results Serum amylase level in ANP group was significantly higher than that in control group.Amylase level in dexamethasone group was lower than that in ANP group,and amylase level in acetazolamide group was higher than that in ANP group at 12 h (P <0.05 ) ; The concentration of EB in intestine tissues at each time point in ANP group was significantly higher than those in control group,and EB in dexamethasone group was lower than those in ANP group at 6,12 and 18 h.EB in acetazolamide group was higher than that in ANP group at 3 h ( P < 0.05 ) ; The mRNA expression of AQPI in ANP group was significantly lower than that in control group.The expression of AQP1 in dexamethasone group was higher than those in ANP group at 6,12 and 18 h,and the expression of AQP1 in acetazolamide group was lower than that in ANP group at 3,6,12 h in intestine tissue ( P < 0.05 ).Protein expression of AQPI in tissues in ANP group was significantly lower than that in control group.The expression of AQP1 in dexamethasone group increased more than that in ANP group at 3,6,12 h,and the expression of AQP1 in acetazolamide group was lower than that in ANP group at 3 h,6 h ( P < 0.05 ).Conclusions The expression of AQP1 is down-regulated in intestine tissue in rats with acute necrotizing pancreatitis,and AQP1 could play an important role in the pathogenesis of capillary endothelial barrier dysfunction.


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