1.Establishment and Validation of Reference Range of Thyroid Function among Healthy 11~16 Year-old Teenagers in Xi'an
Xiaoli XU ; Yingyu YAN ; Yanjun DIAO ; Juan HE ; Yao CHEN ; Zhuoyue LÜ ; Jiayun LIU
Journal of Modern Laboratory Medicine 2024;39(1):170-174
Objective To analyze serum characteristics and determine the reference range for thyroid function among healthy 11~16 year-old teenagers in Xi'an in order to offer a theoretical basis for clinical diagnosis and therapy.Methods A sum of 1 378 healthy 11~16 year-old teenagers who met the inclusion criteria from the First Affiliated Hospital of the Air Force Medical University(Xijing Hospital)between January 2020 and December 2022 were selected as research subjects,including 628 males and 750 females.They were divided into three groups based on age:Group 1:11~<13 year-olds(433 cases),Group 2:13~<15 year-olds(425 cases),and Group 3:15~≤16 year-olds(520 cases).Differences in serum thyroid function indices among different genders and age groups were analyzed,the reference ranges for these indices were established,and 99 healthy 11-16 year-old teenagers who met the inclusion criteria were chosen for verification.Results There were no significant differences between different genders in thyroid stimulating hormone[TSH,2.56(1.80,3.63)μIU/ml vs 2.43(1.68,3.48)μIU/ml]and total thyroxine[TT4,97.84(85.34,111.00)nmol/L vs 98.20(87.16,111.23)nmol/L],the differences were statistically significant(Z=-1.881,-0.638,all P>0.05).Meanwhile,the differences in free thyroxine[FT4,16.93(15.49,18.60)pmol/L vs 16.26(14.80,17.83)pmol/L],free triiodothyronine[FT3,6.21(5.66,6.80)pmol/L vs 5.59(4.98,6.19)pmol/L],and total triiodothyronine[TT3,2.24(1.96,2.55)nmol/L vs 2.04(1.78,2.34)nmol/L]between different genders were significant(Z=-5.368,-11.994,-6.417 all P<0.01).The differences in thyroid function indices were significant among different age groups(Z=10.649~261.003,all P<0.05).The reference ranges for thyroid function indices across different age groups and genders were established,in which thyroid function indicators were verified to be within the established reference range by 99 samples.Conclusion Teenage hormone secretion varies greatly,and the secretion of thyroid hormones is influenced by various factors.Thus,the diagnosis and treatment of teenage thyroid diseases cannot fully rely on the reference ranges provided by adults or manufacturers.This study established the reference range of the thyroid function indices of 11~16 year-old teenagers in Xi'an,offering clinical doctors'diagnosis and treatment data support.
2.PCR-RFLP for Distinguishing Periplocae Cortex from Acanthopanacis Cortex and Lycii Cortex
Xiaowei DIAO ; Yanan LIU ; Yan JIN ; Chao JIANG ; Yuyang ZHAO ; Yuan YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(4):42-47
ObjectiveTo establish a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for rapid distinguishing Periplocae Cortex from Acanthopanacis Cortex and Lycii Cortex, so as to avoid the influence of genetic confusion on drug safety. MethodThe DSS-tagged sequences of Periplocae Cortex were obtained from the Chloroplast Genome Information Resource (CGIR) and analyzed to find the enzymatic cleavage sites that were different from those of Acanthopanacis Cortex and Lycii Cortex. The specific enzymatic cleavage site, Cla I, of Periplocae Cortex was selected, on the basis of which the primers for PCR-RFLP were designed. Furthermore, the factors such as annealing temperature, number of cycles, Taq enzyme, PCR instruments, and enzymatic treatment time that may influence PCR-RFLP were studied. The established PCR-RFLP method was applied to the identification of Periplocae Cortex, Acanthopanacis Cortex, and Lycii Cortex samples produced in different regions. ResultThe PCR-RFLP at the annealing temperature of 59 ℃ and with 40 cycles showed clear bands of the samples. When the enzyme digestion time was 30 min. The reaction produced the target bands at about 140 bp and 290 bp for both Periplocae Cortex and its original plant and only a band at about 430 bp for Acanthopanacis Cortex, Lycii Cortex, and their original plants. The method can accurately distinguish Periplocae Cortex from its confounders Acanthopanacis Cortex and Lycii Cortex. ConclusionThe PCR-RFLP method for distinguishing Periplocae Cortex from Acanthopanacis Cortex and Lycii Cortex was established. It has high stability, sensitivity, and applicability, providing a reference for the quality control of Periplocae Cortex, Acanthopanacis Cortex, and Lycii Cortex.
3.Rapid serotyping of Salmonella based on matrix assisted laser desorption ionization-time of flight mass spectrometry
Luyan WANG ; Xinjiao HOU ; Huiying SUN ; Baowei DIAO ; Jie LI ; Meiying YAN
Chinese Journal of Epidemiology 2024;45(9):1266-1272
Objective:To establish a matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) assay for the identification of common Salmonella serotypes and provide etiology evidence for the early precise treatment of salmonellosis. Methods:A total of 500 strains were collected from different regions and sources and five predominant Salmonella serotypes ( Salmonella Typhi , Salmonella Paratyphi A , Salmonella Typhimurium , Salmonella Enteritidis , and Salmonella Indiana) of each strain was identified by agglutination test and whole-genome sequencing. The protein complex of the strains was extracted by using optimized pretreatment method to establish the fingerprint database of peptides for each Salmonella serotype. The new serotyping assays were established by using different modules based on the mass spectra database. Additional 155 strains with specified serotypes and variant sources were used to test and evaluate the accuracy of the new typing assays. Results:Five MALDI-TOF MS databases were established, and two new serotyping assays were established via peptide fingerprint mapping/matching and machine learning of the neuronal convolutional network respectively based on the databases. The results showed that the fingerprint matching approach could quickly identify five common Salmonella serotypes in clinical practice compared with the machine learning method, the accuracy of fingerprint matching assay to identify five Salmonella serotypes reached 100.00% and the serotyping can be conducted within a short time (15-20 minutes) and had a good reproducibility, while the machine learning method could not completely identify these serotypes. Moreover the sensitivity and specificity of fingerprint matching assay were all 100.00% respectively, while they were only 82.23% and 95.81% for machine learning method. Conclusion:The established Salmonella serotyping assay based on MALDI-TOF MS in this study can easily, rapidly and accurately identify different serotypes of Salmonella.
4.Efficacy and safety of CM310 in moderate-to-severe atopic dermatitis: A multicenter, randomized, double-blind, placebo-controlled phase 2b trial
Yan ZHAO ; Jianzhong ZHANG ; Bin YANG ; Jingyi LI ; Yangfeng DING ; Liming WU ; Litao ZHANG ; Jinyan WANG ; Xiaohong ZHU ; Furen ZHANG ; Xiaohua TAO ; Yumei LI ; Chunlei ZHANG ; Linfeng LI ; Jianyun LU ; Qingchun DIAO ; Qianjin LU ; Xiaoyong MAN ; Fuqiu LI ; Xiujuan XIA ; Hao CHENG ; Yingmin JIA ; Guoqing ZHAO ; Jinchun YAN ; Bo CHEN
Chinese Medical Journal 2024;137(2):200-208
Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.
5.Current Situation and Consideration of Refinement of Hospital Team Service based on Value-based Medicine
Jun DUAN ; Li YI ; Hanjie CHEN ; Chang LIU ; Yuhan DIAO ; Haiyan LIU ; Guixiang HE ; Jing MEI ; Yan LIU ; Yun CHEN
Chinese Hospital Management 2024;44(2):63-66
Objective To describe and analyze the current situation of the four same type of departments in an hospital in order to provide a reference for the construction of"the most cost-effective medical care".Methods The CN-DRG were used to automatically group and compare the medical capacity and inpatient service efficiency of the hospital department groups,and in the refined analysis,one DRG disease group of in situ cancer and non-malignant disease loss uterine surgery and single species uterine fibroid was included,and the Kruskal-Wallis H test was used to further compare the differences in length of stay and various costs.Results It included a total of 22630 patients,whose weights varied from a maximum of 3948.62 in diagnostic group 1 to a minimum of 133.55 in diagnostic group 11.The cost consumption indexes ranged from a minimum of 0.89 in diagnostic group 5 to a maximum of 1.04 in diagnostic group 2,while the time consumption indexes ranged from a minimum of 0.48 in diagnostic group 11 to a maximum of 0.81 in diagnostic group 5.When comparing the diagnostic groups,there were statistically significant differences(P<0.05)in hospitalization days,total cost,diagnostic cost,therapeutic cost,and cost of supplies.Specifically,when comparing the diagnostic and treatment groups within departments,the differences in hospitalization days and all costs were statistically significant(P<0.05)in departments 1 and 2,the differences in diagnostic cost,therapeutic cost,and cost of supplies were statistically significant(P<0.05)in department 3.Conclusion There exists a notable disparity in the extent to which each diagnostic and treatment group contributes to the hospital's service capacity and cost variability.Consequently,it is necessary to reasonably evaluate the length of hospital stay and medical cost of patients to achieve the highest cost-effective medical treatment.
6.Application of project achievement style quality control circle in constructing an outpatient intelligent pharmacy pre-job training model
Ruigang DIAO ; Shuhui REN ; Chunyan YAN ; Lishang WANG ; Quan ZHAO
China Pharmacist 2024;28(11):490-496
Objective To observe and analyze the application of project achievement style quality control circle in constructing an outpatient intelligent pharmacy pre-job training model,and provide new ideas and systematic solutions for pre-job training of new pharmacists in intelligent pharmacies.Methods 70 pharmacists who were newly employed in outpatient pharmacy of Yantai Yuhuangding Hospital from January 2023 to March 2024 and had no working experience in this position were selected and divided into two groups(the control group and the experimental group)by random draw method.The control group implemented the traditional training mode,and the experimental group adopted the new mode of pre-job training of outpatient intelligent pharmacy constructed by project achievement style quality control circle.The theoretical,skill,and practical examination results at the end of the training period and the satisfaction with training of the newly-appointed pharmacists were collected.Results The assessment scores of theory,skills and practice,and the results of satisfaction with the training of newly recruited pharmacists in the experimental group were significantly higher than those of the control group(P<0.05).Conclusion The new model of pre-job training for new pharmacists in the outpatient intelligent pharmacy has great advantages in the design of the training program,standardization of the training content,reasonable arrangement of the training cycle,and innovation of the training mode,which improves the pharmacists'satisfaction with the training and achieves good training results.
7.Epidemiological and clinical characteristics of healthcare-associated infec-tion in neonates with different gestational ages and birth weights
Yan-Min LI ; Li-Li PING ; Xiao-Lei MA ; Yu-Qiao DIAO ; Shu-Fen ZHAI ; Rui-Min ZHANG
Chinese Journal of Infection Control 2024;23(9):1119-1125
Objective To understand the epidemiological and clinical characteristics of healthcare-associated infec-tion(HAI)in neonates with different gestational ages and birth weights,and provide guidance for personalized cli-nical diagnosis and treatment.Methods According to the inclusion and exclusion criteria,240 neonates with HAI in the neonatal intensive care unit(NICU)of a hospital in Handan City from January 2018 to December 2022 were selected as the study group,720 neonates without HAI were selected as the control group based on systematic sam-pling method with a ratio of 1∶3.The incidence of HAI,distribution characteristics of infection site,pathogenic features of HAI,as well as the effect of different delivery modes on HAI in neonates with different gestational ages and birth weights were analyzed.Results Neonates with gestational age<28 weeks and birth weight<1 000 g had the highest incidence of HAI,which were 19.48%and 20.41%,respectively.Among neonates with gestational age<28 weeks,unidentified site infection were the most(37.50%),while in all gestational age groups within 28-36+6 weeks,bloodstream infection(BSI)and respiratory system infection were predominant.For neonates with gestational age ≥37 weeks,BSI and unidentified site infection occurred frequently.Among neonates in all weight groups,BSI was the most frequent,followed by respiratory system infection.Pathogens from different sites of in-fections in neonates with different gestational ages and birth weights varied.Among neonates with gestational age of 28-31+6 weeks and birth weight of 1 000-1 499 g,the constituent of birth modes showed statistically significant difference between neonates with and without HAI(both P<0.05).Conclusion Epidemiological and clinical chara-cteristics of HAI in neonates with different gestational ages and birth weights are different.For the prevention and control of HAI,individualized diagnosis and treatment plans should be developed to achieve precise prevention and control,reduce the incidence of HAI,and improve the overall treatment level of neonates.
8.Morphological classification and molecular identification of Hyalomma asiaticum in parts of Xindi Township,Xinjiang
Xiao-Qing ZAN ; Qiao-Yun REN ; Jin LUO ; Yan-Long WANG ; Pei-Wen DIAO ; Li-Yan CHE ; Jian-Xun LUO ; Hong YIN ; Gui-Quan GUAN ; Guang-Yuan LIU ; Hong-Xi ZHAO
Chinese Journal of Zoonoses 2024;40(4):289-294
The purpose of this study was to identify the tick species native to Xindi Township,Yumin County,Xinjiang,China.Preliminary morphological identification of parasitic ticks collected from animals in the area was conducted with an ultra-depth of field three-dimensional VHX 600 digital stereo microscope.Total DNA of the ticks was extracted,amplified by PCR based on the COI and ITS2 gene loci,and the posi-tive PCR products were sequenced.The sequence were a-ligned with reference sequences from the NCBI database were aligned with the Basic Local Alignment Search Tool.A genet-ic phylogenetic tree was generated with the neighbor-joining method of MEGA 7.0 software to determine the evolutionary biological characteristics of ticks.Morphological identification showed that the ticks collected from Xindi Township of Yu-min County were consistent with the characteristics of Hya-lomma asiaticum.An evolutionary tree based on the COI and ITS2 gene sequences showed that the ticks collected in this study were clustered with known H.asiaticum sequences.The PCR products of COI and ITS2 were sequenced and compared,which confirmed that the collected tick species were H.asiaticum,in agreement with the morphological and molecular biological results.These findings help to clarify the distribution of ticks in Xindi Township of Xinjiang,and provide basic data for the analysis of tick genetic and evolutionary characteristics,as reference for surveillance and control of ticks in the Xinjiang Uygur Autonomous Region.
9.Expression and Clinical Significance of AIB1 mRNA and ANCO1 mRNA in HPV Positive Cervical Cancer Tissue
Kangni XU ; Yan YU ; Diao ZHANG ; Ke WANG ; Qihui CHENG
Journal of Modern Laboratory Medicine 2024;39(6):113-118
Objective To study the expression of amplified in breast cancer 1(AIB1)and ankyrin repeat domain containing11(ANKRD11/ANCO1)in human papillomavirus(HPV)positive cervical cancer and their relationship with clinicopathological characteristics and their predictive value for postoperative recurrence.Methods Cancer tissues and paracancer tissues of 94 HPV positive cervical cancer patients who visited the Third People's Hospital of Mianyang from January 2018 to January 2020 were selected,while 50 HPV negative cervical cancer tissues during this period were taken as controls.Real-time qPCR(RT-qPCR)was conducted to detect AIB1 mRNA and ANCO1 mRNA expression in cancer tissue and paracancer tissues of HPV positive cervical cancer and cancer tissue of HPV negative cervical.Pearson analysis of the correlation between AIB1 mRNA and ANCO1 mRNA expression in HPV positive cervical cancer tissues.Logistic regression analysis was used to identify the risk factors for postoperative recurrence of HPV-positive cervical cancer patients.The predictive value of AIB1 mRNA,ANCO1 mRNA,and their combination in predicting postoperative recurrence in HPV positive cervical cancer patients was analyzed by receiver operating characteristic curve.Results Compared to the adjacent tissues of HPV positive cervical cancer and cancer tissues of HPV negative cervical cancer,AIB1 mRNA(3.04±0.37 vs 0.87±0.21,1.02±0.33)in HPV positive cervical cancer tissues was higher,while ANCO1 mRNA(1.13±0.26 vs 1.91±0.35,1.82±0.36)was lower,with significant differences(t=68.499,53.137;23.649,17.434,all P<0.05).The expression of AIB1 mRNA and ANCO1 mRNA in HPV positive cervical cancer tissues showed a negative correlation(r=-0.714,P<0.001).Compared to patients with FIGO stage ⅡA~ⅡB and without lymph node metastasis,AIB1 mRNA(3.88±0.32 vs 2.04±0.41,4.46±0.33 vs 2.16±0.46)in HPV positive cervical cancer tissues with FIGO stage ⅡA and lymph node metastasis was higher,while ANCO1 mRNA(0.67±0.29 vs 1.68±0.20,0.49±0.24 vs 1.53±0.32)was lower,with significant differences(t=24.425,26.097;19.288,16.777,all P<0.001).FIGO stage ⅡA,lymph node metastasis,and high AIB1 mRNA[OR(95%CI)=1.644(1.223~2.210),1.779(1.295~2.444),1.247(1.050~1.728)]were risk factors for postoperative recurrence in HPV positive cervical cancer patients,while high ANCO1 mRNA[(OR(95%CI):0.634(0.451~0.891)]was a protective factor.The AUC(95%CI)of AIB1 mRNA and ANCO11 mRNA combined for predicting postoperative recurrence in HPV positive cervical cancer patients was 0.914(0.863~0.952),which was higher than the single indicator detection of 0.821(0.782~0.869)and 0.794(0.763~0.847),and the differences were significant(Z=4.123,4.432,all P<0.001).Conclusion The expression of AIB1 mRNA is increased and the expression of ANCO1 mRNA is reduced in HPV positive cervical cancer tissue,which are related to the occurrence and progression of cancer.The combination of the two has a high predictive value for evaluating postoperative recurrence.
10.Clinical study on application of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.
Hui CHEN ; Xin YAN ; Feng HE ; Sheng Chao DING ; Jin Fu DIAO ; Hui GUO ; Shou Ming CAO ; Chun Juan YANG ; Feng YIN
Chinese Journal of Surgery 2023;61(1):61-65
Objective: To examine the application value of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions. Methods: A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus. Results: All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment. Conclusion: The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
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