1.Applications and Clinical Significance of Artificial Intelligence in Antimicrobial Resistance
Ruike ZHANG ; Junqi ZHANG ; Rongchen DAI ; Yating NING ; Yingchun XU ; Li ZHANG
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1088-1095
Antimicrobial resistance (AMR) has emerged as a major global public health challenge, with traditional prevention and control methods exhibiting significant limitations in detection efficiency, data processing, and clinical decision-making. Leveraging its robust capabilities in data analysis and pattern recognition, artificial intelligence (AI) technology has been widely applied across multiple critical aspects of AMR containment. Current evidence demonstrates that AI technologies can significantly enhance the efficiency of resistancediagnosis, optimize personalized treatment strategies, and improve real-time monitoring of resistant pathogen transmission. Despite persistent challenges such as data heterogeneity, model interpretability, and ethical compliance in practical applications, AI holds immense promise in supporting precision infection management and addressing the growing crisis of antimicrobial resistance.This article systematically reviews the clinical applications of AI in AMR prevention and control, including resistance detection and prediction based on mass spectrometry and genomic data, the use of clinical decision support systems in anti-infective therapy, as well as the role of AI in epidemiological surveillance, pathogen tracking, early warning systems, and novel antimicrobial drug discovery aiming to provide reference for clinical practice.
2.Expression of lymphocyte subsets in the bone marrow of patients with acute myeloid leukemia and its influence on prognosis
Jinhong NIE ; Jiebing XIAO ; Yingchun SHAO ; Chenghui LI ; Lu GAO ; Xiao MA ; Xiaojin WU ; Ziling ZHU
Chinese Journal of Blood Transfusion 2025;38(7):902-908
Objective: To explore the correlation between the composition of bone marrow lymphocyte subsets and the clinical attributes observed in de novo AML patients, as well as their influence on prognosis. Methods: A detailed study was carried out on a cohort of 191 de novo acute myeloid leukemia patients who were admitted to our medical center between October 2022 and September 2024. In addition, a group of 24 patients with iron deficiency anemia individuals was carefully chosen as the control cohort. The proportions of lymphocyte subsets within the bone marrow of de novo AML patients were analyzed. Furthermore, an in-depth analysis was performed to investigate the association between the expression levels of these subsets in de novo AML patients and their clinical attributes, as well as their prognostic implications. Results: The proportion of CD19
and CD56
lymphocytes within the bone marrow of de novo AML patients significantly diminished compared to the control cohort (8.5% vs 13.2% P<0.05, and 15.5% vs 18.0%, P<0.05). Conversely, no significant discrepancies were observed in the CD3
, CD3
CD4
, and CD3
CD8
lymphocyte percentages between the AML patients and control group (71.7% vs 72.1%, 32.5% vs 33.7% and 32.8% vs 35.7%, P>0.05). When analyzing the relationships between lymphocyte subsets within the bone marrow of de novo patients and their respective clinical characteristics, patients aged 60 years and above exhibited diminished percentages of CD3
CD8
lymphocytes in the bone marrow compared to their younger counterparts (31.6% vs 34.1%, P<0.05), while the CD56
lymphocyte subsets demonstrated an increased prevalence (17.2% vs 14.4%, P<0.05). Furthermore, patients with leukocytosis (WBC≥100×10
/L) presented lower levels of CD3
and CD3
CD4
lymphocytes in the bone marrow compared with those without it (65.3% vs 72.9% P<0.05, and 28.9% vs 33.2%, P<0.05), respectively. The AML1-ETO fusion gene-positive cohort exhibited a higher prevalence of CD3
CD8
lymphocytes in the bone marrow than in the negative group (38.2% vs 32.3%, P<0.05), whereas the FLT3-ITD mutation-positive group presented a decreased prevalence of CD56
lymphocytes compared with the negative group (12.4% vs 16.8%, P<0.05). In addition, the NPM1 mutation-positive group demonstrated lower levels of CD3
CD8
lymphocytes in the bone marrow than in the negative group (29.1% vs 33.3%, P<0.05). Variables such as tumor protein p53(TP53) mutation positive, the absence of hematopoietic stem cell transplantation, and CD3
CD4
lymphocyte proportions below 25% were identified as independent adverse prognostic indicators for AML patients (P<0.05). Conclusion: The pathogenesis of AML is closely associated with an imbalance in bone marrow lymphocyte subsets. The FLT3-ITD mutation potentially contributes to the dysregulation of CD56
lymphocyte subset expression. The AML1-ETO fusion gene and NPM1 mutation are implicated in the abnormal expression of CD3
CD8
lymphocytes within the bone marrow. Moreover, the percentage of CD3
CD4
lymphocytes in the bone marrow serves as a prognostic factor for de novo AML patients.
3.Expression of lymphocyte subsets in the bone marrow of patients with acute myeloid leukemia and its influence on prognosis
Jinhong NIE ; Jiebing XIAO ; Yingchun SHAO ; Chenghui LI ; Lu GAO ; Xiao MA ; Xiaojin WU ; Ziling ZHU
Chinese Journal of Blood Transfusion 2025;38(7):902-908
Objective: To explore the correlation between the composition of bone marrow lymphocyte subsets and the clinical attributes observed in de novo AML patients, as well as their influence on prognosis. Methods: A detailed study was carried out on a cohort of 191 de novo acute myeloid leukemia patients who were admitted to our medical center between October 2022 and September 2024. In addition, a group of 24 patients with iron deficiency anemia individuals was carefully chosen as the control cohort. The proportions of lymphocyte subsets within the bone marrow of de novo AML patients were analyzed. Furthermore, an in-depth analysis was performed to investigate the association between the expression levels of these subsets in de novo AML patients and their clinical attributes, as well as their prognostic implications. Results: The proportion of CD19
and CD56
lymphocytes within the bone marrow of de novo AML patients significantly diminished compared to the control cohort (8.5% vs 13.2% P<0.05, and 15.5% vs 18.0%, P<0.05). Conversely, no significant discrepancies were observed in the CD3
, CD3
CD4
, and CD3
CD8
lymphocyte percentages between the AML patients and control group (71.7% vs 72.1%, 32.5% vs 33.7% and 32.8% vs 35.7%, P>0.05). When analyzing the relationships between lymphocyte subsets within the bone marrow of de novo patients and their respective clinical characteristics, patients aged 60 years and above exhibited diminished percentages of CD3
CD8
lymphocytes in the bone marrow compared to their younger counterparts (31.6% vs 34.1%, P<0.05), while the CD56
lymphocyte subsets demonstrated an increased prevalence (17.2% vs 14.4%, P<0.05). Furthermore, patients with leukocytosis (WBC≥100×10
/L) presented lower levels of CD3
and CD3
CD4
lymphocytes in the bone marrow compared with those without it (65.3% vs 72.9% P<0.05, and 28.9% vs 33.2%, P<0.05), respectively. The AML1-ETO fusion gene-positive cohort exhibited a higher prevalence of CD3
CD8
lymphocytes in the bone marrow than in the negative group (38.2% vs 32.3%, P<0.05), whereas the FLT3-ITD mutation-positive group presented a decreased prevalence of CD56
lymphocytes compared with the negative group (12.4% vs 16.8%, P<0.05). In addition, the NPM1 mutation-positive group demonstrated lower levels of CD3
CD8
lymphocytes in the bone marrow than in the negative group (29.1% vs 33.3%, P<0.05). Variables such as tumor protein p53(TP53) mutation positive, the absence of hematopoietic stem cell transplantation, and CD3
CD4
lymphocyte proportions below 25% were identified as independent adverse prognostic indicators for AML patients (P<0.05). Conclusion: The pathogenesis of AML is closely associated with an imbalance in bone marrow lymphocyte subsets. The FLT3-ITD mutation potentially contributes to the dysregulation of CD56
lymphocyte subset expression. The AML1-ETO fusion gene and NPM1 mutation are implicated in the abnormal expression of CD3
CD8
lymphocytes within the bone marrow. Moreover, the percentage of CD3
CD4
lymphocytes in the bone marrow serves as a prognostic factor for de novo AML patients.
4.Improvement effect and mechanism of Shengmai powder on heart failure mice with qi-yin deficiency
Lanfang KANG ; Jian LI ; Yating ZHAO ; Yingchun CHEN ; Guiyin CHEN ; Xiaobo NIE ; Jiao LIU ; Jie CHENG
China Pharmacy 2025;36(17):2127-2133
OBJECTIVE To study the improvement effect and mechanism of Shengmai powder on heart failure (HF) mice with qi-yin deficiency. METHODS The mice were randomly divided into blank group (water), model group (water), Shengmai powder low-, medium-, and high-dose groups [2.61, 5.22 and 10.44 g/kg (based on crude drug dosage)] and positive control group (metoprolol, 30 mg/kg), with 10 mice in each group. Except for the blank group, all other groups were subcutaneously injected with D-galactose, and a qi-yin deficiency HF mice model was established by continuous food restriction and weight-bearing swimming. At the same time of modeling, the corresponding medicine/water was gavaged once a day for five weeks. The general state of mice was recorded and the traditional Chinese medicine (TCM) syndrome score was evaluated. Behavioral experiments were conducted to investigate the total distance of open field action, the percentage of immobility time, and the swimming exhaustion time of mice. The contents of aspartate transaminase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH) in the serum of mice were detected; cardiac function indexes [heart rate, left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular mass index and whole heart mass index] were all detected; the histopathological morphology of mice myocardium was observed; the level of cardiomyocyte apoptosis in mice was detected; mRNA expression levels of B-cell lymphoma 2 (Bcl-2), Bcl-2 associated X protein (Bax), and Cleaved-caspase-3 in myocardial tissue of mice were detected; the phosphorylation levels of sarcoplasmic reticulum calcium regulatory related proteins [ryanodine receptor 2 (RyR2) and phospholamban (PLB)] in myocardial tissue of mice were detected. RESULTS Compared with the blank group, the body weight, total distance of open field action, swimming exhaustion time, LVEF, LVEDD, Bcl-2 mRNA expression level in myocardial tissue and PLB protein phosphorylation level in the model group were significantly reduced/shortened (P<0.05); TCM syndrome score, the percentage of immobility time, heart rate, LVESD, left ventricular mass index, whole heart mass index, cardiomyocyte apoptosis rate, the contents of CK, LDH and AST in serum, mRNA expression levels of Cleaved-caspase-3 and Bax and the phosphorylation level of RyR2 protein in myocardial tissue were significantly increased (P<0.05); there were inflammatory cell infiltration, disordered cell arrangement and obvious myocardial interstitial fibrosis in myocardial tissue. After the intervention of Shengmai powder, most of the above quantitative indexes in mice were significantly reversed (P<0.05), the inflammatory cell infiltration in myocardial tissue was reduced, and the degree of fibrosis was significantly reduced. CONCLUSIONS Shengmai powder can improve cardiac function, reduce the level of cardiomyocyte apoptosis and myocardial fibrosis in HF mice with qi-yin deficiency. Its mechanism may be related to the regulation of the expression of sarcoplasmic reticulum calcium regulation related proteins.
5.Effect and mechanism of endoclip papilloplasty in reducing the incidence of cholelithiasis.
Yao LI ; Xiaofang LU ; Yingchun WANG ; Hong CHANG ; Yaopeng ZHANG ; Wenzheng LIU ; Wei ZHENG ; Xiue YAN ; Yonghui HUANG
Chinese Medical Journal 2025;138(20):2596-2603
BACKGROUND:
Endoscopic sphincterotomy (EST) is widely used to treat common bile duct stones (CBDS); however, long-term studies have revealed the increasing incidence of recurrent CBDS after EST. Loss of sphincter of Oddi function after EST was the main cause of recurrent CBDS. Reparation of the sphincter of Oddi is therefore crucial. This study aims to investigate the effectiveness and safety of endoclip papilloplasty (ECPP) for repairing the sphincter of Oddi and elucidate its mechanism.
METHODS:
Eight healthy Bama minipigs were randomly divided into the EST group and the ECPP group at a 1:1 ratio, and bile samples were collected before endoscopy and 6 months later. All minipigs underwent transabdominal biliary ultrasonography for the diagnosis of cholelithiasis 6 months after endoscopy. The biliary microbiota composition and alpha and beta diversity were analyzed by 16S ribosomal RNA gene sequencing. Differential metabolites were analyzed by bile acid metabolomics to explore the predictive indicators of cholelithiasis.
RESULTS:
Three minipigs were diagnosed with cholelithiasis in the EST group, while none in the ECPP group showed cholelithiasis. The biliary Firmicutes/Bacteroidota (F/B) ratio was increased after EST and decreased after ECPP. The Chao1 and observed species index significantly decreased 6 months after EST ( P = 0.017 and 0.018, respectively); however, the biliary α-diversity was similar before and 6 months after ECPP. The β-diversity significantly differed in the EST group before and 6 months after EST, as well as in the ECPP group before and 6 months after ECPP (analysis of similarities [ANOSIM]: R = 0.917, P = 0.040; R = 0.740, P = 0.035; respectively). Glycolithocholic acid (GLCA) and taurolithocholic acid (TLCA) accumulated in bile 6 months after EST.
CONCLUSIONS
ECPP has less impact on the biliary microenvironment than EST and prevents duodenobiliary reflux by repairing the sphincter of Oddi. The bile levels of GLCA and TLCA may be used to predict the risk of cholelithiasis.
Animals
;
Swine, Miniature
;
Swine
;
Cholelithiasis/prevention & control*
;
Sphincterotomy, Endoscopic/methods*
;
Sphincter of Oddi/surgery*
;
Female
;
Male
6.Associations between statins and all-cause mortality and cardiovascular events among peritoneal dialysis patients: A multi-center large-scale cohort study.
Shuang GAO ; Lei NAN ; Xinqiu LI ; Shaomei LI ; Huaying PEI ; Jinghong ZHAO ; Ying ZHANG ; Zibo XIONG ; Yumei LIAO ; Ying LI ; Qiongzhen LIN ; Wenbo HU ; Yulin LI ; Liping DUAN ; Zhaoxia ZHENG ; Gang FU ; Shanshan GUO ; Beiru ZHANG ; Rui YU ; Fuyun SUN ; Xiaoying MA ; Li HAO ; Guiling LIU ; Zhanzheng ZHAO ; Jing XIAO ; Yulan SHEN ; Yong ZHANG ; Xuanyi DU ; Tianrong JI ; Yingli YUE ; Shanshan CHEN ; Zhigang MA ; Yingping LI ; Li ZUO ; Huiping ZHAO ; Xianchao ZHANG ; Xuejian WANG ; Yirong LIU ; Xinying GAO ; Xiaoli CHEN ; Hongyi LI ; Shutong DU ; Cui ZHAO ; Zhonggao XU ; Li ZHANG ; Hongyu CHEN ; Li LI ; Lihua WANG ; Yan YAN ; Yingchun MA ; Yuanyuan WEI ; Jingwei ZHOU ; Yan LI ; Caili WANG ; Jie DONG
Chinese Medical Journal 2025;138(21):2856-2858
7.Association of sleep duration and physical exercise with dyslipidemia in older adults aged 80 years and over in China
Bing WU ; Yang LI ; Lanjing XU ; Zheng ZHANG ; Jinhui ZHOU ; Yuan WEI ; Chen CHEN ; Jun WANG ; Changzi WU ; Zheng LI ; Ziyu HU ; Fanye LONG ; Yudong WU ; Xuehua HU ; Kexin LI ; Fangyu LI ; Yufei LUO ; Yingchun LIU ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Epidemiology 2024;45(1):48-55
Objective:To explore the impact of sleep duration, physical exercise, and their interactions on the risk of dyslipidemia in older adults aged ≥80 (the oldest old) in China.Methods:The study subjects were the oldest old from four rounds of Healthy Aging and Biomarkers Cohort Study (2008-2009, 2011-2012, 2014 and 2017-2018). The information about their demographic characteristics, lifestyles, physical examination results and others were collected, and fasting venous blood samples were collected from them for blood lipid testing. Competing risk model was used to analyze the causal associations of sleep duration and physical exercise with the risk for dyslipidemia. Restricted cubic spline (RCS) function was used to explore the dose-response relationship between sleep duration and the risk for dyslipidemia. Additive and multiplicative interaction model were used to explore the interaction of sleep duration and physical exercise on the risk for dyslipidemia.Results:The average age of 1 809 subjects was (93.1±7.7) years, 65.1% of them were women. The average sleep duration of the subjects was (8.0±2.5) hours/day, 28.1% of them had sleep duration for less than 7 hours/day, and 27.2% had sleep for duration more than 9 hours/day at baseline survey. During the 9-year cumulative follow-up of 6 150.6 person years (follow-up of average 3.4 years for one person), there were 304 new cases of dyslipidemia, with an incidence density of 4 942.6/100 000 person years. The results of competitive risk model analysis showed that compared with those who slept for 7-9 hours/day, the risk for dyslipidemia in oldest old with sleep duration >9 hours/day increased by 22% ( HR=1.22, 95% CI: 1.07-1.39). Compared with the oldest old having no physical exercise, the risk for dyslipidemia in the oldest old having physical exercise decreased by 33% ( HR=0.67, 95% CI: 0.57-0.78). The RCS function showed a linear positive dose-response relationship between sleep duration and the risk for hyperlipidemia. The interaction analysis showed that physical exercise and sleep duration had an antagonistic effect on the risk for hyperlipidemia. Conclusion:Physical exercise could reduce the adverse effects of prolonged sleep on blood lipids in the oldest old.
8.Enterotoxin detection and antimicrobial resistance analysis of Staphylococcus aureus in raw and cooked meat and dairy products in Wuhan
Yanwei LI ; Yingchun ZENG ; Jun LI ; Yan PENG ; Wei ZOU ; Lin YAN ; Bo YU ; Yan PENG
Journal of Public Health and Preventive Medicine 2024;35(5):142-145
Objective To investigate the current situation of Staphylococcus aureus contamination in raw and cooked meat and dairy products in Wuhan, and analyze the enterotoxins production and antimicrobial resistance of isolated bacterial strains. Methods The detection of Staphylococcus aureus was performed according to GB4789.10-2016 National Food Safety Standard. Staphylococcus aureus enterotoxin (SE) PCR kit and ELISA were used for SEA-E type detection. Broth dilution and PCR method were used for drug sensitivity test. Results A total of 13 strains of Staphylococcus aureus were isolated from 202 samples, and the isolation rate of Staphylococcus aureus in the raw and cooked meat and dairy products was 6.43%. The detection rate of Staphylococcus aureus was 9.82% (11/112) in raw meat, and 4% (2/50) in cooked meat products. There was no detection in dairy products. Of the 13 isolated strains, 6 strains were found to have enterotoxins, with a toxin production rate of 46.15% (6/13). Among the 6 strains of enterotoxin producing Staphylococcus aureus, 4 strains were classified as type A, C, D, and AB, respectively. The isolated strains were generally resistant to tetracycline and sulfonamide drugs, and the detection rate of resistant genes was more than 60%. The resistance rate to penicillin and erythromycin exceeded 50%, and the dominant resistance spectrum was the detection of 3 strains of single-resistant (PEN) Staphylococcus aureus (25.08%, 3/13), followed by 2 strains of five-fold resistance (PEN-ERY-CLI-SXT-GEN), and double resistance Staphylococcus aureus (PEN-ERY) (15.38%, 2/13). Genetic testing was consistent with phenotypic testing. Conclusion In 2020, there was a certain degree of contamination of Staphylococcus aureus in raw and cooked meat products in Wuhan, with 13 isolated strains and 6 strains producing enterotoxins. It is necessary to remain vigilant about the potential food risks of raw and cooked meat products, and strengthen the supervision of the safety risks of raw and cooked meat products.
9.Invasive fungal infections in children should not be underestimated
Yanbing LI ; Yingchun XU ; Li ZHANG
Chinese Journal of Applied Clinical Pediatrics 2024;39(1):2-6
With the increasing number of people with immune deficiency in recent years, fungal infections become an important factor threatening human health.Likewise, the number of children who are immunosuppressed due to hematological diseases, malignancies, use of immunosuppressants and spectrum antibacterial drugs has increased, leading to a high mortality of fungal infections.Moreover, infections of the non-candida albicans and aspergillu are prevalent, serving as important causes for the death of critically ill children. Therefore, this review aims to introduce and summarize the epidemiological characteristics, diagnosis and treatment of pediatric invasive fungal infections, thus yielding the concern of pediatric invasive fungal infections, reducing the occurrence of pediatric fungal infections and improving the prognosis.
10.Association of elevated plasma ferritin and triglyceride concentrations in early pregnancy and the risk of gestational diabetes mellitus
Yingchun CHEN ; Ming CHEN ; Minmin WU ; Yilin LI
Journal of Public Health and Preventive Medicine 2024;35(4):153-157
Objective To investigate the relationship between combined plasma ferritin and triglyceride (TG) concentrations in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods A total of 1 000 pregnant women who had antenatal care at the Sixth Hospital of Wuhan from January 2021 to January 2023 were selected as the research subjects. The cut-offs of ferritin and TG were analyzed by using unrestricted cube splines. All participants were divided into 4 groups according to the cut‐off values of ferritin and TG. Associations between combined ferritin and TG concentrations and GDM risk were estimated using multivariable logistic regression models. Results A total of 158 (15.8%) participants were diagnosed with GDM. The ferritin and TG levels in early pregnancy of pregnant women in the GDM group were significantly higher than those in the non-GDM group (P<0.05). After adjusting for potential confounders, the OR for the risk of developing GDM after combining ferritin with TG was 2.35 (1.65, 3.35). Couclusion The increase in plasma ferritin and TG concentrations in early pregnancy is positively correlated with the increased risk of GDM. Pregnant women with high plasma ferritin (˃65.7 ng/mL) and high TG (˃1.9mmoL/L) have the greatest risk of GDM.


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