1.Clinical application and evaluation of health economics for non-invasive prenatal testing of fetuses in Tianjin.
Ruiyu MA ; Xiaozhou LI ; Song XU ; Yunfang SHI ; Duan JU ; Yan LI ; Fanrong MENG ; Xiuyan WANG ; Xinxin DU ; Naiwei XU ; Ying ZHANG
Chinese Journal of Medical Genetics 2023;40(2):135-142
OBJECTIVE:
To assess the clinical efficacy and health economic value of non-invasive prenatal testing (NIPT) for the prenatal screening of common fetal chromosomal aneuploidies.
METHODS:
10 612 pregnant women from October 2017 to December 2019 presented at the antenatal screening clinic of the General Hospital of Tianjin Medical University were selected as the study subjects. Results of NIPT and invasive prenatal diagnosis and follow-up outcome for the 10 612 pregnant women were retrospectively analyzed and compared. Meanwhile, NIPT data for two periods were analyzed for assessing the health economic value of NIPT as the second- or first-tier screening strategy for the prenatal diagnosis of fetal trisomies 21, 18 and 13.
RESULTS:
The NIPT was successful in 10 528 (99.72%) subjects, with the sensitivity for fetal trisomies 21, 18 and 13 being 100%, 92.86% and 100%, and the positive predictive value (PPV) being 89.74%, 61.90% and 44.44%, respectively. The PPV of NIPT for sex chromosome aneuploidies was 34.21%. Except for one false negative case of trisomy 18, the negative predictive value for trisomy 21, trisomy 13 and other chromosomal abnormalities were 100%. For pregnant women with high risk by serological screening, advanced maternal age or abnormal ultrasound soft markers, NIPT has yielded a significantly increased high risk ratio. There was no statistical difference in the PPV of NIPT among pregnant women from each subgroup. NIPT would have higher health economic value as a second-tier screening until 2019, while compared to 2015 ~ 2017, its incremental cost-effectiveness ratio as a first-tier screening had declined clearly.
CONCLUSION
The screening efficacy of NIPT for trisomies 21, 18 and 13 for a mixed population is significantly better than conventional serological screening, but it is relatively low for sex chromosomal abnormalities. NIPT can also be recommended for populations with relatively high risks along with detailed pre- and post-test genetic counselling. From the perspective of health economics, except for open neural tube defects, it is possible for NIPT to replace the conventional serological screening in the future as its cost continues to decrease.
Pregnancy
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Female
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Humans
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Trisomy/genetics*
;
Retrospective Studies
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Prenatal Diagnosis/methods*
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Down Syndrome/genetics*
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Aneuploidy
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Chromosome Aberrations
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Trisomy 18 Syndrome/genetics*
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Sex Chromosome Aberrations
;
Fetus
2.CGRP inhibits proliferation, activation and cytokine secretion of group 2 innate lymphoid cells (ILC2) in peripheral blood from patients with allergic rhinitis.
Hedi ZHUO ; Xueping QI ; Nuowen XU ; Yanjie WANG ; Yunfang AN ; Jinmei XUE ; Changqing ZHAO
Chinese Journal of Cellular and Molecular Immunology 2023;39(12):1094-1099
Objective To investigate the effect of calcitonin gene-related peptide (CGRP) on the regulation of group 2 innate lymphoid cells (ILC2) in the peripheral blood of patients with allergic rhinitis (AR). Methods Peripheral blood mononuclear cells (PBMCs) were extracted from normal healthy individuals and AR patients, then stimulated with CGRP, interleukin 33 (IL-33) and CGRP combined with IL-33 for 3 days, with blank stimulus as control. The percentage of ILC2 in the four groups was measured by flow cytometry. After being sorted, ILC2 was given to CGRP, IL-33 and CGRP combined with IL-33 stimulation for 3 days, with blank stimulus as control. The percentage of IL-5 and IL-13 positive cells in ILC2 was detected by flow cytometry, and the levels of IL-5 and IL-13 in ILC2 supernatant were measured by ELISA. Results The percentage of ILC2 in the peripheral blood of AR patients was significantly higher than that of the control group. The levels of IL-5+ILC2 and IL-13+ILC2 were significantly increased by IL-33 single stimulation after culturing PBMCs. After adding IL-33 combined with CGRP stimulation, the levels of IL-5+ILC2 and IL-13+ILC2 in PBMCs were significantly reduced; after CGRP single stimulation, the levels of IL-5+ILC2 and IL-13+ILC2 in PBMCs were further decreased. After ILC2 was sorted and cultured, the levels of IL-5+ILC2 and IL-13+ILC2 showed significant increase after IL-33 single stimulation. The levels of IL-5+ILC2 and IL-13+ILC2 were decreased by IL-33 and CGRP co-stimulation, and they were further reduced after CGRP single stimulation. Compared to IL-33 single stimulation, IL-5 and IL-13 levels dropped significantly due to the IL-33 and CGRP co-stimulation. The levels of IL-5 and IL-13 were further reduced by CGRP single stimulation. Conclusion CGRP inhibits the proliferation and activation of peripheral blood ILC2 in AR and exert anti-inflammatory effects in AR.
Humans
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Calcitonin Gene-Related Peptide/pharmacology*
;
Leukocytes, Mononuclear
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Immunity, Innate
;
Interleukin-33/pharmacology*
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Interleukin-13
;
Lymphocytes
;
Interleukin-5/pharmacology*
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Rhinitis, Allergic
;
Cell Proliferation
3.Nanoparticles (NPs)-mediated lncBCMA silencing to promote eEF1A1 ubiquitination and suppress breast cancer growth and metastasis.
Ke YANG ; Lei XU ; Ying XU ; Qian SHEN ; Tao QIN ; Yunfang YU ; Yan NIE ; Herui YAO ; Xiaoding XU
Acta Pharmaceutica Sinica B 2023;13(8):3489-3502
Long non-coding RNAs (lncRNAs) play an important role in cancer metastasis. Exploring metastasis-associated lncRNAs and developing effective strategy for targeted regulation of lncRNA function in vivo are of utmost importance for the treatment of metastatic cancer, which however remains a big challenge. Herein, we identified a new functional lncRNA (denoted lncBCMA), which could stabilize the expression of eukaryotic translation elongation factor 1A1 (eEF1A1) via antagonizing its ubiquitination to promote triple-negative breast cancer (TNBC) growth and metastasis. Based on this regulatory mechanism, an endosomal pH-responsive nanoparticle (NP) platform was engineered for systemic lncBCMA siRNA (siBCMA) delivery. This NPs-mediated siBCMA delivery could effectively silence lncBCMA expression and promote eEF1A1 ubiquitination, thereby leading to a significant inhibition of TNBC tumor growth and metastasis. These findings show that lncBCMA could be used as a potential biomarker to predict the prognosis of TNBC patients and NPs-mediated lncBCMA silencing could be an effective strategy for metastatic TNBC treatment.
4.Analysis of laboratory characteristics and evaluation of prognostic value of patients with NPM1 mutated acute myeloid leukemia
Ping WU ; Ting LI ; Huipeng SUN ; Lingjun WAN ; Chunyu ZHOU ; Dandan ZHANG ; Xiaofei ZHOU ; Heng ZHANG ; Mingyue CHEN ; Yunfang WANG ; Ningning WANG ; Wenjing LIU ; Tanlin XU ; Yiwei FU ; Lijun LIU ; Xiaoyu LIU ; Hongxing LIU ; Tong WANG ; Hui WANG
Chinese Journal of Laboratory Medicine 2023;46(5):483-492
Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.
5.The incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis
Jiaqi XU ; Yumin LI ; Bixian ZHONG ; Shaohua LIU ; Ying LEI ; Yunfang ZHANG ; Yanyan SU
Journal of Chinese Physician 2022;24(11):1661-1664
Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.
6.Establishment and evaluation of pyroptosis model of rat chondrocytes induced by TNF-α
Liang Xu ; Yujiao Wu ; Xiaoyang Yuan ; Feng Zhang ; Gang Cheng ; Yunfang Zhang ; Wei Wei ; Shangxue Yan
Acta Universitatis Medicinalis Anhui 2022;57(5):781-786
Objective:
To establish and evaluate the pyroptosis model of rat chondrocytes induced by tumor necrosis factor-α(TNF-α).
Methods:
A two-step enzymatic digestion method was used to obtain rat articular chondrocytes, inverted phase contrast microscope was used to observe the morphological structure of chondrocytes. Toluidine blue staining and type Ⅱ collagen(Col Ⅱ) staining were used to identify chondrocytes. Different mass concentrations of TNF-α(5, 10, 20, 40 ng/ml) were used to establish the pyroptosis model with TNF-α(0 ng/ml) as the control group. Cell viability was detected by CCK-8 method and proteins of pyroptosis signal were detected by Western blot. The levels of IL-1β and IL-18 in cultured supernatants were examined by ELISA kits. The expression of gasdermin D(GSDMD) in chondrocytes was detected by immunofluorescence. Scanning electron microscope was used to observe the morphological changes of chondrocyte.
Results:
Compared with the control group, the cell viability of rat chondrocytes gradually decreased with the increase of TNF-α concentration and the expression of nucleotide-binding and oligomerization domain-like receptor containing protein 3(NLRP3), caspase-1, GSDMD and Phospho-NF-κB p65(P-p65) proteins increased. Furthermore, TNF-α(20 ng/ml) could up-regulate the expression of matrix metalloproteinase-13(MMP-13), the fluorescence expression of GSDMD and the levels of IL-1β and IL-18 while the expression of Col Ⅱ was distinctly reduced. What′s more, the articular chondrocytes were swollen,and the microstructure was destroyed.
Conclusion
TNF-α(20 ng/ml) can cause the swelling and death of rat chondrocytes, degradation of cartilage matrix and activation of pyroptosis signaling pathway. The pyroptosis model of rat chondrocytes was successfully established.
7.Implementation of a WeChat small program assisted process assessment system in "Experiment of Inorganic Chemistry" for Biological Engineering undergraduates.
Jing XU ; Bin CAI ; Yunfang HUANG ; Weihai SUN
Chinese Journal of Biotechnology 2021;37(12):4430-4438
The convenience of "no installation, available at your fingertips" of the WeChat small program makes it unique in the application of mobile terminal auxiliary experimental teaching. In order to optimize the assessment system and improve the quality and outcomes of experimental teaching, a self-designed WeChat small program was used to assist the development of the process assessment system. This system was applied to the teaching practice of "Experiment of Inorganic Chemistry" course for the first-year undergraduates majored in Biological Engineering, with the aim to promote teaching and learning by assessment. The results showed that course scores of the students who used this small program were superior to the control group and the correlation between the process assessment and final examination results was significant. These results indicated the WeChat small program assisted process assessment could effectively improve the learning outcomes of students, enable them to grasp the knowledge of Experiment of Inorganic Chemistry efficiently. The results of the questionnaire for the teachers and students also showed a high recognition of the WeChat small program assisted teaching.
Bioengineering
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Chemistry, Inorganic
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Humans
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Learning
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Process Assessment, Health Care
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Students
8.Study on the incidence of adult herpes zoster in Yichang city and its association with early-life famine exposure
Xiong DING ; Wei JIANG ; Yuehua HU ; Jing JIANG ; Ying WU ; Chengzhong XU ; Zhouzhi WU ; Yunfang YU ; Xiaojun LIU ; Guiwen LI ; Dapeng YIN
Chinese Journal of Preventive Medicine 2021;55(11):1328-1331
Based on Yichang health big data platform, 850 608 patients from September 2018 to September 2019 were included in this study. According to the date of birth, the participants were divided into early childhood famine exposure group, fetal famine exposure group and non-famine exposure group. The incidence of adult herpes zoster (HZ) in Yichang city was analyzed, and the correlation between early life famine exposure and adult HZ was analyzed. In 2019, the crude incidence rate of adult HZ in Yichang was 6.83‰. The crude incidence rate of adult HZ in females (7.26‰) was higher than that in males (6.40‰). Compared with the non-famine exposure group, fetal famine exposure was associated with the incidence of adult HZ ( OR=1.21; 95% CI: 1.01-1.45, P=0.041). After stratification by sex, fetal famine exposure was only found to be associated with the onset of adult HZ in females ( OR=1.28, 95% CI:1.02-1.61, P=0.034).
9.Study on the incidence of adult herpes zoster in Yichang city and its association with early-life famine exposure
Xiong DING ; Wei JIANG ; Yuehua HU ; Jing JIANG ; Ying WU ; Chengzhong XU ; Zhouzhi WU ; Yunfang YU ; Xiaojun LIU ; Guiwen LI ; Dapeng YIN
Chinese Journal of Preventive Medicine 2021;55(11):1328-1331
Based on Yichang health big data platform, 850 608 patients from September 2018 to September 2019 were included in this study. According to the date of birth, the participants were divided into early childhood famine exposure group, fetal famine exposure group and non-famine exposure group. The incidence of adult herpes zoster (HZ) in Yichang city was analyzed, and the correlation between early life famine exposure and adult HZ was analyzed. In 2019, the crude incidence rate of adult HZ in Yichang was 6.83‰. The crude incidence rate of adult HZ in females (7.26‰) was higher than that in males (6.40‰). Compared with the non-famine exposure group, fetal famine exposure was associated with the incidence of adult HZ ( OR=1.21; 95% CI: 1.01-1.45, P=0.041). After stratification by sex, fetal famine exposure was only found to be associated with the onset of adult HZ in females ( OR=1.28, 95% CI:1.02-1.61, P=0.034).
10.Effect of Kangfuxin liquid combined with mupirocin on exit-site granulation tissue hyperplasia in peritoneal dialysis patients
Liqiu HUANG ; Jiaqi XU ; Jiamin TANG ; Huiming HUANG ; Yunfang ZHANG
Chinese Journal of Primary Medicine and Pharmacy 2019;26(2):154-156
Objective To observe the effect of Kangfuxin liquid combined with mupirocin on exit -site granulation tissue hyperplasia in peritoneal dialysis patients. Methods From January 2012 to December 2017, 35 peritoneal dialysis patients with exit-site granulation tissue hyperplasia in the People's Hospital of Huadu District were selected and randomly assigned into treatment group (15 cases) and control group(20 cases). The control group was given conventional treatment, the treatment group received a sterile dressing moistened with Kangfuxin liquid. Before and after treatment,the exit-site granulation tissue outcome and the incidence of complications were recorded and compared. Results The recovery time of the control group was (8. 58 ± 1. 36)d,which was longer than (3. 43 ± 0. 85)d of the treatment group (t=3. 57,P<0. 05). Exit-site exudation was found in 3 patients of the control group. No complications were observed in the treatment group. Conclusion Kangfuxin liquid combined with mupiro-cin can shorter the recovery time of exit-site granulation tissue hyperplasia in peritoneal dialysis patients,and reduce the side effect,which is worthy of clinical application.


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