1.Analysis of urinary iodine level in Hashimoto thyroiditis patients
Xiaodie Li ; Yongxia Xu ; Fen Wang ; Wenlu Guo ; Wei Jia ; Xuefeng Wang ; Lang Lang ; Defa Zhu
Acta Universitatis Medicinalis Anhui 2024;59(1):144-148
Objective :
To analyze the difference of urinary iodine level in Hashimoto thyroiditis ( HT) patients, and to explore the possible relationship between urinary iodine level and HT under different iodine nutritional sta- tus,so as to provide some references for reasonable iodine intake in HT patients.
Methods :
A total of 101 hospi- talized HT patients were selected as HT group and divided into 3 groups according to thyroid function : HT group with hyperthyroidism (41 cases) .There were 25 cases in HT group with normal thyroid function.There were 35 cases in HT combined with hypothyroidism group.In addition,30 healthy subjects were selected as control group. Serum levels of thyroid stimulating hormone(TSH) ,triiodothyronine(T3 ) ,thyroxine (T4 ) ,thyroid peroxidase an- tibody (TPOAb) and thyroglobulin antibody (ATG) were detected by chemiluminescence assay.The size and mor- phological structure of thyroid organs were examined by ultrasonography.Urinary iodine was determined by catalytic spectrophotometry with arsenic and cerium.The nutritional status of iodine was classified into iodine deficiency ( < 100 μg/ L) ,iodine adequacy( 100 -199 μg/ L) ,iodine adequacy (200 -299 μg/ L) and iodine excess ( ≥ 300 μg/ L) .Non-parametric test was used to compare urinary iodine level between HT group and control group,one- way ANOVA and t test were used to compare urinary iodine level between HT group and control group ,and Spearman correlation analysis was used to compare the correlation between urinary iodine level and T3 ,T4 ,TSH, ATG and TPOAb under different iodine nutrition status.
Results :
Compared with control group,ATG and TPOAb levels in HT group increased (P<0. 001) ,and urinary iodine levels increased (P<0. 05) ,with statistical signifi- cance.Compared with the control group in different thyroid function states,only the HT group with hypothyroidism increased the urinary iodine level (P<0. 01) ,and the difference was statistically significant.Spearman correlation analysis showed that urine iodine level was positively correlated with ATG and TPOAb levels in iodine excess condi- tion (P<0. 05) ,and urine iodine level was positively correlated with TSH level in iodine sufficient condition and iodine excess condition in HT patients (P<0. 05) .
Conclusion
The urinary iodine level of HT patients was high- er than that of normal people.When the urinary iodine level of residents is ≥ 300 μg/ L,iodine intake is prone to HT.When the urinary iodine level of HT patients is ≥ 200 μg/ L,iodine consumption is prone to hypothyroidism, and iodine intake should be limited.
2.Association between increased CD177 + neutrophils and chronic activation in people living with HIV.
Lina FAN ; Yue HU ; Liying GAO ; Aiping YU ; Defa ZHANG ; Yue WU ; Fangfang YU ; Lei LI ; Bei LI ; Hongxin ZHAO ; Ping MA
Chinese Medical Journal 2023;136(24):2996-2998
3.Small molecules targeting protein-protein interactions for cancer therapy.
Defa WU ; Yang LI ; Lang ZHENG ; Huan XIAO ; Liang OUYANG ; Guan WANG ; Qiu SUN
Acta Pharmaceutica Sinica B 2023;13(10):4060-4088
Protein-protein interactions (PPIs) are fundamental to many biological processes that play an important role in the occurrence and development of a variety of diseases. Targeting the interaction between tumour-related proteins with emerging small molecule drugs has become an attractive approach for treatment of human diseases, especially tumours. Encouragingly, selective PPI-based therapeutic agents have been rapidly advancing over the past decade, providing promising perspectives for novel therapies for patients with cancer. In this review we comprehensively clarify the discovery and development of small molecule modulators of PPIs from multiple aspects, focusing on PPIs in disease, drug design and discovery strategies, structure-activity relationships, inherent dilemmas, and future directions.
4.Lipids and membrane-associated proteins in autophagy.
Linsen LI ; Mindan TONG ; Yuhui FU ; Fang CHEN ; Shen ZHANG ; Hanmo CHEN ; Xi MA ; Defa LI ; Xiaoxia LIU ; Qing ZHONG
Protein & Cell 2021;12(7):520-544
Autophagy is essential for the maintenance of cellular homeostasis and its dysfunction has been linked to various diseases. Autophagy is a membrane driven process and tightly regulated by membrane-associated proteins. Here, we summarized membrane lipid composition, and membrane-associated proteins relevant to autophagy from a spatiotemporal perspective. In particular, we focused on three important membrane remodeling processes in autophagy, lipid transfer for phagophore elongation, membrane scission for phagophore closure, and autophagosome-lysosome membrane fusion. We discussed the significance of the discoveries in this field and possible avenues to follow for future studies. Finally, we summarized the membrane-associated biochemical techniques and assays used to study membrane properties, with a discussion of their applications in autophagy.
5.Diagnostic value of non-invasive model for hepatic steatosis in patients infected with human immunodeficiency virus
Defa ZHANG ; Shuang LI ; Yuqiang MI ; Ping MA
Chinese Journal of Hepatology 2020;28(9):790-793
Objective:Hepatic steatosis has a high incidence in human immunodeficiency virus (HIV) infected people, and there is no effective non-invasive method to evaluate it. This study aims to evaluate the diagnostic value of non-invasive models for hepatic steatosis in this population.Methods:A single-center retrospective study was applied to evaluate: (1) the diagnostic value of controlled attenuation parameters (CAP) and hepatic steatosis index (HSI) in HIV-infected patients with hepatic steatosis; (2) the ability of the non-invasive model to distinguish hepatic steatosis caused by abnormal glucose and lipid metabolism and hepatic steatosis caused by hepatitis C virus infection; (3) the diagnostic value of the above models for hepatic steatosis in patients co-infected with HIV/hepatitis C virus. The diagnostic value of the model was analyzed and evaluated by diagnostic test and receiver operating characteristic curve.Results:(1) the diagnostic value of hepatic steatosis for HIV-infected patients: when CAP = 232 dB/m, the sensitivity and specificity were 89.2% and 78.1%, respectively; when HSI = 34, the sensitivity and specificity were 79.1% and 83.2%, respectively. (2) The ability to identify the causes of hepatic steatosis in HIV-infected patients: when CAP = 258dB/m, the sensitivity and specificity were 81.5% and 88.2%, respectively; when HSI = 37, the sensitivity and specificity were 70.7% and 92.4%, respectively. (3) The diagnostic value of hepatic steatosis in patients co-infected with HIV/hepatitis C virus: when CAP = 241 dB/m, the sensitivity and specificity were 80% and 71.4%, respectively; when HSI = 32, the sensitivity and specificity were 73% and 68.9%, respectively.Conclusion:CAP and HSI have superior diagnostic value for hepatic steatosis in patients infected with HIV.
6. Investigation on the turnover intention of pediatricians in Shenzhen and its influencing factors
Xiaoqiong LUO ; Jianming ZHANG ; Defa LI ; Min LIU ; Pei YE ; Yao CHEN ; Xiaowei ZHANG ; Liping ZHOU
Chinese Journal of Hospital Administration 2019;35(10):842-845
Objective:
To understand the intention of pediatricians turnover in Shenzhen and its influencing factors.
Methods:
From September to December 2016, a multi-stage stratified cluster sampling method was used to select 948 pediatricians from Shenzhen to conduct a questionnaire survey. The questionnaire cover the following: 1. Basic information: general demographic characteristics(gender, age, marriage, education, etc.); 2. Work status survey: turnover intention, experiences with violence against medical workers, professional job satisfaction, and work stress, etc. Univariate analysis and multivariate analysis were used to identify factors for pediatrician′s turnover intention.
Results:
Among the 948 pediatricians in Shenzhen, 62.5% had turnover intention; age, title, education, seniority, monthly income, medical institution nature, medical institution level, length of sleep, job satisfaction, work stress, experience with violence and family support all affect the pediatrician′s turnover intention(
7. A risk assessment model for esophageal varices occurrence based on endoscopic ultrasonography
Shuang LI ; Defa ZHANG ; Wei LU ; Dongsheng HU ; Jia LI ; Xiaoling GUO ; Xiaofen YUE ; Rui FU ; Xiangjun JI ; Jun WEN
Chinese Journal of Digestive Endoscopy 2019;36(9):659-665
Objective:
To identify the independent risk factors of esophageal varices (EV) in cirrhosis by endoscopic ultrasonography (EUS), and further to establish a risk assessment model for predicting EV occurrence and evaluate the clinical predictive value of the model.
Methods:
A retrospective cohort study was used in this study. Data of patients with cirrhosis without varicosity, who were hospitalized in Tianjin Second People's Hospital from September 2014 to March 2017 were collected. The location, diameter, and number of esophageal collateral circulation were measured by EUS. The non-selective beta blocker (NSBB) medication history and antiviral therapy were recorded. The time of the first EUS examination was taken as the starting point and the follow-up period was set up as 18 months. The end point was the occurrence of EV or the end of follow-up. The independent risk factors of EV occurrence were determined by univariate and multivariate logistic regression analysis, and the risk assessment model of EV occurrence was constructed. The predictive value of evaluation model for disease was studied by ROC analysis. Hosmer-Lemeshow goodness of fit was used to test the fitting efficiency of the evaluation model.
Results:
A total of 638 subjects were recruited initially, 13 of them were lost in the course of the study. Finally, 625 cases were included in the study. Among them, 369 cases did not develop EV (the non-progress group) and 256 cases developed EV (the progress group). (1) Multivariate logistic regression analysis showed that 7 independent risk factors were selected into the risk assessment model of EV occurrence, and were assigned corresponding scores: no NSBB (3 points), no antiviral treatment (2 points), Child-Pugh stage B (1 point), the diameter of peri-ECV>2 mm (1 point), the number of peri-ECV≥5 (3 points), the diameter of para-ECV≥5 mm (4 points), and the number of para-ECV≥5 (4 points). (2) In the risk assessment model, the risk factor scores ranged from 1 to 4 with a total score of 0-18. The predicted incidence of EV increased from 0.003 to 1.000 with the increase of the score. (3) In the risk assessment model, the total risk score ≤2 was assigned into low-risk group, 3-5 into medium-risk group, and ≥6 into high-risk group. The actual EV incidence of each risk stratification was 2.78% in the low-risk group, 36.36% in the medium-risk group and 93.91% in the high-risk group, respectively. (4) The ROC analysis showed that area under curve (AUC) was 0.947 (
8.A retrospective study of endoscopic ultrasonography for predicting progression of esophageal varices in patients with hepatitis B virus-related hepatocirrhosis
Shuang LI ; Zhihong JIANG ; Defa ZHANG ; Wei LU ; Dongsheng HU ; Jia LI ; Xiaoling GUO ; Xiangjun JI ; Jun WEN
Chinese Journal of Digestive Endoscopy 2019;36(3):198-203
Objective To assess the clinical value of endoscopic ultrasonography ( EUS ) for predicting esophageal varices ( EV ) progression in patients with hepatitis B virus ( HBV )-related hepatocirrhosis. Methods A retrospective cohort study was performed on 299 HBV-related hepatocirrhosis patients with light EV in Tianjin Second People′s Hospital admitted from September 2014 to September 2015. The diameter and number of peri-esophageal collateral veins ( ECV ) and para-ECV were measured and described by EUS. The first EUS examination time was the starting point, and the follow-up of 24 months or EV progression was the end. Risk factors of EV progression were evaluated by multivariate Cox regression model, and the predictive value of EUS for EV progression was analyzed by receiver operating characteristic ( ROC) curve. Results The cumulative incidence of EV progression was 2. 3% ( 7/299 ) , 14. 8%( 44/297) , 33. 7% ( 96/285) and 40. 0% ( 120/273) at 6 months, 12 months, 18 months and 24 months of follow-up, respectively. The results of multivariate Cox regression analysis showed that the diameter of peri-ECV ( P=0. 0112, HR=1. 3232, 95%CI: 1. 0656-1. 6429 ) , the number of peri-ECV ( P=0. 0001, HR=1. 3666, 95%CI:1. 1634-1. 6052) and para-ECV diameter ( P=0. 0002, HR=1. 3641, 95%CI:1. 1558-1. 6100) were risk factors for EV progression. The use of nucleoside analogues treating HBV (P=0. 0020, HR=0. 4969, 95%CI: 0. 3186-0. 7751) and non-selective β-blockers descending portal venous pressure ( P=0. 0765, HR=0. 5732, 95%CI:0. 3097-1. 0611) were the protective factors for EV progression. The results of ROC curve analysis showed that the diameter of peri-ECV[ P<0. 001, area under the curve (AUC)= 0. 850, 95%CI: 0. 804-0. 895], the number of peri-ECV (P<0. 001, AUC=0. 831, 95%CI: 0. 784-0. 878), the diameter of para-ECV (P<0. 001, AUC=0. 924, 95%CI: 0. 895-0. 954) , and the number of para-ECV ( P<0. 001, AUC=0. 761, 95%CI: 0. 704-0. 817 ) had higher predictive value for EV progression;and the optimum cut-off values of each index were 1. 85 mm, 3. 5, 3. 35 mm, and 4. 5, respectively. The accuracies of prediction for EV progression were 76. 60%, 75. 19%, 84. 48% and 70. 29%, respectively. Conclusion EUS can be used to predict EV progression in HBV-related hepatocirrhosis patients. Peri-ECV diameter>1. 85 mm, number>3. 5, and para-ECV diameter>3. 35 mm, number>4. 5 suggest a high risk of EV progression. For patients with HBV-related hepatocirrhosis complicated with mild EV, nucleoside analogues to anti-HBV and non-selective β-blockers to reduce portal hypertension can prevent EV progression.
9.Value of endoscopic ultrasonography for risk assessment in esophageal varices bleeding
Shuang LI ; Defa ZHANG ; Wei LU ; Dongsheng HU ; Jia LI ; Jun WEN ; Xiaoling GUO ; Xiaofen YUE ; Xiangjun JI ; Guoqiang ZHOU
Chinese Journal of Digestive Endoscopy 2017;34(12):887-891
Objective To assess the predictive value of endoscopic ultrasonography(EUS)for esophageal varices(EV)bleeding by studying the relationship between esophageal collateral veins(ECV), portal vein(PV)trunk with its main branches and EV bleeding. Methods A retrospective cohort study of 114 cases of moderate and severe EV was conducted. The ECV level was determined through EUS. At the same time,diameters of PV,azygos vein(AIV)and spleen vein(SV)were measured through EUS. The predictive value of ECV level and diameters of PV, AIV, SV for EV bleeding were assessed during the 1-year follow-up, which started from the first EUS examination to EV bleeding or the end of follow-up. Results Single factor Cox regression analysis showed severe peri-ECV varices had higher risk than mild in EV bleeding(HR=4.081,95%CI:1.833-9.086,P=0.001); severe para-ECV varices had higher risk than mild in EV bleeding(HR= 4.042, 95%CI:1.814-9.005,P= 0.001). Multivariable Cox retrospective analysis showed ECV level was an effective predictor for EV bleeding, when the peri-ECV and para-ECV were severe varices, EV bleeding risk increased to 3.831 3(P=0.004 3)and 3.493 3(P=0.003 1) times compared with mild respectively. Diameters of PV,AIV and SV could predict EV bleeding(PV AUC=0.959,P<0.001;AIV AUC=0.958,P<0.001;SV AUC=0.830,P<0.001).In addition, when diameter of PV>13.65 mm(sensitivity=0.94, specificity=0.84), AIV>8.65 mm(sensitivity=0.94, specificity=0.89),SV>9.45 mm(sensitivity=0.90, specificity=0.67), EV bleeding risk increased significantly. Conclusion EUS is helpful to predict the risk of moderate and severe EV bleeding, and severe varices of ECV,PV,AIV,and SV can be used as indicators to predict risk of EV bleeding.
10.The predictive value of endoscopic ultrasound for the recurrence of esophageal varices after endo-scopic esophageal varix ligation
Shuang LI ; Defa ZHANG ; Wei LU ; Dongsheng HU ; Chunyan WANG ; Xiaoling GUO ; Jun WEN ; Xiangjun JI ; Xiaodong ZHOU
Chinese Journal of Digestive Endoscopy 2016;33(4):223-228
Objective To assess the relationship between the recurrence of esophageal varices fol?lowing endoscopic esophageal varix ligation (EVL) and esophageal collateral veins(ECV)under endoscopic ultrasound ( EUS) , and analyze the predictive value of EUS for recurrence of esophageal varices. Methods Sixty patients with cirrhotic portal hypertension combined with esophageal varices underwent EVL for eradica?tion of varices. Endoscopy and EUS were performed before ligation to detect and describe the type of esopha?geal varices, and grade, location, and the number of ECV. Over a 12?month period, variceal recurrence was examined. The statistical analyses were performed to assess the relationship between esophageal varices fol?lowing EVL and ECV. Results Of the 60 patients, 29 ( 48?3%) had variceal recurrence within 12 months after EVL. Univariate logistic regression analysis showed that severe peri?ECV ( OR=22?67;95%CI:4?37? 117?47, P<0?001) ,severe para?ECV( OR=16?31;95%CI:0?84?108?14, P=0?018) , multiple peri?ECV ( OR=22?67;95%CI:4?37?117?47, P<0?001) , and the presence of perforating veins ( OR=6?67,95%CI:1?46?30?43,P=0?014) were significantly related to the variceal recurrence after EVL. Multivariate logis?tic regression model showed that severe peri?ECV ( OR=24?39;95%CI:2?34?253?78,P=0?008) and mul?tiple peri?ECV (OR=24?39;95%CI: 2?34?253?78,P=0?008) severe para?ECV(OR=19?42; 95%CI:4?84?148?54,P=0?012) remained independent prognostic factors for variceal recurrence. The sensitivity and specificity of multivariate logistic regression model in predicting variceal recurrence were 89?2% and 90?5%, respectively (prognostic value AUC=0?946).The sensitivity and specificity were 86?4% and 87?7% in pre?dicting variceal recurrence( prognostic value AUC=0?871) . Conclusion Recurrence rate of esophageal var?ices after EVL is high. EUS can clearly depict ECV. Severe peri?ECV and multiple peri?ECV are significant and independent prognostic factors associated with variceal recurrence risk. EUS before EVL will help predict variceal recurrence after EVL.


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