1.The illness experience and demands of patients with poststroke aphasia during rehabilitation:a qualitative meta-synthesis
Huan WANG ; Shengjuan LI ; Chen LI ; Yuanyuan HE ; Yuyao XIE ; Dongxiang ZHENG
Chinese Journal of Nursing 2024;59(7):873-881
Objective To systematically evaluate and integrate qualitative studies on the disease experience and demands of stroke aphasic patients during rehabilitation,and to provide references for the development of a rehabilitation care strategy oriented to the needs of poststroke aphasia patients.Methods Computer search of PubMed,Web of Science,Embase,Cochrane Library,CINAHL,China Knowledge Network,Wanfang database,and VIP Chinese biomedical journals was conducted for qualitative research on the illness experience and demands of poststroke aphasia patients during rehabilitation from the time of database construction to May 2023.The literature was evaluated using the Australian JBI Quality Evaluation Criteria for Qualitative Research in Evidence-based Health Care Centers(2016),and the results were consolidated using an aggregative integration approach.Results A total of 18 studies were included,and a total of 1 theoretical model and 70 themes were extracted and grouped to form 7 categories,which were combined into 3 integrated outcomes:poststroke aphasia is a traumatic life event;poststroke aphasia patients actively rebuild their lives;the demands of poststroke aphasia patients during rehabilitation.Conclusion Poststroke aphasia patients during rehabilitation face difficulties in life;medical professionals should stimulate patients'positive feelings,strive to promote patients'social integration and self-management,meet patients'multidimensional and diverse rehabilitation demands,and ultimately construct personalized rehabilitation management programs oriented to patients'demands with poststroke aphasia.
2.Guidelines for Ethical Review Entrustment Contract of Life Science and Medical Research Involving Humans
Aijuan SHENG ; Meixia WANG ; Qiang LIU ; Zhongguang YU ; Hu CHEN ; Hui JIANG ; Jiyin ZHOU ; Xiaoqi WANG ; Haibin YU ; Mingjie ZI ; Yifeng JIANG ; Lei XU ; Tao SHI ; Guizhen SUN ; Dongxiang ZHENG
Chinese Medical Ethics 2023;36(5):492-498
The passing of ethical review is a necessary conditions and prerequisite for the development of life science and medical research involving humans. At present, some medical and health institutions have no or insufficient ethical review capabilities. The lack of ethical review ability has become a bottleneck restricting the development of life science and medical research involving humans. According to documents such as Opinions on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Pharmaceutical and Medical Devices, Opinions on Strengthening the Ethical Governance of Science and Technology, institutions can entrust competent institutional ethics review committees or regional ethics review committees in writing to conduct ethical review. Entrustment ethical review provides a viable solution for institutions that need to carry out life science and medical research involving humans but do not have an ethics (review) committee or the ethics (review) committee is not competent to review. To conduct the entrustment ethical review, the entrustment between the principal and the trustee is required. According to The Measures for Ethical Review of Life Sciences and Medical Research Involving Humans, if medical and health institutions and their ethical review committees do not accept the formal entrustment to provide the ethical review opinions for other institutions, the local health authorities at or above the county level will impose administrative penalties and sanctions on the relevant institutions and personnel in accordance with the law. Signing the entrustment ethical review contract, implementing legal compliance entrusted ethical review to protect the rights and interests of the trustee and the principal, and protect the research participants.
3.The study on the segmentation of carotid vessel wall in multicontrast MR images based on U?Net neural network
Jifan LI ; Shuo CHEN ; Qiang ZHANG ; Yan SONG ; Canton GADOR ; Jie SUN ; Dongxiang XU ; Xihai ZHAO ; Chun YUAN ; Rui LI
Chinese Journal of Radiology 2019;53(12):1091-1095
Objective To investigate the value of automatic segmentation of carotid vessel wall in multicontrast MR images using U?Net neural network. Methods Patients were retrospectively collected from 2012 to 2015 in Carotid Atherosclerosis Risk Assessment (CARE II) study. All patients who recently suffered ischemic stroke and/or transient ischemic attack underwent identical, state?of?the?art multicontrast MRI technique. A total of 17 568 carotid vessel wall MR images from 658 subjects were included in this study after inclusion criteria and exclusion criteria. All MR images were analyzed using customized analysis platform (CASCADE). Randomly, 10 592 images were assigned into training dataset, 3 488 images were assigned into validating dataset and 3 488 images were assigned into test dataset according to a ratio of 6∶2∶2. Data augmentation was performed to avoid over fitting and improve the ability of model generalization. The fine?tuned U?Net model was utilized in the segmentation of carotid vessel wall in multicontrast MR images. The U?Net model was trained in the training dataset and validated in the validating dataset. To evaluate the accuracy of carotid vessel wall segmentation, the sensitivity, specificity and Dice coefficient were used in the testing dataset. In addition, the interclass correlation and the Bland?Altman analysis of max wall thickness and wall area were obtained to demonstrate the agreement of the U?Net segmentation and the manual segmentation. Results The sensitivity, specificity and Dice coefficient of the fine?tuned U?Net model achieved 0.878,0.986 and 0.858 in the test dataset, respectively. The interclass correlation (95% confidence interval) was 0.921 (0.915-0.925) for max wall thickness and 0.929 (0.924-0.933) for wall area. In the Bland?Altman analysis, the difference of max wall thickness was (0.037±0.316) mm and the difference of wall area was (1.182±4.953) mm2. The substantial agreement was observed between U?Net segmentation method and manual segmentation method. Conclusion Automatic segmentation of carotid vessel wall in multicontrast MR images can be achieved using fine?tuned U?Net neural network, which is trained and tested in the large scale dataset labeled by professional radiologists.
4. The study on the segmentation of carotid vessel wall in multicontrast MR images based on U-Net neural network
Jifan LI ; Shuo CHEN ; Qiang ZHANG ; Yan SONG ; Gador CANTON ; Jie SUN ; Dongxiang XU ; Xihai ZHAO ; Chun YUAN ; Rui LI
Chinese Journal of Radiology 2019;53(12):1091-1095
Objective:
To investigate the value of automatic segmentation of carotid vessel wall in multicontrast MR images using U-Net neural network.
Methods:
Patients were retrospectively collected from 2012 to 2015 in Carotid Atherosclerosis Risk Assessment (CARE II) study. All patients who recently suffered ischemic stroke and/or transient ischemic attack underwent identical, state-of-the-art multicontrast MRI technique. A total of 17 568 carotid vessel wall MR images from 658 subjects were included in this study after inclusion criteria and exclusion criteria. All MR images were analyzed using customized analysis platform (CASCADE). Randomly, 10 592 images were assigned into training dataset, 3 488 images were assigned into validating dataset and 3 488 images were assigned into test dataset according to a ratio of 6∶2∶2. Data augmentation was performed to avoid over fitting and improve the ability of model generalization. The fine-tuned U-Net model was utilized in the segmentation of carotid vessel wall in multicontrast MR images. The U-Net model was trained in the training dataset and validated in the validating dataset. To evaluate the accuracy of carotid vessel wall segmentation, the sensitivity, specificity and Dice coefficient were used in the testing dataset. In addition, the interclass correlation and the Bland-Altman analysis of max wall thickness and wall area were obtained to demonstrate the agreement of the U-Net segmentation and the manual segmentation.
Results:
The sensitivity, specificity and Dice coefficient of the fine-tuned U-Net model achieved 0.878,0.986 and 0.858 in the test dataset, respectively. The interclass correlation (95% confidence interval) was 0.921 (0.915-0.925) for max wall thickness and 0.929 (0.924-0.933) for wall area. In the Bland-Altman analysis, the difference of max wall thickness was (0.037±0.316) mm and the difference of wall area was (1.182±4.953) mm2. The substantial agreement was observed between U-Net segmentation method and manual segmentation method.
Conclusion
Automatic segmentation of carotid vessel wall in multicontrast MR images can be achieved using fine-tuned U-Net neural network, which is trained and tested in the large scale dataset labeled by professional radiologists.
5. Expression of osteoprotegerin and receptor activator of nuclear factor kappa-B ligand in mandibular ramus osteotomy healing with administration of different doses of parathyroid hormone
Ning AN ; Yao LI ; Zhenglong TANG ; Xiaoyan CHEN ; Dongxiang WANG ; Qiong GAO
Chinese Journal of Stomatology 2018;53(6):413-418
Objective:
To investigate the effect of parathyroid hormone (PTH) on the bone healing of mandibular ramus osteotomy.
Methods:
The mandibular ramus osteotomy model was established in sixty rabbits and these rabbits were randomly divided into experimental group A, experimental group B and control group. In the experimental group A and experimental group B, the rabbits were given PTH (20 and 40 μg/kg respectively) every other day after operation. In the control group, 1 ml saline was given. The animals were sacrificed at 1 week, 2 weeks, 3 weeks and 4 weeks postoperatively. The new bone formation was observed by histology and cone bone CT. The expression of osteoprotegerin and receptor activator of nuclear factor kappa-B (RANKL) in the new bone was detected by real-time quantitative PCR.
Results:
The experimental groups has better osteogenesis and the bone mineral density than the control group in osteotomy area. The experimental group B showed the best osteogenesis.Osteoprotegerin mRNA expression in experimental group A (1.127±0.035, 1.742±0.049, 1.049±0.062, 1.063±0.036) was significantly higher than that in the control group in each period (0.965±0.082, 1.254±0.071, 0.793±0.061, 0.684±0.055) (
6.Osteoprotegerin/receptor activator of nuclear factor-κB ligand expression in mandibular distraction osteogenesis regulated by parathyroid hormone.
Yongdi LI ; Pengna ZHU ; Dongxiang WANG ; Jiamin CHEN ; Zhenglong TANG
West China Journal of Stomatology 2016;34(3):234-238
OBJECTIVEThis research aimed to investigate the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in mandibular distraction osteogenesis (DO) regulated by parathyroid hormone (PTH) and to explore the mechanism by which PTH promotes DO.
METHODSA rabbit mandibular DO model was established. The rabbits were randomly divided into experimental group and control group. The former were subcutaneously injected with different doses of PTH on alternate days, the latter was injected with normal saline every other day. Serum OPG levels were detected through enzyme-linked immunosorbent assay. The OPG and RANKL expression levels in the DO-induced formation of a new bone tissue were examined through immunohistochemistry staining.
RESULTSThe serum OPG levels gradually increased during distraction. At the end of the stretch, the OPG expression in the experimental group was significantly stronger than that in the control group. As the fixed period was extended, the OPG expression in the new bone gradually decreased, but the RANKL expression increased.
CONCLUSIONIntermittent subcutaneous PTH injection can upregulate the OPG expression and accelerate bone metabolism. Thus, this procedure promotes the early generation of a new bone in the mandible through DO.
Animals ; Enzyme-Linked Immunosorbent Assay ; Mandible ; NF-kappa B ; metabolism ; Osteogenesis, Distraction ; methods ; Osteoprotegerin ; metabolism ; Parathyroid Hormone ; metabolism ; RANK Ligand ; metabolism ; RNA, Messenger ; Rabbits ; Random Allocation
7.Clinical application value and research progress of artificial pancreas closed-Loop control in diabctes mellitus
Pei LUO ; Dongxiang XU ; Chengying GU ; Lihua CHEN ; Lihua CHEN ; Ligang ZHOU
Clinical Medicine of China 2016;32(3):277-279
Ideal blood glucose control requires accurate insulin injections under the guidance of frequent glucose monitoring.Artificial pancreas (AP),the closed-loop control system can adjust the input amount of insulin automatically with the body's blood glucose levels.The AP allows diabetics to control blood glucose ideal,then get the benefit of prevention of complications and bring convenience and safety in clinical application.Accuracy is the key issue of the AP.To improve the accuracy of such a system need to improve the detection accuracy and reliability,increase speed and accuracy of the output control,and improve the accuracy of the system regulation model.
8.Influence of STAT1 on proliferation and IFN-βsensitivity of human non-small-cell lung cancer H1299 cells
Jialu ZHAO ; Xiaoru SUN ; Dongxiang JI ; Junjie CHEN ; Mengyi WANG ; Lei JIANG ; Yuping LI ; Chengshui CHEN
Chinese Journal of Pathophysiology 2015;(5):852-856
AIM:To investigate the effect of signal transducer and activator of transcription 1 ( STAT 1 ) on proliferation and interferon-β(IFN-β) sensitivity of human non-small-cell lung cancer H1299 cells.METHODS:STAT1 or EGFP gene was transfected into H1299 cells by the lentiviral vectors system.The cell number was counted under a mi-croscope and cell proliferation was tested by MTT assay.In addition, the cells transfected with STAT1 and EGFP were trea-ted with IFN-βand cell viability was measured by MTT assay.The protein levels of p-STAT1, ICAM-1 and PCNA were de-tected by Western blot.RESULTS: Over-expression of STAT1 inhibited H1299 cell proliferation (P<0.05).H1299 cells transfected with STAT1 gene had a higher sensitivity to IFN-βthan the control cells transfected with EGFP ( P <0.05).Overexpression of STAT1 increased the protein level of p-STAT1, and reduced IACM-1 expression in H1299 cells. Moreover, STAT1 enhanced STAT1 phosphorylation and downregulated the expression of PCNA in H1299 cells treated with IFN-β.CONCLUSION:STAT1 inhibits the proliferation and enhances the IFN-βsensitivity of non-small-cell lung cancer H1299 cells.
9.The correlation of serum lipid and apolipoprotein levels and breast cancer
Shengzao JIANG ; Dongxiang CHEN
China Modern Doctor 2015;(14):17-20
Objective To investigate the correlation between serum lipids, apolipoprotein and breast cancer. Methods A survey on the prevalence of breast cancer was conducted in out hospital from March 2012 to March 2014. The data of 82 subjects with histologically confirmed breast cancer and 80 healthy control subjects were analyzed. Serum TC, TG, Apo-A, Apo-B, HDL-C, LDL-C were tested at the same time. The grouped according to tumor size, lymph node metastasis, the degree of tissue differentiation, measured values were compared. Results The levels of serum TC,TG, LDL-C, Apo-B in the breast cancer group were (6.20±0.24) mmol/L, (2.45±0.12) mmol/L, (4.58±0.20) mmol/L, (1.25±0.15)g/L respectively, while those in the control group were (4.00±0.20) mmol/L, (0.67±0.17) mmol/L, (2.14±0.22) mmol/L, (0.86±0.24) g/L respectively.All above parameters of the breast cancer group were significantly higher than those in the control group (P<0.05). The levels of serum HDL-C, Apo-A in the breast cancer group were (0.90±0.11) mmol/L and (1.20±0.22) g/L, and those in the control group were (1.98±0.21) mmol/L and (1.36±0.20) g/L, which was signifi-cantly lower than that of the control group (P<0.05). The serum TC level were significantly higher in the lump≥2 cm group than that of < 2 cm group (P<0.05). There was not significant difference between patients with lymph node metastasis and non-metastasis for the levels of serum TC, TG, HDL-C, LDL-C, Apo-A and Apo-B. The levels of serum TG in the breast cancer poorly differentiated group were higher than those in the well differentiated group (P<0.05). And in the well differentiated group, but the serum HDL-C, Apo-A were significantly lower than in poorly differentiated group, the differences were statistically significant (P<0.05). Conclusion Abnormal elevated of the serum TC, TG, LDL-C, Apo B and HDL-C, Apo-A decline is related to the tumors accruing and development of breast cancer.
10.Identification of metabolites of Radix Paeoniae Alba extract in rat bile, plasma and urine by ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry
Zhengwei CHEN ; Ling TONG ; Shuming LI ; Dongxiang LI ; Ying ZHANG ; Shuiping ZHOU ; Yonghong ZHU ; He SUN
Journal of Pharmaceutical Analysis 2014;(1):14-25
Ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF/MS) was developed to identify the absorbed parent components and metabolites in rat bile, plasma and urine after oral administration of Radix Paeoniae Alba extract (RPAE). A total of 65 compounds were detected in rat bile, plasma and urine samples, including 11 parent compounds and 54 metabolites. The results indicated that glucuronidation, hydroxylation and methylation were the major metabolic pathways of the components of RPAE. Furthermore, the results of this work demonstrated that UPLC-Q-TOF/MS combined with MetaboLynx? software and mass defect filtering (MDF) could provide unique high throughput capabilities for drug metabolism study, with excellent MS mass accuracy and enhanced MSE data acquisition. With the MSE technique, both precursor and fragment mass spectra can be simultaneously acquired by alternating between high and low collision energy during a single chromatographic run.

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