1.Risk Factors and Countermeasures of Occupational Exposure of Medical Personnel under COVID-19 Epidemic
Yang FU ; Junling MA ; Lin WANG ; Mei YIN
Chinese Medical Ethics 2024;35(1):84-89
The COVID-19 is a severe respiratory pathogen infection, showing a distinct "hospital cluster" transmission characteristics. This paper illustrated the concept of occupational exposure and COVID-19. Combined with the actual situation of COVID-19, the infection status of medical personnel in this outbreak was analyzed from three aspects: the transmission risk and infection rate of medical personnel, the clinical characteristics and the undiscovered super-spreader. Through the analysis of the present situation, this paper summarized the possible occupational exposure risk factors of medical personnel in COVID-19 from five aspects: biological occupational risk factors, chemical occupational risk factors, physical occupational risk factors, violence factors and psychological factors. From isolating the source of infection and cutting off the transmission route, the "safety supervisor" mechanism is established to avoid the risks of biological, chemical and physical occupational exposure, from providing professional psychological counseling for medical personnel to reduce their psychological stress, and from improving the relevant legal level to reduce the risk of medical personnel’s violent occupational exposure.
2.Determination of Eight Lignans in Schisandrae Sphenantherae Fructus on the Market from Different Habitats by UPLC-MS/MS
Lianhao GAO ; Hongwei LI ; Junling WANG ; Xiuping LI ; Zhewei FANG ; Qian XIONG ; Hongxia LIU ; Jinsi YANG ; Rong MA ; Mengxian LI
Chinese Journal of Modern Applied Pharmacy 2024;41(4):520-523
OBJECTIVE
To compare the contents of schizandrin A, schizandrin B, schizandrin C, schisandrol A, schisandrol B, schisantherin A, anwuligan, and schisanhenol in Schisandrae Sphenantherae Fructus on market from 12 habitats.
METHODS
The samples were pre-treated by 96-well fitration plates. The assay was performed on ACE EXCEL 1.7 C18-AMIDE(100 mm×2.1 mm, 1.7 μm) column with 0.1% formic acid-water(A) and methanol(B), gradient elution, flow speed was 0.4 mL·min–1. Ion source was electric spray ion source, positive ion monitoring mode, multireaction monitoring mode for quantitative analysis. Linear, instrument precision, stability, repeatability, average recovery were investigated.
RESULTS
The content of schisantherin A in 10 of 12 producing areas reached the standard of ≥0.2% of Schisandrae Sphenantherae Fructus in 2020 Edition of Chinese Pharmacopoeia.
CONCLUSION
UHPLC-MS/MS is suitable for simultaneous determination of multiple components in Schisandrae Sphenantherae Fructus. The Schisandrae Sphenantherae Fructus in the market basically meet the national legal standards.
3.Role of regulated cell death in the development of gastric cancer
Yang YU ; Yun XU ; Jingyuan CAO ; Junling HAN ; Chenglin ZHOU
Chinese Journal of Clinical Medicine 2024;31(4):652-658
Gastric cancer is one of the most common malignant tumors worldwide,with its incidence and mortality rates ranking third among malignant tumors in China.Regulated cell death(RCD)is a type of cell death activated by signal transduction modules and closely connected to the progression and treatment of gastric cancer.Different types of RCD,comprising apoptosis,pyroptosis,ferroptosis,cuproptosis,and autophagy,not only aid in eliminating damaged cells,but also serve a crucial role in suppressing gastric cancer spread.This paper reviews different forms of RCD and their roles in the progression of gastric cancer,so as to provide reference for new diagnosis and treatment strategies of gastric cancer.
4.Compatibility Mechanism of Mineral Medicine Os Draconis in Bupleuri Radix-containing Tri-herbal Medicines Based on Supramolecular Systems
Zi XING ; Junling HOU ; Yifan ZHAO ; Liman XIAO ; Mengjia WEI ; Mengyuan YANG ; Lu YUN ; Yuanfei NIU ; Zhijie ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):191-198
ObjectiveBy starting with the combination of Os Draconis, Bupleuri Radix, and Ostreae Concha, the role of mineral medicine Os Draconis in the combination of the Bupleuri Radix-containing tri-herbal medicines was preliminarily explored from the perspective of supramolecular system formation. Method① The appearance and Tyndall phenomenon of single decoction of Os Draconis, Bupleuri Radix, and Ostreae Concha, as well as co-decoction of Bupleuri Radix-Os Draconis, Bupleuri Radix-Os Draconis-Ostreae Concha, and Bupleuri Radix-Ostreae Concha were observed, and the average particle size, dispersion coefficient, and Zeta potential of suspension particles in each decoction were determined. The micromorphology of supramolecular structures was observed by scanning electron microscope (SEM). ② The pH of different compatibility systems, liquid viscosity coefficient, liquid surface tension, freeze-dried powder yield rate, and other physical properties were determined, and the interaction of different compatibility systems was detected by infrared absorption spectroscopy (FTIR) and UV-visible spectrophotometry (UV-Vis). ③ The composition and content difference of different compatible systems were determined by high-performance liquid chromatography (HPLC) and ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry (UPLC-Q-TOF-MS). ResultCompared with the single decoction, the co-decoction had more obvious turbidity and Tyndall phenomenon. The particles in the co-decoction suspension were smaller and more evenly distributed, and the Zeta potential was reduced, indicating a more stable system. Under SEM, Bupleuri Radix was irregularly lamellar, and Bupleuri Radix-Os Draconis and Bupleuri Radix-Os Draconis-Ostreae Concha were mainly spherical nanoparticles. Bupleuri Radix-Ostreae Concha was irregularly lamellar, with a small number of spherical nanoparticles. The pH of the single decoction of Bupleuri Radix and co-decoction increased, and the viscosity coefficient increased. The liquid surface tension decreased. The freeze-dried powder yield rate of the Bupleuri Radix-Os Draconis co-decoction was the highest, followed by Bupleuri Radix-Ostreae Concha decoction and Bupleuri Radix-Os Draconis-Ostreae Concha decoction, and the yield rate of Bupleuri Radix single decoction was the lowest. The main change of FTIR was the stretching vibration of -OH, and the co-decoction moved to the low-frequency direction obviously. UV-Vis showed that the maximum absorption occurred at 295.8 nm for all groups, and the absorption intensity was different (Bupleuri Radix-Os Draconis>Bupleuri Radix-Os Draconis-Ostreae Concha>Bupleuri Radix-Ostreae Concha>Bupleuri Radix). The components of Bupleuri Radix were used as the indexes, and the content of methanol extract determined by HPLC was higher than that of water extract, and the components of Bupleuri Radix single decoction were mainly saikosaponin a (SSa) and saikosaponin c (SSc), which were slightly higher after co-decoction compatibility. UPLC-Q-TOF-MS could identify 37 compounds in both single decoction and co-decoction. ConclusionThe combination of Bupleuri Radix, Os Draconis, and Ostreae Concha can form a smaller, more uniform, and stable nano-sized supramolecular system, which is conducive to the dissolution of the main components of Bupleuri Radix, and the Os Draconis contributes the most in this process.
5.Multimodal positron-emission tomography-computed tomography manifestations in a case with frontotemporal dementia with parkinsonism
Jingyu SHAO ; Chang FU ; Junling XU ; Shuai CHEN ; Hongqi YANG ; Jiewen ZHANG
Chinese Journal of Neurology 2024;57(11):1254-1258
Frontotemporal dementia (FTD) is a group of dementia diseases mainly characterized by progressive mental-behavioral abnormalities, executive dysfunction, and language impairment. A small number of FTD patients also present with movement disorders at certain disease course. Here the clinical and multimodal positron-emission tomography (PET) imaging manifestations in a patient with frontotemporal lobe dementia and parkinsonian syndrome are reported. 18F-fluorodopa PET showed reduced uptake in the head of the caudate nucleus. 18F-AV-45 PET showed negative amyloid deposition. 18F-AV-1451 PET showed tau deposition in the neocortex. The clinical and neuroimaging features support the underlying frontotemporal lobar degeneration-tau pathology.
6.Molecular evolution of human infection with H9N2 subtype avian influenza virus in Anhui province from 2013 to 2022
Yidan XIA ; Sitian YANG ; Minhao HU ; Xue ZHOU ; Junling YU ; Wanrong LUO ; Weixi FANG ; Jun HE
Chinese Journal of Experimental and Clinical Virology 2024;38(5):527-532
Objective:To analyze the genetic and molecular characteristics of H9N2 subtype avian influenza viruses from external environment and humans in Anhui Province from 2013 to 2022.Methods:Environmental samples and human samples were collected from Anhui influenza surveillance network laboratory. Sixty-three strains of virus were isolated in chicken embryos. RT-PCR was used to amplify the virus and whole genome sequencing was performed. To construct gene evolutionary tree and analyze its genetic characteristics and potential glycosylation sites.Results:The hemagglutinin (HA) gene belongs to the 9.2.4.5 clade, and the protein cleavage sites are mostly " PSRSSR\GL". The neuraminidase (NA) gene, basic protein-1(PB1) gene, acidic protein (PA) gene, non-structural protein (NS) gene and nucleoprotein (NP) gene belong to the F/98 clade, the matrix protein (MP) gene belongs to the G1/97 clade, and the basic protein-2 (PB2) gene belongs to the ST/7488 clade. Mutations of T155N, R164Q, H183N, T189D/V, A190V/T and Q226L occurred in HA protein, deletion of NA protein occurred at 62-64 sites, and mutations of T271A, I292V/M and E627V/L occurred in PB2 protein. At the same time, mutations of K356R and S409N occurred in the PA protein.Conclusions:The H9N2 subtype avian influenza viruses collected from external environment and human sources in Anhui province from 2013 to 2022 belong to the same evolutionary branch, and amino acid site mutations suggest that the virus shows a tendency to gradually adapt to the mammalian host environment. Therefore, further studies on the adaptive evolution of the virus and related monitoring work are needed.
7.Overexpression of tuftelin and KLF-5 and its clinicopathological features in hepatitis B virus-related hepatocellular carcinoma
Junling YANG ; Rongfei FANG ; Qun XIE ; Bojun TAI ; Dengfu YAO ; Min YAO
Chinese Journal of Hepatology 2024;32(2):148-154
Objective:To analyze and evaluate the expressions and clinical value of tuftelin (TUFT1) and Krüppel-like factor 5 (KLF5) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) tissues.Method:KLF5 mRNA and TUFT1 mRNA transcriptional status in cancer and non-cancer groups were compared according to the Cancer Genome Atlas (TCGA) database. The differences and prognostic value between the groups were analyzed. Postoperative liver cancer and its paired pericancerous tissues, with the approval of the ethics committee, were collected to build tissue chips. The expression of KLF5 and TUFT1 and their intracellular localization were verified by immunohistochemistry. Tissue expression and clinicopathological characteristics were analyzed by immunoblotting. SPSS software was used to analyze the relationship between SPSS and patient prognosis.Results:The transcription level of TUFT1 or KLF5 mRNA was significantly higher in the HCC group than the non-cancer group ( P ?0.001), according to TCGA data. Immunohistochemistry and Western blotting examination confirmed the overexpression of TUFT1 and KLF5 in human HCC tissues, which were mainly localized in the cytoplasm and cell membrane. The positivity rates of TUFT1 and KLF5 were 87.1% (? χ2 ?=?18.563, P ?0.001) and 95.2% (? χ2 ?=?96.435, P ?0.001) in HCC tissues, and both were significantly higher than those in the adjacent group. The expression intensity was higher in stage III-IV than stage I-II of the International Union Against Cancer standard ( P ?0.01). The clinicopathological features showed that the abnormalities of the two were significantly related to HBV infection, tumor size, extrahepatic metastasis, TNM stage, and ascites. Univariate analysis was related to tumor size, HBV infection, and survival. Multivariate analysis was an independent prognostic factor for patients with HCC. Conclusion:TUFT1 and KLF5 may both be novel markers possessing clinical value in the diagnosis and prognosis of HBV-related HCC.
8.Clinical characteristics and outcomes of psoriasis patients with COVID-19: A retrospective, multicenter cohort study in China
Yanhua LIU ; Zhongrui XU ; Jian ZHOU ; Aijun CHEN ; Junling ZHANG ; Xiaojing KANG ; Xian JIANG ; Chengzhi LYU ; Chunrui SHI ; Yuling SHI ; Xiaoming LIU ; Fuqiu LI ; Bin YANG ; Yongmei HUANG ; Chen YU ; Gang WANG
Chinese Medical Journal 2024;137(14):1736-1743
Background::Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection.Methods::A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2.Results::Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685–11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068–2.343), traditional systemic (adjusted OR = 1.887, 95% CI= 1.263–2.818), and nonsystemic treatment (adjusted OR= 1.602, 95% CI= 1.117–2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680–1.274, compared to no treatment), according to multivariable logistic regression analysis. Conclusions::A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension.
9.Deep learning model for automatically segmenting prostate on large-field T2WI based on integrated 68Ga-prostate specific membrane antigen PET/MRI
Guiyu LI ; Wenhui MA ; Junling WANG ; Taoqi MA ; Yunya WANG ; Fei KANG ; Weidong YANG ; Jing WANG
Chinese Journal of Medical Imaging Technology 2024;40(10):1588-1592
Objective To observe the value of deep learning model for automatically segmenting prostate on large-field T2WI based on integrated 68Ga-prostate specific membrane antigen(PSMA)PET/MRI.Methods Ninety male patients with prostate tumors who underwent 68Ga-PSMA PET/MRI were retrospectively enrolled and divided into training set(n=72)and validation set(n=18)at the ratio of 4∶1.Models were established based on 3D SegResNet and 3D Unet deep learning neural networks,respectively.Taken physicians'manual segmentation results as reference standards,the performances of models for segmenting the peripheral zone(PZ)and central zone(CZ)+transition zone(TZ)of prostate on large-field T2WI were evaluated.Results In both training and validation sets,the Dice similarity coefficient(DSC)of 3D SegResNet deep learning model for segmenting prostate on T 2WI were both higher than that of 3D Unet model(both P<0.05),the 95%Hausdorff distance(HD95)of SegR esNet deep learning model for segmenting prostate CZ+TZ was lower than that of 3D Unet model(both P<0.05),while DSC and HD95 of these 2 models for segmenting prostate CZ+TZ were superior to PZ(all P<0.05).Conclusion 3D SegResNet deep learning model could be used to automatically segment prostate on large-field T2WI based on integrated 68Ga-PSMA PET/MRI.
10.A survey on the knowledge of Helicobacter pylori infection diagnosis and treatment among medical staff from general hospitals in Hainan Province
Hui ZHOU ; Guoning CHEN ; Yang GUO ; Yan TAN ; Cheng LAN ; Donghan WU ; Zhanliang MA ; Peng CHENG ; Cuiyi MO ; Ming WANG ; Peiyuan LI ; Ya LIN ; Yongqiang YANG ; Junling HAN ; Zhai CHEN ; Changling LIN ; Zhaona WU ; Shengxiong CHEN ; Zhengyi CHEN ; Xiaoxi HUANG
Chinese Journal of Digestion 2024;44(4):223-233
Objective:To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection ( treatment excluded) (hereinafter referred to as sixth national consensus) and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment (hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan. Methods:From February 20 to May 7, 2023, a questionnaire survey on the diagnosis and treatment of Helicobacter pylori ( H. pylori) infection was conducted among 1 463 medical staff from 15 general hospitals in Hainan Province. The questionnaire was drawn up according to the sixth national consensus and the guideline, covering knowledge of 6 sections, induding H. pylori related diseases, detection of H. pylori, eradication, prevention and influence factors of eradication of H. pylori, etc. Chi-square test was used for statistical analysis. Results:A total of 1 463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1 463 subjects included 225 gastroenterologists and 1 238 other medical staff(including 503 physicians from other departments, 264 surgeons and 471 medical technologists and pharmacists). About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H. pylori in China was more than 20%, the awareness rate was higher than that of other medical staff (physicians from other departments 65.41%(329/503), surgeons 61.74%(163/264), medical technologists and pharmacists 60.30%(284/471); the following datas were sorted by this position), and the difference was statistically significant ( χ2=30.97, P<0.001). About 51.11%(115/225) of gastroenterologists considered that H. pylori serological antibody test could not be used as a diagnostic method for current infection, the awareness rate was higher than that of other medical staff(22.07%(111/503), 14.02%(37/264), 12.31%(58/471)), and the difference was statistically significant( χ2 =152.66, P<0.001). Proton pump inhibitor and potassium-competitive acid blocker should be discontinued for 2 weeks, and antibiotics and bismuth should be discontinued for 4 weeks before urea breath test, and the awareness rates of gastroenterologists were higher than those of other medical staff (38.67%(87/225) vs. 23.26%(117/503), 19.70%(52/264), 18.47%(87/471); 60.89%(137/225) vs. 26.64%(134/503), 25.76%(68/264), 23.78%(112/471)), and the differences were statistically significant ( χ2 =133.70 and 165.51, both P<0.001). For refractory H. pylori infection, 98.67%(222/225)of gastroenterologists agreed with the individualized diagnosis and treatment of H. pylori infection should be guided by bacterial culture, antibiotic susceptibility test or drug resistance gene test, and the awareness rate was higher than that of other medical staff (91.85%(462/503), 93.56%(247/264), 93.21%(439/471)), and the difference was statistically significant( χ2=20.55, P=0.002). About 70.67% (159/225) of gastroenterologists recommended a bismuth containing quadruple regimen, 80.44% (181/225) supported a 10 to 14 day H. pylori eradication course, and the awareness rates were higher than other medical staff (46.92%(236/503), 33.33%(88/264), 32.91%(155/471); 67.20%(338/503), 59.09%(156/264), 53.93%(254/471)), and the differences were statistically significant ( χ2=111.25 and 59.99, both P<0.001). The understanding rates of the sixth national consensus and the guideline in gastroenterologists was 85.33% (192/225), which was higher than that of other medical staff (64.21%(323/503), 66.67%(176/264), 57.96%(273/471)), and the difference was statistically significant ( χ2=85.47, P<0.001). Conclusions:Gastroenterologists from general hospitals in Hainan Province have a better understanding of the sixth national consensus and the guideline than other medical staff. However, there is still a lack of deep understanding of the sixth national consensus and the guideline, and it is necessary to further strengthen the learning and application of the sixth national consensus and the guideline.


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