1.Management and Development of Health-related Standards in Nations and Organizations: An Evidence-based Review
Hongfeng HE ; Qiannan TIAN ; Qi ZHOU ; Junxian ZHAO ; Renfeng SU ; Zhewei LI ; Hui LIU ; Nan YANG ; Yaolong CHEN ; Liqun WU ; Xiaohui WANG
Medical Journal of Peking Union Medical College Hospital 2024;15(1):202-210
2.Reflections on Developing Health Standards Based on Evidence-based Concept
Renfeng SU ; Hui LIU ; Qianling SHI ; Xufei LUO ; Nan YANG ; Junxian ZHAO ; Qiannan TIAN ; Juanjuan ZHANG ; Liqun WU ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(2):435-441
National health standards involve all kinds of technical requirements formulated and numbered in accordance with the procedures and formats stipulated in the standardisation system for the implementation of national health and hygiene laws, regulations and policies, and the protection of human health. The establishment of health standards in China should align with our legal framework, including laws, regulations, departmental rules, and health and hygiene policies. During the development of these standards, a comprehensive approach is advocated, encompassing in-depth investigations, rigorous demonstrations, and extensive stakeholder engagement. However, the process of standard formulation may suffer from insufficient research evidence. The evidence-based concept emphasizes the significance of evidence. Therefore, integrating evidence-based concept into the process of developing health standards can enhance the quality and scientific basis of these standards. This article systematically elucidates the current status and development process of health standards in China, explores the necessity and feasibility of incorporating evidence-based concept into the development of these standards, analyzes the challenges and opportunities, and presents reflections and suggestions.
3.Development and Validation of a Pathomics Model Using Machine Learning to Predict CXCL8 Expression and Prognosis in Head and Neck Cancer
Weihua WANG ; Suyu RUAN ; Yuhang XIE ; Shengjian FANG ; Junxian YANG ; Xueyan LI ; Yu ZHANG
Clinical and Experimental Otorhinolaryngology 2024;17(1):85-97
Objectives:
. The necessity to develop a method for prognostication and to identify novel biomarkers for personalized medicine in patients with head and neck squamous cell carcinoma (HNSCC) cannot be overstated. Recently, pathomics, which relies on quantitative analysis of medical imaging, has come to the forefront. CXCL8, an essential inflammatory cytokine, has been shown to correlate with overall survival (OS). This study examined the relationship between CXCL8 mRNA expression and pathomics features and aimed to explore the biological underpinnings of CXCL8.
Methods:
. Clinical information and transcripts per million mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA)-HNSCC dataset. We identified correlations between CXCL8 mRNA expression and patient survival rates using a Kaplan-Meier survival curve. A retrospective analysis of 313 samples diagnosed with HNSCC in the TCGA database was conducted. Pathomics features were extracted from hematoxylin and eosin–stained images, and then the minimum redundancy maximum relevance, with recursive feature elimination (mRMR-RFE) method was applied, followed by screening with the logistic regression algorithm.
Results:
. Kaplan-Meier curves indicated that high expression of CXCL8 was significantly associated with decreased OS. The logistic regression pathomics model incorporated 16 radiomics features identified by the mRMR-RFE method in the training set and demonstrated strong performance in the testing set. Calibration plots showed that the probability of high gene expression predicted by the pathomics model was in good agreement with actual observations, suggesting the model’s high clinical applicability.
Conclusion
. The pathomics model of CXCL8 mRNA expression serves as an effective tool for predicting prognosis in patients with HNSCC and can aid in clinical decision-making. Elevated levels of CXCL8 expression may lead to reduced DNA damage and are associated with a pro-inflammatory tumor microenvironment, offering a potential therapeutic target.
4.Predictive value of atherogenic index of plasma in the assessment of acute pancreatitis
Yang PAN ; Xiamin TU ; Junxian ZHANG ; Xiaoyan LUO ; Qingxie LIU ; Jie LI ; Xin GAO ; Guotao LU ; Weiming XIAO
Journal of Chinese Physician 2023;25(3):360-364,369
Objective:To investigate the predictive value of atherogenic index of plasma (AIP) in the assessment of acute pancreatitis (AP).Methods:598 patients diagnosed with AP admitted to the Affiliated Hospital of Yangzhou University between January 2016 and December 2020 were recruited and divided into severe acute pancreatitis group (SAP group, n=57) and non-severe acute pancreatitis group (non SAP group, n=541) according to the Atlanta Classification (2012 revision). General clinical data and related biochemical indicators of all enrolled patients were collected, and Bedside Index of Acute Pancreatitis Severity (BISAP) score, Ranson score and CT Severity Index (CTSI) score were performed. The risk factors of SAP were analyzed by logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the evaluation value of AIP and various scoring systems on the severity of pancreatitis. Results:The AIP, white blood cell (WBC), neutrophil count (NEUT), fasting blood glucose (FBG), serum total cholesterol (TC) level, proportion of hyperlipidemia, proportion of diabetes, Ranson score, BISAP score, CTSI score of patients in SAP group were higher than those in non SAP group, and the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that AIP was an independent risk factor for SAP ( P<0.05). ROC curve showed that the are under the curve (AUC) of SAP predicted by AIP was 0.706(95% CI: 0.631-0.782, P<0.001). Conclusions:AIP is an independent risk factor for SAP, which helps to assess the severity of AP.
5.Changes and clinical significance of serum S100β and neuron-specific enolase levels of children with acute brain injury
Junxian FU ; Guanglu YANG ; Hongying DUO
Journal of Chinese Physician 2021;23(8):1181-1185,1191
Objective:To investigate the changes and clinical significance of serum S100β and neuron-specific enolase (NSE) levels of children with acute brain injury(ABI).Methods:100 children with ABI treated in the pediatric intensive care unit (PICU) of the Affiliated Hospital of Inner Mongolia Medical University from June 2019 to June 2020 were prospectively selected as the ABI group, and 30 normal children in the children′s health clinic of the hospital were selected as the control group. The serum S100β and NSE levels of all subjects was detected. According to the Glasgow Coma Scale (GCS), children with ABI were divided into severe brain injury group ( n=26), moderate brain injury group ( n=35) and mild brain injury group ( n=39). The prognosis of children with ABI after 3 months of treatment was evaluated according to the Glasgow prognosis scale (GOS) and they were divided into poor prognosis group ( n=26) and good prognosis group ( n=74). The relationship between serum S100β and NSE levels and the severity and prognosis of children with ABI was analyzed. Results:The serum S100β and NSE levels in the ABI group were significantly higher than those in the control group, and the serum S100β and NSE levels in children with ABI increased with the severity of injury and poor prognosis ( P<0.05). Pearson correlation analysis showed that serum S100β and NSE levels in children with ABI were positively correlated with GCS scores ( r=0.521, 0.643, P<0.05). Multiple logistic regression analysis showed that glucose(GLU) ( OR=1.631, 95% CI: 1.278-2.082), S100β ( OR=1.907, 95% CI: 1.558-5.877), NSE ( OR=2.896, 95% CI: 1.193-7.029) were independent prognostic factor in children with ABI ( P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and accuracy of serum S100β+ NSE [area under curve (AUC)=0.932, 95% CI: 0.875-0.969] in predicting the poor prognosis of children with ABI were higher than those of serum S100β(AUC=0.728, 95% CI: 0.643-0.803), NSE (AUC=0.808, 95% CI: 0.729-0.871) alone. Conclusions:The levels of serum S100β and NSE in children with ABI aresignificantly increased, which are closely related to the severity of the disease and prognosis. They can be used as predictors of poor prognosis in children with ABI. Combined detection can enhance the diagnostic value.
6.Application of clinical nursing pathway standardized management in children with primary vesicoureteral reflux undergoing Politano-Leadbetter operation
Li GOU ; Xiujuan DOU ; Jiali WEI ; Yuan YANG ; Yi LI ; Junxian WANG
Chinese Journal of Modern Nursing 2020;26(24):3360-3364
Objective:To explore the application of clinical nursing pathway (CNP) standardized management in children with primary vesicoureteral reflux (VUR) undergoning Politano-Leadbetter operation for.Methods:From January 2016 to December 2018, we selected 69 children with VUR from the First Affiliated Hospital of Zhengzhou University. Children all underwent modified Politano-Leadbetter operation and were divided into CNP group ( n=39) and control group ( n=30) with the method of random number table. Control group carried out routine clinical nursing management, while CNP group implemented CNP standardized management. We compared the general operation situation, hospitalization, improvement of reflux level and incidence of postoperative complications among children between two groups. Results:There were no intestinal and important vascular injury events during operation in both groups, and there was no significant difference in the operation time, intraoperative blood loss and postoperative hematuria duration between the two groups ( P>0.05) . However, the length of hospitalization, hospitalization costs and incidence of postoperative complications in CNP group were lower than those in control group; the improvement rate of reflux of CNP group was higher than that of control group; the differences were statistically significant ( P<0.05) . Conclusions:For VUR children with Politano-Leadbetter operation, CNP standardized management is more conducive to postoperative recovery of children than routine nursing management, and it can obtain better therapeutic benefits and reduce the risk of postoperative complications to a certain extent.
7.Whole-cell biotransformation for simultaneous synthesis of L-2-aminobutyric acid and D-gluconic acid in recombinant Escherichia coli.
Caizhe ZHANG ; Taowei YANG ; Junping ZHOU ; Junxian ZHENG ; Meijuan XU ; Xian ZHANG ; Zhiming RAO
Chinese Journal of Biotechnology 2017;33(12):2028-2034
A whole-cell catalyst using Escherichia coli BL21(DE3) as a host, expressing L- threonine dehydratase from Escherichia coli, and co-expressing leucine dehydrogenase from Bacillus cereus and glucose dehydrogenase from Bacillus subtilis for cofactor regeneration, was constructed and used for one-pot production of L-2-aminobutyric acid (L-ABA) and D- gluconic acid from L-threonine and D-glucose. We used shake-flask culture to study the whole-cell catalytic condition including temperature, pH, proper permeabilization of cells and optimal wet cells amount. Moreover, the whole-cell catalyst was cultured in 5-L fermentor by fed-batch fermentation, and 164 g/L L-threonine and 248 g/L D-glucose were converted to 141.6 g/L L-ABA and 269.4 g/L D-gluconic acid. The whole-cell catalyst is promising to fulfill industrial requirements for L-ABA and D-gluconic acid.
8.Relationship between Functional Gastrointestinal Disorders and Psychological Factors and Related Treatment
Jun LIU ; Lei DIAO ; Caihong YANG ; Junxian WANG ; Cheng LI
Chinese Journal of Gastroenterology 2016;21(2):98-100
Background:Functional gastrointestinal disorders(FGIDs)is a common disease of digestive system which severely affects the quality of life. Recently,more and more attentions have been paid to the relationship between FGIDs and psychological factors. Aims:To investigate the relationship between FGIDs and psychological factors and related treatment. Methods:A total of 270 patients with FGIDs admitted from Sept. 2013 to Sept. 2014 at Anhui No. 2 Province People’s Hospital were enrolled. Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the mental state of patients,and symptom severity of digestive system was scored. Patients with psychological abnormalities received conventional therapy to relieve digestive symptoms,and those who failed from conventional therapy were assigned into refractory group and others were assigned into response group. Patients in refractory group were further divided into conventional therapy group and combined therapy group for receiving paroxetine in addition to conventional therapy. Results:The rates of anxiety and depression were 61. 5%(166 / 270)and 57. 0%(154 / 270),respectively. The scores of HAMA and HAMD were positively correlated with the score of digestive symptoms(r = 0. 585,P < 0. 01;r = 0. 584,P <0. 01)in patients with anxiety and depression in response group. The scores of HAMA,HAMD and digestive symptoms in response group after conventional therapy were significantly decreased(P < 0. 05),while the scores of HAMA and HAMD in refractory group after therapy were significantly higher than those in response group before therapy(P < 0. 05). The scores of HAMA,HAMD and digestive symptoms in combined therapy group were significantly lower than those in conventional therapy group(P < 0. 05). Conclusions:Relationship is found between FGIDs and psychological factors,and antidepressants might contribute to the amelioration of symptoms of FGIDs.
9.The clinical analysis of 157 cases with colorectal polyps treated by endoscopic therapy
Longsheng CHENG ; Caihong YANG ; Junxian WANG ; Aiping WANG ; Jun LIU ; Cheng LI
Chinese Journal of Primary Medicine and Pharmacy 2015;22(2):213-214
Objective To analyze the clinical feature,the endoscopic treatment,therapy of complication of colorectal polyps.Methods According to polyps'size,location and shape in 157 patients with colorectal polyps,corresponding endoscopic treatment method was selected and observed the complication of the endoscopic treatment and therapeutic efficacy.Results 219 colorectal polyps were found in 157 patients.Colorectal polyps occurred frequently in rectum and sigmoid colon.Moreover,inflammatory polyps and hyperplastic polyp were the majority,and a small portion of polyps may turn cancerous.By using endoscopic therapy,hemorrhage was found in 12 samples,and the bleeding ratio was only 5.5%.Conclusion A diversity of methods used in endoscopic therapy of colorectal polyps is safe,efficient,resulting in less complications.
10.Nurse′s shortcoming repair scheme impacting on nursing quality in Operating Room
Lanlan LIU ; Junxian WU ; Yonghong YANG ; Lei ZHANG
Chinese Journal of Modern Nursing 2015;21(10):1193-1195
Objective To explore nurse′s shortcoming repair scheme ( NSRS ) impacting on nursing quality in Operating Room ( OR) . Methods A total of 62 OR nurses had been chosen as sampling received NSRS after utilizing nurse′s shortcoming scale to acquire shortcomings. Results Nurses had the more younger, lower occupational title and educational background, the easier acquired shortcomings. After application of NSRS, the total comprehensive abilities of nurses improved apparently, of which the comprehensive ability of grade N0, N1, N2, N3 and N4 nurses were (70. 36 ± 5. 38), (74. 86 ± 7. 25), (76. 38 ± 6. 86), (82. 35 ± 4. 72), (86. 97 ± 2. 35) scores before NSRS implementation improved to (79. 58 ± 3. 61), (83. 69 ± 3. 45), (85.31 ±3.11), (90.56 ±2.45), (96.48 ±2.33) after NSRS implementation (t=9.846, 9.012, 9.327, 8. 742, 11. 356;P <0. 01). Before NSRS implementation, the rates were 14. 52%, 19. 35%, 16. 13%, 20. 97%, 17. 74%, 9. 68 % and 27. 42% for taking wrong patents, arranging wrong operative position, incomplete operative equipment preparation, counting mistake, improper use of equipment, medicine error, specimen improper preservation; after NSRS used, there were just one cases for arranging wrong operative position and count error, and the other 6 parts had no nursing error. Conclusions Through repairing nurse′s shortcoming, the incidence of nursing error reduces and the overall OR nurses′comprehensive abilities improve. It also can reduce the surgical care in the process of the accident, and improve the nursing quality of OR.

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