1.The role of Huaiqihuang Granules in the long-term management of bronchial asthma in young children: a multicenter real-world study
Huimin WANG ; Jinghui MU ; Chuanhe LIU ; Changshan LIU ; Ying WANG ; Zhiying HAN ; Xin SUN ; Xing CHEN ; Shuhua AN ; Dolikon MUZAPAR ; Aiping LU ; Min WANG ; Yan CHENG ; Xiaomei YIN ; Hanmin LIU ; Hong WANG ; Shan HUA ; Li DONG ; Ying HUANG ; Yi JIANG ; Jianxin XIONG ; Shenggang DING ; Wei WANG ; Shunying ZHAO ; Yuzhi CHEN
Chinese Journal of Applied Clinical Pediatrics 2023;38(4):286-290
Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.
2.Risk factors of bronchopulmonary dysplasia in very preterm infants: a national multicenter study
Ruihua BA ; Lixia TANG ; Wei SHEN ; Lian WANG ; Zhi ZHENG ; Xinzhu LIN ; Fan WU ; Qianxin TIAN ; Qiliang CUI ; Yuan YUAN ; Ling REN ; Jian MAO ; Yumei WANG ; Bizhen SHI ; Ling LIU ; Jinghui ZHANG ; Yanmei CHANG ; Xiaomei TONG ; Yan ZHU ; Rong ZHANG ; Xiuzhen YE ; Jingjing ZOU ; Huaiyu LI ; Baoyin ZHAO ; Yinping QIU ; Shuhua LIU ; Li MA ; Ying XU ; Rui CHENG ; Wenli ZHOU ; Hui WU ; Zhiyong LIU ; Dongmei CHEN ; Jinzhi GAO ; Jing LIU ; Ling CHEN ; Cong LI ; Chunyan YANG ; Ping XU ; Yayu ZHANG ; Sile HU ; Hua MEI ; Zuming YANG ; Zongtai FENG ; Sannan WANG ; Eryan MENG ; Lihong SHANG ; Falin XU ; Shaoping OU ; Rong JU
Chinese Pediatric Emergency Medicine 2022;29(6):433-439
Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
3.Clinical characteristics of patients with antisynthetase syndrome and positive anti-Ro52 antibody
Xin ZHANG ; Xiangmei ZHAO ; Qihua YANG ; Chaofeng LIAN ; Wei LI ; Lu YANG ; Jiameng LU ; Wenjuan GUAN ; Lijuan ZHANG ; Shuhua CHENG ; Hui LI ; Shengyun LIU
Chinese Journal of Internal Medicine 2022;61(2):200-204
To analyze the clinical characteristics of patients with antisynthetase syndrome (ASS) and positive anti-Ro52 antibody. The clinical data of 203 ASS patients admitted to the First Affiliated Hospital of Zhengzhou University from 2017 to 2020 were analyzed retrospectively. Demographics, clinical manifestations, laboratory results, treatment and outcome were collected including data of 18 patients with rapidly progressive interstitial lung disease (RP-ILD). In total, the majority were women (148,72.9%). The average onset age was (51.9±13.3) years. There were 163 (80.3%) patients with positive anti-Ro52 antibody. The positivity in women (77.3% vs. 55.0%, P=0.004) was higher, and the median time from disease onset to diagnosis [4.5 (2.0, 24.0) months vs. 2.0 (1.0, 12.0) months, P=0.024] was longer in patients with positive anti-Ro52 antibody than those negative. Compared with negative patients, patients with positive anti-Ro52 antibody had a higher incidence of interstitial lung disease (ILD) (96.9% vs. 65.0%, P<0.001), arthritis (33.7% vs. 17.5%, P=0.046), and arthralgia (39.3% vs. 20.0%, P=0.022). Higher rate of positve antinuclear antibody (ANA) (85.3% vs. 55.0%, P<0.001), lower rate of positive anti-Jo-1 antibody (32.5% vs. 50.0%, P=0.039), lower albumin level [(34.6±5.2) g/L vs. (37.3±4.7) g/L, P=0.004] and lower lymphocyte counts [(1.4±0.8) ×10 9/L vs. (1.8±0.8) ×10 9/L, P=0.014] were more common in patients with positive anti-Ro52 antibody. The presence of anti-Ro52 antibody is associated with a particular phenotype of ASS, leading to common ILD, involvement of joints, high ANA positivity, low albumin and low lymphocyte counts.
4.Clinical analysis of 15 cases with myeloperoxidase antineutrophil cytoplasmic antibody associated hypertrophic pachymeningitis
Wenjuan GUAN ; Yanxia DING ; Lijun LIU ; Wei LI ; Lijun JING ; Xin ZHANG ; Lijuan ZHANG ; Hui LI ; Shuhua CHENG ; Shengyun LIU
Chinese Journal of Internal Medicine 2022;61(5):565-569
To study the clinical features of myeloperoxidase(MPO) antineutrophil cytoplasmic antibody (ANCA) associated hypertrophic pachymeningitis (HP). Clinical data of 15 cases diagnosed with MPO-ANCA vasculitis complicated with HP were retrospectively analyzed. Nine cases were males and the other 6 were females, with an average age of (58±8) years. All cases presented with chronic headache. Contrast-enhanced magnetic resonance imaging (MRI) scan showed local or diffused thickening of cerebral and/or spinal dura matter while brain parenchyma were normal. Nine cases developed multiple cranial nerve paralysis, with trigeminal nerve and auditory nerve involved most commonly. The main clinical manifestations were facial pain, hearing loss and tinnitus. Two cases were complicated with hypertrophic spinal pachymeningitis (HSP) and 4 cases were complicated with pulmonary diseases. Positive serum perinuclear pattern ANCA (pANCA) and MPO could be found in all cases, positive serum IgG 4 was seen in two patients. erythrocyte sedimentation rate(ESR;25-116 mm/1h) and C-reactive protein (CRP;29.02-146.00 mg/L) were both elevated in 14 cases. Nine cases had elevated intracranial pressure[180-235 mmH 2O (1 mmH 2O=0.009 8 kPa)] and abnormal protein level (457.6-3710.0 mg/L) in cerebrospinal fluid. Six cases were treated with glucocorticoids (prednisone 20-60 mg/d) and 9 cased with glucocorticoids and immunosuppressants (methotrexate 15 mg/week or cyclophosphamide 100 mg/d po). All patients achieved remission. MPO-ANCA associated HP is a special type of central nervous system involvement in ANCA associated vasculitis (AAV). It rarely involves the lung or kidney. Steroids and immunosuppressive agents are effective. In HP with unknown underlying diseases, it is suggested to screen ANCA and IgG 4 tests for AAV or IgG 4-related disease.
5.m6A Methyltransferase METTL3 Reduces Hippocampal Neuron Apoptosis in a Mouse Model of Autism Through the MALAT1/SFRP2/Wnt/β-catenin Axis
Yue MING ; Zhihui DENG ; Xianhua TIAN ; Yuerong JIA ; Meng NING ; Shuhua CHENG
Psychiatry Investigation 2022;19(10):771-787
Objective:
Hippocampal neuron apoptosis contributes to autism, while METTL3 has been documented to possess great potentials in neuron apoptosis. Our study probed into the role of METTL3 in neuron apoptosis in autism and to determine the underlying mechanism.
Methods:
Bioinformatics analysis was used to analyze expressed genes in autism samples. Institute of Cancer Research mice were treated with valproic acid to develop autism models. The function of METTL3 in autism-like symptoms in mice was analyzed with behavioral tests and histological examination of their hippocampal tissues. Primary mouse hippocampal neurons were extracted for in vitro studies. Downstream factors of METTL3 were explored and validated.
Results:
METTL3, MALAT1, and Wnt/β-catenin signaling were downregulated, while SFRP2 was upregulated in the hippocampal tissues of a mouse model of autism. METTL3 stabilized MALAT1 expression by promoting m6A modification of MALAT1. MALAT1 promoted SFRP2 methylation and led to reduced SFRP2 expression by recruiting DNMT1, DNMT3A, and DNMT3B to the promoter region of SFRP2. Furthermore, SFRP2 facilitated activation of the Wnt/β-catenin signaling. By this mechanism, METTL3 suppressed autism-like symptoms and hippocampal neuron apoptosis.
Conclusion
This research suggests that METTL3 can reduce autism-like symptoms and hippocampal neuron apoptosis by regulating the MALAT1/SFRP2/Wnt/β-catenin axis.
6.Genome Assembly and Population Resequencing Reveal the Geographical Divergence of Shanmei(Rubus corchorifolius)
Yang YINQING ; Zhang KANG ; Xiao YA ; Zhang LINGKUI ; Huang YILE ; Li XING ; Chen SHUMIN ; Peng YANSONG ; Yang SHUHUA ; Liu YONGBO ; Cheng FENG
Genomics, Proteomics & Bioinformatics 2022;(6):1106-1118
Rubus corchorifolius(Shanmei or mountain berry,2n=14)is widely distributed in China,and its fruits possess high nutritional and medicinal values.Here,we reported a high-quality chromosome-scale genome assembly of Shanmei,with contig size of 215.69 Mb and 26,696 genes.Genome comparison among Rosaceae species showed that Shanmei and Fupenzi(Rubus chingii Hu)were most closely related,followed by blackberry(Rubus occidentalis),and that environmental adaptation-related genes were expanded in the Shanmei genome.Further resequenc-ing of 101 samples of Shanmei collected from four regions in the provinces of Yunnan,Hunan,Jiangxi,and Sichuan in China revealed that among these samples,the Hunan population of Shanmei possessed the highest diversity and represented the more ancestral population.Moreover,the Yunnan population underwent strong selection based on the nucleotide diversity,linkage dise-quilibrium,and historical effective population size analyses.Furthermore,genes from candidate genomic regions that showed strong divergence were significantly enriched in the flavonoid biosyn-thesis and plant hormone signal transduction pathways,indicating the genetic basis of adaptation of Shanmei to the local environment.The high-quality assembled genome and the variome dataset of Shanmei provide valuable resources for breeding applications and for elucidating the genome evo-lution and ecological adaptation of Rubus species.
7.Comparison of PICC-associated thrombosis risk prediction models based on machine learning algorithm
Shuhua WANG ; Bo CHENG ; Liqun ZHU ; Songmei CAO ; Yiqing LIANG
Chinese Journal of Modern Nursing 2022;28(16):2144-2151
Objective:To build the three different risk prediction models for peripherally inserted central catheter (PICC) -associated thrombosis based on machine learning algorithm, and compare the performance of the models, so as to provide a basis for evaluating and preventing PICC-associated thrombosis.Methods:The PICC-associated Thrombasis Risk Factor Questionnaire was developed based on the best evidence and expert consultation. From January 2016 to October 2020, convenience sampling was used to select 626 patients with PICC in the Affiliated Hospital of Jiangsu University as the research object to collect clinical data. Based on machine learning algorithms, Support Vector Machine (SVM) , XGBoost and Logistic regression methods were used to construct three different PICC-associated thrombosis risk prediction models, which were evaluated and compared.. Model evaluation indicators included Matthews correlation coefficient ( MCC) , F1 value, area under the receiver operating characteristic curve ( AUC) and Brier score. Results:A total of 30 variables were included, and the predictors included four aspects, namely, demographic data of patients, patient condition, treatment factors, and catheter-related factors. For the model verified on the test set, the Logistic regression prediction model had lower scores than the XGBoost and SVM prediction models in terms of MCC and F1 values. On AUC, the Logistic regression prediction model score was equal to SVM and smaller than XGBoost. On Brier, the Logistic regression prediction model scored higher than the XGBoost and SVM prediction models. Conclusions:The performance of the prediction model based on the machine learning algorithm XGBoost and SVM is superior to the traditional Logistic regression model in terms of sensitivity and accuracy. Thrombotic predictors can help guide medical and nursing staff to identify high-risk patients and reduce the incidence of PICC-associated thrombosis.
8.Analysis of the sleep quality of patients with systemic lupus erythematosus and its influencing factors
Li GONG ; Shuhua CHENG ; Guanmin GAO ; Feng ZHANG
Chinese Journal of Modern Nursing 2018;24(4):393-397
Objective To investigate the sleep quality of patients with systemic lupus erythematosus (SLE) and to analyze its influencing factors. Methods A total of 156 patients with SLE who were treated in the Rheumatology Department of the First Affiliated Hospital of Zhengzhou University from October 2016 to January 2017 were selected as the research objects by convenience sampling method. All the participants were investigated by general information questionnaire, Pittsburgh sleep quality index (PSQI) scale and systemic lupus erythematosus disease activity index (SLEDAI). The influencing factors of patients' sleep quality was analyzed by single factor analysis and multiple linear regression analysis. Results The score of PSQI scale of SLE patients was (10.04±5.83). It was reported that 62.23% of patients had poor sleep quality. The main reason for night sleep disturbance were easy to wake up at night, night frequent urination and sensory heat. Single factor analysis showed that there was significant difference in total sleep quality among SLE patients with different age, education level, number of hospitalization, course of the disease, daily average dose of glucocorticoid and disease activity index (P< 0.05). Multiple linear regression analysis showed that age, course of the disease, daily average dose of glucocorticoid and disease activity index were the influencing factors of SLE patients' sleep quality (P<0.01). Conclusions The results indicate that sleep quality of SLE patients is influenced by age, course of disease, daily average dose of glucocorticoids and disease activity index. Medical staff should pay attention to patients' sleep problems and give sleep nursing interventions on the basis of treatment in order to improve the sleep quality and life quality of SLE patients.
9.Determination of New Bistrifluron, Cyantraniliprole and SYP9080 Residues in Fruits and Vegetables by Liquid Chromatography-Tandem Mass Spectrometry
Shuhua CUI ; Ruijuan LI ; Xiaomei ZHANG ; Gang CHENG ; Yu WANG ; Zhengyi LI
Chinese Journal of Analytical Chemistry 2017;45(4):545-552
A liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed for the determination of bistrifluron, cyantraniliprole and SYP9080 residues in fruits and vegetables. The analytes were extracted from samples with acetonitrile, and purified by dispersion solid phase extraction using C18 and primary secondary amine (PSA) as solid phase adsorbent, then analyzed by LC-MS/MS. Bistrifluron and SYP9080 were analyzed with negative ion multiple-reaction monitoring (MRM), cyantraniliprole was analyzed with positive ion MRM. The matrix-induced weakening effect was observed in the analysis of cyantraniliprole and SYP9080 in several samples including cucumber, apple and onion, and the weakening extent of the matrix-induced effect depended on the sample properties. But no matrix effect was found in the analysis of bistrifluron in several samples. The interference of matrix was reduced by using the matrix-matched calibration standards curve in the analysis of cyantraniliprole and SYP9080. Bistrifluron could be quantified by an external standard of the matrix-matched calibration standards or the pure solvent calibration standards. The linear range was from 0.2 μg/L to 100 μg/L for bistrifluron, cyantraniliprole and SYP9080 with the good correlation coefficients (r≥0.9990). The recoveries of cucumber, grape, apple and scallion added bistrifluron at 0.005-2 mg/kg were 79.8%-99.9%, with relative standard deviations (RSD) of 3.6%-9.8%. The limits of quantification (S/N=10) were 0.210 μg/kg, 0.160 μg/kg and 0.004 μg/kg, and limits of detection (S/N=3) were 0.064 μg/kg, 0.048 μg/kg and 0.001 μg/kg for bistrifluron, cyantraniliprole and SYP9080, respectively.
10.Reliability and validity of the Chinese version of Safety Attitudes Questionnaire
Feng ZHANG ; Xiang LI ; Shuhua CHENG ; Changying CHEN
Chinese Journal of Practical Nursing 2017;33(4):250-254
Objective To translate the English version of Safety Attitudes Questionnaire (SAQ) into Chinese,and to test the reliability and validity of the Chinese version of SAQ. Methods The SAQ was developed into Chinese version through translation, back-translation and cross-culture adaption. The reliability and validity of the Chinese version of SAQ were tested in 823 first-line nurse managers in Henan. Results The scale content validity index was 0.90 of the Chinese SAQ, and the item content validity index ranged from 0.83 to 0.96. The correlations between the items and the full scale, the dimensions and the full scale separately ranged from 0.32 to 0.64 and 0.50 to 0.81 (P<0.01). The confirmatory factor analysis resulted in a good model fit for the six dimensions and the full construct, the goodness-of-fit index was 0.96, Tucker-Lewis index was 0.93, comparative fit index was 0.95, and root mean square error of approximation was 0.06. The Cronbach alpha coefficient for the scale was 0.913 and for the six dimensions were 0.565, 0.655, 0.825, 0.804, 0.880, 0.725 separately, the test-retest reliability coefficient was 0.934. Conclusions The Chinese version of SAQ is a valid and reliable tool to assess the safety culture of first-line nurse managers in Chinese hospitals.

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