1.Values of ATX in predicting disease progression in patients with PBC and PBC related HCC.
M Y ZHANG ; H XIE ; J ZHAO ; Q S LIANG ; L HAN ; X R ZHAI ; B S LI ; Z S ZOU ; Y SUN
Chinese Journal of Hepatology 2023;31(6):40-46
		                        		
		                        			
		                        			Objective:b> To clarify the values of autotaxin (ATX) in patients with primary biliary cholangitis (PBC) and PBC-related hepatocellular carcinoma (HCC). Methods:b> 179 patients with PBC were selected from prospective cohorts of autoimmune liver diseases at the time of first diagnosis of PBC in Department of Hepatology, the Fifth Medical Center of PLA General Hospital, from January 2016 to January 2018, all patients with PBC received UDCA therapy, primary endpoint was event of HCC, the follow-up period was censored at the date of HCC. The relationship between level of ATX and clinical features in patients with PBC and its potential value in predicting disease progression and PBC-related HCC were analyzed. Results:b> The ATX level in the peripheral blood of patients with PBC was significantly higher than that of alcoholic liver cirrhosis(ALC) (t = 3.278, P = 0.001) and healthy controls(HC) (t = 6.594, P < 0.001), however, when comparing PBC to non-PBC related HCC, no significant difference was found between the groups(t=-0.240, P = 0.811). Consistent with peripheral blood levels, histochemical staining indicated that ATX in the liver of patients with PBC was significantly higher than that of HC (Z=-3.633, P < 0.001) and ALC (Z=-3.283, P < 0.001), and the expression of ATX in PBC with advanced histological stage was significantly higher than PBC with early stage (Z=-2.018, P = 0.034). The baseline ATX level in PBC patients without developing to HCC during follow-up had significant difference to patients with developing to HCC (228.451 ± 124.093 ng/ml vs 301.583 ± 100.512 ng/ml, t = 2.339, P = 0.021). The result in multivariate logistic regression analysis showed that ATX were independent predictors of PBC related HCC(OR 1.245, 95%CI 1.097-1.413). The optimal critical value of peripheral blood ATX level at baseline for predicting HCC was 235.254 ng/ml, with the cut-off value of 0.714 in AUC of the ROC (95% CI was 0.597~ 0.857), sensitivity and specificity were 84.6% and 59.0%, respectively. Conclusion:b> ATX level was significantly higher in PBC patients over controls, and it's concentration was correlated with UDCA efficacy and fibrosis stage. ATX has potential values in predicting disease progression and PBC-related HCC.
		                        		
		                        		
		                        		
		                        	
2.Primary pulmonary NUT carcinoma: a clinicopathological analysis of seven cases.
X P ZHUANG ; H J HUANG ; X CHEN ; S L ZHENG ; B C LI ; H SUN
Chinese Journal of Pathology 2023;52(12):1244-1248
		                        		
		                        			
		                        			<b>Objective:b> To investigate the clinicopathological characteristics of primary pulmonary NUT carcinoma. <b>Methods:b> A total of 7 cases of primary pulmonary NUT carcinoma were collected from Fujian Provincial Hospital (n=5), Fuzhou Taijiang Hospital (n=1) and Binzhou City People's Hospital of Shandong Province (n=1) from January 2021 to April 2023. The clinical, histopathological, and immunohistochemical features were analyzed, and NUT rearrangement were detected by fluorescence in situ hybridization (FISH) with break-apart probes. <b>Results:b> Seven cases were all male with age ranging from 32 to 73 years. The main clinical manifestations were cough, expectoration and chest tightness. Microscopically, NUT carcinoma was composed of monotonous proliferation of primitive-appearing small-to-medium round cells, with few eosinophilic cytoplasm, arranged in solid sheets, nests or clusters. Abrupt keratinization was typically observed in 4 cases (4/7), with high mitotic activities and necrosis. Immunohistochemistry (IHC) showed that the tumors were positive for NUT (7/7), CK7 (4/4), CK5/6 (5/6), p40 (6/7). Ki-67 index were 30%-80%. NUT gene segregation (7/7) was detected by FISH break probes. <b>Conclusions:b> Primary pulmonary NUT carcinoma is rare and highly malignant. Diagnosis depends on histopathology and IHC, with molecular detection as an adjunct for diagnosis. Pathologists should be aware of the clinicopathological characteristics to avoid misdiagnosis.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Carcinoma/pathology*
		                        			;
		                        		
		                        			Immunohistochemistry
		                        			;
		                        		
		                        			In Situ Hybridization, Fluorescence
		                        			;
		                        		
		                        			Lung Neoplasms/pathology*
		                        			;
		                        		
		                        			Neoplasm Proteins/genetics*
		                        			
		                        		
		                        	
3.Development and validation of a prognostic prediction model for patients with stage Ⅰ to Ⅲ colon cancer incorporating high-risk pathological features.
K X LI ; Q B WU ; F Q ZHAO ; J L ZHANG ; S L LUO ; S D HU ; B WU ; H L LI ; G L LIN ; H Z QIU ; J Y LU ; L XU ; Z WANG ; X H DU ; L KANG ; X WANG ; Z Q WANG ; Q LIU ; Y XIAO
Chinese Journal of Surgery 2023;61(9):753-759
		                        		
		                        			
		                        			<b>Objective:b> To examine a predictive model that incorporating high risk pathological factors for the prognosis of stage Ⅰ to Ⅲ colon cancer. <b>Methods:b> This study retrospectively collected clinicopathological information and survival outcomes of stage Ⅰ~Ⅲ colon cancer patients who underwent curative surgery in 7 tertiary hospitals in China from January 1, 2016 to December 31, 2017. A total of 1 650 patients were enrolled, aged (M(IQR)) 62 (18) years (range: 14 to 100). There were 963 males and 687 females. The median follow-up period was 51 months. The Cox proportional hazardous regression model was utilized to select high-risk pathological factors, establish the nomogram and scoring system. The Bootstrap resampling method was utilized for internal validation of the model, the concordance index (C-index) was used to assess discrimination and calibration curves were presented to assess model calibration. The Kaplan-Meier method was used to plot survival curves after risk grouping, and Cox regression was used to compare disease-free survival between subgroups. <b>Results:b> Age (HR=1.020, 95%CI: 1.008 to 1.033, P=0.001), T stage (T3:HR=1.995,95%CI:1.062 to 3.750,P=0.032;T4:HR=4.196, 95%CI: 2.188 to 8.045, P<0.01), N stage (N1: HR=1.834, 95%CI: 1.307 to 2.574, P<0.01; N2: HR=3.970, 95%CI: 2.724 to 5.787, P<0.01) and number of lymph nodes examined (≥36: HR=0.438, 95%CI: 0.242 to 0.790, P=0.006) were independently associated with disease-free survival. The C-index of the scoring model (model 1) based on age, T stage, N stage, and dichotomous variables of the lymph nodes examined (<12 and ≥12) was 0.723, and the C-index of the scoring model (model 2) based on age, T stage, N stage, and multi-categorical variables of the lymph nodes examined (<12, 12 to <24, 24 to <36, and ≥36) was 0.726. A scoring system was established based on age, T stage, N stage, and multi-categorical variables of lymph nodes examined, the 3-year DFS of the low-risk (≤1), middle-risk (2 to 4) and high-risk (≥5) group were 96.3% (n=711), 89.0% (n=626) and 71.4% (n=313), respectively. Statistically significant difference was observed among groups (P<0.01). <b>Conclusions:b> The number of lymph nodes examined was an independent prognostic factor for disease-free survival after curative surgery in patients with stage Ⅰ to Ⅲ colon cancer. Incorporating the number of lymph nodes examined as a multi-categorical variable into the T and N staging system could improve prognostic predictive validity.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Neoplasm Staging
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Nomograms
		                        			;
		                        		
		                        			Lymph Nodes/pathology*
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Colonic Neoplasms/surgery*
		                        			
		                        		
		                        	
4.Progress in intestinal adaptation after enterectomy.
H F SUN ; Q B ZHOU ; W X WANG ; F Q WANG ; Q Q ZHANG ; Z Q SUN ; W T YUAN
Chinese Journal of Gastrointestinal Surgery 2022;25(12):1132-1137
		                        		
		                        			
		                        			Intestinal adaptation is a spontaneous compensation of the remanent bowel after extensive enterectomy, which improves the absorption capacity of the remanent bowel to energy, fluid and other nutrients. Intestinal adaptation mainly occurs within 2 years after enterectomy, including morphological changes, hyperfunction and hyperphagia. Intestinal adaptation is the key factor for patients with short bowel syndrome to weaning off parenteral nutrition dependence and mainly influenced by length of remanent bowel, type of surgery and colon continuity. In addition, multiple factors including enteral feeding, glucagon-like peptide 2 (GLP-2), growth hormone, gut microbiota and its metabolites regulate intestinal adaptation via multi-biological pathways, such as proliferation and differentiation of stem cell, apoptosis, angiogenesis, nutrients transport related protein expression, gut endocrine etc. Phase III clinical trials have verified the safety and efficacy of teduglutide (long-acting GLP-2) and somatropin (recombinant human growth hormone) in improving intestinal adaptation, and both have been approved for clinical use. We aim to review the current knowledge about characteristics, mechanism, evaluation methods, key factors, clinical strategies of intestinal adaptation.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Adaptation, Physiological
		                        			;
		                        		
		                        			Glucagon-Like Peptide 2/therapeutic use*
		                        			;
		                        		
		                        			Intestines/surgery*
		                        			;
		                        		
		                        			Parenteral Nutrition
		                        			;
		                        		
		                        			Short Bowel Syndrome/surgery*
		                        			
		                        		
		                        	
5.Mutational analysis of ATP7B gene of hepatolenticular degeneration in Xinjiang region.
Aierken AERZIGULI ; C Z LI ; L H HU ; X B LU ; X F SUN
Chinese Journal of Hepatology 2020;28(8):699-702
		                        		
		                        			
		                        			To understand the mutational characteristics of ATP7B gene of hepatolenticular degeneration in Xinjiang region. 24 cases were diagnosed as hepatolenticular degeneration and the exon of ATP7B gene was detected in some of their siblings and parents. A total of 45 ATP7B gene mutations (93.75%) were detected in 24 cases, of which 14 cases were homozygous mutations or compound heterozygous mutations, six cases were heterozygous mutations and four cases were no mutations. A total of 24 gene mutations and 14 SNPS were detected, including 8 new mutations: c.251C > A, c.121A > c, c.2945C > A, c.2194C > T, c.2947T > c, c.3626T > A, c.3662_3664del, c.3557G > T. The most common mutations were c.2621C > T (p.A874V) [16.7% (4/24)] and c.2333G > T (p.R778L) [12.5% (3/24)]. A total of 4 cases were diagnosed as pre-symptomatic. In this study, the most common mutation in the ATP7B gene is A874V. The most common genetic mutations in Han and Uyghur patients were different. The most common mutation in Han and Uyghur patients is R778L and A874V. Exon 11 is the gene mutations hot spot for patients with hepatolenticular degeneration in Xinjiang region, and is one of the priority exons to be detected when screening patients with suspected hepatolenticular degeneration.
		                        		
		                        		
		                        		
		                        	
6.Human leukocyte antigen polymorphism of HIV infected persons without disease progress for long-term in Henan province, 2011-2016.
X J XUE ; J Z YAN ; D CHENG ; C H LIU ; J LIU ; Z LIU ; S A TIAN ; D Y SUN ; B W ZHANG ; Z WANG
Chinese Journal of Epidemiology 2019;40(1):89-92
		                        		
		                        			
		                        			<b>Objective:b> To understand the disease progression and human leukocyte antigen (HLA) gene polymorphism of HIV-infected persons without disease progress for long term, also known as long-term non-progressors (LTNPs), in Henan province. <b>Methods:b> A retrospective study was conducted in 48 LTNPs with complete detection and follow-up information during 2011-2016 in Henan. Changes of CD(4)(+)T cells counts (CD(4)) and viral load (VL) during follow-up period were discussed. Polymerase chain reaction-sequence-specific oligonucleotide probe (PCR-SSOP) was used for the analyses of HLA-A, HLA-B and HLA-DRB1 alleles between LTNPs and healthy controls. <b>Results:b> From 2011 to 2016, forty-eight LTNPs showed a decrease of the quartile (P(25)-P(75)) of CD(4) from 601.00 (488.50-708.72)/μl to 494.00 (367.00-672.00)/μl, and the difference was significant (P<0.05). The increase of the quartile (P(25)-P(75)) of log(10)VL from 3.40 (2.87-3.97) to 3.48 (2.60-4.37), but the difference was not significant (P>0.05). HLA polymorphism analysis revealed that HLA-B*13:02 and HLA-B*40:06 were more common in LTNPs (P<0.05), while HLA-B*46:01 and HLA-DRB1*09:01 were more common in healthy controls (P<0.05). <b>Conclusions:b> The CD(4) of LTNPs in Henan showed a downward trend year by year. HLA-B*13:02 and B*40:06 might be associated with delayed disease progression for HIV infected persons in Henan.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Alleles
		                        			;
		                        		
		                        			Asian People/genetics*
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Disease Progression
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			HIV
		                        			;
		                        		
		                        			HIV Infections/virology*
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		                        			HIV-1/immunology*
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		                        			HLA-B Antigens/genetics*
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		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Polymorphism, Genetic
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Viral Load
		                        			
		                        		
		                        	
7.National experts consensus on clinical diagnosis and treatment of inhalation injury (2018 version).
Burn and Trauma Branch of Chinese Geriatrics Society ; F GUO ; Y S ZHU ; J HUANG ; Y H WU ; Z F SUN ; X B XIA ; X B FU
Chinese Journal of Burns 2018;34(11):E004-E004
		                        		
		                        			
		                        			Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
		                        		
		                        		
		                        		
		                        			Burns, Inhalation
		                        			;
		                        		
		                        			Consensus
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung
		                        			;
		                        		
		                        			Practice Guidelines as Topic
		                        			;
		                        		
		                        			Smoke Inhalation Injury
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			therapy
		                        			
		                        		
		                        	
8.National experts consensus on clinical diagnosis and treatment of inhalation injury (2018 version).
Burn and Trauma Branch of Chinese Geriatrics Society ; F GUO ; Y S ZHU ; J HUANG ; Y H WU ; Z F SUN ; X B XIA ; Xiaobing FU
Chinese Journal of Burns 2018;34(11):770-775
		                        		
		                        			
		                        			Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
		                        		
		                        		
		                        		
		                        			Burns, Inhalation
		                        			;
		                        		
		                        			Consensus
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung
		                        			;
		                        		
		                        			Smoke Inhalation Injury
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			therapy
		                        			
		                        		
		                        	
9.Association between obesity and DNA methylation among the 7-16 year-old twins.
C X LI ; Y GAO ; W J GAO ; C Q YU ; J LYU ; R R LYU ; J L DUAN ; Y SUN ; X H GUO ; S F WANG ; B ZHOU ; G WANG ; W H CAO ; L M LI
Chinese Journal of Epidemiology 2018;39(4):443-448
		                        		
		                        			
		                        			<b>Objective:b> On whole-genome scale, we tried to explore the correlation between obesity-related traits and DNA methylation sites, based on discordant monozygotic twin pairs. <b>Methods:b> A total of 90 pairs of 6-17 year-old twins were recruited in Chaoyang district, Yanqing district and Fangshan district in Beijing in 2016. Information on twins was gathered through a self-designed questionnaire and <b>results:b> from physical examination, including height, weight and waist circumference of the subjects under study. DNA methylation detection was chosen on the Illumina Human Methylation EPIC BeadChip. R 3.3.1 language was used to read the DNA methylation signal under quality control on samples and probes. Ebayes function of empirical Bayes paired moderated t-test was used to identify the differential methylated CpG sites (DMCs). VarFit function of empirical Bayes paired moderated Levene test was used to identify the differentially variables CpG sits (DVCs) in obese and normal groups. Results According to the obesity discordance criteria, we collected 23 pairs of twins (age range 7 to 16 years), including 12 male pairs. A total of 817 471 qualified CpG loci were included in the genome-wide correlation analysis. According to the significance level of FDR set as <0.05, no positive sites would meet this standard. When DMC CpG site cg05684382, with the smallest P value (1.26E-06) as on chromosome 12, the DVC CpG site cg26188191 with the smallest P value (6.44E-06) appeared in CMIP gene on chromosome 16. <b>Conclusions:b> In this study, we analyzed the genome-wide DNA methylation and its correlation with obesity traits. After multiple testing corrections, no positive sites were found to have associated with obesity. However, results from the correlation analysis demonstrated sites cg05684382 (chr: 12) and cg26188191 (chr: 16) might have played a role in the development of obesity. This study provides a methodologic reference for the studies on discordance twins related problems.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Bayes Theorem
		                        			;
		                        		
		                        			Beijing
		                        			;
		                        		
		                        			Body Weight
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			DNA Methylation/genetics*
		                        			;
		                        		
		                        			Epigenesis, Genetic
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genome-Wide Association Study
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Obesity/genetics*
		                        			;
		                        		
		                        			Twins, Monozygotic
		                        			;
		                        		
		                        			Waist Circumference
		                        			
		                        		
		                        	
10.Analysis of body composition and resting metabolic rate of 858 middle-aged and elderly people in urban area of Beijing.
D N YU ; T Z XIAN ; L J WANG ; B CHENG ; M X SUN ; L X GUO
Chinese Journal of Epidemiology 2018;39(5):686-688
		                        		
		                        			
		                        			<b>Objective:b> To understand the overweight rate and obesity rate in middle-aged and elderly people in urban area of Beijing, and analyze the changes of body composition and resting metabolic rate with age. <b>Methods:b> From November 2014 to December 2015, body composition measurement and resting metabolic rate detection were conducted among 858 people aged 51 to 99 years, including 760 men, 98 women, who received physical examination at Beijing Hospital. <b>Results:b> The overweight rate was 51.4%, and the obesity rate was 16.9%. The overweight rate was 26.5% and the obesity rate was 14.3% in women, significantly lower than those in men (54.6% and 17.2%) (P<0.001). The distribution of skeletal muscle volume, muscle index, body fat percentage, visceral fat area and resting metabolic rate in different age groups were different (P<0.001). In the normal weight group, the skeletal muscle volume, muscle index and resting metabolic rate in age group ≥80 years decreased obviously (P<0.05). At the same time, the body fat percentage and visceral fat area increased obviously (P<0.05). However, the skeletal muscle volume, muscle index and resting metabolic rate of the overweight and obese groups began to decrease obviously in age group 70- years (P<0.05), and the decrease in age group ≥80 years was more obvious. At the same time, body fat percentage and visceral fat area increased significantly in age group 70- years (P<0.05). <b>Conclusion:b> The overweight and obesity rates were high in the middle-aged and elderly people in the urban area of Beijing, and the rates were higher in men than in women. With the increase of age, the skeletal muscle volume, muscle index and resting metabolic rate gradually decreased, while the percentage of body fat and visceral fat area increased; Overweight and obese people had earlier changes in body composition and resting metabolic rate.
		                        		
		                        		
		                        		
		                        			Adipose Tissue
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Basal Metabolism/physiology*
		                        			;
		                        		
		                        			Body Composition
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Intra-Abdominal Fat
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Obesity/epidemiology*
		                        			;
		                        		
		                        			Overweight/epidemiology*
		                        			;
		                        		
		                        			Urban Population
		                        			
		                        		
		                        	
            
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