1.Clinical characteristics of psoriasis and current status of medical care for patients in county areas of China
Min LI ; Bo ZHANG ; Wenjun WANG ; Yixuan ZHANG ; He HUANG ; Yihe WANG ; Hao JIANG ; Daihua TAN ; Lina CHEN ; Yuxiu JIANG ; Yingyou ZHAO ; Qunli ZHAO ; Xianyong YIN ; Liangdan SUN ; Furen ZHANG ; Xinghua GAO ; Yong CUI ; Xuejun ZHANG
Chinese Journal of General Practitioners 2024;23(11):1155-1161
Objective:To investigate the clinical characteristics of psoriasis and status quo of medical care for patients in county areas of China.Methods:This study was a cross-sectional investigation. Based on the “Qianxian Wuyin” Project (a national project for upgrating ability for psoriasis care at county level), an online questionnaire survey was conducted in the dermatology departments of 459 county hospitals in 404 pilot administrative counties across China from February to June 2023. The questionnaire included demographic information of patients (gender, ethnicity, age, place of residence, education, marital status), and clinical characteristics of psoriasis (disease course, type, comorbidities, body surface area (BSA) and previous treatment. The Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) were applied for assessing the quality of life and disease severity, and completed by patients or guardian and doctors, respectively.Results:A total of 16 935 patients completed the questionnaire. The age of patients was 1-102(44.17±11.58)years, and 71.0% (12 036/16 935) were 30-59 years old. The ratio of male to female was 2.21∶1; 24.3%(4 117/16 935) of patients had high school education; there were 9 940 patients(58.7%) with previous or current smoking and/or alcohol use; 42.8%(7 218/16 855) of patients had a disease course of 1-5 years. There were 15 630 patients(92.3%) with DLQI≥10, 8 346 patients(49.7%) with PASI≥10, 15 017 patients(89.2%) with BSA≥10%. The plaque type was the most common disease type ( n=14 965, 88.7%), and spotting type ranked the second ( n=1 141, 6.8%). The most common initial site was the trunk ( n=12 309, 72.9%). Among the comorbidities, hypertension was the most common one ( n=1 681, 10.0%). There were 7 650 reports of treatment response to conventional topical drug therapy and 3 112 reports of treatment response to systemic drug therapy, with 6 269 (81.9%) and 2 493 (80.1%) reporting poor or no response, respectively. Conclusions:The survey shows that in the county areas of China, the majority of psoriasis patients are severe patients with short course of disease, plaque type is the most common type, and hypertension is the most common comorbidity; and the conventional treatment is less effective for most patients.
2.Clinical analysis and prognosis of reoperation of congenital muscular torticollis in 12 children
Xianyong LUO ; Xinrang CHEN ; Jiaxiang WANG
Chinese Journal of Applied Clinical Pediatrics 2021;36(23):1782-1785
Objective:To explore the clinical characteristics and short-term prognosis of reoperation of congenital muscular torticollis (CMT).Methods:A total of 12 cases of recurrent CMT treated in the First Affiliated Hospital of Zhengzhou University from May 2015 to May 2018 were recruited, involving 9 boys and 3 girls with the mean age of 13.2 (8-16) years.The causes of disease recurrence were analyzed, and the postoperative appearance of the children was observed by follow-up.In addition, the prognosis of CMT was evaluated by patient satisfaction survey and Lee score criteria.Results:Among the 12 patients, 10 cases were treated in other hospitals and 2 cases in this hospital.The age of the first surgery ranged from 6 months to 2.2 years.Surgical methods included minimally invasive small needle knife (2 cases), single head release of small incision (5 cases), simple amputation (7 cases) and broken end silk thread ligation (4 cases). During the second surgery, contracture and adhesion of sternocleidomastoid muscle at varying degrees were confirmed, including contracture and adhesion of platysma muscle (3 cases), difficulty in separation of jugular sheath (8 cases), and repair of rupture of internal jugular vein (2 cases). Bipolar release of sternocleidomastoid muscle was performed in all surgeries, and tension-free alignment of the neck to the midline was the complete basis for release.The postoperative appearance of all children was satisfied.They were followed up for an average of 2.3 (1.2-3.0) years.Nine and 3 cases graded more than 90 and 80 patient satisfaction scores, respectively.Lee scores reflected the range of motion of head and neck, and the distance and degree of head deviation from the midline, which yielded excellent, good and fair in 12 cases, 8 cases and 3 cases, respectively.Conclusions:Incomplete release is believed as the basic cause of recurrence in children with CMT.Meanwhile, muscle scar adhesion, early operative age, minimally invasive incision and lack of postoperative rehabilitation may also be the direct factors for CMT recurrence.For recurrent patients, satisfactory therapeutic effect can be achieved through bipolar release, especially complete release of the lower pole, combined with postoperative neck traction, fixation and rehabilitation exercise.
3.Expressions of CD200 and inducible costimulator in angioimmunoblastic T-cell lymphoma and their significances
Xiaojie LI ; Aiping LI ; Wei ZHANG ; Lingqiao LIU ; Yahui CHEN ; Dan SHI ; Xianyong CHEN ; Ren HE
Journal of Leukemia & Lymphoma 2021;30(7):400-406
Objective:To investigate the expressions of CD200 and inducible costimulator (ICOS) protein in angioimmunoblastic T-cell lymphoma (AITL) and the relationship with prognosis as well as their significances in the differential diagnosis of AITL.Methods:A total of 39 AITL patients in the First People's Hospital of Chenzhou, the Fourth People's Hospital of Chenzhou, Xiangnan College Affiliated Hospital and Chenzhou 3rd People's Hospital from June 2012 to December 2019, and 10 patients with classic Hodgkin lymphoma (CHL) and 10 patients with peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) from August 2016 to July 2019 in the First People's Hospital of Chenzhou were selected. Immunohistochemistry was used to detect the expressions of CD200, ICOS, CD10, programmed death 1 (PD-1), bcl-6 and CXC chemokine receptor-13 (CXCL13) proteins, and the correlation of CD200 and ICOS with clinicopathological features and prognosis of AITL patients was analyzed, and the diagnostic significance of both in differentiating AITL from PTCL-NOS and CHL was also analyzed.Results:The positive rates of CD200 and ICOS in 39 AITL patients were 71.79% (28/39) and 61.54% (24/39), respectively. There were 7 cases of CD200 weak and moderate positive in 10 CHL patients, and ICOS proteins were all negative. Among 10 PTCL-NOS patients, 4 patients had CD200 positive and 1 patient had ICOS positive. The differences in positive rates of ICOS protein between AITL patients and CHL, PTCL-NOS patients were statistically significant (all P < 0.05); the differences in positive rates of CD200 protein between AITL patients and CHL, PTCL-NOS patients were not statistically significant ( χ2=0.013, P=0.911; χ2=3.551, P=0.060). The positive rate of CD200 in AITL patients with elevated lactate dehydrogenase (LDH) and international prognostic index (IPI) score of 3-4 was higher than that in AITL patients with normal LDH and IPI score of 0-2 (both P < 0.05); The positive rate of ICOS in AITL patients with elevated LDH and PD-1 positive was higher than that in AITL patients with normal LDH and PD-1 negative (both P < 0.05). CD200 negative AITL patients had better 3-year overall survival (OS) rate (4.2% vs. 66.7%) and 3-year progression-free survival (PFS) rate (5.3% vs. 77.1%) compared with those in CD200 positive AITL patients, and the differences between both groups were statistically significant (both P < 0.01); there was a statistically significant difference in 3-year OS rate between ICOS positive AITL patients and ICOS negative AITL patients (15.3% vs. 38.6%, P=0.011), while there was no statistically significant difference in 3-year PFS rate of both groups (18.6% vs. 41.5%, P=0.059). Multivariate analysis showed CD200 ( HR=0.076, 95% CI 1.555-79.497, P=0.001), extranodal involvement or not ( HR=11.117, 95% CI 1.555-79.497, P=0.016) and LDH ( HR=2.147, 95% CI 0.844-5.459, P=0.109) were independent influencing factors of OS in AITL patients; CD200 ( HR=0.075, 95% CI 0.016-0.357, P=0.001) and LDH ( HR=2.335, 95% CI 0.929-5.870, P=0.071) were independent influencing factors of PFS in AITL patients. Conclusions:CD200 and ICOS can be used as immunohistochemical indicators to assist the diagnosis of AITL patients. ICOS protein helps to differentiate AITL from CHL and PTCL-NOS; CD200 can be used as indicators to judge the prognosis and deterioration of AITL patients.
4.Correlation of homocysteine and blood lipid levels with neurological function in patients with progressive ischemic stroke
Xianyong DAI ; Wei CHEN ; Yan WANG ; Guifen YU ; Jiayong DAI
Chinese Journal of Primary Medicine and Pharmacy 2021;28(10):1521-1524
Objective:To correlate homocysteine (Hcy) and blood lipid levels with neurological function in patients with progressive ischemic stroke.Methods:A total of 400 patients with ischemic stroke who received treatment between June 2018 and June 2020 in Linhai Second People's Hospital were included in this study. Progressive ischemic stroke ( n = 126) and non-progressive ischemic stroke ( n = 274) groups were designated. Hcy level was determined by enzyme-linked immunosorbent assay. High-density lipoprotein cholesterol, triacylglycerol, low-density lipoprotein cholesterol and cholesterol levels were measured using a biochemical analyzer. Hcy and blood lipid levels as well as National Institute Health of Stroke Scale (NIHSS) score were determined in each group. Hcy and blood lipid levels were correlated with NIHSS score. Results:Hcy level in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(28.39 ± 4.36) μmol/L vs. (20.17 ± 3.24) μmol/L, t = 18.894, P < 0.05]. Low-density lipoprotein cholesterol , triacylglycerol and TC levels in the progressive ischemic stroke group were (3.29 ± 0.45) mmol/L, (2.08 ± 0.34) mmol/L and (4.82 ± 0.79) mmol/L, respectively, which were significantly higher than those in the non-progressive ischemic stroke group [(2.48 ± 0.37) mmol/L, (1.56 ± 0.29) mmol/L and (4.08 ± 0.43) mmol/L, t = 17.644, 14.859, 9.860, P < 0.05]. High-density lipoprotein cholesterol level in the progressive ischemic stroke group was significantly lower than that in the non-progressive ischemic stroke group [(1.03 ± 0.13) mmol/L vs. (1.19 ± 0.14) mmol/L, t =11.158, P < 0.05]. NIHSS score in the progressive ischemic stroke group was significantly higher than that in the non-progressive ischemic stroke group [(21.72 ± 4.35) points vs. (15.52 ± 2.89) points, t = 14.582, P < 0.05]. Hcy, low-density lipoprotein cholesterol, cholesterol and triacylglycerol levels were linearly and positively correlated with NIHSS score ( r = 0.846, 0.724, 0.718, 0.765, all P < 0.05), while igh-density lipoprotein cholesterol level was linearly and negatively correlated with NIHSS score ( r = -0.710, P < 0.05). Conclusion:In patients with progressive ischemic stroke, Hcy level is increased and blood lipid level is obviously abnormal. Hcy and blood lipid levels are greatly correlated with neurological function.
5.Insertion/deletion variants within the IGF2BP2 gene identified in reported genome-wide selective sweep analysis reveal a correlation with goat litter size
XIN DONGYUN ; BAI YANGYANG ; BI YI ; HE LIBANG ; KANG YUXIN ; PAN CHUANYING ; ZHU HAIJING ; CHEN HONG ; QU LEI ; LAN XIANYONG
Journal of Zhejiang University. Science. B 2021;22(9):757-766
Insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2, also called IMP2) plays an essential role in the development and maturation of germ cells and embryos and is a candidate gene for goat litter size, based on a previous genome-wide selective sweep analysis. In this study, the mRNA expression level of IGF2BP2 was found to be significantly higher in a single-lamb group than in a multi-lamb group. Insertions/deletions (indels) within the goat IGF2BP2 gene, including P4-Ins-13bp and P5-Del-12bp, were verified in 918 Shaanbei White Cashmere (SBWC) female goats. The minor allelic frequencies (MAFs) of P4-Ins-13bp and P5-Del-12bp loci were 0.349 and 0.295, respectively. Analysis using the Chi-square (χ2) test showed that the genotype (χ2=14.479, P=0.006) distribution of P4-Ins-13bp was significantly different between the single-lamb and multi-lamb groups. Correlation analysis demonstrated that P4-Ins-13bp was significantly associated with goat litter size (P=0.022), and individual goats with the homozygous deletion/deletion (DD) genotype produced more litters than other goats. Therefore, considered as a potential molecular marker significantly related to lambing traits, the P4-Ins-13bp mutation of the goat IGF2BP2 gene can be used in goat breeding with practical molecular marker-assisted selection (MAS) to optimize female reproduction and improve economic efficiency in the goat industry.
6.Analysis of the clinical characteristics and prognosis of 36 cases of newly diagnosed multiple myeloma patients with bone marrow monoclonal plasma cell ratio of less than 10%
Jingting ZHAO ; Xianyong JIANG ; Chen YANG ; Miao CHEN ; Xialu LAN ; Jianhua DU ; Daobin ZHOU ; Junling ZHUANG
Chinese Journal of Hematology 2021;42(4):295-301
Objective:To improve the understanding of newly diagnosed multiple myeloma (NDMM) patients with bone marrow (BM) monoclonal plasma cell ratio of less than 10%.Methods:The clinical characteristics, laboratory examination, response to treatment, and prognosis of 36 NDMM patients with BM plasma cell ratio of less than 10% at Peking Union Medical College Hospital from January 2009 to December 2017 were summarized retrospectively. In the same period, other age- and gender-matched 72 NDMM patients were selected as the control group, whose BM plasma cell ratio was equal to or greater than 10%.Results:First, the patients in the study group accounted for 4.4% of the whole MM population (36/818) , among which only 11 (30.6%) were classified as International Staging System (ISS) Ⅲ, which was significantly lower than that in the control group[45 (62.5%) ] ( P=0.002) . Extramedullary disease (EMD) was more common in the study group (33.3% vs 5.6%, P<0.001) . The median quantity of serum M protein (g/L) in the less than 10% group was 1.04 (0-50.10) , which was significantly lower than that in the control group [4.50 (0-63.10) ] ( P=0.016) , similar to the median quantity of 24-h urinary light chain (510 mg vs 2800 mg, respectively, P=0.023) . Second, the median progression-free survival (PFS) times of front-line regimen in the study and control groups were 26.4 and 19.9 months, respectively ( HR=1.703, 95% CI 0.167-0.233, P=0.002) . In addition, the overall survival (OS) times were 65.8 and 46.2 months, respectively ( HR=2.626, 95% CI 0.439-0.541, P=0.058) . Third, the study group was reclassified based on the quantity of M protein. The median OS times in patients with low/high tumor load were 66.4 and 24.0 months, respectively ( HR=2.349, 95% CI 0.603-0.696, P=0.046) . The median PFS times were 33.1 and 15.5 months, respectively ( HR=1.806, 95% CI 0.121-0.399, P=0.077) . Bortezomib-based regimens did not affect the clinical outcomes. Conclusion:The subpopulation of patients with MM with BM monoclonal plasma cell ratio less than 10% has specific clinical characteristics, including an early disease stage and a lower overall tumor load. Although more patients of this minor group presented with an extramedullary disease, their response rate to the initial treatment and survival outcome are better than those of patients with BM monoclonal plasma cell ratio more than 10%.
7.Preliminary screening of prognosis-related genes in gastric cancer based on TCGA database
Xianping ZHANG ; Ying LI ; Caijia YUAN ; Chunling CHEN ; Xianyong JIANG ; Yong XIA
Chinese Journal of Clinical Laboratory Science 2019;37(5):396-400
Objective:
To search new prognosis-related genes in gastric cancer by analyzing the high-throughput sequencing data of gastric cancer in TCGA database, and then provide data support for future studies.
Methods:
The RNA-seq expression matrix data and patient-related clinical data from 375 gastric cancer tissues and 45 adjacent noncancerous tissues were downloaded from the TCGA database. The data were collated and standardized based on the R language. The difference of gene expression was analyzed by the edgeR and DEseq software packages. The survival analysis of obtained differential genes was performed by the univariate and multivariate COX regressions combined with clinical data of patients, and then the genes with clinical significance were screened out.
Results:
A total of 364 differential genes were obtained by the edgeR and DEseq analysis. Subsequently, the functional enrichment analysis found that these genes were mainly involved in protein digestion and absorption, cytochrome P450 system of drug and exogenous substance metabolism, chemical carcinogenesis, gastric acid secretion and so on. The univariate COX regression analysis showed that FAP, FAT3, PDK4 and ZNF365 genes had significant influences on the prognosis of gastric cancer patients. The multivariate COX stepwise regression analysis showed that the risk model constructed by FAP and PDK4 could predict the prognosis of gastric cancer patients.
Conclusion:
FAP, FAT3, PDK4 and ZNF365 genes may be the prognostic markers of gastric cancer, which may provide data supports for future clinical and basic studies.
8.Effect of calcium dobesilate tablets combined with mecobalamin injection on diabetic peripheral neuropathy and its effects on oxidative stress and neurotrophic factor
Jiayong DAI ; Guifen YU ; Wei CHEN ; Xianyong DAI ; Yan WANG ; Jixin LI
Chinese Journal of Biochemical Pharmaceutics 2017;37(2):187-189
Objective To investigate the calcium dobesilate tablets combined with mecobalamin injection in treatment of diabetic peripheral neuropathy and effects on oxidative stress and neurotrophic factor.Methods 82 cases of diabetic peripheral neuropathy(DPN) patients from February 2015 to October 2016 in our hospital were selected and randomly divided into observation group and control group with 41 cases in each group.The control group was treated with mecobalamin injection, the observation group were treated with calcium dobesilate tablets.The course of treatment was two weeks in two groups.Results The total efficiency of the observation group (90.24%) was higher than the control group (68.29%) , the difference was statistically significant ( P<0.05 ) , patients in the observation group after the treatment of common peroneal nerve and median nerve SCV and MCV higher than the control group, the difference was statistically significant (P <0.05), the level of serum malondialdehyde (MDA) in the observation group was lower than that in the control group and the level of superoxide dismutase ( SOD) in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05), the levels of serum NGF and BDNF in the observation group were higher than those in the control group, the difference was statistically significant (P<0.05), the two groups were no obvious adverse reactions.Conclusion Calcium dobesilate tablets and mecobalamin injection curative effect in the treatment of diabetic peripheral neuropathy , and patients could improve oxidative stress and neurotrophic factors, and the safety is good, has the important research significance.
9.Degranulation and anti-inflammatory effects of shikimic acid in Chaenomeles speciosa on peritoneal mast cells in rats
Qianqian ZHENG ; Tiantian DONG ; Shigang LI ; Wei LIU ; Lingling YU ; Xianyong CHEN ; Jinling WANG
Chinese Journal of Immunology 2017;33(7):1035-1038
Objective:To investigate the effect of Chaenomeles speciosa total extract shikimic acid(SA) on the degranulation of compound 48/80(C48/80) stimulated rat peritoneal mast cells and the anti-inflammatory.Methods: Qualitative analysis of shikimic acid in the total extract of Chaenomeles speciosa by high performance liquid phase;RPMC were identified by toluidine blue,immunohistochemistry and electron microscopy;CCK-8 method was used to detect the proliferation of RPMC in each concentration group.The release rate of β-hexosidase was determined by substrate method.The content of histamine in supernatant was detected by ELISA.Results: SA had no significant effect on the growth of RPMC at the concentration of 0-90 μg/ml.Compared with the positive control group,SA could effectively inhibit the release of β-hexosidase and inhibit the secretion of histamine.Conclusion: SA inhibits the release of histamine in inflammatory mediators by inhibiting the degranulation of RPMC stimulated by C48/80,and then exerts anti-inflammatory effects.
10.Treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia and its mechanism
Xianyong DAI ; Yan WANG ; Wei CHEN
Chongqing Medicine 2017;46(21):2940-2942,2944
Objective To observe the treatment effect of early rehabilitation training on acute cerebral infarction patients with hemiplegia,and to explore its possible mechanism.Methods One hundred cases of acute cerebral infarction hemiplegia in our hospital from January 2013 to June 2016 were selected and divided into the rehabilitation training group (50 cases) and control group (50 cases).The control group was given the routine medication therapy and the rehabilitation training group was given early rehabilitation training on the basis of conventional medication therapy.The functional independence assessment (FIM),Fugl-Meyer assessment (FMA) and modified Barthel index (MBI) were used to evaluate the therapeutic effect of early rehabilitation training.The level of stromal cell-derived factor-1α (SDF-1α) in peripheral blood was measured by enzyme linked immunosorbent assay,and the level of CD34+KDR+ in peripheral blood was measured by flow cytometry.Results There was no statistically significant difference in the FIM total score,FIM sports function score,FMA score,MBI score,SDF-1α and CD34+KDR+ levels before treatment between the rehabilitation training group and the control group (P>0.05).After treatment,the FIM total score,FIM sports function score,FMA score,MBI score and SDF-1α and CD34+KDR+ levels of the rehabilitation training group were higher than those of the control group,the differences were statistically significant (P<0.05).Conclusion The effect of early rehabilitation training on acute cerebral infarction patients with hemiplegic is remarkable.The mechanism may be related to promoting the expression of SDF-1α and CD34+KDR+ in peripheral blood.

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