1.Visual analysis of the impact of T cells on rheumatoid arthritis in the past decade based on multiple analysis methods
Xiaojun SU ; Wenju ZHU ; Huan WANG ; Qian HE ; Qiang BAO ; Ying GUO ; Yihong KE ; Haili SHEN ; Zhiming ZHANG
China Modern Doctor 2024;62(12):1-8
Objective Through a multi-software visual analysis of the literature on the influence of T cells on rheumatoid arthritis(RA)in recent ten years,the research hotspot and frontier development in this field were summarized.Methods The Chinese and English literature on the influence of T cells on RA from 2012 to 2022 years was retrieved from CNKI and Web of Science database as the research object.CiteSpace and VOSviewer software were used to analyze the number of publications,authors and keywords.Results 519 articles in Chinese and 861 in English were retrieved.The results showed that the number of articles in Chinese increased slowly from 2020 to 2022 years,while the overall trend in English was stable.Keyword analysis shows that it is predicted that future research in this field will focus on the pathogenesis of T cells in RA,the mechanism of bone destruction in RA,disease activity,oxidative stress.Conclusion The influence of T cells on RA has attracted much attention in the past,present and future,and has great research value.However,due to the differences in research priorities at home and abroad,the teams should interact positively and communicate with each other to reveal the internal mechanism of RA and provide theoretical basis for targeted therapy.
2.An Empirical Study on the Use of Diagnosis Related Group Tools for Grouping Adjustments in Large Public Hospitals
Guojie ZHANG ; Xutong TAN ; Zhiling CAI ; Qiang XU ; Weifeng XU ; Yihang CHEN ; Yating WANG ; Jinhan LIU ; Zheng CHEN ; Jiong ZHOU ; Xiaojun MA
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1052-1058
To analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources. We retrospectively collected DRG data from two surgical departments in a large public hospital in Beijing from 2017 to 2023. When the case mix index (CMI) of the two surgical departments declined, interventions such as performance appraisal, department education, and hospital publicity were promptly adopted. The changesin CMI values were observed and the trends in disease group weights, time consumption index, cost consumption index, and mortality rate in low-risk groups were analyzed. After the interventions, in surgical department Ⅰ, the proportion of patients with lower-weight diseases, such as major thyroid surgery (KD1), significantly decreased, while that of patients with higher-weight diseases, such as colorectal malignancy surgery (GB2) and pancreatic malignancy surgery (HB1), significantly increased. In surgical department Ⅱ, the proportion of patients with lower-weight diseases, such as chemotherapy (RE1), decreased markedly, while that of patients with higher-weight diseases, including major surgery for malignancy of kidney, ureter, and bladder (LA1), adrenal gland surgery (KC1), surgery for kidney/ureter/bladder except for major malignancy surgery (LB1), and male genital organ malignancy surgery (MA1), increased significantly. Both surgical departments achieved the goal of increasing their CMI values. In terms of efficiency, cost, and quality indicators, the time consumption index and cost consumption index of the two surgical departments were significantly lower than 1, and the mortality rate in low-risk groups was 0. Based on actual conditions and development goals, large public hospitals can achieve improvements in CMI values and optimization of disease group structures through reasonable interventions, thereby enhancing medical efficiency and rational utilization of resources.
3.Quantitatively analyze the relationship between abdominal visceral fat content and type 2 biabetes mellitus by magnetic resonance IDEAL-IQ
Jinfeng WANG ; Lin LUO ; Qiang CHEN ; Xiaojun YUAN
The Journal of Practical Medicine 2024;40(16):2256-2262
Objective To investigate the association between abdominal visceral fat content and the occur-rence of type 2 diabetes mellitus(T2DM)and the potential of predicting the incidence of T2DM with abdominal visceral fat content.Methods The study included 45 patients with T2DM who underwent 3.0T MRI and 80 control patients,recruited from the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology.IDEAL software was utilized for automated image recombination to obtain fat fraction,relaxation rate(R2*),lipid phase,water phase,and in-phase images.Fat fraction images were transferred to AW 4.6 workstation for measurement of fat fraction plots by two observers using a double-blind approach.ITK-SNAP software was employed for semi-automatic delineation of abdominal visceral fat and subcutaneous adipose tissue through threshold segmentation method,followed by volume calculation.Statistical analysis of the data was performed using SPSS 26.0 software.Results(1)The T2DM group exhibited significantly higher levels of abdominal visceral adipocyte volume(VATV),hepatic fat fraction(HFF),pancreatic fat fraction(PFF),triglyceride(TG),and fasting blood glucose(FBG)compared to the control group.Conversely,the high density lipoprotein(HDL)level was significantly lower in the T2DM group than in the control group(P<0.05).The correlation analysis revealed that in male patients,abdominal VATV exhibited positive associations with body mass index(BMI),waist circumference,subcutaneous adipose tissue volume(SATV),hepatic fat fraction(HFF),TG,and FBG;while displaying a negative association with HDL.In female patients,VATV demonstrated positive correlations with BMI,waist circumference,SATV,and HFF.(2)The ROC curve analysis demonstrated that the area under the curve(AUC)for PFF in diagnosing T2DM was 0.656(P<0.01,95%CI:0.534~0.777).The determined cut-off value was 8.44%,yielding a sensitivity of 50%and specificity of 82.5%.Similarly,HFF exhibited an AUC of 0.744(P<0.05,95%CI:0.637~0.851),with a cut-off value of 2.99%,sensitivity of 97.5%,and specificity of 42%.In male patients,VATV displayed an optimal threshold for T2DM diagnosis at a volume of approximately 3 466 cm3,resulting in a sensitivity of 63.2%,specificity of 89.5%,and AUC of 0.78(P<0.01).The sensitivity was 78.9%and specificity was 84.2%when SATV,PFF and HFF were combined and the AUC was 0.839(P<0.01).The optimal threshold for diagnosing T2DM with VATV in female patients was 2 103cm3,and the sensitivity,specificity and AUC of T2DM with VATV were 66.7%,66.7%and 0.68(P<0.05).When SATV,PFF and HFF were combined,the sensitivity was 90.5%.The specificity was 76.2%and the AUC was 0.909(P<0.01).(3)For each additional unit of TG and FBG,the risk of T2DM respectively increased by 3986.3%and 417.1%,in other words,TG and FBG were independent predictors of the occurrence of T2DM.Conclusion The predictive value of pancreatic fat fraction,liver fat fraction,and abdominal visceral fat tissue volume for the onset of type 2 diabetes is limited.However,combining abdominal visceral adipose tissue volume with subcutaneous adipose tissue volume,pancreatic fat fraction,and liver fat fraction significantly enhances the efficacy,sensitivity,and specificity of predicting type 2 diabetes occurrence.The IDEAL-IQ technique offers a convenient method for quantitatively evaluat-ing intra-abdominal ectopic adipose tissue deposition in patients with type 2 diabetes mellitus.It demonstrates advantages such as simplicity,good stability,high reproducibility and holds great potential.
4.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
5.Bibliometric analysis of JAK/STAT signaling pathway in rheumatoid arthritis
Xiaojun SU ; Wenju ZHU ; Qiang BAO ; Huan WANG ; Qian HE ; Jun MA ; Haidong WANG ; Xuemei TIAN ; Fuhai MA ; Haili SHEN ; Huijun YANG
China Modern Doctor 2024;62(20):1-4,8
Objective Based on the multi-software visual analysis of the literature on the effect of Janus kinase(JAK)/signal transducer and activator of transcription(STAT)signaling pathway on rheumatoid arthritis in the past decade,the development trend and research hotspot in this field are summarized.To provide researchers with new directions and ideas to promote the innovative development of the field.Methods The literatures related to JAK/STAT signaling pathway in rheumatoid arthritis were collected from the Web of Science Core Collection database from 2013 to 2023.CiteSpace and VOSviewer software were used to analyze the number of publications,countries,authors and keywords of 354 articles retrieved.Results The number of published papers in this field continues to increase.According to the author's research direction,the presentation of high-frequency words,and the attention to the preface and hot topics,it is suggested that this field focuses on gene expression,immune mechanism,inflammatory mechanism,pathway inhibitors,drug therapy,etc.Future research will focus on the safety,mechanism and controlled trials of pathway inhibitors and antirheumatic drugs.Conclusion The effect of JAK/STAT signaling pathway on rheumatoid arthritis has attracted much attention in the past,present and future.There are differences in the research of different teams in this field,and the regional development is unbalanced,suggesting that we should strengthen cooperation and exchanges,focus on the international frontier,and carry out more high-quality research to promote the development and progress of this field,and provide clinical basis.
6.Efficacy of magnetic resonance IDEAL-IQ technique in diagnosis of fat and iron deposition in acute pancreatitis
Huifang FAN ; Qiang CHEN ; Xiaojun YUAN ; Lin LUO
Journal of Clinical Hepatology 2022;38(10):2320-2324
Objective To perform quantitative evaluation of fat and iron deposition in the pancreas of patients with acute pancreatitis (AP) based on the IDEAL-IQ quantitative parameters fat fraction (FF) and relaxation rate (R 2 * ), and to investigate the efficacy of this technique in the diagnosis of AP. Methods A total of 72 patients with AP who were diagnosed and treated in The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from October 2020 to October 2021, were enrolled as case group, and 82 healthy controls who underwent physical examination during the same period of time were enrolled as control group. The abdominal IDEAL-IQ sequence test was performed for both groups using GE 3.0T magnetic resonance instrument, and FF and R 2 * values were measured on post-processing workstation. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. A receiver operating characteristic (ROC) curve analysis was performed for the parameters with statistical significance, and area under the ROC curve ( AUC ) was used to evaluate the diagnostic efficacy of parameters. Results Compared with the control group, the case group had significantly higher FF value ( Z =-10.01, P < 0.001) and R 2 * value ( Z =-3.73, P < 0.001), while there were no significant differences in FF and R 2 * values between mild AP and moderate-to-severe AP ( P > 0.05). FF value had a sensitivity of 100% and a specificity of 90.2% in the diagnosis of AP, while R 2 * value had a sensitivity of 48.6% and a specificity of 86.6% in the diagnosis of AP. Conclusion The quantitative parameter FF value of magnetic resonance IDEAL-IQ technique has relatively high sensitivity and specificity in the diagnosis of AP, and it is a specific index for the diagnosis of AP and holds promise for clinical application.
7.Prognostic significance of DEK-NUP214 fusion gene in patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation
Mengge GAO ; Qiang FU ; Yazhen QIN ; Yingjun CHANG ; Yu WANG ; Chenhua YAN ; Lanping XU ; Xiaohui ZHANG ; Xiaojun HUANG ; Xiaosu ZHAO
Chinese Journal of Internal Medicine 2021;60(10):868-874
Objective:To investigate the dynamic change and clinical impact of DEK-NUP214 fusion gene in patients with acute myeloid leukemia (AML) receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Real-time quantitative polymerase chain reaction (RQ-PCR) and multicolor flow cytometry (FCM) were used to detect DEK-NUP214 gene expression and leukemia-associated immunophenotype (LAIP) in 15 newly diagnosed patients with positive DEK-NUP214 and receiving allo-HSCT from September 2012 to September 2017 at Peking University People′s Hospital. The clinical outcome was analyzed using Kaplan-Meier survival curves. The impact of DEK-NUP214 expression was analyzed by log-rank test.Results:The subjects were followed-up with a median period of 657 (62-2 212) days. The median DEK-NUP214 expression level at diagnosis was 488% (274%-1 692%). Thirteen patients achieved complete remission before allo-HSCT. Thirteen patients had a residual DEK-NUP214 expression of 0.38% (0.029%-738.9%) before allo-HSCT. After allo-HSCT, DEK-NUP214 expression in 9/13 patients remained positive, which dropped by around 500 folds (5.7-5 663.0 folds) within a month post-transplant. Five patients died and 2 patients relapsed. The 3-year cumulative incidence of relapse in patients with positive DEK-NUP214 before transplant was 17.5%±11.3% and the 3-year overall survival was 60.5%±13.8%. After allo-HSCT, DEK-NUP214-negative patients had a better outcome.Conclusion:Quantitative monitor of DEK-NUP214 fusion gene could be a sensitive indicator of MRD status after allo-HSCT.
8.The effect of donor cytomegalovirus serological status on the outcome of allogeneic stem cell transplantation
Jing LIU ; Qiang FU ; Yu WANG ; Fengrong WANG ; Wei HAN ; Yanru MA ; Chenhua YAN ; Tingting HAN ; Jingzhi WANG ; Zhidong WANG ; Xiaohui ZHANG ; Lanping XU ; Kaiyan LIU ; Xiaojun HUANG ; Yuqian SUN
Chinese Journal of Internal Medicine 2021;60(5):459-465
Objective:Donor cytomegalovirus (CMV) serological negative status may have an adverse effect on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT), while there is inadequate data for Chinese people. This study is to explore the impact of donor CMV serological status on the outcome of CMV seropositive patients receiving allo-HSCT.Methods:Our study retrospectively analyzed 16 CMV seropositive patients with hematological malignancies receiving allogeneic grafts from CMV seronegative donors (antibody IgG negative) at Peking University People′s Hospital from March 2013 to March 2020, which was defined as D -/R + group. The other 64 CMV seropositive patients receiving grafts from CMV seropositive donors at the same period of time were selected as matched controls through a propensity score with 1∶4 depending on age, disease state and donor-recipient relationship (D +/R + group). Results:Patients in D -/R + group developed CMV DNAemia later than patients in the D +/R + group (+37 days vs. +31 days after allo-HSCT, P=0.011), but the duration of CMV DNAemia in D -/R + group was longer than that of D +/R + group (99 days vs. 34 days, P=0.012). The rate of CMV reactivation 4 times or more in D -/R + group was 4/16, significantly higher than that of D +/R + group (4.7%, 3/64, P=0.01). The incidences of refractory CMV DNAemia (14/16 vs. 56.3%, P=0.021) and CMV disease (4/16 vs. 4.7%, P=0.01) in D -/R + group were both higher than those in D +/R + group. In addition, the application of CMV-CTL as the second-line antiviral treatment in D -/R + group was more than that in D +/R + group. Univariate analysis and multivariate analysis suggested that CMV serological negativity is an independent risk factor for refractory CMV DNAemia and the duration of CMV infection. The cumulative incidence of aGVHDⅡ-Ⅳ, cGVHD, 3-year probability of NRM, overall survival, and the cumulative incidence of relapse were all comparable in two groups. Conclusions:Although there is no significant effect on OS and NRM, the incidence of refractory CMV DNAemia, the frequency of virus reactivation, and the development of CMV disease in D -/R + group are higher than those in controls. Therefore, CMV seropositive donors are preferred for CMV seropositive patients.
9.Research progress of CD36 antigen deletion and transfusion-related immunity
Xuehua HE ; Jiajia QIAO ; Xiaojun GUO ; Hongbin ZHAO ; Ling ZHANG ; Qiang ZHANG
Chinese Journal of Blood Transfusion 2021;34(12):1408-1411
As a pattern recognition receptor, CD36 antigen participates in a series of pathophysiological processes, and has well been documented in transfusion medicine. This article reviews the discovery, structure and expression of CD36, the type and frequency of CD36 antigen deletion, as well as the relationship between anti-CD36 and transfusion-related immune diseases.
10.Predictive value of volatile organic compounds in exhaled breath on pulmonary nodule in people aged less than 50 years
Shaohua XIE ; Wei DAI ; Mingxin LIU ; Run XIANG ; Tianpeng XIE ; Xiaojun YANG ; Bin HU ; Xiang ZHUANG ; Xiaozun YANG ; Bo TIAN ; Wenwen LI ; Yixiang DUAN ; Qiang LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(06):675-680
Objective To investigate the predictive value of volatile organic compounds (VOCs) on pulmonary nodules in people aged less than 50 years. Methods The 147 patients with pulmonary nodules and aged less than 50 years who were treated in the Department of Thoracic Surgery of Sichuan Cancer Hospital from August 1, 2019 to January 15, 2020 were divided into a lung cancer group and a lung benign disease group. The lung cancer group included 36 males and 68 females, with the age of 27-49 (43.54±5.73) years. The benign lung disease group included 23 males and 20 females, with the age of 22-49 (42.49±6.83) years. Clinical data and exhaled breath samples were collected prospectively from the two groups. Exhaled breath VOCs were analyzed by gas chromatography mass spectrometry. Binary logistic regression analysis was used to select variables and establish a prediction model. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve of the prediction model were calculated. Results There were statistically significant differences in sex (P=0.034), smoking history (P=0.047), cyclopentane (P=0.002), 3-methyl pentane (P=0.043) and ethylbenzene (P=0.009) between the two groups. The sensitivity, specificity and area under the ROC curve of the prediction model with gender, cyclopentane, 3-methyl pentane, ethylbenzene and N,N-dimethylformamide as variables were 80.8%, 60.5% and 0.781, respectively. Conclusion The combination of VOCs and clinical characteristics has a certain predictive value for the benign and malignant pulmonary nodules in people aged less than 50 years.

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