1.Accuracy of multivariate discriminant analysis versus fibrosis-4 in evaluating the liver fibrosis degree in patients with chronic HBV infection
Hongyu LIU ; Xiaoting LI ; Jianning JIANG ; Chao JIN ; Cailian CAI ; Keshan WANG ; Fangpeng LING ; Bingling FAN ; Minghua SU
Journal of Clinical Hepatology 2025;41(4):677-683
ObjectiveTo investigate the accuracy of multiple discriminant analysis (MDA) versus fibrosis-4 (FIB-4) in assessing liver fibrosis degree in patients with HBV infection, as well as the possibility of MDA as an indicator for disease progression. MethodsA total of 263 patients with HBV infection who underwent liver biopsy in The First Affiliated Hospital of Guangxi Medical University from April 2010 to April 2024 were included, and their clinical data were collected. According to the results of pathological examination, they were divided into non-significant fibrosis group (F<2) with 126 patients and significant fibrosis group (F≥2) with 137 patients. The correlation of MDA and FIB-4 with liver fibrosis degree was analyzed, and MDA and FIB-4 were compared in terms of their accuracy in assessing significant liver fibrosis. A total of 62 patients completed follow-up, and according to the presence or absence of progression to liver cirrhosis at the last follow-up visit, they were divided into progressive group with 21 patients and non-progressive group with 41 patients; the efficacy of MDA and FIB-4 in diagnosing disease progression was analyzed and compared. The independent-samples 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; the Kruskal-Wallis H test was used for comparison between multiple groups, and the Bonferroni method was used for further comparison between two groups. The chi-square test was used for comparison of categorical data. The Spearman’s correlation coefficient was used for correlation analysis. The Wilcoxon signed rank sum test was used for the analysis of baseline data and data at the end of follow-up, and the binary Logistic regression analysis was used to investigate the influencing factors for progression to liver cirrhosis. The receiver operating characteristic (ROC) curve was used to investigate the diagnostic efficacy of indicators, the Z-test was used for comparison of the area under the ROC curve (AUC), and the paired chi-square test was used for comparison of the sensitivity, specificity, and accuracy of the two indicators. ResultsThe correlation coefficient between FIB-4 and liver fibrosis degree was 0.378, while the correlation coefficient between MDA and liver fibrosis degree was -0.325 (both P<0.001). FIB-4 had an AUC of 0.688, a sensitivity of 64.96%, a specificity of 68.87%, a positive predictive value of 67.42%, a negative predictive value of 63.36%, an accuracy of 65.40%, and a cut-off value of 1.01, while MDA had an AUC of 0.653, a sensitivity of 52.55%, a specificity of 78.57%, a positive predictive value of 72.73%, a negative predictive value of 60.37%, an accuracy of 65.02%, and a cut-off value of 0.29, suggesting that compared with FIB-4, MDA had a lower sensitivity (P=0.004) and a higher specificity (P=0.001). The progressive group had a significantly higher age than the non-progressive group at baseline (t=2.611, P=0.011). For the progressive group, there was an increase in FIB-4 and a reduction in MDA from baseline to the end of follow-up (both P<0.001), while the non-progressive group showed no significant changes (both P>0.05). The multivariate Logistic regression analysis showed that aspartate aminotransferase (odds ratio [OR]=0.940, 95% confidence interval [CI]: 0.885 — 0.998, P<0.05) and MDA (OR=0.445, 95%CI: 0.279 — 0.710, P<0.001) were independent influencing factors for disease progression. MDA had an AUC of 0.893 and an optimal cut-off value of -0.01 in diagnosing the disease progression of liver cirrhosis. ConclusionMDA has a comparable accuracy to FIB-4 in the diagnosis of significant liver fibrosis, and MDA<-0.01 has a high accuracy in diagnosing the progression of liver fibrosis to liver cirrhosis, which can help to reduce the need for liver biopsy in clinical practice.
2.Construction and application effect of “internet+”Tibetan-language medication service platform
Man LIU ; Liang YANG ; Linling WANG ; Yaqing OU ; Ling CHENG ; Liangfen WANG ; Yingqiang WANG ; Xiaoting TANG ; Rong CHEN
China Pharmacy 2025;36(12):1515-1519
OBJECTIVE To build a Tibetan-language medication service platform based on “internet+” and evaluate its effect on improving medication compliance and safety of Tibetan patients with chronic disease. METHODS Medication guidance contents of commonly used drugs in the outpatient department were summarized, translated and recorded in Tibetan-language or video to form a “text-audio-video” multi-dimensional “internet+ ” Tibetan-language medication service platform. A total of 387 Tibetan outpatients with chronic disease in our hospital after the implementation of “internet+” Tibetan-language medication service platform (from January 2024 to June 2024) in our hospital were selected as the intervention group, and 387 Tibetan outpatients before the implementation (from January 2023 to June 2023) were selected as the control group. Patients in the control group received conventional window-based Chinese-language medication services, while patients in the intervention group received both conventional window-based Chinese-language medication service and “internet+ ” Tibetan-language medication service. The medication compliance of patients was evaluated using the 12-item Medication Compliance Scale. A six-level causality assessment was conducted as the principles for analyzing adverse drug reactions (ADR) set by the National Center for ADR Monitoring. Additionally, statistics were compiled on the occurrence of ADR that were assessed as “definite”“probable” or “possible” in the causality assessment. RESULTS The proportion (31.0%) of patients with good medication compliance and compliance scores [39.0 (37.0,42.0)] of patients in the intervention group were significantly better than control group [7.0%, 21.0(19.0, 23.0)]( P<0.05). There were no statistically significant differences in the incidence of various types of ADR or the overall incidence between the two groups (P>0.05). CONCLUSIONS The “internet+” Tibetan-language medication service platform is constructed successfully; the service can effectively improve the medication compliance of Tibetan-language patients, but its effect on improving the medication safety of patients is limited.
3.Effective Ingredients of Chinese Medicine in Prevention and Treatment of Osteoarthritis by Regulating Oxidative Stress: A Review
Shuang ZHANG ; Yingyan BI ; Xiaoting LIU ; Yusuo GONG ; Xuerui LIU ; Baohua YUAN ; Chenglong LU ; Xufan CHEN ; Ying WANG ; Jiaru GUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):282-289
Osteoarthritis (OA) is a common degenerative joint disease with a rising incidence rate year by year. Treatment often relies on analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), which can lead to gastrointestinal damage with long-term use and the recurrence of symptoms. Chinese medicine has a long history of preventing and treating OA, with widespread application and fewer side effects. It offers unique advantages such as a broad treatment scope, multiple targets, and pathways. The effective components of Chinese medicine can reduce the content of reactive oxygen species (ROS), relieve oxidative stress (OS) damage, and increase the antioxidant capacity of the body by interfering with the expression of biomarkers of OS response such as malondialdehyde (MDA) and superoxide dismutase (SOD). Through the modulation of signaling pathways such as nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), nuclear factor kappa B (NF-κB), c-Jun N-terminal kinase (JNK), NOD-like receptor protein 3 (NLRP3), and osteoprotegerin (OPG), they downregulated the expression of inflammatory factors such as interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), thereby effectively relieving local joint inflammation, protecting chondrocytes and bone tissue, inhibiting chondrocyte apoptosis, and further alleviating the progression of OA. Currently, there are still certain limitations in the medical research status and development trends of OA, necessitating the continued advancement of traditional Chinese medicine. This paper reviewed the literature on the regulation of OS response by effective components of Chinese medicine for the prevention and treatment of OA, providing new directions and ideas for future research.
4.Progress in regulation of JAK/STAT signaling pathway by traditional Chinese medicine in treatment of osteoarthritis
Xiaoting LIU ; Jiaru GUANG ; Yusuo GONG ; Baohua YUAN ; Chenglong LU ; Xufan CHEN ; Bifeng ZHANG
Chinese Journal of Pathophysiology 2024;40(2):375-384
Osteoarthritis(OA)mainly lies in the lesions of articular cartilage and surrounding tissues,pro-ducing osteophytes and bone sclerosis,resulting in damage to the articular cartilage.The main pathological mechanism of OA rests with a large number of inflammatory cytokines and inflammatory mediators produced by joint synovial lesions as well as pathological vascular growth at the junction of the synovium and cartilage,which may be one of the key reasons for promoting synovitis and cartilage damage.The OA mainly occurs in the knees,hips,hands and the spine.It is mainly manifested by chronic joint pain,swelling and stiffness,and limitation of motion seriously affects the functional activities of patients.The treatment of OA mainly relies on oral administration or intraarticular injection of drugs to relieve symp-toms.When OA develops to the middle and late stages,the action and life of patients will be seriously affected.There-fore,surgical replacement of joints is considered to ensure the basic life demands of patients.Studies show that traditional Chinese medicine(TCM)treatment has attracted widespread attention and application due to its unique advantages in pre-vention and treatment of OA.Janus kinase(JAK)/signaling transduction and transcriptional activator(STAT)signaling pathway may be one of the important signaling pathways that regulate the chondrocyte proliferation,differentiation and apoptosis.Moreover,it is closely associated with intra-articular inflammatory response.The JAK/STAT signaling pathway regulates the expression of inflammatory factors and related proteins through TCM so as to reduce the inflammatory re-sponse and decrease the chondrocyte damage.It has an important reference value for OA treatment.In this paper,the roles and mechanisms of the TCM monomers and active ingredients and the Chinese herbal compounds in OA by regulating JAK/STAT signaling pathway and affecting related cytokine and protein expression levels have been reviewed,providing a new method and direction for TCM treatment of OA.
5.Ultrasonic artificial intelligence-assisted diagnostic system for diagnosing medullary thyroid carcinoma
Liu JIANG ; Lei CHEN ; Xiaoting ZHANG ; Chang LIU ; Zhenwei LIANG ; Xiuming SUN ; Yuhong SHAO ; Luzeng CHEN
Chinese Journal of Medical Imaging Technology 2024;40(2):208-211
Objective To assess the effect of ultrasonic thyroid artificial intelligence(AI)-assisted diagnostic system(AI-assisted diagnostic system)for diagnosing medullary thyroid carcinoma(MTC)compared with different physicians and taken papillary thyroid carcinoma(PTC)as the controls.Methods Totally 63 MTC,70 PTC and 62 benign thyroid nodules confirmed by pathology were enrolled.AI-assisted diagnostic system was utilized to analyze thyroid nodules and identify the likelihood of malignancy,and the probability value threshold was set at ≥0.40.All thyroid nodules were retrospectively reviewed and categorized by 3 physicians(1 senior physician,1 attending physician and 1 junior physician)according to Chinese thyroid imaging reporting and data system(C-TIRADS).The efficacy of AI-assisted diagnostic system and physicians for diagnosing MTC and PTC were evaluated.Results AI-assisted diagnostic system showed lower sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and area under the curve(AUC)for diagnosing MTC and PTC compared with physicians.Significant differences of AUC were found between senior physician and AI-assisted diagnostic system,as well as between attending physician and AI-assisted diagnostic system for diagnosing MTC and PTC(all P<0.01),while no significant difference of AUC was between junior physicians and AI-assisted diagnostic system(both P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and AUC for AI-assisted diagnostic system for diagnosing MTC were all lower than those for diagnosing PTC,but the AUC was not significantly different(P>0.05).Conclusion Ultrasonic thyroid AI-assisted diagnostic system had relatively high value for diagnosing MTC.
6.Effectiveness of fibrosis-4 versus aspartate aminotransferase-to-platelet ratio index in evaluating liver fibrosis degree in patients with chronic HBV infection
Xiaoting LI ; Bobin HU ; Hongyu LIU ; Chao JIN ; Cailian CAI ; Keshan WANG ; Yanchun WEI ; Jianning JIANG ; Minghua SU
Journal of Clinical Hepatology 2024;40(12):2424-2429
ObjectiveTo investigate the performance of fibrosis-4 (FIB-4) versus aspartate aminotransferase-to-platelet ratio index (APRI) in predicting advanced liver fibrosis and disease progression in patients with chronic HBV infection. MethodsA total of 497 patients with chronic HBV infection who underwent liver biopsy in The First Affiliated Hospital of Guangxi Medical University from February 2013 to December 2022 were enrolled, among whom 404 were enrolled in a retrospective study and 75 were enrolled in a prospective study. Related indicators were collected, including demographic features (sex and age), biochemical indices (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), and platelet count, and FIB-4 and APRI were calculated. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The area under the ROC curve (AUC) was used to assess the ability of APRI and FIB-4 in evaluating liver fibrosis degree and disease progression in patients with chronic HBV infection. ResultsIn the retrospective analysis, compared with the FIB-4<2.67 group, the FIB-4≥2.67 group had a significantly higher proportion of the patients who were diagnosed with liver cirrhosis or hepatocellular carcinoma (66.19% vs 47.54%, χ²=12.75, P<0.001). The medians of FIB-4 and APRI increased significantly with liver fibrosis degree from F0 to F4 (H=42.5 and 35.9, both P<0.001). As for the fibrosis stage of F0-F4, the median of FIB-4 was significantly higher than that of APRI in the patients with the same fibrosis stage (H=59.71, P<0.001). FIB-4 and APRI had a similar AUC for predicting stage F3 fibrosis (0.67 vs 0.65, Z=0.71, P=0.480), while FIB-4 had a higher AUC for predicting stage F4 fibrosis than APRI (0.72 vs 0.64, Z=10.50, P<0.001). In the prospective study cohort, FIB-4 and APRI showed an increasing trend over time in predicting disease progression (chronic hepatitis B to liver cirrhosis), with an AUC of 0.718 (95% confidence interval [CI]: 0.476 — 0.760) and 0.555 (95%CI: 0.408 — 0.703), respectively, and FIB-4 had a significantly higher accuracy than APRI in predicting disease progression (χ2=12.44, P<0.001). ConclusionFIB-4 and APRI can be used to evaluate advanced liver fibrosis (F3 and F4) and predict disease progression, and FIB-4 is superior to APRI in certain aspects.
7.The Evolution Path and Prospect of the Health Industry Based on CiteSpace Visual Analysis
Liqing LI ; Xiaoting ZHAI ; Chuanmei ZENG ; Qiao LIU
Chinese Health Economics 2024;43(7):59-65
Objective:To systematically sort out the development trajectory of the research field of health industry,discuss the research hotspots and frontier topics in depth,and reveal the topics that should be focused on in the future research of the domestic health industry.Methods:Using CiteSpace Bibliometric Visualization Software,1 488 core journal articles in the field of health industry from 1994 to 2023 in CNKI Database were used as research samples to systematically analyze the development trend,research themes,hot issues and cutting-edge research of the health industry.Results:The number of papers published from 1994 to 2023 showed a steady growth trend on the whole.The author-institution partnership was relatively independent and loose,and there was no obvious network of collaboration.Meanwhile,the research hotspots in this field at the current stage mainly focused on the integrated development of"health industry+",health care industry,smart elderly care,health service industry chain,elderly care service system,and the background of healthy China.Conclusion:With the change of residents'cognition and demand for health,the focus of research has begun to transform from the traditional medical treatment model to the new business model of health industry of"managing health,preventing diseases,and focusing on residents'health".Based on the in-depth analysis of the existing research sample literature of the health industry,in order to effectively promote the high-quality and sustainable development of the health industry,the research field should focus on the business model of the health industry in the era of digital economy in the future,formulation and management of industry standards for the health industry,and empirical research at the micro level in the field of health industry research.
8.The Evolution Path and Prospect of the Health Industry Based on CiteSpace Visual Analysis
Liqing LI ; Xiaoting ZHAI ; Chuanmei ZENG ; Qiao LIU
Chinese Health Economics 2024;43(7):59-65
Objective:To systematically sort out the development trajectory of the research field of health industry,discuss the research hotspots and frontier topics in depth,and reveal the topics that should be focused on in the future research of the domestic health industry.Methods:Using CiteSpace Bibliometric Visualization Software,1 488 core journal articles in the field of health industry from 1994 to 2023 in CNKI Database were used as research samples to systematically analyze the development trend,research themes,hot issues and cutting-edge research of the health industry.Results:The number of papers published from 1994 to 2023 showed a steady growth trend on the whole.The author-institution partnership was relatively independent and loose,and there was no obvious network of collaboration.Meanwhile,the research hotspots in this field at the current stage mainly focused on the integrated development of"health industry+",health care industry,smart elderly care,health service industry chain,elderly care service system,and the background of healthy China.Conclusion:With the change of residents'cognition and demand for health,the focus of research has begun to transform from the traditional medical treatment model to the new business model of health industry of"managing health,preventing diseases,and focusing on residents'health".Based on the in-depth analysis of the existing research sample literature of the health industry,in order to effectively promote the high-quality and sustainable development of the health industry,the research field should focus on the business model of the health industry in the era of digital economy in the future,formulation and management of industry standards for the health industry,and empirical research at the micro level in the field of health industry research.
9.The Evolution Path and Prospect of the Health Industry Based on CiteSpace Visual Analysis
Liqing LI ; Xiaoting ZHAI ; Chuanmei ZENG ; Qiao LIU
Chinese Health Economics 2024;43(7):59-65
Objective:To systematically sort out the development trajectory of the research field of health industry,discuss the research hotspots and frontier topics in depth,and reveal the topics that should be focused on in the future research of the domestic health industry.Methods:Using CiteSpace Bibliometric Visualization Software,1 488 core journal articles in the field of health industry from 1994 to 2023 in CNKI Database were used as research samples to systematically analyze the development trend,research themes,hot issues and cutting-edge research of the health industry.Results:The number of papers published from 1994 to 2023 showed a steady growth trend on the whole.The author-institution partnership was relatively independent and loose,and there was no obvious network of collaboration.Meanwhile,the research hotspots in this field at the current stage mainly focused on the integrated development of"health industry+",health care industry,smart elderly care,health service industry chain,elderly care service system,and the background of healthy China.Conclusion:With the change of residents'cognition and demand for health,the focus of research has begun to transform from the traditional medical treatment model to the new business model of health industry of"managing health,preventing diseases,and focusing on residents'health".Based on the in-depth analysis of the existing research sample literature of the health industry,in order to effectively promote the high-quality and sustainable development of the health industry,the research field should focus on the business model of the health industry in the era of digital economy in the future,formulation and management of industry standards for the health industry,and empirical research at the micro level in the field of health industry research.
10.Effectiveness of bone plate reduction combined with resorbable plate fixation in the treatment of large mandibu-lar cysts
Yifan HU ; Qingyan SUN ; Chenyi WANG ; Xiaoting ZHAI ; Hua JIANG ; Huawei LIU
West China Journal of Stomatology 2024;42(4):470-475
Objective This study aims to observe the clinical effect of bone plate reduction in combination with a re-sorbable plate on large mandibular cysts.Methods Between October 2017 and September 2022,patients with large mandibular cysts in the presence of labial and buccal cortical bone were involved in the study.Intraoral approach was performed for bone plate reduction.Cone beam computed tomography(CBCT)scan was reviewed at 3,6,and 9 months postoperatively to observe postoperative complications.Osteogenic results were assessed at these times to determine the clinical outcomes of this procedure.Results Eleven cases with large mandibular cysts in the presence of cortical bone were evaluated.The average thickness of the cortical bone on the labial and buccal sides was measured to be about(1.98±0.37)mm before surgery,with a mean value of(0.73±0.17)mm at the thinnest part of the plate and up to 0.51 mm at the thinnest part of the plate.The cystic cavities were well re-vealed during the surgeries,which were completed suc-cessfully.Postoperatively,the wounds healed in one stage without infection.The percentages of cyst shrinkage were 20.01%,41.76%,and 73.41%at 3,6,and 9 months after surgery,respectively.Quantitative measurement of bone mineral density in the jaws by CBCT with MIMICS software.The bone mineral densities of the adult bone were 313.78,555.85,and 657.45 HU at the 3,6,and 9 month time intervals,respectively.No significant change in the patient's maxillofacial appearance were observed from the preoperative period as assessed by the patient's and observer's visual analog scale.Conclusion Bone plate reduction is an effective treatment for large mandibular cysts of the oral and maxillofacial re-gion with the presence of cortical bone.

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