1.Three-dimensional examination of the momentum space construction of red doctor's culture in the new era
Chinese Medical Ethics 2024;37(6):641-645
Red doctor's culture shouldering the important mission of inheriting the red gene and the promotion of medical and health culture.As a multi-dimensional concept of cross-discipline and cross-domain,the cultural momentum space is a mechanical space for the dynamic development of culture.In the context of new era culture and new mission,taking red doctor's culture as a mechanical space field,the paper analyzed the essential connotation of"why red doctor's culture is new in the new era".From the three vectors of diachrony,synchrony,and immediacy,this paper argued for the value implications of"why red doctor's culture needs to be new in the new era".The methodology of"how to promote the new of red doctor's culture in the new era"was formed based on the integration and coherence of excellent medical and health cultures from ancient and modern times,both at home and abroad,combined with the actual laws and necessary rhythms of red medicine culture to push forward,used the internal and external driving forces to help the effective renewal of the space energy of the red doctor's culture in the new era.
2.Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal: A nationwide, multicenter study
Changyang XING ; Xiujing XIE ; Yu WU ; Lei XU ; Xiangping GUAN ; Fan LI ; Xiaojun ZHAN ; Hengli YANG ; Jinsong LI ; Qi ZHOU ; Yuming MU ; Qing ZHOU ; Yunchuan DING ; Yingli WANG ; Xiangzhu WANG ; Yu ZHENG ; Xiaofeng SUN ; Hua LI ; Chaoxue ZHANG ; Cheng ZHAO ; Shaodong QIU ; Guozhen YAN ; Hong YANG ; Yinjuan MAO ; Weiwei ZHAN ; Chunyan MA ; Ying GU ; Wu CHEN ; Mingxing XIE ; Tianan JIANG ; Lijun YUAN
Chinese Medical Journal 2024;137(15):1802-1810
Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.
3.Prognostic nutritional index application value for acute-on-chronic liver failure co-infection
Yamin WANG ; Yushan LIU ; Juan LI ; Qiao ZHANG ; Taotao YAN ; Danfeng REN ; Li ZHU ; Guoyu ZHANG ; Yuan YANG ; Jinfeng LIU ; Tianyan CHEN ; Yingren ZHAO ; Yingli HE
Chinese Journal of Hepatology 2024;32(3):235-241
Objective:To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF).Methods:220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ2 test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results:There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group ( P ?0.05). Among the 220 ACLF cases, 158 (71.82%) were infected with the hepatitis B virus (HBV). The incidence rate of infection during hospitalization was 69.09% (152/220). The common sites of infection were intraabdominal (57.07%) and pulmonary infection (29.29%). Pearson correlation analysis showed that PNI and MELD-Na were negatively correlated ( r ?=?-0.150, P ?0.05). Multivariate logistic analysis results showed that low PNI score ( OR=0.916, 95% CI: 0.865~0.970), ascites ( OR=4.243, 95% CI: 2.237~8.047), and hepatorenal syndrome ( OR=4.082, 95% CI : 1.106~15.067) were risk factors for ACLF co-infection ( P ?0.05). The ROC results showed that the PNI curve area (0.648) was higher than the MELD-Na score curve area (0.610, P ?0.05). The effectiveness of predicting infection risk when PNI was combined with ascites and hepatorenal syndrome complications was raised. Patients with co-infections had a good predictive effect when PNI ≤ 40.625. The sensitivity and specificity were 84.2% and 41.2%, respectively. Conclusion:Low PNI score and ACLF co-infection have a close correlation. Therefore, PNI has a certain appraisal value for ACLF co-infection.
4.Value of peripheral blood lymphocyte count in evaluating the short-term prognosis of patients with acute-on-chronic liver failure
Xiaohua LIU ; Shujuan YANG ; Yushan LIU ; Juan LI ; Qiao ZHANG ; Yamin WANG ; Taotao YAN ; Yuan YANG ; Yingren ZHAO ; Yingli HE
Journal of Clinical Hepatology 2023;39(10):2383-2389
ObjectiveTo investigate the influencing factors for the prognosis of patients with acute-on-chronic liver failure (ACLF), and to establish a short-term prognostic model. MethodsA retrospective analysis was performed for the baseline clinical data of 247 patients with ACLF who were hospitalized in Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, from January 2011 to December 2016, and the patients were divided into survival group and death group. The two groups were compared to identify the influencing factors for prognosis; a prognostic model was established, and the receiver operating characteristic (ROC) curve was used to assess its predictive efficacy and determine the optimal cut-off value. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups; the Fisher’s exact test or the Pearson’s chi-square test was used for comparison of categorical data between groups. The univariate and multivariate logistic regression analyses were used to investigate the independent risk factors for 28- and 90-day prognosis, and the Kaplan-Meier method was used to plot the 28-day survival curves. ResultsA total of 220 patients with ACLF were included based on the inclusion and exclusion criteria; there were 148 patients in the 28-day survival group and 72 patients in the 28-day death group, with a 28-day transplantation-free survival rate of 67.27%; there were 115 patients in the 90-day survival group and 105 patients in the 90-day death group, with a 90-day transplantation-free survival rate of 52.27%. The logistic regression analysis showed that female sex (odds ratio [OR]=2.149, P=0.030), high Model for End-Stage Liver Disease (MELD) score (OR=1.120, P<0.001), and low lymphocyte count (OR=0.411, P=0.002) were independent risk factors for 28-day prognosis, and an LS-MELD model for 28-day prognosis was established as Logit (28-day prognosis)=-3.432+0.765×sex-0.890×lymphocyte count×10-9+0.113×MELD(1 for male sex and 2 for female sex). The ROC curve analysis showed that this model had an optimal cut-off value of 0.35, and then the patients were divided into low LS-MELD group (≤0.35) and high LS-MELD group (>0.35); the low LS-MELD group had a significantly higher 28-day survival rate than the high LS-MELD group (P<0.001). ConclusionPeripheral blood lymphocyte count combined with sex and MELD score has a certain value in predicting the short-term prognosis of ALCF patients.
5. Study on the improvement of Qingdaipowder Gel for external use on mice with specific dermatitis
Yurong HUANG ; Yan WANG ; Jie FAN ; Yingli WANG ; Ying JIA ; Hongqiang ZHANG ; Rongli YOU
Chinese Journal of Clinical Pharmacology and Therapeutics 2023;28(1):19-28
AIM: To study the effect of Qingdaipowder Gel (QDPG) on mice specific dermatitis (AD) model and the antibacterial effect of the ethanol extract of Qingdaipowder. METHODS: AD model of mice was established by repeated skin induction with 2,4-dinitrochlorobenzene (DNCB). Fifty-six mice were randomly divided into blank group, model group, Hydrocortisone Butyrate Cream group (Hyd, 1.5 mg/cm
6. Mechanism of compound kushen injection in the treatment of lung cancer based on serum metabolomics and network pharmacology
Rongli YOU ; Rongli YOU ; Lina HAI ; Yurong HUANG ; Yan WANG ; Rui MAO ; Yingli WANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2023;28(9):988-999
AIM: To explore the mechanism of action of alkaloid components of compound kushen Injection (CKI) in the treatment of lung cancer based on serum metabolomics, network pharmacology, and molecular docking techniques. METHODS: A lung cancer model was established in C57 mice by inoculation of Lewis mouse lung cancer tumor strain. Thirty male mice were randomly divided into normal group, model group and CKI group. The drug was administered by tail vein injection once daily for 17 consecutive days. Mouse serum was examined by ultrahigh performance liquid chromatography tandem mass spectrometry (LC-MS) metabolomics, and several multivariate statistical analyses including principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA), combined with databases such as the human metabolic database (HMDB) and related literature to identify and identify differential metabolites, the relevant metabolic pathways were searched for by the metaboanalyst online tool. Using network pharmacology, construct the“component-target-disease”network of CKI in the treatment of lung cancer. Molecular docking method was used to verify the interaction between potential active ingredients and core targets. Serum metabolomics was jointly analyzed with network pharmacology to construct a“metabolite-germinal-enzyme-gene” network. RESULTS: Through metabolomics technology, 16 differential metabolites associated with lung cancer were screened from serum, and CKI addback these differential metabolite levels compared with the model group. Metabolic pathways mainly involve retinol metabolism, tryptophan metabolism, glycerophospholipid metabolism and other metabolic pathways. Network pharmacology analysis indicated that CKI treatment of lung cancer mainly targets STAT3, MAPK3, and MAPK1, which are closely related to proteoglycans, cellular senescence, and HIF − 1 signaling pathways in cancer. CONCLUSION: This article explains the mechanism of CKI in treating lung cancer from the perspective of metabonomics and network pharmacology, and provides basis for further study of CKI.
7.Recent advance in role of nicotinamide mononucleotide in central nervous system diseases
Chunjia ZHANG ; Yan LI ; Yan YU ; Fan BAI ; Yingli JING ; Degang YANG ; Feng GAO ; Jianjun LI
Chinese Journal of Neuromedicine 2023;22(9):947-952
Nicotinamide mononucleotide (NMN) is an important precursor in conversing nicotinamide adenine dinucleotide (NAD +) in the body. By elevating NAD + level in the body, NMN enhances the hydrogen transfer function of NAD + in biological processes, promotes the synthesis of proteins and polysaccharides, improves substance transportation and regulatory efficiency, and enhances metabolic functions. Specifically, in central nervous system disease, NMN exerts neuroprotective effect through antioxidation, anti-inflammation, mitochondrial protection, and prevention of neuronal and axonal degeneration. This review focuses on the therapeutic role of NMN in common central nervous system diseases and their neuroprotective mechanisms, so as to further understand the role of NMN in central nervous system diseases, and provide references for predicting therapeutic targets and screening therapeutic drugs for central nervous system diseases.
8.Application of quantitative analysis of multi -components by single marker combined with fingerprint and chemical pattern recognition analysis in the quality evaluation of Xihuang pills
Kaili LIU ; Yanzhi LIU ; Shihui WANG ; Chunhong WEI ; Xiuwen WANG ; Yingli WANG ; Yan WANG
China Pharmacy 2022;33(18):2219-2223
OBJECTIVE To evaluate the qualit y of Xihuang pills ,and to screen the differential markers affecting its quality . METHODS Using muskone as internal reference ,the content of α-pinene and other 4 components were determined by quantitative analysis of multi -components by single marker (QAMS),and compared with the results of external standard method . The fingerprints of 13 batches of Xihuang pills were established by gas chromatography (GC)method. Cluster analysis (CA)and orthogonal partial least squares discriminant analysis (OPLS-DA) were performed by SPSS 25.0 software and SIMCA 14.1 software. The variable importance projection (VIP)value greater than 1 was used as the standard to screen differential markers affecting the quality of the samples . RESULTS The contents of α-pinene,octyl acetate and β-elemene measured by QAMS were 0- 0.628 4,0.378 0-2.679 4 and 0.320 9-0.815 4 mg/g,respectively. The contents of α-pinene,octyl acetate ,β-elemene and musk ketone measured by external standard method were 0.001 5-0.627 1,0.378 0-2.594 7,0.329 2-0.837 0 and 0.385 7-0.806 0 mg/g, respectively. The relative error of the content determination results of the two methods was less than 4%. There were 26 common peaks in 13 batches of Xihuang pills ,and 3 common peaks ,such as octyl acetate ,β-elemene and musk ketone ,were identified ; their similarities were 0.912-0.946. 13 batches of samples could be divided into two categories (S1-S2,S6-S10,S13 were clustered into one category and S 3-S5,S11-S12 were clustered into one category ). VIP values of peak 7,11,10,17 and 16 were all greater than 1. CONCLUSIONS The content of 4 components such as α-pinene in Xihuang pills combined with GC fingerprint and chemical pattern recognition analysis can be used to evaluate the quality of Xihuang pills . The components corresponding to 5 common peaks such as peak 7 may be differential markers affecting the quality of the samples .
9.The Practical Dilemma and Solutions of Embedding the Red Doctor’s Spirit into the Cultivation Field of Medical Students’ Humanistic Quality
Chinese Medical Ethics 2022;35(11):1279-1283
Embedding the red doctor’s spirit into the cultivation field of medical students’ humanistic quality is a win-win strategy for creating the excellent doctor 2.0 plan in the new era and inheriting the red genes. Based on the in-depth interpretation of the morphological logic of embedding the red doctor’s spirit into the field of cultivating medical students’ humanistic quality, from the three dimensions of beginning, presence and development, this paper clearly captured many barriers, conflicts and contradictions faced in the process of the red doctor’s spirit embedded in the cultivation field of medical students’ humanistic quality. It is also necessary to break through the practical dilemma by creating the entry card and carrier of the red doctor’s spirit, stabilizing the field of educating people with the red doctor’s spirit, and expanding the development space of educating people with the red doctor’s spirit, so as to win and unite medical students and promote the implementation of the Healthy China strategy.
10.Realistic Examination and Path Optimization of Medical Students’ Professional Spirit Cultivation under the Background of Epidemic Prevention and Control
Yaoyao QI ; Li’e SANG ; Yingli YAN
Chinese Medical Ethics 2022;35(10):1131-1136
The unexpected COVID-19 brings a great challenge to the cultivation of medical students’ professional spirit. However, the traditional cultivation mode of professional spirit is single, which could not meet the urgent needs for cultivating high-quality medical talents. Therefore, under the background of epidemic prevention and control, the optimization of the cultivation path of medical students’ professional spirit should be carried out in the medical colleges and universities to adapt the development requirements of the era. Firstly, taking reshaping the top-level design of the school as the starting point, providing institutional guarantee, improving the curriculum and optimizing the teaching staff. Secondly, focusing on improving teaching process, optimizing teaching design, innovating teaching forms and establishing model education. Lastly, taking realize the unity of knowledge, emotion and intention of medical students as the foothold, strengthening the study of theoretical knowledge, participating in the construction of campus culture and social practice activities. The trinity cultivation model of "school-teachers-students" will be constructed to collaboratively promote the benign development of medical students’ professional spirit cultivation.

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