1.Prognostic Value of MELD 3.0 Based Model for Survival Outcomes in Alcoholic Cirrhosis Patients
Zhenwei ZHONG ; Kodjo Kunale ABASSA ; Rong CHEN ; Yunwei GUO ; Bin WU
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(2):318-327
ObjectiveTo explore the value of the Model for End-Stage Liver Disease (MELD) 3.0 in predicting survival outcomes for patients with alcoholic cirrhosis and to establish an effective mortality prediction model. MethodsClinical data of 788 hospitalized patients who were first diagnosed with alcoholic cirrhosis at the Third Affiliated Hospital of Sun Yat-sen University between January 1, 2011 and December 31, 2019 were analyzed. Patients were followed up until December 31, 2023 and divided into survival and mortality groups based on the survival outcomes at 30 days, 90 days, 1 year, and 3 years after admission. The prognostic values of the MELD 3.0, MELD, MELD-Sodium (MELD-Na) for survival in alcoholic cirrhosis patients were assessed and compared by using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Additional risk factors associated with mortality in alcoholic cirrhosis patients were identified, and a novel mortality prediction model based on MELD 3.0 was developed. ResultsThe AUC of the MELD 3.0 score in predicting 30-day, 90-day, 1-year, and 3-year survival was 0.823, 0.730, 0.686, and 0.658, respectively, which were superior to those of the MELD-Na (0.802, 0.708, 0.666, and 0.645, respectively) and MELD scores (0.698, 0.668, 0.654, and 0.633, respectively) (all P < 0.05). MELD 3.0 demonstrated better performance at 30 and 90 days (AVC=0.823,0.730; both P < 0.05) than at 1 year and 3 years (AVC=0.686,0.658; both P < 0.05). Binary logistic regression combined with LASSO regression indicated that the independent risk factors associated with the 1-year outcome included MELD 3.0, baseline ascites and hepatocellular carcinoma. A survival prediction model was then established with AUC of 0.748, sensitivity of 0.695, and specificity of 0.775. ConclusionsMELD 3.0 has a superior predictive ability for 30-day, 90-day, 1-year, and 3-year survival in patients with alcoholic cirrhosis than MELD-Na and MELD. The prediction model incorporating MELD 3.0, ascites and hepatocellular carcinoma improves the prediction of 1-year survival outcomes for alcoholic cirrhosis patients.
2.Catalysis-based specific detection and inhibition of tyrosinase and their application
Yunwei QU ; Qing ZHAN ; Shubo DU ; Yang DING ; Bin FANG ; Wei DU ; Qiong WU ; Haidong YU ; Lin LI ; Wei HUANG
Journal of Pharmaceutical Analysis 2020;10(5):414-425
Tyrosinase is an important enzyme in controlling the formation of melanin in melanosome, and plays a key role in the pigmentation of hair and skin. The abnormal expression or activation of tyrosinase is associated with several diseases such as albinism, vitiligo, melanoma and Parkinson disease. Excessive deposition of melanin could cause diseases such as freckles and brown spots in the human body, and it is also closely related to browning of fruits and vegetables and insect molting. Detecting and inhibiting the activity of tyrosinase is of extraordinary value in the progress of diagnosis and treatment of these dis-eases. Therefore, many selective optical detection probes and small molecular inhibitors have been developed, and have made significant contributions to the basic and clinical research on these diseases. In this paper, the detection and inhibition of tyrosinase and their application in whitening products are reviewed, with special emphasis on development of fluorescent probes and inhibitors. Hopefully, this review will help design more efficient and sensitive tyrosinase probes and inhibitors, as well as shed light on novel treatment of diseases such as melanoma.
3.Analysis of malaria epidemic situation before and after malaria elimination in Qiandongnan Prefecture of Guizhou
Deliang TANG ; Tao LUO ; Maoming DENG ; Jing DI ; Yu GUO ; Xinghua HOU ; Bin YANG ; Dehui SHI ; Zhangping YANG ; Yunwei LIU ; Yuanfang QI ; Qiong LI ; Xiaoyan PAN ; Guoyan WU
Chinese Journal of Endemiology 2020;39(5):362-366
Objective:To analyze the characteristics of malaria epidemic situation before and after malaria elimination in Qiandongnan Prefecture, and to provide the basis for establishment of effective strategies and measures to consolidate the achievements of malaria prevention and control.Methods:The data of malaria cases in 16 counties (cities) of Qiandongnan Prefecture from 2005 to 2018 were collected, and descriptive epidemiological method was used to analyze the infection rate of Plasmodium among local residents and floating population before (2005-2011) and after (2012-2018) elimination of malaria, and the characteristics of population distribution, seasonal distribution, species of Plasmodium and types of malaria vectors were analyzed. Results:Before elimination of malaria, total of 1 412 cases of malaria were reported, among those cases, 1 361 cases were local cases, accounting for 96.39% of the total cases. After elimination of malaria, total of 17 cases were reported, all of them were imported cases. After comparison of malaria cases before and after the elimination, the proportion of people aged from 18 to 60 was 70.54% (996/1 412) before the elimination, all 17 imported cases were 18-60 years old after the elimination, and the proportion of children/students decreased from 24.65% (348/1 412) before the elimination to 0 after the elimination. The peak incidence of malaria cases before the elimination was from June to October, and cases occurred every month. After the elimination, the imported cases were sporadic. Plasmodium vivax was the main species of Plasmodium before the elimination (98.58%, 1 392/1 412), and Plasmodium falciparum was mainly imported after the elimination (70.59%, 12/17). Before and after the elimination, Anopheles sinensis, the malaria vector, was the dominant population, but no distribution of Anopheles minimus and Anopheles anthropophagus was found after 2015. Conclusions:After the elimination of malaria in Qiandongnan Prefecture, there is a risk of local malaria cases caused by imported cases. It is suggested that local authorities should focus on the treatment of suspected malaria cases and vector surveillance of overseas returnees in the future.
4.Analysis and suggestions of current planning frameworks and the status of research on genetic technologies in China.
Chenjun DING ; Xiaoyan WU ; Yunwei CHEN ; Fang CHEN ; Zhiqiang ZHANG ; Cheng TAO ; Yi SHEN ; Ming YANG
Chinese Journal of Biotechnology 2020;36(1):44-56
This article briefly introduces the strategic framework of genetic technology of Chinese government and Chinese Academy of Sciences, and the remarkable progress of genetic technology under this guidance. Using bibliometric and patent analysis methods, we reveal the current status of genetic technology research and development in China. China has made great achievements, both in terms of quantity and quality of academic publications, and quantity of patent applications. However, there are still something need to be improved, such as international cooperation and combination the efforts of enterprises, universities and research institutes. In the future, China will improve top-level planning and government guidance and supervision. In addition, it is also crucial to encourage investment from enterprise and communities, and to broadcast the science and technology to the whole society. Moreover, actions have to be taken to reduce the risks of bio-safety and bio-security. The innovation and breakthrough of genetic technology is a key to sustainable development in the bio-industry and bio-economy in China.
5.NF- B/HDAC1/SREBP1c pathway mediates the inflammation signal in progression of hepatic steatosis.
Yunwei GUO ; Xiaoying ZHANG ; Zhiyun ZHAO ; Hongyun LU ; Bilun KE ; Xin YE ; Bin WU ; Jianping YE
Acta Pharmaceutica Sinica B 2020;10(5):825-836
The transcription factor nuclear factor kappa B (NF-B) is activated in hepatocytes in the pathogenesis of hepatic steatosis. However, the action mechanism of NF-B remains to be established in the hepatic steatosis. In this study, the subunit of NF-B was found to promote the hepatic steatosis through regulation of histone deacetylase 1 (HDAC1) in hepatocytes. The activity was supported by the phenotypes of knockout (-KO) mice and knockout (-KO) mice. Hepatic steatosis was reduced in the -KO mice, but not in the -KO mice. The reduction was a result of inhibition of HDAC1 activity in the -KO cells. Knockdown of gene led to suppression of hepatocyte steatosis in HepG2 cells. A decrease in sterol-regulatory element binding protein 1c (SREBP1c) protein was observed in the liver of -KO mice and in cell with knockdown. The decrease was associated with an increase in succinylation of SREBP1c protein. The study suggests that stabilizes HDAC1 to support the SREBP1c activity in hepatic steatosis in the pathophysiological condition. Interruption of this novel pathway in the -KO, but not the -KO mice, may account for the difference in hepatic phenotypes in the two lines of transgenic mice.
6.Re‐evaluation of the structure , function and prognosis of bicuspid aortic valve with different anatomic morphology
Yunwei ZHANG ; Yan WU ; Fei WANG ; Yameng ZHENG ; Zhichao SUN ; Shuang WANG ; Shuang CHEN ; Jiawei TIAN ; Guoqing DU
Chinese Journal of Ultrasonography 2019;28(3):200-204
Objective To investigate the association between bicuspid aortic valve ( BAV ) morphologic findings ( raphe vs nonraphe) ,the degree of valve dysfunction and prognosis . Methods Clinical and echocardiographic data in 317 BAV patients were analyzed retrospectively . According to the Sievers classification ,the morphologic BAV findings were categorized into no raphe ( type 0) ,one raphe ( type 1) and two raphes ( type 2 ) . T he patients with type 1 were further divided into three subtypes ,including R‐L subtype ( fusion of the left and right coronary cusps ) ,R‐N subtype ( fusion of the right and noncoronary cusps) and L‐N subtype ( fusion of the left and noncoronary cusps ) . Results Of the 317 patients ,there were 83 ( 26 .2% ) of type 0 ,232 ( 73 .2% ) of type 1 and 2 ( 0 .6% ) of type 2 .Among the 232 patients of type 1 ,there were 126 ( 54 .3% ) of R‐L subtype ,88 ( 37 .9% ) of R‐N subtype and 18 ( 7 .8% ) of L‐N subtype . BAV with raphe had a significantly higher prevalence of aortic valve calcification [ 120 ( 51 .3% ) vs 19 ( 22 .9% ) , P < 0 .001 ] ,with significantly higher frequencies of aortic stenosis [ 164 ( 70 .1% ) vs 6 ( 7 .2% ) , P< 0 .001 ] ,aortic regurgitation [ 168 ( 71 .8% ) vs 40 ( 48 .2% ) , P = 0 .001 ] ,increased left ventricular mass[ ( 253 .4 ± 113 .7) g vs ( 176 .4 ± 69 .3) g , P <0 .001] and left heart failure [ 34 ( 14 .5% ) vs 3 ( 3 .6% ) , P =0 .009] . Furthermore ,the dilation of aortic root and ascending aorta in BAV patients with raphe were significantly higher than those without raphe ( P <0 .01 ) ,however ,ascending aortic aneurysm rates were not significant between BAV with and without raphe[ 23( 9 .8% ) vs 4( 4 .8% ) , P =0 .251] . T he patients in R‐N subtype had a significantly higher proportion of aortic valve calcification than those in R‐L and L‐N subtype [ 55 ( 62 .5% ) vs 57 ( 45 .2% ) vs 6 ( 33 .3% ) , P = 0 .01 ] ,with a significantly higher frequency of severe aortic stenosis [ 50 ( 56 .8% ) vs 21 ( 16 .7% ) vs 3 ( 16 .7% ) , P <0 .001 ] . However , there was no significant difference among different subtypes in other complications( P >0 .05).Conclusions T he presence of raphe is associated with a higher frequency of significant aortic valve calcification ,aortic valve dysfunction ,and increases left ventricular mass and left heart failure .T he R‐N type is also associated with aortic valve calcification and severe aortic stenosis .
7.Automatic evaluation of left ventricular systolic function in rats with myocardial infarction by myocardial contrast echocardiography based on neutrosophic similarity score algorithm
Yameng ZHENG ; Fei WANG ; Yunwei ZHANG ; Zhichao SUN ; Shuang WANG ; Yan WU ; Yanhui GUO ; Jiawei TIAN ; Guoqing DU
Chinese Journal of Ultrasonography 2018;27(5):434-440
Objective To evaluate the accuracy and value of automatically assessing left ventricular systolic function in rats with myocardial infarction ( MI) by myocardial contrast echocardiography ( MCE) based on neutrosophic similarity score( NSS) algorithm. Methods According to different infarction size (IS),SD rats were divided into large MI (MI-L,IS≥15% ) and small MI (MI-S,IS<15% ) groups. MCE was performed before MI and at 7,28 days after MI. In vitro study:the automatic segmentation of the endocardial contour based on neutrosophic similarity score algorithm was compared with the manual segmentation boundary. In vivo study:the left ventricular ejection fraction( LVEF) were calculated using the NSS system,biplane Simpson and PV-loop,respectively,and then NSS-LVEF,Simpson-LVEF and PV-LVEF were acquired,respectively. The IS was calculated by Masson and HE staining. The consistency between the two LVEFs was evaluated by Bland-Altman. The intraclass correlation coefficient ( ICC) was calculated to evaluate the reproducibility of MCE analysis system. Results ① The endocardial contour obtained by automatic segmentation had good agreement with the boundary of artificial tracing. ② There was no significant difference among the three LVEFs in same group ( F =0.028, P = 0.973),but there was significant difference in different group ( F =78.61, P <0.01). NSS-LVEF was well consistent with both Simpson-LVEF and PV-LVEF. ③ The ICC of NSS algorithm for inter-observer and intra-observer were 0.96 and 0.98,respectively. ④Compared with before MI and at 7 days after MI,the LVEF in MI-L and MI-S groups at 28 days after MI decreased significantly ( P <0.05),especially in MI-L group ( P <0.01). There was significantly negative correlation between LVEF and IS ( r = -0.917, P < 0.01). Conclusions Left ventricular endocardium can be identificated automatically and LVEF can be calculated rapidly and accurately by MCE based on neutrosophic similarity score algorithm in rats with myocardial infarction.
8.Application value of ERCP in biliary stricture following liver transplantation
Zhie WU ; Huaying GU ; Yisui WANG ; Fengping ZHENG ; Yunwei GUO ; Ying LIN
Chinese Journal of Hepatic Surgery(Electronic Edition) 2015;(3):173-175
ObjectiveTo investigate the application value of endoscopic retrograde cholangiopancreatography (ERCP) in biliary stricture following liver transplantation (LT).MethodsClinical data of 47 patients with biliary stricture following LT treated with ERCP in the Third Affiliated Hospital of Sun Yat-sen University between January 2008 and January 2014 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 47 patients, 41 were males and 6 were females with the age ranging from 24 to 62 years old and the median of 51 years old. Anastomotic stricture was observed in 31 cases and non-anastomotic stricture in 16 cases. ERCP was performed on patients to localize biliary stricture and then papillotomy was performed under the support of guide wire. The stricture was dilated progressively by dilating catheter or columnar balloon through the guide wire. Endoscopic nasobiliary drainage or plastic stent placement was chosen according to the ERCP results. The evaluation of curative effect was graded by cure, improvement, inefifcacy and restenosis.ResultsAll the 47 patients underwent ERCP successfully with totally 112 times. Nasobiliary drainage was performed 79 person-times, stent placement 33 person-times. Among the 31 patients with anastomtic stricture, 28 were cured and 3 were improved. Among the 16 patients with non-anastomtic stricture, 5 were cured, 3 were improved, and 8 were ineffective. The total cured rate of all the patients was 70% (33/47) and the effective rate was 83% (39/47). The incidence of complications was 9% (4/47), including 2 cases of mild pancreatitis, 1 case of hyperamylasemia and 1 case of biliary tract infection.ConclusionERCP is safe, effective and integrated in diagnosis and treatment for biliary stricture following LT, which is the ifrst choice for non-surgery treatment.
9.Lacrimal sac diverticulum presenting as a lower eyelid mass with a secreting fistula.
Chengyue ZHANG ; Qian WU ; Jifeng YU ; Yanhui CUI ; Wenhong CAO ; Yunwei FAN ; Gang YU
Chinese Medical Journal 2014;127(18):3359-3360
10.Clinical characteristics of infantile malignant osteopetrosis with eye disease
Wenhong, CAO ; Qian, WU ; Gang, YU ; Yanhui, CUI ; Yunwei, FAN ; Chengyue, ZHANG ; Jie, CUI
Chinese Journal of Experimental Ophthalmology 2014;32(8):734-738
Background Malignant osteopetrosis is an extremely rare dense bone disease,and sometimes features ocular disease and cranial nerve palsy.This disease received high attention because of its poor prognosis.And whether the eye manifestation improved after treatment is a problem for concern.Objective This study was to clarify the clinical manifestation,treatment and prognosis of malignant osteopetrosis associated with ocular disease.Methods A retrospective study was adopted.Two children with malignant osteopetrosis associated with eye symptoms were collected from Beijing Children Hospital.The systemic and ocular medical examinations were performed on the patients,including physical examination,hematology laboratory examination,abdominal B ultrasound and bone X ray radiography,external ocular examination,flash visual evoked potential (F-VEP) and CT of orbit.Bone marrow hematopoietic stem cell transplantation was employed and 5-year following-up was cinducted on the chidren.Results The children showed increased bone density,systemic bone sclerosis,basilar thickening,abnormalities of hematology indexes,anemia,hepatosplenomegaly,optical canal stenosis and abnormality of F-VEP P2 wave.In addition,optical disc pale,facial paralysis and paralytic esotropia were seen in a female child and alternating strabismus was found in another boy.After successful treatment,the systemic symptoms remitted in both children,but the eye findings remained unchanged in the female child during the follow-up duration.However,the strabismus diminished in the male child.The optical bone canal widening to 1.9 mm 1 year and 3.2 mm 5 years after treatment in the female child.Conclusions Strabismus and eye disease are the signs of malignant infantile osteopetrosis and reflections of the impairment of the central nervous system.The pathogenetic mechanism of malignant osteopetrosisrelated eye disease is below understanding now.Early bone marrow hematopoietic stem cell transplantation for malignant osteopetrosis can offer the best chance of long-term survival and improve the prognosis of eye diseases.

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