1.Hereditary pheochromocytoma/paraganglioma and associated syndromes:a clinical and genetic study
Peng TANG ; Weihua LAN ; Yao ZHANG ; Jun ZHANG ; Zehua SHU ; Ke LI ; Zaoming HUANG ; Yiqiang HUANG ; Qiuli LIU ; Jun JIANG
Journal of Army Medical University 2024;46(4):377-383
Objective To summarize and analyze the clinical phenotypes,hereditary features and treatment and follow-up strategies of different hereditary pheochromocytoma/paragangliomas(PCC/PGL)and related syndromes.Methods Forty-four clinically diagnosed PCC/PGL patients admitted in our hospital from January 2000 to August 2022 were enrolled,and the clinical data of them and their family members were collected.Second-generation sequencing was performed on 43 patients for genetic detection,and Sanger sequencing was applied to verify the mutation of the probands and family members.Results There were 15 patients diagnosed with hereditary PCC/PGL,including 7 cases of von Hippel-Lindau(VHL)syndrome,3 cases of multiple endocrine neoplasia type 2(MEN2),and 5 cases of familial paraganglioma syndrome.Seven VHL syndrome families were diagnosed as VHL2A(c.500G>A),VHL2B(c.239G>T and c.444_457del),and VHL2C(c.293A>G)according to their clinical manifestations.All probands received surgical treatment,and 2 cases of recurrent PCC and the patients with multiple renal cancer also received targeted therapy with sunitinib.Three MEN2 families carried c.1901G>C,c.1832G>A,and c.1901G>A missense mutations,respectively,and were diagnosed with MEN2A clinically.All of them underwent adrenalectomy and thyroidectomy,including one for preventive thyroidectomy.Among the 5 familial paraganglioma syndrome families,4 patients carried SDHB mutations(SDHB:c.343C>T,c.541-2A>G,c.575G>A,c.268C>T)and 1 patient carried an SDHD mutation(SDHD:c.337_340del).Sporadic retroperitoneal PGL were most common.Conclusion More than 1/3 of PCC/PGL patients carry germline gene mutations,showing obvious genotype-phenotype correlation.Genetic diagnosis technology plays an important guidance role for clinical precision treatment and follow-up,and genetic counseling.
2.Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair (version 2023)
Junchao XING ; Long BI ; Li CHEN ; Shiwu DONG ; Liangbin GAO ; Tianyong HOU ; Zhiyong HOU ; Wei HUANG ; Huiyong JIN ; Yan LI ; Zhonghai LI ; Peng LIU ; Ximing LIU ; Fei LUO ; Feng MA ; Jie SHEN ; Jinlin SONG ; Peifu TANG ; Xinbao WU ; Baoshan XU ; Jianzhong XU ; Yongqing XU ; Bin YAN ; Peng YANG ; Qing YE ; Guoyong YIN ; Tengbo YU ; Jiancheng ZENG ; Changqing ZHANG ; Yingze ZHANG ; Zehua ZHANG ; Feng ZHAO ; Yue ZHOU ; Yun ZHU ; Jun ZOU
Chinese Journal of Trauma 2023;39(1):10-22
Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.
3.A scoping review of application of continuing nursing network platform for discharged premature infants and their caregivers in NICU
Meixian YAO ; Guili WU ; Xiaoxia LU ; Zehua PENG ; Wei CHEN
Chinese Journal of Modern Nursing 2023;29(1):122-127
Objective:To summarize the scope of research on the application of the continuous nursing network platform for premature infants and caregivers discharged from the Neonatal Intensive Care Unit (NICU) , so as to provide reference for future research and practice.Methods:The method of subject words, keywords and Boolean logic was used to retrieve research on the application of NICU's continuous nursing network platform for discharged premature infants and their caregivers in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) , WanFang Data, VIP and China Biomedical Literature Database. The retrieval time limit was from the establishment of the database to February 14, 2022.Results:A total of 23 articles were included. The content elements of continuous nursing based on network platform included the professional knowledge and nursing skills guidance, peer support, contact with professionals, information and decision-making support, and psychological support. Application forms included mobile applications, website platforms and online videos. The types of outcome indicators were mainly the effect incaregivers and premature infants, the quality of parent-child interaction, breastfeeding and feasibility evaluation. Nursing had positive effect and feasibility.Conclusions:Continuous nursing based on the network platform has achieved positive effects on NICU discharged premature infants and caregivers, and the combination of multiple elements, personalized customization, and multidisciplinary participation are in line with the needs of caregivers. Future research needs to focus on promoting the family function of premature infants, further develop the content of continuous nursing suitable for each child's development stage, explore a safer network service supervision mode and conduct cost-benefit evaluation.
4.Analysis on current status and trends of research on standardized nursing terminology in China based on CiteSpace
Zehua CAI ; Gangyi PENG ; Lianhua CHEN ; Huanzhen OU ; Tiantian ZHANG ; Qian ZHANG
Chinese Journal of Modern Nursing 2023;29(2):191-197
Objective:To sort out the current status and development of standardized nursing terminology in China, and reveal research hotspots and trends.Methods:The bibliometric and keyword cluster analysis and burstiness detection were performed using CiteSpace software on periodicals of standardized nursing terminology in China National Knowledge Infrastructure, WanFang Database and VIP Database from their establishment to December 31, 2021.Results:A total of 1 761 articles were included. The development process of standardized nursing terminology includes three stages: sprouting period, stagnant period and rapid growth period. Researches were clinically-oriented. Researches focus on clinical application. The main reference tools of the studies include Omaha system, North America Nursing Diagnosis Association-International (NANDA-I) , Nursing Outcome Classification (NOC) and Nursing Intervention Classification (NIC) . Research settings mostly involve the elderly population and specialties such as stroke, diabetes and chronic obstructive pulmonary disease. Research topics focus on transitional care, case management, home visiting and nursing educationbased on nursing process. The Delphi method is commonly used for quality evaluation.Conclusions:Standardized nursing terminology is paid more attention and the overall trend is positive, but the local construction of nursing terminology needs to be developed. It is suggested that future research aim at actual demand of domestic clinical applications, nursing informatics talents be developed and cultivated, and research consensus be gathered in order to promote the construction of a standardized nursing terminology system with Chinese characteristics.
5.Electrochemical detection of methyl-paraoxon based on bifunctional cerium oxide nanozyme with catalytic activity and signal amplification effect
Sun YUZHOU ; Wei JINCHAO ; Zou JIAN ; Cheng ZEHUA ; Huang ZHONGMING ; Gu LIQIANG ; Zhong ZHANGFENG ; Li SHENGLIANG ; Wang YITAO ; Li PENG
Journal of Pharmaceutical Analysis 2021;11(5):653-660
A new electrochemical sensor for organophosphate pesticide(methyl-paraoxon)detection based on bifunctional cerium oxide(CeO2)nanozyme is here reported for the first time.Methyl-paraoxon was degraded into p-nitrophenol by using CeO2 with phosphatase mimicking activity.The CeO2 nanozyme-modified electrode was then synthesized to detect p-nitrophenol.Cyclic voltammetry was applied to investigate the electrochemical behavior of the modified electrode,which indicates that the signal enhancement effect may attribute to the coating of CeO2 nanozyme.The current research also studied and discussed the main parameters affecting the analytical signal,including accumulation potential,accumulation time,and pH.Under the optimum conditions,the present method provided a wider linear range from 0.1 to 100 μmol/L for methyl-paraoxon with a detection limit of 0.06 μmol/L.To validate the proof of concept,the electrochemical sensor was then successfully applied for the determination of methyl-paraoxon in three herb samples,i.e.,Coix lacryma-jobi,Adenophora stricta and Semen nelum-binis.Our findings may provide new insights into the application of bifunctional nanozyme in electro-chemical detection of organophosphorus pesticide.
6.Rapid detection of drug resistance in mycobacterium tuberculosis using Tag Array chip
Wenjie WU ; Peng CHENG ; Zehua ZHANG ; Fei LUO ; Jianzhong XU
Chinese Journal of Orthopaedics 2018;38(2):110-119
Objective To evaluate the sensitivity and specificity of Tag Array in detecting the clinical isolates of bone and joint tuberculosis.Methods Twenty-four strains of Mycobacterium tuberculosis having sequence differences in extracted plasmids of mutant strains.The plasmid was diluted into different concentrations,and then multiplex PCR amplification was performed to analyze the sensitivity and specificity of the chip system.A total of 187 clinical isolates were collected from patients with bone and joint tuberculosis.Among them,there were 50 strains of sensitive bacteria,and 137 strains of drug-resistant.Designed,optimized and prepared chip inspection system,sequencing and phenotypic drug susceptibility results were analyzed to evaluate the sensitivity and specificity of the gene chip.Results The mutants in accordance with sequencing result in the sets with 1 × 103copy/μl of template concentration and above;while 29 sets showed false negative result in the sets with 1 × 102 copy/μl.Among the 126 rifampicin phenotype drug resistance strains,119 strains appeared mutation in rpoB gene.In the rifampicin phenotype sensitivity strains,9 strains of rpoB gene showed mutation,the sensitivity was 94.40%,and specificity was 86.76%.Among the 118 isoniazid phenotype drug resistance strains,109 strains appeared mutation in relevant drug resistance gene locus,the sensitivity was 92.37%,and specificity was 81.16%.Among the 44 ethambutol phenotype drug resistance strains,27 strains appeared mutation in locus embB306,in the ethambutol phenotype sensitivity strains,the mutation in locus embB306 was detected in 6 strains,the sensitivity was 61.36%,and specificity was 95.80%.Among the 102 levofloxacin phenotype drug resistance strains,81 strains appeared mutation in gyrA gene,4 of the sensitivity strains were detected mutation in gyrA gene,the sensitivity was 79.41%,and specificity was 95.29%.Among the 112 streptomycin phenotype drug resistance strains,the chip detected 101 strains appeared mutation,the sensitivity of chip detection was 90.17%,and specificity was 84.00%.Since amikacin,capreomycin and kanamycin are in cross drug resistance,among the 67 phenotype drug resistance strains,52 strains appeared mutation in relevant drug resistance gene locus,its sensitivity was 79.10% and specificity was 90.83%.Conclusion Tag Array chip can achieve rapid,accurate and high-throughput detection of tuberculosis resistance,which has important clinical significance and feasibility.
7.Expressions of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells and its correlation with drug resistance by targeting MDR1/P-glycoprotein
Zhimin LI ; Xiping LUO ; Liqin ZENG ; Xiuhong PENG ; Yi WANG ; Zehua WANG
China Oncology 2015;(3):190-198
Background and purpose: Resistance of cancer cells to chemotherapy is a major clinical obstacle to successful treatment and leads to poor prognosis for the patients. MicroRNA (miRNA) plays a vital role in tumor cells response to chemotherapeutic agents. This study plans to investigate the expressions of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells and its correlation with drug resistance. Methods:A2780/Taxol cells were established using stepwise selection;Stem-loop quantitative real-time PCR (stem-loop RT-PCR) was used to detect expression of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells. The A2780 and A2780/Taxol cells were transfected with the mimics or inhibitors of miRNA27a or negative control (NC) RNA and the mimics of miRNA451 or NC were transfected into MCF-7/ADM cells by LipofectamineTM 2000. The expression levels of MDR1 mRNA and P-glycoprotein (P-gp) were examined using RT-PCR and Western blot respectively. MTT method was used to analyze drug sensitivity. Results:The expression of miRNA27a was an average of (2.2±0.30) times higher in A2780/Taxol cells than in A2780 cells, with a significant difference between the two groups (P<0.05). The expression of miRNA451 was lower by 84%in MCF-7/ADM cells than in MCF-7 cells, with a signiifcant difference between the two groups (P<0.05). A2780/Taxol cells transfection with inhibitors of miRNA27a showed that the levels of MDR1 mRNA was decreased by (39±0.14)%, P-gp level [(26±5.3)%] decreased compared with the NC group [(43±6.7)%], the IC50 (0.53μmol/L) was less than the NC group (6.8μmol/L), and there was a signiifcant difference between two groups (P<0.05). Transfection of A2780 cells with mimics of miRNA27a led to increase MDR1 mRNA expression by (121±0.11)%and decrease the sensitivity to paclitaxel (IC50:0.2μmol/L vs 0.06μmol/L). There was a signiifcant difference between two groups (P<0.05). Transfection of MCF-7/ADM cells with mimics of miRNA451 showed that expression of MDR1 mRNA was decreased by (65±12)%, P-gp [(31±19)%] was less than the NC group [(83±12)%], the sensitivity of cells to adriamycin enhanced and the IC50 of adriamycin (4.61μmol/L) was less than the NC group (26μmol/L), and there was a signiifcant difference between two groups (P<0.05). Conclusion:The expressions of miRNA27a and miRNA451 are deregulated in A2780/Taxol and MCF-7/ADM cells respectively, which may play vital roles in drug resistance by regulating MDR1/P-gp expression directly or indirectly.
8.Investigation of soft contact lens related knowledge and wearing behaviors
Miao PENG ; Ying ZENG ; Hailian LI ; Zehua ZHANG
Modern Clinical Nursing 2013;(7):8-11
Objective To investigate the soft contact lens related knowledge and wearing behaviors.Method Two hundred outpatients in the ophthalmologic clinic wearing SCL involved in the survey by the questionnaire to investigate the SCL-related knowledge and the wearing behaviors.Results In the 200 SCL wearer,73.50% did not make any examinations by specialists and only 18.00% of them took regular examinations.The wearers were good at the knowledge of selecting SCL diopter and positive and negative lens.The wearers with a history of less than 6 months were better than those wearing SCL more than 6 months in respect of hand cleaning,lens check,lens wearing, and lens cleaning.The wears with the education of two-year vocational training were significantly better than those with the education of three-year or more collegiate training in respect of wearing duration,sleep with lens,hand cleaning and lens cleaning(all P<0.05).Conclusion Contact lens wearers know less about SCL related knowledge and their wearing behaviors needs improvement.
9.Imaging findings of coronary sinus with left atrium muscle connections on dual-source CT coronary angiography
Zehua PENG ; Weifang KONG ; Hong PU ; Lin BAI ; Jiayuan CHEN ; Jin JIANG ; Gang LI
Chinese Journal of Radiology 2012;46(10):890-895
ObjectiveTo investigate the morphologic features of coronary sinus (CS)-left atrium muscle connections,and evaluate the function and anatomical features of coronary sinus on dual-source CT coronary angiography (DSCTCA).MethodsImages of DSCTCA of 144 patients [ control group consisted of 96 patients,and atrial fibrillation (AF) group consisted of 48 patients] were reviewed.The existence of coronary sinus-right atrium muscle connections was indirectly evaluated by measuring the cross-sectional area changes of the CS during atrial systole and atrial diastolic.The number,location,length of the CS-left atrium muscle connections andthe relationship between CS-left atrium muscle connections and CS morphological characteristics were studied.The t test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results( 1 )The anatomic course of the CS in relation to the mitral ring was straight,mild curvature and high riding of 62,16 and 18 cases in control group and 10,8 and 30 cases in AF group,respectively.There was not statistical significance between the 2 group (x2 =0.093,P=0.954). (2)The CS length was (34.1 ±9.1),(33.8 ±8.9)mm in Control group and AF group,respectively.There was no statistical significance between the 2 group ( t =- 0.486,P =0.628 ).(3) Coronary sinus-left atrium muscle connections were seen in 131 of the 144 patients (91.0%).A single connection was seen in 103 of the 144 patients,with a mean length of (22.6 ± 12.7)mm within (6.3 ± 5.8 ) mm of the coronary sinus ostium.28 patients had two connections; distal connections measured ( 13.2 ± 6.2)mm in length within (16.7 ± 6.8 ) mm of the coronary sinus ostium,and proximal connections measured ( 11.1 ± 3.6 ) mm in length within (2.1 ± 1.9) mm of the coronary sinus ostium.And there was no statistical difference the number and length of CS-left atrium connections in between Control group and AF group (P > 0.05 ).(4)The CS narrowed 22.4% (44.5/198.8 )in cross-sectional area from atrial diastolic to atrial systole in control group( t =- 21.076,P < 0.01 ),while the CS had no obvious contraction in AF group(t =0.374,P > 0.05).The cross-sectional area of the coronary sinus during diastole was obviously larger in the AF group than in the control group[( 230.4 ±77.0) mm2 vs (198.8 ±65.4) mm2,respectively,t =- 2.579,P =0.01 ].In control group ( n =9 ),the coronary sinus-left atrium connection was not seen,however,all showed a CS constriction during atrial systole,indicating that coronary sinus-left atrium muscle continuity is not likely the primary cause for coronary sinus contractions. Conclusions DSCTCA can clearly show the anatomical characteristics of CS,it can help to understand the length,number and location of the CS-left atrium muscle connection.
10.Abdominal CT scan in predicting complications of acute pancreatitis
Zehua PENG ; Lin BAI ; Hong PU ; Longlin YIN ; Jiayuan CHEN ; Jin JIANG ; Ning AN
Chinese Journal of General Surgery 2012;27(10):789-793
Objective To evaluate abdominal CT scan in predicting complications and mortality of acute pancreatitis patients. Methods CT imaging data of 606 AP patients from June 2010 to October 2011 were analyzed retrospectively. Fatty liver, pleural effusion, suprahepatic space effusion, biliary tract disease,gastric bare area involvement (GBAI),adrenal gland involvement (AGI) and perirenal space involvement (PSI) were evaluated,and the relationship between CT findings and complications and mortality was analyzed. Results (1) The Logistic regression analysis showed six risk factors for complications of AP,including obesity,fatty liver,PSI,AGI,GBAI and suprahepatic space effusion.The sensitivity,specificity and accuracy of Logistic regression model for predicting complications were 81.3%,89.1% and 85.3 %,respectively. (2) The Logistic regression analysis showed four risk factors for mortality of AP,including obesity,AGI,GBA and suprahepatic space effusion.The sensitivity,specificity and accuracy of Logistic regression model for predicting mortality were 33.3%, 98.6%, 96.0%, respectively.Conclusions Abdominal CT scan effectively indicates the signs of tissue and organ involvement in AP.These CT findings relate with the prognosis of AP.

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