1.A prospective study of the effect of laparoscopic splenectomy and azygoportal disconnection on liver synthetic function and liver cirrhosis
Kunqing XIAO ; Tianming GAO ; Jinhong CAI ; Zhaobao SHI ; Shengjie JIN ; Chi ZHANG ; Baohuan ZHOU ; Dousheng BAI ; Guoqing JIANG
Chinese Journal of Surgery 2025;63(1):51-57
Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.
2.A prospective study of the effect of laparoscopic splenectomy and azygoportal disconnection on liver synthetic function and liver cirrhosis
Kunqing XIAO ; Tianming GAO ; Jinhong CAI ; Zhaobao SHI ; Shengjie JIN ; Chi ZHANG ; Baohuan ZHOU ; Dousheng BAI ; Guoqing JIANG
Chinese Journal of Surgery 2025;63(1):51-57
Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.
3.Cuscutae Semen-Lycii Fructus Improves Spermatogenesis in Rat Model of Oligoasthenozoospermia by Inhibiting Oxidative Stress-induced Blood-testis Barrier Damage via Regulating SIRT1/Nrf2 Signaling Pathway
Wen DUAN ; Xiaojing ZHANG ; Wenjie DING ; Jianning JIN ; Guoqing CHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):29-38
ObjectiveTo investigate the effect of the herb pair Cuscutae Semen-Lycii Fructus on oxidative stress-induced blood-testis barrier dysfunction and spermatogenesis in the rat model of oligoasthenozoospermia (OAS) and decipher the mechanism based on the silent information regulator 1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. MethodsThirty-five male SD rats were randomized into a blank group (n=7) and a modeling group (n=28). The OAS model was established by gavage of hydrocortisone aqueous solution combined with single factor electrical stimulation. The modeled rats were randomly assigned into the following groups: model, Cuscutae Semen-Lycii Fructus granules (3.2 g·kg-1), Cuscutae Semen-Lycii Fructus total flavonoids (0.34 g·kg-1), and L-carnitine (0.38 g·kg-1), and treated for 4 weeks. The sperm quality of rats was assessed by an automatic sperm analyzer. The levels of superoxide dismutase (SOD), malondialdehyde (MAD), and glutathione peroxidase (GSH-Px) in the testicular tissue were determined by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining was employed to reveal the pathological changes in the testicular tissue and score the spermatogenic function. Transmission electron microscopy was employed to observe the ultrastructural changes of Sertoli cells. Western blot and Real-time PCR were employed to determine the protein and mRNA levels, respectively, of SIRT1, Nrf2, Occludin, zonula occludens-1 (ZO-1), connexin 43 (CX43), and β-catenin. ResultsCompared with the blank group, the model group showed decreased total sperm count and motility (P<0.05, P<0.01), obvious damage in the testicular tissue and blood-testis barrier structure, reduced score of spermatogenic function (P<0.01), declined levels of GSH-Px and SOD in the testicular tissue (P<0.05), elevated level of MDA, and down-regulated protein levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin (P<0.05, P<0.01) and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, and β-catenin in the testicular tissue (P<0.05, P<0.01). After treatment, the testicular tissue, blood-testis barrier structure, and score of spermatogenic function (P<0.01) were improved in the Cuscutae Semen-Lycii Fructus granules group, Cuscutae Semen-Lycii Fructus total flavonoids group, and L-carnitine group. Compared with the model group, the treatment groups presented lowered levels of GSH-Px and SOD (P<0.05, P<0.01), and the Cuscutae Semen-Lycii Fructus granule group showed a decline in MDA level. The protein and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin were up-regulated in the Cuscutae Semen-Lycii Fructus granules group and total flavonoids group (P<0.05, P<0.01). ConclusionThe herb pair Cuscutae Semen-Lycii Fructus can regulate the SIRT1/Nrf2 pathway to inhibit oxidative stress and alleviate the blood-testis barrier damage, thereby improving the spermatogenic function in the rat model of OAS. Total flavonoids may be the material basis for the therapeutic effect of Cuscutae Semen-Lycii Fructus.
4.Cuscutae Semen-Lycii Fructus Improves Spermatogenesis in Rat Model of Oligoasthenozoospermia by Inhibiting Oxidative Stress-induced Blood-testis Barrier Damage via Regulating SIRT1/Nrf2 Signaling Pathway
Wen DUAN ; Xiaojing ZHANG ; Wenjie DING ; Jianning JIN ; Guoqing CHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):29-38
ObjectiveTo investigate the effect of the herb pair Cuscutae Semen-Lycii Fructus on oxidative stress-induced blood-testis barrier dysfunction and spermatogenesis in the rat model of oligoasthenozoospermia (OAS) and decipher the mechanism based on the silent information regulator 1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. MethodsThirty-five male SD rats were randomized into a blank group (n=7) and a modeling group (n=28). The OAS model was established by gavage of hydrocortisone aqueous solution combined with single factor electrical stimulation. The modeled rats were randomly assigned into the following groups: model, Cuscutae Semen-Lycii Fructus granules (3.2 g·kg-1), Cuscutae Semen-Lycii Fructus total flavonoids (0.34 g·kg-1), and L-carnitine (0.38 g·kg-1), and treated for 4 weeks. The sperm quality of rats was assessed by an automatic sperm analyzer. The levels of superoxide dismutase (SOD), malondialdehyde (MAD), and glutathione peroxidase (GSH-Px) in the testicular tissue were determined by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining was employed to reveal the pathological changes in the testicular tissue and score the spermatogenic function. Transmission electron microscopy was employed to observe the ultrastructural changes of Sertoli cells. Western blot and Real-time PCR were employed to determine the protein and mRNA levels, respectively, of SIRT1, Nrf2, Occludin, zonula occludens-1 (ZO-1), connexin 43 (CX43), and β-catenin. ResultsCompared with the blank group, the model group showed decreased total sperm count and motility (P<0.05, P<0.01), obvious damage in the testicular tissue and blood-testis barrier structure, reduced score of spermatogenic function (P<0.01), declined levels of GSH-Px and SOD in the testicular tissue (P<0.05), elevated level of MDA, and down-regulated protein levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin (P<0.05, P<0.01) and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, and β-catenin in the testicular tissue (P<0.05, P<0.01). After treatment, the testicular tissue, blood-testis barrier structure, and score of spermatogenic function (P<0.01) were improved in the Cuscutae Semen-Lycii Fructus granules group, Cuscutae Semen-Lycii Fructus total flavonoids group, and L-carnitine group. Compared with the model group, the treatment groups presented lowered levels of GSH-Px and SOD (P<0.05, P<0.01), and the Cuscutae Semen-Lycii Fructus granule group showed a decline in MDA level. The protein and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin were up-regulated in the Cuscutae Semen-Lycii Fructus granules group and total flavonoids group (P<0.05, P<0.01). ConclusionThe herb pair Cuscutae Semen-Lycii Fructus can regulate the SIRT1/Nrf2 pathway to inhibit oxidative stress and alleviate the blood-testis barrier damage, thereby improving the spermatogenic function in the rat model of OAS. Total flavonoids may be the material basis for the therapeutic effect of Cuscutae Semen-Lycii Fructus.
5.The clinical application value of coagulation function indicators in pediatric patients with Burkitt lymphoma
Ping GU ; Qi ZHANG ; Chengyun WANG ; Guoqing ZHU ; Qiuhui PAN ; Jing WANG
Chinese Journal of Blood Transfusion 2025;38(9):1195-1204
Objective: To investigate the abnormal fluctuation of coagulation function indicators in pediatric Burkitt lymphoma patients, and to analyze its correlation with disease progression and prognosis. Methods: The data of 172 children with Burkitt lymphoma in Children's Medical Center, Shanghai Jiao Tong University School of Medicine from January 2020 to December 2023 were retrospectively analyzed, and 120 healthy children were used as control group. Plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib), International standardized ratio (INR), D-dimer (D-D), fibrinogen degradation products (FDP), and antithrombin (AT) were measured. Appropriate statistical methods were used to compare the data between two groups, and the Cox regression model was employed to analyze the influencing factors. A P-value <0.05 was considered statistically significant. Results: Levels of D-D, FDP, INR, and PT were significantly higher in children with Burkitt lymphoma than in the healthy controls [median (P25, P75) for the case group: 0.35 (0.13, 1.22), 3.10 (1.30, 10.20), 1.16 (1.06, 1.24), 12.60 (11.43, 13.50); median (P25, P75) for the healthy control group: 0.10 (0.07, 0.15), 0.60 (0.20, 1.08), 1.06 (1.02, 1.13), 11.50 (11.00, 12.30)](P<0.05). Levels of D-D, FDP, INR, PT, and TT were significantly elevated in children with recurrence compared to those without recurrence [median (P25, P75) for the recurrent group: 0.44 (0.16, 1.42), 3.85 (1.50, 12.25), 1.17 (1.08, 1.24), 12.70 (11.73, 13.50), 16.20 (14.80, 17.80); median (P25, P75) for the non-recurrent group: 0.21 (0.11, 0.69), 2.00 (1.00, 6.85), 1.11 (1.03, 1.24), 11.90 (11.10, 13.43), 15.20 (14.50, 16.40)](P<0.05). Levels of D-D, FDP in children with metastasis were significantly higher than those without metastasis [median (P25, P75) for the metastatic group: 0.51 (0.17, 1.84), 4.38 (1.70, 13.45); median (P25, P75) for the non-metastatic group: 0.20 (0.11, 0.39), 1.50 (1.00, 3.10)] (P<0.05). Levels of D-D and FDP were significantly higher in children with advanced stage than in those with early stage [median (P25, P75) for the high-stage group: 0.33 (0.14, 1.20), 3.10 (1.40, 10.23); median (P25, P75) for the low-stage group: 0.12 (0.08, 0.24), 0.90 (0.50, 2.50)] (P<0.05). Levels of D-D and FDP in high-risk children were significantly higher than those of low-risk [median (P25, P75) for the high-risk group: 0.28 (0.13, 1.01), 2.90 (1.15, 9.65); median (P25, P75) for the low-risk group: 0.12 (0.08, 0.17), 0.80 (0.43, 1.98)] (P<0.05). Levels of D-D, FDP, INR, and PT were significantly higher in children with poor prognosis than in those with favorable prognosis [median (P25, P75) for the poor prognosis group: 1.76 (0.80, 2.72), 13.45 (7.20, 25.30), 1.19 (1.12, 1.32), 12.85 (12.10, 14.35); median (P25, P75) for the favorable prognosis group: 0.23 (0.12, 0.52), 2.00 (1.00, 4.80), 1.14 (1.05, 1.23), 12.30 (11.40, 13.40)] (P<0.05). INR levels significantly increased with accumulating chemotherapy cycles [median (P25, P75) for one session: 1.09 (1.02, 1.20); two sessions: 1.31 (1.23, 1.38); three sessions: 1.79 (1.52, 2.41)] (P<0.05). Age, APTT, D-D, FDP, INR, PT, recurrence and metastasis had a significant effect on the survival of children with Burkitt lymphoma (P<0.05). Conclusion: Patients with Burkitt lymphoma exhibit coagulation disorders, which are influenced by recurrence, metastasis, clinical stage, risk stratification, and prognosis. In clinical practice, it is crucial to prioritize the monitoring of coagulation indicators to facilitate timely detection of coagulation dysfunction.
6.Comparison of gait and hip ambulation ability after total hip arthroplasty through different approaches
Yunchun PAN ; Hongjun WEI ; Guoqing REN ; Qiliang ZHANG
Chinese Journal of Tissue Engineering Research 2024;28(18):2846-2851
BACKGROUND:In the selection of minimally invasive total hip arthroplasty approaches,there is considerable debate about whether direct anterior and posterior approaches differ in postoperative gait,limb balance,and hip motor capacity,and therefore further investigation is warranted. OBJECTIVE:To assess the gait and hip ambulation ability of direct anterior and posterior approaches for primary unilateral total hip arthroplasty with a prospective randomized controlled study. METHODS:A total of 61 patients with unilateral avascular necrosis of the femoral head in Qingdao Municipal Hospital from January 2019 to June 2020 were included in the study.There were 40 males and 21 females,at a mean age of(64.83±5.52)years.All the patients were randomly divided into a direct anterior approach group(n=28)and a posterior approach group(n=33),and received initial total hip arthroplasty by direct anterior approach and posterior approach,respectively.Gait analysis(gait time-space parameters such as stride length,stride frequency,single-leg support time,and plantar pressure difference)and hip ambulation ability(standing-walking timing test and 2-minute walking test)were performed before and 1,3 and 6 months after operation. RESULTS AND CONCLUSION:(1)With the extension of postoperative time,gait time-space parameters in both groups were gradually improved.The stride length,stride frequency,single-leg support time,and plantar pressure difference in the direct anterior approach group were significantly better than those in the posterior approach group 1 month after surgery(P<0.01).The stride frequency,single-leg support time,and plantar pressure difference in the direct anterior approach group were significantly better than those in the posterior approach group 3 months after surgery(P<0.05).The plantar pressure difference in the direct anterior approach group was significantly better than that in the posterior approach group 6 months after surgery(P<0.01).(2)With the extension of postoperative time,the results of the standing-walking timing test and 2-minute walking test were gradually improved in both groups.The results of the standing-walking timing test and 2-minute walking test 1 and 3 months after operation in the direct anterior approach group were better than those in the posterior approach group(P<0.05).(3)The results have indicated that the recovery of postoperative gait and hip ambulation ability of the two groups is inconsistent.The direct anterior approach group has some advantages in the improvement of postoperative gait and hip ambulation ability compared with the posterior approach group in the early postoperative period.
7.The Effect of Shenqi Jianxin Formula (参芪健心方) on Cardiomyocyte Pyroptosis in Chronic Heart Failure Model Rats Based on the NLRP3/Caspase-1 Signaling Pathway
Guoqing LIANG ; Ran XIA ; Yinyan WANG ; Pan LIU ; Jun ZHANG ; Xiaohua DAI
Journal of Traditional Chinese Medicine 2024;65(1):94-102
ObjectiveTo investigate the possible mechanism of Shenqi Jianxin Formula (参芪健心方) in the treatment of chronic heart failure (CHF) from the perspective of pyroptosis. MethodsFifty-two rats were randomly divided into sham operation group (n=8) and modeling group (n=44). In the modeling group, the anterior descending branch of the left coronary artery was ligated to construct CHF rat model. Forty successfully-modelled rats were randomly divided into model group, Entresto group, Shenqi Jianxin Formula group, MCC950 group and the combination group (Shenqi Jianxin Formula plus MCC950), with 8 rats in each group. In Shenqi Jianxin Formula group, 7.4 g/(kg·d) of Shenqi Jianxin Formula was given by gavage, while in Entresto group, 68 mg/(kg·d) of Entresto suspension was given by gavage; in MCC950 group, MCC950 was injected intraperitoneally with 10 mg/kg once every other day, and in the combination group, 7.4 g/(kg·d) of Shenqi Jianxin Formula was given by gavage, and MCC950 was injected intraperitoneally with 10 mg/kg once every other day; 10 ml/(kg·d) of saline was given by gavage in the sham operation group and the model group. After 3 weeks of continuous intervention, serum brain B-type natriuretic peptide (BNP), creatine kinase isoenzyme MB (CK-MB), interleukin 1β (IL-1β), and interleukin 18 (IL-18) levels were detected by ELISA; HE staining and MASSON staining were used to observe pathological changes in rat myocardium. Except for the Entresto group, western blot technique was used to detect the expression of NOD-like receptor protein 3 (NLRP3), caspase-1, and apoptosis-associated speck-like protein possessing a caspase-recruiting domain (ASC); RT-PCR was used to detect the expression of NLRP3 and caspase-1 mRNA. ResultsCompared with the sham operation group, HE staining of rats in the model group showed obvious myocardial injury, while MASSON staining showed increased area of collagen fibrosis, and serum BNP, CK-MB, IL-1β, IL-18, myocardial tissue NLRP3, caspase-1, ASC protein expression and NLRP3, caspase-1 mRNA expression were all elevated (P<0.05). Compared with those in the model group, cardiomyocyte injury of rats and collagen fibrosis area were reduced, and serum BNP, CK-MB, IL-1β, and IL-18 contents were all reduced in Shenqi Jianxin Formula group, Entresto group, MCC950 group, and the combination group; except for Entresto group, myocardial tissue NLRP3, caspase-1, ASC protein expression and NLRP3, caspase-1 mRNA expression were reduced in the remaining three medication group (P<0.05). Compared with Shenqi Jianxin Formula group, the MCC950 group and the combination group showed decreased serum IL-1β and IL-18 content, collagen fibrosis area, myocardial tissue NLPR3, caspase-1 protein expression, and caspase-1 mRNA expression, and decreased ASC and NLRP3 mRNA expression was shown in the combination group (P<0.05). Compared with MCC950 group, collagen fibrosis area was reduced, and serum IL-18 content, NLRP3, caspase-1 mRNA expression were reduced in the combination group (P<0.05). ConclusionShenqi Jianxin Formula can effectively improve the myocardial injury and heart failure in rats with CHF, and its mechanism may be related to the inhibition of cardiomyocyte pyroptosis through NLPR3/Caspase-1 pathway to reduce the level of intramyocardial inflammation. The combined use of MCC950 with Shenqi Jianxin Formula could more effectively inhibite myocardial pyroptosis, with better therapeutic result than single use of each part.
8.Survey on insomnia and its influencing factors among children and adolescents in Chongqing
Chunmei LIAO ; Lixia LUO ; Ni YAN ; Yuchen ZHANG ; Gang YUAN ; Guoqing JIANG
Sichuan Mental Health 2024;37(5):451-456
Background Sleep disturbances in children and adolescents have become a global public health concern,with pronounced issues in the Western China.Despite this,research on the prevalence of insomnia and its influencing factors among children and adolescents in Chongqing is still lacking.Objective To understand the prevalence of insomnia and analyze its influencing factors among children and adolescents in Chongqing,so as to provide references for clinical interventions and preventive strategies of insomnia.Methods A stratified random sampling method was used to select 9 969 children and adolescents in Chongqing from November to December 2021.Insomnia Severity Index(ISI)and a self-designed questionnaire on awareness of core mental health knowledge were administered.Binary Logistic regression analysis was used to identify the influencing factors of insomnia in this population.Results A total of 3 578 children and adolescents(35.89%)were found to have insomnia symptoms.There were statistically significant differences in the detection of insomnia symptoms among gender,ethnicity,education level,domicile,only-child status,parental education level,introversion/extroversion,parental relationship,average monthly per capita income,family history of mental illness,medical insurance coverage,living situation and understanding of mental health knowledge(P<0.05 or 0.01).Binary Logistic regression analysis identified several risk factors for insomnia,including female gender(OR=1.301,95%CI:1.192~1.419),ethnic minority status(OR=1.163,95%CI:1.015~1.333),junior high school for education level(OR=1.985,95%CI:1.774~2.220),senior high school for education level(OR=3.085,95%CI:2.749~3.462),non-only-child status(OR=1.127,95%CI:1.013~1.253),degree of harmony between parents is not high or not harmonious[(OR=1.846,95%CI:1.669~2.041 for relatively harmonious;OR=2.524,95%CI:2.214~2.877 for generally harmonious;OR=2.452,95%CI:1.999~3.007 for not very harmonious;OR=2.926,95%CI:2.307~3.710 for very discordant)]and incomplete medical insurance coverage(OR=1.218,95%CI:1.093~1.358).Protective factors included an extroverted personality(OR=0.838,95%CI:0.766~0.917),absence of family history of mental illness(OR=0.719,95%CI:0.549~0.941),junior high school for mother's education level(OR=0.822,95%CI:0.734~0.920),senior high school or secondary specialized school for mother's education level(OR=0.862,95%CI:0.752~0.988),college and above for mother's education level(OR=0.748,95%CI:0.633~0.884)and knowledge of mental health(OR=0.854,95%CI:0.778~0.937).Conclusion The problem of insomnia among children and adolescents in Chongqing is quite serious.Risk factors for insomnia include female gender,ethnic minority status,higher education levels,being a non-only child,poor family relationships and incomplete medical insurance.Conversely,an extroverted personality,absence of family history of mental illness,higher maternal education and knowledge of mental health serve as protective factors against insomnia.
9.Serological and genetic analysis of a Bel subtype caused by a novel 29insG mutation:a case report
Renlong ZHOU ; Cuiyun ZHANG ; Guoqing HUANG
Chinese Journal of Blood Transfusion 2024;37(10):1201-1205
Objective To investigate the serological characteristics and molecular mechanism of a case of Bel subtype.Methods Serological method was used to analyze the ABO blood group of the patient,absorption and elution test was used to detect the weak antigen on red blood cells,and molecular biology method was used to analyze the ABO gene sequence of the patient.Results The forward typing of the patient was O type,but the reverse typing was B type.The weak B antigen was confirmed by absorption and elution method.This mutation was not found in ISBT and related literature,and was discov-ered for the first time.The patient's blood type was Bel(29insertG)/O.01.01 based on the sequence of exon 3-7.Conclusion In the case of ABO blood group incompatibility,the combination of serological and molecular biological detection tech-niques can improve the accuracy and reliability of ABO blood group identification.
10.Efficacy and safety of CM310 in moderate-to-severe atopic dermatitis: A multicenter, randomized, double-blind, placebo-controlled phase 2b trial
Yan ZHAO ; Jianzhong ZHANG ; Bin YANG ; Jingyi LI ; Yangfeng DING ; Liming WU ; Litao ZHANG ; Jinyan WANG ; Xiaohong ZHU ; Furen ZHANG ; Xiaohua TAO ; Yumei LI ; Chunlei ZHANG ; Linfeng LI ; Jianyun LU ; Qingchun DIAO ; Qianjin LU ; Xiaoyong MAN ; Fuqiu LI ; Xiujuan XIA ; Hao CHENG ; Yingmin JIA ; Guoqing ZHAO ; Jinchun YAN ; Bo CHEN
Chinese Medical Journal 2024;137(2):200-208
Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.

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