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Bai J, Pu X, Zhang Y, Dai E. Renal tubular gen e biomarkers identification based on immune infiltrates in focal segmental glomerulosclerosis. Ren Fail 2022; 44:966-986. [PMID: 35713363 PMCID: PMC9225740 DOI: 10.1080/0886022x.2022.2081579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE The present study identified novel renal tubular biomarkers that may influence the diagnosis and treatment of focal segmental glomerulosclerosis (FSGS) based on immune infiltration. METHODS Three FSGS microarray datasets, GSE108112, GSE133288 and GSE121211, were downloaded from the Gene Expression Omnibus (GEO) database. The R statistical software limma package and the combat function of the sva package were applied for preprocessing and to remove the batch effects. Differentially expressed genes (DEGs) between 120 FSGS and 15 control samples were identified with the limma package. Disease Ontology (DO) pathway enrichment analysis was conducted with statistical R software to search for related diseases. Gene set enrichment analysis (GSEA) was used to interpret the gene expression data and it revealed many common biological pathways. A protein-protein interaction (PPI) network was built using the Search Tool for the Retrieval of Interacting Genes (STRING) database, and hub genes were identified by the Cytoscape (version 3.7.2) plug-in CytoHubba. The plug-in Molecular Complex Detection (MCODE) was used to screen hub modules of the PPI network in Cytoscape, while functional analysis of the hub genes and hub nodes involved in the submodule was performed by ClusterProfiler. The least absolute shrinkage and selection operator (LASSO) regression and support vector machine recursive feature elimination (SVM-RFE) analysis were used to screen characteristic genes and build a logistic regression model. Receiver operating characteristic (ROC) curve analyses were used to investigate the logistic regression model and it was then validated by an external dataset GSE125779, which contained 8 FSGS samples and 8 healthy subjects. Cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) was used to calculate the immune infiltration of FSGS samples. RESULTS We acquired 179 DEGs, 79 genes with downregulated expression (44.1%) and 100 genes with upregulated expression (55.9%), in the FSGS samples. The DEGs were significantly associated with arteriosclerosis, kidney disease and arteriosclerotic cardiovascular disease. GSEA revealed that these gene sets were significantly enriched in allograft rejection signaling pathways and activation of immune response in biological processes. Fifteen genes were demonstrated to be hub genes by PPI, and three submodules were screened by MCODE linked with FSGS. Analysis by machine learning methodologies identified nuclear receptor subfamily 4 group A member 1 (NR4A1) and dual specificity phosphatase 1 (DUSP1) as sensitive tubular renal biomarkers in the diagnosis of FSGS, and they were selected as hub genes, as well as hub nodes which were enriched in the MAPK signaling pathway. Immune cell infiltration analysis revealed that the genetic biomarkers were both correlated with activated mast cells, which may amplify FSGS biological processes. CONCLUSION DUSP1 and NR4A1 were identified as sensitive potential biomarkers in the diagnosis of FSGS. Activated mast cells have a decisive effect on the occurrence and development of FSGS through tubular lesions and tubulointerstitial inflammation, and they are expected to become therapeutic targets in FSGS.
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Lin LS, Chen XY, Zhang HP, Chen YF, Zhang YX, Zeng YM. [Efficacy of selective bronchial occlusion in the treatment of intractable pneumothorax]. ZHONGHUA YI XUE ZA ZHI 2022; 102:3501-3504. [PMID: 36418246 DOI: 10.3760/cma.j.cn112137-20220708-01510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To analyze the effect of selective bronchial occlusion (SBO) in the treatment of intractable pneumothorax. Methods: A total of 86 patients with refractory pneumothorax treated with SBO in the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University from January 1, 2019 to December 31, 2021 were included in this study. The basic information, diagnosis and treatment of the patients were collected and analyzed based on their inpatient records. Results: The age of the subjects was (62±11) years old, and 83 cases (96.5%) were male. The first time SBO cure rate was 30.2% (26/86). The effective rate of the first time SBO treatment was 38.4% (33/86), and the final cure rate of SBO was 59.3% (51/86). The total cure rate of SBO combined with other therapies was 73.3% (63/86). The median time [M (Q1, Q3)] from the first plugging to the complete cessation of air leakage in SBO cured patients was 6.5 (3, 7) days, which was shorter than that in the final extubation patients after SBO [11 (7, 19) days] (H=30.24, P<0.001). The median [M (Q1, Q3)] length of hospital stay of the first SBO cured patients was 19 (14, 25) days, which was shorter than that of all patients [28 (19, 37) days] (H=12.89, P=0.002). The median [M (Q1, Q3)] hospitalization expenses of patients with first SBO cure, effective SBO treatment and ineffective SBO treatment were 23 187 (18 906, 27 798), 41 580 (29 388, 50 762) and 38 462 (27 542, 51 720) yuan, respectively, and the difference was statistically significant (H=18.58, P<0.001). The incidence of complications after SBO was 7.59% (11/145). Conclusion: SBO has good efficacy and relative high safety in the treatment of intractable pneumothorax.
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An FP, Bai WD, Balantekin AB, Bishai M, Blyth S, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen HY, Chen SM, Chen Y, Chen YX, Cheng J, Cheng ZK, Cherwinka JJ, Chu MC, Cummings JP, Dalager O, Deng FS, Ding YY, Diwan MV, Dohnal T, Dolzhikov D, Dove J, Dwyer DA, Gallo JP, Gonchar M, Gong GH, Gong H, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Hans S, He M, Heeger KM, Heng YK, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang JH, Huang XT, Huang YB, Huber P, Jaffe DE, Jen KL, Ji XL, Ji XP, Johnson RA, Jones D, Kang L, Kettell SH, Kohn S, Kramer M, Langford TJ, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li RH, Li S, Li SC, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu JX, Lu C, Lu HQ, Luk KB, Ma BZ, Ma XB, Ma XY, Ma YQ, Mandujano RC, Marshall C, McDonald KT, McKeown RD, Meng Y, Napolitano J, Naumov D, Naumova E, Nguyen TMT, Ochoa-Ricoux JP, Olshevskiy A, Pan HR, Park J, Patton S, Peng JC, Pun CSJ, Qi FZ, Qi M, Qian X, Raper N, Ren J, Morales Reveco C, Rosero R, Roskovec B, Ruan XC, Steiner H, Sun JL, Tmej T, Treskov K, Tse WH, Tull CE, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Wei HY, Wei LH, Wen LJ, Whisnant K, White CG, Wong HLH, Worcester E, Wu DR, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu HK, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zavadskyi V, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JL, Zhang JW, Zhang QM, Zhang SQ, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhao RZ, Zhou L, Zhuang HL, Zou JH. First Measurement of High-Energy Reactor Antineutrinos at Daya Bay. PHYSICAL REVIEW LETTERS 2022; 129:041801. [PMID: 35939015 DOI: 10.1103/physrevlett.129.041801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/05/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
This Letter reports the first measurement of high-energy reactor antineutrinos at Daya Bay, with nearly 9000 inverse beta decay candidates in the prompt energy region of 8-12 MeV observed over 1958 days of data collection. A multivariate analysis is used to separate 2500 signal events from background statistically. The hypothesis of no reactor antineutrinos with neutrino energy above 10 MeV is rejected with a significance of 6.2 standard deviations. A 29% antineutrino flux deficit in the prompt energy region of 8-11 MeV is observed compared to a recent model prediction. We provide the unfolded antineutrino spectrum above 7 MeV as a data-based reference for other experiments. This result provides the first direct observation of the production of antineutrinos from several high-Q_{β} isotopes in commercial reactors.
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Xue ZM, Yang G, Guo ZX, Gao ME, Qin QQ, Zhang YX, Zhao J, Kang YX, Li Y, Zhao RL. Investigation on knowledge level about rational use of antimicrobial drugs among pharmacists in medical institutions in Shanxi province, China. Public Health 2022; 209:67-72. [PMID: 35839623 DOI: 10.1016/j.puhe.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/03/2022] [Accepted: 05/26/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To investigate the pharmacist's knowledge about rational use of antimicrobials in Shanxi of China, so as to find out the problems and provide support for the management of antimicrobials. METHODS A questionnaire survey was conducted, which included the basic information of the respondents, the basic knowledge about antimicrobial management and the related knowledge about antimicrobial drugs. SPSS 25.0 was used for statistical analysis. RESULTS A total of 462 pharmacists were investigated. The average score of the knowledge related to rational use of antimicrobials was 10.49 ± 4.05. It showed that the hospital type, grade, pharmacist's education, professional title and years of experience had effect on the pharmacist's knowledge level about antimicrobial drugs (P < 0.05). Multivariable logistic regression analysis showed that hospital grade and pharmacist's education were the main influencing factors (P < 0.05). CONCLUSION Pharmacists have insufficient knowledge about the rational use of antibacterial drugs. It is essential to strengthen the training in management regulations and application of antibacterial drugs.
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Zhang YX, Jiang ZG. [A case of ANCA-associated vasculitis with ocular-ear-parotid symptoms as the main manifestation]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2022; 57:621-624. [PMID: 35610685 DOI: 10.3760/cma.j.cn115330-20210728-00497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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An FP, Andriamirado M, Balantekin AB, Band HR, Bass CD, Bergeron DE, Berish D, Bishai M, Blyth S, Bowden NS, Bryan CD, Cao GF, Cao J, Chang JF, Chang Y, Chen HS, Chen SM, Chen Y, Chen YX, Cheng J, Cheng ZK, Cherwinka JJ, Chu MC, Classen T, Conant AJ, Cummings JP, Dalager O, Deichert G, Delgado A, Deng FS, Ding YY, Diwan MV, Dohnal T, Dolinski MJ, Dolzhikov D, Dove J, Dvořák M, Dwyer DA, Erickson A, Foust BT, Gaison JK, Galindo-Uribarri A, Gallo JP, Gilbert CE, Gonchar M, Gong GH, Gong H, Grassi M, Gu WQ, Guo JY, Guo L, Guo XH, Guo YH, Guo Z, Hackenburg RW, Hans S, Hansell AB, He M, Heeger KM, Heffron B, Heng YK, Hor YK, Hsiung YB, Hu BZ, Hu JR, Hu T, Hu ZJ, Huang HX, Huang JH, Huang XT, Huang YB, Huber P, Koblanski J, Jaffe DE, Jayakumar S, Jen KL, Ji XL, Ji XP, Johnson RA, Jones DC, Kang L, Kettell SH, Kohn S, Kramer M, Kyzylova O, Lane CE, Langford TJ, LaRosa J, Lee J, Lee JHC, Lei RT, Leitner R, Leung JKC, Li F, Li HL, Li JJ, Li QJ, Li RH, Li S, Li SC, Li WD, Li XN, Li XQ, Li YF, Li ZB, Liang H, Lin CJ, Lin GL, Lin S, Ling JJ, Link JM, Littenberg L, Littlejohn BR, Liu JC, Liu JL, Liu JX, Lu C, Lu HQ, Lu X, Luk KB, Ma BZ, Ma XB, Ma XY, Ma YQ, Mandujano RC, Maricic J, Marshall C, McDonald KT, McKeown RD, Mendenhall MP, Meng Y, Meyer AM, Milincic R, Mueller PE, Mumm HP, Napolitano J, Naumov D, Naumova E, Neilson R, Nguyen TMT, Nikkel JA, Nour S, Ochoa-Ricoux JP, Olshevskiy A, Palomino JL, Pan HR, Park J, Patton S, Peng JC, Pun CSJ, Pushin DA, Qi FZ, Qi M, Qian X, Raper N, Ren J, Morales Reveco C, Rosero R, Roskovec B, Ruan XC, Searles M, Steiner H, Sun JL, Surukuchi PT, Tmej T, Treskov K, Tse WH, Tull CE, Tyra MA, Varner RL, Venegas-Vargas D, Viren B, Vorobel V, Wang CH, Wang J, Wang M, Wang NY, Wang RG, Wang W, Wang W, Wang X, Wang Y, Wang YF, Wang Z, Wang Z, Wang ZM, Weatherly PB, Wei HY, Wei LH, Wen LJ, Whisnant K, White C, Wilhelmi J, Wong HLH, Woolverton A, Worcester E, Wu DR, Wu FL, Wu Q, Wu WJ, Xia DM, Xie ZQ, Xing ZZ, Xu HK, Xu JL, Xu T, Xue T, Yang CG, Yang L, Yang YZ, Yao HF, Ye M, Yeh M, Young BL, Yu HZ, Yu ZY, Yue BB, Zavadskyi V, Zeng S, Zeng Y, Zhan L, Zhang C, Zhang FY, Zhang HH, Zhang JW, Zhang QM, Zhang SQ, Zhang X, Zhang XT, Zhang YM, Zhang YX, Zhang YY, Zhang ZJ, Zhang ZP, Zhang ZY, Zhao J, Zhao RZ, Zhou L, Zhuang HL, Zou JH. Joint Determination of Reactor Antineutrino Spectra from ^{235}U and ^{239}Pu Fission by Daya Bay and PROSPECT. PHYSICAL REVIEW LETTERS 2022; 128:081801. [PMID: 35275656 DOI: 10.1103/physrevlett.128.081801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/17/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
A joint determination of the reactor antineutrino spectra resulting from the fission of ^{235}U and ^{239}Pu has been carried out by the Daya Bay and PROSPECT Collaborations. This Letter reports the level of consistency of ^{235}U spectrum measurements from the two experiments and presents new results from a joint analysis of both data sets. The measurements are found to be consistent. The combined analysis reduces the degeneracy between the dominant ^{235}U and ^{239}Pu isotopes and improves the uncertainty of the ^{235}U spectral shape to about 3%. The ^{235}U and ^{239}Pu antineutrino energy spectra are unfolded from the jointly deconvolved reactor spectra using the Wiener-SVD unfolding method, providing a data-based reference for other reactor antineutrino experiments and other applications. This is the first measurement of the ^{235}U and ^{239}Pu spectra based on the combination of experiments at low- and highly enriched uranium reactors.
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Manawasinghe IS, Calabon MS, Jones EBG, Zhang YX, Liao CF, Xiong YR, Chaiwan N, Kularathnage ND, Liu NG, Tang SM, Sysouphanthong P, Du TY, Luo M, Pasouvang P, Pem D, Phonemany M, Ishaq M, Chen JW, Karunarathna SC, Mai ZL, Rathnayaka AR, Samarakoon MC, Tennakoon DS, Wijesinghe SN, Yang YH, Zhao HJ, Fiaz M, Doilom M, Dutta AK, Khalid AN, Liu JW, Thongklang N, Senanayake IC, Tibpromma S, You LQ, Camporesi E, Gafforov YS, Hyde KD KD. Mycosphere notes 345–386. MYCOSPHERE 2022. [DOI: 10.5943/mycosphere/13/1/3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Song DJ, Li Z, Zhang YX, Zhou B, Lyu CL, Tang YY, Yi L, Luo ZH, Wang ZY, Hua ZZ, Feng G. [Clinical effects of transplantation of turbocharged bipedicle deep inferior epigastric perforator flap in breast reconstruction]. ZHONGHUA SHAO SHANG ZA ZHI = ZHONGHUA SHAOSHANG ZAZHI = CHINESE JOURNAL OF BURNS 2021; 37:1143-1148. [PMID: 34937154 DOI: 10.3760/cma.j.cn501120-20200824-00390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical effects of transplantation of turbocharged bipedicle deep inferior epigastric perforator (DIEP) flap in breast reconstruction. Methods: A retrospective observational study was used. From December 2008 to December 2016, 24 patients who met the inclusion criteria were treated in the Department of Plastic Surgery of Hunan Cancer Hospital, all patients were female, aged 28-51 (36.5±1.6) years. All cases received turbocharged bipedicle DIEP flap for two-staged breast reconstruction. According to the patterns of turbocharged vessels anastomosis, the turbocharged bipedicle DIEP flaps with length of (27.5±0.3) cm and width of (12.8±1.4) cm, were divided into three types: distal end of pedicle anastomosis type, main branch of pedicle anastomosis type, and muscular branch of pedicle anastomosis type. After complete hemostasis in the donor region, the anterior sheath was repaired with intermittent suture, and umbilical reconstruction was completed. Two negative pressure drainage tubes were indwelled, and subcutaneous tissue and skin were sutured layer by layer. The specific ways of vascular anastomosis of the flap pedicle with the internal thoracic vessels of recipient site included anastomosing the proximal end of one artery and one vein, anastomosing the proximal and distal end of one artery and one vein, and anastomosing the proximal end of one artery and two veins. Postoperatively, the survival and blood supply of flaps were observed. The patients were followed up to observe the reconstructed breast shape satisfaction, donor site complications, abdominal wall function, and scar hyperplasia. Results: All turbocharged bipedicle DIEP flaps for two-staged breast reconstruction survived well, with good blood supply. During follow-up for 14 to 56 (20±6) months, the shape of reconstructed breasts was satisfied. Only linear scar was left in the donor sites of abdomen with no complications, and the function of abdominal wall was not affected. Conclusions: For patients with clear indications, transplantation of free turbocharged bipedicle DIEP flap is a safe, reliable, and satisfactory choice for breast reconstruction with autologous tissue.
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Li YB, Li F, Guo S, Gao L, Guo RM, Lu LW, Zhang YX. [Microscopic observation of the enamel microstructures of SD rats with different degrees of fluorosis]. ZHONGHUA KOU QIANG YI XUE ZA ZHI = ZHONGHUA KOUQIANG YIXUE ZAZHI = CHINESE JOURNAL OF STOMATOLOGY 2021; 56:1261-1266. [PMID: 34915662 DOI: 10.3760/cma.j.cn112144-20210916-00414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To establish a dental fluorosis model of SD rats with various degrees, to observe the microstructures of enamel samples under scanning electron microscope and to clarify the changes of enamel microstructures with various degrees of dental fluorosis, so as to provide clinical reference for the treatment of patients with moderate and severe dental fluorosis. Methods: Thirty male SD rats (6 weeks of age) were randomly divided into 3 groups with 10 rats in each group. The control group was fed with deionized water without fluoride, the low fluoride group was fed with 50 mg/L NaF deionized water and the high fluoride group was fed with 100 mg/L NaF deionized water in order to establish the dental fluorosis model of rats. After feeding for 6 weeks, the rats were sacrificed and the mandibular incisor teeth were collected and recorded. The surface and sagittal plane of each tooth were observed by scanning electron microscopy and the enamel thickness was measured. Results: In the control group, the enamel color was brown yellow. Enamel color discoloration occurred both in low-fluoride group and high-fluoride group. The enamel color in low-fluoride group was mostly yellow and white striped while in high-fluoride group was mostly chalky white. Under electronic microscope, the enamel rods were alternately arranged and their structure was clear and plump in the control group. The enamel rods of moderate fluorosis were arranged in a straight orientation like tips of bamboo shoots. The enamel rods of severe fluorosis, however, became thinner and the tips of rods were broken. In the control group, sagittal images of enamel turned out to be a dense outer structure with clear boundaries among the inner. The structure of the middle layer was reticulated showing a clear boundary with middle and outer layers. The structure of enamel rods in the inner layers was arranged vertically and horizontally. In the moderate fluorosis group, the outer layer of the enamel became thinner and the middle layer disappeared although the boundary between the outer and middle layers was still clear. In the inner layer, the vertically arranged enamel rods seemed still clear, however the horizontal enamel rods disappeared. In the severe fluorosis group, the outer layer could not be traced. The middle layer was exposed to the air and the inner enamel rods contracted. The inner layers of the enamel had gradually become thinner with the development of the dental fluorosis. The thicknesses of inner layers in control, moderate and the severe groups were (180.71±7.01), (157.10±11.04) and (121.10±12.56) μm respectively. As for the thicknesses of the full layers in the above mentioned three groups, the same trend was observed. The thicknesses, in order of the severity of dental fluorosis, were (241.54±7.76), (207.42±14.36) and (143.79±14.60) μm. Conclusions: With the development of dental fluorosis, the outer enamel layers became thinner or disappeared and the inner enamel layers became thinner or lost its normal structure as well. It is highly recommended that the resin penetration could be used for the proper treatment of moderate and severe dental fluorosis and the strong bleaching and the micro-grinding should be used cautiously.
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Wang YF, Zhang YX, Zeng YM, Wu WJ, Chen YF, Huang DH, Huang JM. [Two cases of pulmonary Schizophyllum commune infection and literature review]. ZHONGHUA NEI KE ZA ZHI 2021; 60:1169-1172. [PMID: 34856690 DOI: 10.3760/cma.j.cn112138-20210113-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Guo Y, Chen LH, Liu M, Zhang YX, Zhang N, Chen J. [Comparison of clinical characteristics between sporadic gastrinoma and multiple endocrine neoplasia type 1-related gastrinoma]. ZHONGHUA WEI CHANG WAI KE ZA ZHI = CHINESE JOURNAL OF GASTROINTESTINAL SURGERY 2021; 24:875-882. [PMID: 34674462 DOI: 10.3760/cma.j.cn.441530-20210719-00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare clinical characteristics of sporadic gastrinoma and multiple endocrine neoplasia type 1 (MEN1)-related gastrinoma. Methods: A retrospective cohort study was conducted. Patients with clinical manifestations of Zollinger-Ellison syndrome, pathological diagnosis as neuroendocrine neoplasm (NEN) and complete clinical and follow-up data were enrolled. Patients with only high gastric acid secretion but without evidence of NEN, or with other concurrent non-NEN tumors were excluded. According to the above criteria, the clinicopathological data of 52 cases of gastrinoma diagnosed from April 2003 to December 2020 in the First Affiliated Hospital, Sun Yat-sen University, were collected. Patients who met the diagnostic criteria of gastrinoma and met one of the following conditions were diagnosed as MEN1-related gastrinoma: (1) the presence of pathogenic mutations in the MEN1 gene confirmed by genetic testing; (2) NENs involving two or more endocrine glands, namely, pituitary, parathyroid, thymic, pancreatic, and adrenal NENs; (3) NEN and at least one first-degree relatives diagnosed as MEN1. The remaining gastrinomas were defined as sporadic gastrinoma. Student's t test and chi-square test were used for statistical analysis. Clinicopathological characteristics, endoscopic findings, imaging characteristics, treatment, and prognosis of sporadic and MEN1-related gastrinoma were compared. Results: Among 52 patients with gastrinoma, 33 were sporadic gastrinoma and 19 were MEN1-related gastrinoma. The common symptoms of both sporadic and MEN1-related gastrinomas were diarrhea (24/33, 72.7%; 17/19, 89.5%) and abdominal pain (19/33, 57.6%; 9/19, 47.4%). Compared with sporadic gastrinoma, MEN1-related gastrinoma needed longer time for diagnosis [(7.4±4.9) years vs. (3.9±5.2) years, t=-2.355, P=0.022), were more likely multiple tumors [47.4% (9/19) vs. 15.2% (5/33), χ(2)=6.361, P=0.012], had smaller diameter [(1.7±1.0) cm vs. (3.1±1.8) cm, t=2.942, P=0.005), presented the lower tumor grade [G1: 83.3% (15/18) vs. 39.4% (13/33); G2: 11.1% (2/18) vs. 54.5% (18/33); G3: 5.6% (1/18) vs. 6.1% (2/33), Z=-2.766, P=0.006], were less likely to have serum gastrin which was 10 times higher than normal [11.8% (2/17) vs. 56.0% (14/33), χ(2)=8.396, P=0.004], had higher probability of complication with type 2 gastric neuroendocrine tumors (g-NET) [31.6% (6/19) vs. 3.0%(1/33), χ(2)=6.163, P=0.013], and had lower rate of liver metastasis [21.1% (4/19) vs. 51.5% (17/33), χ(2)=4.648, P=0.031). There was no obvious difference between sporadic gastrinomas and MEN1-related gastrinomas in endoscopic findings. Both types presented enlarged and swollen gastric mucosa under the stimulation of high gastric acid, and multiple ulcers in the stomach and duodenum could be seen. Gastrinoma with type 2 g-NET presented multiple polypoid raised lesions in the fundus and body of the stomach. (68)Ga-SSR-PET/CT scan had a 100% detection rate for both types while (18)F-FDG-PET/CT scan had a higher detection rate for sporadic gastrinoma compared with MEN1-related gastrinoma [57.9% (11/19) vs. 20.0% (3/15), χ(2)=4.970, P=0.026]. Among the patients with sporadic gastrinoma, 19 received surgical treatment, 1 underwent endoscopic submucosal dissection, 8 underwent transcatheter arterial embolization (TAE), and 5 underwent surgery combined with TAE. Among patients with MEN1-related gastrinoma, 13 received surgical treatment, and the other 6 received conservative treatment. The median follow-up of all the patients was 21.5 (1-129) months, and the 5-year survival rate was 88.4%. The 5-year survival rate of patients with sporadic and MEN1-related gastrinomas was 89.5% and 80.0% respectively (P=0.949). The 5-year survival rate of patients with and without liver metastasis was 76.2% vs. 100%, respectively (P=0.061). Conclusions: Compared with sporadic gastrinoma, MEN1-related gastrinoma has longer diagnosis delay, smaller tumor diameter, lower tumor grading, lower risk of liver metastasis, and is more likely to complicate with type 2 g-NET, while there is no difference in survival between the two tumor types.
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He BJ, Chen WY, Liu LL, Zhu HY, Cheng HZ, Zhang YX, Wang SF, Zhan SY. [The risk prediction models for occurrence of cervical cancer: a systematic review]. ZHONGHUA LIU XING BING XUE ZA ZHI = ZHONGHUA LIUXINGBINGXUE ZAZHI 2021; 42:1855-1862. [PMID: 34814624 DOI: 10.3760/cma.j.cn112338-20200806-01031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To systematically summarize and assess risk prediction models for occurrence of cervical cancer and to provide evidence for selecting the most reliable model for practice, and guide cervical cancer screening. Methods: Two groups of keywords related to cervical cancer and risk prediction model were searched on Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, and Cochrane Library). Original articles that developed or validated risk prediction models and published before November 21, 2019, were selected. Information form was created based on the CHARMS checklist. The PROBAST was used to assess the risk of bias. Results: 12 eligible articles were identified, describing 15 prediction models, of which five were established in China. The predicted outcomes included multiple stages from cervical precancerous lesions to cancer occurrence, i.e., abnormal Pap smear (1), occurrence or recurrence of CIN (9), and occurrence of cervical cancer (5), etc. The most frequently used predictors were HPV infection (12), age (7), smoking (5), and education (5). There were two models using machine learning to develop models. In terms of model performance, the discrimination ranged from 0.53 to 0.87, while only two models assessed the calibration correctly. Only two models were externally validated in Taiwan of China, using people in different periods. All of the models were at high risk of bias, especially in the analysis domain. The problems were concentrated in the improper handling of missing data (13), preliminary evaluation of model performance (13), improper use of internal validation (12), and insufficient sample size (11). In addition, the problems of inconsistency measurements of predictors and outcomes (8) and the flawed report of the use of blindness for outcome measures (8) were also severe. Compared with the other models, the Rothberg (2018) model had relatively high quality. Conclusions: There are a certain number of cervical cancer risk prediction models, but the quality is poor. It is urgent to improve the measurement of predictors and outcomes, the statistical analysis details such as handling missing data and evaluation of model performance and externally validate existing models to better guide screening.
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Zhang YP, Li YT, Zhang HM, Wang H, Zhang YX. [Comparison of various methods in the diagnosis of malignant melanoma with varying content of melanin]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2021; 50:1172-1176. [PMID: 34619874 DOI: 10.3760/cma.j.cn112151-20210107-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Zhang YX, Shi T, Su QR, Deng JK. [Clinical characteristics and related factors of human respiratory syncytial viruses infection in premature infants within 2 years after birth in Shenzhen Children's Hospital]. ZHONGHUA YI XUE ZA ZHI 2021; 101:2873-2877. [PMID: 34587727 DOI: 10.3760/cma.j.cn112137-20210226-00505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To analyze the clinical characteristics and factors associated with human respiratory syncytial virus (HRSV) infection in preterm infants within the first 2 years of life. Methods: Children with respiratory tract infections admitted to Shenzhen Children's Hospital during the 3-year period from January 2016 to December 2018 who were <2 years old and whose gestational age at birth was <37 weeks were selected, and those who met the diagnostic criteria for RSV infection were categorized as the positive case group, and those who had no detectable influenza virus, parainfluenza virus and adenovirus antigens were categorized as the negative group. The clinical characteristics of the case group were retrospectively analyzed. A multivariable logistic regression model was used to analyze the associated factors. Results: A total of 1, 483 children were included, of whom 149 (10.1%) were HRSV positive (case group) and 447 (30.1%) were in the negative group (control group). In the case group, there were 88 (59.1%) male and 61 (40.1%) female children; 127 children (85.2%) in the mild-to-moderate disease group and 22 children (14.8%) in the severe disease group. The number of cases in the severe disease group was greater than that in the mild-to-moderate disease group [(17 cases, 77.3%) than (59 cases, 46.5%)], with statistical significance (P=0.010). A total of 117 cases (78.5%) had onset from February to July. Multivariable analysis showed that males [OR (95%CI) of 0.105 (0.013-0.112)], age at month [0.045 (0.036-0.112)], congenital heart disease [0.388 (0.206-0.940)] and bronchopulmonary dysplasia [0.622 (0.484-0.927)] were positively associated with HRSV infection in preterm infants. Conclusion: The high prevalence of HRSV infection in preterm infants in Shenzhen is from February to July each year, and male children are more common. Young age, congenital heart disease and bronchopulmonary dysplasia are all independent risk factors for HRSV infection in preterm infants.
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Xi WJ, Zhang Z, Li J, Su WJ, Li H, Pu ZM, Zhang Y, Feng SQ, Zhang YX. [Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars]. ZHONGHUA SHAO SHANG ZA ZHI = ZHONGHUA SHAOSHANG ZAZHI = CHINESE JOURNAL OF BURNS 2021; 37:711-717. [PMID: 34404161 DOI: 10.3760/cma.j.cn501120-20210624-00225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical effect of the fractional carbon dioxide laser in the treatment of contracture scars. Methods: A retrospective before-after self-control study was conducted. From December 2016 to April 2021, 16 patients (7 males and 9 females, aged 3-49 years) with contracture scars causing impaired function of the adjacent joint were admitted to Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Eighteen joint scars of 16 patients were treated with fractional carbon dioxide laser every 2-3 months until the joint retained its normal range of motion or the effect plateaued. The treatment times of each patient were recorded. Before the first treatment and 6 months after the last treatment, the ranges of motion of the affected joint were measured in each patient, and the difference was calculated, meanwhile, the Vancouver Scar Scale (VSS) was used to evaluate the scar of each patient. In the treatment of 1 joint scar in each of 6 patients (totally 6 times of treatments), the ranges of motion of the affected joint before the current treatment, immediately after the treatment, and at the first follow-up after the treatment were documented, and the differences between the ranges before and immediately after the treatment as well as between the ranges before and at the first follow-up after the treatment were calculated. Adverse effects after the treatment in the treatment area were documented. At the last follow-up, a self-made questionnaire was used to collect the implementation status of the physical therapy and other scar management modalities during the treatment interval and follow-up period. Data were statistically analyzed with Wilcoxon rank sum test. Results: Eighteen joint scars in 16 patients received 2 (1, 3) times of fractional carbon dioxide laser treatment. The range of motion of the affected joint of 16 patients 6 months after the last treatment was 56.5 (39.0, 128.8)°, notably higher than 38.4 (22.9, 116.3)° before the first treatment (Z=-3.724, P<0.01), showing a remarkable improvement by 17.4 (8.0, 24.1)°. The vascular distribution, softness, and thickness scores, and total score in VSS scoring of scars of 16 patients 6 months after the last treatment were significantly lower than those before the first treatment (Z=-2.989, -3.762, -2.814, -3.739, P<0.01), with the most obvious improvement in softness. In 6 times of treatments, the range of motion of the affected joint immediately after treatment and at the first follow-up of (2.5±0.6) months after treatment were 156.2 (148.0, 164.2)° and 160.2 (156.7, 166.4)°, both notably higher than 151.4 (145.7, 155.3)° before treatment (Z=-2.201, -2.201, P<0.05), showing a remarkable improvement by 9.1 (4.4, 13.0)° and 13.1 (8.0, 15.7)°, respectively. No adverse effects such as blisters, infection, or hypertrophic scar formation were observed in the treatment area of 16 patients after treatment. Most patients adopted physical therapy, compression, silicone gel or sheets, and braces during the treatment interval and follow-up period. Conclusions: The fractional carbon dioxide laser can soften the scar and increase the range of motion of the affected joint, which is suitable for the clinical treatment of mild contracture scars.
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Cheng SH, Zhang HY, Zhu MY, Zhou LM, Yi GH, He XW, Wu JY, Sui JL, Wu H, Yan SJ, Zhang YX, Lv CZ. Observations of linear aggregation behavior in rotifers (Brachionus calyciflorus). PLoS One 2021; 16:e0256387. [PMID: 34411194 PMCID: PMC8376037 DOI: 10.1371/journal.pone.0256387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 08/06/2021] [Indexed: 11/18/2022] Open
Abstract
Linear aggregation is present in some animals, such as the coordinated movement of ants and the migration of caterpillars and spinylobsters, but none has been reported on rotifers. The rotifers were collected and clone cultured in the laboratory at 25 ± 1°C, under natural light (light intensity ~130 lx, L:D = 14:10). The culture medium(pH = 7.3) was formulated as described by Suga et al., and rotifers were fed on the micro algae Scenedesmus obliquus grown in HB-4 medium to the exponential growth stage. When density was high (150 individuals ml-1), the behavior of rotifers was observed using a stereo microscope (Motic ES-18TZLED). In this paper, linear aggregation in Brachionus calyciflorus was found for the first time, and experiments were carried out to verify the correlation between linear aggregation and culture density of B. calyciflorus. With the increase of density, the number of aggregations increase, the number of individuals in the aggregation increased, and the maintenance time of the aggregation was also increased. Therefore, we speculate that the formation of aggregates is related to density and may be a behavioral signal of density increase, which may transmit information between density increase and formation of dormant eggs.
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Zhang YX, Zhang SN. [Clinical application and mechanism of botulinum toxin type A in scar treatment]. ZHONGHUA SHAO SHANG ZA ZHI = ZHONGHUA SHAOSHANG ZAZHI = CHINESE JOURNAL OF BURNS 2021; 37:705-710. [PMID: 34404162 DOI: 10.3760/cma.j.cn501120-20210701-00232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pathological scars cause both local physical discomforts and mental disorders for patients. With the development of research, botulinum toxin type A (BTX-A) has been gradually used in the clinical treatment of scars. This article summarizes three potential mechanisms of BTX-A, including early tension reduction, inhibition of connective tissue hyperplasia, and alleviation of skin inflammation, as well as the clinical application of BTX-A in treating different types of scars. However, at present there is no uniform standard for the time, method, and proportioning of BTX-A injection for scar treatment, and there is also a lack of long-term follow-up results. Further researches are needed in future to clarify the mechanism of BTX-A in inhibiting scars, establish a uniform protocol of BTX-A injection, and provide a more effective treatment plan for scars.
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Zhang C, Peng Y, Luo XQ, Li QM, Yang ZC, Chen Y, Peng YZ, Zhang YX, Gong YL. [Epidemiological investigation and analysis of etiological characteristics of infection on 3 067 hospitalized pediatric patients with burns]. ZHONGHUA SHAO SHANG ZA ZHI = ZHONGHUA SHAOSHANG ZAZHI = CHINESE JOURNAL OF BURNS 2021; 37:538-545. [PMID: 34139834 DOI: 10.3760/cma.j.cn501120-20210201-00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the epidemiological characteristics and etiological distribution of infection on 3 067 hospitalized pediatric patients with burns, and explore the prevention and treatment strategy of pediatric burns. Methods: A cross-sectional survey was conducted. An analysis was performed on the data of 3 067 hospitalized pediatric patients with burns who met the inclusion criteria and were admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January 2012 to December 2020, including gender, age, causative factors, locations and severities of burns, seasons of accidents, and the type, source of tissue or body fluid, and drug resistance of pathogenic bacteria. API bacterial identification batten and automatic microbial identification system were applied for pathogen identification. Drug sensitivities of top 3 consistent ratio pathogen identifed were tested with minimum inhibitory concentration and disk diffusion method. WHONET 5.6 software was applied to analyze the data. Results: There were 3 067 hospitalized pediatric patients with burns, including 1 768 boys and 1 299 girls. The majority of pediatric burn patients were >1 and ≤4 years, accounting for 72.9% (2 236/3 067), and the minority of pediatric burn patients were >8 and ≤12 years, accounting for 4.9% (150/3 067). Moderate burns and severe burns of pediatric burn patients accounted for the majority parts, and the proportions of the two were close. The top cause of pediatric burns was scald, accounting for 81.6% (2504/3 067). Extremities were the most common burn sites in that of entire 3 254. The most pediatric burns occurred in winter, accounting for 29.4% (903/3 067). A total of 1 018 strains of pathogenic bacteria were collected from pediatric burn patients, all of which were non-repeated isolates. The pathogens with top five consistent ratio were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterobacter cloacae, and Escherichia coli, among which Staphylococcus aureus ranked the first every year. The pathogens were mainly isolated from the wound exudate, accounting for 81.34% (828/1 018). Staphylococcus aureus from 2012 to 2020 showed no resistance to vancomycin, linezolid or teicoplanin while Staphylococcus aureus isolated in 2019 was 100% resistant to macrolides, penicillin, aminoglycosides, and quinolones. Pseudomonas aeruginosa was not resistant to polymyxin B. Acinetobacter baumannii showed a high rate of drug resistance to most antibiotics. Conclusions: Among the pediatric burn patients admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from 2012 to 2020, the majority are male children aged >1 and ≤4 years with moderate burns. Scalds are the leading cause; and extremities are the common burn sites; and the most pediatric burns occurre in winter. Staphylococcus aureus from wound exudate is the primary pathogen of burn wound infections in pediatric patients.
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Fan S, Zhang HS, Zhang YX, Shen KX. [A case of intestinal angiomyofibroblastoma complicated with stomach cancer]. ZHONGHUA WEI CHANG WAI KE ZA ZHI = CHINESE JOURNAL OF GASTROINTESTINAL SURGERY 2021; 24:452-453. [PMID: 34000776 DOI: 10.3760/cma.j.cn.441530-20200911-00519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Jin TT, Zhang YX, Zhu YH, Gong J, Yan LL. [Spatiotemporal variations of ecosystem service values and landscape ecological risk and their correlation in forest area of Loess Plateau, China:A case study of Ziwuling region.]. YING YONG SHENG TAI XUE BAO = THE JOURNAL OF APPLIED ECOLOGY 2021; 32:1623-1632. [PMID: 34042356 DOI: 10.13287/j.1001-9332.202105.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although the awareness of ecosystem services provided by natural landscape is increa-sing, few studies integrate ecosystem services value (ESV) into ecological risk management and its control. With Ziwuling region as an example, we carried out the gridding resampling of landscape pattern types in the forest area of Ziwuling region in 1980, 1990, 2000, 2010 and 2017. We quantified the ESV and landscape ecological risk and their spatiotemporal variations, based on the 2.5 km×2.5 km grid. The spatial correlation between the ESV and landscape ecological risk was examined. The results showed that the ESV decreased from the center to the outside of Ziwuling region, which increased from 12.345 to 12.633 billion yuan from 1980 to 2017. The landscape ecological risk increased from the center to the outside edge of Ziwuling region, indicating that the landscape ecological risk of Ziwuling region was reduced and the overall ecological situation was improved. There was a significant negative correlation and negative spatial correlation between ESV and landscape ecological risk in this area. The high value-low risk area was mainly located in Ziwu-ling forest area, while the ESV might be maintained in the future.
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Zhao N, Yu MJ, Xu J, Wang HY, Liang B, Ding L, Zhang YX, Du K, Leng BL. microRNA-29b mediates Th17/Treg imbalance in chronic obstructive pulmonary disease by targeting IL-22. J BIOL REG HOMEOS AG 2021; 35:987-999. [PMID: 34159768 DOI: 10.23812/21-15-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) represents a chronic inflammatory disorder of the airways induced mainly by cigarette smoking. In the current study, cigarette smoke extract (CSE) was used to develop an in vitro COPD model using human bronchial epithelium (HBE) cells to expound the possible role of microRNA-29b (miR-29b) in COPD. Firstly, miR-29b and interleukin (IL)-22 expression was assessed in serum of 20 healthy non-smokers, 20 healthy smokers and 20 COPD patients as well as CSE-treated HBE cells. Then, miR-29b and IL-22 expression was altered to evaluate their functions in Th17/Treg ratio. miR-29b inhibited Th17/Treg ratio and levels of IL-22; whereas overexpression of IL-22 reversed these trends. Moreover, rescue experiments found that IL-22 neutralized the repressive effects of miR-29b on Th17/Treg ratio and inflammatory response. Finally, we found that miR-29b blocked the JAK/STAT3 pathway in CSE-treated HBE cells. These data highlighted that miR-29bs modulated Th17/Treg imbalance in CSE-induced experimental COPD through inhibition of IL-22-dependent JAK/STAT3 pathway.
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Huang X, Yao L, Deng ZR, Dong J, Zheng RJ, Lu XB, Zhang YX, Sun LH. [Analysis of clinical characteristics of 481 HBV-related liver cirrhotic patients with low viral load]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2021; 29:227-233. [PMID: 33902189 DOI: 10.3760/cma.j.cn501113-20200302-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical characteristics of HBV-related liver cirrhotic patients with low viral load. Methods: A retrospective analysis on 481 inpatients with HBV-related cirrhosis with low viral load [HBV DNA≤2 000 IU/ml (10(4) copies/ml)] general condition, virological indicators, liver function-related indicators, complications, and incidence of complications were analyzed. The t-test was used to compare the average measurement data, and the χ (2) test was used to compare the count data. Results: 481 cases were mainly male (male/female: 324/157), aged 20-83 (53.31 ± 11.67) years old. Han nationality accounted for 71.518%. 386 cases were HBsAg positive. 391 cases were HBeAg positive, and 140 cases were HBV DNA positive. The average value of bilirubin, albumin, alanine aminotransferase, aspartate aminotransferase, platelets, and prothrombin were 50.59 ± 91.25 (μmol/L), 33.68 ± 7.5 (g/L), and 60.66 ± 106.95(U/L), 63.37 ± 86.19(U/L), 106.65 ± 83.22(×10(9)/L), 68.82% ± 25.33%, respectively. CTP class A/B/C had 220/150/111 cases. The average values of CTP, MELD, APRI and FIB-4 were 7.61 ± 2.58, 10.98 ± 5.79, 2.34 ± 3.56, 6.91 ± 8.04, respectively. The overall incidence of complications in HBV-related cirrhotic patients with low viral load, HBV DNA negative, HBV DNA positive, HBsAg negative, and HBsAg positive were 80.0%, 82.7%, 73.6%, 85.3%, and 78.8%, respectively. Among them, 283 cases (58.84%), 197 cases (55.77%), 86 cases (61.43%), 52 cases (54.74%) and 231 cases (59.84%) were of hypersplenism, and 267 cases (55.51%), 197 cases (55.77%), 70 cases (50.00%), 56 cases (58.95%), and 211 cases (54.66%) were of esophagogastric varices. There were 59 cases (12.27%), 48 cases (14.08%), 11 cases (7.86%), 12 cases (12.63%), and 47 cases (12.18%) of rupture of esophageal and gastric varices, respectively. 202 cases (42.00%), 147 cases (43.11%), 55 cases (39.29%), 42 cases (44.21%), and 160 cases (41.45%) were of ascites, respectively. 17 cases (3.53%), 12 cases (3.52%), 5 cases (3.5%), 2 cases (2.11%), 15 (3.89%) cases were of hepatic encephalopathy, respectively. There were 6 cases (1.25%), 3 cases (0.88%), 3 cases (2.14%), 0 cases (0%), 6 cases (1.55%) of liver cancer. 29 cases (6.03%), 21 cases (6.16%), 8 cases (5.71%), 9 cases (9.47%) and 20 cases (5.18%) were of portal vein thrombosis. Compared with the overall incidence of complications, 341 HBV DNA-negative patients and 95 HBsAg-negative patients still had higher incidence of complications. The patients were grouped by age, and in < 40 years old, 40-50 years old, and > 50 years old, the overall complications were 80.8% in 42 cases, 76.8% in 116 cases and 81.7% in 227 cases, and the difference was not statistically significant. Conclusion: HBV infection patients with low viral load, and those whose HBsAg has disappeared, are still at risk of developing liver cirrhosis and even serious complications, and whether such population need antiviral therapy and benefit from it deserves further research.
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Wang AC, Wang LQ, Li J, Li MX, Tu LL, Zhang YX, Liu AJ. [Artificial intelligence aided measurement of cervical squamous epithelial thickness and its correlation with cervical precancerous lesions]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2021; 50:339-343. [PMID: 33831991 DOI: 10.3760/cma.j.cn112151-20201218-00937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the thickness of cervical squamous epithelia and its correlation with cervical precancerous lesions. Methods: We selected 495 HE slides of 209 cervical biopsies from January 2020 to June 2020 in the Department of Pathology, the First and Seventh Medical Center of the PLA General Hospital, including 173 slides with low grade squamous intraepithelial lesion (LSIL) and 214 slides with high grade squamous intraepithelial lesion (HSIL). Artificial intelligence labeling software was used to assist in measuring the epithelial thickness of normal cervical squamous epithelium, LSIL and HSIL of each slide. The thickest, thinnest, and middle widths of epithelial thickness were measured, respectively. Average epithelial thickness was defined as the sum of the above three widths divided by 3. The correlation statistical analysis was performed by combining the data of age and pathological diagnosis. Results: The average thickness of normal cervical squamous mucosa was (245.83±91.40) μm, which was (222.42±81.22) μm and was (195.95±66.59) μm in LSIL and HISL epithelial respectively (F=27.09, P<0.01). The average cell layers of normal cervical squamous epithelium was (15.5±4.2) layers, which of LSIL was (14.8±4.8) layers, and that of HSIL was (15.8±4.8) layers. The differences among normal, LSIL and HSIL were not statistically significant (P>0.05). Further statistical analysis was stratified by age (≤30 years, 31-40 years, 41-50 years, 51-60 years, and >60 years), the results of Pearson correlation analysis showed that the thickness of normal cervical squamous epithelial gradually thinned with age (correlation coefficient r=-0.141 9, P<0.05), while LSIL and HSIL epithelial thickness had significant correlation with age (P>0.05). In the subgroup of ≤50 years old, the epithelial thickness of normal squamous epithelium was the thickest, followed by LSIL, and HSIL epithelial thickness was the thinnest. The differences were statistically significant (P<0.05). While in the subgroup of >50 years, the differences were not statistically significant (P>0.05). Conclusions: The cervical squamous epithelium gradually becomes thinner with the degree of precancerous lesions increasing among patients of ≤50 years old. However, after age of 50 years, with the onset of menopause, the normal mucosal epithelium is becoming atrophy, so that mucosal thickness is no longer correlated with the extent of the lesion. In addition, it is suggested that the cervical vinegar white test performance during colposcopy is related to the protein changes in the mucosal epithelial cells, but not directly related to the thickness of the epithelial layer.
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Shi Z, Chen GZ, Mao L, Li XL, Zhou CS, Xia S, Zhang YX, Zhang B, Hu B, Lu GM, Zhang LJ. Machine Learning-Based Prediction of Small Intracranial Aneurysm Rupture Status Using CTA-Derived Hemodynamics: A Multicenter Study. AJNR Am J Neuroradiol 2021; 42:648-654. [PMID: 33664115 PMCID: PMC8041003 DOI: 10.3174/ajnr.a7034] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/09/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Small intracranial aneurysms are being increasingly detected while the rupture risk is not well-understood. We aimed to develop rupture-risk models of small aneurysms by combining clinical, morphologic, and hemodynamic information based on machine learning techniques and to test the models in external validation datasets. MATERIALS AND METHODS From January 2010 to December 2016, five hundred four consecutive patients with only small aneurysms (<5 mm) detected by CTA and invasive cerebral angiography (or surgery) were retrospectively enrolled and randomly split into training (81%) and internal validation (19%) sets to derive and validate the proposed machine learning models (support vector machine, random forest, logistic regression, and multilayer perceptron). Hemodynamic parameters were obtained using computational fluid dynamics simulation. External validation was performed in other hospitals to test the models. RESULTS The support vector machine performed the best with areas under the curve of 0.88 (95% CI, 0.85-0.92) and 0.91 (95% CI, 0.74-0.98) in the training and internal validation datasets, respectively. Feature ranks suggested hemodynamic parameters, including stable flow pattern, concentrated inflow streams, and a small (<50%) flow-impingement zone, and the oscillatory shear index coefficient of variation, were the best predictors of aneurysm rupture. The support vector machine showed an area under the curve of 0.82 (95% CI, 0.69-0.94) in the external validation dataset, and no significant difference was found for the areas under the curve between internal and external validation datasets (P = .21). CONCLUSIONS This study revealed that machine learning had a good performance in predicting the rupture status of small aneurysms in both internal and external datasets. Aneurysm hemodynamic parameters were regarded as the most important predictors.
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Xu XQ, Jiang X, Gao X, Peng FH, Zhang HD, Wu T, Zhang YX, Jing ZC. [Feasibility and safety of right ventricular endomyocardial biopsy via the right internal jugular vein approach]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2021; 49:17-22. [PMID: 33429481 DOI: 10.3760/cma.j.cn112148-20200723-00584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the feasibility and safety of right ventricular endomyocardial biopsy (EMB) via the right internal jugular vein approach. Methods: It was a retrospective and descriptive study. A total of 272 patients, who underwent right ventricular EMB from December 2014 to June 2020 in Fuwai Hospital and Peking Union Medical College Hospital were enrolled. The preliminary diagnosis included suspected myocarditis, myocardiopathy, unexplained heart failure etc after exclusion of coronary heart disease. Clinical characteristics including age, sex, height, weight, NYHA functional class, NT-proBNP, chest radiography, echocardiography, and hemodynamics parameters were collected at baseline. EMB was performed via right internal jugular vein approach under the biplane fluoroscopic guidance. Success rate was calculated in this study. Complications related to operation were recorded according the following definitions. Major complications included death, urgent cardiac surgery, advanced cardiac life support, pericardiocentesis in cardiac tamponade, permanent complete atrioventricular block requiring permanent pacing etc. Minor complications included pericardial effusion without pericardiocentesis, temporary (lasting less than 24 hours) or permanent right bundle-branch block, temporary Mobitz type Ⅱ atrioventricular block (AV block) with AV conduction 2∶1 requiring medical treatment with atropine, or additive temporary pacing, non-sustained ventricular tachycardia with long runs of more than 10 ventricular complexes, and an episode of atrial fibrillation lasting less than 12 hours or cardioversion of atrial fibrillation. Other complications included tricuspid anterior chorda rupture and new onset tricuspid regurgitation after EMB. Results: In this study, right ventricular EMB were performed successfully in 270 patients, the total success rate was 99.3% (270/272), and EMB were failed in 2 (0.7%) patients. Age of the enrolled patients was (42.7±16.9) years, and there were 164 (60.3%) males. Major complication including cardiac tamponade requiring pericardiocentesis occurred in 2 (0.7%) patients. Minor complications such as small amount pericardial effusion occurred in 18 (6.6%) patients, tricuspid anterior chorda rupture occurred in 1 (0.4%) patient. No patient died, or requiring permanent pacing, or requiring emergency cardiac surgery. The complication rate was 9.3% (13/140), 7.8% (7/90), and 2.4% (1/42) in operators with 1, 2, and 3 years' experience. Conclusions: EMB via the right jugular vein approach under fluoroscopic guidance is a simple, safe and feasible procedure. The complication rates decrease significantly with increasing operator experience.
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