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Identification and validation of a new prognostic signature based on cancer-associated fibroblast-driven genes in breast cancer

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World Journal of Clinical Cases 2024年第4期12卷 700-720页

作者： Zi-Zheng Wu Yuan-Jun Wei Tong Li Jie Zheng Yin-Feng Liu Meng Han Diagnosis and Treatment Center The First Hospital of QinhuangdaoQinhuangdao 066000Hebei ProvinceChina Department of General Surgery Hebei Medical UniversityShijiazhuang 050000Hebei ProvinceChina Breast Disease Diagnosis and Treatment Center The First Hospital of QinhuangdaoHebei Medical UniversityQinhuangdao 066000Hebei ProvinceChina Breast Disease Diagnosis and Treatment Center Chengde Medical CollegeChengde 067000Hebei ProvinceChina

BACKGROUND Breast cancer(BC),a leading malignant disease,affects women all over the world.Cancer associated fibroblasts(CAFs)stimulate epithelial-mesenchymal transition,and induce chemoresistance and immunosuppression.AIM To establish a CAFs-associated prognostic signature to improve BC patient out-come estimation.METHODS We retrieved the transcript profile and clinical data of 1072 BC samples from The Cancer Genome Atlas(TCGA)databases,and 3661 BC samples from the The Gene Expression Omnibus.CAFs and immune cell infiltrations were quantified using CIBERSORT algorithm.CAF-associated gene identification was done by weighted gene co-expression network analysis.A CAF risk signature was established via univariate,least absolute shrinkage and selection operator regression,and mul-tivariate Cox regression analyses.The receiver operating characteristic(ROC)and Kaplan-Meier curves were employed to evaluate the predictability of the model.Subsequently,a nomogram was developed with the risk score and patient clinical signature.Using Spearman's correlations analysis,the relationship between CAF risk score and gene set enrichment scores were examined.Patient samples were collected to validate gene expression by quantitative real-time polymerase chain reaction(qRT-PCR).RESULTS Employing an 8-gene(IL18,MYD88,GLIPR1,TNN,BHLHE41,DNAJB5,FKBP14,and XG)signature,we attemp-ted to estimate BC patient prognosis.Based on our analysis,high-risk patients exhibited worse outcomes than low-risk patients.Multivariate analysis revealed the risk score as an independent indicator of BC patient prognosis.ROC analysis exhibited satisfactory nomogram predictability.The area under the curve showed 0.805 at 3 years,and 0.801 at 5 years in the TCGA cohort.We also demonstrated that a reduced CAF risk score was strongly associated with enhanced chemotherapeutic outcomes.CAF risk score was significantly correlated with most hallmark gene sets.Finally,the prognostic signature were further validated by qRT-PCR.CONCLUSION We introduced a newly-discovered

关键词： Breast cancer Prognosis Gene signature The Cancer Genome Atlas The Gene Expression Omnibus

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Effects of psychological nursing in Parkinson's related depression patients undergoing functional magnetic resonance imaging:A randomized controlled trial

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World Journal of Clinical Cases 2024年第17期12卷 3086-3093页

作者： Xiao-Xia Zhang Xiao-Hui Zhang Yan-Chao Dong Department of Internal Medicine The First hospital of QinhuangdaoQinhuangdao 066000Hebei ProvinceChina Department of Gastroscope The First hospital of QinhuangdaoQinhuangdao 066000Hebei ProvinceChina Medical Imaging Center The First hospital of QinhuangdaoQinhuangdao 066000Hebei ProvinceChina

BACKGROUND Patients with Parkinson’s disease(PD)often experience depression,and some may require magnetic resonance imaging(MRI)for diagnosis,which can lead to MRI failure due to claustrophobia.AIM To explore the value of psychological interventions in successfully completing functional MRI scans of the brain for PD-related depression.METHODS Ninety-six patients with PD were randomly divided into two groups.The control group(47 patients)received general care,and the experimental group(49 patients)received general care combined with psychological care.The Unified Parkinson's Disease Assessment Scale(UPDRS),Hamilton Depression Scale(HAMD),and Geriatric Depression Scale(GDS)-15 scores,heart rate,systolic blood pressure,and MRI-Anxiety Questionnaire(MRI-AQ)scores before and after the scan were recorded.The completion rate of magnetic resonance(MR)scanning,scanning duration,and image quality scores were recorded.RESULTS Before scanning,no statistically significant difference was observed between the two groups in terms of heart rate,systolic blood pressure,and UPDRS,HAMD,GDS-15,and MRI-AQ scores.After scanning,systolic blood pressure,MRI-AQ score,and scan time in the experimental group were significantly lower than those in the control group,whereas the scan completion rate and image quality score were significantly higher than those in the control group.CONCLUSION Psychological nursing interventions are helpful in alleviating PD-related depression and assessing MR depression scores and may be helpful in the successful completion of functional MRI scans of the patient's brain.

关键词： Magnetic resonance imaging Psychological nursing Parkinson's disease Depression Claustrophobia

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Combination of allopurinol with Dahuang Mudan Tang(大黄牡丹汤)significantly improve kidney function and alleviate oxidative stress and inflammation of chronic kidney disease stageⅠ-Ⅲpatients with hyperuricemia

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Journal of Traditional Chinese Medicine 2024年第1期44卷 182-187页

作者： FANG Congcong ZHU Xiaoliang ZHANG Yongjian QI Huan ZHANG Yingjie Department of Endocrinology Qinhuangdao Hospital of Traditional Chinese MedicineQinhuangdao 066000China Department of Nephrology Qinhuangdao Hospital of Traditional Chinese MedicineQinhuangdao 066000China

OBJECTIVE:To evaluate the effect of Dahuang Mudan Tang(大黄牡丹汤,DHMD)and allopurinol on the treatment of chronic kidney disease staged G1-G3b patients with hyperuricemia and to provide novel insights into the clinical management of chronic kidney disease complications.METHODS:A total of 80 chronic kidney patients staged G1-G3b with hyperuricemia were randomly grouped to receive single allopurinol treatment(control)and combined treatment with DHMD(treated)for 8 weeks.The kidney function and proteinuria indicators of patients were compared between pre-and post-treatment.The oxidative stress and inflammation responses were evaluated by corresponding indicators and cytokines.The clinical efficiency rate and adverse reaction events were also summarized to assess the therapeutic efficiency and safety.RESULTS:The kidney function and proteinuria of enrolled patients were alleviated after their therapies,behaved as the increasing estimated glomerular filtration rate and decreasing serum creatinine,serum uric acid,urea nitrogen,24 h urine protein levels.On the other hand,the malondialdehyde level and pro-inflammation cytokines were suppressed by the therapies,and the superoxide dismutase was found to be significantly enhanced.Patients in the treated groups showed a better recovery in kidney function,proteinuria,oxidative stress,and inflammation response.Moreover,patients in the treated group showed a higher efficiency rate(95%)and fewer adverse reaction events(5%).CONCLUSIONS:The combination of allopurinol with DHMD significantly promoted the recovery of chronic kidney disease stage G1-G3b patients with hyperuricemia,which can be considered a novel clinical therapeutic strategy.

关键词： allopurinol renal insufficiency chronic hyperuricemia uric acid urine protein Rhubarb Peony decoction

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Liver as a new target organ in Alzheimer's disease:insight from cholesterol metabolism and its role in amyloid-beta clearance

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Neural Regeneration Research 2025年第3期20卷 695-714页

作者： Beibei Wu Yuqing Liu Hongli Li Lemei Zhu Lingfeng Zeng Zhen Zhang Weijun Peng Department of Integrated Traditional Chinese&Western Medicine The Second Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina Academician Workstation Changsha Medical UniversityChangshaHunan ProvinceChina Yangsheng College of Traditional Chinese Medicine Guizhou University of Traditional Chinese MedicineGuiyangGuizhou ProvinceChina qinhuangdao Shanhaiguan Pharmaceutical Co. LtdQinhuangdaoHebei ProvinceChina National Clinical Research Center for Mental Disorder The Second Xiangya HospitalCentral South UniversityChangshaHunan ProvinceChina

Alzheimer's disease,the primary cause of dementia,is characterized by neuropathologies,such as amyloid plaques,synaptic and neuronal degeneration,and neurofibrillary tangles.Although amyloid plaques are the primary characteristic of Alzheimer's disease in the central nervous system and peripheral organs,targeting amyloid-beta clearance in the central nervous system has shown limited clinical efficacy in Alzheimer's disease treatment.Metabolic abnormalities are commonly observed in patients with Alzheimer's disease.The liver is the primary peripheral organ involved in amyloid-beta metabolism,playing a crucial role in the pathophysiology of Alzheimer's disease.Notably,impaired cholesterol metabolism in the liver may exacerbate the development of Alzheimer's disease.In this review,we explore the underlying causes of Alzheimer's disease and elucidate the role of the liver in amyloid-beta clearance and cholesterol metabolism.Furthermore,we propose that restoring normal cholesterol metabolism in the liver could represent a promising therapeutic strategy for addressing Alzheimer's disease.

关键词： ABCA1 Alzheimer's disease amyloid-beta apolipoprotein E cholesterol metabolism liver liver X receptor low-density lipoprotein receptor-related protein 1 peripheral clearance tauroursodeoxycholic acid

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Three-dimensional psychological guidance combined with evidencebased health intervention in patients with liver abscess treated with ultrasound

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World Journal of Clinical Cases 2022年第23期10卷 8196-8204页

作者： Ya-Nan Shan Ying Yu Yi-Han Zhao Lian-Lian Tang Xiao-Min Chen Department of Infectious Diseases First Hospital of QinhuangdaoQinhuangdao 066000Hebei ProvinceChina Nursing Department First Hospital of QinhuangdaoQinhuangdao 066000Hebei ProvinceChina

BACKGROUND Liver abscess is a common clinical liver disease mainly caused by suppurative bacteria or amoebae,with early clinical signs of chills,high fever,jaundice,and other symptoms.Establishing its early diagnosis is difficult,which may lead to misdiagnosis.AIM To observe the effects of psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound.METHODS A total of 120 patients with bacterial liver abscess admitted to our hospital from May 2018 to February 2021 were selected and divided into groups according to their intervention plan.RESULTS After the intervention,Self-Rating Depression Scale,Self-Rating Anxiety Scale,Self-Perceived Burden Scale(SPBS),and quality of life scores(physical functioning,role physical,bodily pain,general health,vitality,social functioning,role emotional,mental health)were lower than before the intervention in the two groups.The observation group had lower negative sentiment,SPBS,and quality of life scores than the control group.In the observation group,31 and 24 patients had good and general compliance,respectively,with a compliance rate of 91.67%,which was significantly higher than that in the control group.The observation group had significantly lower total incidence of incision infection,abdominal abscess,hemorrhage,and severe abdominal pain than the control group.CONCLUSION Three-dimensional psychological guidance combined with evidence-based health intervention in treating liver abscess can reduce patients’burden and negative emotions,improve patient compliance and quality of life,and reduce complications.

关键词： Three-dimensional psychological guidance Evidence-based health intervention Ultrasound intervention Liver abscess Negative emotions Compliance

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Right ventricular-arterial uncoupling as an independent prognostic factor in acute heart failure with preserved ejection fraction accompanied with coronary artery disease

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Chinese Medical Journal 2023年第10期136卷 1198-1206页

作者： Hongdan Jia Li Liu Xile Bi Ximing Li Hongliang Cong Department of Cardiology Clinical School of ThoracicTianjin Medical UniversityTianjin 300222China Department of Cardiology The First Hospital of QinhuangdaoQinhuangdaoHebei 066000China

Background:Right ventricular(RV)-arterial uncoupling is a powerful independent predictor of prognosis in heart failure with preserved ejection fraction(HFpEF).Coronary artery disease(CAD)can contribute to the pathophysiological characteristics of HFpEF.This study aimed to evaluate the prognostic value of RV-arterial uncoupling in acute HFpEF patients with CAD.Methods:This prospective study included 250 consecutive acute HFpEF patients with CAD.Patients were divided into RV-arterial uncoupling and coupling groups by the optimal cutoff value,based on a receiver operating characteristic curve of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure(TAPSE/PASP).The primary endpoint was a composite of all-cause death,recurrent ischemic events,and HF hospitalizations.Results:TAPSE/PASP≤0.43 provided good accuracy in identifying patients with RV-arterial uncoupling(area under the curve,0.731;sensitivity,61.4%;and specificity,76.6%).Of the 250 patients,150 and 100 patients could be grouped into the RV-arterial coupling(TAPSE/PASP>0.43)and uncoupling(TAPSE/PASP≤0.43)groups,respectively.Revascularization strategies were slightly different between groups;the RV-arterial uncoupling group had a lower rate of complete revascularization(37.0%[37/100]vs.52.7%[79/150],P0.43.Multivariate Cox analysis showed TAPSE/PASP≤0.43 as an independent associated factor for the primary endpoint,all-cause death,and recurrent HF hospitalization(hazard ratios[HR]:2.21,95%confidence interval[CI]:1.44-3.39,P<0.001;HR:3.32,95%CI:1.30-8.47,P=0.012;and HR:1.93,95%CI:1.10-3.37,P=0.021,respectively),but not for recurrent ischemic events(HR:1.48,95%CI:0.75-2.90,P=0.257).Conclusion:RV-arterial uncoupling,based on TAPSE/PASP,is independently associated with adverse outcomes in acute HFpEF patients with CA

关键词： Heart failure with preserved ejection fraction Coronary artery disease Right ventricular-arterial coupling Prognosis Revascularization

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Review and prospect of immune checkpoint blockade therapy represented by PD-1/PD-L1 in the treatment of clear cell renal cell carcinoma

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Oncology Research 2023年第3期31卷 255-270页

作者： WENFEI GE SHIYAN SONG XIAOCHEN QI FENG CHEN XIANGYU CHE YONGHAO SUN JIN WANG XIAOWEI LI NANA LIU QIFEI WANG GUANGZHEN WU Department of Urology The First Affiliated Hospital of Dalian Medical UniversityDalian116011China Department of Urology The First Hospital of QinhuangdaoQinhuangdao066000China Department of General Surgery The First Affiliated Hospital of Dalian Medical UniversityDalian116011China

As a common tumor of the urinary system,the morbidity and mortality related to renal carcinoma,are increasing annually.Clear cell renal cell carcinoma(CCRCC)is the most common subtype of renal cell carcinoma,accounting for approximately 75%of the total number of patients with renal cell carcinoma.Currently,the clinical treatment of ccRCC involves targeted therapy,immunotherapy,and a combination of the two.In immunotherapy,PD-1/PD-L1 blocking of activated T cells to kill cancer cells is the most common treatment.However,as treatment progresses,some patients gradually develop resistance to immunotherapy.Meanwhile,other patients experience great side effects after immunotherapy,resulting in a survival status far lower than the expected survival rate.Based on these clinical problems,many researchers have been working on the improvement of tumor immunotherapy in recent years and have accumulated numerous research results.We hope to find a more suitable direction for future immunotherapy for ccRCC by combining these results and the latest research progress.

关键词： RCC Immunotherapy PD-1/PD-L1

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Chromosomal microarray analysis vs.karyotyping for fetal ventriculomegaly:a meta-analysis

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Chinese Medical Journal 2022年第3期135卷 268-275页

作者： Yan Sun Weiyuan Zhang Zhiwen Wang Likui Guo Shaowen Shi Department of Perinatal Medicine Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100010China Department of Obstetrics First Hospital of QinhuangdaoHebei 066000China

Background:Chromosomal abnormalities are important causes of ventriculomegaly(VM).In mild and isolated cases of fetal VM,obstetricians rarely give clear indications for pregnancy termination.We aimed to calculate the incidence of chromosomal abnormalities and incremental yield of chromosomal microarray analysis(CMA)in VM,providing more information on genetic counseling and prognostic evaluation for fetuses with VM.Methods:The Chinese language databases Wanfang Data,China National Knowledge Infrastructure,and China Biomedical Literature Database(from January 1,1991 to April 29,2020)and English language databases PubMed,Embase,and Cochrane Library(from January 1,1945 to April 29,2020)were systematically searched for articles on fetal VM.Diagnostic criteria were based on ultrasonographic or magnetic resonance imaging(MRI)assessment of lateral ventricular atrium width:≥10 to<15 mm for mild VM,and≥15 mm for severe VM.Isolated VM was defined by the absence of structural abnormalities other than VM detected by ultrasonography or MRI.R software was used for the meta-analysis to determine the incidence of chromosomal abnormalities and incremental yield of CMA in VM,and the combined rate and 95%confidence interval(CI)were calculated.Results:Twenty-three articles involving 1635 patients were included.The incidence of chromosomal abnormalities in VM was 9%(95%CI:5%-12%)and incremental yield of CMA in VM was 11%(95%CI:7%-16%).The incidences of chromosomal abnormalities in mild,severe,isolated,and non-isolated VM were 9%(95%CI:4%-16%),5%(95%CI:1%-11%),3%(95%CI:1%-6%),and 13%(95%CI:4%-25%),respectively.Conclusions:Applying CMA in VM improved the detection rate of abnormalities.When VM is confirmed by ultrasound or MRI,obstetricians should recommend fetal karyotype analysis to exclude chromosomal abnormalities.Moreover,CMA should be recommended preferentially in pregnant women with fetal VM who are undergoing invasive prenatal diagnosis.CMA cannot completely replace chromosome karyotype analysis.

关键词： Ventriculomegaly Chromosome Karyotype Chromosomal microarray analysis Meta-analysis

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Influence of overweight and obesity on the mortality of hospitalized patients with community-acquired pneumonia

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World Journal of Clinical Cases 2022年第1期10卷 104-116页

作者： Ning Wang Bo-Wei Liu Chun-Ming Ma Ying Yan Quan-Wei Su Fu-Zai Yin Department of Endocrinology Hebei Medical UniversityShijiazhuang 050017Hebei ProvinceChina Department of Endocrinology First Hospital of QinhuangdaoQinhuangdao 066001Hebei ProvinceChina Department of Endocrinology Chengde Medical UniversityChengde 067000Hebei ProvinceChina

BACKGROUND Obesity is associated with a better prognosis in patients with community-acquired pneumonia(the so-called obesity survival paradox),but conflicting results have been found.AIM To investigate the relationship between all-cause mortality and body mass index in patients with community-acquired pneumonia.METHODS This retrospective study included patients with community-acquired pneumonia hospitalized in the first hospital of qinhuangdao from June 2013 to November 2018.The patients were grouped as underweight(hospital mortality.RESULTS Among 2327 patients,297(12.8%)were underweight,1013(43.5%)normal weight,and 1017(43.7%)overweight/obesity.The all-cause hospital mortality was 4.6%(106/2327).Mortality was lowest in the overweight/obesity group and highest in the underweight group(2.8%,vs 5.0%,vs 9.1%,P<0.001).All-cause mortality of overweight/obesity patients was lower than normal-weight patients[odds ratio(OR)=0.535,95%confidence interval(CI)=0.334-0.855,P=0.009],while the allcause mortality of underweight patients was higher than that of normal-weight patients(OR=1.886,95%CI:1.161-3.066,P=0.010).Multivariable analysis showed that abnormal neutrophil counts(OR=2.38,95%CI:1.55-3.65,P<0.001),abnormal albumin levels(OR=0.20,95%CI:0.06-0.72,P=0.014),high-risk Confusion-Urea-Respiration-Blood pressure-65 score(OR=2.89,95%CI:1.48-5.64,P=0.002),and intensive care unit admission(OR=3.11,95%CI:1.77-5.49,P<0.001)were independently associated with mortality.CONCLUSION All-cause mortality of normal-weight patients was higher than overweight/obesity patients,lower than that of underweight patients.Neutrophil counts,albumin levels,Confusion-Urea-Respiration-Blood pressure-65 score,and intensive care unit admission were independently associated with mortality in patients with community-acquired pneumonia.

关键词： Body mass index Overweight Community-acquired pneumonia Mortality Prognosis Obesity

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Automatic segmentation of foveal avascular zone based on adaptive watershed algorithm in retinal optical coherence tomography angiography images

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Journal of Innovative Optical Health Sciences 2022年第1期15卷 77-89页

作者： Jian Liu Shixin Yan Nan Lu Dongni Yang Chunhui Fan Hongyu Lv Shuanglian Wang in Zhu Yuqian Zhao Yi Wang Zhenhe Ma Yao Yu School of Control Engineering Northeastern University at Qinhuangdao QinhuangdaoHebei 066004P.R.China Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology qinhuangdao Hebei 066004P.R.China Department of Ophthalmology The First Hospital of Qinhuangdao QinhuangdaoHebei 066004P.R.China Department of Ophthalmology Qinhuangdao Maternal and Child Health Hospital QinhuangdaoHebei 066004P.R.China Tangshan Maternal and Children hospital Tangshan Hebei 063000P.R.China Biomedical Information Engineering Lab The University of Aizu

The size and shape of the foveal avascular zone(FAZ)have a strong positive correlation with several vision-threatening ret inovascular diseases.The identification,segmentation and analysis of FAZ are of great significance to clinical diagnosis and treatment.We presented an adaptive watershed algorithm to automatically extract F AZ from retinal optical coherence tomography angiography(OCTA)images.For the traditional watershed algorithm,"over-segmentation"is the most common problem.FAZ is often incorrectly divided into multiple regions by redundant"dams".This paper analyzed the relationship between the"dams"length and the maximum inscribed circle radius of FAZ,and proposed an adaptive watershed algorithm to solve the problem of"over-segmentation".Here,132 healthy retinal images and 50 diabetic retinopathy(DR)images were used to verify the accuracy and stability of the algorithm.Three ophthal-mologists were invited to make quan titative and qualitative evaluations on the segmentation results of this algorithm.The quantitative evaluation results show that the correlation coffi-cients between the automatic and manual segmentation results are 0.945(in healthy subjects)and 0.927(in DR patients),respectively.For qualitative evaluation,the percentages of"perfect segmentation"(score of 3)and"good segmentation"(score of 2)are 99.4%(in healthy subjects)and 98.7%(in DR patients),respectively.This work promotes the application of watershed algorithm in FAZ segmentation,making it a useful tool for analyzing and diagnosing eye diseases.

关键词： Foveal avascular zone optical coherence tomography angiography watershed algo-rithm diabetic retinopathy.

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