2023 Vol. 36, No. 5

2023, 36(5)
2023, 36(5): 1-2.
Original Article
A Nested Case-Control Study to Explore the Association between Immunoglobulin G N-glycans and Ischemic Stroke
WANG Bi Yan, SONG Man Shu, ZHANG Jie, MENG Xiao Ni, XING Wei Jia, WANG You Xin
2023, 36(5): 389-396. doi: 10.3967/bes2023.048
  Objective  This study prospectively investigates the association between immunoglobulin G (IgG) N-glycan traits and ischemic stroke (IS) risk.  Methods  A nested case-control study was conducted in the China suboptimal health cohort study, which recruited 4,313 individuals in 2013–2014. Cases were identified as patients diagnosed with IS, and controls were 1:1 matched by age and sex with cases. IgG N-glycans in baseline plasma samples were analyzed.  Results  A total of 99 IS cases and 99 controls were included, and 24 directly measured glycan peaks (GPs) were separated from IgG N-glycans. In directly measured GPs, GP4, GP9, GP21, GP22, GP23, and GP24 were associated with the risk of IS in men after adjusting for age, waist and hip circumference, obesity, diabetes, hypertension, and dyslipidemia. Derived glycan traits representing decreased galactosylation and sialylation were associated with IS in men (FBG2S2/(FBG2 + FBG2S1 + FBG2S2): odds ratio (OR) = 0.92, 95% confidence interval (CI): 0.87–0.97; G1n: OR = 0.74, 95% CI: 0.63–0.87; G0n: OR = 1.12, 95% CI: 1.03–1.22). However, these associations were not found among women.  Conclusion  This study validated that altered IgG N-glycan traits were associated with incident IS in men, suggesting that sex discrepancies might exist in these associations.
Clinical Evaluation of a Vancomycin Dosage Strategy Based on a Serum Trough Concentration Model in Elderly Patients with Severe Pneumonia
YAN Wei, SUN Xiao Yan, WANG Meng, ZHAO Fei Fan, ZHOU Qing Tao
2023, 36(5): 397-405. doi: 10.3967/bes2023.049
  Objective  This study aimed to evaluate the clinical benefits of a vancomycin dosage strategy based on a serum trough concentration model in elderly patients.   Methods  This prospective single-center, open-label, randomized controlled trial categorized 66 elderly patients with severe pneumonia into study and control groups. The control group received vancomycin using a regimen decided by the attending physician. Meanwhile, the study group received individualized vancomycin therapy with a dosing strategy based on a serum trough concentration model. The primary endpoint was the proportion of patients with serum trough concentrations reaching the target values. The secondary endpoints were clinical response, vancomycin treatment duration, and vancomycin-associated acute kidney injury (VA-AKI) occurrence.   Results  All patients were at least 60 years old (median age = 81 years). The proportion of patients with target trough concentration achievement (≥ 15 mg/L) with the initial vancomycin regimen was significantly higher in the study group compared to the control group (75.8% vs. 42.4%, P = 0.006). Forty-five patients (68.2%) achieved clinical success, the median duration of vancomycin therapy was 10.0 days, and VA-AKI occurred in eight patients (12.1%). However, there were no significant differences in these parameters between the two groups. The model for predicting vancomycin trough concentrations was upgraded to: serum trough concentration (mg/L) = 17.194 − 0.104 × creatinine clearance rate (mL/min) + 0.313 × vancomycin daily dose [(mg/(kg∙d)].   Conclusion  A vancomycin dosage strategy based on a serum trough concentration model can improve the proportion of patients achieving target trough concentrations in elderly patients with severe pneumonia.
Genotyping Characteristics of Human Fecal Escherichia coli and Their Association with Multidrug Resistance in Miyun District, Beijing
ZHANG Wei Wei, ZHU Xiao Lin, DENG Le Le, HAN Ya Jun, LI Zhuo Wei, WANG Jin Long, CHEN Yong Liang, WANG Ao Lin, TIAN Er Li, CHENG Bin, XU Lin Hua, CHEN Yi Cong, TIAN Li Li, HE Guang Xue
2023, 36(5): 406-417. doi: 10.3967/bes2023.050
  Objective  To explore the genotyping characteristics of human fecal Escherichia coli (E. coli) and the relationships between antibiotic resistance genes (ARGs) and multidrug resistance (MDR) of E. coli in Miyun District, Beijing, an area with high incidence of infectious diarrheal cases but no related data.  Methods  Over a period of 3 years, 94 E. coli strains were isolated from fecal samples collected from Miyun District Hospital, a surveillance hospital of the National Pathogen Identification Network. The antibiotic susceptibility of the isolates was determined by the broth microdilution method. ARGs, multilocus sequence typing (MLST), and polymorphism trees were analyzed using whole-genome sequencing data (WGS).  Results  This study revealed that 68.09% of the isolates had MDR, prevalent and distributed in different clades, with a relatively high rate and low pathogenicity. There was no difference in MDR between the diarrheal (49/70) and healthy groups (15/24).  Conclusion  We developed a random forest (RF) prediction model of TEM.1 + baeR + mphA + mphB + QnrS1 + AAC.3-IId to identify MDR status, highlighting its potential for early resistance identification. The causes of MDR are likely mobile units transmitting the ARGs. In the future, we will continue to strengthen the monitoring of ARGs and MDR, and increase the number of strains to further verify the accuracy of the MDR markers.
HIV-1 Transmission among Injecting Drug Users is Principally Derived from Local Circulating Strains in Guangxi, China
CEN Ping, LIANG Hua Yue, YANG Yuan, ZHANG Fei, YANG Shi Xiong, MO Ju Cong, FENG Yi, HUANG Jie Gang, NING Chuan Yi, HUANG Chun Yuan, YANG Yao, LIANG Na, LIANG Bing Yu, YE Li, LIANG Hao
2023, 36(5): 418-430. doi: 10.3967/bes2023.051
  Objective   The mode of human immunodeficiency virus (HIV) transmission via injection drug use (IDU) still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi.   Methods   We performed a molecular epidemiological investigation of infections across Guangxi from 2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data.   Results   Among the 535 subjects, CRF08_BC (57.4%), CRF01_AE (28.4%), and CRF07_BC (10.7%) were the top 3 HIV strains; 72.6% of infections were linked to other provinces in the transmission network; 93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces, predominantly Guangdong and Yunnan; 92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs.   Conclusion  HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces. Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened.
Automated Classification of Inherited Retinal Diseases in Optical Coherence Tomography Images Using Few-shot Learning
ZHAO Qi, MAI Si Wei, LI Qian, HUANG Guan Chong, GAO Ming Chen, YANG Wen Li, WANG Ge, MA Ya, LI Lei, PENG Xiao Yan
2023, 36(5): 431-440. doi: 10.3967/bes2023.052
  Objective  To develop a few-shot learning (FSL) approach for classifying optical coherence tomography (OCT) images in patients with inherited retinal disorders (IRDs).   Methods  In this study, an FSL model based on a student–teacher learning framework was designed to classify images. 2,317 images from 189 participants were included. Of these, 1,126 images revealed IRDs, 533 were normal samples, and 658 were control samples.   Results  The FSL model achieved a total accuracy of 0.974–0.983, total sensitivity of 0.934–0.957, total specificity of 0.984–0.990, and total F1 score of 0.935–0.957, which were superior to the total accuracy of the baseline model of 0.943–0.954, total sensitivity of 0.866–0.886, total specificity of 0.962–0.971, and total F1 score of 0.859–0.885. The performance of most subclassifications also exhibited advantages. Moreover, the FSL model had a higher area under curves (AUC) of the receiver operating characteristic (ROC) curves in most subclassifications.   Conclusion  This study demonstrates the effective use of the FSL model for the classification of OCT images from patients with IRDs, normal, and control participants with a smaller volume of data. The general principle and similar network architectures can also be applied to other retinal diseases with a low prevalence.
Traditional Chinese Medicine Treatment, Gua Sha, can Induce Subtle Molecular Changes in Gene Expression
QI Fei, CAI Ye, CHEN Jun Jie, CHEN Chun Li, HAN Xue Er, XIA Qiu, KAPRANOV Philipp
2023, 36(5): 441-451. doi: 10.3967/bes2023.053
  Objective   Here, we explored molecular changes that could potentially mediate healing effects of Gua Sha — a method employed by the Chinese traditional medicine with proven track records of safe and efficient applications dating back to ancient times as well as support from randomized controlled trials performed by modern medical studies — yet remaining almost entirely unexplored by the modern-day high-throughput methods of the -omics sciences.   Methods   We investigated transcriptome changes occurring shortly after Gua Sha treatment in the whole blood of healthy volunteers using bulk RNA-seq analysis. We applied various analytical tools to identify genes with consistent expression changes in multiple individuals in response to Gua Sha and their networks.   Results   We found that while the changes were very subtle and individual-specific, we could identify consistent upregulation of three histone genes. Further analysis of the potential regulatory networks of these histone genes revealed the enrichment of functions involved in the immune response and inflammation.   Conclusion   The significance of these results in the context of potential effects of Gua Sha and the next steps in exploring the molecular mechanisms of action of this technique are discussed.
Letter to the Editor
Impact of the Early Stage of the COVID-19 Pandemic on Smoking Cessation in Beijing
WANG Yao, LI Xing Ming
2023, 36(5): 452-457. doi: 10.3967/bes2023.054
Fine Particulate Matter Exposure Induces Toxicity by Regulating Nuclear Factor-κB/toll-like Receptor 4/myeloid Differentiation Primary Response Signaling Pathways in RAW264.7 Cells
ZHENG Mei Zhu, LU Yao, LU Ting Ting, QIN Peng, LI Yu Qiu, SHI Dong Fang
2023, 36(5): 458-462. doi: 10.3967/bes2023.055
Seminal Plasma Biochemical Components Mediate the Inverse Association of Microcystin Exposure with Sperm Motility: A Mediation Analysis in Chinese Men
XU Di Hui, MA Yu Han, YU Wen, ZHOU Xue, LUO Yang, CHEN Ya Bing, HAN Xiao Dong
2023, 36(5): 463-468. doi: 10.3967/bes2023.056
The Potential Impact of EIF4E3 and LARP1 on Tumor Immunity in Hepatocellular Carcinoma
ZHU Wen Li, ZENG Hua, HUANG Dan Ping, OUYANG Wei Jun, WEI Chun Shan, TONG Guang Dong
2023, 36(5): 469-475. doi: 10.3967/bes2023.057
Geographic Distribution of Coal Enterprises and Workers Exposed to Coal Dust in China in 2020
WANG Yu Tong, LI Xin Xin, HU Wei Jiang, WANG Dan, ZHANG Si Yu, LIU An Qi, SUN Xin, WAN Xia
2023, 36(5): 476-480. doi: 10.3967/bes2023.058