Biomedical subjects

Zujiang Yu

Publications and source records attributed to Zujiang Yu.

3 recordsLinked to original sources

PubMed2026

Differentiating tuberculous pleurisy from pulmonary tuberculosis using mNGS: a multicenter cohort analysis.

BACKGROUND: Tuberculous pleurisy (TBP), a major extrapulmonary form of tuberculosis, is characterized by a paucibacillary state that makes diagnosis challenging. Metagenomic next-generation sequencing (mNGS) has emerged as a promising approach for MTB detection; however, its discriminatory value between TBP and pulmonary tuberculosis (PTB) among mNGS-confirmed cases, and its integration with clinical features for differential diagnosis, remain insufficiently defined. METHODS: This multicenter retrospective cohort included hospitalized patients with MTB-positive mNGS results from January 2020 to January 2025. As only mNGS-positive cases were included, overall mNGS diagnostic sensitivity cannot be estimated. Twelve TBP patients were matched 1:2 with twenty-four PTB patients by age and sex; patients with immunosuppressive conditions were excluded prior to matching. Clinical, laboratory, mNGS, and conventional TB test data were collected. Logistic regression and ROC analyses were performed. RESULTS: Conventional tests showed limited sensitivity in TBP despite universal mNGS positivity. MTB read counts were similar between groups (median 1976.5 vs. 990.0, P = 0.920). Pleural-derived specimens predominated in TBP (41.7% vs. 4.2%, P = 0.007). CRP demonstrated the highest individual discriminatory value (AUC = 0.658, P = 0.131), though no single predictor reached significance. A combined model (cough, fever, CRP, WBC) showed modest non-significant improvement (AUC = 0.722, overall P = 0.359; sensitivity 66.7%, specificity 83.3%). Given EPV ≈ 3, all findings are exploratory only. No significant prognostic predictors were identified in TBP; a non-significant trend toward lower lymphocyte counts was observed in patients with unfavorable outcomes (0.60 vs. 1.10 ×109/L, P = 0.115). CONCLUSIONS: Among mNGS-confirmed cases, MTB read counts were comparable between TBP and PTB. No single parameter reliably distinguished the two; a combined clinical model showed modest improvement but requires prospective validation in larger cohorts. Integrating mNGS with systematic clinical evaluation remains essential for accurate TB diagnosis.

Humans↗

PubMed2026

Recombinant Human Thrombopoietin Reduces the Need for Platelet Transfusion in Patients With Chronic Liver Disease and Thrombocytopenia.

Chronic liver disease (CLD)-related thrombocytopenia can limit the feasibility of invasive procedures. Recombinant human thrombopoietin (rhTPO) has demonstrated a favorable safety profile without hepatotoxicity. We evaluated the efficacy and safety of rhTPO in patients with CLD-related thrombocytopenia who were undergoing elective invasive procedures. In this multicenter, randomized (2:1), double-blind, placebo-controlled phase III trial, 120 adult Chinese patients with CLD-related thrombocytopenia (platelet count < 50 × 109/L) received rhTPO (n = 80) or placebo (n = 40) once daily for up to 5 or 7 days. The primary endpoint was the proportion of patients with sustained platelet counts ≥ 50 × 109/L from 24 h before invasive procedure to 7 days post-procedure, without requiring emergency bleeding management. The primary endpoint was achieved by 85.0% of patients in the rhTPO group versus 12.5% in the placebo group (p < 0.0001). Preoperatively, platelet counts ≥ 50 × 109/L were achieved in 92.5% and 20.0% of patients in the rhTPO and placebo groups, respectively (p < 0.0001). Platelet transfusion was avoided in 92.5% of rhTPO-treated patients versus 25.0% of placebo-treated patients (p < 0.0001). The median duration of platelet counts ≥ 50 × 109/L was significantly longer with rhTPO than with placebo (21.0 vs. 3.0 days, p = 0.0007). Treatment-related treatment-emergent adverse events (TEAEs) occurred in 12.5% of patients in both the rhTPO and placebo groups. No treatment-related serious adverse events were reported. Overall, rhTPO was effective and well tolerated in patients with CLD-related thrombocytopenia and may represent a viable therapeutic option for those undergoing elective invasive procedures. Trial Registration: www.chinadrugtrials.org.cn: number CTR20230919.

Humans↗

PubMed2026

Widespread Molecular Imprints in the Serum Proteome of COVID-19 Convalescents Uncovering Immune System Sequelae.

Post-COVID-19 sequelae have become an emerging global health issue, but the mechanisms for the sustained susceptibility of convalescents to the sequelae remain poorly understood. Here we report the use of a restricted open-search approach to explore the molecular imprints of SARS-CoV-2 infection left on the proteome of 412 COVID-19 patients and convalescences. A total of 827 non-standard amino acid variations, chemically modified residues as well as post-translational modifications, termed non-coded amino acids (ncAAs), are found spreading over 29,814 sites in patient's serum proteins. Markedly, widespread ncAAs are induced and sustainedly imprinted on the serum proteome predominately perturbing the immunoglobulin-mediated immune response, complement activation and coagulation regulation even 12 months after recovery. Sustained amino acid variations and chemical modifications are found in the complementary‑determining regions (CDRs) of the variable region of immunoglobulin contributing to the interactions between the emerging antibody and antigens; durable chemical amino acid modifications found in the hyper ncAA-modified regions of the constant region of immunoglobulin important for the interaction with the complement and regulatory receptors. In the complement system, inducible ncAAs are memorized in the components essential for the complement activation, amplification cascades and membrane attack processes. Thus, the workflow described in this study can be used to identify the molecular imprints of viral infection at the proteomic scale, particularly the specific antibodies and the immune targets left in COVID-19 patients and convalescents.

Humans↗