Yue Wang’s research while affiliated with Westlake University and other places

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Publications (3)


Flowchart delineating the inclusion of patients with CRE sepsis following ERCP. Abbreviations: ERCP, Endoscopic retrograde cholangiopancreatography; CRE, Carbapenem-resistant Enterobacterales
LASSO regression variable selection. (A) The variation attributes of the variable coefficients; (B) the selection procedure for the optimal value of the parameter λ within the LASSO regression model
Estimating the likelihood of 30-day mortality in patients with CRE sepsis post-ERCP: a model utilizing nomogram predictions. Abbreviations: ERCP, Endoscopic retrograde cholangiopancreatography; CRE, Carbapenem-resistant Enterobacterales
Assessment and verification of the nomogram. (A) ROC curve representation of the nomogram, SOFA score, and LODS score in the training set and (B) internal validation set. (C) Construction of calibration curves in the training set. (D) DCA curve depicting medical intervention efficacy in patients as evaluated by the nomogram, SOFA score, and LODS. (E) Kaplan‒Meier survival curves for patients with CRE sepsis post-ERCP grouped according to the nomogram. The p value (< 0.001) was ascertained via the log-rank test. The information within the table shows the number at risk at particular time instances. Abbreviations: Sequential Organ Failure Assessment score (SOFA), Logistic Organ Dysfunction Score (LODS)
Visual representation of the consequences of different antimicrobial therapies shown through Kaplan‒Meier curves. (A) There was no difference in 30-day mortality among patients who were given empirical carbapenems. (B-C) Patients who received empirical tigecycline had a negative prognosis within 30 days, whereas those who received empirical polymyxin B had a survival benefit within the same time frame. (D) There was no variation in the 30-day mortality rate among patients who received combination therapy with carbapenem. (E) Individuals who received combination therapy involving tigecycline experienced an unfavorable prognosis within a 30-day period. (F) On the other hand, individuals who received combination therapy involving polymyxin B experienced a survival advantage for a period of 30 days
Carbapenem-resistant Enterobacterales sepsis following endoscopic retrograde cholangiopancreatography: risk factors for 30-day all-cause mortality and the development of a nomogram based on a retrospective cohort
  • Article
  • Full-text available

August 2024

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18 Reads

Antimicrobial Resistance & Infection Control

Hongchen Zhang

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Yue Wang

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Xiaochen Zhang

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[...]

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Xiaofeng Zhang

Background Endoscopic retrograde cholangiopancreatography (ERCP) has become a routine endoscopic procedure that is essential for diagnosing and managing various conditions, including gallstone extraction and the treatment of bile duct and pancreatic tumors. Despite its efficacy, post-ERCP infections – particularly those caused by carbapenem-resistant Enterobacterales (CRE) – present significant risks. These risks highlight the need for accurate predictive models to enhance postprocedural care, reduce the mortality risk associated with post-ERCP CRE sepsis, and improve patient outcomes in the context of increasing antibiotic resistance. Objective This study aimed to examine the risk factors for 30-day mortality in patients with CRE sepsis following ERCP and to develop a nomogram for accurately predicting 30-day mortality risk. Methods Data from 195 patients who experienced post-ERCP CRE sepsis between January 2010 and December 2022 were analyzed. Variable selection was optimized via the least absolute shrinkage and selection operator (LASSO) regression model. Multivariate logistic regression analysis was then employed to develop a predictive model, which was evaluated in terms of discrimination, calibration, and clinical utility. Internal validation was achieved through bootstrapping. Results The nomogram included the following predictors: age > 80 years (hazard ratio [HR] 2.61), intensive care unit (ICU) admission within 90 days prior to ERCP (HR 2.64), hypoproteinemia (HR 4.55), quick Pitt bacteremia score ≥ 2 (HR 2.61), post-ERCP pancreatitis (HR 2.52), inappropriate empirical therapy (HR 3.48), delayed definitive therapy (HR 2.64), and short treatment duration (< 10 days) (HR 5.03). The model demonstrated strong discrimination and calibration. Conclusions This study identified significant risk factors associated with 30-day mortality in patients with post-ERCP CRE sepsis and developed a nomogram to accurately predict this risk. This tool enables healthcare practitioners to provide personalized risk assessments and promptly administer appropriate therapies against CRE, thereby reducing mortality rates.

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Predictive value of the Ranson and BISAP scoring systems for the severity and prognosis of acute pancreatitis: A systematic review and meta-analysis

April 2024

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43 Reads

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3 Citations

Background To systematically assess and compare the predictive value of the Ranson and Bedside Index of Severity in Acute Pancreatitis (BISAP) scoring systems for the severity and prognosis of acute pancreatitis (AP). Methods PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until February 15, 2023. Outcomes in this analysis included severity and prognosis [mortality, organ failure, pancreatic necrosis, and intensive care unit (ICU) admission]. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the quality of diagnostic accuracy studies. The threshold effect was evaluated for each outcome. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve (AUC) as well as 95% confidence intervals (CI) were calculated. The DeLong test was used for AUC comparisons. For the outcome evaluated by over 9 studies, publication bias was assessed using the Deeks’ funnel plot asymmetry test. Results Totally 17 studies of 5476 AP patients were included. For severity, the pooled sensitivity of the Ranson and BISAP was 0.95 (95%CI: 0.87, 0.98) and 0.67 (95%CI: 0.27, 0.92); the pooled specificity of the Ranson and BISAP was 0.74 (0.52, 0.88) and 0.95 (95%CI: 0.85, 0.98); the pooled AUC of the Ranson and BISAP was 0.95 (95%CI: 0.93, 0.97) and 0.94 (95%CI: 0.92, 0.96) (P = 0.480). For mortality, the pooled sensitivity of the Ranson and BISAP was 0.89 (95%CI: 0.73, 0.96) and 0.77 (95%CI: 0.58, 0.89); the pooled specificity of the Ranson and BISAP was 0.79 (95%CI: 0.68, 0.87) and 0.90 (95%CI: 0.86, 0.93); the pooled AUC of the Ranson and BISAP was 0.91 (95%CI: 0.88, 0.93) and 0.92 (95%CI: 0.90, 0.94) (P = 0.480). For organ failure, the pooled sensitivity of the Ranson and BISAP was 0.84 (95%CI: 0.76, 0.90) and 0.78 (95%CI: 0.60, 0.90); the pooled specificity of the Ranson and BISAP was 0.84 (95%CI: 0.63, 0.94) and 0.90 (95%CI: 0.72, 0.97); the pooled AUC of the Ranson and BISAP was 0.86 (95%CI: 0.82, 0.88) and 0.90 (95%CI: 0.87, 0.93) (P = 0.110). For pancreatic necrosis, the pooled sensitivity of the Ranson and BISAP was 0.63 (95%CI: 0.35, 0.84) and 0.63 (95%CI: 0.23, 0.90); the pooled specificity of the Ranson and BISAP was 0.90 (95%CI: 0.77, 0.96) and 0.93 (95%CI: 0.89, 0.96); the pooled AUC of the Ranson and BISAP was 0.87 (95%CI: 0.84, 0.90) and 0.93 (95%CI: 0.91, 0.95) (P = 0.001). For ICU admission, the pooled sensitivity of the Ranson and BISAP was 0.86 (95%CI: 0.77, 0.92) and 0.63 (95%CI: 0.52, 0.73); the pooled specificity of the Ranson and BISAP was 0.58 (95%CI: 0.55, 0.61) and 0.84 (95%CI: 0.81, 0.86); the pooled AUC of the Ranson and BISAP was 0.92 (95%CI: 0.81, 1.00) and 0.86 (95%CI: 0.67, 1.00) (P = 0.592). Conclusion The Ranson score was an applicable tool for predicting severity and prognosis of AP patients with reliable diagnostic accuracy in resource and time-limited settings. Future large-scale studies are needed to verify the findings.


Primary choledocholithiasis occurrence and recurrence is synergetcally modulated by the bile microbiome and metabolome alternations

September 2023

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14 Reads

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4 Citations

Life Sciences

Aims: Primary choledocholithiasis is a common digestive disease with high morbidity and relapse. However, the compositions and functions of the bile microbial ecosystem and the pathogenesis of microfloral regulation of host metabolism resulting in stone formation are poorly understood. Main methods: Biliary samples collected from patients with acute cholangitis induced by benign biliary stricture (nonlithiasis group, n = 17) and primary choledocholithiasis (lithiasis group, n = 33) were subjected to multiomics analyses. Furthermore, clinicopathological features collected over a 24-month follow-up period were examined to evaluate the predictive value of candidate microbes. Key findings: Five alpha diversity indices of the bile microbiome were significantly decreased in the lithiasis group. Furthermore, we identified 49 differential bile flora between the two groups, and the relative abundances of 6 bacteria, Actinobacteria, Actinobacteriota, Staphylococcales, Micrococcales, Altererythrobacter and Carnobacteriaceae, were associated with primary choledocholithiasis relapse conditions. Multiomics analyses showed that specific changes in disease-related bacterial taxa were closely related to metabolite variation (low-molecular weight carboxylic acids, sterol liquid and acylcarnitine), which might reflect disease prognosis. According to microbiomic and metabolomic pathway analyses, we revealed that bacterial infections, microbiota-derived amino acid metabolites and secondary bile acid-related pathways were significantly enriched in the stone-formation group, suggesting a novel host-microbial metabolic mechanism of primary choledocholithiasis. Significance: Our study first indicates bile host-microbial dysbiosis modulates the abnormal accumulation of metabolites might further disrupt calcium homeostasis and generate insoluble saponification. Additionally, we determined the predictive value of Actinomycetes phylum reduction for recurrence in primary common bile duct stone patients.

Citations (2)


... There are some studies that encounter better specificity and sensitivity for the severity of disease of the Ranson score and BISAP score. A study published in 2024 by Jianpeng Zu et al. presents, following a meta-analysis, a pooled sensitivity for severity for the Ranson score and BISAP score of 95% and 67%, a pooled specificity for both scores of 74% and 95%, and a pooled accuracy of Ranson score and BISAP score of 95% and 94% [43]. ...

Reference:

Predictive Value of Several Parameters for Severity of Acute Pancreatitis in a Cohort of 172 Patients
Predictive value of the Ranson and BISAP scoring systems for the severity and prognosis of acute pancreatitis: A systematic review and meta-analysis

... Common bile duct stones are a common disease of the extrahepatic biliary system and are divided into primary and secondary types [1]. Typically, patients with bile duct stones do not experience abdominal pain, nausea, vomiting, or other upper gastrointestinal discomfort when the stones are not causing obstruction [2]. ...

Primary choledocholithiasis occurrence and recurrence is synergetcally modulated by the bile microbiome and metabolome alternations
  • Citing Article
  • September 2023

Life Sciences