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2024 Vol. 30, No. 3
Published: 2024-03-30
353
Molecular Mechanisms Study of WNT3A Promoting Osteoblasts Proliferation and Differentiation by Binding and Stabilizing FZD2 and Activating Wnt Signaling Pathway
CUI Yongjian, LI Yan, WANG Qiaomei, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.01
Objective:
To investigate the effects and the molecular mechanisms of ligand WNT3A on osteoblasts' bone formation by stabilizing and activating FZD2 (Frizzled2).
Methods:
Twenty-four female C57BL/6J mice aged 6~8 week were randomly divided into 4 groups: control group, sham group, ovariectomy-induced osteoporosis (OP) mouse model group (OVX group), and OVX+estradiol treatment group (OVX+E2 treatment group), with 6 mice in each group. The OVX mouse model was established. The expression levels of WNT3A, FZD2, Active-β-Catenin, β-Catenin, ALP and Runx2, and phosphorylated (p-) STAT3, STAT3, P-JAK2 and JAK2 in the tibia tissues of mouse hind limbs were determined by Western blot. The proliferation ability of mouse embryonic osteoblast MC3T3-E1 cells were determined by CCK-8 assay. Adenovirus-shRNA-FZD2 was used to knockdown FZD2 in MC3T3-E1 cells. Co-Immunoprecipitation (co-IP) was used for detecting the direct binding of FZD2 to ubiquitin (Ub) before and after MC3T3-E1 cells treated with WNT3A.
Results:
Compared with the OVX group, the expression levels of WNT3A, FZD2, Active-β-Catenin, β-Catenin, ALP, and Runx2 in the tibia tissue of mice in the OVX+E2 treatment group were up-regulated (P<0.05). Compared with Control group, in the WNT3A treatment group the expression levels of FZD2, Active-β-Catenin, β-Catenin, ALP, and Runx2 in MC3T3-E1 cells were increased (P<0.05); and the cell proliferation ability was increased (P<0.05). Compared with WNT3A treatment group, in the WNT3A treatment+Adv-shRNA-FZD2 group, the expression levels of FZD2, Active-β-Catenin, β-Catenin, ALP, and Runx2 were decreased (P<0.05); the phosphorylation levels of p-STAT3 and p-JAK2 were both decreased (P<0.05); the proliferation ability was decreased (P<0.05). There were no significant differences in the expression levels of STAT3 and JAK2 between the two groups (P>0.05). In the IP: Ub group, compared with WNT3A-treated (-) cells, the expression level of FZD2 was increased in WNT3A-treated (+) cells (P<0.05).
Conclusion:
The bone anabolic activity of WNT3A is mediated by binding and stabilizing FZD2 to activate the Wnt/β-Catenin signaling pathway.
2024 Vol. 30 (3): 353-358 [
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359
Regulation of EI24 and Th1/Th2 Cell Ratio by Hesperidin in the Antagonism of Pulmonary Fibrosis and Its Potential Mechanisms
ZHANG Yan, MA Wen, YANG Hui, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.02
Objective:
To observe the protective effects of hesperidin on bleomycin-induced pulmonary fibrosis in rats and explore its related mechanisms involving E2F-mediated transcription factor 2.4 (EI24) gene and Th1/Th2 balance.
Methods:
Sixty rats were randomly divided into six groups: sham operation group, model group, pirfenidone group (positive control, 0.12 g/kg pirfenidone), low-dose hesperidin group (12mg/kg), medium-dose hesperidin group (24mg/kg), and high-dose hesperidin group (36mg/kg), with 10 rats in each group. Pulmonary fibrosis was induced by tracheal injection of bleomycin. Lung function indicators, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF), were measured using a small animal ventilator. Histopathological evaluation was performed using hematoxylin-eosin and Masson staining. Enzyme-linked immunosorbent assay was used to detect the levels of cytokines in rat lung tissues in February 2023. Flow cytometry was employed to analyze the proportions of helper T cell (Th) subsets in rat lung tissues in February 2023. Protein immunoblotting was conducted to assess the expression of EI24 protein in lung tissues.
Results:
Compared to the model group, rats in the hesperidin treatment groups showed significantly increased FVC, FEV1, and PEF, and a notable decrease in the lung index (P<0.05). Hesperidin-treated rats exhibited reduced lung tissue damage, inflammation, fibrosis, and collagen deposition compared to the model group. Moreover, the levels of TGF-β1, Col I, HYP, IL-6, and TNF-α in lung tissues were significantly lower than those in the hesperidin treatment groups (P<0.05). Compared to the sham operation group, the model group showed significantly decreased expression of EI24 mRNA and protein; however, the medium-dose and high-dose hesperidin groups exhibited a significant increase in EI24 mRNA and protein expression compared to the model group (P<0.05). Additionally, the medium-dose and high-dose hesperidin groups showed a significant increase in the proportion of Th1 cell subsets and a decrease in Th2 cell subsets in lung tissues compared to the model group (P<0.05). Furthermore, the levels of IFN-γ were significantly elevated, while IL-13 and IL-4 levels were significantly decreased in lung tissues of the medium-dose and high-dose hesperidin groups compared to the model group (P<0.05).
Conclusion:
Hesperidin attenuates bleomycin-induced inflammatory cell infiltration, pro-inflammatory cytokine release, and excessive extracellular matrix deposition, thereby improving the process of pulmonary fibrosis in rats. The mechanism may involve the modulation of EI24 and Th1/Th2 immune cell balance.
2024 Vol. 30 (3): 359-365 [
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366
Pinocembrin Inhibits the Malignant Progression of Esophageal Squamous Carcinoma Cells via the JAK2/STAT3 Signaling Pathway
LIU Hongying, XIE Fatao, WEI Yanjun
DOI: 10.3969/j.issn.1006-6233.2024.03.03
Objective:
To investigate the effect of pinocembrin (Pin) on the malignant progression of esophageal squamous carcinoma cells and its regulatory mechanism on the Janus activated kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway.
Methods:
Human esophageal squamous carcinoma cell line KYSE-410 was randomly separated into KYSE-410 group, Pin-low concentration (Pin-L) group, Pin-medium concentration (Pin-M) group, Pin-high concentration (Pin-H) group, and Pin-H+JAK2 activator (Pin-H+Broussonin E) group. CCK-8 method and clone plate assay were applied to detect the proliferative activity of cells in each group. Transwell experiment was applied to detect the migration and invasion abilities of cells; flow cytometry was applied to detect the apoptosis of cells in each group; Western blot was applied to detect the expression levels of JAK2/STAT3 signaling pathway related proteins of cells in each group.
Results:
Compared with the KYSE-410 group, the cell survival rates (79.91±2.31, 62.33±1.41, 51.17±1.05, F=307.400), the number of clone cells formed (162.82±6.33, 144.59± 5.09, 120.18±3.72, F=209.800), and the number of migrated cells (77.73±3.26, 60.83±2.41, 49.28±1.60, F=360.314) were observed in the Pin-L, Pin-M, and Pin-H groups. The number of invasive cells (62.72±2.42, 50.93±2.07, 32.47±1.55, F=460.221), as well as p-JAK2/JAK2 (0.77±0.06, 0.60±0.04, 0.42±0.03, F=68.226) and p-STAT3/STAT3 values (0.70±0.06, 0.58±0.04, 0.39±0.03, F=61.160) in the cells, decreased (P<0.001), while the apoptosis rate (24.72±2.18, 39.62±3.66, 48.33±4.13, F=235.11) increased (P<0.001), the addition of Broussonin E reversed the inhibitory effect of Pin on the malignant progression of KYSE-410 cells (P<0.05).
Conclusion:
Pin can inhibit the malignant progression of esophageal squamous carcinoma cells, and its mechanism of action may be related to the inhibition of the JAK2/STAT3 signaling pathway.
2024 Vol. 30 (3): 366-371 [
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372
Protective Effects and Regulatory Mechanisms of Shenjingshuizhong Decoction on Diabetic Nephropathy in Rats
ZUO Feng, LI Jing, BAI Mengting, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.04
Objective:
To investigate the protective effect and regulatory mechanism of Shenjingshuizhong decoction on diabetic nephropathy (DN) rats.
Methods:
Sixty SPF SD male rats were randomly divided into 6 groups (n=10/group): normal control group, DN model group, Shenjingshuizhong decoction low-dose group (1g/kg), Shenjingshuizhong decoction medium-dose group (2g/kg), Shenjingshuizhong decoction high-dose group (4g/kg) and positive control group (α-lipoic acid, 60mg/kg). Among them, 50 rats in DN model group, Shenjingshuizhong decoction low, medium and high dose groups and positive control group were injected with streptozotocin to construct DN model. The general condition, body weight and blood glucose level of rats were recorded. The levels of serum Creatinine (Cr) and Blood Urea Nitrogen (BUN) were detected by automatic biochemical analyzer. Periodic Acid-Schiff (PAS) staining was used to detect the pathological changes of rat kidney tissue. The protein levels of angiopoietin-1 (Ang-1), activin-like kinase 1 (ALK1) and transforming growth factor-β (TGF-β
1
) in kidney tissue were detected by Western blot.
Results:
Rats in the normal control group were in good health, while those in the DN model group showed poor health with typical symptoms of DN. After treatment with Shenjingshuizhong decoction or α-lipoic acid, the above symptoms were alleviated. Compared with the normal control group, rats of other groups showed that body weight decreased significantly, and the blood glucose level, serum Cr, and BUN levels increased significantly (P<0.05). Compared with the DN model group, the body weight of the low, Shenjingshuizhong decoction medium and high dose groups and the positive control group increased significantly, and the blood glucose level, serum Cr and BUN levels decreased significantly in a concentration-dependent manner (P<0.05). Compared with the normal control group, the renal tissue sections of the other groups showed interstitial hyperplasia and thickening of the glomerular basement membrane. Compared with the DN model group, the degree of renal tissue lesions in the Shenjingshuizhong decoction low, medium and high dose groups and the positive control group was significantly reduced, and it was concentration-dependent. Compared with the normal control group, the protein expression levels of Ang-1, TGF-β
1
and ALK1 in the kidney tissue of the DN model group were significantly increased (P<0.01). Compared with the DN model group, the protein expression levels of Ang-1, TGF-β
1
and ALK1 in the kidney tissue of the Shenjingshuizhong decoction low, medium and high dose groups and the positive control group were significantly decreased in a concentration-dependent manner (P<0.05). There was no significant difference between the Shenjingshuizhong decoction high-dose group and the positive control group (P＞0.05).
Conclusion:
Shenjingshuizhong decoction can reduce blood glucose level, renal function injury, renal angiogenesis, and renal structure changes in DN rats by inhibiting TGF-β
1
/ALK1 signaling pathway.
2024 Vol. 30 (3): 372-376 [
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Mechanistic Study on the Regulation of Diabetes Kidney Disease by METTL3 through the miR-126-Mediated TGF-β/Smad Signaling Pathway
ZHANG Jing, REN Rong, Patiguli·ASITANBAI
DOI: 10.3969/j.issn.1006-6233.2024.03.05
Objective:
To establish a rat model of diabetic kidney disease (DKD) and explore the mechanism by which METTL3 regulates DKD.
Methods:
After 7 days of adaptive feeding, SD rats were randomly divided into four groups: normal control group (Control group), DKD model group (DKD group), DKD model + METTL3 interference control group (DKD+NC group), and DKD model + METTL3 interference group (DKD+siMETTL3 group), with 8 rats in each group. After modeling, blood specimens and kidney tissues were collected, and levels of fasting blood glucose (FBG), blood urea nitrogen (BUN), 24-hour urine protein (UTP), gene expression of miR-126 using RT-qPCR, expression of TGF-β1 using ELISA, and protein levels of METTL3, smad2, smad3, and smad7 using Western blotting were analyzed by a fully automatic biochemical analyzer.
Results:
Compared to the control group, the DKD group showed significant increases in FBG, BUN, UTP, TGF-β1, METTL3, smad2, and smad3 (P<0.05), and significant decreases in body weight, miR-126, and smad7 (P<0.05). When compared to the DKD group, the DKD+siMETTL3 group exhibited significant decreases in FBG, BUN, UTP, TGF-β1, METTL3, smad2, and smad3 (P<0.05), and significant increases in body weight, miR-126, and smad7 (P<0.05).
Conclusion:
METTL3 can mediate the progression of DKD by regulating miR-126 and TGF-β/smad pathway.
2024 Vol. 30 (3): 377-380 [
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381
Mechanism of SPHK1 Regulation of M2 Macrophage Polarization on Epithelial Mesenchymal Transformation of Bladder Cancer Cells
WANG Chenjing, GUO Xiaodan, MA Zhenyu, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.06
Objective:
To investigate the regulation of sphingosine kinascs-1 (SPHK1) on M2 macrophage polarization and its mechanism on epithelial mesenchymal transition (EMT) in bladder cancer cells.
Methods:
Raw264.7 macrophages were cultured using the primary culture method. The cells were divided into the following groups: Control-NC (empty SPHK1 plasmid-transfected Raw264.7 cells), LV-SPHK1 (SPHK1 overexpression plasmid-transfected Raw264.7 cells), and si-SPHK1 (SPHK1 knockdown plasmid-transfected Raw264.7 cells). Western blot was used to detect the expression of SPHK1 and M2 macrophage markers (CD206 and ArgI) proteins in each group. Immunofluorescence was used to detect the fluorescence intensity of M2 macrophage markers (CD206 and ArgI) proteins. After co-culturing the macrophages of each group with bladder cancer T24 cells for 24 hours, the MTT method was used to detect the proliferation activity of T24 cells in each group. The scratch and Transwell assays were used to detect the migration and invasion abilities of T24 cells in each group. Western blot was used to detect the expression levels of proliferation- and invasion-related proteins (Survivin, MMP-2, and MMP-9) and EMT-related proteins (E-Cadherin, Vimentin, and N-Cadherin) in each group.
Results:
Compared with the Control-NC group, the SPHK1 protein expression was significantly increased in the LV-SPHK1 group and significantly decreased in the si-SPHK1 group (P<0.05). The overexpression of SPHK1 upregulated the expression and fluorescence intensity of M2 macrophage markers CD206 and ArgI proteins (P<0.05). The knockdown of SPHK1 downregulated the expression and fluorescence intensity of M2 macrophage markers CD206 and ArgI proteins (P<0.05). With the extension of cell culture time, the proliferation activity of T24 cells in each group showed an increasing trend (P<0.05). Compared with the Control-NC group, SPHK1 overexpression increased the proliferation, migration, and invasion abilities of T24 cells, while SPHK1 knockdown decreased the proliferation, migration, and invasion abilities of T24 cells (P<0.05). SPHK1 overexpression increased the expression of Vimentin and N-Cadherin proteins and decreased the expression of E-Cadherin protein in T24 cells (P<0.05). SPHK1 knockdown decreased the expression of Vimentin and N-Cadherin proteins and increased the expression of E-Cadherin protein in T24 cells (P<0.05).
Conclusion:
Overexpression of SPHK1 can promote the polarization of M2 macrophages, promote the proliferation, migration, invasion, and EMT of bladder cancer cells, and ultimately increase the distant metastasis ability of bladder cancer. This finding is worthy of further clinical research.
2024 Vol. 30 (3): 381-385 [
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Impact of miR-145-5p-Mediated Regulation of Survivin via the Apoptotic Pathway on the Biological Behavior of Esophageal Cancer
ZHENG Jingxiong, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.07
Objective:
To explore the impact of miR-145-5p targeting Survivin and the apoptotic signaling pathway on apoptosis, invasion, and migration in esophageal cancer.
Methods:
Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to detect the relative expression levels of miR-145-5p and Survivin mRNA in esophageal cancer tissues and cell lines. A dual-luciferase reporter gene analysis was conducted to validate the targeted regulatory relationship between miR-145-5p and Survivin. RT-qPCR was used to measure the relative expression levels of miR-145-5p and Survivin mRNA after cell transfection. Western blot was performed to assess the expression of BCL2, MDM2, and Caspase-3 proteins in the apoptotic pathway. Cell survival, apoptosis rate, migration rate, and invasion ability were evaluated using MTT, flow cytometry, scratch healing, and Transwell chamber experiments in TE-1 cells.
Results:
Compared to adjacent normal tissues, miR-145-5p was downregulated, while Survivin was upregulated in cancer tissues (P<0.05). In comparison to normal esophageal mucosal epithelial HEEC cells, TE-1 cells exhibited low expression of miR-145-5p and high expression of Survivin (P<0.05). Dual-luciferase reporter gene experiments confirmed the targeted regulatory relationship between miR-145-5p and Survivin. Transfection with miR-145-5p mimic significantly increased miR-145-5p expression, inhibited Survivin mRNA expression, downregulated BCL2 and MDM2 protein expression, upregulated Caspase-3 expression, promoted cell apoptosis, and inhibited cell viability, invasion, and migration compared to untransfected and miR-145-5p control-transfected TE-1 cells (P<0.05).
Conclusion:
Through negative regulation by miR-145-5p, the expression of Survivin is inhibited, leading to the activation of the apoptotic pathway. This promotes cell apoptosis and inhibits the survival, invasion, and migration capabilities of esophageal cancer cells.
2024 Vol. 30 (3): 386-392 [
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393
Circadian Rhythm of Pain Threshold in Mouse Model and the Analgesic Effect of Bee Venom for Injection: Correlation with Peripheral Blood Substance P β-Endorphin and IL-1β Levels
DONG Hong, LI Zhenbin, GAO Nannan, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.08
Objective:
To investigate the circadian rhythm of pain threshold in mouse models and the circadian difference in the analgesic effects of bee venom for injection (BVI) and its mechanisms.
Methods:
Mouse pain models were established using the hot plate test and radiant heat tail-flick test. Pain thresholds were measured at six zeitgeber time (ZT) points (ZT2, ZT6, ZT10, ZT14, ZT18, ZT22) to analyze their circadian rhythms. Qualified Kunming mice were randomly divided into Bee Venom for Injection high dose (BVI-H), Bee Venom for Injection medium dose (BVI-M), Bee Venom for Injection low dose (BVI-L), Morphine (MOR), and Model (MOD) groups. Each group was further divided into two subgroups based on the circadian rhythm of pain thresholds, and drugs were administered at two time points corresponding to the peak and trough of pain thresholds. The dynamic changes in the behavioral effects on pain models in mice were observed using the hot plate test, radiant heat tail-flick test, and writhing test. The levels of serum Substances P (SP), Beta-endorphin (β-EP), and interleukin-1β (IL-1β) were measured by ELISA.
Results:
The pain thresholds of the mouse pain model exhibited circadian rhythms with a peak in the mid-light phase (ZT6) and a trough in the late dark phase (ZT22). The three BVI dose groups and the MOR group all showed significant analgesic effects, and the analgesic effect of BVI in the hot plate and writhing models was dose-dependent. In the hot plate test and radiant heat test models, BVI administration at ZT22 showed stronger analgesic effects than at ZT6. Bee venom did not upregulate serum β-EP levels in pain model mice but significantly reduced serum SP levels, with a circadian variation (lower at ZT22 than at ZT6, P<0.05). The serum IL-1β levels were significantly downregulated in the writhing test and radiant heat test (ZT22 administration group only) pain model mice, while they were significantly increased in the hot plate test.
Conclusion:
The pain threshold in mice exhibits a circadian rhythm with a peak in the middle-late light phase and a trough value in the late dark phase. BVI has analgesic effect on various pain models in mice, and there is a diurnal difference. The analgesic effect of BVI and its diurnal variation may be related to the regulation of endogenous pain mediators.
2024 Vol. 30 (3): 393-397 [
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398
miR-30b Protects against Myocardial Ischemia-Reperfusion Injury by Targeting NLRP3 Inflammasome
DU Peishan, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.09
Objective:
To investigate the mechanism of miR-30b in alleviating myocardial injury in rats with myocardial ischemia-reperfusion (MI/R) by targeting and inhibiting the activation of NLRP3 inflammasome.
Methods:
Fifty SD rats were selected for inclusion in the study and randomly divided into Sham group (sham surgery group), MIRI group (model group), miR-30b mimics group (miR-30b overexpression group), CY-09 group (NLRP3 signaling pathway inhibitor group), miR-30b+CY-09 group (miR-30b overexpression+NLRP3 signaling pathway inhibitor group), with 10 rats in each group; RT-PCR was used to detect the relative expression of miR-30b in the myocardial tissue of rats in each group; Echocardiography was used to detect rat cardiac function parameters (LVEDP, LVSP,+dp/dtmax, - dp/dtmax); ELISA was used to detect the levels of myocardial tissue damage markers (CK-MB, LDH, cTnI) in rats; HE staining was used to analyze the pathological morphology of rat myocardial tissue; TUNEL method was used to detect myocardial cell apoptosis in rats; Western-blot was used to detect the expression of NLRP3 signaling pathway related proteins NLRP3, ASC, and Caspase-1 in myocardial inflammasome.
Results:
Compared with the Sham group, the MIRI model downregulated the mRNA expression of miR-30b in rat myocardial tissue (P<0.05). Overexpression of miR-30b upregulated the mRNA expression of miR-30b in rat myocardial tissue (P<0.05). Compared with the Sham group, the establishment of the MIRI model upregulated the levels of cardiac function parameters LVEDP, myocardial injury factors (CK-MB, LDH, cTnI), and myocardial cell apoptosis ability, and downregulated the cardiac function parameters (LVSP,+dp/dtmax,-dp/dtmax) (P<0.05). Both miR-30b overexpression plasmid transfection and NLRP3 signaling pathway blockade could downregulate the levels of cardiac function parameters LVEDP, myocardial injury factors (CK-MB, LDH, cTnI), and myocardial cell apoptosis ability, and upregulate the cardiac function parameters (LVSP,+dp/dtmax,-dp/dtmax) (P<0.05). The combination of the two could further downregulate the levels of cardiac function parameters LVEDP, myocardial injury factors (CK-MB, LDH, cTnI), and myocardial cell apoptosis ability, and upregulate cardiac function parameters (LVSP,+dp/dtmax, - dp/dtmax) (P<0.05). The myocardial morphology of Sham group rats was relatively normal. The establishment of the MIRI model could lead to disordered arrangement of myocardial tissue, resulting in myocardial fiber breakage, myocardial cell vacuolization, and inflammatory cell infiltration. Transfection of miR-30b overexpression plasmid and blockade of NLRP3 signaling pathway could improve the pathological morphology of myocardial tissue in MIRI rats, and the combination of the two groups had the greatest improvement in myocardial morphology in rats. Compared with the Sham group, the establishment of the MIRI model upregulated the expression of key proteins NLRP3, ASC, and Caspase-1 in the NLPR3 inflammasome signaling pathway in rat myocardial tissue (P<0.05). Transfection of miR-30b overexpression plasmid and blockade of NLRP3 signaling pathway downregulated the expression of NLRP3, ASC, and Caspase-1 in rat myocardial tissue (P<0.05). The combination of the two could further reduce the expression of NLRP3, ASC, and Caspase-1 in rat myocardial tissue (P<0.05).
Conclusion:
miR-30b improves the manifestations of cardiac dysfunction and myocardial cell damage caused by ischemia-reperfusion injury by targeting the activation of NLPR3 inflammasomes, and has a protective effect on myocardial tissue after ischemia-reperfusion injury. It is worth further clinical researching.
2024 Vol. 30 (3): 398-404 [
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405
TLR2 Mediates High-Fat Diet-Induced IFN-γ Secretion and Insulin Resistance in 3T3L1 Adipocytes
BAI Jichang, TAN Lixin, LIU Zanchao, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.010
Objective:
To explore the mechanism of insulin resistance induced by high-fat diet, and to understand the phenotypic changes of adipocytes induced by high-fat diet.
Methods:
Male C57 BL / 6 J mice were fed with normal diet or high-fat diet. Epididymal adipose tissue was isolated from mice fed with normal diet or high-fat diet for 2 weeks. The expression of interferon-γ (IFN-γ) and toll-like receptor 2 (TLR2) mRNA was detected by real-time fluorescence quantitative RT-PCR. Flow cytometry was used to detect the number of adipocytes expressing TLR2 or IFN-γ. Pancreatic tissue was analyzed by hematoxylin-eosin staining. The expression of TLR2 and IFN-γ in adipose tissue was analyzed by immunohistochemistry. 3T3-L1 adipocytes were treated with FFA or Zymosan A, and the expression of IFN-γ and TLR2 mRNA was detected by real-time fluorescence quantitative RT-PCR.
Results:
Analysis of gene expression profiles in adipocytes showed that high-fat intake induced increased expression of IFN-γ and TLR2. Flow cytometry analysis showed that there were adipocytes co-expressing TLR2 and IFN-γ (TLR2/IFN-γ adipocytes). Compared with subcutaneous adipose tissue, high fat intake increased the number of TLR2 / IFN-γ adipocytes in visceral adipose tissue. Free fatty acids increased the expression of IFN-γ in 3T3-L1 adipocytes through TLR2 signaling.
Conclusion:
TLR2/ IFN-γ adipocytes may be involved in high-fat-induced insulin resistance by inducing IFN-γ expression in visceral adipose tissue.
2024 Vol. 30 (3): 405-410 [
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Impacts of Polysaccharide of Trametes Robiniophila Murr on the Malignant Biological Behavior of Cervical Cancer Cells by Regulating the SPHK1/S1P/S1PR3 Signaling Pathway
LI Lipin, MA Suyan, AN Ruzheng
DOI: 10.3969/j.issn.1006-6233.2024.03.011
Objective:
To investigate the impacts of Huaier polysaccharide (HP) regulating the SPHK1/S1P/S1PR3 signaling pathway on the malignant biological behavior of cervical cancer cells.
Methods:
MTT was used to detect the viability of cervical cancer cells treated with Sophora auricula polysaccharides (0, 25, 50, 100, 200, 400μg/mL) and screen for the optimal drug concentration. The subjects were divided into control group, low, medium, and high concentration groups of Huaier polysaccharide (HP-L, HP-M, HP-H groups), and high concentration of Huaier polysaccharide+SphK1 activator K6PC-5 group (HP-H+K6PC-5 group). The cell proliferation, migration and invasion were observed; Western blot was used to detect the protein levels of SPHK1, S1P, S1PR3, Snail, N-cadherin, and E-cadherin.
Results:
After treatment for 24, 48 and 72h, HP treatments of 50μg/mL, 100μg/mL, 200μg/mL and 400μg/mL significantly decreased cell viability compared with 0μg/mL (P<0.05), Edu positive rate, number of invasive cells, scratch healing rate and Snail, N-cadherin, SPHK1, S1P and S1PR3 levels in HP-L, HP-M and HP-H groups were obviously lower than those in Control group (P<0.05), E-cadherin levels significantly increase (P<0.05). The Edu positive rate, number of invasive cells, scratch healing rate and Snail, N-cadherin, SPHK1, S1P and S1PR3 levels in HP-H+K6PC-5 group were obviously higher than those in HP-H group (P<0.05), E-cadherin levels significantly decrease (P<0.05).
Conclusion:
HP may inhibit the proliferation, invasion and migration of cervical cancer cells by inhibiting SPHK1/S1P/S1PR3 signaling pathway.
2024 Vol. 30 (3): 411-415 [
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TRIM25 Promotes the Proliferation Migration and Invasion of Esophageal Squamous Cell Carcinoma Cells through EZH2-Mediated Macrophage M2 Polarization
ZHANG Shitong, TIAN Xinchun, HUA Haiyang, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.012
Objective:
To explore the roles of TRIM25 and EZH2 in infiltrating macrophages in esophageal squamous cell carcinoma (ESCC) and their potential mechanisms of action.
Methods:
THP-1 cells were induced to M0 macrophages using phorbol ester, co-cultured with KYSE510 cells after transfection, and the collected co-culture macrophages were divided into Ctrl group, sh-NC group, sh-TRIM25 group, sh-NC+oe-NC group, sh-TRIM25+oe-NC group, sh-NC+oe-EZH2 group, and sh-TRIM25+oe-EZH2 group. The co-culture supernatant was added to KYSE510 cells, and they were divided into Ctrl group, TAM group, sh-NC+TAM group, sh-TRIM25+TAM group, sh-NC+oe-NC+TAM group, sh-TRIM25+oe-NC+TAM group, sh-NC+oe-EZH2+TAM group, and sh-TRIM25+oe-EZH2+TAM group. qPCR and WB were used to detect the expression of TRIM25, EZH2, and Arg-1 in cells. Protein synthesis inhibition experiments were used to test the protein stability of EZH2. FCM was used to detect the proportion of F4/80+CD206+ macrophages. CCK-8, colony formation assay, and Transwell assay were used to evaluate cell proliferation, migration, and invasion.
Results:
The mRNA and protein expression of TRIM25 and EZH2 in KYSE510 cells were higher than in human esophageal squamous epithelial cells (HET-1A) (P<0.01). Compared with the sh-NC group and sh-NC+oe-NC group, the proportion of F4/80+CD206+ macrophages and the expression of Arg-1 protein in the sh-TRIM25 group and sh-TRIM25+oe-NC group decreased (P<0.05), while it increased in the sh-NC+oe-EZH2 group (P<0.05). Compared with the sh-NC+TAM group and sh-NC+oe-NC+TAM group, the sh-TRIM25+TAM group and sh-TRIM25+oe-NC+TAM group showed decreased KYSE510 cell viability, colony formation, migration, and invasion (P<0.05), while the sh-NC+oe-EZH2+TAM group showed an increase (P<0.05). Knockdown of TRIM25 could inhibit the protein half-life of EZH2. Overexpression of EZH2 partially reversed the effects of sh-TRIM25 on macrophages and KYSE510 cells.
Conclusion:
TRIM25 induces M2 polarization of macrophages by promoting the stability of EZH2 protein, thereby promoting the proliferation, migration, and invasion of esophageal squamous cell carcinoma cells.
2024 Vol. 30 (3): 416-422 [
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423
The Expression of CXCR4, MFAP2, and KLF4 in Differentiated Thyroid Cancer and Their Predictive Value for Prognosis
GU Zhanguo, LI Jun, LIANG jinping, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.013
Objective:
To investigate the expression of chemokine 4 receptor (CXCR4), microfibril associated protein 2 (MFAP2), and Krüppel like factor 4 (KLF4) in differentiated thyroid cancer (DTC) and their predictive value for prognosis.
Methods:
A total of 113 patients with DTC admitted to our hospital from July 2019 to July 2020 were selected, and their tumor tissue and adjacent normal tissue were preserved during surgery. Protein immunoblotting was used to detect the expression levels of CXCR4, MFAP2, and KLF4 in DTC tissues and adjacent normal tissues. The relationship between the expression levels of CXCR4, MFAP2, and KLF4 and the clinical pathological characteristics of DTC was analyzed. The patients with DTC were followed up for 3 years, the overall survival was counted for 3 years, the expression levels of CXCR4, MFAP2, and KLF4 were compared between the death group and the survival group, and the predictive value of CXCR4, MFAP2, and KLF4 on the prognosis of DTC was analyzed by using the ROC curve, and the Cox regression model was used for the unifactorial and multifactorial analyses of the prognosis of DTC.
Results:
Compared with normal tissue adjacent to cancer, the expression of CXCR4 and MFAP2 proteins in DTC tissue was significantly increased ((P<0.05)), while the expression of KLF4 protein was significantly decreased((P<0.05)). The protein expression of CXCR4 and MFAP2 in TNM stage Ⅲ, lymph node metastasis, and poorly differentiated tumors was significantly higher than in TNM stage Ⅰ+Ⅱ, non-lymph node metastasis, and moderately well differentiated tumors ((P<0.05)). The protein expression of KLF4 in TNM stage Ⅲ, lymph node metastasis, and poorly differentiated tumors was significantly lower than in TNM stage Ⅰ+Ⅱ, non-lymph node metastasis, and moderately well differentiated tumors ((P<0.05)). During a 3-year follow-up period of 113 DTC patients, 8 cases were lost, and 105 cases were ultimately followed up. The expression of CXCR4 and MFAP2 proteins in the death group was significantly higher than those in the survival group (P<0.05), while the expression of KLF4 protein was significantly lower than in the survival group (P<0.05). Drawing the ROC curve, it was found that the AUC (95% CI) of CXCR4, MFAP2, and KLF4 alone or in combination to predict the prognosis of DTC were 0.692 (0.562~0.823), 0.729 (0.590~0.869), 0.766 (0.622~0.910), and 0.832 (0.690~0.975), respectively. The combined prediction performance was significantly better than the single detection (P<0.05). Cox regression analysis showed that lymph node metastasis, TNM stage Ⅲ, poor tumor differentiation, increased CXCR4 expression, increased MFAP2 expression, and decreased KLF4 expression were risk factors for the prognosis of DTC (P<0.05).
Conclusion:
CXCR4 and MFAP2 are highly expressed in tumor tissue of differentiated thyroid cancer patients, while KLF4 is low in expression. Their expression levels are related to lymph node metastasis, tumor differentiation, TNM staging, and 3-year overall survival rate. Combined detection of the three can help predict the prognosis of differentiated thyroid cancer.
2024 Vol. 30 (3): 423-428 [
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24
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429
Effect of Bispectral Index-Guided Propofol Combined with Remifentanil Target-Controlled Infusion on Intraoperative Propofol Dosage and Postoperative Delirium Incidence in Elderly Patients Undergoing Hip Arthroplasty
ZHU Leilei, WU Weiwei, GAO Wu, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.014
Objective:
To investigate the effect of bispectral index (BIS)-guided propofol combined with remifentanil target-controlled infusion (TCI) on intraoperative propofol dosage and postoperative delirium incidence in elderly patients undergoing hip arthroplasty.
Methods:
A retrospective analysis was conducted on the case data of elderly patients with hip fractures. According to the different anesthesia methods received by the patients, they were divided into two groups: the observation group included patients who underwent hip arthroplasty under BIS-guided propofol combined with remifentanil TCI , and the control group included patients who underwent similar surgery under BIS-guided propofol combined with remifentanil continuous intravenous pump infusion . A binary logistic regression analysis was established to construct a propensity score matching model. The results showed that 56 cases were obtained in the observation group and 49 cases were obtained in the control group. There was no significant difference between the two groups (P > 0.05). The parameters (mean arterial pressure (MAP), heart rate (HR)), general surgical conditions, propofol dosage, BIS value maintenance were compared between the two groups at different time points (after admission (T
0
), after anesthesia (T
1
), after bone cementation (T
2
), at the end of surgery (T
3
), after discharge (T
4
), 3 hours after surgery (T
5
) and 5 hours after surgery (T
6
)). The delirium scores (Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)) were compared between the two groups at different time points (preoperative and 1 hour, 6 hours, 1 day, 3 days, and 7 days after surgery). The incidence of postoperative delirium and the changes in blood glucose (Glu) and plasma adrenaline (E) and cortisol (Cor) levels at different time points (preoperative and 1 day after surgery) were recorded and compared between the two groups.
Results:
MAP value at T
1
was significantly decreased in observation group compared with that at T0 (P<0.05), MAP value at T
2
was significantly reduced in both groups compared with that at T0 (P<0.05), and HR value at T
5
, T
6
and T
7
in control group was significantly decreased compared to T
4
(P<0.05). There were no significant differences in surgical time, anesthesia time and intraoperative blood loss between the two groups (P>0.05). The dosage of propofol in observation group was significantly less than that in control group (P<0.05), and the BIS target range maintenance time ratio was significantly longer than that in control group (P<0.05) while the recovery time, tracheal extubation time and orientation recovery time were significantly shorter than those in control group (P<0.05). At 1h, 6h, 1d, 3d and 7d after surgery, the CAM-CR score in the two groups was firstly increased and then decreased, and was significantly higher than that before surgery (P<0.05). The CAM-CR scores in observation group at 1h, 6h, 1d and 3d after surgery were significantly lower than those in control group (P<0.05). There were no significant differences in the score at 7d after surgery compared to before surgery and between the two groups at the same time point (P>0.05). The incidence rate of postoperative delirium in observation group was 5.36%, which was significantly lower than 18.37% in control group (P<0.05). The levels of Glu and plasma E and Cor in the two groups were significantly increased at 1 d after surgery (P<0.05), but the levels in observation group were significantly lower than those in control group (P<0.05).
Conclusion:
The application of BIS-guided TCI of propofol combined with remifentanil in elderly patients with hip replacement can stabilize the hemodynamics, improve the perioperative indicators, reduce the dosage of propofol, improve the maintenance of BIS value, promote the anesthesia recovery, reduce the risk of postoperative delirium, and relieve the body’ s stress response.
2024 Vol. 30 (3): 429-435 [
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436
Analysis of Coagulation Function and Peripheral Blood TIM-3 TAT ACE2 Levels in Patients with Acute Pancreatitis and Secondary Organ Failure
LI Jun, WEI Guofeng, CAI Zhaohui, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.015
Objective:
This study aimed to investigate alterations in coagulation function among patients with acute pancreatitis (AP) and secondary organ failure (OF) and analyze variations in peripheral blood levels of T cell immunoglobulin and mucin domain 3 (TIM-3), thrombin-antithrombin complex (TAT), and angiotensin-converting enzyme 2 (ACE2).
Methods:
Conducted between August 2020 and August 2022, the study involved 118 patients with AP admitted for treatment. Patient severity was assessed using the Atlanta Classification and categorized into mild (n=72) and severe (n=46) groups. Coagulation function indices and peripheral blood TIM-3, TAT, ACE2 levels were compared between the groups, investigating the relationship between secondary organ failure and these parameters.
Results:
Patients in the severe group exhibited significantly elevated coagulation function indices (PT, INR, APTT, and FIB) and higher peripheral blood TIM-3 and TAT levels compared to the mild group, while ACE2 levels were lower (P<0.05). Similarly, the secondary OF group showed markedly higher coagulation function indices and peripheral blood TIM-3 and TAT levels than the non-OF group, with lower ACE2 levels (P<0.05). Multifactorial analysis indicated that PT, INR, APTT, FIB, TIM-3, TAT, and ACE2 influenced the onset of secondary organ failure. The area under the ROC curve for secondary organ failure was 0.846, 0.926, 0.819, 0.862, 0.751, 0.847, and 0.858 for PT, INR, APTT, FIB, TIM-3, TAT, and ACE2, respectively.
Conclusion:
In patients with acute pancreatitis, abnormal coagulation and elevation of TIM-3, TAT and decreased ACE 2 in peripheral blood are strongly associated with disease severity, with potential predictive value for the risk of organ failure secondary to acute pancreatitis.
2024 Vol. 30 (3): 436-440 [
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32
)
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441
Correlation of OASIS Score Combined with Platelet-Albumin-Bilirubin Index with the Severity of Acute Upper Gastrointestinal Bleeding and Its Value in Prognostic Assessment
CHANG Linlin, DAI Ziyan, ZHOU Yabai, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.016
Objective:
To investigate the correlation of oxford acute severity of illness score (OASIS) combined with platelet-albumin-bilirubin index (PALBI) with the severity of acute upper gastrointestinal bleeding (AUGB) and its evaluated value on prognosis.
Methods:
The data of 165 patients with AUGB in our hospital were retrospectively analyzed, and the patients were divided into high-risk group (n=44), medium-risk group(n=63) and low-risk group(n=58) according to the risk classification of Expert Consensus 2020 on the Emergency Diagnosis and Treatment of Acute Upper Gastrointestinal Bleeding. OASIS score and PALBI index were compared among the three groups. Spearman correlation analysis was used to analyze the relationship between OASIS score and PALBI index and risk degree of AUGB. All patients underwent clinical treatment, and then they were divided into good prognosis group (n=114) and poor prognosis group (n=51) according to whether rebleeding, intensive care and death occurred after treatment. The general clinical data and laboratory indicators were compared between the two groups, Logistic regression model was applied to analyze the related factors affecting the prognosis of patients with AUGB, and receiver operating characteristics (ROC) curve was used to analyze the value of OASIS score and PALBI index on the prognosis of patients with AUGB.
Results:
OASIS score and PALBI index in high-risk group were significantly higher than those in middle-risk group and low-risk group (P<0.05), and OASIS score and PALBI index in middle-risk group were significantly higher than those in low-risk group (P<0.05). Spearman correlation analysis analysis showed that OASIS score and PALBI index were significantly positively correlated with AUGB risk degree (P<0.05). AUGB frequency, proportions of hematemesis and Helicobacter pylori infection, heart rate, respiratory rate, OASIS score and PALBI index in poor prognosis group were significantly higher than those in good prognosis group (P<0.05) while HBG, ALB and PLT were significantly lower than those in good prognosis group (P<0.05). There were no statistically significant differences in gender, age, BMI, past history, proportions of syncope, melena and heart failure, etiology, serum TBIL, ALT, AST, Ser, UA, BUN, PT, TT and APTT between the two groups (P>0.05). Multivariate Logistic regression analysis showed that AUGB frequency, hematemesis, OASIS score and PALBI index were the risk factors affecting the prognosis of patients with AUGB (P<0.05). ROC curve analysis showed that the sensitivities of OASIS score and PALBI index alone and in combination in predicting prognosis of patients with AUGB were 88.24%, 70.59% and 90.20%, and the specificities were 80.70%, 78.95% and 84.21%, and the AUCs were 0.897, 0.806 and 0.929 respectively. Combined diagnosis had higher predictive value.
Conclusion:
OASIS score and PALBI index are significantly correlated with disease condition of patients with AUGB, and have high predictive value on prognosis of patients.
2024 Vol. 30 (3): 441-447 [
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26
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448
Correlation of Serum Chi3L1 NEFAs with Glycolipid Metabolism and Bone Density in Patients with Type 2 Diabetes Mellitus Complicated by Osteoporosis
ZHU Rui, MA Hongchuan, CHEN Hualing, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.017
Objective:
To explore the correlation between serum chitinase 3-like protein 1 (Chi3L1), free fatty acids (NEFAs), glycolipid metabolism, and bone density in patients with type 2 diabetes mellitus (T2DM) complicated by osteoporosis.
Methods:
A total of 110 T2DM patients admitted to our hospital from January 2020 to April 2023 were selected for the study. Based on the presence of osteoporosis, T2DM patients were divided into the osteoporosis group (38 cases) and non-osteoporosis group (72 cases). Clinical data of T2DM patients were collected.
Results:
In the osteoporosis group, Chi3L1 levels were significantly lower, while NEFAs levels were significantly higher than those in the non-osteoporosis group (P<0.001). Glycated hemoglobin (HbA1c) and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the osteoporosis group compared to the non-osteoporosis group (P<0.05). Bone density was significantly lower in the osteoporosis group (P<0.05). Serum Chi3L1 levels were negatively correlated with HbA1c and HOMA-IR, and positively correlated with bone density (P<0.05). NEFAs levels were positively correlated with HbA1c and HOMA-IR, and negatively correlated with bone density (P<0.05). Compared to the non-osteoporosis group, the osteoporosis group had a higher proportion of T2DM patients with low grip strength (P<0.05). Both NEFAs and Chi3L1 were influencing factors for the occurrence of osteoporosis in T2DM patients (P<0.05).
Conclusion:
Decreased serum Chi3L1 levels and increased NEFAs levels are associated with the occurrence of osteoporosis in T2DM patients and are significantly correlated with glycolipid metabolism and bone density.
2024 Vol. 30 (3): 448-452 [
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)
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453
Diagnostic Efficacy and Imaging Features of Magnetic Resonance Diffusion-Weighted Imaging in the Differential Diagnosis of Benign and Malignant Prostate Hyperplasia
LI Qian, PU Jingze, JIANG Huating, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.018
Objective:
To explore the efficiency and imaging characteristics of diffusion-weighted imaging (DWI) in the differential diagnosis of benign and malignant prostatic hyperplasia.
Methods:
A total of 126 patients undergoing routine MRI and DWI examinations in the hospital were retrospectively analyzed between March 2021 and March 2023. DWI characteristics in patients with benign and malignant prostatic hyperplasia were analyzed. The diagnosis results and diagnostic efficiency of routine MRI and DWI for benign and malignant prostatic hyperplasia were compared. According to results of pathological examination, patients were divided into malignant group and benign group, and ADC values of DWI were compared between the two groups. The diagnostic value of ADC for malignant prostatic hyperplasia was analyzed by receiver operating characteristic (ROC) curves.
Results:
According to pathological examination, there were 89 cases (70.63%) with malignant prostate lesions (prostate cancer) and 37 cases (29.37%) with benign prostate lesions (prostatitis hyperplasia nodules). When diffusion-sensitivity factor (b) was 0, 1000 s/mm
2
and 2000 s/mm
2
, there were equal, slightly high and high signals in central gland, and there were slightly low signals in ADC maps in patients with benign prostatic hyperplasia. In patients with malignant prostatic hyperplasia, there were slightly low, high and bright signals in right central gland and transitional area, and there were significantly low signals in ADC maps. Routine MRI showed that there were 104 cases with malignant prostatic hyperplasia and 22 cases with benign prostatic hyperplasia, and its accuracy, positive predictive value, negative predictive value, sensitivity, specificity and kappa value were 84.92%, 83.65%, 90.91%, 97.75%, 54.05% and 0.588, respectively. DWI showed that there were 94 cases with malignant prostatic hyperplasia and 32 cases with benign prostatic hyperplasia, and its accuracy, positive predictive value, negative predictive value, sensitivity, specificity and kappa value were 91.27%, 91.49%, 90.63%, 96.63%, 78.38% and 0.781, respectively. ADC value in malignant group was significantly lower than that in benign group [(0.91±0.28) ×10
-3
mm
2
/s vs (1.59±0.33) ×10
-3
mm
2
/s; t=11.769, P<0.001]. The area under the curve, optimum critical value, sensitivity and specificity of ADC value in the diagnosis of malignant prostatic hyperplasia were 0.895 (95%CI: 0.836-0.954), 1.20610
-3
mm
2
/s, 86.52% and 78.38%, respectively.
Conclusion:
Compared with benign prostatic hyperplasia, signals intensity of DWI is significantly increased, while signals in ADC maps are significantly decreased in malignant prostatic hyperplasia. The consistency between DWI and pathological examination is high in the diagnosis of malignant prostatic hyperplasia. ADC has good diagnostic value for malignant prostatic hyperplasia.
2024 Vol. 30 (3): 453-456 [
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Value of Dynamic Bedside Ultrasound IVC and Variability Rate Combined with CVP in Monitoring Fluid Resuscitation of Septic Shock Patients
LIU Zhiyuan, YANG Guicai, WANG Chun, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.019
Objective:
To investigate the value of dynamic bedside ultrasound inferior vena cava (IVC) and variability combined with central venous pressure (CVP) for monitoring fluid resuscitation in patients with septic shock.
Methods:
Ninety-two patients with septic shock were selected and divided into observation group (46 cases) and control group (46 cases) according to random number table method. The control group was guided by liquid resuscitation therapy based on CVP monitoring, and the observation group was guided by dynamic bedside ultrasound IVC and variability rate combined with CVP monitoring. The hemodynamic parameters [heart rate (HR), MAP, CVP, lactic acid (LAC)] the degree of condition [acute physiology and chronic health score (APACHE Ⅱ), sequential organ failure score (SOFA)] of the two groups before treatment and 72h of treatment; statistic patients' 24h resuscitation fluid volume, ICU hospitalization time, resuscitation attainment rate of 6h, 24h and 72h of treatment, 28d morbidity and mortality rates were compared.
Results:
After treatment, HR and LAC of both groups decreased compared with the pre-treatment period, and the observation group was lower than the control group, and MAP and CVP of both groups increased compared with the pre-treatment period, and the observation group was higher than the control group (P<0.05). After treatment, APACHE Ⅱ score and SOFA score of both groups decreased compared with the pre-treatment, and the observation group was lower than the control group (P<0.05). The amount of resuscitation fluid and ICU hospitalization time of the observation group were lower than those of the control group (P<0.05). At 72h of treatment, the resuscitation compliance rate of the observation group was higher than that of the control group (P<0.05). Comparing the 28d morbidity and mortality rates of the two groups, the difference was not statistically significant (P>0.05).
Conclusion:
Fluid resuscitation of septic shock patients under dynamic bedside ultrasound IVC and variability combined with CVP monitoring improves hemodynamics, reduces the volume of resuscitated fluids, shortens ICU length of stay, improves resuscitation attainment, and promotes regression.
2024 Vol. 30 (3): 457-461 [
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462
Comparative Study of the Application Value of Pants-Type Anastomosis and Roux-en-Y Anastomosis after Total Gastrectomy for Gastric Cancer
WANG Liang, ZHAO Jun, WANG Bing, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.020
Objective:
To compare the application value of pants-type anastomosis and Roux-en-Y (RY) anastomosis after total gastrectomy for gastric cancer.
Methods:
A total of 108 patients with gastric cancer who underwent total gastrectomy at our hospital from January 2020 to May 2023 were selected as the research subjects. They were divided into the RY anastomosis group (n=54) and the pants-type anastomosis group (n=54). Both groups underwent total gastrectomy, and the RY anastomosis group and the pants-type anastomosis group underwent digestive tract reconstruction with RY anastomosis and pants-type anastomosis after total gastrectomy for gastric cancer, respectively. The surgical indicators, postoperative complications, nutritional indicators [total protein (TP), hemoglobin (Hb), serum albumin (ALB), and prognostic nutritional index (PNI)], quality of life (QLQ-C30), and the incidence of long-term adverse events were compared between the two groups.
Results:
There was no significant difference in surgical indicators between the two groups (P>0.05). One case in the RY anastomosis group had the stapler replaced due to intestinal size reasons. The replacement rate of the stapler in the RY anastomosis group was higher than that in the pants-type anastomosis group, but the difference was not significant (P>0.05). The total incidence of postoperative complications in the pants-type anastomosis group was lower than that in the RY anastomosis group (P<0.05). The total incidence of long-term adverse events in the pants-type anastomosis group was lower than that in the RY anastomosis group (P<0.05). Compared with the preoperative values, the nutritional evaluation indicators TP, Hb, ALB, and PNI in both groups were increased at 3 and 6 months after surgery, and gradually increased with the extension of the postoperative time (P<0.05). The values of TP, Hb, ALB, and PNI were higher in the pants-type anastomosis group than in the RY anastomosis group at 3 and 6 months after surgery (P<0.05). Compared with the preoperative values, the QLQ-C30 scores of both groups were increased at 3 and 6 months after surgery, and gradually increased with the extension of the postoperative time (P<0.05). The QLQ-C30 scores of the pants-type anastomosis group were higher than those of the RY anastomosis group at 3 and 6 months after surgery (P<0.05).
Conclusion:
Compared with RY anastomosis after total gastrectomy for gastric cancer, pants-type anastomosis has a lower incidence of complications and is superior to RY anastomosis in terms of anti-bile reflux, reflux esophagitis, and food emptying disorder. Patients can obtain better nutritional support after surgery, and their quality of life is significantly improved, with higher application value.
2024 Vol. 30 (3): 462-468 [
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Analysis of Risk Factors for Early Rebleeding after Endoscopic Sequential Treatment in Patients with Cirrhosis Combined with Esophagogastric Varices
LIU Wei, CHU Xiaoyan, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.021
Objective:
To investigate the risk factors of early rebleeding in patients with cirrhosis combined with esophagogastric varices after endoscopic treatment, and to provide accurate prediction for clinical endoscopic treatment of rebleeding.
Methods:
A total of 386 patients with cirrhosis combined with esophagogastric varices who were hospitalized in the Department of Gastroenterology in our hospital from March 2020 to March 2022 were selected for retrospective analysis, and 80 patients with early postoperative rebleeding were selected as the observation group. 306 patients who received endoscopic treatment without bleeding in hospital were selected as the control group. The clinical indicators of the two groups were compared.
Results:
Among 386 patients with cirrhosis combined with esophagogastric varices, 80 had early postoperative rebleeding, accounting for 20.73%, and 306 had no bleeding, accounting for 79.27%. Univariate analysis showed that Child -Pugh grade, albumin, serum sodium, spleen thickness, and whether the first band ligation was associated with patients with liver cirrhosis and esophageal varices, which were statistically significant (P<0.05); univariate analysis screened out statistically significant The difference indexes were analyzed by binary logistic regression, and the results showed that Child-Pugh grade, albumin, serum sodium, spleen thickness, and whether or not the first ligation was the independent risk factor for variceal rebleeding (P<0.05).
Conclusion:
Child-Pugh grade, albumin, serum sodium, spleen thickness, and whether or not the first ligation is an independent risk factor for variceal rebleeding can be used to predict the disease early, and it is worthy of clinical attention.
2024 Vol. 30 (3): 469-473 [
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The Effect of Local Infiltration Anesthesia around the Incision on Postoperative Analgesic Effect of Hallux Valgus Surgery
NIE Zhihong, WANG Wei, ZHANG Mingzhu, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.022
Objective:
To explore the effect of local infiltration anesthesia around the incision on postoperative pain relief after hallux valgus surgery.
Methods:
From March 2022 to July 2022, 70 patients undergoing hallux valgus osteotomy and orthopedic surgery at the Foot and Ankle Surgery Center of Beijing Tongren Hospital affiliated to Capital Medical University were randomly selected and divided into experimental group and control group according to different postoperative analgesia methods, with 35 patients in each group. The control group was given intravenous analgesia pump analgesia after surgery, while the experimental group was given local infiltration anesthesia with 0.375% ropivacaine around the surgical incision on the basis of intravenous analgesia pump analgesia after surgery. The scores of VAS at 6, 18, 24 and 48 hours after surgery, the dosage of postoperative painkillers, the number of compressions of the intravenous analgesic pump the incidence of recent complications after surgery, and the satisfaction of patients with postoperative pain control were compared between the two groups.
Results:
The VAS pain scores in the experimental group were 1.17±0.954, 1.80±0.868, and 1.74±1.172 at 6, 18 and 24 hours after surgery, respectively, lower than those 2.57±2.160, 4.27±1.886, and 3.66±1.984 in the control group, with a statistically significant difference (P<0.05). The VAS score at 48 hours after operation in the experimental group was 1.26±0.980, and 1.69±1.078 in the control group, there was no significant difference between the two groups (P>0.05). The postoperative analgesic doses of hydrocortisone, celecoxib, flurbiprofen axetil and number of compressions of the intravenous analgesic pump in the control group were 603.43±282.811mg, 285.71±176.806mg, 40.87 (0,150) mg, and 9(6,10.25) respectively, which were significantly higher than those in the experimental group (278.14±214.655mg, 205.71±141.302mg, 30.13 (0,400) mg) and 4.5(3,6.75), with a significant difference(P<0.05). The incidence of recent complications such as incision effusion, fat liquefaction, and incision redness and swelling in the experimental group were 5.71%, 2.85%, and 8.57%, respectively. there was no statistically significant difference compared to 8.57%, 0%, and 2.85% in the control group(P>0.05). The postoperative pain satisfaction of the experimental group was higher than that of the control group, with a statistically significant difference (P<0.05).
Conclusion:
Local infiltration anesthesia around the incision can reduce the degree of postoperative pain in patients with hallux valgus, reduce the dosage of postoperative pain relievers and the number of compressions of the intravenous analgesic pump, improve patient satisfaction with pain control, and do not increase the incidence of recent complications after surgery. It is worthy of clinical promotion and application.
2024 Vol. 30 (3): 474-479 [
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Effects of Visual Puncture Percutaneous Nephrolithotomy on the Treatment of Renal Calculi and Its Impact on the Stone Clearance Rate and Postoperative Complication Rate
YUAN Ting, WANG Yu, LIU Dongliang, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.023
Objective:
To explore the effect of visual puncture percutaneous nephrolithotomy on the treatment of renal calculi and its impact on stone clearance rate and postoperative complications rates.
Methods:
Clinical data of patients with renal calculi who underwent visual puncture percutaneous nephrolithotomy in our hospital from January 2020 to January 2023 were retrospectively analyzed, and 73 cases were included in the observation group. Clinical data of patients who underwent minimally invasive percutaneous nephrolithotomy for renal calculi during the same period were retrospectively analyzed, and 74 cases were included in the control group. The clinical indicators (operation time, number of access tracts, intraoperative blood loss), stone clearance status (average stone fragmentation time, stone clearance rates in stage I and stage Ⅱ), postoperative recovery status (VAS score, length of hospital stay, decrease in hemoglobin), and occurrence of postoperative complications within 1 week were compared between the two groups.
Results:
The operation time and average stone fragmentation time in the observation group were longer than those in the control group (P<0.05), and the number of access tracts and stone clearance rate in stage Ⅱ were higher than those in the control group (P<0.05). The length of hospital stay was shorter, and VAS score and decrease in hemoglobin were lower in the observation group than in the control group (P<0.05). There was no statistically significant difference in intraoperative blood loss and the incidence of postoperative complications between the two groups (P>0.05).
Conclusion:
Visual puncture percutaneous nephrolithotomy is safe and effective in the treatment of patients with renal calculi, and it can effectively remove the stones and reduce the hospital stay for patients.
2024 Vol. 30 (3): 480-483 [
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484
Relationship between Levels of IgA, D-Dimer, and Fibrinogen Degradation Products and Disease Recurrence in Children with Henoch-Schonlein Purpura
YANG Yang, TANG Shuai, ZHANG Jian
DOI: 10.3969/j.issn.1006-6233.2024.03.024
Objective:
To explore the relationship between immunoglobulin A (IgA), D-dimer (D-D), fibrinogen degradation products (FDP) levels, and disease recurrence in children with Henoch-Schonlein Purpura (HSP).
Methods:
A total of 160 children with HSP admitted to our hospital from November 2022 to April 2023 were selected as the study subjects. IgA levels were measured using a fully automatic biochemical analyzer, and D-D and FDP levels were determined using a fully automatic blood coagulation analyzer. After a 6-month follow-up, the patients were divided into the recurrence group (n=34) and the non-recurrence group (n=136) based on the follow-up results. The levels of IgA, D-D, and FDP were compared between the two groups. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to analyze the predictive value of each indicator for disease recurrence. Multifactorial logistic regression analysis was employed to assess the impact of various indicators on disease recurrence.
Results:
Children in the recurrence group had higher levels of IgA [3.305 (2.565, 4.402)g/L], D-D [1.470 (0.477, 2.742)μg/mL], and FDP [4.445 (2.442, 9.212)μg/mL] compared to the non-recurrence group with IgA [2.360 (1.697, 3.012)g/L], D-D [0.310 (0.200, 0.575)μg/mL], and FDP [1.920 (1.140, 2.890)μg/mL], and the differences were statistically significant (P<0.05). ROC curve analysis revealed that the AUC for the combined prediction of IgA, D-D, and FDP for disease recurrence in HSP children was 0.892, higher than individual indicators, with a sensitivity of 85.3% and specificity of 82.5%. Multifactorial logistic analysis showed that IgA>3.235 g/L, D-D>0.415 μg/mL, and FDP>3.260μg/mL were independent factors for HSP recurrence (P<0.05).
Conclusion:
IgA, D-D, and FDP levels have a certain predictive value for disease recurrence in HSP. Monitoring the levels of these three indicators is beneficial for evaluating the prognosis.
2024 Vol. 30 (3): 484-487 [
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488
Analysis of the Effects of Relevant Cytokines on Infertility and Construction of a Predictive Model for Endometriosis in Women of Reproductive Age
JIN Fengmei, MA Qingjie, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.025
Objective:
To analyze the influence of related cytokines on infertility and to establish a prediction model for infertility after treatment of women of reproductive age with endometriosis.
Methods:
A total of 108 cases of women of reproductive age with endometriosis from March 2020 to March 2022 were included in the study. They were followed up for one year to observe their natural pregnancy. According to the pregnancy results, they were divided into natural pregnancy group and infertility group. The baseline data and serological test indicators of the two groups were compared to establish a female endometriosis model of reproductive age and analyze the effects of related cytokines on infertility.
Results:
One year follow-up showed that among 108 women of reproductive age with endometriosis, 66 cases (61.11%) were pregnant successfully and 42 cases (38.89%) were not. The proportion of patients with endometriosis in stage Ⅲ~Ⅳ and not receiving ovulation induction in the infertility group was higher than that in the natural pregnancy group (χ
2
=6.495 and 5.945, P<0.05). The levels of IL-1β, IL-18 and TNF-α in the infertility group were higher than those in the natural pregnancy group (t=7.345, 4.095, 5.739, P<0.05). The ROC curve of serum cytokine levels predicting infertility in women of reproductive age with endometriosis was drawn, and the results showed that IL-1β, IL-18, and TNF-α levels had certain predictive value for infertility in women of reproductive age with endometriosis (AUC=0.837, 0.711, 0.779, P<0.05). After logistic regression analysis, the results showed that endometriosis stage Ⅲ~Ⅳ, not receiving ovulation induction therapy, high IL-1β, IL-18, and TNF-α levels were risk factors for infertility in female endometriosis patients of reproductive age (OR = 4.730, 4.173, 16.216, 1.012, and 4.631, P<0.05), which was brought into the regression equation to obtain: logit (P) = -15.285 + 1.554X1 + 1.429X2 + 2.786X3 + 0.012X4 + 1.533X5.
Conclusion:
Endometriosis stage Ⅲ~Ⅳ, not receiving ovulation induction therapy, high IL-1β, IL-18, and TNF-α levels are the risk factors for infertility in women of childbearing age with endometriosis. The established Logistic regression model can predict the possibility of infertility in women of childbearing age with endometriosis, and it is helpful for medical staff to identify high-risk infertility patients.
2024 Vol. 30 (3): 488-492 [
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493
Characteristics of Autonomic Nervous Function in Patients with Anxiety and Depression Analyzed by Transcranial Doppler Upright Tilt Test
ZHANG Yawen, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.026
Objective:
To analyze the characteristics of autonomic nervous function in patients with anxiety and depression based on transcranial Doppler (TCD) upright tilt test.
Methods:
A total of 80 patients with anxiety and depression who were admitted to our hospital from March 2021 to February 2023 were selected as the case group, and another 80 healthy patients who underwent physical examination in our hospital during the same period were selected as the control group. Both groups underwent TCD, upright tilt test, and dynamic electrocardiogram (DCG) examinations. The occurrence rate of incomplete W wave rebound, hemodynamics during the upright tilt test, TCD cerebral blood flow, and heart rate variability (HRV) were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between hemodynamics during the upright tilt test, TCD cerebral blood flow, and HRV. ROC curve analysis was performed to evaluate the predictive value of TCD combined with the upright tilt test for the occurrence of anxiety and depression.
Results:
Compared with the control group, the incidence of W wave callback insufficiency in the case group was significantly higher, with a statistically significant difference (11.25 % VS 0.00 %, χ
2
=5.378, P=0.020). In the case group, HR in the upright tilt position was higher than that in the control group, while DBP and SV were lower (t=6.532, 7.944, 6.152, P all=0.000). The absolute values of changes in DBP, HR, and SV from the supine position to the upright tilt position were higher in the case group than in the control group (t=12.015, 6.644, 5.635, P all=0.000). Vd, Vs, Vm in the upright tilt position were lower, and RI, PI were higher in the case group compared to the control group (t=10.488, 3.927, 11.256, 2.298, 5.918, P=0.000, 0.000, 0.000, 0.023, 0.000). The absolute values of changes in Vd, Vs, Vm, RI, and PI from the supine position to the upright tilt position were higher in the case group than in the control group (t=9.559, 10.943, 10.775, 10.738, 28.236, P all=0.000). LF, HF, PNN50, RMSSD, SDNN were lower in the case group compared to the control group (t=10.992, 12.098, 12.376, 6.078, 7.758, P all=0.000). Pearson correlation analysis showed negative correlations between the absolute values of changes in DBP, HR, SV, Vd, Vs, Vm, RI, PI, and LF, HF, PNN50, RMSSD, SDNN from the supine position to the upright tilt position (r<0, P<0.05). ROC curve analysis revealed that the AUCs for the absolute values of changes in DBP, HR, SV, Vd, Vs, Vm, RI, PI, and the combined prediction of anxiety and depression from the supine position to the upright tilt position were 0.603, 0.728, 0.802, 0.805, 0.756, 0.710, 0.783, 0.739, and 0.949, respectively.
Conclusion:
TCD combined with upright tilt test can effectively predict the occurrence of anxiety and depression, and both can reflect the characteristics of autonomic nervous function in patients.
2024 Vol. 30 (3): 493-498 [
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499
Combined Prediction of Adjacent Vertebral Fracture Using Postoperative Spine-Pelvis Dynamic Posture and Sagittal Balance Parameters in Patients Undergoing Percutaneous Kyphoplasty
WU Hailong, ZHANG Chi, LI Yipeng, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.027
Objective:
To investigate the value of combining postoperative spine-pelvis dynamic posture and sagittal balance parameters in predicting adjacent vertebral fractures following percutaneous kyphoplasty (PKP).
Methods:
A total of 106 patients with osteoporotic vertebral compression fracture (OVCF) from January 2021 to June 2022 were selected, all of whom received PKP surgery. Dynamic spindle-pelvis postural parameters (spine rotation amplitude at rest, scoliosis amplitude during walking, and forward inclination amplitude), sagittal plane balance parameters [Sagittal axis (SVA), sacral inclination Angle (SS), thoracic kyphosis Angle (TK), pelvic incidence Angle (PI), lumbar lordosis Angle (LL), pelvic inclination Angle (PT), and T1 pelvic Angle (TPA)] were measured 3 months after surgery. Patients were followed up for one year and divided into the fracture group (37 cases) and non-fracture group (69 cases) based on the occurrence of adjacent vertebral fractures. The dynamic posture and sagittal plane balance parameters of the spine and pelvis were compared between the two groups, and the correlation and predictive value of the dynamic posture and sagittal plane balance parameters were analyzed.
Results:
The rotation amplitude of the fracture group was smaller, while lateral and forward inclination amplitudes were larger than those of the non-fracture group (P<0.05). SVA and TK were greater in the fracture group, while LL, SS, and PI were smaller compared to the non-fracture group (P<0.05). Rotation amplitude showed a negative correlation with SVA and TK, and a positive correlation with LL, SS, and PI. Lateral and forward inclination amplitudes were positively correlated with SVA and TK, and negatively correlated with LL, SS, and PI (P<0.05). High values of lateral and forward inclination, SVA, TK, and low values of rotation amplitude, LL, SS, PI significantly increased the risk of adjacent vertebral fractures (P<0.05). The combined prediction of spine-pelvis dynamic posture parameters and sagittal balance parameters for adjacent vertebral fractures had an AUC of 0.920 (95% CI: 0.851–0.964), sensitivity of 89.19%, and specificity of 82.61%, outperforming predictions based solely on dynamic posture or sagittal balance parameters.
Conclusion:
Postoperative spine-pelvis dynamic posture and sagittal balance parameters are significantly correlated in OVCF patients undergoing PKP and are associated with an increased risk of adjacent vertebral fractures. The combined prediction of these parameters provides a reliable and superior method for predicting such fractures.
2024 Vol. 30 (3): 499-505 [
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Risk Factors for Axillary Lymph Node Metastasis in Breast Cancer Patients and Comparative Diagnostic Efficacy of X-ray Imaging and CT Scans
WANG Haoyu, SHI Wenda, ZHAO Xiaobin, et al
DOI: 10.3969/j.issn.1006-6233.2024.03.028
Objective:
To explore the risk factors of axillary lymph node metastasis in breast cancer patients and compare the diagnostic efficacy of X-ray and CT examinations.
Methods:
A total of 112 breast cancer patients treated in our hospital from January 2021 to May 2023 were selected. Differences in clinical data between patients with and without axillary lymph node metastasis were analyzed. The diagnostic value of X-ray and CT examinations for axillary lymph node metastasis was also assessed.
Results:
Among the 112 patients, 32 had axillary lymph node metastasis, lymph node metastasis rate was 28.57%. The proportion of patients with axillary lymph node metastasis with low differentiation, invasive cancer, vascular infiltration, tumor diameter ≥5cm, and Ki-67 expression ≥14% were 68.75%, 90.63%, 28.13%, 31.25%, and 84.38%, respectively, which were significantly higher than those without axillary lymph node metastasis (P<0.05). Logistic regression analysis showed that differentiation degree, focus tissue type, vascular invasion, Ki-67 expression were the influencing factors of axillary lymph node metastasis in breast cancer patients (P<0.05). The consistency between X-ray diagnosis of axillary lymph node metastasis and pathological results was poor, with a Kappa value of 0.500 and P<0.05. The consistency between CT diagnosis of axillary lymph node metastasis and pathological results was good, with a Kappa value of 0.825 and P<0.05. The sensitivity, accuracy, and negative predictive values of CT in diagnosing axillary lymph node metastasis were 92.86%, 87.50%, and 95.00%, respectively, which were significantly higher than those of X-ray examination (P<0.05).
Conclusion:
The occurrence of axillary lymph node metastasis in breast cancer patients is influenced by differentiation degree, lesion tissue type, vascular invasion, and Ki-67 expression. Compared to X-ray, CT demonstrates higher diagnostic value for axillary lymph node metastasis.
2024 Vol. 30 (3): 506-510 [
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Clinical Characteristics of Patients with Early Psoriatic Arthritis and Bone Erosion
ZHANG Ying, WANG Junxiang
DOI: 10.3969/j.issn.1006-6233.2024.03.029
Objective:
To explore the clinical characteristics and related factors of patients with early Psoriatic Arthritis (PsA) who develop bone erosion.
Methods:
Fifty patients with early PsA (disease duration ≤ 1 year) hospitalized from January 2018 to January 2023 were selected. Peripheral joints of patients were examined using color Doppler ultrasonography to analyze the location and features of bone erosion. Based on the presence or absence of bone erosion on ultrasound, patients were categorized into the bone erosion group and the non-bone erosion group. The differences in clinical and laboratory parameters, as well as ultrasound images, between the two groups, were analyzed, including age, gender, disease duration, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and others.
Results:
Among the 50 PsA patients, 23 (46.00%) had bone erosion, while 27 (54.00%) did not. The bone erosion group had involvement of a higher number of peripheral joints compared to the non-bone erosion group (P<0.05). The prevalence of involvement in hand and foot joints and enthesitis was significantly higher in the bone erosion group (P<0.05). No statistically significant differences were found between the two groups in terms of age, gender, disease duration, pre-existing skin rash, axial joint involvement, HLA-B27 positivity, and inflammatory markers (P>0.05). Involvement of hand and foot joints, enthesitis, and the number of affected peripheral joints were positively correlated with bone erosion.
Conclusion:
Bone erosion is more common in patients with early PsA, most frequently occurring in hand and foot joints, and is closely associated with enthesitis and the number of affected peripheral joints.
2024 Vol. 30 (3): 511-514 [
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