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Research progress on the mechanism of dura mater in the growth and development of skull/meninges/brain tissue system LIU Song, LI Wenbin, SHAO Guo, ZHANG Chunyang, FENG Shijun Tianjin Medical Journal    2024, 52 (11): 1226-1232.   DOI: 10.11958/20240842 Abstract （276）   HTML （3）    PDF （868KB）（1797）       Knowledge map    Dura mater is a tough collagen connective tissue attached to inner surface of skull and wrapped around brain. As a buffer bridge between brain tissue and skull, its physiological function and role in skull development and repair have always been a focus of research. Recent studies have found that dura mater not only directly participates in skull development during skull growth, but also secretes a variety of cytokines that control the development of central nervous system. There are abundant material exchange and cell communication between the two. This article reviews the role of dura in development and repair of skull, and provides clues for further discovery of the relevant mechanisms of dura in development and repair of skull. Table and Figures | Reference | Related Articles | Metrics

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Mechanism study of ATOX1 promoting biological behavior of hepatocellular carcinoma cells through JAK2/STAT3 pathway MA Jiajia, ZHANG Yaping, YANG Bin, ZHAO Meiqi, JIANG Lu, HUANG Xiaoyu, FAN Luchang, WANG Fengmei Tianjin Medical Journal    2024, 52 (9): 907-912.   DOI: 10.11958/20240221 Abstract （333）   HTML （2）    PDF （1564KB）（1213）       Knowledge map    Objective To investigate the clinical significance of the expression of antioxidant 1 copper chaperone protein (ATOX1) in hepatocellular carcinoma (HCC) and its relationship with tumor proliferation, migration and invasion. Methods The expression of ATOX1 mRNA in HCC cancer tissue and normal liver tissue was analyzed using the Human Genome Atlas database. Immunohistochemical experiment was used to detect the expression of ATOX1 in 15 cases of HCC cancer tissue and adjacent tissue. Human HCC cell lines Hep3B and HepG2 were divided into the control group (NC), the ATOX1 knockdown group 1 (si-ATOX1#1) and the ATOX1 knockdown group 2 (si-ATOX1#2). The effects of ATOX1 knockdown on the malignant biological behavior of HCC cells were observed through CCK-8 cell proliferation experiment, scratch experiment and Transwell invasion experiments. A nude mouse xenograft tumor model was constructed to analyze the effect of ATOX1 knockdown on the quality and volume of transplanted tumors. Western blot assay was used to detect the relationship between ATOX1 and JAK2/STAT3 pathway protein expression. Results Bioinformatics analysis showed that expression of ATOX1 mRNA in HCC cancer tissue was higher than that in adjacent normal tissue (P<0.05). The immunohistochemical staining results showed that the positive rate of ATOX1 protein was higher in HCC cancer tissue than that in adjacent tissue (93.33% vs. 13.33%, P<0.01). In vitro experimental results showed that siRNA knockdown of ATOX1 protein expression in Hep3B and HepG2 cells significantly reduced the proliferation, migration and invasion abilities of cancer cells (P<0.05). In vivo experiments in mice showed that the volume and weight of subcutaneous xenograft tumors were significantly smaller in the sh-ATOX1 group than those in the sh-con group (P<0.05). The expression levels of JAK2/STAT3 pathway-related proteins p-JAK2, p-STAT3, CyclinD1 and MMP2 were significantly lower in the subcutaneous transplanted tumor tissue of the sh-ATOX1 group than that of the sh-con group (P<0.05). Conclusion ATOX1 can promote the proliferation, migration and invasion of HCC through JAK2/STAT3 pathway, which can potentially become a potential tumor marker and therapeutic target. Table and Figures | Reference | Related Articles | Metrics

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Predictive value of CALLY index for depression after ischemic stroke ZHANG Jingjing, ZHAO Wendong, ZHAO Yuan, ZHANG Qingxia, DU Jia, LIU Yanxia Tianjin Medical Journal    2024, 52 (12): 1300-1304.   DOI: 10.11958/20241063 Abstract （232）   HTML （0）    PDF （931KB）（1012）       Knowledge map    Objective To investigate the predictive value of CALLY index for ischemic post-stroke depression (PSD). Methods The clinical data of 179 patients with ischemic stroke were included, and the demographic information, medical history, stroke severity and laboratory indicators at admission were collected. After 6 months of follow-up, all patients were assessed for depressive symptoms using the 17-item Hamilton Depression Scale (HAMD-17). Patients were divided into the PSD group (48 cases) and the non-PSD group (131 cases). Differences in clinical characteristics were compared between the PSD group and the non-PSD group. CALLY index was calculated from C-reactive protein (CRP), albumin (ALB) and lymphocyte counts. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of CALLY index to PSD. Spearman correlation analysis was used for the correlation between CALLY index and neurological and cognitive function in PSD patients. K-M curve and Cox regression were used for analyzing the influence of CALLY index on PSD. Results The CALLY index of 179 patients ranged from 0.54 to 1.79, with a median of 1.08. ROC curve analysis showed that the optimal critical value of CALLY index to predict PSD was 1.09, and the area under ROC curve was 0.757 (95%CI: 0.687-0.818). Compared with the non-PSD group, the proportion of females was higher in the PSD group, and the proportion of patients with hyperlipidemia was increased with shorter years of education. The serum C-reactive protein (CRP) was higher, and albumin (ALB) and CALLY index were lower (P<0.05). The K-M curve showed that the incidence of PSD was significantly higher in the low CALLY index group (CALLY≤1.08) than that in the higher CALLY index group (CALLY>1.08, 33.0% vs. 20.5%, Log rank χ2=8.553, P=0.004). Cox regression analysis showed that after adjusting for other covariates, the decreased CALLY index was an independent risk factor for PSD (HR=2.651, 95%CI: 1.269-5.540, P<0.05). Conclusion CALLY index has a certain predictive value for PSD in acute ischemic stroke patients, which is helpful for early identification and timely intervention to improve the prognosis of patients. Table and Figures | Reference | Related Articles | Metrics

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Roxadustat improves myocardial ischemia-reperfusion injury in mice by inhibiting apoptosis and inflammatory response CAI Dengta, CHANG Jingyi, JIA Shanshan, TU Yinqiong Tianjin Medical Journal    2024, 52 (11): 1146-1151.   DOI: 10.11958/20240445 Abstract （218）   HTML （2）    PDF （3736KB）（557）       Knowledge map    Objective To investigate the improvement effect and related mechanism of roxadustat on myocardial ischemia-reperfusion (I/R) injury in mice. Methods Twenty four male C57BL/6N mice were randomly divided into the sham operation group, the control group and the roxadustat group, with eight mice in each group. A mouse myocardial I/R model was established. The control group was given 100 μL saline injection containing 5% dimethyl sulfoxide by gavage. The roxadustat group was given 25 mg/kg roxadustat by gavage. The left anterior descending coronary artery of mice in both groups was ligated for 40 minutes, and then reperfusion for 24 hours to establish the myocardial I/R model. In the sham operation group, only the left anterior coronary artery was pierced without ligation. The area of myocardial infarction in mice was detected by triphenyltetrazolium chloride (TTC) staining. The apoptosis of mouse cardiomyocytes was detected by TdT-mediated dUTP nick and labeling (TUNEL) staining. The expression of apoptosis-related proteins bcl-2 associated X protein (Bax), Caspase3 and inflammatory cell markers F4/80 and myeloperoxidase (MPO) were detected by immunohistochemistry staining. The damage of myocardial cells was observed by hematoxylin-eosin (HE) staining. Results The area of myocardial infarction after myocardial I/R was reduced in the roxadustat group compared to the control group and the sham operation group (P<0.05). The number of apoptotic cells was higher in the control group and the roxadustat group than that in the sham operation group, and the number of apoptotic cells was lower in the roxadustat group than that in the control group (P<0.05). The expression levels of Bax and Caspase3 proteins in myocardial tissue were higher in the control group and the roxadustat group than those in the sham operation group, while those of the roxadustat group was lower than those of the control group (P<0.05). The expression levels of F4/80 and MPO proteins in myocardial tissue were lower in the roxadustat group than those in the control group (P<0.05). In the control group, the myocardial tissue arrangement was disordered, and there was an increase in interstitial vacuoles. Compared with the control group, the myocardial cells were arranged more neatly in the roxadustat group, and the interstitial vacuoles were reduced. Conclusion Roxadustat can reduce the myocardial infarction area after I/R injury, inhibit myocardial cell apoptosis, alleviate myocardial injury, reduce infiltration of myocardial macrophages and neutrophils, and reduce inflammatory injury. Table and Figures | Reference | Related Articles | Metrics

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Identification of key ferroptosis genes in paraspinal muscle degeneration based on RNA sequencing and bioinformatics analysis ZHANG Chunhong, HUANG Hongchao, LIU Yue, DU Lilong, XU Haiwei, LI Ning, LI Yongjin Tianjin Medical Journal    2024, 52 (9): 991-995.   DOI: 10.11958/20240587 Abstract （307）   HTML （4）    PDF （1604KB）（463）       Knowledge map    Objective To explore the gene expression profile in paraspinal muscle degeneration (PMD) and identify key ferroptosis genes. Methods RNA sequencing was performed on paraspinal muscle tissue of 3 normal and 3 PMD patients respectively to obtain differentially expressed genes. Through protein-protein interaction (PPI) and gene functional enrichment analysis, the intersection of ferroptosis genes was identified to identify key hub genes associated with ferroptosis. The diagnostic value for PMD disease was analyzed by receiver operating characteristic (ROC) curves. Results A total of 292 differentially expressed genes were identified in PMD. Among them, 125 genes were significantly downregulated and 167 genes were significantly upregulated. Bioinformatics analysis revealed that 14 differentially expressed genes were associated with ferroptosis. Among them, ferroptosis genes MUC1, ATF3 and CDKN1A were key hub genes with good specificity and sensitivity for diagnosing PMD. Functional enrichment analysis revealed that they may mediate the occurrence and progression of PMD by regulating cell apoptosis, ferroptosis and skeletal muscle tissue development and differentiation. Conclusion Ferroptosis genes MUC1, ATF3 and CDKN1A can serve as biomarkers for diagnosing PMD, providing theoretical basis for decoding the pathological mechanism of PMD and developing new drugs. Table and Figures | Reference | Related Articles | Metrics

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Progress of the aryl hydrocarbon receptor in inflammatory skin diseases LIU Haoying, SHI Tianwei Tianjin Medical Journal    2024, 52 (11): 1221-1225.   DOI: 10.11958/20240117 Abstract （193）   HTML （4）    PDF （929KB）（405）       Knowledge map    The aryl hydrocarbon receptor (AhR), also known as dioxin receptor, is a ligand-dependent transcription factor. Because of its important role in occurrence and development of cancer, it has been widely studied. AhR is now considered to be an important regulator of host-environment interactions in immune and inflammatory responses and is involved in pathogenesis of many skin diseases. Because AhR is highly expressed in all types of skin cells and regulates many genes that are critical to skin function, it has the potential to be a new target for the treatment of inflammatory skin diseases. This paper presents and analyzes research findings on the relationship between AhR and inflammatory skin diseases to help accelerate the development of new drugs. Table and Figures | Reference | Related Articles | Metrics

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Mechanism study of BOC2 alleviating SAP inflammatory damage by inhibiting N-formyl peptide/formyl peptide receptor pathway ZHANG Guixian, LIU Dawei, LI Wenchang, CAI Jun, ZONG Wenhui, LIU Hongbin, ZHAO Xiumei Tianjin Medical Journal    2024, 52 (10): 1031-1037.   DOI: 10.11958/20240774 Abstract （255）   HTML （3）    PDF （2124KB）（328）       Knowledge map    Objective To observe the effect of BOC-Phe-Leu-Phe-Leu-Phe (BOC2) on the expression of six types of mitochondrial N-formyl peptides (NFPs) in blood and two formyl peptide receptors (FPRs) in pancreatic tissue of rats with severe acute pancreatitis (SAP), and to explore its mechanism of alleviating inflammatory damage of SAP. Methods Forty male SD rats were randomly divided into four groups: the sham group, the SAP model group, the BOC2 low-dose and the BOC2 high-dose group (0.1 and 0.2 mg/kg), with 10 animals in each group. The SAP model was prepared by retrograde injection of 5% sodium taurocholate (50 mg/kg) into biliary and pancreatic ducts in the last 3 groups. BOC2 was intraperitoneally injected at 0.5 hours after SAP modeling, and samples were taken 4 hours after modeling. HE staining was used to observe pathological changes in pancreas. Western blot assay was used to detect the expression of NFPs in plasma. IHC staining was used to detect the expression of FPRs in pancreatic tissue. ELISA was used to detect interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α levels in plasma. qPCR was used to detect expression levels of inflammatory factors in local pancreatic tissue. Results Compared with the model group, the BOC2 high-dose group and the BOC2 low- dose group showed improvement in pathological phenomena, such as pancreatic bleeding, acinar cell necrosis, inflammatory cell infiltration and edema. The pancreatic injury score, pancreatic FPRs expression, plasma MT-ND1, MT-ND2, MT-ND3, MT-ND5, MT-ND6 expression, as well as expression levels of three inflammatory factors in plasma and local pancreatic tissue, were significantly reduced (P<0.05). Conclusion BOC2 can reduce the production of inflammatory factors and alleviate SAP inflammatory damage by antagonizing mitochondrial NFPs/FPRs signaling pathway. Table and Figures | Reference | Related Articles | Metrics

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Predictive value of combined detection of serum VCAM-1, PECAM-1 levels and MMSE score for postoperative delirium in elderly patients underwent total hip arthroplasty LI Fan, LI Shihuan, XIE Shuang Tianjin Medical Journal    2024, 52 (10): 1046-1050.   DOI: 10.11958/20240396 Abstract （266）   HTML （2）    PDF （1513KB）（278）       Knowledge map    Objective To investigate the predictive value of combined detection of serum vascular cell adhesion molecule-1(VCAM-1), platelet endothelial cell adhesion molecule-1 (PECAM-1) levels and mini mental state examination (MMSE) score for postoperative delirium (POD) in elderly patients underwent total hip arthroplasty (THA). Methods A total of 200 elderly patients with hip fracture underwent surgical treatment were selected as the research objects. Patients were divided into the POD group (n=44) and the non-POD group (n=156) according to whether POD occurred within 3 days after operation. The clinical data of patients in the two groups were collected. The preoperative cognitive status was evaluated by MMSE, and serum levels of VCAM-1 and PECAM-1 were detected before operation and 1st and 3rd day after operation. The differences of the above indexes between the two groups were compared, and the correlation between preoperative serum VCAM-1, PECAM-1 levels and MMSE score were analyzed. Multivariate Logistic regression analysis was utilized to investigate influencing factors of POD in elderly patients underwent THA. A receiver operating characteristic (ROC) curve was constructed to assess the predictive value of preoperative serum levels of VCAM-1 and PECAM-1, as well as MMSE score, both individually and in combination for POD in elderly patients undergoing THA. Results The age, hospital anxiety and depression scale score, incidence of intraoperative hypotension and postoperative hospital stay were significantly higher or longer in the POD group than those in the non-POD group, and the MMSE score was lower than that in the non-POD group (P<0.05). The serum levels of VCAM-1 and PECAM-1 before operation, 1st and 3rd day after operation were increased in the POD group, and which were significantly higher than those in the non-POD group (P<0.05). The serum levels of VCAM-1 and PECAM-1 were significantly negatively correlated with MMSE score in elderly patients undergoing THA (r=-0.390, -0.501, P<0.01). The elevated serum levels of VCAM-1 and PECAM-1 before operation and prolonged postoperative hospital stay were independent risk factors for POD in elderly patients underwent THA, and the elevated value of MMSE score was independent protective factor (P<0.05). Preoperative serum VCAM-1 (AUC=0.793, 95%CI:0.730-0.847), PECAM-1 (AUC=0.799, 95%CI:0.736-0.852) and MMSE score (AUC=0.805, 95%CI: 0.744-0.858) showed high predictive value for POD in elderly patients underwent THA, and the combined detection of the three indicators had higher predictive efficiency. Conclusion The elevated serum levels of VCAM-1 and PECAM-1 are related to the impairment of cognitive function in elderly patients undergoing THA, and they are independent predictors for POD in elderly patients undergoing THA, thus may be helpful for early diagnosis and prevention of POD． Table and Figures | Reference | Related Articles | Metrics

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Observation of curative effect of Shenqu Xiaoshi oral liquid on rotavirus infectious diarrhea in children YAO Qian, WANG Jing, CHENG Na Tianjin Medical Journal    2024, 52 (12): 1296-1300.   DOI: 10.11958/20240945 Abstract （240）   HTML （0）    PDF （844KB）（278）       Knowledge map    Objective To explore the therapeutic effect of Shenqu Xiaoshi oral liquid combined with Xiyanping on children with rotavirus infected diarrhea and its impact on immune function. Methods A total of 200 children with rotavirus infected diarrhea were diveded into two groups according to treatment methods. The control group was treated with Xiyanping. The experimental group was treated with Shenqu Xiaoshi oral liquid combined with Xiyanping. The therapeutic effects and impacts on inflammatory factors and immune function were compared between the two groups. Results The total effective rate of clinical efficacy was higher in the experimental group than that in the control group (P<0.05). After treatment, traditional Chinese medicine (TCM) syndrome scores, serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ), hypersensitive C-reactive protein (hs-CRP) and CD8+ were lower in the experimental group than those in the control group (P<0.05), the serum levels of CD3+, CD4+ and CD4+/CD8+ were higher than those of the control group (P<0.05). The antidiarrheal time was earlier in the experimental group than that of the control group (P<0.05), and the negative rate of stool rotavirus was higher than that of the control group (P<0.05). Conclusion The combination of Shenqu Xiaoshi oral liquid and Xiyanping in the treatment of children with rotavirus infected diarrhea can quickly relieve symptoms of children, reduce inflammatory reactions and improve immune function. Table and Figures | Reference | Related Articles | Metrics

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Effects of Tianma Gouteng Yin combined with butylphthalide on symptom improvement and vascular elasticity in patients with acute cerebral infarction LIU Pengcheng, FANG Wujie, WANG Xiaotao, DENG Dianfeng Tianjin Medical Journal    2024, 52 (12): 1326-1330.   DOI: 10.11958/20241191 Abstract （219）   HTML （0）    PDF （840KB）（259）       Knowledge map    Objective To explore the effect of Tianma Gouteng Yin combined with butylphthalein (NBP) on symptom improvement and vascular elasticity in patients with acute cerebral infarction (ACI). Methods Eighty-two ACI patients admitted to Lu'an Hospital of Traditional Chinese Medicine were included in this study, and they were randomly separated into the single group and the combination group, with 41 cases in each group. The single group was given intravenous infusion of NBP sodium chloride injection, and the combination group was given treatment with Tianma Gouteng Yin on the basis of the single group. Cerebrovascular reserve function, endothelial function, neurological function, independent living ability, hemodynamic indicators, vascular elasticity, clinical efficacy and incidence of adverse reactions were compared between the two groups of patients at 1 day after admission (T0) and 14 days after treatment (T1). Results There were no significant differences in cerebrovascular reserve function, endothelial function, National Institutes of Health Stroke Scale (NIHSS) scores, independent living ability scores, hemodynamic indicators and vascular elasticity indicators at T0 between the two groups (P>0.05). At T1, levels of cerebrovascular reactivity (CVR), nitric oxide (NO), nitric oxide synthase (NOS), large artery elasticity index (C1) and small artery elasticity index (C2) were significantly increased in both groups, and levels were higher in the combined group than those of the single group (P<0.05). At T1 moment, levels of ET-1, vascular endothelial growth factor (VEGF), NIHSS score, MRS score, red blood cell count, whole blood viscosity, platelet adhesion rate and arterial pressure were reduced in both groups, and levels were lower in the combined group than those of the single group (P<0.05). The total effective rate was higher in the combination group (80.5%) than that of the single group (46.3%). The overall incidence of adverse reactions was lower in the combined group than that in the single group (P<0.05). Conclusion Tianma Gouteng Yin combined with NBP can effectively improve the cerebral vascular reserve function, endothelial function and neurological damage in ACI patients, increase vascular elasticity and improve hemodynamic levels. Table and Figures | Reference | Related Articles | Metrics

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Effects of GABA signaling pathway on endoplasmic reticulum stress and mitochondrial autophagy in septic rats with acute lung injury ZHONG Min, SHI Zhen, ZHOU Jinsong, LI Jinjie Tianjin Medical Journal    2024, 52 (7): 733-737.   DOI: 10.11958/20231352 Abstract （308）   HTML （1）    PDF （953KB）（253）       Knowledge map    Objective To investigate the effect of γ-aminobutyric acid (GABA) signaling pathway on endoplasmic reticulum (ER) stress and mitochondrial autophagy in septic rats with acute lung injury (ALI). Methods SD rats were randomly grouped into the control (CON) group, the model group, the GABA signaling pathway activator Baclofen group (the Baclofen group), the GABA signaling pathway inhibitor dicentrine group (the BIC group), with 6 rats in each group. The Baclofen group received intraperitoneal injection of 5 mg/kg Baclofen, and the BIC group received intraperitoneal injection of 1 mg/kg BIC, once a day, for two consecutive weeks. The CON group and the model group were injected with an equal amount of physiological saline via intraperitoneal injection. Enzyme linked immunosorbent assay was applied to detect serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA) and levels of cytochrome C (Cyt.C) and Nicotinamide adenine dinucleotide phosphate (NADPH) in bronchoalveolar lavage fluid (BALF). Transmission electron microscopy (TEM) was applied to observe the ultrastructure of lung tissue cells. HE staining was applied to observe the pathological morphology of lung tissue. TUNEL staining was applied to observe the apoptosis of lung tissue. Western blot assay was applied to detect expression levels of GABAAR, GRP78 and CHOP proteins in lung tissue. Results Compared with the model group, the lung swelling, congestion and inflammatory cell infiltration were improved in the Baclofen group, and the lung injury score, MDA content, apoptosis index, Cyt.C and NADPH levels, GRP78, and CHOP protein levels were reduced (P<0.05). The number of autophagic vacuoles in phagocytic mitochondria, SOD content and GABAAR protein level were increased (P<0.05), however, the trend of above indicators in the BIC group was opposite to that in the Baclofen group. Conclusion Up-regulation of GABA signaling pathway may have an improvement effect on ALI in sepsis rats. Table and Figures | Reference | Related Articles | Metrics

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Research progress on changes in EEG time-frequency signals in patients with chronic pain DING Ning, LI Yajie, LIU Minqi, LI Qi, XING Zheng, CHU Xiaolei, XU Weiguo Tianjin Medical Journal    2024, 52 (12): 1340-1344.   DOI: 10.11958/20241120 Abstract （208）   HTML （2）    PDF （842KB）（222）       Knowledge map    Chronic pain is a subjective experience that is difficult to accurately and objectively assess. Electroencephalography (EEG) can record physiological electrical signals generated during brain activity, and time signals reflect brain activity during task processing. The frequency signals reflect quiet brain activity. This paper reviews changes of event-related potential in EEG time signal, changes of different frequency bands in frequency signal and changes of event-related synchronization or desynchronization between the two signals in patients with chronic pain. Table and Figures | Reference | Related Articles | Metrics

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Promoting effect of circulating FGF23 on atrial fibrosis in chronic kidney disease GAO Pan, XIE Bingxin, ZHOU Zandong, LIU Tong Tianjin Medical Journal    2024, 52 (9): 917-923.   DOI: 10.11958/20240171 Abstract （364）   HTML （2）    PDF （1708KB）（196）       Knowledge map    Objective To explore the possible mechanisms by which fibroblast growth factor (FGF) 23 promoted atrial fibrosis in circulation of chronic kidney disease (CKD) by binding to atrial tissue fibroblast growth factor receptor (FGFR) 4. Methods Twenty-two healthy male Sprague-Dawley (SD) rats were selected. Rats were randomly selected to undergo 5/6 nephrectomy and fed for 15 weeks to establish a CKD model (n=14). The remaining 8 rats were used as the sham group. The sham group (n=8) underwent the same surgery without removing renal tissue. Body weight, blood pressure, renal function, cardiac ultrasound, epicardial electrocardiography and pathological indices were monitored in both groups. Enzyme-linked immunosorbent assay (ELISA) method was used to determine the circulating levels of FGF23 in the two groups of rats. Transcriptomic analysis of left atrial tissue was performed to search for differentially expressed genes. Rat atrial fibroblasts were divided into the control group, the FGFR inhibitor group, the transforming growth factor-β (TGF-β) group and the TGF-β+FGFR inhibitor group. The expression levels of α-smooth muscle actin (α-SMA), collagenⅠ (Col Ⅰ) and phosphorylated protein kinase B (p-AKT) protein were detected by Western blot assay. Results Systolic blood pressure, blood urea nitrogen and creatinine were elevated in the CKD group of rats. Cardiac electrophysiological study showed that CKD could promote the occurrence of atrial fibrillation (AF) and atrioventricular block. Cardiac ultrasound suggested that the internal diameter of the left atrium was significantly increased in rats of the CKD group. Pathological findings showed that the left atrium in the CKD group underwent significant fibrosis, and epicardial electrical markers showed that left atrial electrical conduction velocity was significantly slower and conduction heterogeneity was significantly increased in the CKD group. These changes were accompanied by higher circulating FGF23. Western blot results showed that FGFR4 expression was upregulated in the CKD group. After blocking the FGF23/FGFR4 signaling pathway in atrial fibroblasts, the fibrosis-related proteins α-SMA, Col Ⅰ and p-AKT/AKT were decreased. Conclusion CKD promotes the occurrence of AF by inducing both structural and electrical remodeling. Increased circulating FGF23 promotes atrial fibrosis by activating the downstream AKT pathway binding to FGFR4 in atrial tissue. Table and Figures | Reference | Related Articles | Metrics

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The value of cardiac magnetic resonance in evaluating severe pulmonary hypertension associated with connective tissue disease WU Caixin, YAN Yan, DENG Yuanlin, DU Yamin, YANG Zhenwen, PAN Qing, YANG Fan Tianjin Medical Journal    2024, 52 (7): 691-694.   DOI: 10.11958/20231770 Abstract （324）   HTML （1）    PDF （1226KB）（190）       Knowledge map    Objective To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in patients with severe connective tissue disease-associated pulmonary hypertension (CTD-PAH). Methods A total of 48 patients diagnosed with CTD-PAH by right heart catheterization (RHC) in Tianjin Medical University General Hospital from June 2018 to July 2021 were retrospectively included. The parameters of right ventricular (RV) morphology, function and ventricular septum (IVS) were obtained by manual delineation on CMR images and corrected by body surface area. The late gadolinium enhancement (LGE) myocardial mass (MM) and its percentage in left ventricular (LV) MM were manually sketched and calculated on LGE images. The patients were divided into the mild-moderate group and the severe group according to mean pulmonary arterial pressure (mPAP). CMR parameters were compared between the two groups. The diagnostic value of CMR for severe CTD-PAH was analyzed by receiver operating characteristic (ROC) curve. Results A total of 48 patients with CTD-PAH were included in this study. The curvature of interventricular septum (CIVS) and RV ejection fraction (EF) were lower in the severe group than those in the mild-moderate group, and the time proportion of IVS deformation, RV end-diastolic volume index (EDVI), RV end-systolic volume index (ESVI) and RV MM were higher than those in the mild-moderate group (P<0.05). ROC curve analysis showed that RV MM, time proportion of IVS deformation and RV ESVI had better diagnostic efficacy in severe CTD-PAH patients (AUC was 0.792, 0.766 and 0.731, respectively). The combined AUC of the three parameters was 0.840, specificity was 85.7% and sensitivity was 79.4%. Conclusion The parameters of RV and IVS measured by CMR can effectively evaluate patients with severe CTD-PAH and directly reflect serverity of cardiac impairment in patients with severe CTD-PAH from the morphological and functional perspective. Table and Figures | Reference | Related Articles | Metrics

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Clinical significance of SS related antibodies in idiopathic inflammatory myopathy and its associated interstitial disease YIN Weiyu, LIAO Hongli, LIU Yuan Tianjin Medical Journal    2024, 52 (7): 695-700.   DOI: 10.11958/20230993 Abstract （316）   HTML （2）    PDF （1035KB）（138）       Knowledge map    Objective To investigate the clinical significance of anti-Sj?gren's syndrome type A antibody (SSA) and anti-Sj?gren's syndrome type B antibody (SSB) in idiopathic inflammatory myopathies (IIM) and IIM associated interstitial disease (ILD). Methods A total of 102 patients with IIM were selected. The general information, clinical manifestations and auxiliary examinations were collected. Their positive rates of anti-SSA and anti-SSB antibodies in IIM patients were analyzed. IIM patients were divided into the SS antibody negative group (73 patients) and the SS antibody positive group (29 patients) according to the results of anti SSA and SSB antibody tests. The clinical significance of anti-SSA and anti-SSB antibodies in IIM and IIM related ILD was analyzed. Results Compared with patients in the SS antibody positive group, patients in the SS antibody negative group were more likely to experience dry mouth, increased erythrocyte sedimentation rate (ESR) and increased immunoglobulin A (IgA) levels (P<0.05). The general situation score of the MDAAT (myositis disease activity assessment tool) was significantly higher in the SS antibody positive group than that in the SS antibody negative group (P<0.05), and there were no significant differences in scores of other MDAAT items between the two groups (P>0.05). There were no significant differences in the positive rate of myositis autoantibodies, recurrence rate, hormone therapy and immunosuppressive therapy between the two groups (P>0.05). The proportion of patients treated with intravenous human immunoglobulin was higher in the SS antibody positive group than that of the SS antibody negative group (P<0.05). Non-specific interstitial pneumonia (NSIP) was the most type of ILD in both the SS antibody negative group and the positive group, followed by usual interstitial pneumonia (UIP). Patients with IIM who were positive for anti-SSA/SSB antibodies were more likely to progress to the overlapping syndrome of combined SS. Conclusion Positive anti-SSA and anti-SSB antibodies in IIM patients are associated with dry mouth symptoms, and anti-SSA/SSB antibodies may become one of the important laboratory indicators for judging patient conditions and predicting disease outcomes. Table and Figures | Reference | Related Articles | Metrics

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Development and validation of a preoperative nomogram predictive model for proximal gastric cancer with microscopic positive margin GUO Zhenjiang, ZHAO Guangyuan, DU Liqiang, LIU Fangzhen Tianjin Medical Journal    2024, 52 (8): 845-849.   DOI: 10.11958/20231766 Abstract （311）   HTML （1）    PDF （929KB）（135）       Knowledge map    Objective To explore the preoperative predictive factors influencing microscopic positive proximal margin in upper gastric cancer, and to establish a nomogram prediction model and to validate it internally. Methods Retrospective analysis of 187 patients with upper gastric cancer operated in the Department of Gastrointestinal Surgery of Hengshui People's Hospital from January 2018 to October 2022 were included in this study. Patients were divided into the microscopic positive proximal margin (the R0 group, n=15) and the negative microscopic proximal margin group (the R1 group, n=172) according to histopathological diagnosis. Preoperative factors that may influence positive upper margin of proximal gastric cancer were collected, including patient age, gender, tumor size, tumor location, Borrmann staging, tumor differentiation, Lauren staging, cT stage and cN stage. Receiver operating characteristic (ROC) curve was used to figure out the optimal cut-off value for predicting positive margin of proximal gastric cancer by tumor length. Multivariate Logistic regression was used to analyze the variables with statistical difference between the two groups, and independent risk factors were screened out, and prediction mode was constructed. The prediction accuracy of the model was verified internally using Bootstrap method. Results The best threshold for predicting positive margin of proximal gastric cancer by tumor length was 4.85 cm. Univariate analysis showed that there were significant differences in tumor length, tumor location, Borrmann staging, Lauren staging, cT staging and cN staging between the two groups (all P<0.05). Multivariate Logistic regression analysis showed that tumor length >4.85 cm (OR=4.000, 95%CI: 1.039-15.399), tumor located in esophagogastric junction (OR=7.108, 95%CI: 1.604-31.494), Borrmann staging Ⅲ—Ⅳ(OR=6.991, 95%CI: 1.538-31.782), Lauren staging as diffuse or mixed (OR=7.583, 95%CI: 1.814-31.701) and cT staging as cT4 (OR=8.249, 95%CI: 1.890-36.007) were independent predictors of microscopic positive proximal margin of advanced upper gastric cancer before surgery, and a prediction model was established based on results of multivariate analysis. The area under ROC curve (AUC) value for subjects with the model was 0.862 after internal validation. The calibration curve showed that the model predicted the probability of microscopic positive proximal margin occurrence in good agreement with the probability of actual microscopic positive proximal margin occurrence （Hosmer-Lemeshow χ2=6.145，P=0.523）. Conclusion The established nomogram prediction model can predict the probability of positive upper incisal margin of proximal gastric cancer before operation, and provide clinical guidance for formulating surgical strategy. Table and Figures | Reference | Related Articles | Metrics

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Connective tissue disease-associated interstitial lung disease: from pathogenesis to "dual-target" treatment strategies LI Mengtao, WANG Qian Tianjin Medical Journal    2024, 52 (7): 673-678.   DOI: 10.11958/20240260 Abstract （433）   HTML （7）    PDF （784KB）（131）       Knowledge map    Connective tissue diseases (CTD) are a spectrum of heterogeneous diseases with multiple organ involvements. Interstitial lung diseases (ILD) are serious complications of CTD. There is great heterogeneity in pathogenesis, clinical manifestations, and treatment of different CTD-ILD. Previous basic and clinical studies have explored the pathogenesis of CTD-ILD, and the "dual-target" treatment strategy has therefore emerged. The implementation of the "dual-target" treatment strategy helps to control CTD activity and lung inflammation in the early stage, prevent the progression of pulmonary fibrosis, and thus improve patient survival and quality of life. Reference | Related Articles | Metrics

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Construction and verification of prediction model of type 2 diabetic nephropathy based on machine learning WANG Xian, LIU Xiaming, CHEN Manyu, ZHAO Jun, WANG Lidong Tianjin Medical Journal    2024, 52 (7): 775-780.   DOI: 10.11958/20231584 Abstract （330）   HTML （0）    PDF （1292KB）（131）       Knowledge map    Objective To search for independent predictive factors of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM), construct and validate an optional machine learning (ML) model for the risk of DKD. Methods A total of 528 patients with T2DM, hospitalized in the Endocrinology Department of Chengde Central Hospital from October 2019 to September 2020, were selected as the study objects, and patients were randomly divided into a training set (370 cases), and a validation set (158 cases). The training set was divided into the DKD group (89 cases) and the non-DKD group (281 cases) according to whether DKD existed. The general data and diagnostic examination of patients were performed by univariate analysis, in which variables with statistical differences were used to screen the best predictors by least absolute shrinkage and selection operator (LASSO) regression analysis. The best predictors were used to establish eight ML algorithms by three cross-validation methods, including Logistic regression (LR), K-nearest neighbor (KNN), support vector machine (SVM), decision tree (DT), random forest (RF), naive Bayes (NB), artificial neural network (ANN), and extreme gradient lift (XGBoost). The optimal prediction model was selected by receiver operating characteristic (ROC) curve, Delong test and GiViTI calibration curve. Decision curve analysis (DCA) was used to evaluate the clinical practicability of the model. Results Age, alanine aminotransferase, creatinine, triglyceride, cystatin C, 25-hydroxy vitamin D and monocyte count were independent predictive factors of DKD. Eight ML models were established based on the above 7 predictors, and the ANN model performed best in the 8 ML models. The GiViTiI calibration curve indicated that the model had good accuracy (P>0.05), and the DCA showed that the prediction model curve had clinical practical value in the threshold probability range of 0.027-0.612. Conclusion In this study, the ANN model constructed in this study to predict the risk of DKD is helpful for early discrimination of high-risk T2DM patients with DKD. Table and Figures | Reference | Related Articles | Metrics

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The predictive value of NIHSS score combined with serum BDNF and IL-6 for post-stroke depression JIAO Aiju, REN Baolong, ZHANG Chunhua, LI Wenrui, ZHAO Weijing Tianjin Medical Journal    2024, 52 (9): 963-966.   DOI: 10.11958/20240005 Abstract （283）   HTML （3）    PDF （885KB）（124）       Knowledge map    Objective To investigate the predictive value of National Institutes of Health Stroke Scale (NIHSS) score, serum brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) in post-stroke depression (PSD). Methods A total of 180 patients with stroke were selected and divided into the PSD group (n=80, HAMD≥8 points) and the non-PSD (NPSD) group (n=100, HAMD<8 points), according to HAMD score at 3 months after stroke. The basic information, NIHSS score,serum BDNF and IL-6 were compared between the two groups. The influencing factors of PSD were analyzed by Logistic regression method. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of NIHSS score, serum BDNF and IL-6 for PSD. Results Compared with the NPSD grope, low density lipoprotein cholesterol (LDL-C) and serum BDNF level were significantly lower, NIHSS score and serum IL-6 level were significantly increased in the PSD group (P<0.05). Results of Logistic regression analysis showed that increased NIHSS score and serum IL-6 were risk factors for PSD, and increased serum BDNF was the protective factor in patents with PSD (P<0.05). The area under curve (AUC) of NIHSS score, serum BDNF and IL-6 and their combination prediction of PSD were 0.762, 0.746, 0.796 and 0.839, respectively. The sensitivity of the combined prediction was 86.0% and a specificity was 95.0%. Conclusion Compared with NPSD patients, the NIHSS score and serum IL-6 level are increased, and the serum BDNF level is decreased in patients with PSD. The combination of all three has a high predictive value for patients of PSD. Table and Figures | Reference | Related Articles | Metrics

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Changes of pulmonary function of pertussis in children aged 5-17 years CHEN Wei, ZHAO Mengya, XIAO Fei, LIU Chuanhe Tianjin Medical Journal    2024, 52 (10): 1075-1079.   DOI: 10.11958/20240218 Abstract （303）   HTML （0）    PDF （1588KB）（121）       Knowledge map    Objective To investigate the characteristics of pulmonary function changes in older children with pertussis. Methods Clinical data and pulmonary function date of older children diagnosed with pertussis in outpatient clinics from April 2021 to December 2023 were collected. The clinical data of the case group were collected. A group of healthy older children were included as the control group. Pulmonary function parameters included peak expiratory flow (PEF), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, expiratory flow at 50% of vital capacity (FEF50), maximum mid-expiratory flow (MMEF) and expiratory flow rate with 75% vigorous exhalation (FEF75). Results Seventy children (36 boys and 34 girls) with pertussis were recruited in the case group, including 54 children with pertussis only and 16 children with pertussis and asthma together. The incidence of paroxysmal cough was 40.0% (28/70) and inspiratory croup 8.5% (6/70) in the case group. Sixty healthy children (28 boys and 32 girls) were included in the control group. There were no significant differences in gender, age, height and body weight between children with pertussis alone group and the control group (P>0.05). The pulmonary function parameters were significantly lower in the children with pertussis alone group than those in the control group, and PEF had the most obvious decline: PEF%pred [80.5 (62.6, 85.9) vs. 109.8 (103.2, 118.7)]. Compared with the pertussis alone group, pulmonary function was not decrease further in the pertussis combined with asthma group. After the improvement of clinical symptoms of children in the pertussis alone group, the level of pulmonary function (PEF and FEF50) increased significantly, but they were still lower than those of the control group. Conclusion The pulmonary function declines slightly in loder children with pertussis. The decreased PEF is most significant. Table and Figures | Reference | Related Articles | Metrics