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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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Association between single nucleotide polymorphism of TP53 gene and prognosis of primary hepatocellular carcinoma TANG Haoyan, PAN Zhenglong, LIU Xiaofang Tianjin Medical Journal    2023, 51 (11): 1249-1254.   DOI: 10.11958/20230151 Abstract （317）   HTML （3）    PDF （915KB）（1113）       Knowledge map    Objective To explore the relationship between single nucleotide polymorphism (SNP) of TP53 gene and postoperative prognosis in patients with primary hepatocellular carcinoma (HCC). Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genotypes of rs1625895, rs9895829 and rs28934578 of TP53 gene in 213 HCC patients after operation. The Log-rank test was used to plot the Kaplan-Meier survival curves of postoperative HCC patients. Multifactorial Cox proportional risk regression analysis was used to explore influencing factors of postoperative prognosis of HCC patients. Results Patients carrying the rs1625895 AA genotype had a worse prognosis in both co-dominant (HR=2.190, 95%CI: 1.142-4.201, P=0.018) and implicit models (HR=2.275, 95%CI: 1.225-4.227, P=0.009). Cox proportional risk model analysis showed that the rs1625895 polymorphism (HR=2.169, 95%CI: 1.015-4.637, P=0.046) was a risk factor for the prognosis of patients with HCC after surgery. Conclusion TP53 gene rs1625895 polymorphism is associated with postoperative prognosis in hepatocellular carcinoma patients. Table and Figures | Reference | Related Articles | Metrics

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Analysis of the urinary protein and pathological characteristics of IgA vasculitis with nephritis in children with dyslipidemia BAI Mengke, YANG Xiaoqing, MEI Xiaofeng, LI Jin’gang, ZHANG Qiushuang, HUANG Yanjie Tianjin Medical Journal    2023, 51 (7): 751-755.   DOI: 10.11958/20222046 Abstract （420）   HTML （1）    PDF （759KB）（1078）       Knowledge map    Objective To investigate the effect of dyslipidemia on urinary protein and pathological characteristics in children with immunoglobulin vasculitis with nephritis (IgAVN). Methods A total of 316 children with IgAVN diagnosed clinically and pathologically were selected. Children with IgAVN were divided into the normal lipid group (121 cases) and the dyslipidemia group (195 cases) according to the condition of blood lipid. The dyslipidemia group was further divided into the hypercholesterolemia group (55 cases), the hypertriglyceridemia group (44 cases), the mixed hyperlipidemia group (58 cases) and the low high density lipoprotein cholesterol (HDL-C) group(38 cases). The children's sex, age, 24-hour urinary protein quantification (24 hUP), urinary protein/creatinine (UPCR), urinary immunoglobulin G/creatinine (UIgG/Cr), urinary retinol-binding protein/creatinine (URBP/Cr), urinary red blood cell count (URBC), serum albumin, total cholesterol (TC), triacylglycerol (TG) and HDL-C were collected. The renal pathology was graded according to the IgAVN grading standard of the International Study of Kidney Disease in Children. According to the Oxford pathological classification of IgA nephropathy (IgAN), children were scored semi-quantitatively. Clinical data and pathological characteristics of the normal and abnormal blood lipid groups and each subgroup were compared. Results The serum albumin level decreased in the dyslipidemia group, and the proportion of children with 24 h UP, UPCR, UIgG/Cr, URBP/Cr levels, and serum albumin<30 g/L were higher than those in the normal lipid group (P<0.05). The pathological grading of children was mainly grade Ⅲ (223 cases, 70.6%) and grade Ⅱ (82 cases, 25.6%), of which children with grade Ⅳ (11 cases, 3.8%) were all in the dyslipidemia group. The proportion of pathological grade Ⅲ+Ⅳ, diffuse mesangial hyperplasia (Mb), glomerular segmental sclerosis or adhesion (S1) was higher in the dyslipidemia group than that in the normal blood lipid group (P<0.05). Compared with the normal blood lipid group, URBP/Cr increased and serum albumin decreased in the hypercholesterolemia group, while 24 h UP, UPCR, UIgG/Cr, URBP/Cr, URBC increased and serum albumin decreased in the mixed hyperlipidemia group (P<0.05). The proportion of pathological grade Ⅲ+Ⅳ, Mb and S1 was increased in the hypercholesterolemia group and the combined hyperlipidemia group (P<0.05). Conclusion IgAVN children with hypercholesterolemia and mixed hyperlipidemia, whose renal pathological damage and proteinuria are more serious than those with normal blood lipids, should be actively treated with lipid-lowering therapy. Table and Figures | Reference | Related Articles | Metrics

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Effects of edaravone dexborneol combined with rt-PA intravenous thrombolysis therapy on efficacy and prognosis of ultra-early acute cerebral infarction NIE Yameng, ZHANG Xiaoqiang, FENG Pengzhan, DING Yaqian Tianjin Medical Journal    2023, 51 (7): 766-770.   DOI: 10.11958/20221607 Abstract （906）   HTML （2）    PDF （796KB）（1063）       Knowledge map    Objective To observe the efficacy and prognosis of edaravone dexborneol combined with intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in the treatment of ultra-early acute cerebral infarction (ACI). Methods A total of 163 patients with ultra-early ACI were randomly divided into the combination group (treated with edaravone dexborneol combined with intravenous thrombolysis with rt-PA, n=78) and the control group (treated with intravenous thrombolysis with rt-PA, n=85). Therapeutic effects and changes of superoxide dismutase (SOD), reactive oxygen species (ROS), malondialdehyde (MDA), neuron-specific enolase (NSE), matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-12 (MMP-12), central nervous system-specific protein β (S100β), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), D-dimer (D-D), C-reactive protein (CRP), the National Institutes of Health Stroke Scale (NIHSS) scores, Modified Rankin Scale (mRS) scores and activity of daily living (ADL) scores were observed before and after treatment in the 2 groups. The fatality rate and the incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate, SOD level and ADL score were higher in the combination group than those in the control group. Levels of ROS, MDA, NSE, MMP-9 and S100β, NIHSS score and mRS score were lower in the combination group than those in the control group (P<0.05). There were no significant differences in fatality rate and incidence of adverse reactions between the two groups (P>0.05). Conclusion Edaravone dexborneol combined with intravenous thrombolysis with rt-PA can improve the clinical effect in the treatment of patients with ultra-early ACI, and improve the prognosis. 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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Construction of airway organoid microinjection and polarity reversal model SONG Licheng, ZHANG Yuhan, YU Zhongkuo, XIE Lixin Tianjin Medical Journal    2024, 52 (1): 4-10.   DOI: 10.11958/20231469 Abstract （243）   HTML （4）    PDF （2014KB）（1007）       Knowledge map    Objective To explore novel methods for efficient respiratory viral infection of organoids by microinjection and polarity inversion techniques. Methods Lung tissue samples were obtained from 8-week-old male C57BL/6 mouse, and respiratory epithelial cells were extracted to establish a transwell organoid culture model. The green fluorescent protein (GFP) labeled influenza virus PR8 (GFP-PR8) was quantitatively injected into organoids by improving the traditional microinjection platform, and morphologic changes in organoids and the immunofluorescence staining characteristics of tight junction proteins and microtubule proteins were observed. Polarity inversion apical-out (AO) was induced by suspension culture, and the morphological characteristics of polarity inversion was determined by HE staining. Normal and inverted organoids were infected with PR8, and the infection efficiency and expression differences of key pathway genes under different virus concentrations were observed. Results Ordinary organoids showed a significant increase in volume after microinjection. Following PR8 injection, the efficiency of infection was significantly higher in the apical region of organoids, accompanied by noticeable damage, as evidenced by significant down-regulation of tight junction proteins and microtubule protein expression. After suspension culture of the organoids, the polarity of ciliated cells gradually inverted outward over time, and the proportion of AO organoids stabilized on the 6th day. The efficiency of viral infection significantly increased in the inverted organoids, accompanied by significant cellular damage. After PR8 infection at 0.01 MOI, AO organoids showed significant changes in the inflammatory pathway and differentiation-related genes, with the opposite trend observed after higher concentration of PR8 infection. Conclusion Both polarity inversion and microinjection techniques significantly enhance the efficiency of influenza virus infection in organoids, thereby facilitating organoid widespread application in the field of respiratory tract infections. Table and Figures | Reference | Related Articles | Metrics

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Clinical study of transcranial direct current stimulation combined with eszopiclone in the treatment of chronic insomnia ZHANG Lu, ZHANG Wei, YUAN Changhong, LI Xia, LYU Yujing, WANG Yu Tianjin Medical Journal    2023, 51 (11): 1227-1231.   DOI: 10.11958/20230429 Abstract （390）   HTML （4）    PDF （775KB）（960）       Knowledge map    Objective To investigate the clinical application value of transcranial direct current stimulation (tDCS) combined with eszopiclone in treating chronic insomnia. Methods Sixty-eight patients with chronic insomnia were randomized into the control group (n=35, false tDCS combined with eszopiclone) and the study group (n=33, tDCS combined with eszopiclone). Both groups were treated for 4 weeks. Clinical efficacy after treatment, polysomnography (PSG) results, serum cortisol (CORT) and adrenocorticotropic hormone (ACTH) levels, Pittsburgh Sleep Quality Index (PSQI) scores, Patient Health Questionnaire-9 (PHQ-9) scores, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) scores and adverse reaction were compared between the two groups. Results After 4 weeks of treatment, the total effective rate was higher in the study group (93.94%, 31/33) than that in the control group (74.29%, 26/35, P<0.05). After 2 weeks and 4 weeks of treatment, compared with the control group, the total sleep time (TST) was longer, sleep latency (SL) was shorter, the proportion of stage N3 sleep and sleep efficiency (SE) were higher, microarousal index, the proportion of stage N1 sleep, serum CORT and ACTH levels were lower in the study group (P<0.05). After 4 weeks and 6 months of treatment, PSQI scores and PHQ-9 scores were lower in the study group than those of the control group (P<0.05). After 2 weeks, 4 weeks and 6 months of treatment, GAD-7 scores were lower in the study group than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion tDCS combined with eszopiclone can improve sleep quality in patients with chronic insomnia, reduce anxiety and depression and have long-term effect. The mechanism may be related to the down regulation of serum CORT and ACTH levels in patients. Table and Figures | Reference | Related Articles | Metrics

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Changes of serum angiopoietin-like protein 2 and 4 levels and their relationship with ovarian interstitial hemodynamics in patients with PCOS ZHAO Fangyuan, ZOU Hong, SHI Simao, XU Fang, ZUO Dongdong Tianjin Medical Journal    2023, 51 (9): 988-992.   DOI: 10.11958/20222119 Abstract （396）   HTML （12）    PDF （965KB）（955）       Knowledge map    Objective To investigate changes of serum Angptl2 and Angptl4 levels in patients with polycystic ovary syndrome (PCOS) and their relationship with ovarian interstitial hemodynamics. Methods A total of 123 PCOS patients (the PCOS group) and 41 healthy volunteers (the control group) were selected. The serum Angptl2 and Angptl4 levels, the peak systolic velocity (PSV), pulsation index (PI) and resistance index (RI) of ovarian interstitial were compared between the two groups. The relationship between Angptl2, Angptl4, PSV, PI, RI and PCOS and their predictive value to PCOS were analyzed. Results The PI and RI values of left and right ovarian interstitial were lower in the PCOS group than those in the control group, and PSV values were higher than those in the control group (P<0.05). Pearson analysis showed that serum Angptl2 and Angptl4 were positively correlated with PSV of left and right ovarian interstitial, and negatively correlated with PI and RI of left and right ovarian interstitial in patients with PCOS (P<0.01). Logistic regression results showed that high HOMA-IR (OR=1.921, 95%CI: 1.017-4.154), high BMI (OR=1.459, 95%CI: 1.085-3.220), high Angptl2 (OR=2.625, 95%CI: 1.330-6.324), high Angptl4 (OR=3.543, 95%CI: 1.915-8.147) levels were related factors affecting the occurrence of PCOS (P<0.05). Receiver operating characteristic curve (ROC) showed that the AUC (95%CI) of predicted PCOS were 0.747 (0.661-0.821) and 0.769 (0.685-0.841) when serum Angptl2 and Angptl4 were used alone. It was lower than that of 0.879 (0.793-0.921, P<0.05) for the combined application. Conclusion The abnormal levels of serum Angptl2 and Angptl4 in PCOS patients are related to the hemodynamics of ovarian interstitial, and they are closely related to the occurrence of PCOS, which can be used as reference indexes for the evaluation of PCOS. Table and Figures | Reference | Related Articles | Metrics

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Research progress of cerebral organoid technology and its application in stroke treatment SUN Kexin, XIAO Yuqian, WAN Jun, CHEN Shuying, CHEN Limin, WANG Yan, BAI Yanjie Tianjin Medical Journal    2024, 52 (1): 38-43.   DOI: 10.11958/20231381 Abstract （262）   HTML （4）    PDF （853KB）（945）       Knowledge map    Cerebral organoids are three-dimensional nerve cultures induced by embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs) that mimic the structure and function of human brain. With the continuous optimization of cerebral organoid culture technology and the combination with emerging technologies such as organ transplantation, gene editing and organoids-on-chip, complex brain tissue structures such as functional vascular structures and neural circuits have been produced, which provides new methods and ideas for studying human brain development and diseases. This article reviews the latest advances in brain organoid technology, describes its application in neurological diseases and advances in stroke modeling and transplantation treatment. Table and Figures | Reference | Related Articles | Metrics

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Research progress on the role of HMGB1 and RAGE in ventilator associated pneumonia HUANG Xuanli, MI Le, XU Yu, WANG Hongman Tianjin Medical Journal    2023, 51 (11): 1276-1280.   DOI: 10.11958/20230486 Abstract （350）   HTML （12）    PDF （762KB）（896）       Knowledge map    The pathogenesis of ventilator associated pneumonia (VAP) is complicated, and inflammatory response plays a key role in the pathological process of VAP. High mobility group protein B1 (HMGB1) and advanced glycation end-product receptor (RAGE) are key mediums for inflammatory response and play an important role in the progression of sepsis. Sepsis is the main outcome and cause of death of VAP. Therefore, HMGB1/RAGE may be used as markers and therapeutic targets for early detection of VAP progression into sepsis. This article reviews the role of HMGB1/RAGE in the development of VAP inflammatory and the progress in its treatment. Reference | Related Articles | Metrics

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Neuroprotective mechanism of edaravone dexborneol in rats with cerebral hemorrhage through ferroptosis-lipid peroxidation pathway MAO Quanxi, LI Zuoxiao Tianjin Medical Journal    2023, 51 (11): 1199-1204.   DOI: 10.11958/20221777 Abstract （768）   HTML （5）    PDF （1269KB）（881）       Knowledge map    Objective To investigate the neuroprotective effect of edaravone dexborneol on cerebral hemorrhage in rats and the effect of lipid peroxidation on perihematomal brain tissue. Methods A total of 128 SD rats were randomly divided into the sham-operated group, the cerebral hemorrhage group, the edaravone group and the edaravone dexborneol group, with 32 rats in each group. The acute cerebral hemorrhage model was constructed in all groups except for the sham-operated group. The edaravone group and edaravone dexamphene group were injected intraperitoneally with 6 mg/kg of edaravone and edaravone dexamphene 7.5 mg/kg, one injection every 12 hours. The sham-operated group and the cerebral hemorrhage group were injected intraperitoneally with equal amounts of saline. The neurological function was scored according to Garcia score at 1 d, 3 d, 7 d, and 14 d after surgery. Brain tissue around hematoma was stained with HE staining. Chemo fluorescence assay was used to observe pathological changes and reactive oxygen species (ROS) content of brain tissue around hematoma. Micro enzyme labeling assay was used to detect glutathione (GSH) content of brain tissue around hematoma. The expression levels of glutathione peroxidase 4 (GPX4), long-chain lipid acyl-coenzyme A synthase 4 (ACSL4) and phospholipid choline acyltransferase 3 (LPCAT3) in brain tissue around hematoma were detected by protein immunoblotting. Results Compared with the sham-operated group, neurological function scores were decreased in the cerebral hemorrhage group. Massive inflammatory cell infiltration and neuronal degeneration in brain tissue around hematoma were found, and ROS content, ACSL4 and LPCAT3 protein expression level increased. GSH content and GPX4 protein expression level decreased in the cerebral hemorrhage group (P<0.05). Compared with the cerebral hemorrhage group, neurological function scores were increased, histopathological damage around the hematoma was significantly reduced, ROS content, ACSL4 and LPCAT3 protein expression level were decreased, and the GSH content and GPX4 protein expression level were increased in the edaravone group and the edaravone dexborneol group (P<0.05). The intervention effect was better in the edaravone dexcamphenol group than that of the edaravone group (P<0.05). Except for the sham operated group, changes of the other groups were the most obvious at 3 d postoperatively, and gradually recovered at 7 d and 14 d postoperatively (P<0.05). Conclusion Edaravone dexborneol may play a protective role in cerebral hemorrhage by regulating the expression of ferroptosis-related proteins in nerve cells, reducing lipid peroxidation in brain tissue, and inhibiting iron death of nerve cells. Table and Figures | Reference | Related Articles | Metrics

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Risk factors of silent aspiration in patients with amyotrophic lateral sclerosis and the predictive value of ALSFRS-R scale XIA Xiaoqian, ZHANG Wei, CHANG Xueli, GUO Junhong Tianjin Medical Journal    2023, 51 (7): 677-680.   DOI: 10.11958/20230473 Abstract （310）   HTML （19）    PDF （844KB）（871）       Knowledge map    Objective To detect risk factors of silent aspiration in patients with amyotrophic lateral sclerosis (ALS) and the diagnostic value of ALSFRS-R scale. Methods A total of 68 patients with ALS were recruited in our study. According to the results of Videofluoroscopic Swallowing Study (VFSS), patients were divided into the silent aspiration group (9 cases) and the non-silent aspiration group (59 cases). The muscle strength of neck and limb was assessed using the Medical Research Council score (MRC) scale, and the independent influencing factors of silent aspiration were assessed using Logistic regression analysis. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of ALSFRS-R bulbar subscales and swallowing items for silent aspiration. Results The results of univariate analysis showed that compared with the non-silent aspiration group, cervical flexor muscle strength and right proximal upper limb muscle strength were decreased in the silent aspiration group (P<0.05), and the proportion of patients with bulbar onset was higher in the silent aspiration group (P<0.05). Multivariate Logistic regression analysis showed that patients with limb onset were less likely to have occult aspiration than those of bulbar onset (OR=0.001, 95%CI: 0.000-0.222, P=0.014). The higher the cervical flexor muscle strength was, the less the risk of occult aspiration was (OR=0.089, 95%CI: 0.010-0.814, P=0.032). The results of ROC curve showed that the ALSFRS-R bulbar subscales and swallowing items had limit clinical diagnostic value for ALS patients with silent aspiration, and the areas under the curve (AUC) were 0.774 (95%CI：0.741-0.924) and 0.781 (95%CI： 0.757-0.934), respectively (P<0.05). When the Youden index was the maximum, the optimal cut-off value of ALSFRS-R bulbar subscales was 11, and the sensitivity and specificity for the diagnosis of silent aspiration were 88.89% and 57.63%, respectively. The optimal cut-off value of ALSFRS-R swallowing items was 3, and the sensitivity and specificity for the diagnosis of silent aspiration were 77.78% and 67.80%, respectively. Conclusion For ALS patients with bulbar onset and poor cervical flexor muscle strength, attention should be paid to the screening of dysphagia and early clinical intervention. ALSFRS-R bulbar subscales and swallowing items have limited diagnostic value for silent aspiration, and new scales need to be developed to assess the risk of silent aspiration in ALS patients. Table and Figures | Reference | Related Articles | Metrics

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Short-term clinical efficacy observation of belizumab in the treatment of primary systemic lupus erythematosus WU Chunye, XING Jun, GONG Baoqi Tianjin Medical Journal    2023, 51 (7): 771-775.   DOI: 10.11958/20221006 Abstract （551）   HTML （3）    PDF （751KB）（868）       Knowledge map    Objective To investigate the efficacy and safety of belimumab in the treatment of new-onset systemic lupus erythematosus (SLE). Methods Sixty patients with newly diagnosed SLE were selected and divided into 2 groups, with 30 patients in each group. One group received standard treatment, and the other group received beliumab combined with standard treatment. The indexes of the two groups before and after 10-month treatment were recorded，including white blood cell (WBC), platelet (PLT), hemoglobin (Hb), complement C3 (C3), complement C4 (C4), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum white sphere ratio (AGR), immunoglobulin G (IgG), double-stranded DNA (ds-DNA), antinuclear antibody titer (ANA), 24 h urine protein quantification, prednisone acetate dosage before and after treatment and disease activity index (SLEDAI-2000). Adverse events were also recorded. Results After treatment, blood WBC, PLT, Hb, C3, C4 and AGR were higher than those before treatment in the two groups, and WBC, C3 and AGR were significantly higher in the belliumab group than those in the standard treatment group (P<0.05). IgG, ESR and ds-DNA were all decreased after treatment in the two groups of patients, and those of belliumab group were lower than the other groups after treatment (P<0.05). After treatment, doses of SLEDAI-2000 and prednisone acetate decreased in the 2 groups compared with before treatment, and those of belliumab group were lower than the standard treatment group after treatment (P<0.05). After treatment, 24 h urinary protein quantity of renal affected patients was lower in 2 groups than before treatment, and that of the belliumab group was lower than that of the standard treatment group (P<0.05). After treatment, the total effective rate was higher in the belliumab group than that of the standard treatment group (P<0.05). There was no significant difference in the incidence of adverse reactions during treatment between the two groups (P =1.000). Conclusion Beliumab can assist in reducing glucocorticoid dosage to help control disease activity without increasing adverse events, and it is recommended for the treatment of lupus patients with initial mild to moderate disease activity. Table and Figures | Reference | Related Articles | Metrics

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Changes and clinical significance of serum circPVT1 and miR-486-5p levels before and after radiotherapy for advanced NSCLC ZHANG Tianwei, ZHANG Jinbiao, ZHANG Yan, MING Hui, ZHANG Peng, NIE Dong Tianjin Medical Journal    2023, 51 (9): 998-1001.   DOI: 10.11958/20230346 Abstract （351）   HTML （11）    PDF （832KB）（867）       Knowledge map    Objective To investigate changes of serum levels of circulating RNA plasmacytoma variant translocation 1 (circPVT1) and microRNA-486-5p (miR-486-5p) before and after radiotherapy in patients with advanced non-small cell lung cancer (NSCLC) and their evaluation value for radiotherapy efficacy. Methods A total of 137 patients with advanced NSCLC were selected as the NSCLC group, and 140 health examination personnel in our hospital were selected as the control group. Real-time fluorescence quantitative PCR (RT-qPCR) was applied to detect serum expression levels of circPVT1 and miR-486-5p. Serum levels of circPVT1 and miR-486-5p before and after radiotherapy were compared. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of serum circPVT1 and miR-486-5p levels for radiotherapy efficacy. Results Compared with the control group, the serum expression level of circPVT1 was obviously higher before radiotherapy in the NSCLC group, and the expression level of miR-486-5p was obviously lower (P<0.05). According to Targetscan online analysis, circPVT1 had a targeted relationship with miR-486-5p. There were no significant differences in serum expression levels of circPVT1 and miR-486-5p before radiotherapy between patients with squamous cell carcinoma and adenocarcinoma NSCLC (P>0.05). Compared with TNM stage Ⅲ group, the serum expression level of circPVT1 was obviously higher in patients with stage IV NSCLC, and serum expression level of miR-486-5p was obviously lower (P<0.05). The serum expression level of circPVT1 was obviously lower in patients after radiotherapy than that before radiotherapy, and the expression level of miR-486-5p was obviously higher (P<0.05). Compared with the effective radiotherapy group, the serum expression level of circPVT1 was increased and the expression level of miR-486-5p was decreased before and after radiotherapy in the ineffective group (P<0.05). Compared with before radiotherapy, both the effective and ineffective radiotherapy groups showed a decreased serum circPVT1 level and an increased miR-486-5p level after radiotherapy (P<0.05). The AUC (95%CI: 0.859-0.958) of combined diagnosis of serum circPVT1 and miR-486-5p was 0.918, the sensitivity was 80.65% and the specificity was 88.00%. The combined diagnosis was better than single diagnosis (Z=2.06, 2.024, P<0.05). Conclusion Serum levels of circPVT1 and miR-486-5p have certain value in evaluating the efficacy of radiotherapy for advanced NSCLC. Table and Figures | Reference | Related Articles | Metrics

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The study on the mechanism of salidroside in the adjuvant treatment of patients with moderately severe acute pancreatitis WANG Xiaohong, QIAN Jing, WANG Jiawei, QI Xiaoming, MENG Yun, WANG Ping, CHENG Ruizhi, ZHOU Guoxiong Tianjin Medical Journal    2023, 51 (7): 762-765.   DOI: 10.11958/20221606 Abstract （376）   HTML （20）    PDF （738KB）（830）       Knowledge map    Objective To observe the adjuvant therapeutic effect of salidroside on patients with moderately severe acute pancreatitis (MSAP) and explore its mechanism. Methods A total of 60 patients with MSAP were randomly divided into the routine group (30 cases) and the experimental group (30 cases) using the random number table method. A routine treatment method was given to patients in both groups, and patients in the experimental group were additionally treated with salidroside. Serum levels of cysteine-containing aspartate-specific proteases (Caspase)-1, Gasdermin D (GSDMD), absent in melanoma 2 (AIM2), interleukin (IL)-1β and IL-18 were detected by enzyme-linked immunosorbent assay (ELISA) before and 7 days after treatment in both groups. The acute physiology and chronic health evaluation (APACHE) Ⅱ and pancreas-modified CT severity index (MCTSI) scores were evaluated. The time of abdominal pain-relieving and the hospital stay were also recorded in the two groups. Results Compared with 1 d before treatment, serum levels of Caspase-1, GSDMD, AIM2, IL-1β and IL-18 decreased 7 d after treatment in both groups, and serum levels of all above indexes were significantly lower in the experimental group than those in the routine group (P<0.01). Scores of APACHE Ⅱ and pancreas-MCTSI decreased in both groups on 7 d after treatment, and scores of two indexes were significantly lower 7 d after treatment in the experimental group than those in the routine group (P<0.01). The time of abdominal pain-relieving and the hospital stay were all shorter in the experimental group than those in the routine group (P<0.01). Conclusion Salidroside can play a good adjuvant therapeutic effect on patients with MSAP by inhibiting AIM2 inflammasome-mediated pyroptosis. Table and Figures | Reference | Related Articles | Metrics

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Emphasize the role of electrophysiological measurements in the diagnosis of amyotrophic lateral sclerosis ZHU Ju, ZHANG Zhecheng Tianjin Medical Journal    2023, 51 (7): 673-676.   DOI: 10.11958/20230474 Abstract （310）   HTML （19）    PDF （727KB）（826）       Knowledge map    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by loss of upper and lower motor neurons, resulting in progressive weakness and wasting of all voluntary muscles, culminating in respiratory failure. Neuroelectrophysiological detection plays an an essential role in early diagnosis of ALS, and can even detect subclinical dysfunction. Nerve conduction and needle electromyography, as standard neurophysiological detection method, are very important for early detection of lower motor neuron disease. Many emerging techniques for estimating the number of motor units have been proposed to increase diagnostic sensitivities and used to assess ALS progression. Reference | Related Articles | Metrics

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Neuroelectrophysiological study of sensory system in amyotrophic lateral sclerosis REN Yanping, ZHU Ju, TIAN Li, SUN Xiaohui, LIU Yufei, LIU Na, ZHANG Zhecheng Tianjin Medical Journal    2023, 51 (7): 690-693.   DOI: 10.11958/20230451 Abstract （243）   HTML （5）    PDF （743KB）（825）       Knowledge map    Objective To evaluate the functional status of the sensory system in patients with amyotrophic lateral sclerosis (ALS) by neuroelectrophysiological techniques. Methods According to the revised El Escorial diagnostic criteria, 66 patients with clinically confirmed and proposed limb-onset ALS were included and divided into the sensory symptom (sALS, n=13) group and without sensory symptom (nsALS, n=53) group according to the presence or absence of clinical sensory symptoms. Sixty healthy individuals were selected as the health control (HC) group. Sensory nerve conduction studies (SNCS) and skin sympathetic response (SSR) of bilateral upper and lower limbs were detected by Keypoint 4 electromyography evoked potential instrument. Pathway pain and sensation assessment system was used to conduct contact heat evoked potential (CHEP) detection of bilateral anterolateral leg and forearm volar side. Results (1) The abnormal rates of SNCS, SSR and CHEP in the ALS group were 0%, 21.2% (14/66) and 27.3% (18/66), respectively. The abnormal rates of SSR and CHEP in the sALS group were 30.8% (4/13) and 38.5% (5/13). The abnormal rates of SSR and CHEP in the nsALS group were 18.9% (10/53) and 24.5% (13/53). (2) Compared with the HC group, the latency of SSR in lower limbs was prolonged in the sALS group and the nsALS group, the latency of N wave in CHEP of upper and lower limbs was prolonged, and the amplitude of N-P wave was decreased (P<0.05). Compared with the nsALS group, the sALS group showed prolonged N wave latency and reduced N-P wave amplitude for anterolateral calf stimulation by CHEP detection (P<0.05). Conclusion ALS patients have small fiber damage in the sensory system. Table and Figures | Reference | Related Articles | Metrics

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A clinical analysis of single row anchor combined with bone tunnel and double row anchor in the treatment of humerus greater tuberosity fracture LIU Guoyin, LYU Dezhen, LENG Nannan, BAI Tianting, WANG Yongqiang, CHEN Jianmin, WANG Yong Tianjin Medical Journal    2023, 51 (7): 746-750.   DOI: 10.11958/20221971 Abstract （397）   HTML （1）    PDF （972KB）（816）       Knowledge map    Objective To investigate the clinical effect of single row anchor (SRA) combined with bone tunnel (SRA-BT) and double row anchor (DRA) in the treatment of greater tuberosity fracture (GTF) of humerus. Methods The medical records of 40 patients with GTF treated with anchor fixation technique were retrospectively analyzed. Patients were divided into the SRA-BT group (18 cases) and the DRA group (22 cases) by surgical methods after doctor-patient communication. The suture bridge technique of SRA combined with bone tunnel was used in the SRA-BT group, and DRA with suture bridge was used in the DRA group. The perioperative and postoperative indicators, complications and postoperative displacement distance of the greater tuberosity were compared between the two groups. The pain degree, functional status and range of motion were assessed 6 months after surgery. Results Bone healing was achieved in all patients without infection or internal fixation failure. There were no significant differences in operative time, intraoperative blood loss, hospital stay, postoperative complications, bone healing time and postoperative displacement distance of the greater tuberosity between the two groups (P>0.05). The incision length was larger in the SRA-BT group than that of the DRA group (P<0.05). The in-patients costs was significantly lower in the SRA-BT group than that of the DRA group (P<0.05). There were no significant differences in postoperative complications between the two groups (P>0.05). The VAS score and ASES score at rest and activity were significantly improved after operation in both groups (P<0.05), but there were no significant differences in VAS score, ASES score and ranges of motion in flexion, abduction, 0°external rotation and 90° internal rotation at rest and activity after operation between the two groups (P>0.05). Conclusion The clinical effect of technology of SRA-BT and DRA have clear clinical efficacy in the treatment of GTF, and both of them could effectively improve shoulder joint function and relieve postoperative pain. However, the SRA-BT has more advantages in reducing medical costs. Table and Figures | Reference | Related Articles | Metrics

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Clinical characteristics of amyotrophic lateral sclerosis patients LIU Yufei, ZHU Ju, LIU Na, REN Yanping, SUN Xiaohui, TIAN Li, ZHANG Zhecheng Tianjin Medical Journal    2023, 51 (7): 681-686.   DOI: 10.11958/20230447 Abstract （273）   HTML （13）    PDF （791KB）（810）       Knowledge map    Objective To analyze the clinical characteristics and epidemiological status of amyotrophic lateral sclerosis (ALS). Methods A total of 110 ALS patients (62 males and 48 females) with a median age of 60 years of onset, were collected. The basic information, site of onset, diagnostic process, modified amyotrophic lateral sclerosis function score (ALSFRS-R), rate of disease progression (ΔFS), electrophysiology and pulmonary function were analyzed comprehensively. The patients were followed up by outpatient or telephone every 3 to 6 months to record changes of their condition, the application of non-invasive positive pressure ventilation (NIPPV), gastric tube, percutaneous gastrostomy (PEG) and the treatment of riluzole. Results Among 110 patients, limb onset accounted for 90 patients (81.8%). The delay diagnosis was 12 (7, 20) months. The misdiagnosis interval was 11 (7, 17) months, and the misdiagnosis rate was 81.3% (74 cases). The most misdiagnosed cases were cervical spondylosis and lumbar spondylosis. The ALSFRS-R score was 39 (36, 45) points, and the ΔFS was 0.6 (0.3, 1.0) points/month. The proportion of confirmed and suspected diagnosis was higher in patients with ball onset than that in patients with limb onset (90% vs. 83%, χ2=2.098, P<0.05). Compared with patients of rapid disease progression, the age of onset was younger in patients with moderate and slow disease progression. Compared with patients of slow disease progression, patients of rapid and moderate disease progression had shorter diagnostic delay. Results of EMG in 90 (81.8%) patients indicated that lower motor neuron lesion segment was greater than or equal to the clinically involved segment. The first pulmonary function examination indicated that 50% (45 cases) patients had restrictive ventilation dysfunction, and the forced vital capacity (FVC)<70% accounted for 17.8% (16 cases). After discharge, the treatment rate of riluzole was 85.6%, and the application rate of NIPPV and PEG was low. During the follow-up, 50 patients (45.5%) died, and the median survival time was 44.0 months. Median survival time was shorter in patients with onset age ≥60 years than that in patients under 60 years (36 months vs. 50 months, P<0.05). Survival time was shorter in patients with rapid disease progression than that in patients with moderate and slow disease progression (27 months vs. 32 months vs. 65 months, P<0.01). Conclusion A full and correct understanding of clinical features of ALS is helpful to make a reasonable diagnosis and treatment plan for patients and improve the prognosis. Table and Figures | Reference | Related Articles | Metrics