Tianjin Medical Journal

The mechanism of breast cancer cell culture supernatant promoting migration and proliferation of human adipose mesenchymal stem cells

LIU Danyang, WANG Lulu, HE Jun, JIANG Yang, LI Yongtao, ZHANG Xiaodong, LI Penghui, SHEN Lei

2023, 51 (11): 1153-1157. doi: 10.11958/20230255

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Objective To explore the effect of MDA-MB-231 breast cancer cell culture supernatant on migration, proliferation and apoptosis of human adipose mesenchymal stem cell (hAdMSC) and its molecular mechanism. Methods hAdMSC cultured from MDA-MB-231 cell supernatant and RPMI-1640 medium without fetal bovine serum were mixed at a volume ratio of 1∶4 to form the MDA-MB-231 supernatant group. CXCR1/2 inhibitor group was added with 10 μmol/L Reparixin (CXCR1/2 inhibitor) to the MDA-MB-231 supernatant group. The Akt inhibitor group was added with 10 nmol/L GSK690693 (Akt inhibitor) to the MDA-MB-231 supernatant group. hAdMSC cultured without any stimulation was used as the control group. The migration ability of hAdMSC in each group was detected by cell scratch assay. hAdMSC proliferation was detected by CCK-8 assay. Annexin V-FITC/PI double labeled flow cytometry was used to detect hAdMSC apoptosis rate in each group. The protein expression levels of mTOR/phosphorylated mTOR (p-mTOR) and Akt/phosphorylated Akt (p-Akt) in hAdMSC of each group were detected by Western blot assay. Results Compared with the control group, the 24 h and 48 h scratch closure area, cell proliferation level and relative expression levels of p-Akt, p-mTOR protein of hAdMSC were increased in the MDA-MB-231 supernatant group, and the apoptosis rate was decreased (P<0.05). Compared with the MDA-MB-231 supernatant group, the 48 h cell scratch closure area, cell proliferation level and relative expression levels of p-Akt, p-mTOR proteins of hAdMSC were decreased in the Akt inhibitor group and the CXCR1/2 inhibitor group, and the apoptosis rate was increased (P<0.05). Conclusion MDA-MB-231 breast cancer cell culture supernatant promotes hAdMSC migration and proliferation and inhibits hAdMSC apoptosis by activating Akt-mTOR signaling pathway, in which IL-8-CXCR1/2 axis plays a key role.

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Investigation on the determination of tumor-associated macrophages inducing the drug resistance of albumin-bound paclitaxel in triple-negative breast cancer cells by activating IGF-1R signaling pathway

LIU Shujuan, LIU Mengying, SU Wuyun, DOU Jia, WANG Wei

2023, 51 (11): 1158-1163. doi: 10.11958/20230438

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Objective To investigate the effect of tumor-associated macrophages (TAM) on the chemosensitivity of triple-negative breast cancer (TNBC) cells to albumin-bound paclitaxel (Nab-PTX). Methods TAM model was constructed and identified. TNBC cell line MDA-MB-231 was established by Transwell cell co-culture method. They were divided into the control group (MDA-MB-231 cells and blank chamber), the Nab-PTX group (MDA-MB-231 cells, blank chamber and 0.5 nmol/L Nab-PTX), the TAM group (MDA-MB-231 cells, containing M2-type macrophages), the TAM+Nab-PTX group (MDA-MB-231 cells, cells containing M2-type macrophages and 0.5 nmol/L Nab-PTX) and the insulin-like growth factor 1 receptor (IGF-1R) inhibitor group (MD-MB-231 cells, macrophage compartment containing M2-type, 0.5 nmol/L Nab-PTX and 4 nmol/L IGF-1R inhibitor Linsitinib). The cell survival rate of each group was determined by CCK-8 method. Flow cytometry was used to detect cell apoptosis. The mRNA levels of multidrug resistant protein (MDR) 1 and Caspase-3 were detected by real-time quantitative PCR (qPCR). The key proteins of IGF-1R signaling pathway were detected by Western blot assay. Results THP-1 cells were induced to differentiate into M2 macrophages. Compared with the Nab-PTX group, the cell proliferation rate was increased and apoptosis rate was decreased in the TAM+Nab-PTX group (P<0.01). The mRNA expression of MDR1was increased and Caspase-3 mRNA was decreased (P<0.05). The key protein of IGF-1R signaling pathway was activated (P<0.01). Compared with the TAM+Nab-PTX group, the proliferation rate was decreased and apoptosis rate of cells was increased in the IGF-1R inhibitor group. The mRNA expression of MDR1 was decreased, the mRNA expression of Caspase3 was increased, and the expression of key proteins in IGF-1R signaling pathway was decreased (P<0.01). Conclusion TAM may induce resistance of TNBC cells to Nab-PTX by activating IGF-1R signaling pathway.

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Impacts of theaflavin on biological behavior of oral squamous cell carcinoma cells by regulating Snail/Slug signaling pathway

SUN Xugao, YANG Wenchao, LIU Yanjie, YANG Xu

2023, 51 (11): 1164-1169. doi: 10.11958/20230202

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Objective To study the impact of theaflavin on the proliferation, apoptosis and epithelial mesenchymal transformation of oral squamous cell carcinoma (OSCC) cells by regulating Snail/Slug signaling pathway. Methods MTT method was used to detect the survival rate of human OSCC cells SCC-25 treated with 25, 50, 100, 150 and 175 mg/L theaflavin, and the appropriate concentration of theaflavin was selected. SCC-25 cells were cultured in vitro and OSCC transplanted tumor model was constructed. Cells were randomly divide into the control group, the low dose theaflavin group, the high dose theaflavin group, the high dose theaxanthin+empty group and the high dose theaflavin+Snail overexpression group. The expression levels of Snail and Slug in cells of each group were detected by real-time fluorescent quantitative PCR and Western blot assay. MTT assay and flow cytometry were applied to detect cell proliferation and apoptosis. The migration and invasion of SCC-25 cells in each group were detected by cell scratch and Transwell invasion tests. The apoptosis of SCC-25 cells and the expression of epithelial mesenchymal transformation related proteins were detected by Western blot assay. The tumor volume and tumor weight of nude mice in each group were detected. Results Compared with the control group, the cell survival rate, migration rate, invasion number, Snail mRNA and protein expression, Slug mRNA and protein expression, Bcl-2, N-cadherin protein expression, tumor weight and volume of nude mice were decreased in the low dose theaflavin group and the high dose theaxanthin group (P<0.05), and the apoptosis rate, Bax, ZO-1 and E-cadherin protein expression increased (P<0.05). There was no significant difference in each index between the high-dose theaxanthin group and the high-dose theaflavin+no-load group (P>0.05). Overexpression of Snail can reverse the effect of theaflavin on cells and nude mice. Conclusion Theaflavin can down regulate the expression of Snail/Slug pathway, thus inhibit the epithelial mesenchymal transformation, proliferation, migration and invasion of OSCC cells, promote their apoptosis, and delay the growth of transplanted tumors in nude mice.

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Impacts of CircBACH1 on proliferation, apoptosis and chemosensitivity of multiple myeloma cells by regulating miR-140-5p /MDM2 axis

LIU Huimin, XU Xuanxuan, WANG Yuanli, XIONG Tao, TANG Yuanyan

2023, 51 (11): 1170-1175. doi: 10.11958/20230126

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Objective To investigate the effect of CircBACH1 on proliferation, apoptosis and chemotherapy sensitivity of multiple myeloma (MM) cells and the regulatory mechanism on miR-140-5p/MDM2 axis during this process. Methods Bone marrow plasma cells were collected from the MM patient group and normal control group. Human MM cell line U266 cells were divided into the untransfected group, the si-NC group, the si1-CircBACH1 group, the si2-CircBACH1 group, the si-CircBACH1+anti-miR-NC group and the si-CircBACH1+anti-miR-140-5p group. The mRNA expressions of CircBACH1, miR-140-5p and mouse double microsoma 2 (MDM2) were detected by real-time quantitative PCR. Cell proliferation activity was detected by CCK-8 assay. Flow cytometry was used to detect apoptosis and sensitivity to bortezomib. The expression levels of B-cell lymphofactor 2 (Bcl-2), Bcl-2 associated X protein (Bax) and cleaved caspase -3 were detected by Western blot assay. Dual luciferase reporter gene assay was used to verify the targeting relationship of CircBACH1, miR-140-5p and MDM2. Results Compared with the normal control group, the mRNA expression levels of CircBACH1 and MDM2 were increased in bone marrow plasma cells and U266 cells in the MM group, while the expression of miR-140-5p was decreased (P<0.05). Compared with the control group and the si-NC group, the mRNA expression of CircBACH1 and MDM2, cell proliferation activity and Bcl-2 protein expression were decreased in the transfected si-CircBACH1 group. The expression of miR-140-5p, cell apoptosis rate, chemotherapy sensitivity, cleaved caspase-3 and Bax expressions were increased (P<0.05). In the anti-miR-140-5p supplementation experiment, the effect of si-CircBACH1 on MM cells was reversed, and the expression of MDM2 was increased (P<0.05). Dual luciferase gene reporting experiment verified the targeting relationship between CircBACH1 and MDM2 and miR-140-5p. Conclusion Knock down of CircBACH1 can up-regulate the expression of miR-140-5p, down-regulate the expression of MDM2, inhibit the proliferation of MM cells, promote the apoptosis of MM cells and improve the chemosensitivity.

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Mechanism of Calpain-2 resistance to paclitaxel through induction of epithelial mesenchymal transition in triple-negative breast cancer cells

CHEN Cong, WU Yuanzhao, ZHENG Kesi, YING Wenbing, HU Yiren

2023, 51 (11): 1176-1180. doi: 10.11958/20230208

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Objective To investigate the role and mechanism of Calpain-2 in paclitaxel (PTX) resistance in triple-negative breast cancer cells. Methods Human triple negative breast cancer MDA-MB-231 cells were transfected with Calpain-2 plasmid and corresponding empty vector, and cells were used as the overexpression group and the empty vector group. The untransfected cells were used as the blank group. MTT assay was performed to detect the effect of PTX on the survival rate of each group of cells. Western blot assay was performed to detect the expression of Calpain-2, E-calmodulin (E-cadherin), N-cadherin, Vimentin, phosphorylated large tumour suppressor gene 1 (p-LATS1) and phosphorylated yes-associated protein (p-YAP). Immunofluorescence assay was performed to detect the distribution of YAP. YAP inhibitor XMU-MP-1 was added to intervene on the basis of overexpression of Calpain-2. The mediated effect of YAP on PTX resistance was observed. Results Compared with the empty vector group, the survival rate of cells increased after PTX treatment in the overexpression group, and the IC₅₀ value increased (P<0.05). Compared with the empty vector group, N-cadherin and Vimentin protein expression were up-regulated, E-cadherin protein expression was down-regulated in the overexpression group (P<0.05), and p-LATS1 and p-YAP protein expression were up-regulated (P<0.01). YAP distribution in nucleus was reduced in the overexpression group. Compared with the overexpression group, N-cadherin and Vimentin protein expression were down-regulated and E-cadherin protein expression was up-regulated in the XMU-MP-1+ overexpression group (P<0.01). After PTX treatment, cell survival was reduced, and IC₅₀ was lower in the XMU-MP-1+ overexpression group compared with the overexpression group (P<0.01). Conclusion Calpain-2 induces epithelial mesenchymal transition in triple-negative breast cancer cells via YAP, resulting in drug resistance to PTX.

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Research on effect of mitophagy-NLRP3 inflammasome pathway in cerebral ischemia-reperfusion of neonatal rats

LIN Yongwen, CHEN Qiaomei, AO Dang, HUANG Binglong, LUO Chengzhu, LI Chengyan

2023, 51 (11): 1181-1186. doi: 10.11958/20230415

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Objective To investigate the effect of mitophagy-NOD-like receptor heat protein domain associated protein 3 (NLRP3) inflammasome pathway on cerebral ischemic injury in neonatal rats. Methods Forty-two 7-day SD rats were divided into the sham group, the cerebral ischemia-reperfusion injury (CIRI) group, the CIRI+dimethyl sulfoxide (DMSO) group, the CIRI+Mdivi-1 group, the CIRI+MCC950 group and the CIRI+Ac-YVAD-CMK group (7 rats in each group). Except for the sham group, the neonatal rat model of hypoxic-ischemic brain injury was established by unilateral common carotid artery occlusion. Neurological symptom score was performed by Londa method. Cell morphology in CA1 region of hippocampus was observed by hematoxylin-eosin (HE) staining. Ultrastructure of hippocampal neurons was observed by transmission electron microscopy, and related proteins of mitochondrial autophagy and NLRP3 inflammasome pathway were detected by Western blot assay. Results Compared with the CIRI+DMSO group, the CIRI+Mdivi-1 group had higher scores of neurobehavioral disorders, fewer synapses and more swollen mitochondria (all P<0.05). Compared with the CIRI+Mdivi-1 group, the neurobehavioral disorder score and the number of synapses increased, and the number of swollen mitochondria decreased in the CIRI+MCC950 group and the CIRI+Ac-YVAD-cmk group (all P<0.05). Compared with the CIRI+DMSO group, the protein expressions of PINK1, Parkin and LC3 Ⅱ/Ⅰ were down-regulated in the CIRI+Mdivi-1 group, and the protein expressions of TOMM20, P62, NLRP3, caspase-1 and caspase-8 were up-regulated (P<0.05). Compared with the CIRI+Mdivi-1 group, the protein expressions of PINK1, Parkin, LC3 Ⅱ/Ⅰ were up-regulated in the CIRI+MCC950 group and the CIRI+Ac-YVAD-cmk group (P<0.05). The expression levels of NLRP3, caspase-1 and caspase-8 proteins were down-regulated in the CIRI+MCC950 group, and caspase-1 and caspase-8 proteins decreased in the CIRI+Ac-YVAD-cmk group (P<0.05). Conclusion Activation of mitochondrial autophagy or inhibition of NLRP3 inflammasome activation have protective effects on cerebral ischemic injury in neonatal rats.

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Influence of miR-139-5p on cognitive dysfunction in rats with chronic cerebral hypoperfusion by targeting RIPK1/RIPK3/MLKL signal pathway

SHI Wenqian, ZHAO Meiying, HUANG Jie, HE Gui, WANG Guiqing

2023, 51 (11): 1187-1192. doi: 10.11958/20230110

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Objective To investigate the influence of miR-139-5p on cognitive dysfunction in chronic cerebral hypoperfusion (CCH) rats by targeting receptor-interacting protein kinase-1 (RIPK1)/receptor-interacting protein kinase-3 (RIPK3)/mixed lineage kinase domain-like protein (MLKL) signal pathway. Methods Sixty SPF SD rats were randomly divided into the sham operation group, the model group, the miR-NC group, the miR-139-5p mimic group and the miR-139-5p mimic+RIPK1 inhibitor Nec-1 group (miR-139-5p mimic+Nec-1 group), with 12 rats in each group. Except the sham group, the other groups used permanent ligation of bilateral common carotid arteries to construct rat CCH model. New object recognition experiment and Morris water maze were used to evaluate the cognitive function of rats. Enzyme linked immunosorbent assay (ELISA) was used to detect levels of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), inflammatory factor tumor necrosis factor (TNF)-α and interleukin-6 (IL-6) in rat hippocampus. Real-time quantitative PCR (qPCR) was used to detect the expression of miR-139-5p, RIPK1, RIPK3, MLKL mRNA in rat hippocampus. Western blot method was used to detect the protein expression levels of RIPK1, RIPK3, MLKL, synaptophysin (SYP), postsynaptic density protein 95 (PSD95) and α-synuclein (α-SYN). Double luciferase reporter gene experiment was used to verify the relationship between miR-139-5p and RIPK1. Results Compared with the sham group, the resolution coefficient, target quadrant residence time, levels of miR-139-5p, GSH-Px, SOD and the protein expression levels of SYP and PSD95 decreased obviously in hippocampus of the model group rats (P<0.05). The escape latency extended, and levels of MDA, TNF-α and IL-6 in hippocampus increased. The mRNA and protein expression of RIPK1, RIPK2, MLKL, the protein expression of α-SYN increased obviously (P<0.05). Compared with the model group and the miR-NC group, the expression trends of related indexes were opposite to the above in the miR-139-5p mimic group (P<0.05). Nec-1 further promoted the recovery of cognitive function in CCH rats by up-regulating the expression of miR-139-5p (P<0.05). MiR-139-5p negatively regulated the expression of RIPK1. Conclusion The up regulation of miR-139-5p may alleviate the cognitive dysfunction of CCH rats by targeting the inhibition of RIPK1/RIPK3/MLKL signaling pathway.

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Experimental study of chronic retinal damage induced by blue light exposure in Brown Norway rats

YU Yongzhen, CHENG Tianhao, ZOU Xiulan, ZHANG Mengyi, YU Yangyang, ZOU Yuping, PANG Long

2023, 51 (11): 1193-1198. doi: 10.11958/20230030

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Objective To investigate the injury characteristics and possible mechanism of photoreceptor cell and retinal pigment epithelium cell (RPEc) by establishing a model of a retinal damage in Brown Norway (BN) rats induced by blue light illumination. Methods According to random number table method, rats were divided into the light 0 d (normal control group), the light 1, 3, 7 and 14 d groups, with 8 rats in each group. The normal control group was not exposed to light. The other groups were exposed to LED blue light source with light intensity of (1 000±100) Lux for 3 h every day for 1, 3, 7 and 14 days, and the behavior and activities of rats were observed. The amplitudes of a and b waves and latency of the maximum mixed response were recorded by electroretinogram (ERG). Fundus photography was performed. Retinal tissue was observed by HE staining. The content of reactive oxygen species (ROS) in rat retina was detected by enzyme-linked immunosorbent assay (ELISA). Results Compared with the normal control group, the response to photoacoustic stimulation was slow in the 3 d light group, the spirit was weak and the action was slower in the 7 d and 14 d light group, and the response to light and sound was slower. Retinal hemorrhagic spots were occasionally observed in the group treated with 3 days of light irradiation, pigment particles increased in the base of retinal pigment epithelium (RPEc) layer, and mild nuclear pyresis was observed in the outer nuclear layer. In the group exposed to light for 7 days, scattered punctate hemorrhagic spots and yellow-white punctate particles were observed in the retina, and retinal veins were tortuous and dilated. After 14 days of light exposure, a large amount of yellow-white spot-like exudation was observed in retina. The retinal arteries were copper or even silver wire, and retinal veins were tortuous and dilated. The inner segment (IS)/outer segment (OS) of retinal photoreceptors were disordered in the 7 and 14 day light groups, the nucleus of outer nuclear layer shrank, and pigment particles were deposited at the base of RPEc layer. Compared with the normal group, the retina of rats became thinner in the 3, 7 and 14 day light groups (P<0.05). The latency of ERG b wave was gradually prolonged, the amplitudes of a wave and b wave were gradually decreased, and retinal tissue ROS was gradually increased in the groups 3, 7 and 14 d of light exposure (P<0.05). Conclusion Continuous exposure of blue light to BN rats can produce oxidative stress response, resulting in chronic retinal light damage, and with the extension of exposure time, the retinal light damage is more serious.

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Neuroprotective mechanism of edaravone dexborneol in rats with cerebral hemorrhage through ferroptosis-lipid peroxidation pathway

MAO Quanxi, LI Zuoxiao

2023, 51 (11): 1199-1204. doi: 10.11958/20221777

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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.

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Effects of hyperin on inflammatory reaction, wound healing and AMPK/SIRT1 signaling pathway in diabetic foot ulcer model rats

LEI Hui, BAO Yaling, BAO Xijing, MA Jun

2023, 51 (11): 1205-1210. doi: 10.11958/20230140

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Objective To explore the effect of hyperin on inflammatory reaction, wound healing and AMP-activated protein kinase (AMPK)/silent information regulator 1 (SIRT1) signaling pathway in diabetic foot ulcer (DFU) rats. Methods The DFU rat model was established, and 48 rats with successful DFU model were randomly divided into the model group, the hyperin low dose (100 mg/kg) group, the hyperin high dose (200 mg/kg) group and the metformin (200 mg/kg) group, with 12 rats in each group. Another 12 rats were taken as the control group. Rats of each group were given corresponding drug intervention, once a day for 4 weeks. Fasting blood glucose (FBG) levels of rats were detected by glucose meter after modeling (before administration) and after administration. Serum levels of interleukin (IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay. The wound healing rate of rats was calculated by taking pictures. Hematoxylin-eosin staining was used to observe pathological changes of wound granulation tissue. Fluorescence quantitative PCR was used to detect mRNA expression levels of AMPK and SIRT1 in wound granulation tissue of rats. Western blot assay was used to detect protein expression levels of AMPK and SIRT1 in wound granulation tissue of rats. Results In the control group, the granulation tissue cells on the wound surface of rats were intact and orderly arranged, with less inflammatory cell infiltration. Compared with the control group, the necrosis of fibroblasts and capillaries in wound granulation tissue was severe, accompanied by a large number of inflammatory cell infiltration, and FBG,TNF-α and IL-6 levels in serum were significantly increased (P<0.05). The wound healing rate, the mRNA and protein expression levels of AMPK and SIRT1 in wound granulation tissue were significantly decreased (P<0.05). Compared with the model group, the lesion degree of wound granulation tissue was reduced in turn in the hyperin low dose group and the hyperin high dose group, and the FBG, serum levels of TNF-α and IL-6 were decreased in turn as well (P<0.05). The wound healing rate, the mRNA and protein expression levels of AMPK and SIRT1 in wound granulation tissue were increased in turn (P<0.05). There were no significant differences in pathological changes of the wound granulation tissue and other indicators between the metformin group and the hyperin high dose group (P>0.05). Conclusion Hyperin can reduce inflammatory reaction and accelerate wound healing in DFU rats, and its mechanism may be related to the activation of AMPK/SIRT1 signal pathway.

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Study of persimmon leaf flavonoids ameliorates liver steatosis by activating autophagy and antioxidant stress in NAFLD rats

WANG Lian, XIAO Jichun, TIAN Yao, LI Xijing, WANG Luyao, WANG Lan, YANG Bohan, ZHANG Rongquan

2023, 51 (11): 1211-1216. doi: 10.11958/20230145

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Objective To investigate the effect and mechanism of persimmon leaf flavonoids (PLF) on nonalcoholic fatty liver disease (NAFLD) in rats. Methods Male SD rats were fed the high-fat diet for 12 weeks to prepare a NAFLD rat model. The model rats were randomly divided into the model group, the shuilinjia group (28 mg/kg), the PLF group (200 mg/kg) and the PLF+autophagy inhibitor group (PLF+3-MA group, 200 mg/kg PLF+2 mg/kg 3-MA). Another normal SD male rats were selected as the control group, with 6 rats in each group. After treatment for 6 weeks, Hematoxylin-eosin (HE) staining was used to observe changes of liver morphology and pathology. The liver index was calculated. Total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in serum were detected by automatic biochemical analyzer. The contents of superoxide dismutase (SOD) and malondialdehyde (MDA) in liver tissue were determined with microcalorimetric method. Western blot assay was performed to detect expression levels of nuclear factor erythroid 2 related factor 2 (Nrf2), autophagy protein sequencosome-1/protein 62 (SQSTM-1/P62) and microtubule associated protein 1 light chain 3-Ⅱ (LC3-Ⅱ). Results In the control group, there was no significant abnormality in the morphology of hepatocytes, while in the model group, there were fat vacuoles and inflammation in liver cells. Compared with the control group, the liver index, levels of TC, TG, LDL-C, ALT, AST and MDA were increased in the model group, and the expression level of P62 increased, while levels of HDL-C and SOD were decreased, expression levels of Nrf2 and LC3-Ⅱ decreased (P<0.05). Compared with the model group, the fat vacuoles and inflammation were significantly improved in the shuilinjia group and the PLF group. The liver index, levels of TC, TG, LDL-C, ALT, AST and MDA were decreased in the shuilinjia group and the PLF group, and the expression level of P62 decreased, while the level of SOD was increased, expression levels of Nrf2 and LC3-Ⅱ increased (P<0.05). The improvement effect on blood lipid levels, SOD and MDA indicators, as well as marker proteins were lower in the PLF+3-MA group than those of the PLF group. Conclusion PLF has protective effect on liver of NAFLD rats by activating autophagy and antioxidant stress.

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Exploring the correlation between immune function and poor prognosis in alloimmune recurrent miscarriage

LI Jianbin, HAN Ting, WU Rui

2023, 51 (11): 1217-1220. doi: 10.11958/20230467

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Objective To investigate the correlation between immune function and adverse pregnancy outcomes in pregnant women with recurrent alloimmune abortion (RSA). Methods A total of 136 patients with isoimmune RSA were included and divided into the pregnancy success group (50 cases) and pregnancy loss group (86 cases) according to pregnancy outcome. The age of patients and the number of abortions were collected, and glucocorticoid (GC), hydroxychloroquine sulfate (HCQ), aspirin (ASP), low molecular weight heparin, alfacalcalcitol, cyclosporine (CsA) and tacrolimus (FK506) were also collected. Levels of interleukin (IL-2), IL-4, IL-5, IL-6, IL-8, IL-10, IL-17 and tumor necrosis factor (TNF)-α were determined by enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate Logistic regression analysis was used to explore risk factors of pregnancy loss. Results Compared with the pregnancy loss group, levels of IL-6 and IL-10, the proportion of GC and low molecular weight heparin were increased in the pregnancy success group, while levels of IL-2 and IL-17 were decreased (P<0.05). There were no significant differences in age, abortion frequency, TNF-α level, HCQ, ASP, alfacalcalcitol, CsA and FK506 between the two groups. Single factor Logistic regression analysis showed that the use of IL-2, IL-6, IL-10, IL-17, GC and low molecular weight heparin were factors affecting pregnancy loss (P<0.01). Multivariate Logistic regression analysis showed that increased IL-17 was a risk factor for pregnancy loss, and increased IL-10, and the use of GC and low molecular weight heparin were protective factors (P<0.01). Conclusion Elevated IL-17 increases the risk of pregnancy loss in patients with isoimmune RSA, while elevated IL-10 and rational use of GC and low molecular weight heparin reduce the risk of pregnancy loss.

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Construction and verification of risk prediction model for acute myocardial infarction with heart failure

MA Mengxue, MA Ping, XU Qingbin, ZHANG Shichang

2023, 51 (11): 1221-1226. doi: 10.11958/20230055

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Objective To analyze the factors affecting of heart failure (HF) in patients with acute myocardial infarction (AMI), and use the selected indicators to construct a risk prediction model. Methods A total of 1 061 AMI patients were included, and they were divided into the model-constructed training set (786 cases) and the test set (275 cases). Lasso regression and multiple Logistic regression were used to build a predictive model for HF occurrence in AMI patients, and a Nomogram diagram was drawn. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the discrimination and calibration of the model. Results Lasso regression and multiple Logistic regression were used to select 7 variables to establish the model, including age, heart rate (HR), ST segment deviation, N-telencephalic natriuretic peptide precursor (NT-proBNP), homocysteine (Hcy), fibrinogen (Fib) and left ventricular ejection fraction (LVEF). The regression equation for constructing predictive model by multivariate Logistic regression was Logit (P) =0.718×ST segment deviation+0.042×age+0.037×HR+0.000 294×NT-proBNP+0.040×Hcy+0.220×Fib-5.617×LVEF-5.781. The area under ROC curve of the training set was 0.846 (95%CI: 0.817-0.875), the sensitivity was 78.50% and the specificity was 76.60%. The calibration curve showed that the incidence of HF in the training set was basically consistent with the actual incidence. The test set was used to verify the model externally. The area under ROC curve was 0.848 (95%CI: 0.801-0.896), the sensitivity was 76.40% and the specificity was 78.00%. Conclusion The occurrence of HF in AMI patients is related to ST segment deviation, age, HR, NT-proBNP, Hcy, Fib and LVEF. The predictive model based on the above variables has high predictive efficacy and is helpful for early identification of such patients.

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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

2023, 51 (11): 1227-1231. doi: 10.11958/20230429

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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.

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Effects of enteral nutrition on pulmonary function and BODE index in elderly patients with stable chronic obstructive pulmonary disease

ZHU Pengfei, NIE Xiaohong, ZHOU Qian, ZHANG Meifeng, YAO Mengdie, ZHOU Qing, XIAO Zhu

2023, 51 (11): 1232-1236. doi: 10.11958/20222117

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Objective To explore the effect of enteral nutrition powder on pulmonary function and BODE index in elderly patients with stable chronic obstructive pulmonary disease (COPD). Methods A total of 116 elderly stable COPD patients were selected and divided into the normal nutrition group (MNA>23.5 points, 24 cases), the malnutrition risk group (17.0 points ≤ MNA ≤ 23.5 points, 65 cases) and the malnutrition group (MNA<17.0 points, 27 cases) based on the MNA score. Ninety-two patients with malnutrition risk and malnutrition were randomly divided into the control group (routine treatment) and the experimental group (enteral nutrition powder was given on the basis of routine treatment). The experimental group was divided into two subgroups (MNA<17.0 points，27 cases): group A (17.0 points ≤ MNA ≤ 23.5 points, 33 cases) and group B (MNA<17.0 points, 13 cases). At admission and 3 months after treatment, differences in body mass index (BMI), forced expiratory volume at 1 second (FEV₁), percentage of FEV₁ to predicted value (FEV₁pred%), FEV₁/FVC, 6-minute walking distance (6MWD), modified British Medical Research Council Respiratory Questionnaire (mMRC) and BODE index were compared between groups. Results Compared with the group with normal nutrition, the BMI, 6MWD and MNA scores were decreased in the malnutrition risk group, while the proportion of women in the malnutrition group, BMI, FEV₁, FEV₁pred%, 6MWD and MNA scores were decreased, and the mMRC and BODE index were increased (P<0.05). BMI, FEV₁ and MNA scores were lower in the malnutrition group than those of the malnutrition risk group (P<0.05). After 3-month treatment, BMI, FEV₁, FEV₁pred%, 6MWD and MNA scores were increased in the experimental group, while mMRC and BODE index decreased. The 6MWD and MNA scores were higher in the experimental group than those of the control group, while mMRC and BODE index were lower than those of the control group (P<0.05). After 3 months of treatment, BMI, FEV₁, 6MWD and MNA scores increased in the group A, while mMRC and BODE index decreased. BMI, FEV₁, FEV₁pred%, 6MWD and MNA scores increased in the group B, while BODE index decreased (P<0.05). BMI, FEV₁ and MNA scores were lower in the group B than those of the group A, while mMRC and BODE index were higher than those of the group A (P<0.05). The MNA score of COPD patients at admission was positively correlated with BMI, FEV₁, FEV₁pred%, FEV₁/FVC and 6MWD, while negatively correlated with mMRC and BODE index (P<0.05). Conclusion Enteral nutrition powder could improve lung function and BODE index in elderly stable malnutrition COPD patients.

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Analysis of the clinical characteristics and influencing factors of fatigue symptoms in patients with interstitial lung disease

LUO Cheng, ZHANG Ning, PENG Yanru, LI Shu, GUO Yali, WANG Yuguang

2023, 51 (11): 1237-1241. doi: 10.11958/20230264

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Objective To explore the clinical characteristics and influencing factors of fatigue symptoms in patients with interstitial lung disease (ILD). Methods A total of 238 patients with ILD were selected. Gender, age, marital status, body mass index (BMI), occupation, education, smoking and alcohol consumption of patients were collected. The pulmonary function of patients was measured. The percentage of forced vital capacity in the predicted value (FVC%pred), the percentage of forced expiratory volume in the first second in the predicted value (FEV1%pred), the percentage of forced expiratory volume in the end of the first second in the predicted value (FEV1/FVCpred) and the percentage of diffusing capacity of the lungs for carbon monoxide in the predicted value (DLCO%pred) were detected. The fatigue rating scale (FAS) was used to evaluate the physical and mental fatigue of patients. The improved Medical Research Council Respiratory Questionnaire (mMRC) was used to assess the degree of dyspnea. Charlson comorbidity index was used to evaluate the severity of comorbidity. The hospital anxiety and depression scale (HADS) including HADS-A and HADS-D were used to score the anxiety and depression of patients. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients. The differences of FAS scores and the correlation between FAS scores and clinical features were analyzed. Multiple linear stepwise regression analysis was used to explore the influencing factors of fatigue in ILD patients. Results The FAS score of 238 patients was (26.03 ± 9.53), of which 159 (66.81%) experienced fatigue and 60 (37.74%) experienced severe fatigue. The FAS scores of mMRC grade 0 and 1 ILD patients were lower than those of mMRC grade 2, 3 and 4 patients, and the FAS scores of mMRC grade 2 ILD patients were lower than those of mMRC grade 4 patients (P<0.01). There were no significant differences in FAS scores between patients with different course of disease, age, sex, marriage, work, education level, smoking, drinking, ILD type and Charlson complication index. FAS score was positively correlated with age, disease course, HADS-A, HADS-D and PSQI, and negatively correlated with DLCO% pred (P<0.05). Multiple linear stepwise regression analysis showed that HADS-D, mMRC, PSQI and disease course were influencing factors of FAS score (P<0.05). Conclusion The incidence of fatigue is high in ILD patients, and the long course of disease, dyspnea, depression and sleep disorders are important influencing factors of fatigue.

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Clinical value of retroperitoneal space inflammatory infiltration, pleural effusion and peripancreatic effusion in evaluating the severity of acute pancreatitis

XU Yulong, YE Chunjuan, TAN Bing

2023, 51 (11): 1242-1244. doi: 10.11958/20230197

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Objective To explore the clinical value of retroperitoneal space (RPS) inflammatory infiltration, pleural effusion and peripancreatic effusion in evaluating the severity of acute pancreatitis (AP). Methods A retrospective analysis was conducted on 108 patients with AP, and their CT severity index (CTSI) grading and RPS inflammatory infiltration grading were performed to clarify the correlation between RPS inflammatory infiltration, pleural effusion, peripancreatic effusion and clinical severity of AP. Results According to the CTSI grading, 53 AP patients with grade Ⅰ AP were diagnosed, and the degree of RPS inflammation infiltration was mainly grade A. The detection rate of pleural effusion in the early stage (within 48 hours after the onset) was 11.32%, the incidence of peripancreatic effusion was 54.72%, and the number of peripancreatic effusion was mainly 1. Of the 31 AP patients with grade Ⅱ, the degree of RPS inflammatory infiltration was mainly grade C. The detection rate of early pleural effusion was 38.71%, the incidence of peripancreatic effusion was 80.65%, and the number of peripancreatic effusion was mainly 1 or 2. There were 24 AP patients with grade Ⅲ and the degree of RPS inflammatory infiltration was mainly grade D. The detection rate of early pleural effusion was 70.83%, the incidence of peripancreatic effusion was 95.83%, and the number of peripancreatic effusion was 3 or more. The degree of RPS inflammatory infiltration and the detection rate of early pleural effusion in AP patients were positively correlated with the CTSI grade (r_s=0.818, P<0.05; r_s=0.990, P<0.05). The number of peripancreatic effusion in AP patients increased with the increase of CTSI grade. Conclusion The degree of RPS inflammatory infiltration, pleural effusion and peripancreatic effusion are closely related to the clinical severity of acute pancreatitis, and should be given sufficient attention in clinical practice.

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Curative efficacy and influencing factors of transesophageal atrial pacing to terminate atrial flutter after cardiac surgery

ZHAO Shaofeng, CHEN Yuanlu, CHEN Qinghua, GAO Jing, CUI Zhuang

2023, 51 (11): 1245-1248. doi: 10.11958/20222116

Abstract ( 297 )

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Objective To investigate the clinical efficacy and influencing factors of transesophageal atrial pacing (TEAP) for atrial flutter after cardiac surgery. Methods A total of 298 patients with atrial flutter within 5 days after cardiac surgery in a single center were divided into the amiodarone group (control group, n=150) and the TEAP group (observation group, n=148) according to different treatment regimens. The differences of atrial diameter, operation related indicators, effective rate, adverse reactions and recurrence rate 6 months after operation were analyzed between the two groups. Logistic regression analysis was performed to analyze factors affecting the efficacy of TEAP terminating atrial flutter. Results There were no significant differences in atrial diameter and operation related parameters between the two groups. Compared with the control group, the effective rate was increased in the observation group (47.3% vs. 83.8%, P<0.05). There were no significant differences in adverse reactions, mortality during hospitalization and recurrence rate 6 months after operation between the two groups. Larger left atrial anteroposterior diameter (OR=1.156, 95%CI:1.066-1.255), continuous equal frequency stimulation (continuous stimulation) and termination mode (OR=6.019,95%CI:1.911-18.953) were independent risk factors for failure of atrial flutter in TEAP treatment. Conclusion TEAP is reliable to terminate atrial flutter after cardiac surgery. Continuous incremental stimulation (incremental stimulation) is recommended.

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Association between single nucleotide polymorphism of TP53 gene and prognosis of primary hepatocellular carcinoma

TANG Haoyan, PAN Zhenglong, LIU Xiaofang

2023, 51 (11): 1249-1254. doi: 10.11958/20230151

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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.

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Analysis of the effect of sublingual immunotherapy for allergic rhinitis in children and judgment of obvious effect time

WANG Yingying

2023, 51 (11): 1255-1257. doi: 10.11958/20230138

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Objective To investigate the efficacy of sublingual immunotherapy (SLIT) in children with mite allergic rhinitis (AR) and to determine the time to efficacy. Methods Sixty-four children with mite AR were recruited and treated with sublingual corresponding dust mite drops once daily according to the treatment schedule, along with symptomatic medication as needed. The patients were divided into the ≤6 years old group and the >6 years old group according to school age. The TNSS, TMS and VAS scores were compared before, half a year, and one year after SLIT treatment between the two groups and within the groups. Results Compared with pre-treatment, TNSS, TMS and VAS scores were significantly reduced in 64 AR children after half a year of SLIT treatment, and scores further reduced after one year of treatment (P<0.05). There were no significant differences in TNSS, TMS and VAS scores before treatment, half a year and one year after treatment between the ≤6 years old group and the >6 years old group (P>0.05). All scores were significantly lower after half a year of treatment than those before treatment in the two groups, and scores were further reduced after one year treatment (P<0.05). Conclusion Children with AR have shown good clinical results after SLIT, and should be initiated as early as possible to reduce the occurrence of long-term complications.

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Analysis of clinical effect of vertebroplasty combined with zoledronate in preventing postoperative recurrence of vertebral fractures

QIAN Li, WANG Dashou, PAN Qi, XIAO Yang, DUAN Binwu, CHEN Qian

2023, 51 (11): 1258-1261. doi: 10.11958/20220262

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Objective To investigate the effect of zoledronic acid on the recurrence of osteoporotic vertebral compression fracture (OVCF) after vertebroplasty. Methods One hundred and fifty-two patients with OVCF were retrospectively collected. According to postoperative zoledronic acid infusion, patients were divided into the zoledronic acid group (68 cases) and the control group (84 cases). The visual analogue scale (VAS) score and bone mineral density (BMD) T value were recorded before operation and at 3, 6 and 12 months after operation. Serum procollagen type I N-terminal peptide (P1NP) and β-collagen degradation products (β-CTX) were measured by enzyme-linked immunosorbent assay. The patients were followed up for 2 years to record the occurrence of vertebral fracture. Results Compared with the control group, BMD T value was significantly increased, VAS score was decreased, β-CTX and P1NP were decreased at 3, 6 and 12 months after operation in the zoledronic acid group (P<0.05). Two years after operation, the recurrence rate of vertebral fracture was lower in the zoledronic acid group (5/84, 5.95%) than that in the control group (11/68, 16.18%) (χ²=4.171, P<0.05). Conclusion Zoledronic acid can effectively prevent the recurrence of vertebral fracture in patients with OVCF after PVP.

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Feasibility analysis of small titanium plate fixation through oropharyngeal approach in the treatment of unstable atlas fracture

DUAN Lianhong, HAN Heng, ZENG Yun, HE Ning

2023, 51 (11): 1262-1266. doi: 10.11958/20220476

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Objective To study the feasibility of small titanium plate fixation through oropharyngeal approach in the treatment of unstable atlas fracture. Methods Sixty-four patients with unstable atlas fracture were selected, of which 30 patients were treated with small titanium plate fixation through oropharyngeal approach were used as the observation group, and 34 patients were treated with posterior atlantoaxial pedicle screw internal fixation were used as the control group. Intraoperative indexes including operation time, blood loss, postoperative indicators, length of hospital stay, occurrence of complications (chronic neck pain, incision infection and dysphagia), visual analogue pain (VAS) score, Japanese Orthopaedic Association (JOA) score before surgery, 1 month after surgery and at the last follow-up and cervical extension, flexion, left and right rotation range of motion were compared between the two groups. Results The operation time and blood loss were significantly lower in the observation group than those in the control group (P<0.05), and there was no significant difference in the length of hospital stay between the two groups. There were no significant differences in the incidence of chronic neck pain, incision infection and dysphagia between the two groups. The VAS score was lower and the JOA score was higher 1 month after surgery and at the last follow-up than those before surgery (P<0.05), and there was no significant difference between the two groups. The extension, flexion, dextral and dextral movements were all increased one month after surgery and at the last follow-up in the two groups (P<0.05). The cervical extension, flexion, left rotation and right rotation of the observation group were higher than those of the control group one month after surgery and the last follow-up (P<0.05). Conclusion The oropharyngeal approach with small titanium plate fixation for unstable atlantic fracture is less invasive and shorter operation time, and can retain cervical spine mobility to the greatest extent than traditional posterior atlantoaxial pedicle screw fixation.

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Effects of esketamine on respiratory depression after radical thoracoscopic resection of lung cancer in elderly patients

REN Qiqi, ZHANG Bokang, KONG Lingsuo

2023, 51 (11): 1267-1270. doi: 10.11958/20230281

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Objective To investigate the effect of esketamine on respiratory depression after radical thoracoscopic resection of lung cancer in elderly patients. Methods Sixty elderly patients undergoing radical operation of lung cancer under general anesthesia were selected and divided into the observation group (30 cases) and the control group (30 cases) according to random number table method. Patient-controlled intravenous analgesia was performed after surgery. The analgesic formula in the observation group was esketamine 0.2 mg/kg+Sufentanil 1.3 μg/kg+dexamethasone 5 mg+dexmedetomidine 100 μg, and the analgesic formula of the control group was Sufentanil 1.5 μg/kg+ dexamethasone 5 mg+ dexmedetomidine 100 μg. Visual analog scale (VAS) at rest and during exercise and Ramsay sedation score were recorded at 4, 8, 24 and 48 h after surgery. The Montreal Cognitive Assessment Scale (MoCA) was used to assess cognitive function 1 day before surgery and 1 and 3 days after surgery. The duration of operation, length of hospital stay, rate of remedial analgesia and postoperative complications were recorded. Results The hospitalization time of the observation group was shorter than that of the control group (P<0.05). There was no significant difference in resting VAS score within 48 h after surgery between the two groups. The VAS scores at 4, 8, 24 and 48 h after operation were significantly lower in the observation group than those of the control group (P<0.05). Ramsay scores within 48 h after surgery were higher in the observation group than those in the control group (P<0.05). There were no significant differences in MoCA scores between the two groups. Incidence rates of analgesia, hypotension, dizziness and respiratory depression were lower in the observation group than those in the control group (P<0.05), and there were no significant differences in incidences of nausea and vomiting between the two groups. Conclusion Esketamine can provide better analgesia and sedation after thoracoscopic lung cancer surgery in elderly patients, reduce hospital stay, and reduce the incidence of postoperative respiratory depression, hypotension and dizziness.

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Diagnostic value of blood cell count-derived ratio parameters in rheumatoid arthritis

BAO Buhe, ZHANG Qi, LI Hailin, DU Shuangshuang, GAO Yingtang

2023, 51 (11): 1271-1275. doi: 10.11958/20230481

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Objective To analyze the relationship between blood cell count-derived ratio parameters and rheumatoid arthritis (RA) and to explore their clinical diagnostic value. Methods The aggregate inflammation systemic index (AISI), neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), hemoglobin-to-lymphocyte ratio (HLR), hemoglobin-to-platelet ratio (HPR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), platelet-to-monocyte ratio (PMR), systemic immune-inflammatory index (SII), and systemic immune response index (SIRI) in 217 RA patients and 211 healthy individuals were collected and compared. The correlations between these parameters and clinical scores, as well as inflammatory and immune markers were investigated. Logistic regression analysis was used to determine the relationship between these ratio parameters and RA. Receiver operating characteristic (ROC) curves were used to evaluate their diagnostic values for RA. Results Compared to the healthy control group, PMR, LMR, HPR and HLR were significantly decreased (P<0.05), while erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-mutated citrullinated vimentin antibody (aMCV), NLR, dNLR, PLR, SII, SIRI and AISI were significantly increased (P<0.05) in the RA group. DAS28 score was positively correlated with ESR, CRP, RF, aMCV, and PLR, while negatively correlated with HPR (P<0.05). Multivariate Logistic regression analysis showed that high levels of ESR, CRP, RF, ASO and PLR were independent risk factors for the occurrence of RA, while high levels of PMR and HLR were protective factors (P<0.05). The combined detection based on ESR, CRP, RF, ASO, PLR, PMR and HLR showed better performance in the diagnosis of RA compared to individual parameters, with an area under the curve (AUC) of 0.889 (95%CI: 0.852-0.927). Conclusion PLR and HPR are associated with the clinical activity of RA. The multi-index combined detection provides a new approach for the auxiliary diagnosis of RA.

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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

2023, 51 (11): 1276-1280. doi: 10.11958/20230486

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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.

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