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15 October 2024, Volume 52 Issue 10 Previous Issue    Next Issue
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Cell and Molecular Biology
Experimental Research
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Cell and Molecular Biology

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Role of NID1 in angiogenesis of clear cell renal cell carcinoma SUN Chuangxin, LI Gang 2024, 52 (10):  1009-1013.  doi: 10.11958/20240301 Abstract ( 387 )   HTML ( 6 )   PDF (1675KB) ( 160 )   Objective To explore the expression of nestin-1 (NID1) in clear cell renal cell carcinoma (ccRCC) and its effect on angiogenesis. Methods The expression of NID1 in ccRCC was analyzed using data from the TCGA database, cell lines and clinical samples. Additionally, the relationship between NID1 and the angiogenesis marker CD31 was investigated. A stable knockdown 786-O cell line with reduced NID1 expression was generated through lentiviral transfection. The conditioned medium obtained from these cells was used to treat human umbilical vein endothelial cells (HUVECs). HUVEC cells were divided into four groups: the DMEM group, the blank group, the NID1 empty vector group and the NID1 knockdown group. Cell proliferation ability was assessed using CCK-8 method, while tube formation ability and migration ability were evaluated through tube formation test and scratch test respectively. A mouse model of dextran hydrogel unloaded/NID1 knockdown tumor cell complex culture system was established and divided into the unloaded NID1 group and the NID1 knockdown group. Immunohistochemical staining was performed to detect the expression of CD31. Results Bioinformatics analysis revealed an increased expression of NID1 in ccRCC tissue. Furthermore, 500 differentially expressed genes positively correlated with elevated levels of NID1 were primarily enriched in angiogenesis-related processes. The results showed a positive correlation between the expression of NID1 and CD31 in cancer tissue. After treatment with conditioned medium derived from the knockdown group, HUVEC cells exhibited weakened migration and tube formation abilities in the empty vector control group (P<0.05), while their proliferation ability remained unchanges compared to the empty vector control group (P>0.05). In vivo experiments using a nude mouse model, the expression of CD31 demonstrated significantly lower levels in the NID1 knockdown group (P<0.05). Conclusion The expression of NID1 is increased in ccRCC, and it can promote angiogenesis. Figures and Tables | References | Related Articles | Metrics

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Krüppel-like factor 4 alleviated cholesterol deposition in macrophages by promoting autophagy at high glucose concentration ZHANG Rui, CHEN Sisi, WANG Tongdan, YU Pei 2024, 52 (10):  1014-1019.  doi: 10.11958/20240283 Abstract ( 346 )   HTML ( 6 )   PDF (1126KB) ( 36 )   Objective To observe the effect of Krüppel-like factor 4 (KLF4) on cholesterol deposition in macrophages treated with high glucose, and to explore the mechanism related to macrophage autophagy. Methods Ten Balb/c mice were randomly divided into the normal control (NC, n=5) group and the DM group (n=5). A diabetic mouse model was established, and the expression level of KLF4 protein in aorta was detected after high fat diet. After induction of THP-1 monocytes into macrophages, they were divided into the LV-NC group, the LV-KLF4 group, the si-NC group and the si-KLF4 group. Changes of cholesterol content, cell apoptosis and the expression level of autophagy related proteins and AKT/mTOR signaling pathway related proteins in THP-1 macrophages were observed after overexpression or knockout of KLF4. Results The expression level of KLF4 protein in aorta of diabetic mice was lower in the DM group than that of the NC group (P<0.05). Meanwhile, under high glucose concentration, overexpression of KLF4 in THP-1 macrophages significantly decreased cholesterol deposition, cell apoptosis and P62 expression, increased Beclin1 expression, LC3 fluorescence intensity and also inhibited AKT/mTOR signaling pathway related protein expression (P<0.05). After knocking down KLF4 expression, the results were reversed. Conclusion KLF4 alleviates cholesterol deposition in THP-1 macrophages by promoting autophagy under high glucose concentration. Figures and Tables | References | Related Articles | Metrics

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Impacts of lncRNA MALAT1 on apoptosis, autophagy of granulosa cells and PI3K/Akt/mTOR pathway in polycystic ovary syndrome QIAO Na, TIAN Ying, CHEN Yang, HAO Jing 2024, 52 (10):  1020-1024.  doi: 10.11958/20240332 Abstract ( 322 )   HTML ( 6 )   PDF (1167KB) ( 82 )   Objective To investigate the impacts of long non-coding RNA-lung adenocarcinoma metastasis-associated transcripton-1 (lncRNA MALAT1) on apoptosis, autophagy and phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/mammalian rapasin target protein (mTOR) pathway in granulosa cells of polycystic ovary syndrome (PCOS). Methods The expression levels of lncRNA MALAT1 in PCOS ovarian tissue, normal ovarian tissue, human ovarian granulosa cells (KGN) and normal ovarian epithelial cells IOSE80 were detected by qRT-PCR. KGN cells were cultured in vitro and grouped into the control group, the si-NC group, the si-MALAT1 group, the pc-NC group, the pc-MALAT1 group and the pc-MALAT1+740Y-P (PI3K activator) group. qRT-PCR was applied to detect the expression level of MALAT1 mRNA in cells of each transfection group. CCK-8 was applied to detect cell viability. Flow cytometry was applied to detect cell apoptosis rate. Transmission electron microscopy was applied to observe autophagosomes in KGN cells. Western blot assay was applied to detect expression levels of B-cell lymphoma 2 (Bcl-2), Bcl-2 associated X protein (Bax), microtubule-associated protein Ⅱ light chain 3 (LC3 Ⅱ), microtubule-associated protein Ⅰ light chain 3 (LC3Ⅰ), Beclin1, p-PI3K, PI3K, p-Akt, Akt, p-mTOR and mTOR proteins in cells. Results The expression level of MALAT1 mRNA in PCOS ovarian tissue was lower than that in normal ovarian tissue, and that in KGN cells was lower than that in normal ovarian epithelial IOSE80 cells. A small number of autophagosomes were observed in KGN cells in the control group. After interfering MALAT1 expression, OD450 values (24, 48 and 72 hours) and the Bcl-2 protein expression of KGN cells were reduced, and the apoptosis rate, the expression of Bax, LC3 Ⅱ/LC3 Ⅰ, Beclin1, p-PI3K/PI3K, p-Akt/Akt and p-mTOR/mTOR proteins were increased (P<0.05). The number of autophagosomes increased. Changes of the above indexes were reversed after overexpression of MALAT1 (P<0.05). Compared with the pc-MALAT1 group, the OD450 values (24, 48, 72 h), and the expression of Bcl-2 protein were obviously reduced in the pc-MALAT1+740Y-P group, while the apoptosis rate, number of autophagosomes, the expression of Bax, LC3 Ⅱ/LC3 Ⅰ, Beclin1, p-PI3K/PI3K, p-Akt/Akt, and p-mTOR/mTOR proteins were obviously increased (P<0.05). The number of autophagosomes increased. Conclusion Overexpression of MALAT1 may inhibit apoptosis and autophagy in PCOS granulosa cells by inhibiting the PI3K/Akt/mTOR signaling pathway. Figures and Tables | References | Related Articles | Metrics

Experimental Research

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Study on the effect of fisetin on alleviating cognitive impairment after sepsis by inhibiting the activation of microglial NLPR3 inflammasome LIAO Zhong, LIAO Weijian, LAI Guoli, WEN Yin, SU Zhiwei, ZENG Juhao, DING Hongguang 2024, 52 (10):  1025-1030.  doi: 10.11958/20240619 Abstract ( 434 )   HTML ( 2 )   PDF (2379KB) ( 87 )   Objective To investigate the mechanism of fisetin inhibiting the activation of microglia NOD-like receptor family protein 3 (NLRP3) inflammasome in microglia and alleviating cognitive impairment after sepsis. Methods C57BL/6 mice were used to establish the sepsis model by cecal ligation and puncture. Mice were divided into four groups: the sham group, the sepsis group, the sepsis+caspase-1 knockout group (sepsis+Cas-1-/- group) and the sepsis+fisetin group. Evans blue was used to detect the permeability of blood-brain barrier (BBB). Morris water maze was used to evaluate the cognitive function of mice. Western blot assay and immunofluorescence double staining were used to detect the expression of NLRP3 inflammasome-related proteins including caspase-1, N-terminal fragment of the GSDMD (GSDMD-N), interleukin (IL)-1β, IL-18 and mitophagy-related proteins (Pink1, Parkin and LC3-Ⅱ) in brain tissue and microglia. Results Compared with the sham group, expression levels of caspase-1, GSDMD-N, IL-1β and IL-18 were significantly increased in the sepsis group (P<0.05). Compared with the sepsis group, expression levels of caspase-1, GSDMD-N, IL-1β and IL-18 were significantly decreased in the sepsis+Cas-1-/- group (P<0.05). The expression levels of Pink1, Parkin and LC3-Ⅱ were significantly higher in the sepsis+fisetin group than those of the sepsis group (P<0.05), and expression levels of caspase-1, GSDMD-N, IL-1β and IL-18 were significantly lower (P<0.05). After fisetin intervention, the permeability of BBB was decreased and the cognitive impairment (decreased escape latency and increased frequencies of crossing the platform) was alleviated in the sepsis+fisetin group compared with those of the sepsis group (P<0.05). Conclusion Fisetin may alleviate central inflammation and cognitive impairment after sepsis by inhibiting the activation of microglial NLRP3 inflammasome through activating mitophagy. Figures and Tables | References | Related Articles | Metrics

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Mechanism study of BOC2 alleviating SAP inflammatory damage by inhibiting N-formyl peptide/formyl peptide receptor pathway ZHANG Guixian, LIU Dawei, LI Wenchang, CAI Jun, ZONG Wenhui, LIU Hongbin, ZHAO Xiumei 2024, 52 (10):  1031-1037.  doi: 10.11958/20240774 Abstract ( 285 )   HTML ( 3 )   PDF (2124KB) ( 329 )   Objective To observe the effect of BOC-Phe-Leu-Phe-Leu-Phe (BOC2) on the expression of six types of mitochondrial N-formyl peptides (NFPs) in blood and two formyl peptide receptors (FPRs) in pancreatic tissue of rats with severe acute pancreatitis (SAP), and to explore its mechanism of alleviating inflammatory damage of SAP. Methods Forty male SD rats were randomly divided into four groups: the sham group, the SAP model group, the BOC2 low-dose and the BOC2 high-dose group (0.1 and 0.2 mg/kg), with 10 animals in each group. The SAP model was prepared by retrograde injection of 5% sodium taurocholate (50 mg/kg) into biliary and pancreatic ducts in the last 3 groups. BOC2 was intraperitoneally injected at 0.5 hours after SAP modeling, and samples were taken 4 hours after modeling. HE staining was used to observe pathological changes in pancreas. Western blot assay was used to detect the expression of NFPs in plasma. IHC staining was used to detect the expression of FPRs in pancreatic tissue. ELISA was used to detect interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α levels in plasma. qPCR was used to detect expression levels of inflammatory factors in local pancreatic tissue. Results Compared with the model group, the BOC2 high-dose group and the BOC2 low- dose group showed improvement in pathological phenomena, such as pancreatic bleeding, acinar cell necrosis, inflammatory cell infiltration and edema. The pancreatic injury score, pancreatic FPRs expression, plasma MT-ND1, MT-ND2, MT-ND3, MT-ND5, MT-ND6 expression, as well as expression levels of three inflammatory factors in plasma and local pancreatic tissue, were significantly reduced (P<0.05). Conclusion BOC2 can reduce the production of inflammatory factors and alleviate SAP inflammatory damage by antagonizing mitochondrial NFPs/FPRs signaling pathway. Figures and Tables | References | Related Articles | Metrics

Clinical Research

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Application of enhanced recovery after surgery in minimally invasive surgery for adrenal tumors YANG Xianrui, KANG Shaosan, GUO Qi, ZHAO Yan, LI Gang, HAN Ruifa, CAI Qiliang 2024, 52 (10):  1038-1040.  doi: 10.11958/20240073 Abstract ( 312 )   HTML ( 3 )   PDF (745KB) ( 78 )   Objective To evaluate the feasibility and effectiveness of enhanced recovery after surgery (ERAS) in minimally invasive surgery for adrenal tumors. Methods A total of 139 patients underwent retroperitoneal laparoscopic adrenalectomy were selected in this study. The maximum tumor diameter was ≤ 6.0 cm. According to the perioperative plan, patients were divided into the ERAS group (n=65) and the conventional group (n=74). The general information (age, gender, tumor location and tumor diameter), surgical indicators (surgical time and surgical blood loss), postoperative rehabilitation indicators (first off-bed ambulation time, first exhaust time, postoperative catheterization time, postoperative drainage tube retention time and postoperative hospitalization time) and incidence of complications were compared between two groups of patients. Results There were no significant differences in gender, age, tumor location, tumor diameter, surgical time and surgical blood loss between the two groups of patients (P>0.05). In the ERAS group, first off-bed ambulation time, first exhaust time, the indwelling duration of catheters and drainage tubes were shorter than those in the conventional group, and the overall incidence of postoperative complications was lower in the ERAS group than that in the conventional group (P<0.05). Conclusion The ERAS protocol is safe and feasible for minimally invasive surgery in patients with adrenal tumors with a maximum tumor diameter of ≤ 6.0 cm. Figures and Tables | References | Related Articles | Metrics

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Predictive values of PNI, LMR and MELD for early lung infection after liver transplantation YANG Kai, HOU Dingcong, DUAN Shaoxian, BI Yi, XIE Yan, ZHANG Li, JIANG Wentao 2024, 52 (10):  1041-1045.  doi: 10.11958/20240184 Abstract ( 286 )   HTML ( 3 )   PDF (920KB) ( 28 )   Objective To explore risk factors of early lung infection after liver transplantation and to construct a prediction model of early lung infection after liver transplantation. Methods The clinical data of 269 patients who underwent orthotopic liver transplantation for the first time were retrospectively analyzed. Patients were divided into the infected group (n=97) and the non-infected group (n=172) according to whether pulmonary infection occurred within 30 days after operation. The preoperative general data, preoperative laboratory examination results, intraoperative and postoperative data of the patients were collected. Multivariate Logistic regression analysis were used to screen risk factors of pulmonary infection. Based on the results of multivariate analysis, the prediction model was constructed and the prediction efficiency of the model was evaluated. Results Univariate and multivariate Logistic regression analysis showed that preoperative PNI ≤41.70 (OR=1.972, 95%CI: 1.047-3.714, P=0.036), LMR≤1.52 (OR=2.020, 95%CI: 1.102-3.705, P=0.023), MELD score>10.72（OR=1.985, 95%CI: 1.103-3.573，P=0.022), operative time > 448.00 min (OR=2.676, 95%CI: 1.515-4.727, P=0.001) and intensive care unit (ICU) hospitalization time > 4.0 days (OR=2.623, 95%CI: 1.335-5.154, P=0.005) were independent risk factors for early pulmonary infection after liver transplantation. The ROC area under the curve (AUC) of the prediction model based on the results of multivariate Logistic regression analysis was 0.768, the sensitivity was 80.41% and the specificity was 60.47%. Conclusion The prediction model based on PNI, LMR, MELD score, operation time and ICU hospitalization time can effectively predict the occurrence of early pulmonary infection after liver transplantation. Figures and Tables | References | Related Articles | Metrics

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Predictive value of combined detection of serum VCAM-1, PECAM-1 levels and MMSE score for postoperative delirium in elderly patients underwent total hip arthroplasty LI Fan, LI Shihuan, XIE Shuang 2024, 52 (10):  1046-1050.  doi: 10.11958/20240396 Abstract ( 314 )   HTML ( 2 )   PDF (1513KB) ( 465 )   Objective To investigate the predictive value of combined detection of serum vascular cell adhesion molecule-1(VCAM-1), platelet endothelial cell adhesion molecule-1 (PECAM-1) levels and mini mental state examination (MMSE) score for postoperative delirium (POD) in elderly patients underwent total hip arthroplasty (THA). Methods A total of 200 elderly patients with hip fracture underwent surgical treatment were selected as the research objects. Patients were divided into the POD group (n=44) and the non-POD group (n=156) according to whether POD occurred within 3 days after operation. The clinical data of patients in the two groups were collected. The preoperative cognitive status was evaluated by MMSE, and serum levels of VCAM-1 and PECAM-1 were detected before operation and 1st and 3rd day after operation. The differences of the above indexes between the two groups were compared, and the correlation between preoperative serum VCAM-1, PECAM-1 levels and MMSE score were analyzed. Multivariate Logistic regression analysis was utilized to investigate influencing factors of POD in elderly patients underwent THA. A receiver operating characteristic (ROC) curve was constructed to assess the predictive value of preoperative serum levels of VCAM-1 and PECAM-1, as well as MMSE score, both individually and in combination for POD in elderly patients undergoing THA. Results The age, hospital anxiety and depression scale score, incidence of intraoperative hypotension and postoperative hospital stay were significantly higher or longer in the POD group than those in the non-POD group, and the MMSE score was lower than that in the non-POD group (P<0.05). The serum levels of VCAM-1 and PECAM-1 before operation, 1st and 3rd day after operation were increased in the POD group, and which were significantly higher than those in the non-POD group (P<0.05). The serum levels of VCAM-1 and PECAM-1 were significantly negatively correlated with MMSE score in elderly patients undergoing THA (r=-0.390, -0.501, P<0.01). The elevated serum levels of VCAM-1 and PECAM-1 before operation and prolonged postoperative hospital stay were independent risk factors for POD in elderly patients underwent THA, and the elevated value of MMSE score was independent protective factor (P<0.05). Preoperative serum VCAM-1 (AUC=0.793, 95%CI:0.730-0.847), PECAM-1 (AUC=0.799, 95%CI:0.736-0.852) and MMSE score (AUC=0.805, 95%CI: 0.744-0.858) showed high predictive value for POD in elderly patients underwent THA, and the combined detection of the three indicators had higher predictive efficiency. Conclusion The elevated serum levels of VCAM-1 and PECAM-1 are related to the impairment of cognitive function in elderly patients undergoing THA, and they are independent predictors for POD in elderly patients undergoing THA, thus may be helpful for early diagnosis and prevention of POD． Figures and Tables | References | Related Articles | Metrics

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Analysis of clinical characteristics and risk factors for diabetes mellitus complicated with urinary tract infection in children NIJAT Alim, MA Shifeng, XAMSIYA Alim, ZHANG Jing, ZHENG Rongxiu 2024, 52 (10):  1051-1055.  doi: 10.11958/20240181 Abstract ( 349 )   HTML ( 2 )   PDF (818KB) ( 88 )   Objective To investigate clinical features and risk factors of childhood diabetes mellitus (DM) complicated with urinary tract infection (UTI). Methods The data of 160 children with DM in our hospital in the past 2 years were collected as the research object, and they were divided into the UTI group and the non-UTI group UTI, with 80 cases in each group. The clinical data of children with DM and UTI were collected and analyzed, including DM type, sex, age, body mass index (BMI), living environment, duration of disease, length of hospital stay, indwelling catheter, ketoacidosis, antibiotic and insulin use, the types of bacteria isolated from urine samples and various laboratory indicators on admission. Results Pathogen bacteria mainly included Escherichia coli (n=37, 46.2%), Enterococci (n=21, 26.2%) and Klebsiella pneumoniae (n=9, 11.2%) in the UTI group. Univariate analysis showed that there were significant differences in obesity, duration of disease, length of hospital stay, indwelling catheter, ketoacidosis, antibiotic use, glycosylated hemoglobin (HbA1c), albumin (ALB) and serum creatinine (Cr) between the two groups (P<0.05). Multivariate regression analysis showed that risk factors for DM complicating UTI included prolonged hospitalization (OR=2.087, 95%CI: 1.562-2.789), indwelling urinary catheter (OR=15.886, 95%CI: 2.336-108.007), ketoacidosis (OR=9.300, 95%CI: 1.169-73.992), duration of disease ≥36 months (OR=20.548, 95%CI: 2.425-174.119), increased HbA1c (OR=16.686, 95%CI: 3.666-75.955) and serum Cr (OR=1.010, 95%CI: 1.002-1.019), while the increased serum ALB (OR=0.799, 95%CI: 0.702-0.910) was its protective factor. Conclusion Pathogenic bacteria in the UTI group are mainly Escherichia coli. Children with DM and UTI are closely related to the length of hospitalization, indwelling catheter, ketoacidosis, duration of disease, HbA1c, serum Cr and ALB levels. Figures and Tables | References | Related Articles | Metrics

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Effect of phacoemulsification combined with CTR implantation on capsule stability after cataract surgery for high myopia MENG Keqing, ZHANG Wulin, DONG Wei, XU Yanhui, LI Nan 2024, 52 (10):  1056-1060.  doi: 10.11958/20240043 Abstract ( 260 )   HTML ( 1 )   PDF (864KB) ( 36 )   Objective To investigate the stability of pouch in patients with high myopia cataract after phacoemulsification cataract extraction combined with capsular tension ring (CTR) implantation. Methods A total of 80 patients with high myopia complicated with cataract (80 eyes) were included and randomly divided into the experimental group and the control group. The experimental group received phacoemulsification cataract extraction combined with CTR implantation, while the control group was not combined with CTR implantation, and the other interventions were completely consistent. The naked eye visual acuity (UCVA), best corrected distant visual acuity (BCVA), corneal biomechanics, contrast sensitivity, intraocular lens inclination and anterior capsular opening area were compared between the two groups at 1, 3 and 6 months after surgery. The incidence of late cataract (PCO) was measured 6 months after surgery. Results UCVA and BCVA were improved at 1, 3 and 6 months after operation. There were no significant differences in postoperative corneal biomechanical parameters ARTh and SP-A between the two groups of patients (P>0.05). The Corvis biomechanical index (CBI) of the experimental group was significantly higher 3 months after surgery than that of the control group (P<0.05), and there were no significant differences at other time points between the 2 groups. There was no significant difference in contrast sensitivity at each time point after surgery between the experimental group and the control group (P>0.05). At 3 and 6 months after operation, the anterior capsule opening area was increased in the experimental group, and IOL inclination angle was decreased compared with the control group (P<0.05). At 6 months after operation, no PCO occurred in 38 eyes and PCO grade Ⅰ in 2 eyes. No PCO occurred in 35 eyes in the control group, 3 eyes in grade Ⅰ, 2 eyes in grade Ⅱ and 2 eyes in grade Ⅲ. Conclusion Phacoemulsification cataract extraction combined with CTR implantation has higher stability, long-term clinical effect and visual quality in patients with high myopia cataract, and is worthy of clinical application. Figures and Tables | References | Related Articles | Metrics

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Comparative study of sequential nutritional support and parenteral nutrition support in clinical intervention of pediatric acute pancreatitis YANG Wenshan, SHENG Yu, CHEN Xiuli, CHEN Ji 2024, 52 (10):  1061-1064.  doi: 10.11958/20231850 Abstract ( 359 )   HTML ( 3 )   PDF (1462KB) ( 21 )   Objective To compare and analyze the effectiveness of sequential nutritional support and parenteral nutrition support in clinical intervention of pediatric acute pancreatitis. Methods Data of 102 children with acute pancreatitis were retrospectively collected and divided into the parenteral nutrition group (n=51) and the sequential nutrition group (n=51) based on the type of parenteral nutrition support. Changes in nutritional status, immune function indicators and body rehabilitation indicators were compared before and after intervention between two groups. The humoral immune indexes (IgA, IgG and IgM) were detected by immunonephelometry. The body recovery indexes (abdominal distension relief time, oral feeding recovery time, body temperature recovery time, blood and urine amylase recovery time and hospital stay) were compared between the two groups. Results After intervention, levels of serum albumin, total protein and prealbumin were higher in the study group than those in the control group, while levels of blood amylase and urine amylase were lower than those in the control group (P<0.05). After intervention, the CD3+, CD4+ and CD4+/CD8+ indicators were higher in the study group than those in the control group (P<0.05). After intervention, IgA, IgG and IgM indicators were higher in the study group than those in the control group (P<0.05). The relief time of abdominal distension, recovery time of oral feeding, recovery time of body temperature, recovery time of blood and urine amylase and hospitalization time were all shorter in the study group than those in the control group (P<0.05). Conclusion Sequential nutritional support can effectively improve the nutritional status of children with acute pancreatitis, enhance immune function and promote physical recovery compared to parenteral nutrition support. Figures and Tables | References | Related Articles | Metrics

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The relationship between TLR4, JAK3 gene expression and Th17/Treg imbalance in peripheral blood of patients with ankylosing spondylitis ZHANG Zhiqiang, WANG Weiwei, DONG Tengjing, LIAN Hongkai 2024, 52 (10):  1065-1068.  doi: 10.11958/20240195 Abstract ( 298 )   HTML ( 2 )   PDF (761KB) ( 20 )   Objective To explore the relationship between the expression of Toll like receptor 4 (TLR4) and Janus protein tyrosine kinase 3 (JAK3) genes and the imbalance of helper T cell 17 (Th17)/regulatory T cells (Treg) in peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS). Methods A total of 101 AS patients were selected as the AS group. According to the AS Disease Activity Index (BASDAI) score, patients were divided into the AS stable phase (ASS) group (<4 points, 42 cases) and the AS active phase (ASA) group (≥ 4 points, 59 cases). Additionally, 50 healthy volunteers who underwent physical examinations at our hospital during the same period were selected as the control group (health group). Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to determine the mRNA expression of TLR4 and JAK3 in PBMCs, and the proportion of serum Th17 and Treg was measured and Th17/Treg levels were calculated. Results The levels of TLR4 mRNA and JAK3 mRNA in PBMCs of peripheral blood were higher in the AS group than those in the health group (P<0.05). The levels of Th17, proportion and Th17/Treg in peripheral blood were higher in the AS group than those of the health group (P<0.05). Higher levels of TLR4 mRNA, JAK3 mRNA, Th17, and Th17/Treg were risk factors for AS, while higher level of Treg was protective factors for AS. TLR4 mRNA and JAK3 mRNA in AS patients were positively correlated with Th17 ratio and Th17/Treg ratio, and negatively correlated with Treg ratio (P<0.05). Conclusion TLR4 and JAK3 genes are highly expressed and Th17/Treg is unbalanced in PBMC of AS patients. The high expression of TLR4 and JAK3 genes is closely related to Th17/Treg imbalance in AS patients. Figures and Tables | References | Related Articles | Metrics

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Relationship between placental growth factor and ultrasonic blood flow parameters in patients with late-onset preeclampsia and its effect on pregnancy outcome LIU Guiying, LIU Lizhi, YANG Zongmei 2024, 52 (10):  1069-1074.  doi: 10.11958/20240179 Abstract ( 266 )   HTML ( 2 )   PDF (854KB) ( 53 )   Objective To explore the relationship between the serum level of placental growth factor (PLGF) and ultrasonic blood flow parameters and pregnancy outcome in patients with late-onset preeclampsia (LOPE). Methods A total of 152 patients with LOPE were selected and divided into the P1 (< 12.00 ng/L) group, the P2 (12.00-56.73 ng/L) group, the P3 (>56.73-89.41 ng/L) group and the P4 (> 89.41 ng/L) group according to serum level of PLGF. There were 38 cases in each group. The clinical data, uterine artery pulsatility index (PI), resistance index (RI), peak systolic velocity (S)/ end-diastolic velocity (D) and adverse pregnancy outcome were compared between the four groups. The relationship between PLGF level and clinical characteristics was analyzed by linear regression analysis. The influence of LOPE severity on the relationship between PLGF and ultrasonic blood flow parameters was analyzed by stratified interactive analysis. Multivariate generalized linear mixed effect model was used to analyze the relationship between PLGF level and adverse pregnancy outcome in patients with LOPE. Results The diastolic blood pressure, 24 h urinary protein, PI, RI and S/D decreased significantly with the increase of PLGF level (P<0.05). The proportion of severe LOPE and systolic blood pressure were significantly higher in the P1 group than those of the other groups (P<0.05), and the above indexes were influencing factors of the level of PLGF (P<0.05). The results of stratified interactive test showed that the LOPE severity did not affect the relationship between PLGF and ultrasonic blood flow parameters. There were significant differences in the incidence of HELLP syndrome, fetal growth restriction, fetal distress, premature delivery and neonatal asphyxia between patients with different PLGF levels (P<0.05). The incidence of preterm delivery was higher in the P1 group than that in the other groups, and the other adverse pregnancy outcomes were higher in the P3 group and P4 group. Conclusion Serum PLGF levels affect uterine artery blood flow parameters and adverse pregnancy outcome in patients with LOPE. Figures and Tables | References | Related Articles | Metrics

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Changes of pulmonary function of pertussis in children aged 5-17 years CHEN Wei, ZHAO Mengya, XIAO Fei, LIU Chuanhe 2024, 52 (10):  1075-1079.  doi: 10.11958/20240218 Abstract ( 349 )   HTML ( 0 )   PDF (1588KB) ( 137 )   Objective To investigate the characteristics of pulmonary function changes in older children with pertussis. Methods Clinical data and pulmonary function date of older children diagnosed with pertussis in outpatient clinics from April 2021 to December 2023 were collected. The clinical data of the case group were collected. A group of healthy older children were included as the control group. Pulmonary function parameters included peak expiratory flow (PEF), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, expiratory flow at 50% of vital capacity (FEF50), maximum mid-expiratory flow (MMEF) and expiratory flow rate with 75% vigorous exhalation (FEF75). Results Seventy children (36 boys and 34 girls) with pertussis were recruited in the case group, including 54 children with pertussis only and 16 children with pertussis and asthma together. The incidence of paroxysmal cough was 40.0% (28/70) and inspiratory croup 8.5% (6/70) in the case group. Sixty healthy children (28 boys and 32 girls) were included in the control group. There were no significant differences in gender, age, height and body weight between children with pertussis alone group and the control group (P>0.05). The pulmonary function parameters were significantly lower in the children with pertussis alone group than those in the control group, and PEF had the most obvious decline: PEF%pred [80.5 (62.6, 85.9) vs. 109.8 (103.2, 118.7)]. Compared with the pertussis alone group, pulmonary function was not decrease further in the pertussis combined with asthma group. After the improvement of clinical symptoms of children in the pertussis alone group, the level of pulmonary function (PEF and FEF50) increased significantly, but they were still lower than those of the control group. Conclusion The pulmonary function declines slightly in loder children with pertussis. The decreased PEF is most significant. Figures and Tables | References | Related Articles | Metrics

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The effect of OSTA index on baPWV in menopausal women and its predictive value for peripheral atherosclerosis CHENG Fangyuan, ZHANG Xiaoqin, LI Junxiang, LI Yun, WU Bihua, GU Jianwei, YANG Yunfeng, LIU Juhua 2024, 52 (10):  1079-1083.  doi: 10.11958/20240177 Abstract ( 337 )   HTML ( 2 )   PDF (799KB) ( 22 )   Objective To investigate the effect of Osteoporosis Self-Assessment Tool for Asia (OSTA) index on brachial ankle pulse wave velocity (baPWV) and its predictive value for peripheral atherosclerosis in menopausal women. Methods A total of 1 138 menopausal women who underwent physical examination at our hospital from January 2022 to December 2022 were enrolled in the study. General clinical data were collected, the OSTA index was calculated, and baPWV was measured. Patients were divided into the control group (n=539) and the peripheral atherosclerosis group (n=599) according to the baPWV values (peripheral atherosclerosis occurs with baPWV ≥1 400 cm/s). Linear regression and Logistic regression were used to analyze the effect of OSTA index on baPWV in menopausal women. The predictive value of peripheral atherosclerosis was evaluated using the receiver operating characteristic (ROC) curve. Results The OSTA index was lower in the peripheral atherosclerosis group than that in the control group [-0.40 (-2.20, 1.00) vs. 0.40 (-0.60, 1.40), P<0.05]. Univariate linear regression analysis was used to conclude that the OSTA index was an influencing factor of baPWV, and after correcting for risk factors, multivariate linear regression analysis indicated that OSTA index still affected the value of baPWV (P<0.05). The linear regression equation was baPWV= -27.911-39.752×OSTA+6.444×SBP+7.008×DBP+11.506×HCY+27.942×Hs-CRP. Logistic regression analysis suggested that increased OSTA index was a protective factor for peripheral atherosclerosis (OR=0.664, 95%CI: 0.535-0.823, P<0.001). ROC curve analysis suggested that OSTA index was -1.25 as the optimal cutoff point, which predicted peripheral atherosclerosis with an area under the curve of 0.619, a sensitivity of 36.2% and a specificity of 86.3%. Conclusion In menopausal women, OSTA index is an influential factor for baPWV, and increased OSTA index is a protective factor against peripheral atherosclerosis, which can be used to predict baPWV value. Figures and Tables | References | Related Articles | Metrics

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Effects of 3-2-3 abdominal breathing exercises on supine hypotension syndrome and fetus after subarachnoid block in caesarean section parturients CAI Jun, QIN Han, YAN Jian'e 2024, 52 (10):  1084-1088.  doi: 10.11958/20240288 Abstract ( 309 )   HTML ( 1 )   PDF (778KB) ( 10 )   Objective To discuss the effect of 3-2-3 abdominal breathing exercises on the occurrence of supine hypotension syndrome (SHS) and fetus in women with caesarean section after subarachnoid block. Methods A total of 131 cesarean section women were selected and randomly divided into three groups: the control group, the deep breathing group and the 3-2-3 abdominal breathing exercise group (3-2-3 group), with 44, 43 and 44 cases in each group. After subarachnoid block, the postpartum women were lied flat and received the following treatment: the control group received no intervention, the deep breathing group only instructed deep breathing and abdominal distension and in the 3-2-3 group inhalation counted 1, 2 and 3 with abdominal bulge to the highest, holding counts 1, 2 and with exhalation counted 1, 2 and 3 until the abdomen reaches the lowest. Changes of heart rates (HR) before anesthesia (T0), supine position for 5 minutes after anesthesia (T1), immediately before surgery (T2), before fetal removal (T3), after fetal removal (T4), as well as systolic blood pressure (SBP), mean arterial pressure (MAP) at T0 and T1 were recorded in the three groups. The occurrence of adverse reactions, the use rate of vasopressors, incidence of SHS, duration of respiratory persistence and Apgar scores of 1-minute and 5-minute in newborns were compared between the three groups. Umbilical artery blood was collected, and interleukin (IL)-1,IL-6 and tumor necrosis factor alpha (TNF-α), cortisol (Cor), norepinephrine (NE), pH value, lactate (Lac) and buffuer excess (BE) were detected. Results (1) Compared to the control group，the HR at T1 to T4 showed significant changes in the deep breathing group (P<0.05), while the HR at T1 to T4 of the 3-2-3 group showed less fluctuation compared to the control group (P<0.05). SBP and MAP of the control group and the deep breathing group significantly decreased at T1 (P<0.05), but there was no significant change in MAP in the 3-2-3 group (P>0.05). (2) Compared with the control group, the incidence of adverse reactions and SHS, as well as the use of vasopressors decreased obviously in the 3-2-3 group (P<0.05), and Apgar score of newborns increased (P<0.05). The respiratory persistence duration was longer in the 3-2-3 group than that in the deep breathing group and the control group (P<0.05). (3) Compared to the control group, there were significant improvements in IL-1, IL-6, TNF-α, Cor, NE, pH, Lac and BE in the 3-2-3 group (all P<0.05). Compared to the deep breathing group, there were significant differences in IL-6, TNF-α, pH value, Lac and BE in the 3-2-3 groups (P<0.05). Conclusion The 3-2-3 abdominal breathing exercises can reduce the incidence of SHS, inhibit fetal stress response and acidosis, and is superior to abdominal deep breathing method in women with cesarean section after subarachnoid block. Figures and Tables | References | Related Articles | Metrics

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Clinical characteristics and risk prediction model construction of children with Kawasaki disease complicated with pleural effusion YANG Hu, LEI Jun, YANG Li, PENG Xiaotong 2024, 52 (10):  1089-1094.  doi: 10.11958/20240256 Abstract ( 311 )   HTML ( 1 )   PDF (1049KB) ( 11 )   Objective To investigate the clinical features of pediatric Kawasaki disease (KD) complicated with pleural effusion (PE) and construct a clinical prediction model. Methods A retrospective review was conducted on clinical data of 462 children with KD from June 2017 to June 2023. Eleven KD children with PE were selected as the KD-PE group, and 118 patients without PE were selected as the KD control group. Using propensity score matching, the clinical data including clinical manifestation, auxiliary examination, treatment process and complications were collected and analyzed. Univariate and Lasso-Logistic regression were used to analyze influence factors of PE in children with KD. A line chart model for predicting KD-PE was constructed, and the prediction efficiency of the model was evaluated. Results The respiratory symptoms were generally mild in the KD-PE group, with 10 cases exhibiting mild PE. Two variables of C-reactive protein (CRP, OR=1.045, 95%CI: 1.009-1.082) and albumin (ALB, OR=0.755, 95%CI: 0.591-0.964) were screened out by Lasso regression and multi-factor Logistic regression to construct the prediction model. The regression equation was Logit (P)=2.221+0.044×CRP-0.281×ALB. The area under the ROC curve of the prediction model was 0.957 (95%CI: 0.911-1.000), and the Hosmer-Lemeshow test showed that the curve of the calibration model was well coincident with the curve of the actual model (χ2=4.320, P=0.827). The evaluation model using clinical decision curve and clinical impact curve had good clinical applicability. Conclusion KD complicated with PE in children is rare, elevated CRP is a risk factor for KD-complicated PE, and elevated ALB is a protective factor. The model has higher accuracy, discriminatory power and net benefit. Figures and Tables | References | Related Articles | Metrics

Applied Research

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Preliminary research on clinical application of a new flexible patch ECG LU Yibei, JIN Dongxia, SONG Zhenchun, MA Haoyuan, LI Yan, HAO Tianxu, LI Ximing 2024, 52 (10):  1095-1099.  doi: 10.11958/20240064 Abstract ( 290 )   HTML ( 3 )   PDF (822KB) ( 9 )   Objective To explore the diagnostic value of a wearable flexible patch ECG instrument in arrhythmia, the alarm situation during clinical application, patient satisfaction and safety. Methods A total of 1 443 subjects wore flexible patch ECG and conventional dynamic ECG (control) for 24 h to test the validity and consistency of arrhythmia diagnosis, and counted the alarm of remote ECG and the occurrence of related adverse events during the wearing of the instrument. Results There were 987 cases of arrhythmia detected by flexible patch ECG and 992 cases by conventional dynamic ECG. The total coincidence rate of arrhythmia diagnosis was 98.7%. The mean heart rate was measured by flexible patch ECG (75.4±11.4) times/min, conventional dynamic heart rate (71.5±12.1) times/min, the intra-group correlation coefficient (ICC) of 2 instruments was 0.892 (95%CI: 0.537-0.956), with good repeatability. The correct alarm rate of flexible patch ECG was 100%. The incidences of skin pruritus (0.28% vs.1.32%), skin allergy, redness and swelling (0.14% vs. 0.69%) and electrode strip shedding (0 vs.0.28%) during wearing the flexible patch electrocardiogram were lower than those of the conventional holter electrocardiogram (P<0.05). Conclusion The flexible patch ECG has few adverse reactions, high comfort, good safety and clinical applicability. Figures and Tables | References | Related Articles | Metrics

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The application value of ultrasound radiomics in the histological classification of nephritis WANG Zhong, ZHAO Jingwen, WANG Tianchi, TANG Ying 2024, 52 (10):  1100-1105.  doi: 10.11958/20231935 Abstract ( 264 )   HTML ( 2 )   PDF (1335KB) ( 12 )   Objective To explore the application value of ultrasound radiomics technology based on grayscale ultrasound images in the differential diagnosis of histological classification of glomerulonephritis. Methods A total of 204 patients with renal biopsy were selected from our hospital, and according to pathological results, they were divided into the membranous nephropathy group (n=133) and the mesangial proliferative glomerulonephritis group (n=71). The ultrasound images were sketched and the image omics features were extracted by two physicians. The pathological results and ultrasound data of renal biopsy were collected from the two groups, and the ultrasound radiomics features were preliminarily screened by the maximum correlation and minimum redundancy algorithm (mRMR) algorithm for all the obtained omics feature data. Then the optimal effective features were selected from the screened features by minimum absolute shrinkage and selection operator (LASSO) algorithm, and random forest (RF), support vector machine (SVM), logistic regression (LR), four kinds of classifiers of K-nearest neighbor (KNN) method were used to establish a prediction model. All cases were randomly divided into the training set and the validation set according to the ratio of 7:3, and the four models were trained by the training set, and then validated in the validation set, and the best prediction model was selected by comparing the receiver operating characteristic (ROC) curve, Delong test and GiViTI calibration curve. Decision curve analysis (DCA) was used to evaluate the clinical utility of the model. Results The radiomics method was used to extract 837 radiomics features per image, and 16 meaningful features were finally screened out by using the mRMR + LASSO algorithm. Among the four prediction models of RF, SVM, LR and KNN, the best performing model was LR model, with the AUC of 0.944, the specificity of 0.867 and the sensitivity of 0.878. The GiViTI calibration curve showed that the model had good accuracy (P>0.05), and the decision curve showed that the prediction model had good clinical practical value. Conclusion Ultrasound radiomics has a good ability to distinguish the more common histological types of glomerulonephritis, and is a non-invasive method with good application prospects. Figures and Tables | References | Related Articles | Metrics

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The application progress of digital technology in Alzheimer's disease RAN Longfei, NIE Zhiqiang, GUO Junhui 2024, 52 (10):  1106-1109.  doi: 10.11958/20240039 Abstract ( 474 )   HTML ( 0 )   PDF (760KB) ( 41 )   Alzheimer's disease (AD) is a neurodegenerative disease characterized by clinical manifestations of cognitive decline, abnormal mental behavior and decreased ability to engage in daily activities. The etiology of this disease is diverse and the onset is insidious. Traditional neuropsychological assessments are time-consuming, imaging detection sensitivity is low, and drug development progress is slow. With the rapid development of cognitive neuroscience and digital technology, digital technologies such as artificial intelligence and virtual reality are receiving increasing attention. This article aims to review the clinical research on digital technology in the prediction, screening, auxiliary diagnosis and treatment of AD in recent years, as well as the progress and breakthroughs in multiple fields such as AD gait, fine motor and speech, providing a directions for clinical diagnosis and further exploration. References | Related Articles | Metrics

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Research progress on the role and mechanism of exosomal circRNA in gastric cancer YAO He, LIN Yanli, CUI Yumeng, YAN Xinlong 2024, 52 (10):  1110-1115.  doi: 10.11958/20240059 Abstract ( 405 )   HTML ( 5 )   PDF (783KB) ( 129 )   Gastric cancer (GC) is one of the most common and high mortality tumors in the world, and the clinical staging during diagnosis is closely related to the prognosis of patients. Therefore, finding sensitive diagnostic biomarkers to improve the early diagnosis rate has become an urgent issue. Exosomes are nanoscale extracellular vesicles secreted by various cells, which play an important role in cellular communication by transporting bioactive substances in tumor microenvironment (TME). CircRNA is a type of non-coding RNA with a specific structure. Because it is difficulty in degradation, it can be enriched in extracellular vesicles and participate in various pathophysiological processes mediated by it. Exo-circRNA can affect the proliferation, invasion, drug resistance and tissue metastasis of tumor cells, and has more significant diagnostic specificity than conventional diagnostic biomarkers in clinical practice. It may become a supplement to biomarker for the diagnosis and prognosis of GC. This article briefly introduces the characteristics, formation mechanism and role of extracellular vesicles and circRNA in GC. It discusses in detail the role of exo-circRNA in the occurrence and development of GC, and discusses their potential clinical application value and challenges in GC. Figures and Tables | References | Related Articles | Metrics

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Application value of neutrophil gelatinase associated lipocalin in clinical diagnosis of Crohn's disease MA Kai, YAO Yibo, WANG Chen 2024, 52 (10):  1116-1120.  doi: 10.11958/20240286 Abstract ( 295 )   HTML ( 2 )   PDF (770KB) ( 138 )   Crohn's disease (CD) is an autoimmune intestinal disease characterised by chronic and non-specific inflammation, and the exact etiology and pathogenesis are still unclear. Neutrophil gelatinase associated lipocalin (NGAL), a secreted glycoprotein and isolated from neutrophils, is widely involved in pathophysiological processes such as intestinal inflammation response, apoptosis and tumour progression. It has been found that NGAL has the potential to be a clinical biological marker in clinical diagnosis and monitoring of CD activity. Therefore, this paper reviews the application value of NGAL in different clinical samples of CD, in order to provide reference for clinical diagnosis and treatment of CD. Figures and Tables | References | Related Articles | Metrics