1.Shaoyaotang Regulates miRNA-155-mediated SOCS1/JAK1/STAT1 Signaling Pathway to Affect Macrophage Polarization
Qi CHENG ; Bo ZOU ; Youwei XIAO ; Yiqian YU ; Ruoru HUANG ; Yan GONG ; Jiachun XIONG ; Jun XIONG ; Dichang LAI ; Dongsheng WU ; Hui CAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):43-52
ObjectiveTo investigate the mechanism by which Shaoyaotang regulates the miRNA-155-mediated suppressor of cytokine signaling 1 (SOCS1)/Janus kinase 1 (JAK1)/signal transducer and activator of transcription 1 (STAT1) signaling pathway and thereby affects macrophage polarization. MethodsThe cell-counting kit-8 (CCK-8) assay was used to detect the effect of drug-containing serum of Shaoyaotang at different concentrations on the viability of RAW 264.7 cells. A cell model of inflammation was established by stimulating RAW264.7 cells with lipopolysaccharide (LPS) at a concentration of 10 mg·L-1 The modeled cells were assigned by the random number table method into seven groups: LPS-induced M1 polarization (model), M1+miRNA-155 mimics, M1+miRNA-155 inhibitor, M1+Shaoyaotang-containing serum, M1+miRNA-155 mimics+Shaoyaotang-containing serum, M1+miRNA-155 inhibitor+Shaoyaotang-containing serum, and M1+blank serum. Enzyme-linked immunosorbent assay was employed to measure the levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β)]. Immunofluorescence assay was used to detect the expression of macrophage polarization markers [inducible nitric oxide synthase (iNOS) and macrophage mannose receptor 1 (CD206)]. Real-time PCR was employed to measure the expression of miRNA-155 in cells. Western blot was performed to determine the protein levels of SOCS1, STAT1, and JAK1. ResultsCompared with the LPS-induced M1 polarization (model) group, the M1+miRNA-155 mimics group showed up-regulated expression of miRNA-155, JAK1, STAT1, TNF-α, IL-6, IL-1β, and iNOS (P<0.05) and down-regulated expression of CD206 (P<0.05). In both the M1+miRNA-155 inhibitor group and the M1+Shaoyaotang-containing serum group, the expression levels of miRNA-155, JAK1, STAT1, TNF-α, IL-6, IL-1β, and iNOS were down-regulated (P<0.05), while those of SOCS1 and CD206 were up-regulated (P<0.05). Compared with the M1+miRNA-155 mimics group, the M1+miRNA-155 mimics+Shaoyaotang-containing serum group showed down-regulated expression of miRNA-155, JAK1, STAT1, TNF-α, IL-6, IL-1β, and iNOS (P<0.05) and up-regulated expression of SOCS1 and CD206 (P<0.05). Compared with the M1+miRNA-155 inhibitor group, the M1+miRNA-155 inhibitor+Shaoyaotang-containing serum group showed down-regulated expression of miRNA-155, JAK1, STAT1, TNF-α, IL-6, IL-1β, and iNOS (P<0.05) and up-regulated expression of SOCS1 and CD206 (P<0.05). ConclusionShaoyaotang regulates macrophage polarization by modulating miRNA-155 expression and interfering with the SOCS1/JAK1/STAT1 signaling pathway. The findings provide new experimental evidence for the treatment of ulcerative colitis with Shaoyaotang.
2.Effect and Mechanisms of Shaoyaotang on Murine Ulcerative Colitis via Modulating Macrophage Glycolytic Reprogramming and Polarization Through HIF-1α Pathway
Yiqian YU ; Hui CAO ; Dongsheng WU ; Bo ZOU ; Ruoru HUANG ; Qi CHENG ; Youwei XIAO ; Yan GONG ; Jiachun XIONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):53-60
ObjectiveTo investigate the potential role and underlying mechanisms of Shaoyaotang in intervening macrophage glycolytic reprogramming in ulcerative colitis (UC). MethodsForty-eight C57BL/6 mice were randomly divided into six groups: Normal control group, model group, mesalazine group (0.39 g·kg-1), Shaoyaotang group (15.54 g·kg-1), 2-deoxy-D-glucose (2-DG) group (glycolysis inhibitor, 100 mg·kg-1), and 2-DG + Shaoyaotang combined group (100 mg·kg-1+15.54 g·kg-1). Except for the normal control group, mice in the other five groups were induced to establish UC models using dextran sulfate sodium (DSS). The normal control group was administered pure water via intragastric gavage, while the other groups received intragastric gavage of mesalazine solution, intragastric gavage of Shaoyaotang, and the 2-DG group was treated with 2-DG via intraperitoneal injection. After 7 consecutive days of treatment, colonic tissues were extracted. Hematoxylin and eosin (HE) staining was performed to evaluate histopathological changes and tissue injury in the colon. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in colonic tissues. Western blot analysis was employed to determine the expression levels of hypoxia-inducible factor-1α (HIF-1α), glucose transporter (GLUT1), lactate dehydrogenase A (LDHA), pyruvate kinase M2 (PKM2), and 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 (PFKFB3) in colonic tissues. Immunofluorescence was conducted to detect the expression of CD206 and inducible nitric oxide synthase (iNOS) in colonic tissues. Liquid chromatography-mass spectrometry (LC-MS) was utilized to measure lactate and citrate levels in colonic tissues. ResultsCompared with the normal control group, mice in the model group exhibited a significant increase in disease activity index (DAI) scores, accompanied by colonic mucosal congestion, edema, and inflammatory cell infiltration, significantly elevated expression of the inflammatory cytokine TNF-α (P<0.05), significantly decreased IL-10 expression (P<0.05), significantly increased levels of HIF-1α, GLUT1, LDHA, PKM2, and PFKFB3 in colonic tissues (P<0.05), markedly elevated iNOS expression (P<0.05), significantly decreased CD206 expression (P<0.05), and significantly elevated lactate and citrate levels in colonic tissues (P<0.05). In contrast to the model group, the Shaoyaotang group, inhibitor group, and Shaoyaotang combined with inhibitor group demonstrated amelioration of mucosal injury in colonic tissues, markely decreased expression levels of the inflammatory cytokine TNF-α (P<0.05), elevated IL-10 expression levels, significantly decreased expression of HIF-1α, GLUT1, LDHA, PKM2, and PFKFB3 (P<0.05), markedly reduced iNOS expression levels (P<0.05), significantly increased CD206 expression (P<0.05) and significantly decreased lactate and citrate levels (P<0.05). ConclusionShaoyaotang ameliorates symptoms of DSS-induced UC in mice, and its therapeutic mechanism may be associated with regulating macrophage glycolytic reprogramming via modulation of the HIF-1α signaling pathway.
3.Shaoyaotang Ameliorates Ulcerative Colitis by Regulating miR-155-5p
Ruoru HUANG ; Bo ZOU ; Yu ZHANG ; Yiqian YU ; Qi CHENG ; Youwei XIAO ; Jiachun XIONG ; Yan GONG ; Dongshen WU ; Hui CAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):61-68
ObjectiveTo investigate the role of microRNA-155-5p (miR-155-5p) in ulcerative colitis (UC) and study the molecular mechanism of Shaoyaotang in the treatment of UC by regulating miR-155-5p. MethodsForty-eight SPF-grade male C57BL/6 mice were selected and assigned via the random number table method into 6 groups (n=8): A blank control group, a model group, a mesalazine (0.39 g·kg-1) group, a Shaoyaotang (31.08 g·kg-1) group, a Janus kinase 1 (JAK1) inhibitor (baricitinib, 10 mg·kg-1) group, and a Shaoyaotang combined with inhibitor (baricitinib 10 mg·kg-1 + Shaoyaotang 31.08 g·kg-1) group. After successful modeling of UC by gavage of 3% dextran sulphate sodium solution, each group received corresponding drug intervention for 7 days. Shaoyaotang and mesalazine were administered by gavage, and baricitinib by intraperitoneal injection. Twenty-four hours after the last administration, mice were anesthetized by intraperitoneal injection of pentobarbital sodium, and blood was collected for determination of white blood cell count and erythrocyte sedimentation rate (ESR). Mice were then sacrificed for measurement of colon length. Hematoxylin-eosin staining was used to observe colonic pathological changes and perform pathological scoring. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was employed to determine the relative expression of miR-155-5p in the colonic tissue, and Western blot was used to determine the protein levels of JAK1, phosphorylated JAK1 (p-JAK1), suppressor of cytokine signaling 1 (SOCS1), signal transducer and activator of transcription 1 (STAT1), and phosphorylated STAT1 (p-STAT1). ResultsCompared with the blank control group, the model group showed increased disease activity index (DAI) score and pathological score, shortened colon, upregulated relative expression of miR-155-5p and protein levels of p-JAK1 and p-STAT1, downregulated protein level of SOCS1 in the colonic tissue, prolonged time of erythrocyte sedimentation, and increased white blood cell count (P<0.01). Compared with the model group, all drug-treated groups exhibited improvements in the above indicators (P<0.01). Moreover, the Shaoyaotang group showed better therapeutic effects than the mesalazine group in regulating miR-155-5p expression, related protein levels, DAI score, and colonic pathological score (P<0.01). ConclusionShaoyaotang may downregulate miR-155-5p to relieve its inhibition on SOCS1, thereby suppressing the excessive activation of the JAK1/STAT1 signaling pathway and ultimately alleviating intestinal inflammatory damage.
4.Shaoyaotang Regulates TLR4/MyD88/NF-κB Signaling Pathway to Protect Intestinal Mucosal Barrier in Ulcerative Colitis
Dongsheng WU ; Yu ZHANG ; Wenjing QUAN ; Wanqing XIONG ; Bo ZOU ; Youwei XIAO ; Ruoru HUANG ; Yan GONG ; Hui CAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):69-75
ObjectiveTo investigate the role of the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway in intestinal mucosal barrier damage in ulcerative colitis, as well as the intervention mechanism of Shaoyaotang. MethodsSixty SD rats were allocated into a blank group, a model group, a mesalazine (0.42 g·kg-1) group, and low-, medium-, and high-dose (11.1, 22.2, 44.4 g·kg-1, respectively) Shaoyaotang groups. A model of ulcerative colitis was induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS). After successful modeling, rats were administrated with corresponding agents via gavage for 7 days. Changes in colon length and colon weight were observed. Hematoxylin-eosin staining was performed to examine the pathological changes of the colon, and immunohistochemistry was employed to detect the expression of the inflammatory cytokine interleukin-8 (IL-8), cyclooxygenase-2 (COX-2), junction adhesion molecule-1 (JAM-1), and claudin-1 in the colon. Western blot analysis was performed to determine the protein levels of TLR4, MyD88, and NF-κB in the colon. ResultsCompared with the blank group, the model group showed elevated DAI score (P<0.01), reduced colon length and colon weight (P<0.01), down-regulated protein levels of JAM-1 and claudin-1 (P<0.01), and up-regulated protein levels of IL-8, COX-2, TLR4, MyD88, and NF-κB p65 (P<0.01) in the colon tissue. Compared with the model group, each treatment group showed decreased DAI score (P<0.05, P<0.01), increased colon length and colon weight (P<0.05, P<0.01), up-regulated protein levels of JAM-1 and claudin-1 (P<0.01), and down-regulated protein levels of IL-8, COX-2, TLR4, MyD88, and NF-κB p65 (P<0.01) in the colon tissue. ConclusionShaoyaotang alleviates intestinal inflammation and intestinal mucosal damage to protect intestinal barrier integrity by regulating the TLR4/MyD88/NF-κB signaling pathway.
5.In Vivo Study of C1q-like Protein 4 on Invasion and Metastasis of Breast Cancer
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2025;54(2):203-210
Objective In vivo validation of the effects of C1q-like protein 4(C1ql4)on epithelial-mesenchymal transition(EMT)and stemness characteristics of breast cancer metastatic tissues in NOD/SCID mice.Methods Immunofluorescence-la-beled cell lines with stable low-expression and over-expression of C1ql4(MDA-MB-231,MCF-7)were constructed,and then in-jected intravenously into 4-week-old female NOD/SCID mice.The formation of metastatic tumors was detected by IVIS live ima-ging.Eight weeks after injection,the mice were euthanized,and lung tissues were fixed in paraffin.HE staining was performed to observe the number of metastatic foci,and immunohistochemistry(IHC)was used to detect the expression levels of CD4,SOX2,ER,Her-2 protein in tissue specimens.Total RNA and protein were extracted from fresh lung metastatic tumors,and the expression of EMT-related proteins and stem cell-related proteins were detect by qRT-PCR and Western blotting.Results The IVIS live imaging results showed that,compared with MDA-MB-231 group,the fluorescence intensity and density of tumors in the MDA-MB-231-sh group were significantly decreased(P<0.05);compared with the MCF-7 group,the fluorescence intensity and density of tumors in the MCF-7-OE group were significantly increased(P<0.05).HE staining and IHC results of mouse lung metastatic tissues showed that,compared with the MDA-MB-231 group,the number of lung metastatic foci in the MDA-MB-231-sh group was significantly reduced,and the expressions of CD44 and SOX2 were downregulated(all P<0.05),with no significant changes in ER and Her-2 expression;whereas compared with the MCF-7 group,the number of lung metastatic foci in the MCF-7-OE group was significantly increased,and expressions of CD44 and SOX2 were upregulated(all P<0.05),with no significant changes in ER and Her-2 expression.The expression levels of stemness-related proteins and interstitial markers of mouse lung metastatic tissues detected by qRT-PCR and Western blotting in the MDA-MB-231-sh group were significantly low-er than those in the MDA-MB-231 group(all P<0.05),but the expression levels of epithelial markers were higher than those in the MDA-MB-231 group(P<0.05);the expression levels of stemness-related proteins and interstitial markers in the MCF-7-OE group were significantly higher than those in the MCF-7 group(all P<0.05),but the expression levels of epithelial markers were lower than those in the MCF-7 group(P<0.05).Conclusion C1ql4 promotes the formation and progression of mouse breast cancer lung metastatic tumors by enhancing cancer cell stemness expression and EMT processes.
6.GOLM1 promotes cholesterol gallstone formation via ABCG5-mediated cholesterol efflux in metabolic dysfunction-associated steatohepatitis livers
Yi-Tong LI ; Wei-Qing SHAO ; Zhen-Mei CHEN ; Xiao-Chen MA ; Chen-He YI ; Bao-Rui TAO ; Bo ZHANG ; Yue MA ; Guo ZHANG ; Rui ZHANG ; Yan GENG ; Jing LIN ; Jin-Hong CHEN
Clinical and Molecular Hepatology 2025;31(2):409-425
Background/Aims:
Metabolic dysfunction-associated steatohepatitis (MASH) is a significant risk factor for gallstone formation, but mechanisms underlying MASH-related gallstone formation remain unclear. Golgi membrane protein 1 (GOLM1) participates in hepatic cholesterol metabolism and is upregulated in MASH. Here, we aimed to explore the role of GOLM1 in MASH-related gallstone formation.
Methods:
The UK Biobank cohort was used for etiological analysis. GOLM1 knockout (GOLM1-/-) and wild-type (WT) mice were fed with a high-fat diet (HFD). Livers were excised for histology and immunohistochemistry analysis. Gallbladders were collected to calculate incidence of cholesterol gallstones (CGSs). Biles were collected for biliary lipid analysis. HepG2 cells were used to explore underlying mechanisms. Human liver samples were used for clinical validation.
Results:
MASH patients had a greater risk of cholelithiasis. All HFD-fed mice developed MASH, and the incidence of gallstones was 16.7% and 75.0% in GOLM1-/- and WT mice, respectively. GOLM1-/- decreased biliary cholesterol concentration and output. In vivo and in vitro assays confirmed that GOLM1 facilitated cholesterol efflux through upregulating ATP binding cassette transporter subfamily G member 5 (ABCG5). Mechanistically, GOLM1 translocated into nucleus to promote osteopontin (OPN) transcription, thus stimulating ABCG5-mediated cholesterol efflux. Moreover, GOLM1 was upregulated by interleukin-1β (IL-1β) in a dose-dependent manner. Finally, we confirmed that IL-1β, GOLM1, OPN, and ABCG5 were enhanced in livers of MASH patients with CGSs.
Conclusions
In MASH livers, upregulation of GOLM1 by IL-1β increases ABCG5-mediated cholesterol efflux in an OPN-dependent manner, promoting CGS formation. GOLM1 has the potential to be a molecular hub interconnecting MASH and CGSs.
7.In Vivo Study of C1q-like Protein 4 on Invasion and Metastasis of Breast Cancer
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2025;54(2):203-210
Objective In vivo validation of the effects of C1q-like protein 4(C1ql4)on epithelial-mesenchymal transition(EMT)and stemness characteristics of breast cancer metastatic tissues in NOD/SCID mice.Methods Immunofluorescence-la-beled cell lines with stable low-expression and over-expression of C1ql4(MDA-MB-231,MCF-7)were constructed,and then in-jected intravenously into 4-week-old female NOD/SCID mice.The formation of metastatic tumors was detected by IVIS live ima-ging.Eight weeks after injection,the mice were euthanized,and lung tissues were fixed in paraffin.HE staining was performed to observe the number of metastatic foci,and immunohistochemistry(IHC)was used to detect the expression levels of CD4,SOX2,ER,Her-2 protein in tissue specimens.Total RNA and protein were extracted from fresh lung metastatic tumors,and the expression of EMT-related proteins and stem cell-related proteins were detect by qRT-PCR and Western blotting.Results The IVIS live imaging results showed that,compared with MDA-MB-231 group,the fluorescence intensity and density of tumors in the MDA-MB-231-sh group were significantly decreased(P<0.05);compared with the MCF-7 group,the fluorescence intensity and density of tumors in the MCF-7-OE group were significantly increased(P<0.05).HE staining and IHC results of mouse lung metastatic tissues showed that,compared with the MDA-MB-231 group,the number of lung metastatic foci in the MDA-MB-231-sh group was significantly reduced,and the expressions of CD44 and SOX2 were downregulated(all P<0.05),with no significant changes in ER and Her-2 expression;whereas compared with the MCF-7 group,the number of lung metastatic foci in the MCF-7-OE group was significantly increased,and expressions of CD44 and SOX2 were upregulated(all P<0.05),with no significant changes in ER and Her-2 expression.The expression levels of stemness-related proteins and interstitial markers of mouse lung metastatic tissues detected by qRT-PCR and Western blotting in the MDA-MB-231-sh group were significantly low-er than those in the MDA-MB-231 group(all P<0.05),but the expression levels of epithelial markers were higher than those in the MDA-MB-231 group(P<0.05);the expression levels of stemness-related proteins and interstitial markers in the MCF-7-OE group were significantly higher than those in the MCF-7 group(all P<0.05),but the expression levels of epithelial markers were lower than those in the MCF-7 group(P<0.05).Conclusion C1ql4 promotes the formation and progression of mouse breast cancer lung metastatic tumors by enhancing cancer cell stemness expression and EMT processes.
8.Efficacy and safety of a facilitated percutaneous coronary intervention with half-dose recombinant staphylokinase in ST-segment elevation myocardial infarction
Tian-yu WU ; Wen-hao ZHANG ; Peng-sheng CHEN ; Chen LI ; Tian WU ; Zhan LÜ ; Tong WANG ; Kun LIU ; Zhi-wen TAO ; Xiao-xuan GONG ; Liang YUAN ; Yong LI ; Bo CHEN ; Xin CHEN ; Zeng-guang CHEN ; Nai-quan YANG ; Yuan-yuan SANG ; Xiao-yan WANG ; Bai-hong LI ; Li ZHU ; Guo-yu WANG ; Xin ZHAO ; Chuan LU ; Jun JIANG ; Rui-na HAO ; Chun-jian LI
Chinese Journal of Interventional Cardiology 2025;33(8):431-438
Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P<0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P>0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.
9.Design of electric ice blanket system for early treatment of heat stroke disease
Bo-wen YAN ; Yan-yi LU ; Lin ZENG ; Zhi-gang ZHANG ; Nan XIAO ; Qing-hua HE
Chinese Medical Equipment Journal 2025;46(9):16-21
Objective To design an electric ice blanket system for prehospital emergency care of patients of heat sroke disease.Methods The electric ice blanket system consisted of a cooling host and cooling accessories.The cooling host had its chassis made of acrylonitrile-butadiene-styrene(ABS),which was equipped externally with an lithium battery and a DC power adapter,and integrated internally a cooling system,an internal circulation pump,an external circulation pump and a main control system;the cooling accessories included a cooling blanket,a cooling cap and a cooling vest,which had the inner layer made of thermoplastic polyurethane(TPU)elastomer and the outer layer made of Oxford cloth or polyester fiber.The system was compared with the existing subcooling therapeutic apparatus on the market in terms of cooling effect with a water bag simulation cooling experiment.Results The cooling experiment showed that the system was comparable to the existing subcooling therapeutic apparatus on the market in terms of cooling effect while behaved well in size and weight.Conclusion The system developed has a high cooling effect and advantages in portability and compatibility to the environment without power supply,which can be used for the early treatment of patients of heat stroke disease.[Chinese Medical Equipment Journal,2025,46(9):16-21]
10.Transcatheter aortic valve implantation for native aortic valve regurgitation:single-centre experience
Xiao-xue ZHANG ; Yi FENG ; Xian-tao MA ; Yu-jie YANG ; Akilu WAJEEHULLAHI ; Chen-xi YAN ; Zi-yue ZHANG ; Zi-jun CHEN ; Bo QIN ; Shi-liang LI ; Cai CHENG
Chinese Journal of Interventional Cardiology 2025;33(1):33-41
Objective To evaluate the efficacy and safety of transcatheter aortic valve implantation(TAVI)for the treatment of primary aortic valve regurgitation(NAVR)and to compare the difference in the choice of prosthetic valve size and the difference in complications with aortic stenosis(AS).Methods According to the definition of Valve Academic Research Consortium(VARC-3),143 patients with NAVR/AS treated with TAVI and patients with NAVR treated with surgical aortic valve replacement(SAVR)at Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from March 2019 to September 2024 were selected,and clinical data on baseline,perioperative,and primary endpoint events were were retrospectively collected and compared.Results Forty-three patients with NAVR were treated with TAVI,with a device success rate of 86.0%and a surgical success rate of 95.3%.Subgroup comparisons:(1)NAVR-TAVI group than NAVR-SAVR group:patients in the TAVI group had a significantly shorter operative time than those in the SAVR group(P<0.001);complete left bundle branch block was more likely to occur after TAVI(P=0.042),and complete right bundle branch block was more likely to occur after SAVR(P=0.044).SAVR postoperatively The incidence of congestive heart failure was higher(P=0.013),and the mortality rate was significantly higher in the SAVR group than in the TAVI group(P=0.019).(2)NAVR-TAVI group than AS-TAVI group:the differences in access selection,THV size[28(22,34)mm vs.24(22,32)mm,P=0.044]and proportion of THV overdiameter[14%(7%,20%)vs.7%(3%,11%),P<0.001]were statistically significant.patients in AS and NAVR groups had 1 case of permanent pacing after TAVI treatment.In the AS and NAVR groups,there was 1 case of permanent pacemaker implantation after TAVI.2 patients in the AS group were converted to surgical treatment,and 6 patients died.Conclusions The use of"off-label"(transfemoral)and"on-label"(transapical)TAVI devices(both from domestic sources)is safer than SAVR for the treatment of NAVR,especially in elderly and high-risk patients.Compared with patients with AS treated with TAVI,larger diameter annulas are usually selected for NAVR,with higher rates of valve migration,but overall safety and efficacy are comparable to AS.

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