1.Analysis of Microbiological and Parasitic Testing Results for Laboratory Animals in Jiangxi Province, 2020-2024
Fangping XIAO ; Lijuan XIONG ; Bo JIA ; Huan LIU ; Yongbing LUO ; Xiaorong WAN
Laboratory Animal and Comparative Medicine 2026;46(1):119-126
Objective To assess the current status of microbial and parasitic quality control for laboratory animals in Jiangxi Province by analyzing microbiological and parasitic test results from production facilities between 2020 and 2024, and to provide a basis for enhancing quality control measures. MethodsIn accordance with the current national standards for laboratory animals at the time of testing, the Jiangxi Provincial Laboratory Animal Quality Inspection Station (affiliated to Institute of Occupational Medicine of Jiangxi) conducted microbial and parasitic testing on 451 laboratory animals of 4 species from 6 laboratory animal production units in Jiangxi Province between 2020 and 2024, and analyzed the quality status of laboratory animals in the province. ResultsPasteurella pneumotropica was detected in one mouse sample in 2020, with a detection rate of 5.00%. Pseudomonas aeruginosa was detected in one mouse sample and mouse hepatitis virus antibody was detected in another mouse sample in 2023, with a detection rate of 2.78%, respectively. No microorganisms or parasites that should be excluded from SPF grade mice as specified in the national standards were detected in 2021, 2022, or 2024, with a qualification rate of 100.00%. Pasteurella pneumotropica was detected in four rat samples in 2020, with a detection rate of 20.00%. Pseudomonas aeruginosa was detected in two rat samples in 2021, with a detection rate of 10.00%, and Tyzzer's disease agent antibody was detected in four rat samples in 2024, with a detection rate of 10.00%. No microorganisms or parasites that should be excluded from SPF grade rats as specified in the national standards were detected in 2022 or 2023, with a qualification rate of 100.00%. For rabbits and guinea pigs, no microorganisms or parasites required to be tested for conventional grade rabbits and guinea pigs as specified in the national standards were detected from 2020 to 2024, with the qualification rate of both species reaching 100.00%. ConclusionBased on the microbial and parasitic testing results, the quality of rabbits and guinea pigs in Jiangxi Province is satisfactory. However, some issues persist with rats and mice. It is recommended to enhance the quality of experimental animals in Jiangxi Province by increasing the frequency of random inspections by quality testing units or by improving the self-inspection capabilities of production and user facilities.
2.Disease burden and changing trends of bladder cancer in China and globally in 1992 - 2021
Zhengnan LI ; Zhuang LI ; Yuanyuan LUO ; Bo YU ; Hao SU ; GuangYong CAO ; Kai YIN ; Dongbo YUAN ; Jianguo ZHU
Journal of Public Health and Preventive Medicine 2026;37(3):8-13
Objective To analyze the disease burden and trends of bladder cancer in China and globally from 1992 to 2021. Methods Using the GBD 2021 database, the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates of bladder cancer in China and globally from 1992–2021 were analyzed. Average annual percentage change (AAPC) was calculated using Joinpoint regression. Subgroup analyses by sex and age were conducted, and a Bayesian age-period-cohort (BAPC) model was used to predict trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for the next 15 years. Results In 2021, China reported 106 000 new cases (ASIR: 5.14/100 000), 571 000 prevalent cases (age-standardized prevalence rate, ASPR: 26.61/100 000), 43 000 deaths (ASMR: 2.34/100 000), and a DALY rate of 45.31/100 000. From 1992–2021, China showed upward trends in ASIR and ASPR but declines in ASMR and DALYs, while global ASIR, ASMR, and DALYs decreased overall with slow ASPR growth. The peak cases in China and globally were both concentrated in the 65-79 age group, with a significantly higher burden on males than females. In China, smoking-related ASMR and ASDR exceeded global averages and rose, whereas high glucose-related indexes were lower and declined. Projections for 2021–2036 indicated that the global incidence and mortality rates would be rising, but ASIR/ASPR would be declining, while in China, the incidence rate would continue to rise, and the mortality rate will stabilize, with a significant increase in ASIR and a gradual decrease in ASPR. Conclusion From 1992 to 2021, the incidence of bladder cancer in China has shown a continuous upward trend and is projected to persist in the future, with significant gender and age differences. Particular attention should be given to elderly males aged 85-89. The disease burden of bladder cancer attributable to smoking continues to rise, highlighting the urgent need to strengthen tobacco control policies.
3.Jianpi Xiao'ai Prescription Inhibits Colorectal Cancer Progression by Inducing Mitochondrial Dysfunction via Modulation of iNOS-ARG1 Axis
Xing LUO ; Bo PAN ; Jianfeng FU ; Jia HUANG ; Wei PENG ; Fang LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):99-111
ObjectiveTo investigate the mechanism by which Jianpi Xiao'ai prescription (JPXAP) inhibits colorectal cancer progression by regulating the inducible nitric oxide synthase-arginase 1 (iNOS-ARG1) metabolic axis and inducing mitochondrial reactive oxygen species (mito-ROS)-mediated mitochondrial structural and functional impairment. MethodsAn arginine metabolism disorder model of human colorectal cancer HCT116 cells was established by combined treatment with recombinant human interferon-γ (IFN-γ, 10 μg·L-1) and N(ω)-hydroxy-L-arginine (Nor-NOHA, 200 μmol·L-1) for 24 h, followed by intervention with 5%, 10%, or 20% JPXAP-containing serum. Cell proliferation was assessed using cell counting kit-8 (CCK-8), 5-ethynyl-2′-deoxyuridine (EdU) staining, and colony formation assays. Cell invasion and migration were evaluated using Transwell chamber and wound healing assays. Mitochondrial membrane potential (MMP) and ROS levels were assessed by JC-1 and MitoSOX staining, respectively. Mitochondrial ultrastructure was observed by transmission electron microscopy (TEM). The expression of iNOS, ARG1, and mitochondrial dynamics-related proteins, including mitofusin 2 (MFN2) and dynamin-related protein 1 (DRP1), was analyzed by Western blot and immunofluorescence. The levels of L-arginine, citrulline, and urea were determined by colorimetric methods and enzyme-linked immunosorbent assay (ELISA). ResultsCompared with the blank group, the model group exhibited significantly upregulated iNOS expression, downregulated ARG1 expression, a decreased ARG1/iNOS ratio, reduced L-arginine and urea levels, and increased citrulline levels (P<0.05). Meanwhile, mito-ROS accumulation was significantly increased, the JC-1 red/green fluorescence ratio was decreased, and mitochondria showed swelling and cristae disruption, indicating that metabolic disorder induced mitochondrial injury. Compared with the model group, all JPXAP-treated groups further decreased the ARG1/iNOS ratio, enhanced nitric oxide (NO) and reactive nitrogen species accumulation, further reduced L-arginine and urea levels, and increased citrulline levels (P<0.01). EdU-positive rate, colony formation rate, wound healing rate, and Transwell invasion number all decreased significantly with increasing serum concentration (P<0.01). Mito-ROS levels were further elevated, and the JC-1 red/green ratio further decreased. TEM revealed aggravated mitochondrial swelling and vacuolization. MFN2 expression was downregulated and DRP1 expression was upregulated (P<0.01),in a dose-dependent manner. ConclusionJPXAP further activates NO-mediated oxidative/nitrosative stress under arginine metabolism imbalance, inducing mito-ROS accumulation, MMP collapse, and mitochondrial dynamics imbalance, thereby inhibiting colorectal cancer cell proliferation and migration. These findings reveal an antitumor mechanism of JPXAP based on coordinated targeting of the "metabolism-mitochondria" axis.
4.Huoluo Xiaolingdan Suppresses Triple-negative Breast Cancer in Mice by Regulating TCF1+ CD8+ Stem Cell-like T Cells Infiltration
Bo LUO ; Qu ZHANG ; Yujie SUN ; Lin LIU ; Lan ZENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):108-115
ObjectiveTo investigate the inhibitory effect of Huoluo Xiaolingdan on triple negative breast cancer (TNBC) in mice through its regulation of TCF1+CD8+ stem cell-like T cells infiltration. MethodsA mouse model of TNBC was established and the mice were randomly divided into the model group, low-dose (3.9 g·kg-1), medium-dose (7.8 g·kg-1) and high-dose (15.6 g·kg-1) Huoluo Xiaolingdan groups, and anti-PD-1 antibody treatment group. Each group was given a dose of 0.01 mL·g-1, while the model group and the anti-PD-1 treatment group were also given an equivalent volume of normal saline. The drug was administered for 21 days. In the anti-PD-1 antibody group, mice were intraperitoneally injected with 100 μg of mouse anti-PD-1 antibody twice a week, for a total of five injections. The tumor volume, survival time and tumor mass were measured at different time points. Hematoxylin-eosin (HE) staining was used to observe the histological changes of the tumor. The expression of CD8+T cells and TCF1+CD8+ stem-like T cells in tumor tissues was detected by immunohistochemistry and immunofluorescence staining. Flow cytometry was used to detect the difference of immune cell subsets in tumors and the expression difference of TCF1+CD8+ stem cell-like T cells in tumors and peripheral blood. The expression level of PD-L1 in tumor tissues was detected by Western blot. ResultsCompared with model group, the tumor volume and mass of in low-, medium- and high-dose Huoluo Xiaolingdan groups and anti-PD-1 group were decreased (P<0.05, P<0.01). The median survival time of mice in low-, medium- and high-dose Huoluo Xiaolingdan groups and anti-PD-1 group was as follows: 27.00 days (95%CI, 0.45-2.65), 31.00 days (95%CI, 0.32-1.89), 34.00 days (95%CI, 0.40-2.33), and 35.00 days (95%CI, 0.42-2.47). All of them were higher than that of the model group [24.50 days (95%CI, 0.37-10.5)]. Flow cytometry showed that compared with the model group, the proportion and number of infiltrating CD8+ T cells in tumor were increased in low-, medium- and high-dose Huoluo Xiaolingdan groups and anti-PD-1 group (P<0.05, P<0.01), while the proportion of tumor regulatory T cells (Treg) and M2 macrophages decreased (P<0.05). Compared with the model group, the proportion of IFN-γ+CD8+ T and GrzB+CD8+ T cells in tumors in low-, medium- and high-dose Huoluo Xiaolingdan groups and anti-PD-1 group was increased (P<0.01), and the proportion of TCF1+CD8+ T cells in tumor and peripheral blood was also increased. Immunofluorescence staining further showed that the number of TCF1+CD8+ T cells in tumor tissues increased in low-, medium- and high-dose Huoluo Xiaolingdan groups. Western blot analysis showed no significant decrease in the PD-L1 protein expression in tumor tissues between the Huoluo Xiaolingdan groups and the model group. ConclusionHuoluo Xiaolingdan can inhibit TNBC in mice by increasing tumor infiltration of TCF1+CD8+ stem-like T cells, enhancing CD8+ T cell activity, and regulating immune cell subgroups such as M2 macrophages and Treg cells to enhance anti-tumor immunity. This study provides a theoretical basis for the clinical application of Huoluo Xiaolingdan in breast cancer treatment and combination therapy.
5.Preparation of polyphenol-mediated copper ion coating on titanium surface and antibacterial and antioxidant properties
Zhenju GUAN ; Yonglin XIE ; Shougang XIANG ; Chengdong ZHANG ; Xiaolong LI ; Xingping LI ; Chao PU ; Bo ZHANG ; Xuwei LUO ; Dongqin XIAO
Chinese Journal of Tissue Engineering Research 2025;29(10):1997-2005
BACKGROUND:Titanium implants are widely used in clinical practice because of their high strength and good biocompatibility.However,during implantation,bacterial infection and tissue damage environment produce a large number of reactive oxygen species,which can easily lead to delayed tissue healing and surgical failure.Consequently,the development of titanium implants with antimicrobial and antioxidant properties becomes paramount. OBJECTIVE:Considering the potent antimicrobial attributes of copper ions and the remarkable antioxidant qualities of polyphenols,we proposed the fabrication of polyphenol-mediated copper ion coatings on titanium surfaces.These coatings were subsequently assessed for their in vitro antimicrobial and antioxidant properties. METHODS:Nanostructures were generated on the titanium surface using the alkali thermal method.The titanium was immersed in a solution containing tannic acid and copper ions to achieve polyphenol-mediated copper ion coatings.The surface morphology and water contact angle were detected.The loading and release of copper ions were examined using atomic absorption spectroscopy.Staphylococcus aureus was inoculated on the surface of pure titanium sheet(blank group),alkali heat treated titanium sheet(control group),and polyphenol mediated copper ion modified titanium sheet(experimental group)to observe the bacterial survival status.Osteoblast precursor cells MC3T3-E1 were co-cultivated on the surface of three groups of titanium sheets to assess their antioxidant properties and bioactivity. RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that the polyphenol-mediated copper ion modified titanium sheet had rod-like nanostructures and no cracks on the surface.The surface hydrophilicity of copper ion modified titanium sheet mediated by polyphenol was close to that of pure titanium sheet.Atomic absorption spectrometry results showed a 51%increase in the loading capacity of copper ions after polyphenol mediation,with a uniform release of copper ions.(2)The antibacterial rates of titanium sheets in the blank group,control group,and experimental group were 0%,21.65%,and 93.75%,respectively.The live/dead staining and CTC staining showed that the live bacteria on the surface of titanium plates in the blank group were the most,and the live bacteria on the surface of titanium plates in the experimental group were the least.(3)The results of live/dead staining and CCK-8 assay showed that the three groups of titanium sheets had good cytocompatibility,and the titanium sheets in the experimental group were more conducive to the proliferation of MC3T3-E1 cells.Active oxygen fluorescence probe detection exhibited that compared with the other two groups,the fluorescence intensity of active oxygen on the surface of the experimental group was significantly reduced.The results of alkaline phosphatase and alizarin red S staining showed that the osteogenic differentiation and extracellular matrix mineralization of MC3T3-E1 cells on the surface of titanium sheets in the experimental group were stronger than those in the other two groups.(4)These results show that the polyphenol-mediated copper ion coating has strong antibacterial and antioxidant properties and promotes osteogenic differentiation.
6.Effect of oxymatrine on expression of stem markers and osteogenic differentiation of periodontal ligament stem cells
Jing LUO ; Min YONG ; Qi CHEN ; Changyi YANG ; Tian ZHAO ; Jing MA ; Donglan MEI ; Jinpeng HU ; Zhaojun YANG ; Yuran WANG ; Bo LIU
Chinese Journal of Tissue Engineering Research 2025;29(19):3992-3999
BACKGROUND:Human periodontal ligament stem cells are potential functional cells for periodontal tissue engineering.However,long-term in vitro culture may lead to reduced stemness and replicative senescence of periodontal ligament stem cells,which may impair the therapeutic effect of human periodontal ligament stem cells. OBJECTIVE:To investigate the effect of oxymatrine on the stemness maintenance and osteogenic differentiation of periodontal ligament stem cells in vitro,and to explore the potential mechanism. METHODS:Periodontal ligament stem cells were isolated from human periodontal ligament tissues by tissue explant enzyme digestion and cultured.The surface markers of mesenchymal cells were identified by flow cytometry.Periodontal ligament stem cells were incubated with 0,2.5,5,and 10 μg/mL oxymatrine.The effect of oxymatrine on the proliferation activity of periodontal ligament stem cells was detected by CCK8 assay.The appropriate drug concentration for subsequent experiments was screened.Western blot assay was used to detect the expression of stem cell non-specific proteins SOX2 and OCT4 in periodontal ligament stem cells.qRT-PCR and western blot assay were used to detect the expression levels of related osteogenic genes and proteins in periodontal ligament stem cells. RESULTS AND CONCLUSION:(1)The results of CCK8 assay showed that 2.5 μg/mL oxymatrine significantly enhanced the proliferative activity of periodontal stem cells,and the subsequent experiment selected 2.5 μg/mL oxymatrine to intervene.(2)Compared with the blank control group,the protein expression level of SOX2,a stem marker of periodontal ligament stem cells in the oxymatrine group did not change significantly(P>0.05),and the expression of OCT4 was significantly up-regulated(P<0.05).(3)Compared with the osteogenic induction group,the osteogenic genes ALP,RUNX2 mRNA expression and their osteogenic associated protein ALP protein expression of periodontal ligament stem cells were significantly down-regulated in the oxymatrine+osteogenic induction group(P<0.05).(4)The oxymatrine up-regulated the expression of stemness markers of periodontal ligament stem cells and inhibited the bone differentiation of periodontal ligament stem cells,and the results of high-throughput sequencing showed that it may be associated with WNT2,WNT16,COMP,and BMP6.
7.Chinese Medicine Regulates Ferroptosis to Treat Lung Cancer: A Review
Cheng LUO ; Yuanhang YE ; Bo NING ; Jia KE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):268-278
This article provides a systematic review of the research progress in the mechanisms related to lung cancer and ferroptosis, ferroptosis-related lung cancer biomarkers and gene mutation targets, and ferroptosis-targeted regulation of Chinese medicine in treating lung cancer in the past five years, providing a feasible and effective basis for the prevention and treatment of lung cancer with Chinese medicine and the development of new drugs. According to the available studies, ferroptosis is widely suppressed in lung cancer, while the specific regulatory mechanisms have not been fully elucidated. The suppression is related to lipid metabolism, iron metabolism, cystine/glutamate antiporter system Xc- (System Xc-)/glutathione (GSH)/glutathione peroxidase 4 (GPX4), ferroptosis suppressor protein 1 (FSP1)/coenzyme Q10 (CoQ10)/nicotinamide adenine dinucleotide phosphate [NAD(P)H], long non-coding RNA (lncRNA), nuclear factor E2-related factor 2 (Nrf2), and p53. In modern times, traditional Chinese medicine is widely used in the comprehensive treatment of lung cancer, and it has gradually become a hot research topic due to its obvious advantages of anti-tumor activity, high efficacy, and low toxicity. Traditional Chinese medicine plays an important role in the treatment of lung cancer. Studies have shown that the active components, extracts, and prescriptions of Chinese medicine can induce ferroptosis in lung cancer cells through targeted regulation of iron metabolism, lipid metabolism, and p53, Nrf2, LncRNA, and GPX4 pathways to inhibit the growth and proliferation of lung cancer, thus exerting anti-tumor effects. Therefore, regulating ferroptosis is expected to become a new direction for preventing lung cancer. Basic research has shown that Chinese medicine can regulate ferroptosis via multiple targets and pathways in the treatment of lung cancer. At present, Chinese medicine demonstrates great research prospects in regulating ferroptosis to treat lung cancer, which, howeve, still faces challenges to achieve clinical transformation.
8.Application of blended teaching methodology of "teaching-selection-investigation-analysis-presentation- discussion" in Medical Immunology
Shu MENG ; Yunping LUO ; Minghong JIANG ; Hui CHEN ; Jianmin ZHANG ; Bo HUANG ; Qin ZHANG ; Wei HE
Chinese Journal of Medical Education Research 2025;24(1):87-91
Objective:To explore the application effects of the blended teaching methodology of "teaching-selection-investigation-analysis-presentation-discussion" in Medical Immunology. Methods:Eight-year program clinical medical students who were enrolled at Peking Union Medical College in 2016, 2017, and 2018 were selected as the research subjects. An anonymous questionnaire survey was used to analyze students' multidimensional evaluations of the new teaching methodology. The percentage of frontier hotspot topics in the "Immunology Forum" was used to analyze the students' mastery of cutting-edge knowledge in immunology. The number of "Immunology Forum" related "College Students Innovative Training Plan Program" from 2020 to 2023 was used to analyze the effectiveness of this new teaching method in cultivating students' scientific research and innovation abilities. Statistical analysis was conducted using SPSS 25.0 software, and the normality of all continuous variables was assessed using the Shapiro-Wilk test.Results:The questionnaire survey showed 100.00% satisfaction with the course and 95.90% recognition of the new teaching method. More than 90% of students agreed that the new teaching method improved their learning ability, research ability, innovation ability, internal drive, and academic communication ability. The average proportion of hotspot topics in the "Immunology Forum" was 90.37%±7.12%, which was significantly higher than the proportion of non-hotspot topics (5.67%±3.12%). The average number of topics related to "Immunology Forum" in the "College Students Innovative Training Plan Program" was 17.67±1.15 per session, which was significantly higher than the number of topics not related to "Immunology Forum" (8.00±1.73).Conclusions:The blended teaching methodology of "teaching-selection-investigation-analysis-presentation-discussion" can help students timely grasp the cutting-edge knowledge of immunology, cultivate their learning ability, internal drive, academic communication ability, innovation ability, and research ability, and lay a foundation for students to further explore their scientific research and innovation activities.
9.Knockdown of GPER1 aggravates neuronal injury and cognitive dysfunction after epilepsy
Shi-jie HAO ; Yi-jin LUO ; Xiao-fan REN ; Na DING ; Jing-bo CAO ; Qian ZHAO ; Wei HE ; Shao-zhang HOU ; Di ZUO
Chinese Pharmacological Bulletin 2025;41(7):1332-1339
Aim To investigate the impact of G pro-tein-coupled estrogen receptor 1(GPER1),also known as GPR30 playing a significant role in the nerv-ous system,on neuronal damage and cognitive dysfunc-tion following epileptic seizures.Methods The pro-tein expression levels of GPER1 and the DNA damage marker γ-H2AX in epileptic rats were assessed using Western blot.The hippocampal neuronal damage and apoptosis in pilocarpine-induced epilepsy models were evaluated using Nissl and TUNEL staining techniques,compared with GPER1 knockdown(GPER1-KD)rats with wild-type(WT)controls.The behavioral activi-ties,including memory and spatial learning,were mo-nitored during the chronic phase of epilepsy using the IntelliCage system.Results Compared to the control group,GPER1 protein expression in the cerebral cortex and hippocampus significantly increased 24 hours post-epilepsy onset.In the GPER1-KD+EP group,hipp-ocampal neuronal damage was more severe,with a sig-nificant increase in apoptotic neurons compared to the WT+EP group.The IntelliCage data revealed that during free exploration,nose contact,position learn-ing,and reverse position learning stages in the GPER1-KD+EP group exhibited fewer visits and a higher error rate than in the WT+EP group.Conclu-sions Deficiency in GPER1 impairs memory and spa-tial learning abilities following epilepsy,potentially due to exacerbated neuronal injury,apoptosis,and inflam-mation.GPER1 represents a promising therapeutic tar-get for mitigating post-epileptic nerve damage and cog-nitive impairment.
10.The value of Th17/Treg imbalance in the evaluation of intravenous immunoglobulin resistance in children with Kawasaki disease and Kobayashi score ≤4
Bo XIE ; Lan LUO ; Haiyan LUO ; Longgui YANG ; Jianghua FAN ; Lihui LIU ; Wei DUAN ; Nianci CHENG
Chinese Pediatric Emergency Medicine 2025;32(7):488-494
Objective:To investigate the value of T helper 17 cells(Th17)/regulatory T cells(Treg)imbalance in the evaluation of intravenous immunoglobulin(IVIG)resistance in children with Kawasaki disease and Kobayashi score≤4.Methods:A total of 78 children with Kawasaki disease and Kobayashi score ≤ 4 admitted to Hunan Children's Hospital from January 2020 to December 2023 were prospectively selected as the study subjects,all of whom received IVIG treatment.In the acute phase,the proportion of Th17 cells and Treg cells was detected.Children were divided into IVIG sensitive group and IVIG resistance group based on their responsiveness to IVIG treatment.Baseline data of children with different IVIG treatment responsiveness,acute Th17 cell inflammatory factors [interleukin(IL)-17,IL-21,tumor necrosis factor-α(TNF-α)],Treg cell inflammatory factors [IL-10,IL-35,transforming growth factor-β(TGF-β)] levels,and Th17/Treg values were compared.The correlation between Th17/Treg values and IVIG resistance in children with Kawasaki disease was analyzed using a restricted cubic spline model(RCS).According to the threshold of correlation between Th17/Treg values obtained from RCS analysis and drug resistance in children,Th17/Treg was grouped,with a focus on analyzing the predictive value and clinical benefits of Th17/Treg values for IVIG resistance in children with Kawasaki disease.Results:Among the 78 children with Kawasaki disease,16 were resistant to IVIG treatment,accounting for 20.51%.The levels of C-reactive protein(CRP),IL-17,and Th17/Treg in the acute phase of children in the IVIG resistance group were higher than those in the IVIG sensitive group,while the levels of IL-10 were lower than those in the IVIG sensitive group( P<0.05).RCS analysis showed that there was a non-linear dose-response relationship between IVIG resistance and acute Th17/Treg values in children with Kawasaki disease( P<0.05).When the acute Th17/Treg value was greater than 1.05,the risk of IVIG resistance in children with Kawasaki disease increased with the increase in indicator levels.The levels of CRP and IL-17 in the acute phase of children with Th17/Treg>1.05 were higher than those in the Th17/Treg < 1.05 group,while IL-10 levels were lower than those in the Th17/Treg<1.05 group.The proportion of children resistant to IVIG treatment was higher than that in the Th17/Treg<1.05 group( P<0.05).Multivariate Logistic regression analysis showed that CRP,IL-17,IL-10,and Th17/Treg were the influencing factors of IVIG resistance in children with Kawasaki disease( P<0.05).It was found through a nomogram that the C-index of the acute phase Th17/Treg values and their secretion of inflammatory factors in children with Kawasaki disease and Kobayashi score ≤ 4,as well as other major indicators,predicted the risk of IVIG resistance.The C-index was 0.975(95% CI 0.944-1.000),indicating good discrimination.When drawing the decision curve,it was found that compared to using each indicator separately,the Th17/Treg value and its secreted inflammatory factors in the acute phase assisted other major indicators in drawing the decision curve with a higher net benefit rate,with a maximum net benefit rate of 0.205. Conclusion:IVIG resistance in children with Kawasaki disease and Kobayashi score≤4 is related to Th17/Treg imbalance.When the Th17/Treg value in the acute phase of the disease is greater than 1.05,the risk of IVIG resistance is higher.The inflammatory factors IL-17 and IL-10 secreted by the two can assist other known indicators related to IVIG resistance in Kawasaki disease patients,improving the accuracy of predicting resistance risk.


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