1.Effect of Shixiaosan on Neurological Function and Ferroptosis in Rats with Cerebral Ischemia-reperfusion Injury Based on Nrf2/SLC7A11/GPX4 Signaling Pathway
Ying WEI ; Lixia WANG ; Junjun YIN ; Xiaohong CHEN ; Lijuan SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):22-31
ObjectiveTo investigate whether Shixiaosan can improve neurological function and inhibit ferroptosis in rats with cerebral ischemia-reperfusion injury (CIRI) by regulating the nuclear factor E2-related factor 2 (Nrf2)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway. MethodsA rat model of CIRI was established using the intraluminal filament method. Briefly, cervical blood vessels were separated, branches of the external carotid artery were ligated, and the common carotid artery and internal carotid artery were clamped. A nylon filament was inserted through the opening of the external carotid artery to the origin of the middle cerebral artery to block blood flow and induce cerebral ischemia. After 60-120 min of ischemia, the filament was withdrawn to restore blood flow, and the external carotid artery incision was ligated. The rats were divided into a CIRI group, a Shixiaosan low-dose (-L) group (intragastric administration of 1.26 g·kg-1 Shixiaosan), a Shixiaosan high-dose (-H) group (intragastric administration of 2.52 g·kg-1 Shixiaosan), a donepezil hydrochloride tablet (DON) group (intragastric administration of 0.45 mg·kg-1 DON), and a Shixiaosan -H + Nrf2 inhibitor (ML385) group (intragastric administration of 2.52 g·kg-1 Shixiaosan combined with intraperitoneal injection of 30 mg·kg-1 ML385). An additional 12 rats underwent cervical artery separation followed by incision suturing and served as the control group. Equal volumes of double-distilled water were administered to the CIRI and control groups. Neurological function impairment was assessed using the modified Garcia JH score. Magnetic resonance imaging was used to determine the cerebral infarct volume ratio. Hematoxylin-eosin (HE) staining and Prussian blue staining were performed to observe neuronal injury and iron accumulation in the ischemic penumbra, respectively. Transmission electron microscopy was used to examine the ultrastructure of neuronal mitochondria in the ischemic penumbra. Commercial kits were used to measure ferrous iron (Fe2+), malondialdehyde (MDA), reduced glutathione (GSH) content, and reactive oxygen species (ROS) activity in the ischemic penumbra. The BODIPY (581/591) C11 fluorescent probe was used to detect intracellular lipid peroxidation levels. Western blot was performed to detect protein expression levels of Nrf2, SLC7A11, GPX4, transferrin receptor 1 (TFRC), ferritin heavy chain (FHC), and ferritin light chain (FLC) in the ischemic penumbra. ResultsCompared with the control group, the CIRI group exhibited neuronal injury in the ischemic penumbra, characterized by reduced neuron numbers, nucleolar shrinkage, and interstitial edema. Marked iron accumulation was observed in the tissue. Neuronal mitochondria showed atrophy and rupture, with reduced mitochondrial cristae and increased membrane density. The cerebral infarct volume ratio, Fe2+ content, MDA content, ROS activity, and lipid peroxidation levels were increased, whereas the modified Garcia JH score, GSH content, and protein expression levels of Nrf2, SLC7A11, GPX4, FHC, and FLC were decreased, and TFRC protein expression was increased (P<0.05). Compared with the CIRI group, the Shixiaosan -L group, Shixiaosan -H group, and DON group showed attenuated neuronal injury in the ischemic penumbra, reduced iron accumulation, alleviated mitochondrial damage, decreased cerebral infarct volume ratio, Fe2+ and MDA contents, ROS activity, and lipid peroxidation levels, as well as increased modified Garcia JH scores, GSH content, and protein expression levels of Nrf2, SLC7A11, GPX4, FHC, and FLC, while TFRC protein expression was decreased (P<0.05). The magnitude of changes in all indicators was greater in the Shixiaosan -H group than in the Shixiaosan -L group (P<0.05). Compared with the Shixiaosan -H group, all measured indicators in the Shixiaosan -H + ML385 group showed opposite trends (P<0.05). ConclusionShixiaosan may inhibit ferroptosis and restore neurological function in rats with CIRI by activating the Nrf2/SLC7A11/GPX4 pathway.
2.Mechanism of Yangjing Zhongyutang in Regulating SIRT1/PGC-1α Signaling Pathway to Promote Mitochondrial Function and Alleviate Oxidative Stress Damage in Rats with Diminished Ovarian Reserve
Ping ZHANG ; Lijuan YANG ; Shenghui CHEN ; Wenliang YAO ; Yuliang ZHOU ; Ling MA ; Huiying WU ; Yanwen XU ; Ziyan ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):46-55
ObjectiveTo observe the effects of Yangjing Zhongyutang (YJZYT) on mitochondrial biogenesis and oxidative stress damage mediated by the silent information regulator 1 (SIRT1)/peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC-1α) signaling pathway in cyclophosphamide (CTX)-induced rats with diminished ovarian reserve (DOR), and to explore its mechanism in improving ovarian reserve function and follicular development. MethodsForty-two 8-week-old female SD rats with normal estrous cycles were randomly divided into a blank control group (n=7) and a model group (n=35). Rats in the model group received a single intraperitoneal injection of CTX (90 mg·kg-1) to establish the DOR model. After modeling, estrous cycles were monitored for 7 consecutive days, and model success was confirmed based on criteria for estrous cycle disruption. After successful modeling, rats were divided into groups for intervention: estradiol valerate group (0.09 mg·kg-1), and YJZYT high-, medium-, and low-dose groups (19.98, 9.99, 5.00 g·kg-1). The blank control group and model group were given an equal volume of distilled water by gavage. All groups received daily gavage once for 4 consecutive weeks. The general state, body weight, and ovarian wet weight of rats were observed and recorded, and the ovarian organ index was calculated. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), anti-Müllerian hormone (AMH), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px). Hematoxylin-eosin (HE) staining was performed to observe ovarian histomorphological changes and follicular development status. Immunofluorescence was used to detect reactive oxygen species (ROS) expression levels. Colorimetric assays were employed to measure adenosine triphosphate (ATP) and malondialdehyde (MDA) content in ovarian tissues. Quantitative Real-time polymerase chain reaction (Real-time PCR) was used to detect mitochondrial DNA (mtDNA) copy number and the mRNA expression levels of key genes including SIRT1, PGC-1α, nuclear respiratory factor 1 (NRF1), and mitochondrial transcription factor A (TFAM). Western blot was performed to detect the protein expression levels of SIRT1, PGC-1α, NRF1, and TFAM. ResultsCompared with the blank group, rats in the model group exhibited disrupted estrous cycles, obviously reduced body weight, and decreased ovarian index (P<0.05). Ovarian histopathology revealed cortical thinning, loose structure, and a significant reduction in both primordial and growing follicles (P<0.01). Serum FSH and LH levels were significantly elevated (P<0.01), while E2 and AMH levels were obviously reduced (P<0.05, P<0.01). ATP content and mtDNA copy number decreased in ovarian tissue (P<0.01), ROS expression increased, MDA levels rose, while SOD and GSH-Px activities obviously decreased (P<0.05, P<0.01), mRNA and protein expression levels of SIRT1, PGC-1α, NRF1, and TFAM were obviously downregulated (P<0.05, P<0.01). After treatment, compared with the model group, body weight and ovarian index obviously recovered in rats administered various doses of YJZYT (P<0.05), serum E2 and AMH levels increased, while FSH and LH levels obviously decreased (P<0.05, P<0.01), ovarian tissue ATP content and mtDNA copy number were up-regulated, ROS and MDA levels decreased, and antioxidant enzymes SOD and GSH-Px activity obviously increased (P<0.05, P<0.01), Gene and protein expression levels related to the SIRT1/PGC-1α /NRF1/TFAM signaling pathway were obviously up-regulated compared to the model group (P<0.05, P<0.01), HE staining revealed that ovarian structure gradually recovered to integrity in all treatment groups, with a obviously increase in the number of primordial and growing follicles (P<0.05, P<0.01). Granulosa cells were neatly arranged, indicating marked improvement in ovarian function. ConclusionYJZYT may improve ovarian function and follicular development in rats with diminished ovarian reserve by activating the SIRT1/PGC-1α signaling pathway, promoting mitochondrial biogenesis, enhancing mitochondrial function, and alleviating oxidative stress damage.
3.Association of vegetables and fruits intake with depressive symptoms in Yunnan multi ethnic first year junior high school students
CHEN Yiyao*, DU Yeming, YIN Wan, HUANG Jianhong, LIU Zihan, JIANG Yinghong, YU Qiaoying, PAN Lijuan, XU Honglü ;
Chinese Journal of School Health 2026;47(1):32-36
Objective:
To explore the association of vegetables and fruits intake with depressive symptoms among multi ethnic first year junior high school students in Yunnan Province, so as to provide data support for preventing and reducing depressive symptoms among first year junior high school students.
Methods:
From October to December 2022, a cluster random sampling method was used to select 8 500 first year junior high school students from 11 ethnic minority areas in Yunnan Province (Fugong County, Longling County, Longyang District, Luchun County, Mojiang County, Nanjian County, Qiaojia County, Shuangjiang County, Tengchong City, Yuanmou County, Zhenyuan County), to investigate with a questionnaire. The Dietary Frequency Questionnaire was used to collect dietary behavior datas, and the Chinese version of Depression Anxiety Stress Scale-21 (DASS-21) was used to assess depressive symptoms. The generalized linear model was used to analyze the association of vegetable and fruit intake with depressive symptoms in students, and stratified analysis was performed according to ethnicity.
Results:
The detection rate of depressive symptoms among first year junior high school students in Yunnan Province was 29.5%. The detection rates of depressive symptoms in Han and minority first year junior high school students were 26.9% and 31.6%. After controlling for demographic variables such as gender, age, family residence and other confounding factors, the generalized linear model analysis results showed that the intake of leafy vegetables ( β= -0.07 , 95%CI =-0.12 to -0.01), flat fruits ( β=-0.06, 95%CI =-0.12 to -0.00) and hot natured fruits ( β=0.11, 95%CI = 0.04- 0.17) were associated with depressive symptoms in Han first year junior high school students (all P <0.05). The intake of melon and fruit vegetables ( β=-0.06, 95%CI =-0.11 to -0.01) and hot natured fruits ( β=0.06, 95%CI =0.01-0.12) were associated with depressive symptoms in ethnic minority first year junior high school students (both P <0.05).
Conclusions
The intake of vegetables and fruits among multi ethnic first year junior high school students in Yunnan Province is related to the risk of depressive symptoms. It is suggested to strengthen the consumption guidance and education of vegetables and fruits to prevent depressive symptoms among first year junior high school students.
4.Association of personality and sleep quality with psychological distress of junior and senior high school stduents
Chinese Journal of School Health 2026;47(1):65-69
Objective:
To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health.
Methods:
In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress.
Results:
The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ).
Conclusions
Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.
5.Study on the molecular mechanisms by which gut microbiota dysbiosis promotes the development of cholangiocarcinoma through immunometabolic reprogramming
FANG Chen ; KE Xi△ ; SHI Lijuan
Chinese Journal of Cancer Biotherapy 2026;33(4):429-438
[摘 要] 目的:通过多组学整合分析,解析肠道菌群在胆管癌(CCA)发生发展中的潜在作用机制并识别相关关键基因。方法:基于SRA数据库的16S rRNA测序数据,比较CCA患者与健康对照者的肠道菌群组成;采用孟德尔随机化(MR)分析评估菌群与CCA风险的遗传关联。通过gutMGene和GeneCards数据库获取相关代谢物与基因,进行代谢和功能富集分析。整合GEO单细胞转录组数据(GSE213452),解析肿瘤微环境的细胞组成,重点关注T细胞亚群及其功能状态,并结合TCGA-CHOL数据集验证关键候选基因的表达差异。结果:与健康对照组相比,CCA患者肠道菌群组成发生显著改变,变形菌门下菌群异常富集(LDA > 4)。MR分析进一步证实,肠杆菌目与肠杆菌科的遗传易感性均与CCA风险呈正向关联。代谢通路富集分析提示,菌群相关代谢物主要参与嘌呤代谢及糖酵解/糖异生等通路;功能富集分析显示,相关基因显著富集于NOD样受体、IL-17、Toll样受体及NF-κB信号通路等炎症免疫通路。单细胞转录组分析结果显示,CCA组织中肿瘤细胞比例显著升高(P < 0.05),T细胞比例由20.7%增至39.2%;拟时序分析结果表明,MKI67⁺ T细胞处于分化末期并呈高增殖特征,其差异基因与菌群相关基因存在交集,其中SERPINA1和IFNG表达在肿瘤免疫微环境中显著变化(P < 0.001),可能发挥核心调控作用。TCGA-CHOL数据集验证显示,SERPINA1在CCA肿瘤组织中显著下调(P < 0.001),而IFNG在肿瘤与正常组织间无显著差异(P > 0.05)。结论:肠道菌群失衡(尤其是肠杆菌科异常增殖)可能通过代谢-免疫调控网络促进CCA进展,T细胞功能变化与关键基因(SERPINA1和IFNG)在MKI67+ T细胞中的差异化表达模式密切相关。
6.Timing of Termination and Cost-Effectiveness Analysis of Acupuncture for Acute Peripheral Facial Paralysis:A Randomized Controlled Trial
Xiaohan ZHANG ; Tao WANG ; Jinbo WANG ; Yiwen MIAO ; Lijuan DAI ; Jiaying ZHANG ; Shulan WANG ; Hui WANG ; Guoxin WANG ; Yuhang CHEN ; Xinjun WANG ; Bingguo XU
Journal of Traditional Chinese Medicine 2026;67(11):1185-1191
ObjectiveTo investigate the optimal termination time for acupuncture in treating patients with acute peripheral facial paralysis and its cost-effectiveness. MethodsA total of 120 eligible patients with acute-stage peri-pheral facial paralysis were randomly assigned to either the mild dysfunction termination group and the complete recovery termination group, with 60 patients in each group. Both groups received the standard acupuncture treatment protocol. Treatment in the mild dysfunction termination group was terminated when the Sunnybrook facial grade scale (SFGS) score first reached or exceeded 83 points, while that in the complete recovery termination group was terminated when the SFGS score first reached or exceeded 95 points. Assessments were conducted before treatment, 6 and 12 months after onset. SFGS, facial disability index (FDI) including physical function (FDIp) and social function (FDIs), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores were assessed before treatment, and 6 and 12 months after onset. Any acupuncture-related adverse events during treatment were recorded for safety evaluation. Treatment sessions and medical costs including direct costs, indirect costs, insurance coverage, total societal costs, and patient out-of-pocket expenses were also recorded, and an economic evaluation was conducted including cost-effectiveness ratio (CER) and incremental cost-effectiveness ratio (ICER). ResultsUltimately, 56 patients in the mild dysfunction termination group and 55 in the complete recovery termination group completed the follow-up. At 6 and 12 months after onset, SFGS and FDIp scores in both groups improved significantly while FDIs, SAS and SDS scores decreased (P<0.05). Comparison of scores between groups 6 months and 12 months after onset showed no statistically significant differences (P>0.05). During the trial, the incidence of adverse events was 13.3% (8/60) in the mild dysfunction termination group and 18.3% (11/60) in the complete recovery termination group, with no statistically significant difference (P>0.05). The number of treatment sessions, total social costs, and out-of-pocket expenses in the mild dysfunction termination group were significantly lower than those in the complete recovery termination group (P<0.05). The CER of the mild dysfunction termination group in SFGS, FDIp, FDIs, SAS, and SDS scores was lower than that of the complete recovery termination group. The ICER analysis showed that continuing treatment until full recovery incurred an additional cost of 573.30 CNY/point in SFGS improvement, whereas 1-point improvement in FDIp, FDIs, SAS, and SDS required 21,355.25 CNY, 1779.60 CNY, 3713.96 CNY, and 2755.52 CNY, respectively. ConclusionFor acupuncture in treating acute peripheral facial palsy, terminating treatment when mild dysfunction is achieved yields long-term efficacy comparable to that of continuing treatment until complete recovery, while significantly reducing medical costs and socioeconomic burden.
7.Traditional Chinese Medicine Regulates AMPK Signaling Pathway to Prevent and Treat Non-alcoholic Fatty Liver Disease: A Review
Lijuan DAN ; Shuanglan CHEN ; Tianyuan WANG ; Xiaojie YOU ; Xiuyan LI ; Hongfei SONG ; Dong WANG ; Jie MU ; Qiao LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):133-143
Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent forms of liver diseases globally. Its progression can lead to cirrhosis and end-stage liver disease, and there is currently a lack of effective pharmacological treatments. Adenosine monophosphate-activated protein kinase (AMPK), as a regulatory hub for maintaining cellular energy homeostasis, can coordinate key cellular processes such as adipogenesis, glucose metabolism, and mitochondrial functions. Its activation exerts metabolic regulatory effects through pathways including inhibiting lipogenesis, enhancing mitochondrial β-oxidation, regulating inflammation and oxidative stress, and promoting autophagy. Accordingly, AMPK emerges as a potential target for the prevention and treatment of NAFLD. Traditional Chinese Medicine (TCM), with low toxicity, high accessibility, and multi-component, multi-target synergistic effects, has demonstrated unique value in NAFLD treatment, particularly showing notable advantages in regulating the AMPK signaling pathway. Sichuan is known as the treasure house of TCM, and the active components of its authentic medicinal materials such as Coptidis Rhizoma not only reflect regional characteristics in AMPK signaling regulation but also form a multi-level metabolic regulatory network through crosstalk with pathways such as sirtuin 1 (SIRT1) and peroxisome proliferator-activated receptor α (PPARα). They can achieve specific regulation by directly activating AMPK and modulating upstream and downstream targets, exerting prominent effects in ameliorating hepatic steatosis and inflammation. This study systematically reviews the research findings on TCM for the prevention and treatment of NAFLD over the past five years, elaborating the mechanisms by which TCM treats NAFLD through regulating the AMPK signaling pathway. It aims to provide new perspectives and references for clinical diagnosis and treatment, basic research, and drug development.
8.Retrospective study on adverse prognosis of neonates with late onset sepsis and invasive procedures in neonatal intensive care unit
Mengwen CHEN ; Chengyi FENG ; Jianfang WANG ; Ying LIU ; Hui WANG ; Haiying SONG ; Rongping ZHU ; Lin ZHANG ; Yu WANG ; Lijuan GAO ; Fang HE
Chinese Journal of Infection Control 2025;24(6):782-788
Objective To investigate the incidence and adverse prognosis of late onset sepsis(LOS)in neonates in neonatal intensive care unit(NICU).Methods A retrospective study was conducted to collect and analyze the peri-natal condition,underlying diseases,invasive procedures,and adverse prognosis of neonates in NICU of a regional maternal and child healthcare hospital from 2019 to 2023.According to whether LOS occurred during hospitaliza-tion,neonates were divided into LOS group and non-LOS group.The LOS group was divided into 5 subgroups based on whether invasive procedures were performed:LOS plus umbilical vein catheter(UVC)group,LOS plus peripherally inserted central catheter(PICC)group,LOS plus sequential catheter group,LOS plus tracheal intuba-tion group,and LOS plus lumbar puncture group,the relationship between LOS and adverse prognosis was ana-lyzed.Results Among 2 945 neonates in NICU,354(12.02%)developed LOS.Comparison between LOS groups and non-LOS group were as follows:in term of perinatal condition of neonates,there were statistically significant difference in weight,gestational age,and whether they were twins between the two groups(all P<0.001);in term of underlying diseases,there were statistically significant differences in the number of cases of maternal gestational hypertension,neonatal asphyxia,neonatal congenital heart disease,neonatal ventricular dilation,neonatal pneumo-nia,neonatal hyperthyrotropinemia,and neonatal anemia,as well as five invasive procedures between the two groups(all P<0.05).Compared with the non-LOS group,the incidences of retinopathy of prematurity(ROP),neonatal necrotizing enterocolitis(NNEC),bronchopulmonary dysplasia(BPD),and neonatal respiratory distress syndrome(NRDS)in LOS group were all higher(all P<0.001).Regression analysis showed that compared with the non-LOS groups,the risk of ROP increased in the LOS group and its subgroups,with the LOS plus sequential catheter group having a 2.27-fold higher risk of ROP than non-LOS group;the risk of NNEC increased in the LOS group and its subgroups,with the LOS plus UVC group having an 8.29-fold higher risk of NNEC than the non-LOS group.Except for the LOS plus UVC group,the risk of BPD increased in the LOS group and other subgroups,with the LOS plus PICC group and LOS plus sequential catheter group having 4.68-and 4.64-fold higher risk of BPD than the non-LOS group,respectively;the risk of NRDS in the LOS plus PICC group was 6.84-fold higher than the non-LOS group(all P<0.05).The top three pathogens causing LOS were coagulase negative Staphylococcus,Klebsiella pneumoniae,and Escherichia coli.Conclusion LOS can significantly increase the risks of ROP,NNEC,BPD,and NRDS.LOS plus invasive procedures can further increase the risk of adverse prognosis.
9.Effect of measurement site on diagnostic performance of CT-derived fractional flow reserve
Yutao ZHOU ; Na ZHAO ; Yunqiang AN ; Lei SONG ; Chaowei MU ; Jingang CUI ; Tao JIANG ; Li XU ; Hongjie HU ; Lin LI ; Dumin LI ; Wenqiang CHEN ; Lijuan FAN ; Feng ZHANG ; Yang GAO ; Bin LYU
Chinese Journal of Radiology 2025;59(6):704-711
Objective:To investigate the effect of CT-derived fractional flow reserve (CT-FFR) measurement sites on the values and the diagnostic performance, and to determine the optimal measurement site for CT-FFR using invasive FFR as the reference standard.Methods:This study was part of the CT-FFR CHINA clinical trial. Patients with suspected coronary artery disease who were scheduled for invasive coronary angiography (ICA) were prospectively recruited from five clinical centers across the country from November 2018 to March 2020. Each enrolled patient underwent coronary CT angiography (CCTA), CT-FFR, ICA, and invasive pressure wire-based FFR assessments sequentially within one week. Four groups of CT-FFR values were obtained on each enrolled target vessels according to different CT-FFR measurement locations: 1, 2, 3 cm distal to the target lesion, and terminal vessel groups. Spearman and Bland-Altman analyses were used to explore the correlation and consistency of CT-FFR values and FFR values at different measurement sites. The measurement deviation of CT-FFR was also compared. Diagnostic accuracy and performance of CT-FFR, including sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC), in discriminating myocardial ischemia were analyzed across all measurement site groups on a per-vessel level, using FFR as the reference standard.Results:A total of 289 patients with 345 target lesion vessels were included. According to CCTA, there were 51 target vessels (14.8%) with<50% stenosis, 106 vessels (30.7%) with 50%-69% stenosis, and 188 vessels (54.5%) with stenosis≥70%. At per-vessel level, CT-FFR and FFR values at each measurement position group were highly positively correlated: 1 cm distal to target lesion group, r=0.734 ( P<0.001); 2 cm distal to target lesion group, r=0.732 ( P<0.001); 3 cm distal to target lesion group, r=0.737 ( P<0.001); terminal vessel group was 0.719 ( P<0.001). At per-vessel level, CT-FFR and FFR values of all measurement sites were in good agreement (Bland-Altman analysis results): 1 cm distal to target lesion group, 0.014 (95% LoA 0.002-0.026); 2 cm distal to target lesion group, 0.026 (95% LoA 0.015-0.038); 3 cm distal to target lesion group, 0.040 (95% LoA 0.039-0.051); terminal vessel group, 0.075 (95% LoA 0.064-0.087). And at per-vessel level, the accuracy of diagnosing myocardial ischemia with CT-FFR at 1 cm was highest [84.6% (95% CI 80.4%-88.3%)], and the lowest accuracy in the terminal vessel group [67.0% (95% CI 61.7%-72.0%)]. However, there was no significant difference in the diagnostic accuracy of CT-FFR at 1 cm, 2 cm [80.6% (95% CI 76.1%-84.6%)] and 3 cm [77.5% (95% CI 72.6%-81.7%)]. AUC of CT-FFR at 1 cm distal to the lesion were both highest for global level and moderately stenosis (50%-69%) lesions [0.85 (95% CI 0.81-0.89), 0.84 (95% CI 0.77-0.90)]. And the differences were statistically significant among the four measurement location groups (all P<0.05). Conclusions:The deviation of CT-FFR increases with measurement site distance distal to target lesions. One centimeter distal to the target lesion is the optimal measurement site, and the CT-FFR value here shows the highest diagnostic performance for myocardial ischemic lesions, especially for moderate stenosis.
10.Vascularization characteristics of tissue-engineered oral mucosa equivalents
Lijuan SHI ; Jian WEI ; Xuan ZHANG ; Lingxiao HE ; Xiaoxi JIANG ; Minhai NIE ; Jiana CHEN ; Xuqian LIU
Chinese Journal of Tissue Engineering Research 2025;29(22):4748-4760
BACKGROUND:In previous studies,the equivalent structure of three-dimensional cell reconstruction of tissue engineering oral mucosa is similar to normal oral mucosa,including epithelial-like structure,lamina propria-like structure,and vascular lumen-like structure,and has initially achieved the establishment of vascular equivalent,but its vascularization characteristics are not very clear.OBJECTIVE:Vascular-like structures of vascularized oral mucosa equivalent were obtained by targeting vascular endothelial cells specific marker expression profiles correlated with laser capture microdissection system,and their vascularization ability was evaluated to reveal their vascularization characteristics.METHODS:Human gingival epithelial cells were cultured from human gingival epithelium and human gingival fibroblasts,human gingival mesenchymal stem cells were cultured from human gingival lamina propria.Human gingival mesenchymal stem cells were induced to differentiate into vascular endothelial-like cells after monoclonal expansion culture.Human gingival epithelial cells,human gingival fibroblasts,and vascular endothelial-like cells were loaded with acellular vascular matrix-0.25%human-like collagen type Ⅰ scaffold to construct the vascularized oral mucosa equivalent.The layered structure of oral mucosa equivalent(experimental group)and the acellular vascular matrix-0.25%human-like collagen type Ⅰ scaffold(control group)were implanted subcutaneously into the back of nude mice,respectively.14 days later,the incision surface of the two groups was coated with biogel.The biogel surface of the experimental group was inoculated with human gingival epithelial cells,while the control group was not inoculated with cells.The samples were collected after 14 days of feeding.The layered structure of oral mucosa equivalent was observed by morphology.The neovascular-like structures in oral mucosa equivalents were labeled by immunohistochemistry and immunofluorescence with a more comprehensive expression profile of vascular endothelial cells,and the vascularization characteristics were analyzed.A laser capture microdissection system was used to capture the neovascularization structures in the oral mucosa equivalents specifically labeled by immunohistochemistry and analyze their vascularization characteristics.RESULTS AND CONCLUSION:(1)The morphology showed that the cell level of oral mucosa equivalent was clear,and the structure was similar to that of normal oral mucosa,that is,there were epithelioid structures,lamina-like structures,and vascular cavelike structures,and there were scattered erythrocytes in the vascular cavelike structures.(2)The results of EdU Apollo tracer seed cells in the oral mucosa equivalent group showed that human gingival epithelial cells labeled with EdU Apollo 488 showed green fluorescence expression.DAPI labeled human gingival fibroblasts showed blue fluorescence expression and formed lamina-like structures in vivo.EdU Apollo 567 labeled vascular endothelial-like cells showed red fluorescence expression and formed a vascular-like structure in vivo.(3)Vascular endothelial cell specific marker expression profile immunofluorescence labeling of vascular structure showed that compared with normal oral mucosa,the expressions of CD31,CD51,CD54,CD105,Tie-2,VWF,vascular endothelial growth factor receptor 1,and vascular endothelial growth factor receptor 2 in oral mucosa equivalents were increased(P<0.000 1).There were no significant changes in CD34 expression(P>0.05).(4)Compared with the specifically labeled oral mucosal vascular structures,the expression levels of CD51,CD54,CD105,Tie-2,VWF,vascular endothelial growth factor receptor 1,and vascular endothelial growth factor receptor 2 of the oral mucosa equivalents targeted by the laser capture microdissection system were increased(P<0.000 1).There were no significant changes in expression of CD31 and CD34(P>0.05).(5)The results showed that the oral mucosa equivalent reconstructed by three-dimensional cell stratification could achieve good vascularization,and its vascularization characteristics were consistent with the immunological function and characteristics of neovascularization.Vascularization helps three-dimensional cell layer reconstruction of oral mucosa equivalent regeneration.


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