1.Association Between Abnormal Body Weight and Physical Fitness Levelsin Chinese Older Adults: Findings from the 5th National PhysicalFitness Surveillance in China
Chaoqun FAN ; Mei WANG ; Qiang FENG ; Jingjing WANG ; Dongming WU ; Zonghao SUN ; Jiarong ZHU ; Yini WU
Medical Journal of Peking Union Medical College Hospital 2025;16(3):617-626
Based on the data from the 5th National Physical Fitness Surveillance in China, this study aimed to explore the relationship between abnormal body weight and physical fitness levels in older adults. The study included adults aged 60-79 years from the 5th National Physical Fitness Surveillance database. Body weight was categorized into four groups—underweight, normal weight, overweight, and obesity—based on body mass index (BMI), with underweight, overweight, and obesity classified as abnormal weight. Physical fitness indicators such as cardiorespiratory endurance (number of 2-minute high-knee steps), lower limb muscle strength (number of 30-second chair stands), flexibility (sit-and-reach test), balance ability (eyes-closed single-leg stance time), and reaction ability (choice reaction time) were collected. Each physical fitness indicator was divided into four levels (excellent, good, pass, and fail) based on quartile cutoffs. After adjusting for demographic factors (including age, sex, urban/rural residence, education level, pre-retirement occupation, marital status, exercise habits, smoking, sleep quality, and self-rated fitness), binary Logistic regression was used to analyze the association between physical fitness indicators and abnormal weight. A total of 39 927 older adults aged 60-79 years were included, comprising 19 777 men (49.5%) and 20 150 women (50.5%), with a mean age of 69.2±5.6 years. The prevalence rates of underweight, overweight, and obesity were 2.3%, 41.8%, and 16.7%, respectively, with underweight prevalence significantly increasing with age ( Chinese older adults aged 60-79 years face a dual burden of underweight and overweight/obesity. Poor cardiorespiratory endurance and muscle strength (in women) are significantly associated with abnormal weight. Maintaining good cardiorespiratory endurance and muscle strength may help improve abnormal weight status in older adults.
2.Effect and mechanism of embryonic intervention with Zuogui pill on the glucose tolerance in offsprings of pregnant rats with gestational diabetes mellitus
Min YANG ; Yujie WU ; Kainan SUN ; Yonghui WANG ; Chaoqun WANG ; Kaixia XU
China Pharmacy 2025;36(16):1981-1987
OBJECTIVE To explore the effect and mechanism of embryonic intervention with Zuogui pill on the glucose tolerance in offsprings of pregnant rats with gestational diabetes mellitus. METHODS Pregnant rats were randomly divided into blank group, model group, positive control group (insulin glargine), Zuogui pill low-, medium- and high-dose groups (4.725, 9.45, 18.9 g/kg). In addition to the blank group, streptozotocin was injected intraperitoneally to establish a gestational diabetes mellitus rat model. From day 6 to day 18 of pregnancy, each group was given relevant medicine and distilled water intragastrically, once a day. After 21 days of birth, the body weight and body length of offsprings were recorded, and the area under the curve (AUC) was calculated through a glucose tolerance test. After 22 days of birth, fasting blood glucose (FBG), fasting insulin (FINS) levels in serum, insulin sensitivity index (ISI), and homeostasis model assessment of insulin resistance (HOMA-IR) were measured, and the morphological structure of pancreatic tissue was observed. The protein spectrum of pancreatic tissue was analyzed by tandem mass tag-based proteomics, and protein and mRNA expression levels of apolipoprotein A1(ApoA1), solute carrier family 27 member 1 (Slc27a1), kininogen 1(Kng1) and sodium/potassium-transporting ATPase subunit alpha 2 (Atp1a2), solute carrier family 7 member 5 (Slc7a5), solute carrier family 3 member 2 (Slc3a2), bile acid-coenzyme A: amino acid N- acyltransferase (Baat), eukaryotic translation initiation factor 2 subunit gamma (Eif2s3) were detected. RESULTS Compared with the model group, the body weight, body length and ISI of offsprings in the positive control group and Zuogui pill medium-dose group were significantly increased (P<0.05), while the glucose tolerance and islet cell proliferation were significantly improved, and the AUC, FBG, FINS and HOMA-IR were significantly decreased (P<0.05). There were 88 potential target proteins for the embryonic intervention of Zuogui pill in offsprings of pregnant rats with gestational diabetes mellitus,involving multiple pathways such as peroxisome proliferator-activated receptor (PPAR), cyclic guanosine monophosphate-protein kinase G (cGMP-PKG), fat digestion and absorption, and bile secretion. The proteins closely related to glucose metabolism and insulin resistance mainly included ApoA1, Slc27a1, Kng1, Atp1a2, Slc7a5, Slc3a2, Baat, and Eif2s3. Among them, compared with the model group, protein and mRNA expressions of Slc7a5, Slc3a2, and Baat in the pancreatic tissues of pregnant rat offsprings in the Zuogui pill medium-dose group were significantly up-regulated (P<0.05); protein and mRNA expressions of ApoA1, Slc27a1, Kng1, Atp1a2 and Eif2s3 were all significantly down-regulated (P<0.05). CONCLUSIONS The intervention of Zuogui pill in the embryonic period on offsprings of pregnant rats with gestational diabetes mellitus can improve their blood glucose levels and pancreatic pathological morphology. The mechanism may be related to the upregulation of the expressions of Slc7a5, Slc3a2, and Baat and the down-regulation of ApoA1, Slc27a1, Kng1, Atp1a2 and Eif2s3 expressions in the PPAR, cGMP-PKG, fat digestion and absorption, and bile secretion pathways.
3.Research of the effect of para-tumoral micro-metastasis on the outcome after radical resection for intrahepatic cholangiocarcinoma
Chaoqun WANG ; Haoting SUN ; Xiaojia LIU ; Bolun ZHU ; Jintong LUO ; Lu LU ; Baobing YIN
Chinese Journal of Surgery 2025;63(6):523-528
Objective:To investigate the impact of para-tumoral micro-metastasis(PTMM) and other clinicopathological characteristics on the prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:This is a retrospective cohort study. Clinical data from 137 ICC patients who underwent radical resection at the Hepatobiliary Surgery Center, Department of General Surgery, Huashan Hospital, Fudan University, between January 2017 and December 2022 were analyzed retrospectively. The cohort included 91 males and 46 females, with age ( M(IQR)) of 63 (13) years (range: 32 to 82 years). Kaplan-Meier curves were used to estimate median survival times, while Log-rank tests assessed differences in overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate Cox regression models were employed to identify factors associated with OS and RFS. Results:The median OS for all 137 ICC patients was 34 months, with 1-, 2-, and 3-year OS rates of 90.7%, 69.4%, and 39.5%, respectively. The results of univariate and multivariate Cox analysis showed that Child-Pugh grade, CA19-9, carcinoembryonic antigen, and PTMM were independent prognostic factors for OS in ICC patients after radical resection (all P<0.05), Child-Pugh grade, maximum tumor diameter, whether lymph node metastasis, and PTMM were independent prognostic factors for RFS in radical resection in ICC patients (all P<0.05). PTMM-positive patients had a median OS of 21 months and median RFS of 12 months, whereas PTMM-negative patients exhibited a median OS exceeding 60 months and median RFS of 36 months. Log-rank tests demonstrated statistically significant differences in OS and RFS between PTMM-positive and PTMM-negative patients ( P<0.01 and P=0.001, respectively). Conclusion:Preliminary findings suggest that PTMM holds significant prognostic value in evaluating outcomes for ICC patients undergoing curative resection.
4.Promoting effect of LRG1 on fibrosis of human pterygium fibroblasts and its mechanism
Yanjie WEN ; Chaoqun WEI ; Yang CHEN ; Liyao SUN ; Yi GAO ; Jie HE ; Jialin LUO ; Yujing BAI ; Hongyan GE
Chinese Journal of Experimental Ophthalmology 2025;43(4):315-322
Objective:To investigate the role and mechanism of leucine-rich α-2-glycoprotein 1 (LRG1) in the fibrosis of human pterygium fibroblasts (HPFs).Methods:A total of 30 nasal primary pterygium tissues from patients who underwent pterygium excision surgery and 30 nasal normal conjunctival tissues from patients who underwent strabismus correction surgery were collected from the First Affiliated Hospital of Harbin Medical University between January 2022 and March 2023, serving as the pterygium group and normal control group, respectively.LRG1 protein expression in both groups was detected by immunofluorescence staining.The mRNA and protein levels of LRG1 and transforming growth factor-β1 (TGF-β1) were evaluated by quantitative real-time PCR (qRT-PCR) and Western blot.Primary HPFs were cultured from excised pterygium tissues using tissue block adhesion method, and cell morphology was observed.Vmentin and cytokeratin were identified by immunofluorescence staining.HPFs were divided into recombinant human LRG1 (rhLRG1) group and blank control group treated with or without 10 μg/ml rhLRG1 for 24 hours, respectively, and cell migration was evaluated via scratch assay.Additionally, HPFs were divided into blank control group, LRG1 overexpression group and LRG1 knockdown group.HPFs in LRG1 overexpression group and LRG1 knockdown group were transfected with LRG1 overexpression plasmids and small interfering RNA for 24 hours, respectively.TGF-β1 mRNA level was evaluated by qRT-PCR and expression of TGF-β1, fibronectin (FN), type Ⅲ collagen (COL3), and α-smooth muscle actin (α-SMA) proteins were evaluated by Western blot.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University (No.2022IIT026).Written informed consent was obtained from each subject.Results:HPFs were successfully isolated, exhibiting spindle-shaped morphology with whorled arrangement, positive identification for vimentin, and negative immunofluorescence staining for cytokeratin.The migration rate of the rhLRG1 group was (83.01±2.56)%, significantly higher than (50.32±4.97)% of the blank control group ( t=9.59, P<0.001).Immunofluorescence staining results showed that compared with normal conjunctival tissue, LRG1 protein was significantly higher expressed in pterygium tissue and was widely distributed in fibrous connective tissue and epithelial layer.Both mRNA and protein levels of LRG1 and TGF-β1 were significantly higher in the pterygium group than in the normal control group (mRNA: t=10.18, 6.15, both P<0.05.protein: t=6.83, 8.79, both P<0.05).In the LRG1 overexpression group, mRNA level of TGF-β1, and protein levels of FN, COL3 and α-SMA were significantly increased compared with the blank control and LRG1 knockdown groups (all P<0.05). Conclusions:LRG1 promotes fibrosis and enhances the migration ability in HPFs, and its mechanism may be associated with the upregulation of the TGF-β1 signaling pathway.
5.The safety and efficacy of urinary microbiota transplantation in the treatment of interstitial cystitis
Bo LIU ; Yuwei ZHANG ; Lili ZHANG ; Xinyu XU ; Yang WANG ; Hao LIN ; Chaoqun GU ; Peng JIANG ; Yifan SUN ; Ninghan FENG
Chinese Journal of Urology 2025;46(6):421-429
Objective:To investigate the safety and efficacy of urinary microbiota transplantation(UMT)in treating interstitial cystitis(IC).Methods:A retrospective analysis of the clinical data of three patients with IC treated with UMT at the Central Hospital of Jiangnan University from May 2022 to August 2024. Three women(45,62,79 years)presented with urinary frequency(10 - 90 min intervals),urgency,dysuria,lower abdominal pain,and non-organic sleep disorder,with nocturia(2 - 15 episodes)causing sleep difficulty. Disease durations were 3,6,and 21 years. Prior antibiotic therapy failed. Preoperative urinalysis/culture(x2)ruled out bacterial cystitis,and diagnosed as interstitial cystitis(IC),with one of transient positive urine culture. Preoperative scores for case 1 were self-rating depression scale(SDS)of 49,self-rating anxiety scale(SAS)of 31,interstitial cystitis symptom index(ICSI)of 5,interstitial cystitis problem index(ICPI)of 2,brief urological problem scale of 50,genitourinary pain assessment scale of 10,and pain catastrophizing scale(PCS)of 0. For case 2,the scores were 60 of SDS,66 of SAS,9 of ICSI,11 of ICPI,50 of brief urological problem scale,28 of genitourinary pain assessment scale,and 34 of PCS. For case 3,the scores were 44 of SDS,48 of SAS,11 of ICSI,5 of ICPI,33 of brief urological problem scale,27 of genitourinary pain assessment scale,and 21 of PCS. Preoperative bladder hydro-distention showed mucosal hemorrhage including central block hemorrhage(Case 1),numerous spots(Case 2),and distinct sheets(Case 3). Preoperative urine 16S rRNA sequencing revealed low diversity,increased Gardnerella/ Bacteroides(opportunistic),and decreased Bacillus/ Streptococcus(beneficial). Two healthy young female donors had normal comprehensive tests covering blood/urine/stool,coagulation,CRP,immunity,liver/kidney function,lipids,infectious diseases,hormones,tumor markers,urine culture,TOUCH,and expanded quantitative urine culture. Donor urine 16S rRNA showed low pathogenic( Gardnerella/ Bacteroides)abundance. Donor midstream morning urine was catheter-collected,centrifuged,and the bacterial pellet resuspended in saline. Recipients underwent bladder irrigation pre-UMT. On UMT day,donor bacterial suspension was instilled via catheter with adverse event monitoring. Follow-up included clinic visits at 1 month and 1 year for symptom assessment,scale scoring,cystoscopy evaluating mucosal inflammation,hydrodistension checks,and telephone tracking of urinary symptoms every 2 - 3 months. Prognosis was assessed by symptom relief,scale score reduction,and mucosal recovery. Results:No adverse reactions occurred within 24 hours post-UMT in all 3 cases. Two patients showed same-day urinary urgency reduction;three reported relief from urinary frequency/urgency on postoperative day 7,with 2 - 3 hour daytime intervals and 0 - 5 nocturnal voids. Two patients experienced lower abdominal pain alleviation. Postoperative Week 1 urinalysis and urine cultures revealed no abnormalities. The 16S rRNA test showed a decrease in the abundance of harmful bacteria(e.g., Cupriavidus,Ureaplasm,Mycobacterium,Pseudomonas)and an increase in the abundance of beneficial bacteria( Dietzia,Halomonas,and Streptococcus),and the overall urobacterial structure was significantly improved and similar to that of the donor. Case 1 was followed up for 20 months,and the lab tests were normal,with SDS scales of 38,SAS of 20,ICSI of 3,ICPI of 2,brief urological problem scale of 44,genitourinary pain assessment scale of 10,PCS of 0,at 9 months post-op follow-up,indicating physical and mental improvement. The bladder hydro-distention revealed intact mucosa with only mild inflammation,which improved versus preoperative situation. Case 2 was followed up for 15 months,and the lab tests were normal,with SDS scales of 44,SAS of 34,ICSI of 4,ICPI of 2,brief scale of urinary problems of 0,genitourinary pain assessment scale of 9,PCS of 7,at 2 months post-op follow-up,showing improved anxiety/depression and quality of life. The hydro-distention showed decreased scattered hemorrhagic dots and mucosal inflammation. Case 3 was followed up for 13 months,with an increased leukocytes of urine and the other being normal for lab tests,and SDS scales of 35,SAS of 46,ICSI of 13,ICPI of 13,brief scale of urinary problems of 10,genitourinary pain assessment scale of 33,PCS of 11,at 13 months post-op follow-up,indicating physical and mental improvement. The hydro-distention revealed mucosal congestion,marked submucosal vasodilation,and inflammation decreased compared with preoperative situation. Conclusions:UMT alleviates urinary frequency,urgency,and pain in IC patients with sustained effects,significantly improves urine microecology,and shows no adverse events,positioning it as a viable intervention for IC.
6.Promoting effect of LRG1 on fibrosis of human pterygium fibroblasts and its mechanism
Yanjie WEN ; Chaoqun WEI ; Yang CHEN ; Liyao SUN ; Yi GAO ; Jie HE ; Jialin LUO ; Yujing BAI ; Hongyan GE
Chinese Journal of Experimental Ophthalmology 2025;43(4):315-322
Objective:To investigate the role and mechanism of leucine-rich α-2-glycoprotein 1 (LRG1) in the fibrosis of human pterygium fibroblasts (HPFs).Methods:A total of 30 nasal primary pterygium tissues from patients who underwent pterygium excision surgery and 30 nasal normal conjunctival tissues from patients who underwent strabismus correction surgery were collected from the First Affiliated Hospital of Harbin Medical University between January 2022 and March 2023, serving as the pterygium group and normal control group, respectively.LRG1 protein expression in both groups was detected by immunofluorescence staining.The mRNA and protein levels of LRG1 and transforming growth factor-β1 (TGF-β1) were evaluated by quantitative real-time PCR (qRT-PCR) and Western blot.Primary HPFs were cultured from excised pterygium tissues using tissue block adhesion method, and cell morphology was observed.Vmentin and cytokeratin were identified by immunofluorescence staining.HPFs were divided into recombinant human LRG1 (rhLRG1) group and blank control group treated with or without 10 μg/ml rhLRG1 for 24 hours, respectively, and cell migration was evaluated via scratch assay.Additionally, HPFs were divided into blank control group, LRG1 overexpression group and LRG1 knockdown group.HPFs in LRG1 overexpression group and LRG1 knockdown group were transfected with LRG1 overexpression plasmids and small interfering RNA for 24 hours, respectively.TGF-β1 mRNA level was evaluated by qRT-PCR and expression of TGF-β1, fibronectin (FN), type Ⅲ collagen (COL3), and α-smooth muscle actin (α-SMA) proteins were evaluated by Western blot.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University (No.2022IIT026).Written informed consent was obtained from each subject.Results:HPFs were successfully isolated, exhibiting spindle-shaped morphology with whorled arrangement, positive identification for vimentin, and negative immunofluorescence staining for cytokeratin.The migration rate of the rhLRG1 group was (83.01±2.56)%, significantly higher than (50.32±4.97)% of the blank control group ( t=9.59, P<0.001).Immunofluorescence staining results showed that compared with normal conjunctival tissue, LRG1 protein was significantly higher expressed in pterygium tissue and was widely distributed in fibrous connective tissue and epithelial layer.Both mRNA and protein levels of LRG1 and TGF-β1 were significantly higher in the pterygium group than in the normal control group (mRNA: t=10.18, 6.15, both P<0.05.protein: t=6.83, 8.79, both P<0.05).In the LRG1 overexpression group, mRNA level of TGF-β1, and protein levels of FN, COL3 and α-SMA were significantly increased compared with the blank control and LRG1 knockdown groups (all P<0.05). Conclusions:LRG1 promotes fibrosis and enhances the migration ability in HPFs, and its mechanism may be associated with the upregulation of the TGF-β1 signaling pathway.
7.The safety and efficacy of urinary microbiota transplantation in the treatment of interstitial cystitis
Bo LIU ; Yuwei ZHANG ; Lili ZHANG ; Xinyu XU ; Yang WANG ; Hao LIN ; Chaoqun GU ; Peng JIANG ; Yifan SUN ; Ninghan FENG
Chinese Journal of Urology 2025;46(6):421-429
Objective:To investigate the safety and efficacy of urinary microbiota transplantation(UMT)in treating interstitial cystitis(IC).Methods:A retrospective analysis of the clinical data of three patients with IC treated with UMT at the Central Hospital of Jiangnan University from May 2022 to August 2024. Three women(45,62,79 years)presented with urinary frequency(10 - 90 min intervals),urgency,dysuria,lower abdominal pain,and non-organic sleep disorder,with nocturia(2 - 15 episodes)causing sleep difficulty. Disease durations were 3,6,and 21 years. Prior antibiotic therapy failed. Preoperative urinalysis/culture(x2)ruled out bacterial cystitis,and diagnosed as interstitial cystitis(IC),with one of transient positive urine culture. Preoperative scores for case 1 were self-rating depression scale(SDS)of 49,self-rating anxiety scale(SAS)of 31,interstitial cystitis symptom index(ICSI)of 5,interstitial cystitis problem index(ICPI)of 2,brief urological problem scale of 50,genitourinary pain assessment scale of 10,and pain catastrophizing scale(PCS)of 0. For case 2,the scores were 60 of SDS,66 of SAS,9 of ICSI,11 of ICPI,50 of brief urological problem scale,28 of genitourinary pain assessment scale,and 34 of PCS. For case 3,the scores were 44 of SDS,48 of SAS,11 of ICSI,5 of ICPI,33 of brief urological problem scale,27 of genitourinary pain assessment scale,and 21 of PCS. Preoperative bladder hydro-distention showed mucosal hemorrhage including central block hemorrhage(Case 1),numerous spots(Case 2),and distinct sheets(Case 3). Preoperative urine 16S rRNA sequencing revealed low diversity,increased Gardnerella/ Bacteroides(opportunistic),and decreased Bacillus/ Streptococcus(beneficial). Two healthy young female donors had normal comprehensive tests covering blood/urine/stool,coagulation,CRP,immunity,liver/kidney function,lipids,infectious diseases,hormones,tumor markers,urine culture,TOUCH,and expanded quantitative urine culture. Donor urine 16S rRNA showed low pathogenic( Gardnerella/ Bacteroides)abundance. Donor midstream morning urine was catheter-collected,centrifuged,and the bacterial pellet resuspended in saline. Recipients underwent bladder irrigation pre-UMT. On UMT day,donor bacterial suspension was instilled via catheter with adverse event monitoring. Follow-up included clinic visits at 1 month and 1 year for symptom assessment,scale scoring,cystoscopy evaluating mucosal inflammation,hydrodistension checks,and telephone tracking of urinary symptoms every 2 - 3 months. Prognosis was assessed by symptom relief,scale score reduction,and mucosal recovery. Results:No adverse reactions occurred within 24 hours post-UMT in all 3 cases. Two patients showed same-day urinary urgency reduction;three reported relief from urinary frequency/urgency on postoperative day 7,with 2 - 3 hour daytime intervals and 0 - 5 nocturnal voids. Two patients experienced lower abdominal pain alleviation. Postoperative Week 1 urinalysis and urine cultures revealed no abnormalities. The 16S rRNA test showed a decrease in the abundance of harmful bacteria(e.g., Cupriavidus,Ureaplasm,Mycobacterium,Pseudomonas)and an increase in the abundance of beneficial bacteria( Dietzia,Halomonas,and Streptococcus),and the overall urobacterial structure was significantly improved and similar to that of the donor. Case 1 was followed up for 20 months,and the lab tests were normal,with SDS scales of 38,SAS of 20,ICSI of 3,ICPI of 2,brief urological problem scale of 44,genitourinary pain assessment scale of 10,PCS of 0,at 9 months post-op follow-up,indicating physical and mental improvement. The bladder hydro-distention revealed intact mucosa with only mild inflammation,which improved versus preoperative situation. Case 2 was followed up for 15 months,and the lab tests were normal,with SDS scales of 44,SAS of 34,ICSI of 4,ICPI of 2,brief scale of urinary problems of 0,genitourinary pain assessment scale of 9,PCS of 7,at 2 months post-op follow-up,showing improved anxiety/depression and quality of life. The hydro-distention showed decreased scattered hemorrhagic dots and mucosal inflammation. Case 3 was followed up for 13 months,with an increased leukocytes of urine and the other being normal for lab tests,and SDS scales of 35,SAS of 46,ICSI of 13,ICPI of 13,brief scale of urinary problems of 10,genitourinary pain assessment scale of 33,PCS of 11,at 13 months post-op follow-up,indicating physical and mental improvement. The hydro-distention revealed mucosal congestion,marked submucosal vasodilation,and inflammation decreased compared with preoperative situation. Conclusions:UMT alleviates urinary frequency,urgency,and pain in IC patients with sustained effects,significantly improves urine microecology,and shows no adverse events,positioning it as a viable intervention for IC.
8.Research of the effect of para-tumoral micro-metastasis on the outcome after radical resection for intrahepatic cholangiocarcinoma
Chaoqun WANG ; Haoting SUN ; Xiaojia LIU ; Bolun ZHU ; Jintong LUO ; Lu LU ; Baobing YIN
Chinese Journal of Surgery 2025;63(6):523-528
Objective:To investigate the impact of para-tumoral micro-metastasis(PTMM) and other clinicopathological characteristics on the prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:This is a retrospective cohort study. Clinical data from 137 ICC patients who underwent radical resection at the Hepatobiliary Surgery Center, Department of General Surgery, Huashan Hospital, Fudan University, between January 2017 and December 2022 were analyzed retrospectively. The cohort included 91 males and 46 females, with age ( M(IQR)) of 63 (13) years (range: 32 to 82 years). Kaplan-Meier curves were used to estimate median survival times, while Log-rank tests assessed differences in overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate Cox regression models were employed to identify factors associated with OS and RFS. Results:The median OS for all 137 ICC patients was 34 months, with 1-, 2-, and 3-year OS rates of 90.7%, 69.4%, and 39.5%, respectively. The results of univariate and multivariate Cox analysis showed that Child-Pugh grade, CA19-9, carcinoembryonic antigen, and PTMM were independent prognostic factors for OS in ICC patients after radical resection (all P<0.05), Child-Pugh grade, maximum tumor diameter, whether lymph node metastasis, and PTMM were independent prognostic factors for RFS in radical resection in ICC patients (all P<0.05). PTMM-positive patients had a median OS of 21 months and median RFS of 12 months, whereas PTMM-negative patients exhibited a median OS exceeding 60 months and median RFS of 36 months. Log-rank tests demonstrated statistically significant differences in OS and RFS between PTMM-positive and PTMM-negative patients ( P<0.01 and P=0.001, respectively). Conclusion:Preliminary findings suggest that PTMM holds significant prognostic value in evaluating outcomes for ICC patients undergoing curative resection.
9.A Comparative Study of Three Methods of Preventing Intrauterine Adhesions after HEOS
Liyan MENG ; Junli GAO ; Chunlin LI ; Jie NIU ; Yan SUN ; Chaoqun WANG
Journal of Kunming Medical University 2024;45(2):141-147
Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions.Methods 284 patients with mild,moderate and severe intrauterine adhesions,who were treated with the HEOS system,were divided into three groups,the intrauterine device with sodium hyaluronate gel was placed in Group A,Foley water capsule tube with sodium hyaluronate gel was placed in Group B,and sodium hyaluronate gel was placed in Group C only.The recovery of uterine adhesion,improvement of menstruation,endometrial thickness,and adverse reactions were compared among the three groups.Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05).Group A had a higher menstrual improvement rate than Group C(P<0.017),and there was no significant difference in other therapeutic indicators(P>0.017).However,the adverse reaction rate in Group A was also higher than that in Group C(P<0.017).In the moderate intrauterine group,there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups(P<0.017).Group A and B were higher than Group C in terms of menstrual status,endometrial thickness,and adverse reactions(P<0.017).In severe intrauterine adhesions,Group A had higher efficacy indicators than other groups(P<0.017).Conclusions The curative effect index and adverse reaction rate were analyzed,after operation.For the light,moderate,and severe intrauterine adhesions,sodium hyaluronate gel,Foley water capsule tube with sodium hyaluronate gel,and intrauterine device with sodium hyaluronate gel were the best choice for adhesion.Individual and hierarchical management can achieve good clinical effects,which is worth popularizing.
10.Chinese Medicine Intervention in Ulcerative Colitis Based on Nrf2/HO-1 Pathway: A Review
Haoxian SUN ; Guixiang SUN ; Liting QIU ; Qianxu ZHANG ; Chaoqun XIE ; Ying ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(11):224-230
Ulcerative colitis (UC) is a common chronic digestive system disease in clinic. The disease is repeated and difficult to treat, and the pathogenesis is complex, which is related to oxidative stress response. Nuclear factor E2-related factor 2 (Nrf2) is an important factor in antioxidant reaction, which regulates the expression of downstream heme oxygen-1 (HO-1), and plays a role in maintaining redox homeostasis. In the course of UC, the biological activity and content of Nrf2 and HO-1 are decreased, the antioxidant and anti-inflammatory abilities of tissues are weakened, the intestinal epithelial cells are damaged, and the intestinal mucosal barrier is destroyed. At present, western medicine mainly focuses on controlling inflammation and alleviating symptoms in clinical treatment. Although it has a certain effect, there are many problems such as easy recurrence after drug withdrawal and long-term side effects. Studies have shown that Chinese medicine has rich and flexible therapeutic methods and has broad application prospects in the prevention and treatment of UC. In recent years, with Nrf2/HO-1 pathway as the entry point, a large number of basic and clinical experiments on this signal in UC have been carried out in the field of Chinese medicine, and the results show that the intervention of Nrf2/HO-1 pathway is an important potential target for the treatment of UC by Chinese medicines. Based on the etiology and pathogenesis of deficiency-excess in complexity, Chinese medicine regulates Nrf2/HO-1 pathway by clearing heat and detoxifying dampness, activating blood circulation to remove stasis and relieve pain, invigorating Qi, tonifying middle, and warming interior, and treating both symptoms and root causes, to improve the tissue's ability to resist oxidative stress, maintain the balance between pro-inflammatory factors and anti-inflammatory factors, relieve inflammatory response, and play a therapeutic role in UC. This paper summarized and analyzed the effect of Chinese medicine targeting the Nrf2/HO-1 signaling pathway on interfering with UC and its mechanism. The purpose of this study is to provide references for researchers to have a more comprehensive understanding of the mechanism of Chinese medicines in the Nrf2/HO-1 signaling pathway in UC and promote the rational application of Chinese medicines in the prevention and treatment of UC in the future.

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