1.Action Mechanism of Huamoyan Granules in Treatment of Knee Osteoarthritis Based on TRPV1/p38 MAPK Pathway
Jin ZHANG ; Lili YANG ; Canwen ZHENG ; Jing KANG ; Yanlei MA ; Yue SHI ; Lei LI ; Hongxu MENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):79-89
ObjectiveThis paper aims to observe the protective effect of Huamoyan granules on knee osteoarthritis (KOA) and explore whether its protective effect is oriented toward an anti-inflammatory direction by regulation of macrophage polarization, which can effectively inhibit the progression of pathological inflammatory response, reduce the release of inflammatory pain mediators, and downregulate the protein expression level of transient receptor potential vanilloid 1 (TRPV1), so as to provide experimental evidence for its clinical application and investigate its action mechanism. MethodsAfter adaptive feeding, Sprague-Dawley (SD) rats were randomly divided into six groups: sham group, model group, celecoxib group, and high, medium, and low-dose synovitis granule groups (9.6, 4.8, 2.4 g·kg-1). The administration dose of celecoxib capsules was 20 mg·kg-1. There were 10 rats in the sham group and 12 rats in the model group and each administration group. A KOA animal model was established by means of intra-articular injection of sodium iodoacetate into the knee joint. From the 10th day of the experiment, each administration group was given intragastric administration at a dose of 10 mL·kg-1 for 4 weeks. General conditions of rats in each group were assessed daily. The pressure pain threshold (PPT) to mechanical stimulation and joint diameter were recorded. X-ray examination was performed on the right knee joints of rats for imaging analysis. Enzyme linked immunosorbent assay (ELISA) was performed to detect the tumor necrosis factor-α (TNF-α), serum interleukin-1β (IL-1β), and other pro-inflammatory cytokines in rat serum samples, as well as the expression levels of neurogenic inflammatory mediators such as nerve growth factor (NGF) and calcitonin gene-related peptide (CGRP). Histopathological changes in the knee joint synovial tissues were examined by hematoxylineosin (HE) staining. Safranin O-fast green staining was performed to observe and evaluate the degree of knee cartilage lesions. Western blot was employed to quantitatively analyze TRPV1, p38 mitogen-activated protein kinase (p38 MAPK), and phosphorylated (p)-p38 MAPK in rat knee synovial tissues. Immunofluorescence (IF) was used to measure and assess M1/M2 macrophage polarization. ResultsCompared with those in the sham group, the circumference and joint diameter of the right knee were markedly enlarged in the model group (P<0.01), while PPTs of rats showed a significant reduction (P<0.01). The contents of IL-1β, TNF-α, CGRP, and NGF in rats' serum were significantly elevated (P<0.01), and the synovial Krenn score was increased (P<0.01). The Mankin score of cartilage tissue was increased (P<0.01), and the protein expressions of TRPV1 and p-p38 MAPK/p38 MAPK were significantly upregulated (P<0.01). The experimental intervention significantly reduced the proportion of pro-inflammatory M1 macrophages in the total macrophage population (P<0.01), and the percentage of M2 macrophages was decreased (P<0.01). The M1/M2 macrophage ratio was significantly elevated (P<0.01). Knee joint diameters of all dose groups of Huamoyan granules and the celecoxib group were reduced (P<0.01) compared with those of the model group, and the PPT recovery speeds in the high and medium-dose groups of Huamoyan granules were more obvious (P<0.05). The contents of IL-1β, CGRP, and NGF in the rats' serum in all administration groups were significantly reduced (P<0.05, P<0.01), and the content of TNF-α in rats' serum was significantly reduced (P<0.01). All dose groups of Huamoyan granules demonstrated significant reductions in both synovial Krenn score (P<0.05, P<0.01) and protein expression of TRPV1 and p-p38 MAPK/p38 MAPK in rats' synovial tissues (P<0.01). The percentage of M1 macrophages in the synovial tissues of the celecoxib group and all dose groups of Huamoyan granules was decreased (P<0.01). The percentage of M2 macrophages was increased (P<0.05), and the M1/M2 ratio was decreased (P<0.01). ConclusionHuamoyan granules can alleviate the inflammatory response of KOA, reduce the release of inflammatory pain mediators, and downregulate TRPV1 protein expression by regulating macrophage polarization. Its mechanism may be related to the TRPV1/p38 MAPK signaling pathway, thereby achieving the effect of improving peripheral pain hypersensitivity in KOA.
2.Effect of Gynostemma pentaphyllum Alcohol Extract on Glucose and Lipid Metabolism Disorders in db/db Mice Based on Transcriptomics and Gut Microbiota
Yifei ZHU ; Lei DING ; Wei LIU ; Yahui SUN ; Lingling QIN ; Lili WU ; Tonghua LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):80-89
ObjectiveTo investigate the efficacy and underlying mechanisms of Gynostemma pentaphyllum alcohol extract in improving glucose and lipid metabolism disorders in db/db mice through transcriptomics and gut microbiota analysis. MethodsEighteen db/db mice were randomly assigned to the model(DM) group, metformin(MET) group, and G. pentaphyllum alcohol extract(GP) group, with six mice in each group, based on stratification of fasting blood glucose and body weight. An additional six db/m mice were selected as the normal control(NC) group. Mice in the NC and DM groups were administered deionized water (10 mL·kg-1) daily. The MET group received metformin (0.195 g·kg-1) by gavage. The GP group was treated with G. pentaphyllum alcohol extract (3.9 g·kg-1) by gavage for six weeks. Fasting blood glucose was measured every two weeks. After six weeks of intervention, serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine (CREA), and blood urea nitrogen (BUN) were assessed. Enzyme-linked immunosorbent assay (ELISA) was used to measure insulin (FINS), adiponectin (ADP), and tumor necrosis factor-α (TNF-α). Hematoxylin-eosin (HE) staining was used to observe liver histomorphology, periodic acid-Schiff (PAS) staining was employed to assess hepatic glycogen synthesis, and Oil Red O staining was used to detect hepatic lipid deposition. Liver transcriptomic data were used to identify differentially expressed genes in the liver and conduct enrichment analysis. Real-time PCR was employed to verify the expression levels of adiponectin gene (Adipoq), peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor α (PPARα), glucokinase (GCK), forkhead box (Fox)O1, FoxO3, phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6-phosphatase (G6PC). Metagenomic sequencing was conducted to analyze changes in gut microbiota composition. ResultsCompared with the NC group, the DM group exhibited significantly elevated fasting blood glucose (P<0.01), serum AST, ALT, TC, TG, LDL-C, and HDL-C (P<0.01). FINS, homeostatic model assessment for insulin resistance (HOMA-IR), and the inflammatory cytokine TNF-α were significantly increased (P<0.01), while ADP was significantly decreased (P<0.05). Histological analysis confirmed severe hepatic steatosis and excessive lipid accumulation in the DM group, along with markedly reduced glycogen synthesis. Compared with the DM group, the GP group showed significantly decreased fasting blood glucose (P<0.01), reduced serum TC, LDL-C, and HDL-C levels (P<0.05), significantly decreased serum TG and AST levels (P<0.01), significantly reduced FINS, HOMA-IR, and TNF-α levels (P<0.01), and significantly increased ADP (P<0.01). Hepatic steatosis and lipid deposition were significantly alleviated, while glycogen synthesis was markedly enhanced. Transcriptomic differential and enrichment analyses suggested that the mechanisms by which G. pentaphyllum alcohol extract improved hepatic glucose and lipid metabolism in db/db mice may involve regulation of the AMPK and FoxO signaling pathways. Real-time PCR results confirmed that expression of PGC-1α, PEPCK, G6PC, FoxO1, and FoxO3 was significantly downregulated following treatment with G. pentaphyllum alcohol extract (P<0.05, P<0.01), whereas mRNA expression of Adipoq, PPARα, GCK, and AMPK was significantly upregulated (P<0.05, P<0.01). Metagenomic analysis showed that the relative abundance of Lactobacillus, Alistipes, and Akkermansia species was higher in the GP group than in the DM group. ConclusionG. pentaphyllum alcohol extract may improve glucose and lipid metabolism disorders in db/db mice by regulating the hepatic AMPK/PPARα pathway to suppress lipid deposition and alleviate hepatic steatosis, by inhibiting gluconeogenesis through the AMPK/PGC-1α and FoxO pathways to lower fasting blood glucose, and by increasing the abundance of beneficial gut bacteria such as Lactobacillus, Alistipes, and Akkermansia to restore gut microbiota balance.
3.Effect of Gynostemma pentaphyllum Alcohol Extract on Glucose and Lipid Metabolism Disorders in db/db Mice Based on Transcriptomics and Gut Microbiota
Yifei ZHU ; Lei DING ; Wei LIU ; Yahui SUN ; Lingling QIN ; Lili WU ; Tonghua LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):80-89
ObjectiveTo investigate the efficacy and underlying mechanisms of Gynostemma pentaphyllum alcohol extract in improving glucose and lipid metabolism disorders in db/db mice through transcriptomics and gut microbiota analysis. MethodsEighteen db/db mice were randomly assigned to the model(DM) group, metformin(MET) group, and G. pentaphyllum alcohol extract(GP) group, with six mice in each group, based on stratification of fasting blood glucose and body weight. An additional six db/m mice were selected as the normal control(NC) group. Mice in the NC and DM groups were administered deionized water (10 mL·kg-1) daily. The MET group received metformin (0.195 g·kg-1) by gavage. The GP group was treated with G. pentaphyllum alcohol extract (3.9 g·kg-1) by gavage for six weeks. Fasting blood glucose was measured every two weeks. After six weeks of intervention, serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine (CREA), and blood urea nitrogen (BUN) were assessed. Enzyme-linked immunosorbent assay (ELISA) was used to measure insulin (FINS), adiponectin (ADP), and tumor necrosis factor-α (TNF-α). Hematoxylin-eosin (HE) staining was used to observe liver histomorphology, periodic acid-Schiff (PAS) staining was employed to assess hepatic glycogen synthesis, and Oil Red O staining was used to detect hepatic lipid deposition. Liver transcriptomic data were used to identify differentially expressed genes in the liver and conduct enrichment analysis. Real-time PCR was employed to verify the expression levels of adiponectin gene (Adipoq), peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor α (PPARα), glucokinase (GCK), forkhead box (Fox)O1, FoxO3, phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6-phosphatase (G6PC). Metagenomic sequencing was conducted to analyze changes in gut microbiota composition. ResultsCompared with the NC group, the DM group exhibited significantly elevated fasting blood glucose (P<0.01), serum AST, ALT, TC, TG, LDL-C, and HDL-C (P<0.01). FINS, homeostatic model assessment for insulin resistance (HOMA-IR), and the inflammatory cytokine TNF-α were significantly increased (P<0.01), while ADP was significantly decreased (P<0.05). Histological analysis confirmed severe hepatic steatosis and excessive lipid accumulation in the DM group, along with markedly reduced glycogen synthesis. Compared with the DM group, the GP group showed significantly decreased fasting blood glucose (P<0.01), reduced serum TC, LDL-C, and HDL-C levels (P<0.05), significantly decreased serum TG and AST levels (P<0.01), significantly reduced FINS, HOMA-IR, and TNF-α levels (P<0.01), and significantly increased ADP (P<0.01). Hepatic steatosis and lipid deposition were significantly alleviated, while glycogen synthesis was markedly enhanced. Transcriptomic differential and enrichment analyses suggested that the mechanisms by which G. pentaphyllum alcohol extract improved hepatic glucose and lipid metabolism in db/db mice may involve regulation of the AMPK and FoxO signaling pathways. Real-time PCR results confirmed that expression of PGC-1α, PEPCK, G6PC, FoxO1, and FoxO3 was significantly downregulated following treatment with G. pentaphyllum alcohol extract (P<0.05, P<0.01), whereas mRNA expression of Adipoq, PPARα, GCK, and AMPK was significantly upregulated (P<0.05, P<0.01). Metagenomic analysis showed that the relative abundance of Lactobacillus, Alistipes, and Akkermansia species was higher in the GP group than in the DM group. ConclusionG. pentaphyllum alcohol extract may improve glucose and lipid metabolism disorders in db/db mice by regulating the hepatic AMPK/PPARα pathway to suppress lipid deposition and alleviate hepatic steatosis, by inhibiting gluconeogenesis through the AMPK/PGC-1α and FoxO pathways to lower fasting blood glucose, and by increasing the abundance of beneficial gut bacteria such as Lactobacillus, Alistipes, and Akkermansia to restore gut microbiota balance.
4.Diarrhea caused by foodborne Salmonella infection in children aged 0-6 years in Guizhou Province from 2016 to 2023
LIAO Hongxia, WANG Yafang, LIU Lin, ZHANG Lili, YANG Qi, LI Lei
Chinese Journal of School Health 2025;46(5):732-736
Objective:
To analyze the epidemilogical and seasonal characteristics of foodborne Salmonella-associated diarrhea among children aged 0-6 years in Guizhou Province from 2016 to 2023, so as to provide a basis for the prevention and control of foodborne diseases.
Methods:
Data were extracted from the Foodborne Disease Survellance System for cases reported between January 1, 2016, and December 31, 2023. The incidence, seasonal characteristics, and peak periods were analyzed by the method of concentration and circular distribution.
Results:
A total of 6 434 cases of diarrhea in children aged 0-6 years were collected, and 455 cases of Salmonella were detected, with a positive detection rate of 7.07%. Salmonella typhimurium was the main serotype causing diarrhea (59.34%). The peak of the disease was from May 3 to September 30, with certain seasonal characteristics. The highest detection rate was found in children aged 1-3 years (8.66%). Among food types, the positive detection rates of Salmonella were relatively high in other foods (17.39%), fruits and their products (10.22%), infant and toddler foods (10.09%), and aquatic animals and their products (9.80%). The processing and packaging methods of food were mainly home-made (9.38%) and bulk food (7.54%).
Conclusions
The detection rate of Salmonella in children aged 0-6 years is high in Guizhou Province, with strong seasonal characteristics. The detection rates of other foods, fruits and their products, infant and toddler foods, and aquatic animals and their products are high. Enhanced pathogen surveillance for susceptible populations and high-risk foods, coupled with public health education during summer/autumn, is recommended.
5.Hemifacial microsomia with cardiac and vertebral anomalies: a case report and literature review
ZHANG Zhiqiang ; WANG Lili ; WEN Cai ; LEI Bo ; LI Shiting ; LI Jihua
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(11):979-985
Objective:
To investigate the clinical characteristics, diagnostic approach, and multidisciplinary treatment strategy for a rare case of congenital defect presenting as a complex of hemifacial microsomia with cardiac and spinal deformities, in order to provide a reference for the clinical management of such cases
Methods :
The clinical data of a 9-year-old patient with hemifacial microsomia (HFM) complicated by post-operative Tetralogy of Fallot and scoliosis were retrospectively analyzed. A definitive diagnosis was established through specialized examinations, imaging studies, bone age assessment, and intellectual evaluation. The patient presented with right-sided HFM (with 3 accessory auricles, a transverse facial cleft, a microform median cleft of the upper lip, hypoplasia of the mandible and facial soft tissues, and agenesis of the right parotid gland and coronoid process), increased orbital distance, dental malalignment, congenital absence of one lateral incisor, and rampant caries in both primary and permanent dentition. The patient had undergone open-heart surgery for Tetralogy of Fallot with a patent foramen ovale four years prior and also presented with scoliosis and systemic developmental delay (bone age approximately 7 years). A retrospective analysis of the diagnosis and treatment of this type of case was conducted in conjunction with a literature review.
Results:
A multi-disciplinary treatment (MDT) model was adopted. The patient first received treatment for dental caries, followed by excision of the right accessory auricles, repair of the transverse facial cleft, and correction of the microform upper lip cleft under general anesthesia. A 6-month follow-up showed significant improvement in facial appearance and good recovery of oral function. The literature review indicated that hemifacial microsomia is a congenital disease characterized by the hypoplasia of multiple tissue structures on one side of the face. Its etiology may be related to impaired blood supply to the first and second branchial arches during early pregnancy. It often affects the craniofacial bones, ears, and soft tissues, leading to functional impairments in respiration, feeding, speech, and hearing, as well as psychological issues, severely impacting the quality of life in serious cases. The combination with cardiac and spinal deformities is relatively rare and requires individualized sequential treatment plans based on clinical evaluation and surgical indications. This typically includes cardiac surgical correction, spinal orthopedics, early soft and hard tissue reconstruction (e.g., distraction osteogenesis, facial cleft repair, and accessory auricle excision), orthodontic and dental management during the growth period, and final facial contouring in adulthood.
Conclusion
HFM can be associated with cardiac and spinal deformities, presenting with complex clinical manifestations. Early diagnosis, MDT collaboration, and sequential treatment plans are key to improving patients’ prognosis and quality of life.
6.Expert consensus on the diagnosis and treatment of cemental tear.
Ye LIANG ; Hongrui LIU ; Chengjia XIE ; Yang YU ; Jinlong SHAO ; Chunxu LV ; Wenyan KANG ; Fuhua YAN ; Yaping PAN ; Faming CHEN ; Yan XU ; Zuomin WANG ; Yao SUN ; Ang LI ; Lili CHEN ; Qingxian LUAN ; Chuanjiang ZHAO ; Zhengguo CAO ; Yi LIU ; Jiang SUN ; Zhongchen SONG ; Lei ZHAO ; Li LIN ; Peihui DING ; Weilian SUN ; Jun WANG ; Jiang LIN ; Guangxun ZHU ; Qi ZHANG ; Lijun LUO ; Jiayin DENG ; Yihuai PAN ; Jin ZHAO ; Aimei SONG ; Hongmei GUO ; Jin ZHANG ; Pingping CUI ; Song GE ; Rui ZHANG ; Xiuyun REN ; Shengbin HUANG ; Xi WEI ; Lihong QIU ; Jing DENG ; Keqing PAN ; Dandan MA ; Hongyu ZHAO ; Dong CHEN ; Liangjun ZHONG ; Gang DING ; Wu CHEN ; Quanchen XU ; Xiaoyu SUN ; Lingqian DU ; Ling LI ; Yijia WANG ; Xiaoyuan LI ; Qiang CHEN ; Hui WANG ; Zheng ZHANG ; Mengmeng LIU ; Chengfei ZHANG ; Xuedong ZHOU ; Shaohua GE
International Journal of Oral Science 2025;17(1):61-61
Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans
;
Dental Cementum/injuries*
;
Consensus
;
Diagnosis, Differential
;
Cone-Beam Computed Tomography
;
Tooth Fractures/therapy*
7.Status of tuberculosis prevention and control knowledge with perceived stress among college and middle school students with pulmonary tuberculosis in Yantai
Chinese Journal of School Health 2025;46(12):1706-1710
Objective:
To understand the current status of tuberculosis prevention and control knowledge and perceived stress among college and middle school students with pulmonary tuberculosis (PTB) in Yantai City, and to analyze the related factors, so as to provide a basis for the school to carry out health education and psychological counseling.
Methods:
A matched case control study was conducted, with 100 PTB student patients in junior high school and above who were diagnosed at designated medical institutions from October 2020 to October 2024. Four healthy control students of the same gender, same dormitory, or same class were selected for each case. Therefore, 100 cases and 400 controls were investigated by questionnaire. The following information was collected: personal basic information; tuberculosis prevention and control awareness; and scores of the Chinese Perceived Stress Scale (CPSS). Conditional Logistic regression model and mixed linear models were used to compare the PTB prevention and control awareness rate, as well as the perceived stress between the case and control groups. Multiple linear regression analysis was used to analyze the factors that may affect the perceived stress of students with PTB.
Results:
The awareness rates of four tuberculosis knowledge items (symptoms of PTB, main causes of onset after infection, consequences of PTB patients not receiving standardized and complete treatment, the most important method to prevent PTB) were higher in the case group (40.00%, 72.00% , 38.00%, 49.00%) than the control group (21.50%, 57.50%, 22.25%, 31.25%) and the differences were statistically significant ( Wald χ 2=18.44, 8.78, 13.20, 16.89, all P <0.01). The tension score (10.49±4.20), loss of control score ( 11.21± 4.58), and total score (21.70±6.88) in the case group were higher than the control group (9.35±4.73, 9.75±5.60, 19.09±8.36) and the differences were statistically significant ( t =2.21, 2.42, 2.88, all P <0.05). The results of multiple linear regression analysis showed that age ≥ 18 years and family history of tuberculosis were the related factors affecting the overall perceived stress and tension of college and middle school students with PTB ( B total scores =4.50, 5.91; B tension score =2.39, 3.23, all P <0.05).
Conclusions
The tuberculosis prevention and control awareness rate, and the perceived stress of college and middle school students with PTB in Yantai are both higher than students without tuberculosis. Moreover, the perceived stress of students with PTB who are aged ≥18 years or have a family history of tuberculosis is even higher.
8.Association of dietary nutrition with perimenopausal symptoms among middle-aged and elderly women:multiple mediating effects of anxiety and depression
Zhengjie WANG ; Yingzhu HUANG ; Huiting ZHANG ; Lili YU ; Ping YI ; Xun LEI
Journal of Chongqing Medical University 2025;50(9):1141-1148
Objective:To investigate the multiple mediating effects of anxiety and depression on the relationship between dietary nutri-tion and perimenopausal symptoms in middle-aged and elderly women.Methods:A total of 1129 middle-aged and older women were surveyed using a dietary nutrition status questionnaire,the modified Kupperman Index,the Patient Health Questionnaire-9,and the Generalized Anxiety Disorder 7-item scale.The multiple mediating effect analysis was performed using the PROCESS macro in SPSS.Results:Dietary nutrition,anxiety,and depression were all significantly associated with perimenopausal symptoms(P<0.01).Dietary nutrition had a significant direct impact on perimenopausal symptoms(β=0.06,95%CI=0.002-0.119),and also exerted indirect nega-tive effects through three pathways:anxiety(β=0.059,95%CI=0.031-0.091),accounting for 29.65%of the total effect;depression(β=0.034,95%CI=0.017-0.054),accounting for 17.29%of the total effect;and anxiety-depression(β=0.045,95%CI=0.024-0.073),accounting for 22.76%of the total effect.Conclusion:Dietary nutrition not only directly affects perimenopausal symptoms,but also influences them through the mediating effects of anxiety and depression.
9.Correlations of serum stromal cell-derived factor-1,chemokine receptor 7 and vascular density in the optic disc area with clinical stages in patients with normal-tension glaucoma
Ping WANG ; Jianrong LIU ; Lei YU ; Lifen MA ; Lili ZHAO
Journal of Clinical Medicine in Practice 2025;29(4):1-5
Objective To investigate the correlations of serum stromal cell-derived factor-1(SDF-1),chemokine receptor 7(CXCR7)and vascular density in the optic disc area with clinical stages in patients with normal-tension glaucoma(NTG).Methods A total of 157 patients with NTG were included in the NTG group and divided into stage Ⅰ group(n=29),stage Ⅱ group(n=88),and stage Ⅲ group(n=40)based on different clinical stages;additionally,56 healthy individuals with physical examinations in the same period were selected as control group.Serum SDF-1 and CXCR7 levels were compared between the NTG group and the control group;changes in vascular den-sity in the optic disc area among patients with different clinical stages were analyzed;the multivariate Logistic regression analysis was conducted to explore the risk factors for NTG.Results Compared with the control group,the NTG group had significantly increased serum levels of SDF-1 and CXCR7(P<0.05).Compared with the control group,patients in the NTG group showed significantly decreased densities of large vessels,capillaries,and the entire area,as well as significantly increased density of avascular areas(P<0.05).The densities of capillaries and the entire area were significantly lower in the stage Ⅱ group and stage Ⅲ group than the stage Ⅰ group,while the density of avascu-lar areas was significantly higher(P<0.05).The densities of large vessels(r=-0.503,P=0.006),capillaries(r=-0.546,P<0.001),and the entire area(r=-0.553,P<0.001)were negatively significantly correlated with clinical stages,while the density of avascular area was positively significantly correlated with clinical stages(r=0.521,P=0.002).The proportions of patients with hypertension,history of alcohol consumption,family history of glaucoma,and high ser-um levels of SDF-1 and CXCR7 in the NTG group were significantly higher than those in the control group(P<0.05).Multivariate Logistic regression analysis revealed that hypertension,family histo-ry of glaucoma,history of alcohol consumption,and high serum levels of SDF-1 and CXCR7 were risk factors for NTG(P<0.05).Conclusion Patients with NTG have significantly increased ser-um levels of SDF-1 and CXCR7.The densities of large vessels,capillaries,and the entire area are negatively correlated with clinical stages,while the density of avascular areas is positively correlated with clinical stages.Serum levels of SDF-1 and CXCR7 can serve as effective reference indicators for the diagnosis and clinical staging of NTG.
10.Value of three-dimensional echocardiographic parameters for left ventricular reverse remodeling after transcatheter aortic valve replacement in patients with severe bicuspid aortic valve stenosis
Lili XING ; Lei HUANG ; Baixin ZHAO ; Junyue ZHANG
Journal of Clinical Medicine in Practice 2025;29(19):114-119,124
Objective To explore the evaluation value of three-dimensional echocardiographic parameters for left ventricular reverse remodeling(LVRR)after transcatheter aortic valve replacement(TAVR)in patients with severe bicuspid aortic valve(BAV)stenosis.Methods A total of 140 pa-tients with severe BAV stenosis admitted to our hospital from January 2021 to April 2024 were select-ed.All patients underwent TAVR surgery and completed three-dimensional echocardiographic exami-nations.According to whether LVRR occurred,the patients were divided into occurrence group(69 cases)and non-occurrence group(71 cases).Clinical data and three-dimensional echocardiographic parameters[left ventricular remodeling index(LVRI),left ventricular mass index(LVMI),left ventricu-lar end-diastolic volume index(LVEDVI),and left ventricular end-systolic volume index(LVESVI)]were compared between the two groups.Logistic regression analysis was used to analyze the risk factors for LVRR after TAVR in patients with severe BAV stenosis.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of three-dimensional echocardiographic parameters for LVRR after TAVR in patients with severe BAV stenosis.Results Among the 140 patients with severe BAV stenosis after TAVR,69 cases developed LVRR,with an incidence rate of 49.29%.Compared with the non-occurrence group,the occurrence group had lower values of LVMI,LVEDVI,and LVESVI,and the differences were statistically significant(P<0.05).The proportion of patients with cardiac function classification ≥ grade Ⅲ and the calcification score in the occurrence group were lower than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis results showed that cardiac function classification<grade Ⅲ,low values of LVMI,LVEDVI,LVESVI,and LVRI were protective fac-tors for LVRR after TAVR in patients with severe BAV stenosis.ROC curves showed that the areas under the curve(AUCs)and 95%CI of LVRI,LVMI,LVEDVI,and LVESVI for predicting LVRR after TAVR alone were 0.876(0.810 to 0.926),0.878(0.812 to 0.927),0.758(0.678 to 0.826),and 0.786(0.709 to 0.851),respectively.The AUCs(95%CI)of the combined model and the predictive model were 0.911(0.852 to 0.953)and 0.947(0.895 to 0.978),respective-ly,indicating high efficacy of both models.Conclusion After TAVR,LVRI,LVMI,LVEDVI,and LVESVI are closely related to LVRR in patients with severe BAV stenosis and are influencing factors for LVRR occurrence in these patients.The combined detection of these indicators has a high predictive value for LVRR after surgery.


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