1.Research progress on the status and management of diabetes mellitus after acute pancreatitis
Chen WU ; Xingmei MAO ; Shengxiao XIANG ; Ping XIE ; Can ZHANG ; Jing WANG
Chinese Journal of Practical Nursing 2024;40(2):157-161
Post-acute pancreatitis diabetes is one of the most common distant complications of acute pancreatitis. However, its incidence has been underestimated for a long time, indicating that it has not been taken seriously by healthcare professionals in clinical practice. This article provides a review of the urgent need for healthcare professionals to focus on the current status, adverse outcomes, screening and management aspects of diabetes after acute pancreatitis, and aims to provide a reference for healthcare professionals in their relevant clinical work.
2.Clinical application and research progress of mini-midline catheters
Jing XIANG ; Bochun CHEN ; Shengxiao LAI ; Mingjun ZHANG ; Longlong LIU ; Xide LIANG
China Medical Equipment 2024;21(11):157-162
The mini-midline catheter is a new technology for catheter placement that opens up a new field of peripheral venous access devices(PVADs)and plays an important role in the intravenous treatment of patients with fragile vasculature and difficult intravenous access(DIVA).Mini-midline catheter is more economical and easier to puncture than midline catheter,longer retention time than short cannula,lower catheter-related complications,it is the preferred solution for venous vascular access device(VAD)in short-to medium-term infusion and has been widely used in intravenous infusion abroad.Domestic research and application of this technology are still in the exploratory stage,and the specifications,guidelines and expert consensus for mini midline catheters have not yet been released,and there is a lack of standardized operation procedures,indications,contraindications and other guidelines.More studies with higher quality and multi-center linkage cooperation need to be carried out to provide a theoretical and practical basis for the formulation of industry standards for mini midline catheters in line with clinical practice.The definition,attributes,innovation,indications,advantages and disadvantages of the mini midline catheter were reviewed,so as to provide reference for clinical application.
3.The proportion of Th17 cells in patients with systemic sclerosis: a Meta-analysis
Yanrong LI ; Wei SONG ; Yun LI ; Mengying FAN ; Xingru WANG ; Jiaying LI ; Shengxiao ZHANG ; Caihong WANG
Chinese Journal of Rheumatology 2023;27(4):236-242
Objective:To clarify peripheral Th17 level in SSc patients and its correlation with disease.Methods:Chinese databases CNKI, CBM, Wanfang and VIP, and English databases PubMed, EMBASE, Web of Science, Cochrane Library and Science Direct were searched to collect a case-control study on the content of Th17 cells in peripheral blood of patients with SSc. The papers published when the database was first developed in 25 February 2021. Meta-analysis was conducted using Stata 12.0 software, and I2 and Egger tests were used to evaluate the heterogeneity and publication bias between studies. Results:A total of 26 case-controls were included in the study, including 1 160 patients with SSc and 778 healthy controls. Overall, the percentage of Th17 cells in SSc patients was higher than in healthy controls [SMD(95% CI)=1.85 (1.33, 2.38), P<0.001], which was most significant in IL-17 +Th17 concentration [SMD(95% CI)=1.88 (1.28, 2.48), P<0.001]. As for disease activity, the proportion of Th17 cells in active SSc patients was much higher than those of patients in remission [SMD(95% CI)=1.92 (1.12, 2.71), P<0.001]. SSc patients had a reduced Th17 level after receiving DMARDs treatment [SMD(95% CI)=-0.74 (-1.05, -0.42), P=0.029]. Conclusion:The number of Th17 cells increase significantly in the peripheral blood of patients with SSc, and is related to disease activity. DMARDs can be used to treat this disease by downregulating Th17 levels.
4.Study on the relationship between intestinal flora analysis and CD4 +T lymphocyte subsets in patients with systemic lupus erythematosus
Rong ZHAO ; Shan SONG ; Can WANG ; Minjing CHANG ; Jun QIAO ; Shengxiao ZHANG ; Xiaofeng LI
Chinese Journal of Rheumatology 2023;27(5):309-314,C5-1-C5-3
Objective:To explore the characteristics of intestinal microbiota in patients with systemic lupus erythematosus (SLE), and further explore the relationship between microbiota and CD4 +T lymphocyte subsets and disease activity. Methods:Fecal samples were collected from 96 patients with SLE, and 96 sex- and age-matched healthy controls (HCs). The gut microbiota were investigated via 16s rRNA sequencing. Flow cytometry was used to detect peripheral CD4 +T lymphocyte subsets of Th1, Th2, Th17 and Treg cells. Indicators of disease activity such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement C3 and C4, Systemic lupus erythematosus disease activity index(SLEDAI) for each patient were recorded. Differential abundance analysis was carried out using the edgeR algorithm. The Wilcoxon rank-sum test was used to compare alpha diversity indices, bacterial abundances, and the F/B ratio between groups. R (version 4.0.1) was used for comparative statistics, and Pearson′s correlation analysis was used to assess the correlations between the relative abundances of bacterial genera and serum levels of ESR, CRP, C3 and C4 in the samples. Results:The alpha estimators of richness (ACE and Chao 1) were significantly reduced in SLE feces samples compared with those of HCs ( P<0.01). Bacterial diversity estimators, including the Shannon ( P<0.01) and Simpson′s ( P<0.01) indices, were also significantly lower in SLE. Significant differences in gut microbiota composition between SLE and HCs were found using the edgeR algorithm. Compared with HC, 24 species of bacteria were significantly different in SLE patients at the genus level ( P<0.05). Moreover, there was a significant positive correlation between CRP and Coprococcus ( r=0.30, P=0.014), C4 and Corynebacterium ( r=0.31, P=0.013) and Faecalibacterium( r=0.25, P=0.048), Hemoglobin and Morganella( r=0.41, P=0.001), as well as SLIDA and Corynebacterium( r=0.25, P=0.047). In terms of lymphocyte subsets, there was significant positive correlation between B cells, Treg cells and Eubacterium eligens group, as well as CD8 +T, CD4 +T, NK cells and Corynebacterium. In additional, Th1 was positively correlated with Shigella Escherichia coli ( r=0.52, P=0.008), and Th2 was positively correlated with Dielma ( r=0.51, P<0.001). Conclusion:The abundance and diversity of intestinal flora in SLE patients were significantly reduced, and the differentially expressed bacteria were closely related to the CD4 +T lymphocyte subsets and disease activity indicators of patients.
5.Protein-based Bioinformatics Analysis of Cervical Cancer Related Genes
Lingjing CHENG ; Hetong LI ; Shengxiao ZHANG ; Hongqi LIU ; Qi YU ; Chaoyue ZHENG ; Shuang FENG ; Teng KONG ; Xiangfei SUN ; Peifeng HE ; Xiaoping LYU
Journal of Medical Informatics 2023;44(12):47-54
Purpose/Significance To explore the characteristics and clinical significance of differentially expressed genes closely re-lated to HPV E6/E7 by using bioinformatics.Method/Process The cervical tissue and clinical information of cervical cancer in TCGA and GTEx of UCSC are used as the training set.The expression profile chip GSE63514 related to cervical cancer in GEO is used as the validation set.Firstly,the limma package of R software is used to screen DEGs of tumor and normal samples,and Venn map of genes re-lated to E6/E7 protein in MigDB is made.Survival analysis is performed by survival kit and verified by ROC and protein expression lev-els.Secondly,key genes are obtained by copy number variation and methylation correlation.Finally,the specific co-expression network is constructed and enrichment analysis and immune infiltration analysis are performed.Result/Conclusion There are 101 differentially expressed genes related to HPV E6/E7 protein,and three genes are found to have significance after screening,namely E2F1,MCM4 and PCNA.At the same time,it is found that the genes in the specific coexpression network are significantly enriched in the DNA replication and chromosome organization pathways.Immune correlation analysis shows that key genes are significantly associated with CD4 T cells,B cells and neutrophils.DNA replication,chromosome organization,etc.,are the molecular mechanisms and key genes significantly related to the development of cervical squamous cell carcinoma and HPV E6/E7 encoded proteins.
6.Effect of DMARDs on differentially expressed genes in synovium of rheumatoid arthritis
Lingjing CHENG ; Shengxiao ZHANG ; Qi YU ; Chaoyue ZHENG ; Shuang FENG ; Teng KONG ; Xiangfei SUN ; Peifeng HE ; Xuechun LU
Chinese Journal of Rheumatology 2023;27(8):541-544,C8-4-C8-6,F3
Objective:To identify differentially expressed genes (DEGs) associated with the progression of synovitis in RA by using bioinformatics analysis and explore the effects of DMARDs such as methotrexate, tocilizumab and rituximab on the DEGs in RA synovium.Methods:RA expression profile microarray data GSE7307、GSE12021、GSE55457、GSE55235、GSE77298、GSE89408 were acquired from the public gene chip database (GEO), including 113 synovial tissue samples from RA and 70 healthy controls (HC). At the same time, synovial expression microarrays GSE45867, GSE24742 and GSE97165 after DMARDs treatment were obtained. These data included 8 samples treated with methotrexate, 12 treated with tocilizumab, 12 treated with rituximab and 19 treated with combined tDMARDs. R software was used to screen DEGs and Venn plots using gene ontology function enrichment and Kyoto encyclopedia of genes and genomes pathway enrichment analysis. Hub genes were selected by STRING online analysis tool and Cytoscape software.Results:Compared with HC, 797 DEGs were up-regulated and 434 DEGs were down-regulated in the synovial tissue of RA. These DEGs were mainly enriched in T cell activation, immune response-activating cell surface receptor signaling pathway. Using Cytoscape and cytoHubba to obtain 5 sets of DEGs based on the STRING database model, the degree algorithm screened out 10 hub genes: LCK, SYK, PTPRC, HLA-DRA, LYN, NCAPG, TOP2A, JUN, CXCR4, CCNB1. Methotrexate treatment significantly up-regulated 20 DEGs and down-regulated 30 DEGs. Rituximab treatment up-regulated 100 DEGs and down-regulated 55 DEGs. Tocilizumab treatment up-regulated 91 DEGs and down-regulated 317 DEGs. These altered DEGs were enriched in regulating cell adhesion, leukocyte-cell adhesion, leukocyte transfer, and insulin-like growth factor receptor signaling pathways. It was worth noting that after treatment, a total of 306 high-expressing DEGs were down-regulated, and 36 low-expressing DEGs were up-regulated.Conclusion:LCK, insulin-like growth factor receptor signaling pathway, etc. are the responsible molecular mechanisms and key pivot genes for the occurrence and development of RA, and the treatment of DMARDs, which are closely related to the response of RA to the treatment of DMARDs.
7.The relationship between gut microbiota characteristics and peripheral blood lymphocytes in patients with primary Sj?gren′s syndrome
Shan SONG ; Rong ZHAO ; Jun QIAO ; Shengxiao ZHANG ; Ting CHENG ; Xiaofeng LI
Chinese Journal of Rheumatology 2023;27(10):659-665
Objective:By detecting the species and distribution of fecal flora in patients with pSS, we investigated the relationship between the alterations of the gut microbiome and its metabolic characteristics with peripheral lymphocyte subsets, and their potential role in the occurrence and development of pSS.Methods:A total of 101 pSS patients who were hospitalized in the department of rheumatology of the Second Hospital of Shanxi Medical University, and 101 age and sex-matched healthy control (HC) in the health check-up center of Shanxi Provincial People′s Hospital from January 2019 to January 2020 were enrolled for 16s rDNA-Amplicon sequencing. The statistical analysis was performed in R software 4.0.3. The Alpha diversity were compared by Wilcoxon test, and Beta diversity were compared by ANOSIM analysis between pSS patients and HC. The difference flora was analyzed by t test. The levels of peripheral lymphocyte subsets pSS patients were detected by flow cytometry. Then the relationship between characteristic flora and clinical indicators such as lymphocyte subsets, erythrocyte sedimentation rate, C-reactive protein, unstimulated whole saliva and stimulated whole saliva were analyzed using Pearson′s correlation analysis. Results:Patients with pSS exhibited a significant reduction in the richness (Chao1, ACE) and diversity (Shannon,Simpson) of gut microbiota compared with those of HC, and there was statistical significant difference in gut microbiota composition (ANOSIM, r=0.09, P=0.001). At the phylum level, the relative abundance of Firmicutes decreased and the relative abundance of Proteobacteria increased in pSS patients. At the genus level, the proportion of Escherichia-shigella ( P<0.001), Lactobacillus ( P<0.001), Bifidobacterium ( P<0.001), Subdoligranulum ( P<0.001), Alistipes ( P<0.001) and [ Eubacterium]_ coprostanoligenes (P=0.002) were increased. The proportion of Faecalibacterium ( P<0.001), Prevotella ( P<0.001), Roseburia ( P<0.001), Megamonas ( P<0.001), Agathobacter ( P<0.001), Lachnospira ( P<0.001), Lachnospira_NK4A136 ( P=0.006), [ Eubacterium] _eligens ( P<0.001) were significantly reduced. PICRUST analysis showed significant enrichment of amino acid metabolism taurine and hypotaurine metabolism ( P<0.001), fatty acid metabolism such as propanoate metabolism ( P<0.001), glutathione metabolism ( P=0.002), lipoic acid metabolism ( P=0.003), lipopolysaccharide biosynthesis and biosynthesis of siderophore group nonribosomal peptides ( P=0.005) and Aminobenzoate degradation ( P=0.002) in patients with pSS. The Pearson correlation results showed that there were significant different in the abundances of the key gut microbiota between the HC and pSS groups, and they were closely related to unstimulated whole saliva, the absolute number of Treg cells and Th17 cells. Conclusion:The dysbiosis and metabolism changes of the pSS intestinal microbiota may contribute to immune homeostasis imbalance, and may be involved in the occurrence and development of pSS.
8.Effects of rapamycin on proliferation and apoptosis of fibroblast synovial cells of rheumatoid arthritis by regulating the AKT/mTORC1 pathway
Xiaorong HU ; Wei LI ; Ru FAN ; Yuqing LIU ; Fen ZHANG ; Fan ZHANG ; Junwei CHEN ; Shengxiao ZHANG
Chinese Journal of Rheumatology 2023;27(12):814-819
Objective:To investigate the effect of rapamycin on the proliferation and apoptosis of rheumatoid arthritis synovial fibroblasts (RA-FLS) and its mechanism.Methods:Synovial tissues were collected from patients with RA during joint replacement surgery, and primary synovial fibroblasts were extracted by trypsin digestion. The effect of rapamycin on the proliferation of RA-FLS was detected by cell counting kit (CCK-8) method. RA-FLS were divided into the control group and the rapamycin group (10 nmol/L). The effect of rapamycin on apoptosis of RA-FLS cells was detected by flow cytometry. The mRNA expres-sion levels of mammalian target of rapamycin (mTOR), serine/threonine-protein kinase AKT, B lymphocy-toma-2 (Bcl-2) associated X gene (Bax) and Bcl-2 were detected by RT-PCR. The protein expression levels of Bax, Bcl-2, mTOR, p-mTOR (2448), AKT, p-AKT and mTORC1 downstream related molecules protein S6 kinase 1(S6K1), p-S6K1, eukaryotic translation initiation factor-binding protein 1 (4EBP1) and p-4EBP1 were detected by Western blot. Differences between the two groups were compared using two independent samples t-test. Results:The results showed that the proliferation efficiency of RA-FLS treated with rapamycin was significantly weaker than that of the control group, and the drug inhibition rate of rapamycin increased with the increase of rapamycin concentration. The apoptosis rate of rapamycin group was significantly higher than that of the control group (5.31±0.59)% vs (3.49±0.40)%, t=7.83, P=0.001). The expression of Bax mRNA in rapamycin group was significantly increased (1.35±0.04 vs 1.00±0.00, t=15.60, P=0.004), while the expression of Bcl-2 mRNA (0.790±0.003 vs 1.000±0.000, t=85.50, P=0.007), mTOR mRNA (0.41±0.08 vs 1.00±0.00, t=14.37, P=0.044) and AKT mRNA (0.59±0.08 vs 1.00±0.00, t=7.54, P=0.017) were decreased, and the differences were statistically significant when compared with the control group. Compared with the control group, the protein expression of Bax in rapamycin group was significantly increased (0.75±0.10 vs 0.48±0.09, t=4.04, P=0.007), and the expression levels of Bcl-2 (0.632±0.055 vs 0.758±0.020, t=7.35, P=0.002), p-AKT/AKT(0.61±0.07 vs 0.88±0.04, t=5.61, P=0.005), p-mTOR/mTOR(0.92±0.12 vs 1.28±0.09, t=5.05, P=0.002), p-S6K1/S6K1(0.884±0.020 vs 1.023±0.058, t=4.52, P=0.004) and p-4EBP1/4EBP1 were decreased(0.86±0.05 vs 1.11±0.05, t=6.00, P=0.004). Conclusion:Rapamycin may inhibit the proliferation and induce apoptosis of RA-FLS cells by inhibiting AKT/mTORC1 pathway.
9.Progress in adverse effects of sleep deprivation on body fertility
Shengxiao ZHANG ; Xingdao GUO ; Wenyang CHEN ; Yaqi XU ; Wei LI ; Guirong ZHANG
Chinese Journal of Pharmacology and Toxicology 2023;37(7):486-486
Sleep is essential for the maintenance of human normal functions.Nowadays,the occurrence of active sleep deprivation(ASD)or passive sleep depriva-tion(PSD)is becoming more and more common due to the inability of the body adapting to the rapid changes in the internal and external environment.SD is not only an action,a brief process or a result,but also a directly or indirectly sustained state,which is associated to sleep time,circadian rhythm or sleep quality.SD can lead to numerous adverse effects on the body,such as sleep-related acute and chronic diseases.Long-term SD increases the risk of neurological and cardiovascular dis-eases as well as immune system dysfunction.In addi-tion,SD may affect the reproductive health of the body,giving rise to a series of potential fertility problems.In recent years,the correlation research and mechanism between SD and the related diseases have become a focus of scholars' attention.Numerous lines of evidence suggest that pathological sleep,such as insomnia and sleep apnea syndrome,is associated with impaired repro-ductive function.Disruptions in the circadian rhythm can also lead to impaired hypothalamic-pituitary-gonadal(HPG)axis function and thereby interfere with the repro-ductive process.Our research team has demonstrated that SD significantly affects the fertility of male and female rats and has adverse effects on reproduction.By new generation sequencing(NGS)and RT-PCR verifica-tion,we have identified differently expressed genes that are involved in mediating the effect of SD on fertility.However,the mechanisms and biological macromolecules regulated by SD are worthy of being further explored.This paper provides a brief review of SD research and then focuses on the adverse impact of SD on fertility,conducting a literature review to sort out the ideas and pro-vide references for research in this field.
10.Research progress on the mechanism of action of endoplasmic reticulum stress inhibitors
Luge HAO ; Qi ZHANG ; Shengxiao ZHANG ; Caiyun SHI ; Wei LI
Chinese Journal of Pharmacology and Toxicology 2023;37(7):508-508
Endoplasmic reticulum stress(ERS)is closely related to the mechanisms of multiple diseases,and regulation of ERS has become a therapeutic target for several diseases.Previous studies by our group have demonstrated that ERS can be alleviated and neuronal cells can be protected by downregulating ERS-related proteins such as GRP78,caspase12 and caspase3.The research on ERS inhibitors has progressed rapidly in recent years,and they can be classified into various types such as molecular chaperones,small molecule compounds and natural products,such as 4-phenylbutyric acid(4-PBA),tauroursodeoxycholic acid(TUDCA)and tumor necrosis factor α-stimulating factor 6(TSG-6),etc.These inhibitors can regulate the ERS signaling pathway through different pathways,such as:silent information regulator 1(SIRT1)promotes the expression of anti-apop-totic proteins by inhibiting the PERK-eIF2α-ATF4-CHOP pathway,thus reducing apoptosis.In addition,SIRT1 deacetylates XBP-1,regulates the IRE1α-XBP1 signaling pathway,and inhibits the expressions of GRP78 and CHOP,thereby reducing the protein load of endoplasmic reticulum(ER)and alleviating ERS;PDE4 inhibitor regu-lates c-Jun-mediated apoptotic pathway,reduces the interaction between IRE1 and TRAF2,and attenuates the level of c-Jun phosphorylation,thereby restoring ER homeostasis.In addition,PDE4 inhibitor activates the antioxidant-acting Nrf-2 pathway,decreases the concen-tration of intracellular calcium ion and reduces the pro-duction of ROS;TSG-6 exerts anti-inflammatory effects by regulating the secretion of inflammatory factors through PERK-eIF-2α-NF-κB p65 and IRE1α-TRAF2-NF-κB p65 signaling pathways.In-depth exploration of the potential mechanism of action of ERS inhibitors is of great signifi-cance for finding ways to treat related diseases by regu-lating ERS.

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