1.Effect of Huangling Jidu Xizhuo Granules on NLRP3, Intestinal Flora and Short-term Prognosis in Patients with Gout
Dandan TIAN ; Shanping WANG ; Li YANG ; Tingting ZHANG ; Xi CHEN ; Chuanbing HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):150-156
ObjectiveTo investigate the effects of retention enema with Huangling Jiedu Xiezhuo granules(HJXG) on Nod-like receptor protein 3(NLRP3), intestinal flora, and short-term prognosis in patients with gout. MethodsA total of 60 patients with gout admitted to the hospital from January 2021 to December 2023 were selected and divided into a control group and an observation group according to the random number table method, with 30 cases in each group. The control group was treated with febuxostat, and the observation group was treated with retention enema with HJXG on the basis of the control group. After 14 days of continuous treatment, the clinical efficacy, traditional Chinese medicine (TCM) syndrome score, and visual analogue scale (VAS) pain index of the two groups were compared, and serum creatinine(SCr), blood urea nitrogen(BUN), uric acid(UA), cystatin C(CysC), β2- microglobulin(β2-MG), glomerular filtration rate test(GFR), creatinine clearance rate (Ccr), erythrocyte sedimentation rate(ESR), hypersensitive C-reactive protein,(hs-CRP), interleukin 6(IL-6), interleukin-1β(IL-1β), interleukin-18 (IL-18), NLRP3 inflammasome levels, and the number of intestinal flora were detected in the two groups. The prognosis of patients was followed up within 12 weeks. COX regression analysis was used to analyze the effect of short-term prognosis. ResultsAfter treatment, TCM syndrome scores and VAS pain index in both groups were reduced (P<0.05), and TCM syndrome scores in the observation group were significantly lower than those in the control group. After treatment, ESR, hs-CRP, IL-6, NLRP3, IL-18, and IL-1β were significantly decreased in both groups (P<0.01), and the levels of IL-6, ESR, NLRP3, and IL-18 were significantly improved in the observation group compared with the control group (P<0.05). BUN, SCr, UA, β2-MG, GFR indexes in both groups were significantly lower after treatment, Ccr indexes in both groups were significantly higher after treatment, and the levels of SCr, UA, CysC, and Ccr in the observation group were significantly better than those in the control group (P<0.05). After treatment, the intestinal flora in both groups was improved, and the observation group was significantly improved compared with the control group in terms of Lactobacillus, Proteus, Bacteroides, and Escherichia coli (P<0.05). COX regression analysis showed that retention enema with HJXG could reduce the risk of poor short-term prognosis in patients with gout compared with Western medicine alone. ConclusionThe retention enema with HJXG can improve the curative effect of patients with gout, improve the TCM syndromes, reduce inflammation, and enhance renal function, intestinal flora, and short-term prognosis.
2.Effect of Xinfeng Capsules Combined with Chronic Disease Management of Traditional Chinese Medicine on Rapid Disease Control and Short-term Prognosis of Patients with Rheumatoid Arthritis
Dandan TIAN ; Hong ZHAO ; Man LUO ; Shanping WANG ; Li YANG ; Tingting ZHANG ; Xi CHEN ; Chuanbing HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):137-144
ObjectiveTo investigate the effects of Xinfeng capsules combined with chronic disease management of traditional Chinese medicine (TCM) on rapid disease control and short-term prognosis of patients with rheumatoid arthritis (RA). MethodsA total of 80 RA patients hospitalized in the Department of Rheumatology of The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2022 to March 2024 were enrolled and randomly divided into an observation group (40 cases) and a control group (40 cases). The control group was treated with conventional methotrexate combined with standard chronic disease management, while the observation group was additionally treated with Xinfeng Capsules combined with TCM chronic disease management. The treatment course lasted 24 weeks. The outcomes were compared between two groups, including disease activity [28-joint disease activity score (DAS28), clinical disease activity index (CDAI), simplified disease activity index (SDAI)], visual analogue scale (VAS) for pain, TCM syndrome score, tender joint count (TJC), swollen joint count (SJC), morning stiffness duration, Health Assessment Questionnaire (HAQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), American College of Rheumatology (ACR) 20%, 50% and 70% response rates (ACR20/50/70), erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (CCP-Ab), interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), and serum immunoglobulin G (IgG). The Chronic Disease Self-Management Scale (CDSMS) was used to evaluate patients’ self-management ability, self-care ability, and nursing satisfaction. Patients were followed up for 12 weeks to assess prognosis, and COX regression analysis was performed to determine the impact on short-term prognosis. ResultsAfter treatment, TJC, SJC, morning stiffness duration, DAS28, CDAI, SDAI, VAS, TCM syndrome score, ESR, hs-CRP, RF, CCP-Ab, IL-6, IL-1β, TNF-α, IgG, HAQ, SAS, SDS, chronic disease self-management behavior, self-efficacy, and self-care ability all improved significantly in both groups compared with baseline (P<0.05,P<0.01). Compared with the control group, the observation group showed more significant improvements in TJC, SJC, morning stiffness duration, DAS28, CDAI, SDAI, VAS, TCM syndrome score, ESR, IL-1β, IgG, HAQ, SAS, SDS, self-care ability, chronic disease self-management behavior, and self-efficacy (P<0.05 or P<0.01). The ACR70 response rate and nursing satisfaction were significantly higher in the observation group than in the control group (P<0.01). COX regression analysis showed that Xinfeng capsules combined with TCM chronic disease management reduced the risk of poor short-term prognosis in RA patients. ConclusionXinfeng capsules combined with TCM chronic disease management facilitates rapid disease control in RA patients, effectively improves short-term prognosis, and plays an important role in the treatment of the disease.
3.Mediating effects of activities of daily living and social participation on depressive symptoms and cognitive function among the elderly
Journal of Preventive Medicine 2025;37(5):438-442
Objective:
To explore the mediating effects of activities of daily living (ADL) and social participation on depressive symptoms and cognitive function among the elderly, so as to provide the basis for preventing cognitive decline.
Methods:
Basic information, depressive symptoms, cognitive function, ADL, and social participation of the elderly aged 60 and above were collected through the 2020 database of China Health and Retirement Longitudinal Study. The Process 4.3 program was used to analyze the mediating effects of ADL and social participation on depressive symptoms and cognitive function among the elderly.
Results:
A total of 6 722 elderly people were enrolled, including 3 791 males (56.40%) and 2 931 females (43.60%). The mean age was (68.52±6.00) years. The median depressive symptoms score was 7.00 (interquartile range, 9.00) points, with 2 436 individuals (36.24%) having depressive symptoms. The median cognitive function score was 12.50 (interquartile range, 4.50) points. The median ADL score was 0 (interquartile range, 1.00) point, with 2 173 individuals (32.33%) having ADL impairment. The median social participation score was 1.00 (interquartile range, 1.00) point. Mediating effect analysis showed that, after controlling for variables such as age, educational level, and residence, depressive symptoms indirectly negatively affected cognitive function through the independent mediating effects of ADL (β=-0.031, 95%CI: -0.042 to -0.020) and social participation (β=-0.008, 95%CI: -0.011 to -0.004), and negatively affected cognitive function via the chain mediating effects of ADL and social participation (β=-0.002, 95%CI: -0.003 to -0.001). The total mediating effect accounted for 25.79% of the total effect.
Conclusion
Depressive symptoms may indirectly and negatively affect the cognitive function among the elderly through ADL and social participation.
4.Multidisciplinary expert consensus on weight management for overweight and obese children and adolescents based on healthy lifestyle
HONG Ping, MA Yuguo, TAO Fangbiao, XU Yajun, ZHANG Qian, HU Liang, WEI Gaoxia, YANG Yuexin, QIAN Junwei, HOU Xiao, ZHANG Yimin, SUN Tingting, XI Bo, DONG Xiaosheng, MA Jun, SONG Yi, WANG Haijun, HE Gang, CHEN Runsen, LIU Jingmin, HUANG Zhijian, HU Guopeng, QIAN Jinghua, BAO Ke, LI Xuemei, ZHU Dan, FENG Junpeng, SHA Mo, Chinese Association for Student Nutrition & ; Health Promotion, Key Laboratory of Sports and Physical Fitness of the Ministry of Education,〖JZ〗 Engineering Research Center of Ministry of Education for Key Core Technical Integration System and Equipment,〖JZ〗 Key Laboratory of Exercise Rehabilitation Science of the Ministry of Education
Chinese Journal of School Health 2025;46(12):1673-1680
Abstract
In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.
5.The application effect of a new type of laparoscopic multi-freedom surgical instrument in the training of basic surgical skills
Zhida CHEN ; Jianhan YIN ; Yi LIU ; Tingting LU ; Gan ZHANG ; Xiaoyu DONG ; Xiaohui DU ; Hongqing XI
Chinese Journal of Surgery 2024;62(11):1045-1053
Objective:To evaluate the application effect of a new type of laparoscopic multi-degree-of-freedom surgical instrument in the training of basic surgical skills and analyze the learning curve.Methods:The teaching records of the trainees who received training in the training base of laparoscopic surgeons in Chinese People′s Liberation Army General Hospital from January to October, 2023 were collected. The 50 trainees were randomly divided into conventional instrumentation group and new instrumentation group with 25 trainees in each group according to the random number table method before the training. According to the research design, five modules such as "accurate bean clamping, plum blossom pile bean clamping, ferrule positioning, threading with both hands, sewing and knotting" were trained. After the training, they were assessed and the completion time of each module was recorded. The comparison of the changes of the completion time of the two groups of students before and after training was statistically analyzed by differences-in-differences(DID) method, and the fitting analysis of learning curve was analyzed by cumulative summation method .Results:Before the training, there was no statistically significant difference in the time required to complete five modules between the two groups of trainees (all P>0.05). After the training, the time to complete the five modules in both groups was reduced compared to before the training (accurate bean clamping: (63.7±9.3) seconds vs. (85.4±18.2) seconds, t=2.38, P=0.035; plum blossom pile bean clamping: (45.2±6.8) seconds vs. (103.1±57.2) seconds, t=8.77, P=0.047; ring positioning: (78.5±19.1) seconds vs. (126.2±26.3) seconds, t=6.96, P=0.019; threading with both hands: (63.3±21.2) seconds vs. (105.8±27.9) seconds, t=3.43, P=0.015; sewing and knotting: (160.2±79.5) seconds vs. (228.9±96.6) seconds, t=4.58, P=0.008).The average time required to complete the five modules was shorter in the new instrument group compared to the conventional instrument group (DID for accurate bean clamping=37.66, t=2.43, P=0.007; DID for plum blossom pile bean clamping=58.42, t=3.03, P=0.013; DID for ferrule positioning=28.33, t=2.83, P=0.031; DID for threading with both hands=48.89, t=2.10, P=0.042; DID for sewing and knotting=54.78, t=3.57, P=0.012). In the learning curves for the plum blossom pile bean clamping, ferrule positioning, and sewing and knotting modules, the new instrument group required fewer class hours to reach proficiency compared to the conventional instrument group (plum blossom pile bean clamping: 3 class hours vs. 4 class hours; ferrule positioning: 4 class hours vs. 5 class hours; sewing and knotting: 3 class hours vs. 5 class hours). In the accurate bean clamping and threading with both hands modules, both the conventional and new instrument groups crossed the learning curve at the 5 th class hour, but there was a statistically significant difference in the slopes of the curves between the two groups (accurate bean clamping: t=-2.85, P=0.004; threading with both hands: t=-2.66, P=0.008). Conclusion:The new type of laparoscopic multi-degree-of-freedom surgical instruments can improve the learning effect and shorten the learning curve in laparoscopic training teaching, which shows good application effect and has the possibility of clinical trial.
6.Experimental Studies Butorphanol on the Biological Activity and Chemotherapy Drug Resistance of Osteosarcoma Cells by Regulating the FOXO3-FOXM1 Signal Axis
Tingting AO ; Zhenzhen JIANG ; Xi ZHANG
Journal of Modern Laboratory Medicine 2024;39(6):37-42,66
Objective To investigate the impacts of butorphanol(BUT)on the biological activity and chemotherapy drug resistance of osteosarcoma cells by regulating the forkhead box protein O3(FOXO3)-forkhead box protein M1(FOXM1)signal axis.Methods CDDP resistant MG-63 cells(MG-63/CDDP)treated with 2.0 μmol/L cisplatin(CDDP)were separated into control group(MG-63/CDDP cells were treated with 0.05%DMSO medium),BUT group(MG-63/CDDP cells were treated with 40 μg/mL BUT),JY-2 group(MG-63/CDDP cells were treated with 100 μmol/L FOXO3-FOXM1 inhibitor JY-2),and BUT+JY-2 group(MG-63/CDDP cells were treated with 40 μg/ml BUT and 100 μmol/L JY-2).CCK8 method was applied to detect MG-63/CDDP cell activity.Flow cytometry was used to detect apoptosis in MG-63/CDDP cells.The Transwell method was applied to detect the migration and invasion of MG-63/CDDP cells;Western blot was applied to detect the expression of autophagy proteins and proteins related to the FOXO3-FOXM1 signaling pathway.Results Compared with MG-63 cells,the IC50(20.56±2.52μmol/L vs(0.97±0.10μmol/L)of MG-63/CDDP cells was increased,and the differences was statistically significant(q=19.017,P<0.05),and the optimal concentration of 1 μmol/L CDDP was selected for subsequent experiments.Compared with the control group,the A value(0.43±0.05 vs 0.68±0.06),numbers of cell migration(63.63±7.58 vs 114.56±10.57)and invasion(43.38±4.58 vs 79.56±8.48),and the levels of autophagy-related protein Beclin1(0.31±0.05 vs 0.62±0.07)and microtubule-associated protein light chain 3(LC3)-Ⅱ/Ⅰ proteins(0.51±0.08 vs 0.98±0.11)in the BUT group were reduced(q=6.763~9.591,all P<0.05),the apoptosis rate(28.57%±3.14%vs 8.67%±1.46%),the levels of FOXO3(0.72±0.08 vs 0.33±0.04)and FOXM1(1.22±0.15 vs 0.70±0.08)proteins were increased(q=14.077,10.681,7.493,all P<0.05),however,in the JY-2 group,the A value(0.99±0.13 vs 0.68±0.06),numbers of cell migration(147.59±15.37 vs 114.56±10.57)and invasion(111.83±12.58 vs 79.56±8.48),and the levels of Beclin1(0.94±0.11 vs 0.62±0.07)and LC3-Ⅱ/Ⅰ(1.27±0.13 vs 0.98±0.11)proteins in the JY-2 group were increased(q=4.171~6.012,all P<0.05),the apoptosis rate(4.56%±0.86%vs 8.67%±1.46%),the levels of FOXO3(0.17±0.01 vs 0.33±0.04)and FOXM1(0.46±0.03 vs 0.70±0.08)proteins were reduced(q=5.941,9.505,6.881,all P<0.05),and the differences were statistically significant,respectively.JY-2 reversed the beneficial effects of BUT on MG-63/CDDP cell activity and chemotherapy resistance.Conclusion BUT may regulate the cell activity and CDDP resistance of osteosarcoma cells by activating the FOXO3-FOXM1 signaling pathway.
7.The application effect of a new type of laparoscopic multi-freedom surgical instrument in the training of basic surgical skills
Zhida CHEN ; Jianhan YIN ; Yi LIU ; Tingting LU ; Gan ZHANG ; Xiaoyu DONG ; Xiaohui DU ; Hongqing XI
Chinese Journal of Surgery 2024;62(11):1045-1053
Objective:To evaluate the application effect of a new type of laparoscopic multi-degree-of-freedom surgical instrument in the training of basic surgical skills and analyze the learning curve.Methods:The teaching records of the trainees who received training in the training base of laparoscopic surgeons in Chinese People′s Liberation Army General Hospital from January to October, 2023 were collected. The 50 trainees were randomly divided into conventional instrumentation group and new instrumentation group with 25 trainees in each group according to the random number table method before the training. According to the research design, five modules such as "accurate bean clamping, plum blossom pile bean clamping, ferrule positioning, threading with both hands, sewing and knotting" were trained. After the training, they were assessed and the completion time of each module was recorded. The comparison of the changes of the completion time of the two groups of students before and after training was statistically analyzed by differences-in-differences(DID) method, and the fitting analysis of learning curve was analyzed by cumulative summation method .Results:Before the training, there was no statistically significant difference in the time required to complete five modules between the two groups of trainees (all P>0.05). After the training, the time to complete the five modules in both groups was reduced compared to before the training (accurate bean clamping: (63.7±9.3) seconds vs. (85.4±18.2) seconds, t=2.38, P=0.035; plum blossom pile bean clamping: (45.2±6.8) seconds vs. (103.1±57.2) seconds, t=8.77, P=0.047; ring positioning: (78.5±19.1) seconds vs. (126.2±26.3) seconds, t=6.96, P=0.019; threading with both hands: (63.3±21.2) seconds vs. (105.8±27.9) seconds, t=3.43, P=0.015; sewing and knotting: (160.2±79.5) seconds vs. (228.9±96.6) seconds, t=4.58, P=0.008).The average time required to complete the five modules was shorter in the new instrument group compared to the conventional instrument group (DID for accurate bean clamping=37.66, t=2.43, P=0.007; DID for plum blossom pile bean clamping=58.42, t=3.03, P=0.013; DID for ferrule positioning=28.33, t=2.83, P=0.031; DID for threading with both hands=48.89, t=2.10, P=0.042; DID for sewing and knotting=54.78, t=3.57, P=0.012). In the learning curves for the plum blossom pile bean clamping, ferrule positioning, and sewing and knotting modules, the new instrument group required fewer class hours to reach proficiency compared to the conventional instrument group (plum blossom pile bean clamping: 3 class hours vs. 4 class hours; ferrule positioning: 4 class hours vs. 5 class hours; sewing and knotting: 3 class hours vs. 5 class hours). In the accurate bean clamping and threading with both hands modules, both the conventional and new instrument groups crossed the learning curve at the 5 th class hour, but there was a statistically significant difference in the slopes of the curves between the two groups (accurate bean clamping: t=-2.85, P=0.004; threading with both hands: t=-2.66, P=0.008). Conclusion:The new type of laparoscopic multi-degree-of-freedom surgical instruments can improve the learning effect and shorten the learning curve in laparoscopic training teaching, which shows good application effect and has the possibility of clinical trial.
8.Construction of a Nomogram model for personalized prediction of the risk of delayed postoperative bleeding after endoscopic submucosal dissection for early gastric cancer
Tingting GONG ; Aihua QIAN ; Xi CHEN
Journal of Surgery Concepts & Practice 2024;29(3):236-242
Objective To analyze the influencing factors of delayed postoperative bleeding(DPPB)after endoscopic submucosal dissection(ESD)for early gastric cancer and construct a Nomogram model.Methods The clinical information of 234 patients who underwent ESD treatment at our hospital and pathologically diagnosed with early gastric cancer from April 2021 to April 2023 were collected.The patients were grouped based on the presence or absence of DPPB.Logistic regression analysis was applied to screen for risk factors affecting DPPB after ESD in early gastric cancer patients.R software was applied to construct a Nomogram model for predicting the risk of DPPB in early gastric cancer patients after ESD.Receiver operator characteristic(ROC)curve,calibration curve,and Hosmer-Lemeshow goodness of fit test were plotted to evaluate the Nomogram model.Results A total of 23(9.8%)of 234 early gastric cancer patients who underwent ESD treatment developed DPPB.Multivariate Logistic regression analysis showed that the number of biopsies≥3(95%CI:2.482-20.424,P=0.000),the maximum diameter of lesions≥3 cm(95%CI:1.620-13.244,P=0.004),the depth of invasion to submucosa(95%CI:1.421-10.536,P=0.008),and intraoperative bleeding(95%CI:1.160-11.300,P=0.027)were independent risk factors for DPPB after ESD in early gastric cancer patients.The area under ROC curve(AUC)was 0.838(95%CI:0.743-0.932).The slope of the calibration curve was close to 1.Hosmer-Lemeshow goodness of fit test showed χ2=3.328,P=0.505.Conclusions The number of biopsies≥3,the maximum diameter of lesion≥3 cm,the depth of invasion to submucosa,and intraoperative bleeding are independent risk factors for DPPB after ESD in early gastric cancer patients.The Nomogram model based on these four independent risk factors can effectively predict the risk of DPPB after ESD in early gastric cancer patients.
9.Prognosis and influencing factors analysis of patients with initially resectable gastric cancer liver metastasis who were treated by different modalities: a nationwide, multicenter clinical study
Li LI ; Yunhe GAO ; Liang SHANG ; Zhaoqing TANG ; Kan XUE ; Jiang YU ; Yanrui LIANG ; Zirui HE ; Bin KE ; Hualong ZHENG ; Hua HUANG ; Jianping XIONG ; Zhongyuan HE ; Jiyang LI ; Tingting LU ; Qiying SONG ; Shihe LIU ; Hongqing XI ; Yun TANG ; Zhi QIAO ; Han LIANG ; Jiafu JI ; Lin CHEN
Chinese Journal of Digestive Surgery 2024;23(1):114-124
Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.
10.Inhibitory Effect of Curcumin and Its Derivatives on TGF-β Induced Fibrosis of LX-2 Cells
Yidan SHAO ; Tingting SHI ; Yanmei ZHAO ; Xi ZOU ; Jianjun XI ; Jing ZHANG ; Xiaojie JIANG ; Rangxiao ZHUANG
Chinese Journal of Modern Applied Pharmacy 2024;41(13):1750-1757
OBJECTIVE
To study the inhibitory effect and mechanism of curcumin and its derivatives A and B on TGF-β induced LX-2 cell fibrosis.
METHODS
Established the liver fibrosis model of LX-2 cells induced by TGF-β(10 ng·mL−1).The effects on cell proliferation were detected by CCK-8. The effects on cell apoptosis was detected by flow cytometry. The effects on fibrosis related factors(Collagen I, Collagen Ⅳ, Fibronectin, Vimentin, α-SMA, PDGFRβ, TGFβR1, TGFβR2, MMP2, MMP9, TIMP1 and TIMP2) protein expression and gene transcription levels were detected by Western blotting and q-PCR.
RESULTS
The curcumin and its derivative A and B had the inhibition effects on normal LX-2 cells, and the IC25 values were 15.7, 2.6, 10.2 μmol·L−1, respectively. Compared to the model group, the curcumin(15.7 μmol·L−1) and its derivative A(2.6 μmol·L−1) and B(10.2 μmol·L−1) had the significant inhibition effects on cell proliferation of the TGF-β induced LX-2 cells(P<0.05). The cell apoptosis rate of curcumin derivative B group was higher than the model group(P<0.05). Collagen I, Fibronectin, Vimentin, α-SMA, TGFβR1 and TIMP-1 protein expression levels in curcumin group were lower, while the protein expression level of MMP-9 was higher(P<0.05). The protein expression levels of Collagen I, Collagen IV, Fibronectin, Vimentin, α-SMA, TIMP-1 and TIMP-2 in curcumin derivative A group were lower, while the protein expression level of MMP-2 was higher(P<0.05). The protein expression levels of Collagen I, Collagen IV, Fibronectin, Vimentin, α-SMA, PDGFRβ, TGFβR1, TGFβR2, TIMP-1 and TIMP-2 in curcumin derivative B group were lower, while the protein expression level of MMP-2 was higher(P<0.05). The gene transcription levels of Collagen I, Fibronectin, α-SMA and TIMP-1 in curcumin group were lower(P<0.05). The gene transcription levels of Collagen I, Fibronectin and α-SMA in curcumin derivative A and B groups were lower(P<0.05).
CONCLUSION
Curcumin and its derivatives A and B inhibit the abnormal activation and proliferation of TGF-β-induced LX-2 cells, inhibit the excessive secretion and accumulation of its extracellular matrix components, and promote its degradation, thus playing an anti-fibrotic effect in vitro, especially the curcumin derivative B.


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