1.Xianglian Huazhuo Prescription Regulates GP73/PERK/ATF4 Signaling Pathway to Influence Endoplasmic Reticulum Stress and Ameliorate Chronic Atrophic Gastritis
Pengli DU ; Yuxi GUO ; Yican WANG ; Ziqi JIN ; Xin KANG ; Xuemei JIA ; Weichao XU ; Yanru CAI ; Qian YANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):19-28
ObjectiveTo explore the mechanism by which Xianglian Huazhuo prescription ameliorates chronic atrophic gastritis (CAG) through regulating the Golgi protein 73 (GP73)/protein kinase R-like endoplasmic reticulum kinase (PERK)/activating transcription factor 4 (ATF4) signaling pathway and modulating endoplasmic reticulum stress (ERS). MethodA mouse model of CAG was induced by multiple factors, including ranitidine, N-methyl-N′-nitro-N-nitrosoguanidine (MNNG), and irregular feeding. The CAG mice were randomized into five groups: model, Morodan (2.0 g·kg-1), and high-dose, medium-dose, and low-dose (7.6, 3.8, 1.9 g·kg-1, respectively) Xianglian Huazhuo prescription, with 10 mice in each group. At the same time, 10 mice in normal group were set up. The mice in the Morodan group and the high-dose, medium-dose, and low-dose groups of Xianglian Huazhuo prescription were administrated with corresponding agents by gavage, and those in the normal group and the model group were administrated with an equal volume of normal saline. All the mice were intervened once a day for 60 consecutive days. After the last administration, the overall morphological changes of the gastric tissue were observed. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were used to evaluate the pathological morphology and the endoplasmic reticulum ultrastructure in the gastric tissue. The serum levels of pepsinogen Ⅰ (PGⅠ), pepsinogen Ⅱ (PGⅡ), gastrin-17 (G-17), and GP73 were determined by enzyme-linked immunosorbent assay (ELISA). The pepsinogen ratio (PGR, PGⅠ/PGⅡ) was calculated. The protein levels of GP73, PERK, phosphorylated (p)-PERK, glucose-regulated protein 78 (GRP78), ATF4, CCAAT enhancer-binding protein homologous protein (CHOP), cysteinyl aspartate-specific protease-12 (Caspase-12), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax) were assessed by Western blot. The expression of GRP78 was detected by immunofluorescence (IF) assay, and the location of Bcl-2 and Bax by immunohistochemistry (IHC). ResultsCompared with the normal group, the model group showed pale gastric mucosa with flattened folds and reduced and loosely arranged gastric mucosal glands, declined serum levels of PGI, PGR, G-17, and GP73 (P<0.01). downregulated protein levels of GP73, p-PERK, ATF4, GRP78, CHOP, Caspase-12, and Bax in the gastric tissue, and upregulated protein level of Bcl-2 (P<0.01). Compared with the model group, the Morodan group and each Xianglian Huazhuo prescription group exhibited red gastric mucosa with increased folds, alleviated pathological damage, swelling endoplasmic reticulum, elevated serum levels of PGI, G-17, and GP73 (P<0.05, P<0.01), and upregulated protein levels of Caspase-12 and Bax and downregulated protein level of Bcl-2 in the gastric tissue (P<0.05, P<0.01). The Morodan group and the high-dose and medium-dose Xianglian Huazhuo prescription groups exhibited increased serum level of PGR (P<0.05, P<0.01) and upregulated protein levels of GP73, p-PERK, ATF4, GRP78, and CHOP in the gastric tissue (P<0.05, P<0.01). ConclusionXianglian Huazhuo prescription can activate the GP73/PERK/ATF4 signaling pathway and induce ERS-mediated apoptosis to alleviate the pathological damage of the gastric mucosa, thereby demonstrating a protective effect against CAG in mice.
2.Xianglian Huazhuo Prescription Regulates GP73/PERK/ATF4 Signaling Pathway to Influence Endoplasmic Reticulum Stress and Ameliorate Chronic Atrophic Gastritis
Pengli DU ; Yuxi GUO ; Yican WANG ; Ziqi JIN ; Xin KANG ; Xuemei JIA ; Weichao XU ; Yanru CAI ; Qian YANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):19-28
ObjectiveTo explore the mechanism by which Xianglian Huazhuo prescription ameliorates chronic atrophic gastritis (CAG) through regulating the Golgi protein 73 (GP73)/protein kinase R-like endoplasmic reticulum kinase (PERK)/activating transcription factor 4 (ATF4) signaling pathway and modulating endoplasmic reticulum stress (ERS). MethodA mouse model of CAG was induced by multiple factors, including ranitidine, N-methyl-N′-nitro-N-nitrosoguanidine (MNNG), and irregular feeding. The CAG mice were randomized into five groups: model, Morodan (2.0 g·kg-1), and high-dose, medium-dose, and low-dose (7.6, 3.8, 1.9 g·kg-1, respectively) Xianglian Huazhuo prescription, with 10 mice in each group. At the same time, 10 mice in normal group were set up. The mice in the Morodan group and the high-dose, medium-dose, and low-dose groups of Xianglian Huazhuo prescription were administrated with corresponding agents by gavage, and those in the normal group and the model group were administrated with an equal volume of normal saline. All the mice were intervened once a day for 60 consecutive days. After the last administration, the overall morphological changes of the gastric tissue were observed. Hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM) were used to evaluate the pathological morphology and the endoplasmic reticulum ultrastructure in the gastric tissue. The serum levels of pepsinogen Ⅰ (PGⅠ), pepsinogen Ⅱ (PGⅡ), gastrin-17 (G-17), and GP73 were determined by enzyme-linked immunosorbent assay (ELISA). The pepsinogen ratio (PGR, PGⅠ/PGⅡ) was calculated. The protein levels of GP73, PERK, phosphorylated (p)-PERK, glucose-regulated protein 78 (GRP78), ATF4, CCAAT enhancer-binding protein homologous protein (CHOP), cysteinyl aspartate-specific protease-12 (Caspase-12), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax) were assessed by Western blot. The expression of GRP78 was detected by immunofluorescence (IF) assay, and the location of Bcl-2 and Bax by immunohistochemistry (IHC). ResultsCompared with the normal group, the model group showed pale gastric mucosa with flattened folds and reduced and loosely arranged gastric mucosal glands, declined serum levels of PGI, PGR, G-17, and GP73 (P<0.01). downregulated protein levels of GP73, p-PERK, ATF4, GRP78, CHOP, Caspase-12, and Bax in the gastric tissue, and upregulated protein level of Bcl-2 (P<0.01). Compared with the model group, the Morodan group and each Xianglian Huazhuo prescription group exhibited red gastric mucosa with increased folds, alleviated pathological damage, swelling endoplasmic reticulum, elevated serum levels of PGI, G-17, and GP73 (P<0.05, P<0.01), and upregulated protein levels of Caspase-12 and Bax and downregulated protein level of Bcl-2 in the gastric tissue (P<0.05, P<0.01). The Morodan group and the high-dose and medium-dose Xianglian Huazhuo prescription groups exhibited increased serum level of PGR (P<0.05, P<0.01) and upregulated protein levels of GP73, p-PERK, ATF4, GRP78, and CHOP in the gastric tissue (P<0.05, P<0.01). ConclusionXianglian Huazhuo prescription can activate the GP73/PERK/ATF4 signaling pathway and induce ERS-mediated apoptosis to alleviate the pathological damage of the gastric mucosa, thereby demonstrating a protective effect against CAG in mice.
3.Current status of implementation of infection control core elements in grass-roots medical institutions under background of construction of"compact county-level medical communities"
Fangfang WANG ; Yuncui GUO ; Xiaoyan WU ; Haibo ZHANG ; Jing ZHOU ; Xu LIU ; Jia DI ; Shufang JIANG ; Chengyi FENG ; Xuemei LI
Chinese Journal of Nosocomiology 2025;35(18):2821-2825
OBJECTIVE To explore the implementation and standardized management of infection control core ele-ments in grass-roots medical institutions within county-level medical communities.METHODS From Mar.2024 to Apr.2024,the current status of implementation of infection control core elements in the grass-roots medical institu-tions within county-level medical communities was investigated by means of questionnaire survey and qualita-tive interview,and the implementation strategies were further explored.RESULTS The infection management or-ganizational system and functions of the two county-level medical institutions within the county medical communi-ties were completed,there is no independent hospital infection management department in the primary medical in-stitutions.The infection management personnel in the 16 grass-roots medical institutions were part-time person-nel,the personnel with the educational background below junior college accounted for 84.21%,the personnel with the professional background of nursing accounted for 100.00%,the personnel with less than 5 years of working experience accounted for 78.95%,none of them had an on-the-job training certificate.The monitoring programs of the county-level medical institutions within the county medical communities were completed,there was no infec-tion management monitoring information platform in the grass-roots medical institutions.The infection cases,hand hygiene,environmental health and occupational exposures were monitored by people.The grass-roots medi-cal institutions had the highest requirements for various professional trainings and increase of training contents of prevention and control of public health infectious diseases(100.00%).The county-level medical institutions had inadequate capabilities of professional examination of medical equipment replacement and construction of medi-cal architecture.CONCLUSION It is necessary for the country and local levels of governments to attach great importance to the implementation of the infection control core elements in the grass-roots medical institutions within the county-lev-el medical communities,establish the county-level regional information platform,formulate the corresponding surveil-lance indexes and homogenized management systems,complete the cultivation of talents,and offer financial support.
4.Study on relationship between qSOFA score, serum procalcitonin, lactic acid and hypersensitive C-reactive protein levels and with the prognosis of SAP patients
Jun LIU ; Yao CHEN ; Xuemei XU ; Shijie YU
Clinical Medicine of China 2025;41(6):452-458
Objective:To investigate the relationship between the quick sequential organ failure assessment (qSOFA) score, procalcitonin (PCT), blood lactate, hypersensitive C-reactive protein (hs-CRP) levels, and the prognosis of patients with severe acute pancreatitis (SAP).Methods:This retrospective analysis included 225 pancreatitis cases admitted to the Department of Gastroenterology at Ganzi Tibetan Autonomous Prefecture People's Hospital between February 2020 and February 2025. Patients were categorized into three groups based on severity: SAP group ( n=125), moderately severe acute pancreatitis (MSAP) group ( n=50), and mild acute pancreatitis (MAP) group ( n=50). General patient data, qSOFA scores, PCT, lactate, and hs-CRP levels were compared among the groups. Within the SAP group, patients were further divided into a favorable prognosis group ( n=101) and a poor prognosis group ( n=24) based on 28-day survival. The relationship between qSOFA score, PCT, lactate, hs-CRP, and SAP prognosis was analyzed. Normally distributed continuous data were expressed as Mean±SD. Independent samples t-test was used on comparison between two groups, while one-way ANOVA was used on comparison among multiple groups. LSD test was used on post-hoc pairwise comparison. Categorical data were expressed as n(%) and compared by χ2 test. Spearman correlation analysis assessed the correlation between qSOFA score, PCT, lactate, hs-CRP levels, and acute pancreatitis (AP) severity. Multivariable logistic regression modeling was used for joint prediction, incorporating qSOFA score, serum PCT, lactate, and hs-CRP levels to calculate combined predictive efficacy. The predictive performance of each indicator for prognosis was evaluated using receiver operating characteristic (ROC) curves. The areas under the ROC curves (AUC) were compared using DeLong's test. Results:Significant differences were observed among the MAP, MSAP, and SAP groups for qSOFA score [(0.63±0.29), (1.32±0.37), (1.70±0.33) points], serum PCT [(4.06±0.74), (5.35±0.89), (6.12±0.98) μg/L], lactate [(1.74±0.32), (2.77±0.70), (4.29±1.06) mmol/L], and hs-CRP levels [(15.38±3.75), (27.64±5.09), (35.26±6.42) mg/L] ( F values=187.51, 91.83, 169.18, 223.92, respectively, all P<0.001). The SAP group had significantly higher levels of qSOFA score, serum PCT, lactate, and hs-CRP compared to both the MAP and MSAP groups (all P<0.05), and the MSAP group levels were significantly higher than the MAP group (all P<0.05). The poor prognosis group had significantly higher levels of qSOFA score [(1.92±0.19) points], PCT [(6.65±0.47) μg/L], lactate [(5.14±0.62) mmol/L], and hs-CRP [(40.65±4.73) mg/L] compared to the favorable prognosis group [(1.65±0.25) points, (5.99±0.84) μg/L, (4.09±0.94) mmol/L, (34.16±6.09) mg/L] ( t values=4.96, 3.71, 5.20, 4.88, respectively, all P<0.001). Multivariate logistic regression analysis identified qSOFA score ( OR=14.658, 95% CI: 2.612-82.253), PCT ( OR=2.809, 95% CI: 1.288-6.129), lactate ( OR=3.658, 95% CI: 1.635-8.187), and hs-CRP ( OR=1.168, 95% CI: 1.055-1.293) as independent influencing factors for SAP patient prognosis ( P=0.002, 0.010, 0.002, 0.003, respectively). ROC curve analysis showed that the AUCs for qSOFA score, PCT, lactate, and hs-CRP in predicting poor prognosis in SAP patients were 0.754, 0.856, 0.766, and 0.809, with sensitivities of 87.50%, 83.33%, 83.33%, 85.50%, and specificities of 60.40%, 77.20%, 64.40%, 75.20%, respectively. The combined prediction model yielded an AUC of 0.934, with a sensitivity of 95.80% and specificity of 72.30%. Conclusion:The qSOFA score, PCT, blood lactate, and hs-CRP levels are associated with the severity of AP and possess reference value for predicting the prognosis of SAP patients.
5.Summary of the best evidence on family doctor-patient communication strategies for perinatal loss
Yiting WANG ; Xuan WANG ; Jin HE ; Xuemei FAN ; Congshan PU ; Ping XU ; Juan WANG ; Chunjian SHAN
Chinese Journal of Practical Nursing 2025;41(3):206-214
Objective:To retrieve, evaluate and summarize relevant evidence on communication strategies for families with perinatal loss, and to provide an evidence-based basis for communication practice among clinical health professionals.Methods:The system searches for evidence related to the loss of family doctor-patient communication strategies during the perinatal period in computer decision support systems such as UpToDate, BMJ Best Clinical Practice, International Guidelines Network, UK National Institute for Health and Clinical Excellence, PubMed, Web of Science, CINAHL, China National Knowledge Infrastructure, Wanfang Data, as well as in Chinese and English databases and related websites.The search was conducted between January 2012 and December 2022. The literature ′s quality and extracted evidence were independently evaluated by two researchers according to professional judgement. Results:A total of 13 articles were included, including 1 clinical decision, 2 guidelines, 4 national standards, 2 expert consensus, and 4 systematic reviews. 30 pieces of evidence have been summarized across five aspects, comprising communication environment, communication skills, timing and key points of communication, communication for special populations, and system-level communication support.Conclusions:This study summarizes the relevant evidence on communication strategies for family doctor-patient communication strategies for perinatal loss. Clinical professionals should carefully select and apply relevant evidence based on available medical resources and parental preferences, Develop and implement practical standards for family doctor-patient communication strategies for perinatal loss at the system level, further harmonize communication behaviors, and improve communication quality.
6.Current status of implementation of infection control core elements in grass-roots medical institutions under background of construction of"compact county-level medical communities"
Fangfang WANG ; Yuncui GUO ; Xiaoyan WU ; Haibo ZHANG ; Jing ZHOU ; Xu LIU ; Jia DI ; Shufang JIANG ; Chengyi FENG ; Xuemei LI
Chinese Journal of Nosocomiology 2025;35(18):2821-2825
OBJECTIVE To explore the implementation and standardized management of infection control core ele-ments in grass-roots medical institutions within county-level medical communities.METHODS From Mar.2024 to Apr.2024,the current status of implementation of infection control core elements in the grass-roots medical institu-tions within county-level medical communities was investigated by means of questionnaire survey and qualita-tive interview,and the implementation strategies were further explored.RESULTS The infection management or-ganizational system and functions of the two county-level medical institutions within the county medical communi-ties were completed,there is no independent hospital infection management department in the primary medical in-stitutions.The infection management personnel in the 16 grass-roots medical institutions were part-time person-nel,the personnel with the educational background below junior college accounted for 84.21%,the personnel with the professional background of nursing accounted for 100.00%,the personnel with less than 5 years of working experience accounted for 78.95%,none of them had an on-the-job training certificate.The monitoring programs of the county-level medical institutions within the county medical communities were completed,there was no infec-tion management monitoring information platform in the grass-roots medical institutions.The infection cases,hand hygiene,environmental health and occupational exposures were monitored by people.The grass-roots medi-cal institutions had the highest requirements for various professional trainings and increase of training contents of prevention and control of public health infectious diseases(100.00%).The county-level medical institutions had inadequate capabilities of professional examination of medical equipment replacement and construction of medi-cal architecture.CONCLUSION It is necessary for the country and local levels of governments to attach great importance to the implementation of the infection control core elements in the grass-roots medical institutions within the county-lev-el medical communities,establish the county-level regional information platform,formulate the corresponding surveil-lance indexes and homogenized management systems,complete the cultivation of talents,and offer financial support.
7.Effects of medicated serum of Siwutang on autophagy of ovarian granulosa cells in polycystic ovarian syndrome
Yanshe SHAO ; Xuemei XU ; Baoqin YANG ; Huijuan LI ; Xia JI
China Pharmacy 2025;36(2):185-190
OBJECTIVE To investigate the effects of medicated serum of Siwutang on autophagy of ovarian granulosa cells(KGN cells)in polycystic ovarian syndrome(PCOS)and its underlying mechanism.METHODS Blank serum and different-concentration medicated serum of Siwutang were prepared by intragastric administration of normal saline and different doses of Siwutang[0.52,1.04,2.08 g/(kg·d)]in 3-month-old female SD rats.After screening the intervention concentration of Siwutang medicated serum,KGN cells were divided into control group(without any treatment),dehydroepiandrosterone(DHEA)group(treated with 50 μmol/L DHEA for 48 h),blank serum group(treated with 50 μmol/L DHEA for 48 h and with 10%blank serum for 72 h)and medium-concentration of Siwutang medicated serum group(treated with 50 μmol/L DHEA for 48 h and with 10%medium-concentration Siwutang medicated serum for 72 h).The number of autophagosomes was observed in each group,and protein expressions of pathway-related proteins[fructose-1,6-bisphosphatase 1(FBP1),mammalian target of rapamycin(mTOR),phosphorylated mTOR(p-mTOR)],autophagy-related proteins[p62,microtubule-associated protein 1 light chain 3(LC3)]and mRNA expression of FBP1 were also detected.The(transfected)cells were further divided into Siwutang group(treated with 10%medium dose of Siwutang medicated serum for 72 h after 48 h intervention with 50 μmol/L DHEA),Siwutang+si-NC group[negative control small interfering RNA(siRNA)transfected cells treated with 50 μmol/L DHEA for 48 h,and then with 10%medium-concentration of Siwutang medicated serum for 72 h]and Siwutang+si-FBP1 group(FBP1 siRNA transfected cells treated with 50 μmol/L DHEA for 48 h,and then with 10%medium-concentration Siwutang medicated serum for 72 h).The effects of knocking down FBP1 on the above-mentioned effects of Siwutang were detected.RESULTS Compared with control group,DHEA group exhibited an increase in the number of autophagosomes,an elevated LC3-Ⅱ/LC3-Ⅰ and p-mTOR/mTOR,as well as increases in protein and mRNA expressions of FBP1,and decreased protein expression of p62(P<0.05).Compared to both DHEA group and blank serum group,the medium-concentration of Siwutang medicated serum group showed a decrease in the number of autophagosomes,a decrease in LC3-Ⅱ/LC3-Ⅰ,and increases in p-mTOR/mTOR,protein expression of p62,protein and mRNA expressions of FBP1(P<0.05).After knocking down FBP1,compared with Siwutang+si-NC group,Siwutang+si-FBP1 group showed a significant decrease in cell viability,protein expression of p62,protein and mRNA expressions of FBP1 as well as p-mTOR/mTOR,and an increase in LC3-Ⅱ/LC3-Ⅰ(P<0.05).CONCLUSIONS Siwutang can promote the phosphorylation of mTOR protein by up-regulating the protein and mRNA expressions of FBP1 in KGN cells,thus inhibiting autophagy of KGN cells.
8.Role of cancer-associated fibroblasts autophagy in papillary thyroid cancer
Xuemei ZHANG ; Danyang SUN ; Ning LI ; Qicheng ZHANG ; Ke XU ; Wei ZHENG ; Qiang JIA ; Jian TAN ; Zhaowei MENG
Chinese Journal of Endocrinology and Metabolism 2025;41(2):135-144
Objective:To investigate the inpact of thyroid cancer-derived cancer-associated fibroblasts(CAF) autophagy on papillary thyroid cancer(PTC).Methods:CAF and normal fibroblasts were isolated from cancerous and adjacent normal thyroid tissues from four PTC patients. Expressions of fibroblast activation protein(FAP) and α-smooth muscle actin in cells were assessed. Conditioned medium of CAF and normal fibroblasts were prepared and used to culture PTC cells. The effects of CAF and normal fibroblasts on survival, proliferation, migration, invasion and iodine uptake of PTC cells were evaluated through cell proliferation assay, cell scratch assay, cell invasion assay, and cell iodine uptake assay. The autophagy level of CAF was also evaluated. Autophagy inhibition and activation were used to regulate the autophagy of CAF, and then their effects on PTC cell proliferation, migration and invasion were further evaluated. The in vivo effect of CAF autophagy on PTC xenograft tumor growth was evaluated.Results:CAF exhibited higher FAP expression and basal autophagy levels. PTC cells co-cultured with CAF-conditioned media showed enhanced proliferation, migration, invasion, and reduced iodine uptake. Autophagy inhibition reduced these effects, while autophagy activation further promoted them. In vivo, inhibiting CAF autophagy suppressed tumor growth.Conclusions:CAF promotes PTC cell malignancy through autophagy activation, enhancing proliferation, migration, and invasion while reducing iodine uptake.
9.Clinical characteristics of juvenile dermatomyositis in anti-nuclear matrix protein 2 antibody-positive patients and risk factors for severity: a national multicenter retrospective study
Huiyuan YANG ; Wanzhen GUAN ; Ling2 YANG ; Haimei LIU ; Xiaoqing3 LI ; Haiguo YU ; Meiping LU ; Jun YANG ; Xiaohui LIU ; Hongxia ZHANG ; Wei ZHANG ; Jihong XIAO ; Xiaozhong LI ; Guomin LI ; Hong CHANG ; Sheng HAO ; Yue DU ; Daliang XU ; Ling WU ; Wenjie ZHENG ; Li LIU ; Xinhui JIANG ; Shaohui ZHU ; Dongmei ZHAO ; Xuemei TANG ; Li SUN
Chinese Journal of Pediatrics 2025;63(12):1299-1305
Objective:To investigate the clinical characteristics and independent risk factors of severe disease in patients with anti-nuclear matrix protein (NXP) 2 antibody-positive juvenile dermatomyositis (JDM).Methods:A retrospective cohort study was conducted, including 219 anti-NXP2 antibody-positive JDM patients admitted to 23 children′s hospitals across China from July 2011 to July 2023. Patients were classified into severe and non-severe groups based on classification criteria for severe dermatomyositis. Demographic characteristics, clinical manifestations, and laboratory parameters were compared between the 2 groups using independent sample t-test, Mann-Whitney U test, or χ2 test. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for severe disease. The receiver operating characteristic curve was employed to calculate optimal cut-off values. Results:Among the 219 patients, 108 were male and 111 were female, with an age at onset of 6.3 (3.5, 9.4) years. The severe group comprised 69 patients, and the non-severe group 150 patients. The severe group had significantly higher rates of fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, as well as elevated levels of ferritin-to-albumin ratio (FAR), creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (all P<0.05). Multivariate analysis identified anti-Ro52 antibody positivity ( OR=13.26, 95% CI 1.37-128.29) and elevated FAR ( OR=1.90, 95% CI 1.09-2.31) as independent risk factors for severe anti-NXP2 antibody-positive JDM (both P<0.05). Receiver operating characteristic curve analysis revealed that a FAR cutoff value of 6.82 predicted severe disease with an area under the curve of 0.87 (95% CI 0.81-0.94, P<0.001), sensitivity of 0.85, and specificity of 0.70. All patients received glucocorticoid therapy, and the severe group received higher proportions of steroid pulse therapy, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulin, biologics, and adjuvant treatments compared to the non-severe group (all P<0.05). In terms of outcomes, 2 patients (2.9%) in the severe group died (due to neurological involvement and intestinal perforation, respectively), while the remaining patients achieved complete clinical response or remission. All patients in the non-severe group achieved remission. Conclusions:The primary clinical features of anti-NXP2 antibody-positive JDM included fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, and elevated levels of CK, AST, LDH, and FAR. Furthermore, anti-Ro52 antibody positivity and a FAR>6.82 were identified as independent risk factors.
10.Study on relationship between qSOFA score, serum procalcitonin, lactic acid and hypersensitive C-reactive protein levels and with the prognosis of SAP patients
Jun LIU ; Yao CHEN ; Xuemei XU ; Shijie YU
Clinical Medicine of China 2025;41(6):452-458
Objective:To investigate the relationship between the quick sequential organ failure assessment (qSOFA) score, procalcitonin (PCT), blood lactate, hypersensitive C-reactive protein (hs-CRP) levels, and the prognosis of patients with severe acute pancreatitis (SAP).Methods:This retrospective analysis included 225 pancreatitis cases admitted to the Department of Gastroenterology at Ganzi Tibetan Autonomous Prefecture People's Hospital between February 2020 and February 2025. Patients were categorized into three groups based on severity: SAP group ( n=125), moderately severe acute pancreatitis (MSAP) group ( n=50), and mild acute pancreatitis (MAP) group ( n=50). General patient data, qSOFA scores, PCT, lactate, and hs-CRP levels were compared among the groups. Within the SAP group, patients were further divided into a favorable prognosis group ( n=101) and a poor prognosis group ( n=24) based on 28-day survival. The relationship between qSOFA score, PCT, lactate, hs-CRP, and SAP prognosis was analyzed. Normally distributed continuous data were expressed as Mean±SD. Independent samples t-test was used on comparison between two groups, while one-way ANOVA was used on comparison among multiple groups. LSD test was used on post-hoc pairwise comparison. Categorical data were expressed as n(%) and compared by χ2 test. Spearman correlation analysis assessed the correlation between qSOFA score, PCT, lactate, hs-CRP levels, and acute pancreatitis (AP) severity. Multivariable logistic regression modeling was used for joint prediction, incorporating qSOFA score, serum PCT, lactate, and hs-CRP levels to calculate combined predictive efficacy. The predictive performance of each indicator for prognosis was evaluated using receiver operating characteristic (ROC) curves. The areas under the ROC curves (AUC) were compared using DeLong's test. Results:Significant differences were observed among the MAP, MSAP, and SAP groups for qSOFA score [(0.63±0.29), (1.32±0.37), (1.70±0.33) points], serum PCT [(4.06±0.74), (5.35±0.89), (6.12±0.98) μg/L], lactate [(1.74±0.32), (2.77±0.70), (4.29±1.06) mmol/L], and hs-CRP levels [(15.38±3.75), (27.64±5.09), (35.26±6.42) mg/L] ( F values=187.51, 91.83, 169.18, 223.92, respectively, all P<0.001). The SAP group had significantly higher levels of qSOFA score, serum PCT, lactate, and hs-CRP compared to both the MAP and MSAP groups (all P<0.05), and the MSAP group levels were significantly higher than the MAP group (all P<0.05). The poor prognosis group had significantly higher levels of qSOFA score [(1.92±0.19) points], PCT [(6.65±0.47) μg/L], lactate [(5.14±0.62) mmol/L], and hs-CRP [(40.65±4.73) mg/L] compared to the favorable prognosis group [(1.65±0.25) points, (5.99±0.84) μg/L, (4.09±0.94) mmol/L, (34.16±6.09) mg/L] ( t values=4.96, 3.71, 5.20, 4.88, respectively, all P<0.001). Multivariate logistic regression analysis identified qSOFA score ( OR=14.658, 95% CI: 2.612-82.253), PCT ( OR=2.809, 95% CI: 1.288-6.129), lactate ( OR=3.658, 95% CI: 1.635-8.187), and hs-CRP ( OR=1.168, 95% CI: 1.055-1.293) as independent influencing factors for SAP patient prognosis ( P=0.002, 0.010, 0.002, 0.003, respectively). ROC curve analysis showed that the AUCs for qSOFA score, PCT, lactate, and hs-CRP in predicting poor prognosis in SAP patients were 0.754, 0.856, 0.766, and 0.809, with sensitivities of 87.50%, 83.33%, 83.33%, 85.50%, and specificities of 60.40%, 77.20%, 64.40%, 75.20%, respectively. The combined prediction model yielded an AUC of 0.934, with a sensitivity of 95.80% and specificity of 72.30%. Conclusion:The qSOFA score, PCT, blood lactate, and hs-CRP levels are associated with the severity of AP and possess reference value for predicting the prognosis of SAP patients.

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