1.Correlation between Serum lncRNA XIST,miR-140-3p Levels and Degree of Coronary Artery Disease and Prognosis in Patients with Acute Myocardial Infarction before PCI
Yuanjie FAN ; Yayun ZHANG ; Yingchun NIU
Journal of Modern Laboratory Medicine 2025;40(5):28-34,51
Objective To investigate the relationship between preoperative serum levels of long noncoding RNA(lncRNA)X inactive specific transcript(XIST)and microRNA(miR)-140-3p in acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI)and blood glucose,blood lipids,myocardial injury indexes,degree of coronary artery disease and the occurrence of major adverse cardiovascular events(MACE)within 3 years after surgery.Methods A total of 164 patients with AMI(AMI group)and 148 healthy subjects(healthy group)were selected from Hankuang General Hospital of North China Medical and Health Group from November 2018 to February 2021.Clinical data were collected at admission,and blood glucose,blood lipids,myocardial injury indicators,serum lncRNA XIST and miR-140-3p levels in AMI group before PCI and healthy group during physical examination were detected.According to the degree of coronary artery disease,AMI patients were divided into mild coronary artery disease group(n=33),moderate coronary artery disease group(n=76),and severe coronary artery disease group(n=55).Follow up for 3 years after surgery,AMI patients were divided into MACE group(n=36)and non-MACE group(n=128).Clinical data,preoperative PCI blood glucose,blood lipids,myocardial injury indicators,synergy between percutaneous coronary intervention with TAXUS and cardiac surgery(SYNTAX)score,and serum lncRNA XIST and miR-140-3p expression levels of health group and AMI group,AMI patients with different prognoses within 3 years after PCI were compared.The serum lncRNA XIST and miR-140-3p expression levels of AMI patients with different degrees of coronary artery disease before PCI were compared.The correlation between preoperative PCI serum lncRNA XIST and miR-140-3p with blood glucose,blood lipids,myocardial injury indicators,SYNTAX score in AMI patients,the influencing factors of MACE occurrence,and predicting the value of preoperative PCI serum lncRNA XIST and miR-140-3p in predicting MACE occurrence within 3 years after PCI in AMI patients were analyzed.Results Compared with healthy group,the preoperative PCI fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),homocysteine(Hcy),cardiac troponin I(cTnI),brain natriuretic peptide(BNP),lncRNA XIST expression levels of AMI group were significantly increased(t=2.426~80.642),and high density lipoprotein-cholesterol(HDL-C),left ventricular ejection fraction(LVEF)and miR-140-3pexpression levels were significantly reduced(t=6.166~66.119),the differences were statistically significant(all P<0.05).Before PCI,the expression levels of serum lncRNA XIST were increased successively,and the expression levels of miR-140-3p were decreased successively in mild,moderate,and severe coronary artery lesions group,the differences were statistically significant(F=174.600,231.138,all P<0.05).The serum lncRNA XIST of AMI patients before PCI was positively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=0.235~0.681,all P<0.05),and negatively correlated with miR-140-3p,HDL-C and LVEF(r=-0.571,-0.262,-0.513,all P<0.05).miR-140-3p was negatively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=-0.672~-0.209,all P<0.05),and positively correlated with HDL-C and LVEF(r=0.245,0.524,all P<0.05).Compared with non-MACE group,the hs-CRP,CK-MB,Hcy,cTnI,BNP,SYNTAX scores and lncRNA XIST expression levels before PCI in MACE group were significantly increased(t=3.032~26.330),while the LVEF and miR-140-3p expression levels were significantly reduced(t=2.821,13.318),the differences were statistically significant(all P<0.05).LVEF and miR-140-3p were independent protective factors for MACE in AMI patients within 3 years after PCI(Wald χ2=6.098,7.851,all P<0.05),while CK-MB,Hcy,cTnI,BNP,SYNTAX score and lncRNA XIST were independent risk factors for MACE in AMI patients within 3 years after PCI(Wald χ2=4.263~7.853,all P<0.05).Compared with the area under curve(AUC)of serum lncRNA XIST and miR-140-3p before PCI separately predicting MACE occurrence within 3 years after PCI in AMI patients,the combined prediction of MACE occurrence within 3 years after PCI in AMI patients was higher,and the differences were statistically significant(Z=2.059,2.017,all P<0.05).Conclusion The expression of lncRNA XIST in the serum of AMI patients is increased while the expression of miR-140-3p is decreased.Both are associated with blood glucose,blood lipids myocardial injury indicators,degree of coronary artery disease,and the occurrence of MACE within three years after PCI.They have high value in predicting the occurrence of MACE within three years after PCI surgery.
2.Effect of transitional care combined with personalized discharge preparation services on discharge preparedness and growth and development in premature infants
Yuting HUANG ; Caixia WANG ; Yayun LAI ; Huiping YAN ; Kexia LI ; Meili ZHANG
Chinese Journal of Practical Nursing 2025;41(3):167-174
Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.
3.Correlation between Serum lncRNA XIST,miR-140-3p Levels and Degree of Coronary Artery Disease and Prognosis in Patients with Acute Myocardial Infarction before PCI
Yuanjie FAN ; Yayun ZHANG ; Yingchun NIU
Journal of Modern Laboratory Medicine 2025;40(5):28-34,51
Objective To investigate the relationship between preoperative serum levels of long noncoding RNA(lncRNA)X inactive specific transcript(XIST)and microRNA(miR)-140-3p in acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI)and blood glucose,blood lipids,myocardial injury indexes,degree of coronary artery disease and the occurrence of major adverse cardiovascular events(MACE)within 3 years after surgery.Methods A total of 164 patients with AMI(AMI group)and 148 healthy subjects(healthy group)were selected from Hankuang General Hospital of North China Medical and Health Group from November 2018 to February 2021.Clinical data were collected at admission,and blood glucose,blood lipids,myocardial injury indicators,serum lncRNA XIST and miR-140-3p levels in AMI group before PCI and healthy group during physical examination were detected.According to the degree of coronary artery disease,AMI patients were divided into mild coronary artery disease group(n=33),moderate coronary artery disease group(n=76),and severe coronary artery disease group(n=55).Follow up for 3 years after surgery,AMI patients were divided into MACE group(n=36)and non-MACE group(n=128).Clinical data,preoperative PCI blood glucose,blood lipids,myocardial injury indicators,synergy between percutaneous coronary intervention with TAXUS and cardiac surgery(SYNTAX)score,and serum lncRNA XIST and miR-140-3p expression levels of health group and AMI group,AMI patients with different prognoses within 3 years after PCI were compared.The serum lncRNA XIST and miR-140-3p expression levels of AMI patients with different degrees of coronary artery disease before PCI were compared.The correlation between preoperative PCI serum lncRNA XIST and miR-140-3p with blood glucose,blood lipids,myocardial injury indicators,SYNTAX score in AMI patients,the influencing factors of MACE occurrence,and predicting the value of preoperative PCI serum lncRNA XIST and miR-140-3p in predicting MACE occurrence within 3 years after PCI in AMI patients were analyzed.Results Compared with healthy group,the preoperative PCI fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),homocysteine(Hcy),cardiac troponin I(cTnI),brain natriuretic peptide(BNP),lncRNA XIST expression levels of AMI group were significantly increased(t=2.426~80.642),and high density lipoprotein-cholesterol(HDL-C),left ventricular ejection fraction(LVEF)and miR-140-3pexpression levels were significantly reduced(t=6.166~66.119),the differences were statistically significant(all P<0.05).Before PCI,the expression levels of serum lncRNA XIST were increased successively,and the expression levels of miR-140-3p were decreased successively in mild,moderate,and severe coronary artery lesions group,the differences were statistically significant(F=174.600,231.138,all P<0.05).The serum lncRNA XIST of AMI patients before PCI was positively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=0.235~0.681,all P<0.05),and negatively correlated with miR-140-3p,HDL-C and LVEF(r=-0.571,-0.262,-0.513,all P<0.05).miR-140-3p was negatively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=-0.672~-0.209,all P<0.05),and positively correlated with HDL-C and LVEF(r=0.245,0.524,all P<0.05).Compared with non-MACE group,the hs-CRP,CK-MB,Hcy,cTnI,BNP,SYNTAX scores and lncRNA XIST expression levels before PCI in MACE group were significantly increased(t=3.032~26.330),while the LVEF and miR-140-3p expression levels were significantly reduced(t=2.821,13.318),the differences were statistically significant(all P<0.05).LVEF and miR-140-3p were independent protective factors for MACE in AMI patients within 3 years after PCI(Wald χ2=6.098,7.851,all P<0.05),while CK-MB,Hcy,cTnI,BNP,SYNTAX score and lncRNA XIST were independent risk factors for MACE in AMI patients within 3 years after PCI(Wald χ2=4.263~7.853,all P<0.05).Compared with the area under curve(AUC)of serum lncRNA XIST and miR-140-3p before PCI separately predicting MACE occurrence within 3 years after PCI in AMI patients,the combined prediction of MACE occurrence within 3 years after PCI in AMI patients was higher,and the differences were statistically significant(Z=2.059,2.017,all P<0.05).Conclusion The expression of lncRNA XIST in the serum of AMI patients is increased while the expression of miR-140-3p is decreased.Both are associated with blood glucose,blood lipids myocardial injury indicators,degree of coronary artery disease,and the occurrence of MACE within three years after PCI.They have high value in predicting the occurrence of MACE within three years after PCI surgery.
4.Research progress in reconstruction of internal iliac artery with iliac branch device
Xiaolong LI ; Yayun XIAO ; Ruihua WANG ; Yulin ZHANG ; Liwei ZHANG
Chinese Journal of Arteriosclerosis 2025;33(10):901-906
Endovascular aneurysm repair(EVAR)is the most common treatment for abdominal aortic aneurysm.However,when the common iliac artery has expansion or aneurysm,there may be internal leakage at the distal end of the stent.In this case,the ideal endovascular repair should ensure the pelvic blood supply on the premise of complete exclu-sion of the aneurysm.It is feasible and safe to use iliac branch devices(IBD)to preserve unilateral or bilateral internal iliac arteries,and its technology and clinical results are equivalent to standard EVAR.But IBD has certain anatomical a-daptability.In this paper,the current status of preservation of internal iliac artery with IBD is systematically reviewed.
5.Effect of transitional care combined with personalized discharge preparation services on discharge preparedness and growth and development in premature infants
Yuting HUANG ; Caixia WANG ; Yayun LAI ; Huiping YAN ; Kexia LI ; Meili ZHANG
Chinese Journal of Practical Nursing 2025;41(3):167-174
Objective:To explore the impact of a comprehensive intervention program that integrates transitional care with personalized discharge preparation services on discharge preparedness on the growth, development, and motor development in premature infants, providing guidance and reference for clinical practice.Methods:The 90 pairs of premature infants and their main caregivers who were treated in the neonatal department, Children ′s Hospital, Quanzhou Maternal and Child Health Hospital were studied from February 2023 to February 2024 by randomized control method. Used the table of random numbers, they were divided into the control group and the observation group, with 45 pairs in each group. The control group routinely administered care, while the observation group was implemented a transitional care combined with personalized discharge preparation services. The discharge preparedness, growth and motor development, and the disease uncertainty of caregivers were observed between the 2 groups. Results:There were 27 males and 18 females of the 45 preterm infants,with gestational age of 30.86 (29.36, 31.50) weeks in the control group, 24 males and 21 females with gestational age of 30.29(29.00, 31.07) weeks in the observation group. The main caregiver identities 43 were mothers and 2 were other identities in the control group, 42 were mothers and 3 were other identities in the observation group, with them being 31.00(28.00, 35.00) years old. There were 97.78% (44 /45) caregivers who thought the child was ready to go home in the observation group, while the control group were 84.44% (38 /45), these differences were statistically significant ( χ2=4.88, P<0.05). The total score of discharge readiness in the observation group were 240.00(237.00, 242.50) points, higher than in the control group 226.00(219.00, 229.50) points, these differences were statistically significant ( Z=-6.23, P<0.05). The head circumference and body weight of the observation group were (34.82 ± 1.14) cm and (3.60 ± 0.55) kg, while the control group were (34.25 ± 1.22) cm and (3.35 ± 0.53) kg, there were statistically significant between the two groups ( t=-2.29, -2.22, all P<0.05). The Test of Infant Motor Performance score in the observation group was 50.00(46.00, 52.00) points, while the control group was 45.00(42.00, 48.00) points, there were statistically significant between the two groups ( Z=-3.65, P<0.05). The total score of disease uncertainty in the observation was 52.00(45.50, 60.00) points, while the control group was 61.00(58.50, 65.00) points, there was statistically significant between the two groups ( Z=-4.62, P<0.05). Conclusions:The discharge preparedness of the caregivers of preterm infants was improved because of the use of transitional care combined with personalized discharge preparation services, and the growth and motor development of preterm infants were promoted, and the uncertainty of the family caregivers of preterm infants about the disease was reduced.
6.Development of a nursing training program for malignant hyperthermia in perioperative patients: based on Instructional System Design model
Yayun ZHANG ; Lina GUAN ; Jianjun YANG ; Jie ZHANG
Chinese Journal of Anesthesiology 2025;45(1):87-91
Objective:To develop a nursing training program for malignant hyperthermia (MH) in perioperative patients based on the Instructional System Design model.Methods:Based on the Instructional System Design model, a preliminary draft of the nursing training program for MH was developed using literature review and semi-structured interviews in perioperative patients. Through expert consultations and the use of the Analytic Hierarchy Process, the content and weight of each item of the nursing training program for MH in perioperative patients were determined.Results:The effective response rates for the two rounds of expert consultation questionnaires were 84% and 97% respectively, with expert authority coefficients of 0.833 and 0.853 respectively, and Kendall′s harmony coefficients of 0.148 and 0.210 respectively ( P<0.01). The finalized nursing training program included 5 first-level items, 16 second-level items, and 61 third-level items. Conclusions:The construction process of the nursing training program for MH in perioperative patients is standardized and scientific, with detailed and practical content, which helps improve the level and quality of MH care.
7.Research progress in reconstruction of internal iliac artery with iliac branch device
Xiaolong LI ; Yayun XIAO ; Ruihua WANG ; Yulin ZHANG ; Liwei ZHANG
Chinese Journal of Arteriosclerosis 2025;33(10):901-906
Endovascular aneurysm repair(EVAR)is the most common treatment for abdominal aortic aneurysm.However,when the common iliac artery has expansion or aneurysm,there may be internal leakage at the distal end of the stent.In this case,the ideal endovascular repair should ensure the pelvic blood supply on the premise of complete exclu-sion of the aneurysm.It is feasible and safe to use iliac branch devices(IBD)to preserve unilateral or bilateral internal iliac arteries,and its technology and clinical results are equivalent to standard EVAR.But IBD has certain anatomical a-daptability.In this paper,the current status of preservation of internal iliac artery with IBD is systematically reviewed.
8.Clinical features and prognosis of acute B lymphoblastic leukemia children carrying a TCF3: : PBX1 fusion gene
Lulu HUANG ; Yunyan HE ; Yang LI ; Danna LIN ; Ning LIAO ; Yayun LING ; Lyuhong XU ; Xinyu LI ; Huirong MAI ; Ying WANG ; Wuqing WAN ; Ying LIU ; Yanlai TANG ; Xiaoli ZHANG ; Chuan TIAN ; Xiaofeng LI ; Qiwen CHEN ; Xingjiang LONG ; Liuhua LIAO ; Qiaoru LI ; Jianling CAI ; Zijun ZHEN ; Zhiguang LI ; Keyan YANG ; Qinlong ZHENG ; Lihua YANG
Chinese Journal of Applied Clinical Pediatrics 2025;40(7):497-502
Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.
9.Clinical efficacy analysis of different antiplatelet aggregation treatment regimens for patients with ruptured wide-neck intracranial aneurysms undergoing LVIS stent-assisted coil embolization in the acute phase
Wenshuai LI ; Yayun ZHAO ; Zhen GUO ; Haibing ZHANG ; Fengmiao WANG ; Xinfang ZHANG ; Quanzhong ZHANG ; Qingmin LI
Chinese Journal of Cerebrovascular Diseases 2025;22(5):302-309
Objective To compare the clinical efficacy of intraoperative intravenous tirofiban versus preoperative loading dose dual antiplatelet therapy in the acute phase LVIS stent-assisted coil embolization treatment for ruptured wide-necked intracranial aneurysms.Methods Patients with acutely ruptured,wide-neck intracranial aneurysms underwent LVIS stent-assisted coil embolization in the Department of Neurosurgery at Heze Municipal Hospital were retrospectively and consecutively enrolled from January 2017 to June 2023.According to the Chinese expert consensus on antiplatelet therapy for intracranial aneurysms,patients were divided into two groups based on the types of antiplatelet therapy they received:the loading-dose dual antiplatelet therapy(DAPT)group and the tirofiban group.Baseline and clinical data were collected and compared between the two groups,including age,sex,hypertension,diabetes mellitus,coronary artery disease,history of cerebral hemorrhage,preoperative Hunt-Hess grade,maximum aneurysm diameter,aneurysm neck width,and aneurysm location.Perioperative ischemic and hemorrhagic complications were collected and compared between the two groups.Perioperative ischemic complications included:intraoperative stent thrombosis(defined as filling defects in the parent artery,and,occlusion of the parent artery or stented branch during the procedure),and symptomatic ischemic infarction within 24 h postoperatively(confirmed by imaging with corresponding neurological deficits).Perioperative hemorrhagic complications included:intraoperative rupture of the target aneurysm(contrast extravasation or acute hemorrhage during embolization)and intracranial hemorrhage within 24 h postoperatively(new or worsened subarachnoid hemorrhage or intraparenchymal hemorrhage on CT).Clinical outcomes at 90 days were collected via telephone or outpatient follow-up,and evaluated using favorable prognosis defined as modified Rankin scale(mRS).A mRS score of 0-2 were defined as favorable prognosis and 3-6 as poor prognosis.Six-month postoperative imaging follow-up were collected,angiographic outcomes were categorized into four groups based on comparison with immediate post-embolization results:complete occlusion,total absence of contrast filling in the aneurysm sac;improved,reduced contrast filling;stable,unchanged contrast filling;and,recurrence,increased contrast filling.Results Totals of 108 patients with intracranial aneurysms treated by LVIS stent-assisted coiling were enrolled,with 30 males and 78females,aged32-75years(median age63[50,66]years).Among the108cases,55cases were assigned into the DAPT group,and 53 cases were included in the tirofiban group.(1)No statistically significant differences were observed between the tirofiban group and the DAPT group in baseline and clinical characteristics(all P>0.05).(2)All patients underwent successful LVIS stent-assisted coiling,with a technical success rate of 100%.The total perioperative ischemic complications were 12.0%(13/108),including 4.6%(5/108)intraoperative stent thrombosis and 7.4%(8/108)symptomatic ischemic infarction within 24h after surgery.The total perioperative hemorrhagic complications rate was 1.9%(2/108),including 1 case of intraoperative aneurysm rupture and 1 case of postoperative intracranial hemorrhage within24h.92.6%(100/108)of the patients exhibited favorable prognosis and 7.4%(8/108)showed poor prognosis at the 90-day follow-ups.78.7%(85/108)of the patients accomplished at 6-month imaging follow-ups,the complete occlusion ratio was 94.1%(80/85)and the recurrence ratio was 2.4%(2/85).(3)The overall perioperative ischemic complication rates were 13.2%(7/53)in the tirofiban group and 10.9%(6/55)in the DAPT group,with no statistically significant difference(P=0.720).Intraoperative stent thrombosis occurred more frequently in the DAPT group(9.1%[5/55]vs.0,P=0.025),while symptomatic ischemic infarction within 24 h post-procedure was lower in the DAPT group(1.8%[1/55]vs.13.2%[7/53],P=0.028).The hemorrhagic complications occurred only in the DAPT group,with a rate of 3.6%(2/55),while no events observed in the tirofiban group.At the 90-day follow-up,the proportion of patients with favorable outcomes was 94.3%(50/53)in the tirofiban group and 90.9%(50/55)in the DAPT group,with no statistically significant difference between the groups(P=0.754).Conclusions Both intraoperative intravenous tirofiban and preoperative loading-dose DAPT demonstrated comparable safety profile and favorable clinical efficacy in the acute-phase treatment of ruptured wide-necked intracranial aneurysms with LVIS stent-assisted coil embolization.The results require further validation through large-scale prospective studies.
10.Potential Components and Mechanisms of Ganlu Xiaodu Dan in Treatment of Viral Pneumonia
Weichao ZHANG ; Yayun LI ; Tianci GAO ; Mengxing HOU ; Wenzhong XU ; Fenqiao CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):188-196
ObjectiveTo explore the mechanisms of action of Ganlu Xiaodu Dan in treating viral pneumonia by combining network pharmacology and molecular docking with in vivo experimental validation. MethodsNetwork pharmacology and molecular docking were used to predict the core components, target genes, and major pathways of Ganlu Xiaodu Dan. Molecular docking was then applied to verify the interactions between the core components and key targets. Sixty male C57BL/6 mice were randomly divided into six groups (n = 10 per group), including blank, model, dexamethasone, and Ganlu Xiaodu Dan low-, medium-, and high-dose groups. The blank and model groups were gavaged with physiological saline (10 mL·kg-1) every 12 h. The dexamethasone group received intraperitoneal injections of dexamethasone (5 mg·kg-1). The low-, medium-, and high-dose groups of Ganlu Xiaodu Dan were gavaged with solutions at concentrations of 7.2, 14.4, and 21.6 g·kg-1, respectively, every 12 h. Lung wet/dry weight ratio (W/D) was measured. Hematoxylin-eosin (HE) staining was used to observe pathological changes in lung tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to determine the expression levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-17, and IL-1β in bronchoalveolar lavage fluid (BALF). Western blot was performed to detect the expression of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) in lung tissue for further validation. ResultsTwelve potential active components of Ganlu Xiaodu Dan were identified through network pharmacology. A total of 306 overlapping target genes were obtained between Ganlu Xiaodu Dan and viral pneumonia. PPI network analysis identified the top 20 key targets, and GO and KEGG enrichment analyses revealed the top 20 signaling pathways. An “active component–target–pathway” network was constructed. Molecular docking demonstrated strong affinity between the core components of Ganlu Xiaodu Dan and key targets related to viral pneumonia. In animal experiments, compared with the blank group, the model group showed severe bronchial epithelial damage, disordered alveolar structure, massive inflammatory cell infiltration, widened alveolar septa, and obvious interstitial edema. W/D, levels of IL-1β, TNF-α, and IL-17 in BALF, and protein expression of p-PI3K/PI3K and p-Akt/Akt in lung tissue were all significantly increased (P<0.05). Compared with the model group, lung injury in the Ganlu Xiaodu Dan groups and the dexamethasone group was alleviated. W/D and TNF-α levels were significantly decreased (P<0.05). IL-1β and IL-17 levels were significantly reduced in the medium- and high-dose groups and the dexamethasone group, and the protein expression levels of p-PI3K/PI3K and p-Akt/Akt in lung tissue were significantly decreased (P<0.05). ConclusionGanlu Xiaodu Dan can alleviate lung injury in viral pneumonia by suppressing the inflammatory response, and its mechanism may be related to the inhibition of PI3K/Akt pathway activation.

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