1.Dystrophinopathy in the paravertebral muscle of adolescent idiopathic scoliosis: a prospective case-control study in China
Junyu LI ; Danfeng ZHENG ; Zekun LI ; Jiaxi LI ; Zexi YANG ; Xiang ZHANG ; Yingshuang ZHANG ; Miao YU
Asian Spine Journal 2025;19(1):64-73
Methods:
This study enrolled 40 patients with AIS, 20 patients with congenital scoliosis (CS), and 20 patients with spinal degenerative disease (SDD). All patients underwent open posterior surgery in our hospital, and a paravertebral muscle (multifidus muscle) biopsy was performed intraoperatively. This study included many indexes that describe muscle, especially dystrophin staining. The above pathological results were compared among the AIS, CS, and SDD groups. The correlation between the Cobb angle and Nash–Moe classification and the above pathological results was analyzed in patients with AIS.
Results:
Significant reductions in the dystrophin staining of dystrophin-1 (p<0.001), dystrophin-2 (p<0.001), and dystrophin-3 (p<0.001) were observed in the AIS group than in the CS and SDD groups. The higher the Nash–Moe classification in the AIS group, the more significant the loss of dystrophin-2 (p=0.042) in the convex paraspinal muscles. Additionally, a significantly positive correlation was observed between the reductions of dystrophin-2 on the concave side of the AIS group and Cobb angle (p=0.011).
Conclusions
Dystrophin protein deficiency in the paraspinal muscles plays a crucial role in AIS formation and progression. The severity of scoliosis in patients with AIS is correlated with the extent of dystrophin loss in the paravertebral muscles. Therefore, dystrophin dysfunction may be relevant to AIS occurrence and development.
2.Advances in research on the application of Lactobacillus and its engineered probiotics to the prevention and treatment of radiation-induced intestinal injury
Xiaoxiao JIA ; Kaihua JI ; Manman ZHANG ; Yingshuang LIU ; Jianguo LI ; Qiang LIU
Chinese Journal of Radiological Medicine and Protection 2025;45(10):1015-1024
Intestinal radiosensitivity makes radiation-induced intestinal injury (RIII) as a common complication among individuals exposed to accidental radiation and patients with abdominal or pelvic malignancies receiving radiotherapy. At present, there are no effective measures for the prevention and treatment of RIII. Developing novel prevention and treatment strategies is of great significance for improving the prognosis and quality of life for both individuals exposed to accidental radiation and cancer patients. Lactobacillus, a Gram-positive bacterium, is widely observed in humans and animals. It exhibits notable probiotic functions, including maintaining gut microbiota homeostasis, preserving intestinal barrier, and modulating immune responses. Substantial studies have demonstrated that Lactobacillus has remarkable protective and therapeutic effects against radiation-induced injury, specifically significantly alleviating RIII. These probiotic functions of Lactobacillus make it have high priority to become the chassis of genetically engineered strains. However, multiple factors influence the construction of a genetically engineered strain, limiting the application of Lactobacillus as a chassis. This review focuses on the probiotic functions of Lactobacillus, highlighting advances in research on Lactobacillus and its engineered probiotics in radiation protection and treatment. Furthermore, it summarizes key factors influencing the construction of genetically engineered strains based on the Lactobacillus chassis. It aims to provide insights for developing genetically engineered strains with radioprotective and therapeutic effects using Lactobacillus as the chassis.
3.Dystrophinopathy in the paravertebral muscle of adolescent idiopathic scoliosis: a prospective case-control study in China
Junyu LI ; Danfeng ZHENG ; Zekun LI ; Jiaxi LI ; Zexi YANG ; Xiang ZHANG ; Yingshuang ZHANG ; Miao YU
Asian Spine Journal 2025;19(1):64-73
Methods:
This study enrolled 40 patients with AIS, 20 patients with congenital scoliosis (CS), and 20 patients with spinal degenerative disease (SDD). All patients underwent open posterior surgery in our hospital, and a paravertebral muscle (multifidus muscle) biopsy was performed intraoperatively. This study included many indexes that describe muscle, especially dystrophin staining. The above pathological results were compared among the AIS, CS, and SDD groups. The correlation between the Cobb angle and Nash–Moe classification and the above pathological results was analyzed in patients with AIS.
Results:
Significant reductions in the dystrophin staining of dystrophin-1 (p<0.001), dystrophin-2 (p<0.001), and dystrophin-3 (p<0.001) were observed in the AIS group than in the CS and SDD groups. The higher the Nash–Moe classification in the AIS group, the more significant the loss of dystrophin-2 (p=0.042) in the convex paraspinal muscles. Additionally, a significantly positive correlation was observed between the reductions of dystrophin-2 on the concave side of the AIS group and Cobb angle (p=0.011).
Conclusions
Dystrophin protein deficiency in the paraspinal muscles plays a crucial role in AIS formation and progression. The severity of scoliosis in patients with AIS is correlated with the extent of dystrophin loss in the paravertebral muscles. Therefore, dystrophin dysfunction may be relevant to AIS occurrence and development.
4.Dystrophinopathy in the paravertebral muscle of adolescent idiopathic scoliosis: a prospective case-control study in China
Junyu LI ; Danfeng ZHENG ; Zekun LI ; Jiaxi LI ; Zexi YANG ; Xiang ZHANG ; Yingshuang ZHANG ; Miao YU
Asian Spine Journal 2025;19(1):64-73
Methods:
This study enrolled 40 patients with AIS, 20 patients with congenital scoliosis (CS), and 20 patients with spinal degenerative disease (SDD). All patients underwent open posterior surgery in our hospital, and a paravertebral muscle (multifidus muscle) biopsy was performed intraoperatively. This study included many indexes that describe muscle, especially dystrophin staining. The above pathological results were compared among the AIS, CS, and SDD groups. The correlation between the Cobb angle and Nash–Moe classification and the above pathological results was analyzed in patients with AIS.
Results:
Significant reductions in the dystrophin staining of dystrophin-1 (p<0.001), dystrophin-2 (p<0.001), and dystrophin-3 (p<0.001) were observed in the AIS group than in the CS and SDD groups. The higher the Nash–Moe classification in the AIS group, the more significant the loss of dystrophin-2 (p=0.042) in the convex paraspinal muscles. Additionally, a significantly positive correlation was observed between the reductions of dystrophin-2 on the concave side of the AIS group and Cobb angle (p=0.011).
Conclusions
Dystrophin protein deficiency in the paraspinal muscles plays a crucial role in AIS formation and progression. The severity of scoliosis in patients with AIS is correlated with the extent of dystrophin loss in the paravertebral muscles. Therefore, dystrophin dysfunction may be relevant to AIS occurrence and development.
5.Advances in research on the application of Lactobacillus and its engineered probiotics to the prevention and treatment of radiation-induced intestinal injury
Xiaoxiao JIA ; Kaihua JI ; Manman ZHANG ; Yingshuang LIU ; Jianguo LI ; Qiang LIU
Chinese Journal of Radiological Medicine and Protection 2025;45(10):1015-1024
Intestinal radiosensitivity makes radiation-induced intestinal injury (RIII) as a common complication among individuals exposed to accidental radiation and patients with abdominal or pelvic malignancies receiving radiotherapy. At present, there are no effective measures for the prevention and treatment of RIII. Developing novel prevention and treatment strategies is of great significance for improving the prognosis and quality of life for both individuals exposed to accidental radiation and cancer patients. Lactobacillus, a Gram-positive bacterium, is widely observed in humans and animals. It exhibits notable probiotic functions, including maintaining gut microbiota homeostasis, preserving intestinal barrier, and modulating immune responses. Substantial studies have demonstrated that Lactobacillus has remarkable protective and therapeutic effects against radiation-induced injury, specifically significantly alleviating RIII. These probiotic functions of Lactobacillus make it have high priority to become the chassis of genetically engineered strains. However, multiple factors influence the construction of a genetically engineered strain, limiting the application of Lactobacillus as a chassis. This review focuses on the probiotic functions of Lactobacillus, highlighting advances in research on Lactobacillus and its engineered probiotics in radiation protection and treatment. Furthermore, it summarizes key factors influencing the construction of genetically engineered strains based on the Lactobacillus chassis. It aims to provide insights for developing genetically engineered strains with radioprotective and therapeutic effects using Lactobacillus as the chassis.
6.Incidence of common gene mutations in early-onset colorectal cancer and the association with cancer survival: a meta-analysis
Rongqi ZHANG ; Shuhui LI ; Tianjie HU ; Liying XU ; Yingshuang ZHU ; Xue LI
Chinese Journal of Gastrointestinal Surgery 2024;27(5):495-506
Objective:The incidence of early-onset colorectal cancer (EOCRC) is increasing globally; however, the molecular characteristics and prognosis of sporadic EOCRC are unclear. In this systematic review and meta-analysis, we aimed to investigate the incidence of gene mutations and their association with cancer survival in sporadic EOCRC, focusing on six common gene mutations ( TP53, BRAF, KRAS, NRAS, PTEN, and APC). Methods:Ovid Embase and Ovid Medline electronic databases were searched for studies involving patients with sporadic EOCRC (i.e., diagnosed with colorectal cancer before the age of 50 years and with no evidence of hereditary syndromes predisposing to colorectal cancer). The included articles were evaluated using quality assessment tools. Meta-analysis was performed using random-effects and fixed-effects models. Cochran's Q statistic and the I2 index were used to assess heterogeneity. The incidence of the six common gene mutations listed above in sporadic EOCRC and their association with cancer survival were evaluated.Results:(1) Incidence of specific gene mutations in sporadic EOCRC. A total of 34 articles were included in this meta-analysis. The incidence of APC gene mutation was 36% (from 13 articles, 95%CI: 19%-55%, P=0.043); of KRAS gene mutation 30% (from 26 articles, 95%CI: 24%-35%, P=0.190); of BRAF gene mutation 7% (from 18 articles, 95%CI: 5%-11%, P=0.422); of NRAS gene mutation 4% (from five articles, 95%CI: 3%-5%, P=0.586); of PTEN gene mutation 6% (from six articles, 95%CI: 4%-10%, P=0.968); and of TP53 gene mutation 59% (from 13 articles, 95%CI: 49%-68%, P=0.164). (2) Association between gene mutations and survival in sporadic EOCRC . A total of six articles were included in this meta-analysis. Compared with wild-type BRAF, mutant BRAF was significantly associated with increased overall mortality risk in patients with EOCRC (pooled HR=2.85, 95%CI: 1.45-5.60, P=0.002). Subgroup analysis showed that the incidence of BRAF gene mutation was higher in Eastern than in Western countries, whereas the incidence of TP53, KRAS, NRAS, and APC gene mutations was lower. There was no significant difference in the incidence of PTEN gene mutation between different regions. Conclusion:Compared with colorectal cancer occurring in the general population, the incidence of APC and KRAS mutations is lower in EOCRC, whereas the incidence of TP53 mutation remains consistent. BRAF mutation is associated with increased overall mortality risk in patients with EOCRC.
7.Incidence of common gene mutations in early-onset colorectal cancer and the association with cancer survival: a meta-analysis
Rongqi ZHANG ; Shuhui LI ; Tianjie HU ; Liying XU ; Yingshuang ZHU ; Xue LI
Chinese Journal of Gastrointestinal Surgery 2024;27(5):495-506
Objective:The incidence of early-onset colorectal cancer (EOCRC) is increasing globally; however, the molecular characteristics and prognosis of sporadic EOCRC are unclear. In this systematic review and meta-analysis, we aimed to investigate the incidence of gene mutations and their association with cancer survival in sporadic EOCRC, focusing on six common gene mutations ( TP53, BRAF, KRAS, NRAS, PTEN, and APC). Methods:Ovid Embase and Ovid Medline electronic databases were searched for studies involving patients with sporadic EOCRC (i.e., diagnosed with colorectal cancer before the age of 50 years and with no evidence of hereditary syndromes predisposing to colorectal cancer). The included articles were evaluated using quality assessment tools. Meta-analysis was performed using random-effects and fixed-effects models. Cochran's Q statistic and the I2 index were used to assess heterogeneity. The incidence of the six common gene mutations listed above in sporadic EOCRC and their association with cancer survival were evaluated.Results:(1) Incidence of specific gene mutations in sporadic EOCRC. A total of 34 articles were included in this meta-analysis. The incidence of APC gene mutation was 36% (from 13 articles, 95%CI: 19%-55%, P=0.043); of KRAS gene mutation 30% (from 26 articles, 95%CI: 24%-35%, P=0.190); of BRAF gene mutation 7% (from 18 articles, 95%CI: 5%-11%, P=0.422); of NRAS gene mutation 4% (from five articles, 95%CI: 3%-5%, P=0.586); of PTEN gene mutation 6% (from six articles, 95%CI: 4%-10%, P=0.968); and of TP53 gene mutation 59% (from 13 articles, 95%CI: 49%-68%, P=0.164). (2) Association between gene mutations and survival in sporadic EOCRC . A total of six articles were included in this meta-analysis. Compared with wild-type BRAF, mutant BRAF was significantly associated with increased overall mortality risk in patients with EOCRC (pooled HR=2.85, 95%CI: 1.45-5.60, P=0.002). Subgroup analysis showed that the incidence of BRAF gene mutation was higher in Eastern than in Western countries, whereas the incidence of TP53, KRAS, NRAS, and APC gene mutations was lower. There was no significant difference in the incidence of PTEN gene mutation between different regions. Conclusion:Compared with colorectal cancer occurring in the general population, the incidence of APC and KRAS mutations is lower in EOCRC, whereas the incidence of TP53 mutation remains consistent. BRAF mutation is associated with increased overall mortality risk in patients with EOCRC.
8.Development and validation of a questionnaire for the management of nutrition and immune-related adverse events in patients with liver cancer who received immunotherapy
Wen WEN ; Yingshuang CHEN ; Chunling LIU ; Liling TONG ; Hua ZHANG
Chinese Journal of Digestion 2024;44(10):693-701
Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.
9.Development and validation of a questionnaire for the management of nutrition and immune-related adverse events in patients with liver cancer who received immunotherapy
Wen WEN ; Yingshuang CHEN ; Chunling LIU ; Liling TONG ; Hua ZHANG
Chinese Journal of Digestion 2024;44(10):693-701
Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.
10.Reprogrammed siTNFα/neutrophil cytopharmaceuticals targeting inflamed joints for rheumatoid arthritis therapy.
Yijun CHEN ; Kaiming LI ; Mengying JIAO ; Yingshuang HUANG ; Zihao ZHANG ; Lingjing XUE ; Caoyun JU ; Can ZHANG
Acta Pharmaceutica Sinica B 2023;13(2):787-803
Rheumatoid arthritis (RA) is an autoimmune disease characterized by severe synovial inflammation and cartilage damage. Despite great progress in RA therapy, there still lacks the drugs to completely cure RA patients. Herein, we propose a reprogrammed neutrophil cytopharmaceuticals loading with TNFα-targeting-siRNA (siTNFα) as an alternative anti-inflammatory approach for RA treatment. The loaded siTNFα act as not only the gene therapeutics to inhibit TNFα production by macrophages in inflamed synovium, but also the editors to reprogram neutrophils to anti-inflammatory phenotypes. Leveraging the active tendency of neutrophils to inflammation, the reprogrammed siTNFα/neutrophil cytopharmaceuticals (siTNFα/TP/NEs) can rapidly migrate to the inflamed synovium, transfer the loaded siTNFα to macrophages followed by the significant reduction of TNFα expression, and circumvent the pro-inflammatory activity of neutrophils, thus leading to the alleviated synovial inflammation and improved cartilage protection. Our work provides a promising cytopharmaceutical for RA treatment, and puts forward a living neutrophil-based gene delivery platform.

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