1.Knockdown TMEM16B reduces brain edema and protects the blood-brain barrier after cerebral ischemia-reperfusion injury in rats
Jingbin ZHANG ; Qian LIU ; Ziyan PAN ; Tianxi YAO ; Jiangwen YIN
Acta Universitatis Medicinalis Anhui 2026;61(4):644-652
ObjectiveTo explore the effects of transmembrane protein 16B (TMEM16B) on brain edema and blood-brain barrier after cerebral ischemia-reperfusion injury in rats. MethodsTMEM16B overexpression and knockdown was performed by adeno-associated virus (AAV), and then adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO). Rats were randomly divided into Sham group, MCAO group, AAV no-load group, TMEM16B overexpression group and TMEM16B knockdown group. Modified neurological severity scores, adhesive removal test and cylinder test were used to evaluate neurologic function. The ultrastructure of ischemic brain tissue was observed by transmission electron microscope. Brain water content was reflected by dry wet weight ratio of brain tissue. The expressions of TMEM16B, aquaporin4 (AQP4), Claudin5 and zonula occludens-1 (ZO-1) were investigated by immunofluorescence and Western blot. ResultsCompared with the AAV no-load group, the sensory and motor functions of rats in TMEM16B overexpression group were significantly impaired. Mitochondria were swollen; mitochondrial cristae and tight junctions disappeared. The brain water content was higher in overexpression group. The expression of TMEM16B and AQP4 increased while the expression of Claudin5 and ZO-1 decreased (all P<0.05). Compared with the AAV no-load group, the rats in TMEM16B knockdown group showed some recovery in motor function. The mitochondrial cristae and structure were clear, and the basement membrane was partially blurred. The brain water content was lower in knockdown group. The protein levels of TMEM16B and AQP4 were lower while the levels of Claudin5 and ZO-1 were higher in TMEM16B knockdown group than in AAV no-load group (all P<0.05). ConclusionAn increase in TMEM16B expression aggravates brain edema and blood-brain barrier damage in rats after cerebral ischemia-reperfusion injury, while a decrease in TMEM16B expression alleviates brain edema and protects the blood-brain barrier.
2.Clinical phenotypes and genetic analysis of five children with Lamb-Shaffer syndrome due to novel variants of SOX5 gene.
Ziyan ZHANG ; Yaxue XIE ; Ping PANG ; Qiyan LIU ; Zhichao LI ; Guang YANG
Chinese Journal of Medical Genetics 2026;43(1):13-18
OBJECTIVE:
To explore the clinical phenotypes and genetic characteristics of five children with Lamb-Shaffer syndrome (LAMSHF).
METHODS:
Five children with LAMSHF diagnosed at the Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital from April 2021 to December 2024 were selected as study subjects. Clinical data of the children was collected. Genomic DNA was extracted from peripheral blood samples of the children and their parents. Whole exome sequencing (WES) was carried out to screen for variants. This study was approved by the Medical Ethics Committee of the Chinese PLA General Hospital (Ethics No.: S2025-411-01).
RESULTS:
All five children had presented with global developmental delay. Among them, two had manifestations of autism spectrum disorder, two had abnormal electroencephalogram findings, four had abnormal MRI results, and two had ocular abnormalities. WES has detected five novel variants in the SOX5 gene. Among these, c.1771G>C (p.Gly591Arg) was unreported previously. Sanger sequencing confirmed that none of the parents had carried the same variants, suggesting that they were all de novo variants. According to the guidelines from the American College of Medical Genetics and Genomics (ACMG), two nonsense variants and one missense variant were classified as pathogenic, whilst two missense variants were classified as likely pathogenic.
CONCLUSION
This study has clarified the correlation between the clinical phenotypes of five children with LAMSHF and variants of the SOX5 gene, which expanded the mutational spectrum of the SOX5 gene and provided a basis for the clinical diagnosis and genetic counseling.
Humans
;
Male
;
Female
;
Phenotype
;
Child, Preschool
;
Child
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SOXD Transcription Factors/genetics*
;
Exome Sequencing
;
Mutation
;
Infant
3.Proteomic Analysis of Danlou Tablet in Improving Platelet Function for Treating Coronary Heart Disease with Phlegm-stasis Intermingling Syndrome in Minipigs
Ziyan WANG ; Ying LI ; Aoao WANG ; Hongxu MENG ; Yue SHI ; Yanlei MA ; Guoyuan ZHANG ; Lei LI ; Jianxun LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):41-53
ObjectiveThis paper aims to observe the role of Danlou tablet in treating coronary heart disease (CHD) with phlegm-stasis intermingling syndrome in minipigs by improving platelet function and explore the potential pharmacological mechanism of Danlou tablet in regulating platelet function by using proteomics technology. MethodsThirty Bama minipigs were randomly divided into a normal control group (6 pigs) and a high-fat diet group (24 pigs). After 2 weeks of high-fat diet feeding, the high-fat diet group was randomly subdivided into a model group, an atorvastatin group (1 mg·kg-1), and Danlou tablet groups (0.6 g·kg-1 and 0.3 g·kg-1). All groups continued to receive a high-fat diet for 8 weeks after the procedure. The normal control group was given a regular diet, underwent only coronary angiography, and did not receive an interventional injury procedure. The model group and each administration group were fed a high-fat diet. Two weeks later, they underwent a coronary angiography injury procedure. After the procedure, drugs were mixed into the feed every morning for 8 consecutive weeks, with the minipigs maintained on a continuous high-fat diet during this period. Quantitative proteomics technology was further used to study platelet proteins, and differential proteins were obtained by screening. Bioinformatics analysis was performed to analyze key regulatory proteins and biological pathways involved in the therapeutic effect of Danlou tablet on CHD with phlegm-stasis intermingling syndrome. ResultsCompared with the normal control group, the model group showed a significant increase in total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) of minipigs' serum (P<0.01), a significant shortening in prothrombin time of (PT) (P<0.01), a coagulation function index, and an increase in whole blood viscosity (P<0.01) and platelet aggregation rate (P<0.01). Moreover, the platelet morphology was altered, and the contents of endothelin-1 (ET-1) and nitric oxide (NO) were significantly increased (P<0.01). Hemodynamic parameters were obviously abnormal, including significantly decreased systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), and left ventricular maximal positive dp/dt (LV+dp/dtmax) (P<0.01). Left ventricular maximal negative dp/dt (LV-dp/dtmax) was significantly increased (P<0.01). Besides, there were myocardial cell hypertrophy, obvious edematous degeneration, massive interstitial inflammatory cell infiltration, high degree of fibrosis, and coronary endothelial atherosclerosis. TC and TG levels in minipigs' serum were significantly reduced in Danlou tablet groups with 0.6 g·kg-1 and 0.3 g·kg-1 (P<0.05, P<0.01), compared with those in the model group. LDL-C was decreased in the Danlou tablet group with 0.6 g·kg-1 (P<0.05). The whole blood viscosity under low and high shear conditions was significantly reduced in the Danlou tablet group with 0.6 g·kg-1 (P<0.05). In groups with all doses of Danlou tablet, maximum aggregation rate (MAR) and average aggregation rate (AAR) were significantly decreased (P<0.05, P<0.01), and platelets' morphological changes such as pseudopodia extension were reduced. ET-1 levels in the serum were significantly reduced. In the Danlou tablet group with 0.6 g·kg-1, NO level in the serum was reduced (P<0.05). In groups with all doses of Danlou tablet, DBP and MAP were significantly increased (P<0.05). In the Danlou tablet group with 0.6 g·kg-1, LVSP and LV+dp/dtmax were significantly increased (P<0.05, P<0.01), and LV-dp/dtmax was significantly decreased (P<0.05). In groups with all doses of Danlou tablet, edematous degeneration in myocardial tissue was milder, and coronary artery lesion degree was significantly alleviated. Compared with the normal control group, there were 94 differentially expressed proteins in the model group, including 81 up-regulated and 13 down-regulated proteins. Compared with the model group, the Danlou tablet group with 0.6 g·kg-1 showed 174 differentially expressed proteins, including 100 up-regulated and 74 down-regulated proteins. A total of 30 proteins were reversed after Danlou tablet intervention. Bioinformatics analysis revealed that its pharmacological mechanism may exert anti-platelet activation, aggregation, and adhesion effects through biological pathways such as regulation of actin cytoskeleton, platelet activation pathway, Fcγ receptor-mediated phagocytosis, as well as proteins such as growth factor receptor-bound protein 2 (GRB2), Ras-related C3 botulinum toxin substrate 2 (RAC2), RAC1, and heat shock protein 90 alpha family class A member 1 (HSP90AA1). ConclusionDanlou tablet can effectively reduce platelet activation and aggregation, exerting a good therapeutic effect on CHD with phlegm-stasis intermingling syndrome in minipigs. Its pharmacological mechanism may involve regulating biological pathways such as actin cytoskeleton and platelet activation pathway, as well as proteins like GRB2, RAC2, RAC1, and HSP90AA1, thereby exerting a pharmacological effect in anti-platelet activation, aggregation, and adhesion.
4.Effect and Mechanism of Schisandrae Chinensis Fructus Lignans on Behavior of Schizophrenic Mice
Jiaqi LI ; Xi CHEN ; Siwei WANG ; Qi WANG ; Yiting LIU ; Ziyan GUO ; Zilong LUN ; Chengyi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):65-71
ObjectiveTo investigate the effects of Schisandrae Chinensis Fructus lignans on schizophrenia induced by dizocilpine maleate (MK-801) in mice and to clarify its mechanism. MethodsMale mice of 4-6 weeks old were randomized into blank, model, positive drug, and low-, medium-, and high-dose (40, 80, 160 mg·kg-1, respectively) Schisandrae Chinensis Fructus lignans groups. The blank group was administrated with distilled water, and the other groups were injected with 0.5 mg·kg-1 MK-801 to induce schizophrenia symptoms. Meanwhile, risperidone was injected at 0.2 mg·kg-1 in the positive drug group, and mice in the intervention groups were injected with corresponding drugs for 14 consecutive days. The behavioral changes of mice were observed by autonomous activity test, open field test, forced swimming test, and water maze test. The levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) in the brain and tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in peripheral blood were quantified by enzyme-linked immunosorbent assay (ELISA). The changes in the prefrontal lobe of mice were observed by hematoxylin-eosin staining, and the changes of the hippocampal tissue were observed by Nissl staining. The protein levels of silencing information regulatory factor 1 (SIRT1) and forkhead box protein O3a (FoxO3a) in the hippocampus of mice were determined by Western blot. ResultsCompared with the model group, low, medium, and high doses of Schisandrae Chinensis Fructus lignans reduced the total number of autonomous activities, total distance in the open field test, immobile time in the forced swimming test, and levels of TNF-α and NF-κB in peripheral blood (P<0.05), while increasing the number of platform crossings in the water maze test and DA and 5-HT levels in the brain tissue (P<0.05). Compared with the model group, risperidone and low, medium, and high doses of Schisandrae Chinensis Fructus lignans improve the neural cell morphology in the CA1 region, with full cells in neatly dense arrangement and exhibiting clear membrane boundary. Schisandrae Chinensis Fructus lignans inhibited the expression of SIRT 1 and FoxO3a in the hippocampus (P<0.05). ConclusionTo sum up, Schisandrae Chinensis Fructus lignans may improve the behavior of schizophrenic mice by activating the SIRT1/FoxO3a signaling pathway to exert neuroprotective effects.
5.Mechanism of Shenling baizhu san in ameliorating ulcerative colitis via regulating flora metabolism-related proteins and TLR4/NF-κB/NLRP3 inflammatory axis
Jiajia XU ; Yu YOU ; Jiaoman WANG ; Yuhui LIU ; Shiyao CHANG ; Zhixian HE ; Ping LI ; Ziyan WANG ; Wei XIONG ; Fei HAN
China Pharmacy 2026;37(15):1992-1997
OBJECTIVE To investigate the mechanism of Shenling baizhu san (SLBZS) in ameliorating ulcerative colitis (UC). METHODS Mice were randomly divided into normal group, model group, and low-, medium-, high-dose SLBZS groups (3, 6, 12 g/kg), with 10 mice in each group. Except for the normal group, mice in other groups were given free access to 3% dextran sulfate sodium solution for 7 days to establish UC models. Simultaneously, mice in each group were intragastrically administered corresponding medicinal liquid or double-distilled water once a day for consecutive 7 days. After the last administration, the histopathological morphology of colon tissues was observed; the serum levels of inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-18 were detected; the total bile acid contents in liver, gallbladder and colon tissues were determined; the expression level of NOD-like receptor family pyrin domain-containing protein 3 (NLRP3) in colon tissues was tested. The expression levels of flora metabolism-related proteins [G protein-coupled receptor 41(GPR41),GPR43,farnesoid X receptor (FXR), G protein-coupled bile acid receptor 1 (TGR5), flavin-containing monooxygenase 3 (FMO3), cytochrome P450 family 27 subfamily A member 1 (CYP27A1), CYP7A1] in liver or colon tissues, as well as the proteins related to Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB)/NLRP3 inflammatory axis [TLR4, NF-κB, phosphorylated NF-κB (p-NF-κB), myeloid differentiation factor 88 (MyD88), NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), caspase-1] in colon tissues were measured. RESULTS Compared with the model group, the colon tissue injury and inflammatory cell infiltration were alleviated in medium- and high-dose SLBZS groups. The serum levels of TNF-α, IL-1β and IL-18, total bile acid contents in liver and colon tissues, as well as the protein expression levels of FMO3 and CYP7A1 in liver tissues, TLR4, p-NF-κB, NF-κB, MyD88, NLRP3, ASC and caspase-1 in colon tissues were significantly decreased (P<0.05). Meanwhile, the total bile acid content in gallbladder, the protein expression levels of GPR41 and GPR43 in colon tissues, along with CYP27A1, FXR and TGR5 in liver tissues were significantly increased (P<0.05). CONCLUSIONS SLBZS may relieve colonic inflammatory injury and ameliorate UC by regulating the expression of flora metabolism-related proteins and inhibiting the abnormal activation of TLR4/NF-κB/NLRP3 inflammatory axis.
6.Pathogens and prognostic value of PCSK9,PTX-3 and HDAC2 in sepsis patients
Xiyi LIU ; Ziyan LIU ; Lan CHEN ; Na ZHANG
Chinese Journal of Nosocomiology 2025;35(15):2278-2282
OBJECTIVE To analyze the etiological characteristics of sepsis patients,changes in serum levels of prop-rotein convertase subtilisin/kexin type 9(PCSK9),pentraxin 3(PTX-3)and histone deacetylase 2(HDAC2)in patients with sepsis and their relationship with the severity of the disease and prognosis.METHODS A total of 156 sepsis patients admitted to Wuhan No.8 Hospital(Wuhan Anorectal Hospital)from Jan.2020 to Apr.2022 were selected as the study group.They were divided into the general sepsis,severe sepsis and septic shock groups ac-cording to their condition,with 58,51 and 47 cases,respectively.According to the clinical outcome at day 28 post-admission,the patients were divided into the good prognosis and poor prognosis groups with 124 and 32 ca-ses,respectively.Additionally,50 healthy individuals were randomly selected as the control group.The etiological characteristics in patients with sepsis were analyzed.Serum levels of PCSK9,PTX-3 and HDAC2 were compared among different severity groups and prognosis groups.The predictive value was assessed by plotting the receiver operating characteristic(ROC)curve and calculating the area under the curve(AUC).RESULTS A total of 162 strains were detected from 156 sepsis patients,with gram-negative bacteria accounted for 56.79%.Serum levels of PCSK9 and PTX-3 were higher in the study group than those in the control group,while serum level of HDAC2 was lower than that in the control group(P<0.05).Serum levels of PCSK9 and PTX-3 showed a gradual increase among the general sepsis group,severe sepsis group,and septic shock group,while serum level of HDAC2 showed a decreasing trend among the three groups(P<0.05).Serum levels of PCSK9 and PTX-3 were higher in the poor prognosis group than those in the good prognosis group,and serum level of HDAC2 was lower than that in the good prognosis group(P<0.05).ROC analysis showed that the AUC value of the combined detection of se-rum PCSK9,PTX-3 and HDAC2 was 0.931,higher than that of single markers(P<0.05),with sensitivity and specificity of 90.62%and 81.45%,respectively.CONCLUSIONS The pathogens in patients with sepsis are prima-rily gram-negative bacteria.Serum levels of PCSK9 and PTX-3 are high in patients,while serum HDAC2 is low.All the three markers are closely related to the patient's condition and prognosis,and their combined detection of-fers a more advantageous approach for predicting the poor prognosis of patients with sepsis.
7.Prediction of Endometrial Cancer Microsatellite Expression Status via Deep Transfer Learning Features Based on Multi-Parameter MRI
Ziyan LIU ; Yuxin DING ; Genji BAI
Chinese Journal of Medical Imaging 2025;33(5):546-552,561
Purpose To explore deep transfer learning(DTL)based on multi-parameter MRI for joint prediction of uterine endometrial cancer microsatellite expression with clinical parameters.Materials and Methods Retrospective analysis was conducted on 262 patients with uterine endometrial cancer in the Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University from January 2020 to December 2022,who were randomly divided into a training cohort(n=183)and a validation cohort(n=79)in a 7∶3 ratio.DTL features were extracted from T2WI and diffusion-weighted imaging(DWI)using a 50-layer residual neural network(ResNet50).Subsequently,T2-net,DWI-net,multi-sequence fusion and a combined model were constructed.A combined model was constructed via incorporating multiparametric fusion DTL features and clinically independent prognostic factors identified through both univariate and multivariate Logistic regression analysis.Model performance was assessed using the area under the curve,calibration curve and decision curve.Grad-CAM was used for model visualization analysis.Results Compared with single-sequence models,the multi-sequence fusion models exhibited superior performance,with area under the curve value of 0.898 for the validation cohort,accuracy of 0.823,sensitivity of 0.812,specificity of 0.825,respectively,and F1 score was 0.650.Univariate and multivariate Logistic regression analyses revealed that serum human epididymis protein 4 levels and the presence of uterine fibroids were clinically independent risk factors.Ultimately,the combined model demonstrated the best predictive performance in the validation cohort,with area under the curve value of 0.924,accuracy of 0.835,sensitivity of 0.875,specificity of 0.825,respectively,and F1 score was 0.683.Conclusion The multi-parameter fusion model based on DTL features can effectively and non-invasively predict the microsatellite status of endometrial cancer patients.
8.Comparison of automatic tube voltage modulation combined with an artificial intelligence iterative reconstruction algorithm versus conventional scanning protocol in contrast-enhanced thoracic-abdominal-pelvic CT
Wei DING ; Ziyan LIU ; Zepeng MA ; Tianle ZHANG ; Yongxia ZHAO
Chinese Journal of Radiological Medicine and Protection 2025;45(7):692-698
Objective:To evaluate the image quality and radiation dose in contrast-enhanced thoracic-abdominal-pelvic CT using automatic tube voltage modulation (ATVM) coupled with artificial intelligence iterative reconstruction (AIIR) versus routine tube voltage combined with Karl-3D iterative reconstruction (Karl-3D IR), and to determine the optimal noise level for AIIR in contrast-enhanced thoracic-abdominal-pelvic CT.Methods:A total of 100 patients who underwent contrast-enhanced thoracic-abdominal-pelvic CT examination in the Affiliated Hospital of Hebei University from April to October, 2023 were randomly divided into group A and group B using a random number table, with 50 patients in each group. Group A was scanned using ATVM, and images were reconstructed using AIIR with 1-5 noise levels. Group B was scanned using tube voltage 120 kVp and images were reconstructed with Karl-3D IR and noise level 5. The single-to-noise ratio (SNR), contrast-to-noise ratio (CNR), effective dose (E), and size-specific dose estimate (SSDE) were recorded or calculated for all patients or images. Subjective evaluations of all images were performed. The quality of the reconstructed images using AIIR with 1-5 noise levels were compared and the optimal noise level of AIIR for image reconstruction was determined. Image quality and radiation dose were statistically analyzed for Group A (image reconstruction with optimal AIIR noise level) and Group B.Results:The mean SNR and mean CNR of the reconstructed images using AIIR with noise levels 1, 2, and 3 in group A were higher than those using AIIR with noise levels 4 and 5. The images reconstructed using AIIR with noise levels 3 and 4 scored higher in subjective assessment than those reconstructed using AIIR with noise levels 1, 2, and 5. Therefore, noise level 3 was optimal for AIIR in reconstruction of contrast-enhanced thoracic-abdominal-pelvic CT images. The mean SNR, mean CNR, and subjective evaluation score of group A using AIIR with noise level 3 were higher than those of group B using Karl-3D IR with noise level 5 ( P<0.001). The mean SSDE and the mean E of group A were reduced by 46% and 41%, respectively, compared with those of group B. Conclusions:ATVM technology combined with the AIIR algorithm can improve image quality and reduced patient radiation dose in contrast-enhanced thoracic-abdominal-pelvic CT. Noise level 3 is optimal for AIIR in the reconstruction of arterial-phase and venous-phase contrast-enhanced thoracic-abdominal-pelvic CT images.
9.Preliminary analysis of mRNA m7G modifications in human Adenocarcinoma of esophagogastric junction
Ziyan LIU ; Xiaoyan WANG ; Binbin HU ; Shiqi ZHANG ; Yakun LANG ; Yu FAN
Chinese Journal of Medical Genetics 2025;42(2):187-197
Objective:To explore the potential role of mRNA m7G modification in the pathogenesis of human adenocarcinoma of esophagogastric junction (AEG).Methods:Pathological tissue specimens from four AEG patients who underwent surgical treatment at the People′s Hospital Affiliated to Jiangsu University between 2018 and 2019 were selected. Tumor tissues and adjacent normal tissues were collected from these patients. RNA was extracted from both tissue types and subjected to m7G methylated RNA immunoprecipitation sequencing (m7G-MeRIP-seq) to analyze the patterns of m7G modification, the characteristics of differential m7G modification sites, the differentially expressed mRNA, and the correlation between m7G modification and mRNA expression levels. Differential m7G-modified genes ( MSH6, BRCA1, and SOX9) were further validated using methylated RNA immunoprecipitation quantitative PCR (MeRIP-qPCR), while the expression of METTL1 and WDR4 genes was examined by real-time quantitative PCR (RT-qPCR). This study was approved by the Medical Ethics Committee of the People′s Hospital Affiliated to Jiangsu University (Ethics No. 20150083). Results:① m7G-MeRIP-seq analysis revealed that m7G modifications in both AEG and adjacent normal tissues were predominantly located in the GC-rich region surrounding the internal start codon of mRNA. Differential m7G modification sites between the two groups were closely associated with cancer-related genes. ② mRNA library analysis showed that differentially expressed mRNA were predominantly upregulated in AEG tissues and downregulated in adjacent normal tissues. ③ Cross-analysis indicated that genes with hypermethylation tended to exhibit upregulated expression, while genes with hypomethylation were typically downregulated in AEG tissues. ④ MeRIP-qPCR validation confirmed that the mRNA expression of MSH6, BRCA1, and SOX9 were significantly upregulated in AEG tissues compared to adjacent normal tissues (AEG vs. normal, P<0.05). ⑤ RT-qPCR results demonstrated that the mRNA expression levels of METTL1 and WDR4 were also upregulated in AEG tissues (AEG vs. normal, P<0.000 5). Conclusion:These findings suggest that mRNA m7G modification plays a significant role in the development of AEG. Furthermore, proteins as METTL1 and WDR4 may facilitate AEG progression by regulating mRNA m7G modification. These results provide valuable insights into the molecular mechanisms underlying AEG and may inform future therapeutic strategies for this malignancy.
10.Pathogens and prognostic value of PCSK9,PTX-3 and HDAC2 in sepsis patients
Xiyi LIU ; Ziyan LIU ; Lan CHEN ; Na ZHANG
Chinese Journal of Nosocomiology 2025;35(15):2278-2282
OBJECTIVE To analyze the etiological characteristics of sepsis patients,changes in serum levels of prop-rotein convertase subtilisin/kexin type 9(PCSK9),pentraxin 3(PTX-3)and histone deacetylase 2(HDAC2)in patients with sepsis and their relationship with the severity of the disease and prognosis.METHODS A total of 156 sepsis patients admitted to Wuhan No.8 Hospital(Wuhan Anorectal Hospital)from Jan.2020 to Apr.2022 were selected as the study group.They were divided into the general sepsis,severe sepsis and septic shock groups ac-cording to their condition,with 58,51 and 47 cases,respectively.According to the clinical outcome at day 28 post-admission,the patients were divided into the good prognosis and poor prognosis groups with 124 and 32 ca-ses,respectively.Additionally,50 healthy individuals were randomly selected as the control group.The etiological characteristics in patients with sepsis were analyzed.Serum levels of PCSK9,PTX-3 and HDAC2 were compared among different severity groups and prognosis groups.The predictive value was assessed by plotting the receiver operating characteristic(ROC)curve and calculating the area under the curve(AUC).RESULTS A total of 162 strains were detected from 156 sepsis patients,with gram-negative bacteria accounted for 56.79%.Serum levels of PCSK9 and PTX-3 were higher in the study group than those in the control group,while serum level of HDAC2 was lower than that in the control group(P<0.05).Serum levels of PCSK9 and PTX-3 showed a gradual increase among the general sepsis group,severe sepsis group,and septic shock group,while serum level of HDAC2 showed a decreasing trend among the three groups(P<0.05).Serum levels of PCSK9 and PTX-3 were higher in the poor prognosis group than those in the good prognosis group,and serum level of HDAC2 was lower than that in the good prognosis group(P<0.05).ROC analysis showed that the AUC value of the combined detection of se-rum PCSK9,PTX-3 and HDAC2 was 0.931,higher than that of single markers(P<0.05),with sensitivity and specificity of 90.62%and 81.45%,respectively.CONCLUSIONS The pathogens in patients with sepsis are prima-rily gram-negative bacteria.Serum levels of PCSK9 and PTX-3 are high in patients,while serum HDAC2 is low.All the three markers are closely related to the patient's condition and prognosis,and their combined detection of-fers a more advantageous approach for predicting the poor prognosis of patients with sepsis.

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