1.Effect and mechanism of Jingangteng capsules in the treatment of non-alcoholic fatty liver disease based on gut microbiota and metabolomics
Shiyuan CHENG ; Yue XIONG ; Dandan ZHANG ; Jing LI ; Zhiying SUN ; Jiaying TIAN ; Li SHEN ; Yue SHEN ; Dan LIU ; Qiong WEI ; Xiaochuan YE
China Pharmacy 2025;36(11):1340-1347
OBJECTIVE To investigate the effect and mechanism of Jingangteng capsules in the treatment of non-alcoholic fatty liver disease (NAFLD). METHODS Thirty-two SD rats were randomly divided into normal group and modeling group. The modeling group was fed a high-fat diet to establish a NAFLD model. The successfully modeled rats were then randomly divided into model group, atorvastatin group[positive control, 2 mg/(kg·d)], and Jingangteng capsules low- and high-dose groups [0.63 and 2.52 mg/(kg·d)], with 6 rats in each group. The pathological changes of the liver were observed by hematoxylin-eosin staining and oil red O staining. Enzyme-linked immunosorbent assay was performed to determine the serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine transaminase (ALT), aspartate transaminase (AST), tumour necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-18. 16S rDNA amplicon sequencing and metabolomics techniques were applied to explore the effects of Jingangteng capsules on gut microbiota and metabolisms in NAFLD rats. Based on the E-mail:591146765@qq.com metabolomics results, Western blot analysis was performed to detect proteins related to the nuclear factor kappa-B (NF-κB)/NOD-like receptor family protein 3 (NLRP3) signaling pathway in the livers of NAFLD rats. RESULTS The experimental results showed that Jingangteng capsules could significantly reduce the serum levels of TG, TC, LDL-C, AST, ALT, TNF-α, IL-1β, IL-6, IL-18, while increased the level of HDL-C, and alleviated the hepatic cellular steatosis and inflammatory infiltration in NAFLD rats. They could regulate the gut microbiota disorders in NAFLD rats, significantly increased the relative abundance of Romboutsia and Oscillospira, and significantly decreased the relative abundance of Blautia (P<0.05). They also regulated metabolic disorders primarily by affecting secondary bile acid biosynthesis, fatty acid degradation, O-antigen nucleotide sugar biosynthesis, etc. Results of Western blot assay showed that they significantly reduced the phosphorylation levels of NF-κB p65 and NF-κB inhibitor α, and the protein expression levels of NLRP3, caspase-1 and ASC (P<0.05 or P<0.01). CONCLUSIONS Jingangteng capsules could improve inflammation, lipid accumulation and liver injury in NAFLD rats, regulate the disorders of gut microbiota and metabolisms, and inhibit NF-κB/NLRP3 signaling pathway. Their therapeutic effects against NAFLD are mediated through the inhibition of the NF-κB/NLRP3 signaling pathway.
2.Weifuchun Alleviates Gastric Precancerous Lesions by Inhibiting Pyroptosis via NF-κB/GSDME Pathway
Yegui JIA ; Dan XIAO ; Qiong LIU ; Ao WANG ; Fengqin AO ; Zhimin HUANG ; Qin JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(21):61-69
ObjectiveTo explore the role and molecular mechanism of Weifuchun (WFC) in inhibiting inflammation and alleviating gastric precancerous lesions (GPL). MethodHuman gastric mucosal epithelial cells (GES-1) were stimulated with N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) for the modeling of GPL (MC cells), with Caspase-3 inhibition by Z-DEVD-FMK. MC cells were divided into control (20% blank serum), WFC (15% and 20% WFC-containing serum), and caspase-3 inhibitor groups. The cell counting kit-8 (CCK-8) was used to examine the viability of GES-1 cells or MC cells. The Transwell assay and 5-acetylidene-2′-deoxyuridine (EdU) staining were employed to examine cell invasion and proliferation, respectively. Flow cytometry was employed to determine the level of reactive oxygen species. Real-time PCR was conducted to determine the mRNA levels of interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α. Gene Expression Omnibus (GEO) was used to analyze the role of pyroptosis in gastric cancer progression. Western blotting was employed to determine the protein levels of nuclear factor-κB (NF-κB) p65, gasdermin E (GSDME), and Caspase-3. Immunofluorescence staining was employed to detect the NF-κB p65 protein level and nuclear translocation. Hematoxylin-eosin staining was carried out to observe the pathological changes in the gastric mucosa before and after WFC treatment in the patients. ResultCompared with the control group, MC cells presented enhanced proliferation and invasion energy (P<0.01). Compared with the blank serum group, WFC-containing serum inhibited the proliferation and invasion of MC cells (P<0.01), down-regulated the mRNA levels of IL-1, IL-6, and TNF-α, and lowered the level of reactive oxygen species (P<0.05, P<0.01). The transcriptome data at different stages of gastric cancer showed that pyroptosis was involved in gastric cancer progression, and the GSDME level was significantly higher in GPL patients than in the normal group. Compared with the blank serum, WFC-containing serum lowered the level of NF-κB and inhibited the nuclear translocation of NF-κB (P<0.05), and it inhibited pyroptosis by suppressing the cleavage of Caspase-3 on GSDME (P<0.05, P<0.01). The analysis of patient specimens further demonstrated that WFC treatment down-regulated the NF-κB level and GSDME cleavage (P<0.01), inhibited pyroptosis, and alleviated gastric mucosal inflammation and intestinal epithelial metaplasia. ConclusionPyroptosis is involved in the progression of gastric cancer, and WFC inhibits pyroptosis via the NF-κB/GSDME pathway, thereby alleviating gastric mucosal inflammation in GPL.
3.Clinical Efficacy of Liuwei Anshen Capsules Combined with Amlodipine Plus Benazepril in the Treatment of Senile Essential Hypertension Patients Complicated with Anxiety and Depressive Disorders and Its Intervention Effect on NR2B Protein Expression
Hui-Qiong LI ; Sheng-Jun MA ; Xun-Ping MA ; Li LIU ; Dan LIU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(8):2001-2008
Objective To investigate the clinical efficacy of Liuwei Anshen Capsules combined with Amlodipine+Benazepril Tablets in the treatment of senile essential hypertension(EH)patients complicated with anxiety and depressive disorders and its intervention effect on the expression of N-methyl-D-aspartate receptor 2B subunit(NR2B)protein.Methods A retrospective study was conducted on 138 senile EH patients complicated with anxiety and depressive disorders of accumulation of excess phlegm-heat syndrome treated in the Geriatric Department of Sinopharm Gezhouba Central Hospital from December 2020 to December 2022.The patients were divided into an observation group and a control group according to the treatment schemes,with 69 cases in each group.The control group was treated with Amlodipine+Benazepril Tablets and routine psychotherapy,and the observation group was treated with Liuwei Anshen Capsules orally on the basis of treatment for the control group.The course of treatment lasted for one month.The changes of blood pressure indicators of systolic blood pressure(SBP)and diastolic blood pressure(DBP),Hamilton Anxiety Scale(HAMA)score,17-Item Hamilton Depression Scale(HAMD-17)score,NR2B protein expression,and the levels of monoamine neurotransmitters of dopamine(DA),epinephrine(NE),and 5-hydroxytryptamine(5-HT)in the two groups were observed before and after treatment.After treatment,the clinical efficacy and total incidence of adverse reactions were compared between the two groups.Results(1)After one month of treatment,the total effective rate of the observation group was 95.65%(66/69),and that of the control group was 75.36%(52/69).The intergroup comparison(tested by chi-square test)showed that the curative effect of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the SBP and DBP of the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease of SBP and DBP in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the HAMA score and HAMD-17 score of the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease of HAMA score and HAMD-17 score in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the expression level of NR2B protein in the two groups was significantly decreased compared with that before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.01).(5)After treatment,the levels of serum DA,NE and 5-HT in the two groups were significantly decreased in comparison with those before treatment(P<0.05),and the decrease of serum DA,NE and 5-HT levels in the observation group was significantly superior to that in the control group(P<0.01).(6)The total incidence of adverse reactions in the observation group was 2.90%(2/69)and that in the control group was 5.80%(4/69).There was no significant difference between the two groups(P>0.05).Conclusion Liuwei Anshen Capsules combined with Amlodipine+Benazepril Tablets can effectively alleviate the bad mood,decrease blood pressure,inhibit the overexpression of NR2B protein,and correct the disorder of monoamine neurotransmitters in senile EH patients complicated with anxiety and depressive disorders of accumulation of excess phlegm-heat syndrome.The combined treatment does not cause serious adverse reactions,which is safe and effective.
4.Application of single-sperm sequencing in resolving the carrier status of preimplantation genetic testing for chromosomal structural rearrangements in Robertsonian translocations
Bao-Qiong LIAO ; Li-Dan LAI ; Ru-Tian LIU ; Qi ZHANG ; Wen-Chang LIAN ; Wu-Ming XIE
National Journal of Andrology 2024;30(6):499-506
Objective:To investigate the application value of single-sperm sequencing in resolving the carrier status of preim-plantation genetic testing(PGT)for chromosomal structural rearrangements in Robertsonian translocations.Methods:Haplotypes were constructed by single-sperm isolation combined with single-sperm sequencing for a patient with 45,XY,der(13;14)(q10;q10).Twenty single-sperm samples were isolated by mechanical braking and subjected to whole-genome amplification(WGA),and then the Asian Screening Array(ASA)gene chip was used to detect the 183 708 single nucleotide polymorphisms(SNP)of the WGA products.The single sperm associated with the translocation that could be used as haplotype inference was detected by copy number variation(CNV)sequencing,and the chromosomal haplotypes with normal and Robertsonian translocations were inferred.Three biopsy samples of embryonic trophoblast cells were used as the objects.After whole-genome amplification,high-throughput sequencing was employed to determine the status of the translocation chromosome carried by the embryos.The available blastocysts were selected for transfer,and the amniotic fluid samples were taken at 18 weeks of gestation to confirm whether the fetus carried the pathogenic muta-tion.Results:A total of 6 037 SNP sites were screened by single-sperm sequencing,and 30 sites selected to distinguish normal and translocation haplotypes.Preimplantation haplotype analysis showed that all the three embryos were euploids without Robertsonian translocation chromosome.Genetic testing of amniotic fluid in the second trimester confirmed that the karyotype of the fetus was 46,XN,carrying no Robertsonian translocation chromosome.Conclusion:For male carriers of Robertsonian translocation,single sperm sequencing can be used to screen SNP sites to construct haplotypes for distinguishing normal and Robertsonian translocation em-bryos,and to provide a basis for embryo selection by preimplantation chromosomal structural genetic testing.
5. Diterpenoids of Tripterygium wilfordii decrease inflammatory response of macrophage by inhibiting multiple signaling pathways
Kai-Rui RAO ; Cai-Cen LIAO ; Ran YI ; Xin-Ye DU ; Xiao-Qiong ZHOU ; Rong-Lao LI ; Dan LIU
Chinese Pharmacological Bulletin 2023;39(1):153-160
Aim To study the anti-inflammatory activ¬ity of diterpenes from Tripterygium wilfordii on lipopo- lysaccharide ( LPS)-induced macrophage and its mech¬anism. Methods MTT assay was used to detect the cytotoxicity of compounds. The Griess method was used to detect the NO on LPS-induced RAW264. 7 cells. ELISA was applied to determine the contents of inter- leukin 6 (IL-6) , tumor necrosis factor a ( TNF-a ) , interleukin lp (IL-lfj) and interleukin 18 (IL-18) in cell culture supernatant. Western blot was used to de¬tect IkBcx, .INK, ERK, p38, STAT3 and their phos-phorylation in LPS-induced RAW264.7, as well as the effect on COX-2, iNOS, NLRP3, caspase-1 , cleaved- caspase-1. Flow cytometry was employed to detect the effects of compounds on the phagocytosis of RAW 264. 7 cells. Results Hypoglicin II (1) and ent-pimara-8 (14) , 15-diene-19-ol (6) , two diterpenoid compounds from Tripterygium wilfordii could effectively inhibit the expression of inflammatory mediators ( COX-2 and iN- OS) and inflammatory cytokines (IL-6, IL-lp, IL- 18) in LPS-induced RAW264. 7 cells. Further re¬search found that the phosphorylation of IkBcx , JNK, ERK, P38, STAT3 and NLRP3 was all inhibited; however, there was no significant effect on the expres¬sion of IkBcx, JNK, ERK, P38 and STAT3. At the same time, they also inhibited the phagocytosis of mac-rophages. Conclusions The anti-inflammatory mecha¬nism of Tripterygium wilfordii diterpenoids 1 and 6 might be through inhibiting the production of NLRP3 inflammatory bodies, inflammatory mediators (COX-2 and iNOS) and inflammatory cytokines (IL-6, IL-lp and IL-18) , which is closely related to inhibiting the activation of MAPK, NF-kB and STAT3 pathway.
6.Effect of Spontaneous Blastocyst Collapse on Pregnancy and Neonatal Outcomes in Frozen-thawed Transfer Cycle
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2023;52(6):834-838
Objective To observe the effect of spontaneous blastocyst collapse on pregnancy and neonatal outcomes in fro-zen-thawed transfer cycle.Methods The clinical data of 10120 single blastocyst frozen-thawed transfer cycles from January 2018 to December 2020 was retrospectively analyzed,of which 133 cycles were spontaneous collapsed blastocysts(collapse group),133 cycles of transplanted embryos were obtained as non-collapse blastocysts(non-collapse group)after balancing the co-variates between groups by 1∶1 propensity score matching(PSM),pregnancy and neonatal outcomes were compared between the two groups.Results The live birth rate in collapse group was significantly lower than that in non-collapse group(30.08%vs.45.86%,P<0.01).The implantation rate and clinical pregnancy rate in collapse group were decreased,and the early abor-tion rate was increased,but the differences were not statistically significant(all P>0.05).Logistic regression analysis showed that women's age,infertility type and spontaneous blastocyst collapse had significant effects on live birth(all P<0.05).The odds ratio of live birth between collapse group and non-collapse group was 0.54(95%CI:0.32~0.91).There was no statistical-ly significant difference in the gestation days at birth,birth weight and the proportion of male newborns between the two groups(all P>0.05).There were 2 premature births in live birth of each group,and 1 birth defect in singleton pregnancy in collapse group,which was the enlargement of infant adrenal gland.There was no birth defect in singleton pregnancy newborns in non-collapse group.Conclusion In frozen-thawed transfer cycle,the transplantation of spontaneous collapsed blastocysts can reduce the maternal live birth rate,spontaneous collapsed blastocysts for implantation may not increase incidence rates of poor perinatal outcomes and neonatal defects.Spontaneous collapsed blastocysts can be used as a means to improve embryo selection,so as to improve the live birth rate and improve the pregnancy outcome of assisted reproductive technology.
7.Associations of genetic polymorphisms in Corin with blood pressure responses to salt and potassium intake
Lan WANG ; Zejiaxin NIU ; Yanjie GUO ; Nairong LIU ; Yanni YAO ; Beibei YANG ; Jiaxin WANG ; Chuang LI ; Panpan LIU ; Chang’e YANG ; Mingfei DU ; Guilin HU ; Xi ZHANG ; Dan WANG ; Xiaoyu ZHANG ; Chao CHU ; Yueyuan LIAO ; Qiong MA ; Keke WANG ; Hao JIA ; Yue SUN ; Tongshuai GUO ; Weihua GAO ; Jianjun MU ; Yang WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):22-29
【Objective】 Corin, a transmembrane serine protease that can cleave atrial natriuretic peptide precursor (pro-ANP) into atrial natriuretic peptide with smaller bioactive molecules, participates in the pathophysiological process of hypertension and cardiac hypertrophy. The purpose of this study was to explore the relationship of Corin gene variation with blood pressure responses to sodium and potassium dietary interventions. 【Methods】 In 2004, we recruited 514 participants from 124 families in 7 villages of Baoji, Shaanxi Province, China. All the subjects received a 3-day normal diet, a 7-day low-salt diet, a 7-day high-salt diet, and finally a 7-day high-salt and potassium supplementation. Fifteen single nucleotide polymorphisms (SNPs) of Corin gene were selected for final analysis. 【Results】 SNPs rs12509275 were significantly associated with diastolic blood pressure (DBP) response to low-salt diet, while rs3749584 was associated with pulse pressure (PP) response to low-salt diet.SNP rs3749584 and rs10517195 were significantly associated with PP response to high-salt diet. In addition,rs17654278 were significantly associated with systolic blood pressure (SBP) response to high-salt and potassium supplementation, rs2271037 was significantly correlated with DBP responses to high-salt and potassium supplementation, and rs4695253, rs12509275, rs2351783, rs36090894 were significantly associated with PP response to high-salt and potassium supplementation. 【Conclusion】 Corin gene polymorphisms were associated with blood pressure response to sodium and potassium, suggesting that Corin gene may be involved in pathophysiological process of salt sensitivity and potassium sensitivity.
8.Dahuang Mudantang Alleviates Intestinal Injury in Rat Model of Acute Pancreatitis by Regulating HMGB1/RAGE/NF-κB Signaling Pathway
Linlin WEN ; Yongfeng WANG ; Min BAI ; Zhandong WANG ; Bing SONG ; Yanying ZHANG ; Xinhong LIU ; Yingfeng SUN ; Dan YANG ; Qiong WANG ; Hongzhang ZHAO ; Runze YANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(19):1-8
ObjectiveTo explore the mechanism of Dahuang Mudantang in alleviating the intestinal injury in the rat model of acute pancreatitis via the high-mobility group box 1 (HMGB1)/receptor for advanced glycation endproduct (RAGE)/nuclear factor-κB (NF-κB) signaling pathway. MethodOne hundred and twenty SPF-grade Wistar rats received retrograde injection of 5% sodium taurocholate into the biliopancreatic duct for the modeling of intestinal injury in acute pancreatitis. The rats were randomized into blank, model, low-, medium-, and high-dose (3.5, 7, 14 g·kg-1, administrated by gavage) Dahuang Mudantang, and octreotide (1×10-5 g·kg-1, subcutaneous injection) groups (n=20). The rats in blank and model groups received equal volume of distilled water by gavage. Drugs were administered 1 h before and every 12 h after modeling, and samples were collected 24 h after modeling. The general status of the rats was observed. The biochemical methods were employed to measure the levels of amylase (AMS) and C-reactive protein (CRP) in the serum. The enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the colon tissue. The morphological changes of pancreatic and colon tissues were observed by hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were employed to measure the expression levels of HMGB1, RAGE, inhibitor of NF-κB kinase (IKK), and NF-κB suppressor protein α(IκBα)in the colon tissue. ResultThe rats in the model group showed poor general survival, writhing response, reduced frequency of defecation, and dry stool. The symptoms of rats in the model group were mitigated in each treatment group, and the high-dose Dahuang Mudantang showed the most significant effect. Compared with the normal group, the model group had elevated AMS and CRP levels (P<0.05), which were lowered by Dahuang Mudantang (P<0.05), especially that at the high dose (P<0.05). Compared with the normal group, the modeling elevated that levels of TNF-α, IL-1β, and IL-6 (P<0.05). Such elevations were lowered by Dahuang Mudantang (P<0.05), and the high-dose group and the octreotide group showed better performance (P<0.05). The modeling caused necrotic, congested, and destructed pancreatic and colonic tissues, which were ameliorated by the drugs, especially high-dose Dahuang Mudantang. Compared with the normal group, the modeling up-regulated the mRNA levels of HMGB1, RAGE, IKK, IκBα, and NF-κB (P<0.05). Compared with the model group, Dahuang Mudantang and octreotide down-regulated the mRNA levels of HMGB1, RAGE, IKK, IκBα, and NF-κB (P<0.05), and the high-dose Dahuang Mudantang demonstrated the best performance (P<0.05). Western blot results showed a trend consistent with the results of Real-time PCR. ConclusionDahuang Mudantang can improved the general status, reduce inflammation, and alleviate histopathological changes in the pancreatic and colon tissues in the rat model of acute pancreatitis by inhibiting the HMGB1/RAGE/NF-κB signaling pathway.
9.Mechanism of intestinal injury induced by WNT2B high-expressed fibroblasts in Crohn's disease.
Yan Ling CHENG ; Shu Zhe XIAO ; Dan Qiong LIU ; Lan Lan GENG ; Jian Biao GU ; Rui TANG ; Lin LAN ; Yun ZHU ; Pei Yu CHEN ; Zhi Hua HE ; Si Tang GONG ; Yang CHENG
Chinese Journal of Pediatrics 2023;61(7):606-613
Objective: To explore the mechanism of intestinal tissue damage induced by macrophages activated by WNT2B high-expressed fibroblasts. Methods: This study involved biological information analysis, pathological tissue research and cell experimental research. The biological information of the colon tissue from the children with inflammatory bowel disease in previous study was analyzed again with single-cell sequencing. The pathological tissues were collected by colonoscopy from 10 children with Crohn's disease treated in the Department of Gastroenterology of Guangzhou Women and Children's Medical Center from July 2022 to September 2022. According to the findings of colonoscopy, tissues with obvious inflammation or ulceration were classified as the inflammatory group, while tissues with slight inflammation and no ulceration were classified as the non-inflammatory group. HE staining was performed to observe the pathological changes of the colon tissues. Macrophage infiltration and CXCL12 expression were detected by immunofluorescence. In terms of cell experiments, fibroblasts transfected with WNT2B plasmid or empty plasmid were co-cultured with salinomycin treated or non-treated macrophages, respectively; the expression of proteins through Wnt classical pathway were detected by western blotting. Macrophages treated with SKL2001 were used as the experimental group, and those with phosphate buffer as the control group. The expression and secretion of CXCL12 in macrophages were detected by quantitative Real-time PCR and enzyme-linked immunosorbent assay (ELISA). T-test or rank sum test were used for the comparison between groups. Results: Single-cell sequencing analysis suggested that macrophages were the main cells in inflammatory bowel disease colon tissue, and there was interaction between WNT2B high-expressed fibroblasts and macrophages. HE staining of the 10 patients ((9.3±3.8) years old, 7 males and 3 females) showed that the pathological score of colon tissue in the inflammatory group was higher than that in the non-inflammatory group (4 (3, 4) vs. 2 (1, 2) points, Z=3.05, P=0.002). Tissue immunofluorescence indicated that the number of infiltrating macrophages in the inflammatory group was significantly higher than that in the non-inflammatory group under high power field of view (72.8±10.4 vs.8.4±3.5, t=25.10, P<0.001), as well as the number of cells expressing CXCL12 (14.0±3.5 vs. 4.7±1.9, t=14.68, P<0.001). In cell experiments, western blotting suggested an elevated level of glycogen synthase kinase-3β phosphorylation in macrophages co-cultured with fibroblast transfected with WNT2B plasmid, and salinmycin could reverse this change. Real-time PCR suggested that the transcription level of CXCL12 in the experimental group was higher than that in the control group (6.42±0.04 vs. 1.00±0.03, t=183.00, P<0.001), as well as the expression and secretion of CXCL12 by ELISA ((465±34) vs. (77±9) ng/L, t=13.21, P=0.006). Conclusion: WNT2B high-expressed fibroblasts can secrete WNT2B protein and activate the Wnt classical signaling pathway thus enhancing the expression and secretion of CXCL12 in macrophages, inducing the development of intestinal inflammation of Crohn's disease.
Child
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Male
;
Humans
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Female
;
Child, Preschool
;
Adolescent
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Crohn Disease
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Inflammatory Bowel Diseases
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Colon
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Inflammation
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Colonoscopy
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Glycoproteins
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Wnt Proteins
10.Risk factors for neonatal asphyxia and establishment of a nomogram model for predicting neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture: a multicenter study.
Fang JIN ; Yu CHEN ; Yi-Xun LIU ; Su-Ying WU ; Chao-Ce FANG ; Yong-Fang ZHANG ; Lu ZHENG ; Li-Fang ZHANG ; Xiao-Dong SONG ; Hong XIA ; Er-Ming CHEN ; Xiao-Qin RAO ; Guang-Quan CHEN ; Qiong YI ; Yan HU ; Lang JIANG ; Jing LI ; Qing-Wei PANG ; Chong YOU ; Bi-Xia CHENG ; Zhang-Hua TAN ; Ya-Juan TAN ; Ding ZHANG ; Tie-Sheng YU ; Jian RAO ; Yi-Dan LIANG ; Shi-Wen XIA
Chinese Journal of Contemporary Pediatrics 2023;25(7):697-704
OBJECTIVES:
To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia.
METHODS:
A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively.
RESULTS:
Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia.
CONCLUSIONS
The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn
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Humans
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Male
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Pregnancy
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Female
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Nomograms
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Retrospective Studies
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Cesarean Section
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Risk Factors
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Asphyxia Neonatorum/etiology*

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