1.Mechanism of Yueju Wan in Treatment of Functional Dyspepsia Based on Regulation of 5-HT Signaling Pathway
Haoran SHEN ; Yaru GU ; Muqing ZHANG ; Zhikuo DONG ; Xingxing GAO ; Dantong LI ; Ying GU ; Yixin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):20-28
ObjectiveTo investigate the effects of Yueju Wan on the 5-hydroxytryptamine (5-HT) signaling pathway in rats with functional dyspepsia (FD) and to explore its therapeutic mechanism in the treatment of FD. MethodsSixty Sprague-Dawley (SD) rats were randomly divided into a normal group, model group, mosapride group (1.575 mg·kg-1), and Yueju Wan low-, medium-, and high-dose groups (0.735, 1.47, and 2.94 g·kg-1, respectively). The FD rat model was established using GUO's tail-clamping stimulation combined with irregular feeding. After 14 days of modeling, rats were administered the corresponding drugs by gavage for 28 days. After treatment, gastric emptying rate and small intestinal propulsion rate were measured. Serum levels of 5-HT, tryptophan hydroxylase (TPH), and substance P (SP) were detected by enzyme-linked immunosorbent assay (ELISA), and acetylcholine (ACh) levels were determined by chemical methods. Histopathological changes in the gastric antrum were observed using hematoxylin-eosin (HE) staining. Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to assess the mRNA and protein expression levels of 5-hydroxytryptamine 4 receptor (5-HT4R), SP, and acetylcholinesterase (AChE) in colon tissue, as well as 5-hydroxytryptamine 3 receptor (5-HT3R), SP, and AChE in hypothalamic tissue. Immunohistochemistry (IHC) was used to examine the expression of 5-HT and 5-HT4R in the colon and 5-HT and 5-HT3R in the hypothalamus. ResultsCompared with the normal group, the gastric emptying rate and small intestinal propulsion rate in the model group were significantly decreased (P<0.01). Serum levels of 5-HT, SP, ACh, and TPH were significantly reduced (P<0.01). Histopathological examination revealed irregular arrangement of glands in the gastric antrum, slight mucosal atrophy, and mild inflammatory cell infiltration. The mRNA and protein expression levels of 5-HT4R, SP, and AChE in colon tissue, as well as 5-HT3R, SP, and AChE in hypothalamic tissue, were significantly decreased (P<0.01), and 5-HT protein expression in both the colon and hypothalamus was also significantly reduced (P<0.01). Compared with the model group, all Yueju Wan groups showed significantly increased gastric emptying rate and small intestinal propulsion rate (P<0.01). The glands in the gastric antrum were more regularly arranged, with no inflammatory cell infiltration observed. Serum levels of 5-HT, SP, ACh, and TPH were significantly increased (P<0.01). The mRNA and protein expression levels of 5-HT4R, SP, and AChE in colon tissue and 5-HT3R, SP, and AChE in hypothalamic tissue were significantly upregulated (P<0.05, P<0.01), and 5-HT protein expression in both the colon and hypothalamus was significantly increased (P<0.01). ConclusionYueju Wan has preventive and therapeutic effects on FD, and its mechanism may be related to regulation of the 5-HT signaling pathway, promotion of brain-gut peptide secretion, and enhancement of gastric motility.
2.Therapeutic effect of Rhizoma Corydalis on ulcerative colitis induced by dextran sodium sulfate and its mechanism:a study based on metabolomics
Chentao XIE ; Jialing LIU ; Yangyang GAO ; Haoran XU ; Hui WANG ; Yuanjing ZHAO ; Ruyi FAN ; Simin CHEN
Journal of Chongqing Medical University 2025;50(7):879-888
Objective:To investigate the interventional effect of Rhizoma Corydalis on mice with ulcerative colitis(UC)induced by dextran sulfate sodium(DSS),as well as the potential mechanism of Rhizoma Corydalis in the treatment of UC based on metabolomics and inflammation biomarkers.Methods:A mouse model of UC was established,and then the mice were divided into model group,high-dose group(1.517 g/kg crude drug),middle-dose group(0.986 g/kg crude drug),low-dose group(0.455 g/kg crude drug),and positive drug group(5-aminosalicylic acid at a dose of 718.8 mg/kg),while the mice without modeling were selected as normal group(0.9%NaCl by gavage).The mice in each group were administered for 7 consecutive days,and phenotypic parameters were dynamically moni-tored,such as body weight change,disease activity index(DAI),mean daily food intake,and daily water intake.The mice were sacri-ficed after 7 days to collect serum and colon tissue samples;ELISA was used to measure the serum levels of the proinflammatory fac-tors interleukin-6(IL-6),interleukin-17A(IL-17A),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α),and ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was used to perform the non-targeted metabolomics analysis and compare the differences in se-rum metabolite profiles between groups.The mice were selected for modeling and validation with the same method,and glutathione(GSH)was selected as the positive drug.Colon length and mucosal damage were assessed,and quantitative real-time PCR was used to measure the relative mRNA expression levels of the key genes in the glutathione synthesis pathway(γ-glutamylcysteine synthetase[γ-GCS]and oxidative stress regulators yap1p and skn7)and mito-chondrial GSH transporter protein(Slc25a39)in colonic tissue.Results:Rhizoma Corydalis significantly improved weight loss,DAI,and colon length in a dose-dependent manner in the model animals,and there were reductions in the serum levels of IL-6,CRP,and TNF-α,while it had no significant effect on IL-17A.The metabolomics analysis revealed 21 potential biomarkers associated with amino acid and lipid metabolism,which were significantly regulated by Rhizoma Corydalis.In the verification experiment,both Rhi-zoma Corydalis and GSH exerted a significant protective effect against colonic mucosal damage without affecting colon length.Rhizoma Corydalis upregulated the expression of genes associated with glutathione synthesis,especially γ-GCS,suggesting that Rhizoma Co-rydalis could enhance intestinal antioxidant defenses.Conclusion:Rhizoma Corydalis has a therapeutic potential in a mouse model of DSS-induced UC and can alleviate symptoms,reduce the serum levels of inflammatory markers,and regulate metabolic pathways,and upregulation of the genes associated with glutathione synthesis suggests that the drug can enhance intestinal antioxidant defenses.
3.Comparison of the quality of bowel preparation for colonoscopy between 2.0 L and 1.5 L polyethylene glycol under optimized dietary restrictions: a multicenter randomized controlled study
Peng PAN ; Yuping WANG ; Junyan GAO ; Xiaofei LI ; Danian JI ; Haoran LI ; Yu BAI
Chinese Journal of Digestive Endoscopy 2025;42(8):634-638
Objective:To compare bowel preparation quality between 2.0 L and 1.5 L polyethylene glycol (PEG) regimens with optimized dietary restrictions.Methods:This study was a randomized controlled trial conducted in three hospitals: the First Affiliated Hospital of Naval Medical University ( n=57), Huadong Hospital Affiliated to Fudan University ( n=30), and General Hospital of Northern Theater Command ( n=30) from May 5th to 30th, 2024. Participants consumed food for special medical purpose one day before examination or therapeutic colonoscopy and were randomized to receive either 2.0 L PEG (group A) or 1.5 L PEG (group B). Outcomes included the completion rate of bowel preparation, the adequate/excellent bowel preparation rate, Boston bowel preparation scale scores, the subject/endoscopist satisfaction, the willingness to repeat the preparation regimen, and incidence of adverse events. Results:A total of 60 subjects in group A and 57 in group B were included. There was no significant difference in baseline characteristics between the two groups ( P>0.05). The adequate bowel preparation rate [81.7% (49/60) VS 64.9% (37/57), χ2=4.21, P=0.040] and endoscopist satisfaction [88.3% (53/60) VS 70.2% (40/57), χ2=5.91, P=0.015] in group A were significantly higher than those in group B. There were no significant differences in bowel preparation completion rates, the excellent bowel preparation rate, the bowel preparation score, subject satisfaction, willingness to repeat the preparation regimen, or incidence of adverse events ( P>0.05). Conclusion:When combined with optimized dietary restrictions, 2.0 L PEG provides superior bowel preparation quality compared with 1.5 L PEG.
4.Effects of childhood trauma on resting blood pressure, heart rate, and heart rate variability in patients with depression
Kuaikuai LIU ; Fanfan HUANG ; Lulu YU ; Meina BAI ; Wenting LU ; Bufan LIU ; Tianyu ZHAO ; Ruojia REN ; Yuanyuan GAO ; Haoran ZHANG ; Xueyi WANG
Chinese Journal of Psychiatry 2025;58(9):681-689
Objective:To explore the effects of childhood trauma on resting blood pressure, heart rate, and heart rate variability in patients with depression.Methods:A cross-sectional study was designed to prospectively collect clinical data on a total of 163 patients with depression, including 47 males and 116 females, aged 18-50 years,with mean[ M( Q1, Q3)] [29.0, (21.0, 37.0)]years, who were either the outpatients or the inpatients in the Mental Health Center of the First Hospital of Hebei Medical University from September 2022 to June 2024. The Childhood Trauma Questionnaire-Short form (CTQ-SF) was used to assess the experience of abuse and neglect during childhood. According to the CTQ-SF score, the subjects were divided into a trauma group ( n=80) and a non-trauma group ( n=83). The 17-item Hamilton Depression Scale (HAMD 17) and Hamilton Anxiety Scale (HAMA) were used to assess depressive and anxiety symptoms in the participants, respectively. A digital blood pressure monitor and an autonomic nervous system response detector were employed to measure resting blood pressure, heart rate, and heart rate variability (HRV). Spearman correlation analysis was used to examine the relationships between childhood trauma and resting blood pressure, heart rate, and HRV. Multiple linear regression analysis was performed to analyze factors influencing these parameters. The Bootstrap method was employed to test the potential mediating role of parasympathetic nervous system activity in the relationships between childhood trauma and resting blood pressure, and heart rate. Results:No significant difference was observed in resting heart rate between the trauma and non-trauma groups ( P>0.05). However, the trauma group exhibited higher resting systolic and diastolic blood pressure [(123.3±9.1) mmHg (1 mmHg=0.133 kPa) vs(116.9±10.8) mmHg, (80.0±8.6) mmHg vs (77.0±8.0) mmHg; Z=4.08, 2.24, all P<0.05]. HRV indices, including the standard deviation of normal to normal interval (SDNN), root mean square of successive differences (RMSSD), total power (TP), low frequency (LF), and high frequency (HF), were significantly lower in the trauma group [25.3 (19.4, 30.4) me vs 36.3 (27.4, 49.0) ms, 18.3 (12.9, 27.2) me vs 26.2 (19.0, 38.5) ms, 6.0(5.4, 6.5)ms 2vs 7.0(6.3, 7.4)ms 2,4.4(3.7,5.3)ms 2vs 5.8(4.9,6.3)ms 2, 4.2(3.4, 5.2)ms 2vs 5.2(4.6, 6.1)ms 2, respectively; all P<0.001]. Spearman correlation analysis showed that childhood trauma experiences in patients with depression were positively correlated with resting systolic blood pressure and diastolic blood pressure ( r=0.309, 0.236; P<0.01), childhood trauma was negatively correlated with HRV (SDNN, RMSSD, TP, LF, HF) ( r=-0.264, -0.274, -0.271, -0.235, -0.279; all P<0.01). Multiple linear regression analysis showed that childhood trauma was positively correlated with resting-state systolic blood pressure and resting-state diastolic blood pressure ( β=0.305, 0.291; all P<0.001). Childhood trauma was negatively correlated with RMSSD, TP, LF, and HF( β=-0.244, -0.249, -0.233, -0.263; all P<0.01). Mediation effect analysis showed that parasympathetic activity partially mediated the relationship between childhood trauma and resting systolic blood pressure (effect size 0.04, standard error 0.02, 95% CI=0.01-0.09), accounting for 14.29% (0.04/0.28) of the total effect. Conclusion:Childhood trauma experiences are associated with elevated resting blood pressure and reduced HRV in patients with depression. Decreased parasympathetic activity partially mediates the relationship between childhood trauma and elevated resting systolic blood pressure in these patients.
5.Risk factors related to intradural lumbar disc herniation analyzed by propensity score matching
Haoran GAO ; Heling ZHANG ; Fanglin JIA ; Di GUO ; Li JING ; Yaozhou SHI ; Hanlin SONG ; Xiao GAO ; Hu FENG
Chinese Journal of Tissue Engineering Research 2025;29(15):3199-3205
BACKGROUND:According to different locations of lumbar disc herniation,it can be classified into many types.Among them,patients with intradural sac type lumbar disc herniation have severe clinical symptoms,which greatly affect their quality of life.Therefore,this article studies the risk factors for its onset,and improving the preoperative diagnostic rate is of great significance for the treatment and prevention of this disease.OBJECTIVE:To explore the risk factors for intradural lumbar disc herniation.METHODS:A retrospective analysis was conducted on 15 patients with intradural lumbar disc herniation(herniation group)admitted to three hospitals in Xuzhou city from May 2014 to November 2022.Propensity score matching was used to match patients with lumbar disc herniation who did not protrude into the dura mater in a ratio of 1:4.A total of 59 patients were selected and included in the non-herniation group.Clinical data were observed in the two groups.Univariate and binary logistic regression analysis,multiple linear regression,and PROBIT regression analysis were utilized to identify the relevant risk factors for intradural lumbar disc herniation.RESULTS AND CONCLUSION:(1)The results of univariate analysis showed that the average disease course,proportion of segments,modified Pfiirmann grading,sacral tilt angle,proportion of previous lumbar spine surgery history,and proportion of heavy manual workers,proportion of lumbar spinal stenosis,redundancy of the cauda equina,and ossification of the posterior longitudinal ligament all showed statistical differences in the herniation and non-herniation groups(P<0.05).(2)Multivariate regression analysis showed that duration of disease,protruding segment,history of lumbar surgery,modified Pfiirmann grading,cauda equina redundancy,and lumbar spinal stenosis were independent risk factors for intradural lumbar disc herniation.(3)Based on the influencing factors,an receiver operating characteristic curve was constructed,with an area under curve of 0.956(95%CI:0.913-0.998),indicating good discrimination.(4)There was a significant correlation between the duration of the disease,the protruded segment,the history of lumbar spine surgery,the modified Pfirmann classification,cauda equina redundancy,lumbar spinal canal stenosis,and the incidence rate of intradural lumbar disc herniation.
6.Buzhong Yiqitang Induces Ferroptosis by Regulating PCBP1 to Attenuate Cisplatin Resistance in Non-small Cell Lung Cancer
Yuetong LIU ; He LI ; Qirui MU ; Jingyi HUANG ; Haoran CAI ; Chunying LIU ; Yuan GAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):90-97
ObjectiveTo explore the molecular mechanism of Buzhong Yiqitang in attenuating cisplatin resistance in non-small cell lung cancer (NSCLC) by inducing ferroptosis via poly(rC)-binding protein 1 (PCBP1). MethodsThe serum containing Buzhong Yiqitang was prepared and cisplatin-resistant human non-small cell lung cancer (NSCLC) cells (A549/DDP) were cultured and randomly grouped as follows: Blank (10% blank serum), model (10% blank serum+20 mg·L-1 cisplatin), Buzhong Yiqitang (10% serum containing Buzhong Yiqitang+20 mg·L-1 cisplatin), Fe-1 (10% blank serum+20 mg·L-1 cisplatin+5 μmol·L-1 Fe-1), and Buzhong Yiqitang+Fe-1 (10% serum containing Buzhong Yiqitang+20 mg·L-1 cisplatin+5 μmol·L-1 Fe-1). Firstly, PCR Array was used to screen ferroptosis-related genes regulated by Buzhong Yiqitang, and PCBP1 was identified as the target for studying the attenuation of cisplatin resistance by Buzhong Yiqitang. Subsequently, the median inhibitory concentration (IC50) of cisplatin in each group was determined by the cell counting kit-8 (CCK-8) method and the resistance index (RI) was calculated. The ultrastructure of A549/DDP cells in each group was observed by transmission electron microscopy. The protein levels of PCBP1 and glutathione peroxidase 4 (GPX4) were determined by Western blot. The lipid reactive oxygen species (ROS) content in each group was determined by the C11-BODIRY 581/591 fluorescence probe. The ferrous ion assay kit was used to measure the ferrous ion content in each group. The malondialdehyde (MDA) assay kit was used to determine the MDA content in each group. ResultsCompared with model group, the IC50 of cisplatin and the RI of A549/DDP cells decreased in the Buzhong Yiqitang group (P<0.05) but increased in the Fe-1 group (P<0.05). The IC50 of cisplatin and the RI of A549/DDP cells in the Buzhong Yiqitang+Fe-1 group were lower than those in the Fe-1 group (P<0.05). Compared with the model group, the Buzhong Yiqitang group showed obvious mitochondrial ferroptosis, while the mitochondrial damage became less obvious after Fe-1 treatment. Compared with that in the Fe-1 group, the mitochondrial ferroptosis was aggravated after the intervention with Buzhong Yiqitang. Compared with blank group, the model group showed down-regulated expression levels of PCBP1 and GPX4 (P<0.05) and increased content of lipid ROS, ferrous ions, and MDA (P<0.05) in A549/DDP cells. Compared with model group, the Buzhong Yiqitang group showed down-regulated expression levels of PCBP1 and GPX4 (P<0.05) and increased content of lipid ROS, ferrous ions, and MDA (P<0.05), while the Fe-1 group showed up-regulated expression levels of PCBP1 and GPX4 (P<0.05) and reduced content of lipid ROS, ferrous ions, and MDA (P<0.05). Compared with the Fe-1 group, the Buzhong Yiqitang+Fe-1 group showed down-regulated expression levels of PCBP1 and GPX4 and increased content of lipid ROS, ferrous ions, and MDA (P<0.05). ConclusionBuzhong Yiqitang attenuated cisplatin resistance in NSCLC by regulating PCBP1 to induce ferroptosis.
7.Comparison of the efficacy of different minimally invasive surgical approaches for lumbar disc herniation: a network meta-analysis
Kai LIU ; Lei WANG ; Haoran GAO ; Fu SUN
Chinese Journal of General Practitioners 2025;24(8):992-1001
Objective:To compare the efficacy of different minimally invasive surgical approaches for the treatment of lumbar disc herniation (LDH).Methods:This study was a network meta-analysis (NMA). Databases the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, China Biology Medicine disc (CBM), PubMed, Embase, Cochrane Library, and Web of Science from database inception to December 22, 2024 were searched. Randomized controlled trials (RCTs) on minimally invasive surgery (MIS) for LDH were retrieved using a combination of subject headings and free-text terms. Literature was screened according to predefined inclusion and exclusion criteria. The NMA was conducted within a Bayesian framework. Direct and indirect comparisons among the MIS approaches were presented using league tabulations. Cumulative ranking probability plots were generated using the ggplot2 package in R software. Treatment efficacy outcomes were ranked based on the surface under the cumulative ranking curve (SUCRA) value, ranging from 0 to 100%; a SUCRA value closer to 100% indicates a more favorable intervention.Results:A total of 15 RCTs were finally included. The interventions assessed were percutaneous endoscopic interlaminar discectomy (PEID), percutaneous endoscopic transforaminal discectomy (PETD), microendoscopic discectomy (MED), unilateral biportal endoscopy (UBE), transforaminal discectomy (TD), and microscopic discectomy (MD). Length of hospital stay (reported in 13 studies, n=1 414): ranked from the shortest to the longest were PETD, PEID, TD, MD, UBE, MED (SUCRA: 82.03%, 78.37%, 72.06%, 43.86%, 11.51%, 12.16%). Oswestry Disability Index (ODI) at 3 months postoperatively (reported in 10 studies, n=1 004): ranked from the lowest to the highest ODI were MD, UBE, PEID, TD, MED, PETD (SUCRA: 88.33%, 50.56%, 50.36%, 47.59%, 32.13%, 31.03%). ODI at 1 year postoperatively (reported in 10 studies, n=960): ranked from the lowest to the highest were PEID, MD, TD, MED, PETD, UBE (SUCRA: 74.03%, 66.56%, 43.22%, 42.63%, 40.75%, 32.80%). Surgical complications (reported in 12 studies, n=1 412): ranked from the lowest to the highest complication rate were MD, TD, UBE, PETD, PEID, MED (SUCRA: 81.60%, 76.55%, 72.86%, 24.43%, 23.41%, 20.97%). Conclusions:The efficacy of different MIS approaches for LDH varies. PETD is associated with the shortest postoperative hospital stay, MD is associated with the lowest ODI at 3 months and the lowest complication rate, PEID is associated with the lowest ODI at 1 year postoperatively.
8.Effectiveness of "Internet plus" continuous intervention among patients with depression after hospital discharge
CHEN Chunmian ; JIN Tingting ; GAO Si ; CHEN Haoran ; LU Xiaoyuan ; ZHENG Lidan
Journal of Preventive Medicine 2025;37(10):1049-1053
Objective:
To evaluate the effectiveness of "Internet plus" continuous intervention on psychological status and nursing satisfaction of patients with depression after hospital discharge, so as to provide the reference for reducing the recurrence risk of patients with depression and improving the quality of life.
Methods:
From January to December 2024, patients with mild to moderate depression who were hospitalized in a tertiary grade-a mental health specialized hospital in Wenzhou City and met the discharge criteria were selected as the research objects. The patients were divided into the control group and the intervention group according to a ratio of 1∶1 by the random number table method. Hamilton Depression Scale, Hamilton Anxiety Scale, and Nursing Satisfaction Questionnaire were used to evaluate depressive symptoms, anxiety symptoms, and nursing satisfaction before and after intervention. Covariance analysis was used to compare the differences between the two groups before and after the intervention.
Results:
A total of 62 patients with mild to moderate depression were enrolled, with 31 patients in the intervention group and 31 patients in the control group. Before the intervention, there were no statistically significant differences in gender, age, course of disease, educational level, marital status, depression symptoms score, anxiety symptoms score, and nursing satisfaction score between the two groups (all P>0.05). After the intervention, the scores of depression and anxiety symptoms in the intervention group decreased by 8.87 and 5.01 points, respectively, compared with those before the intervention, and the scores of depression and anxiety symptoms in the control group decreased by 2.52 and 1.16 points, respectively (all P<0.05). After the intervention, the scores of depression and anxiety symptoms in the intervention group decreased more than those in the control group (both P<0.05). The nursing satisfaction score of the intervention group increased by 6.57 points on average compared with that before the intervention, and that of the control group increased by 4.23 points on average (both P<0.05). There was no statistically significant difference in the increase of nursing satisfaction scores between the two groups before and after intervention (P>0.05).
Conclusion
The "Internet plus" continuous intervention has a good effect on improving the depressive symptoms and anxiety symptoms of patients with depression after haspital discharge, which can consolidate the treatment effect and improve nursing satisfaction.
9.Programmed death-ligand 1 tumor proportion score in predicting the safety and efficacy of PD-1/PD-L1 antibody-based therapy in patients with advanced non-small cell lung cancer: A retrospective, multicenter, observational study.
Yuequan SHI ; Xiaoyan LIU ; Anwen LIU ; Jian FANG ; Qingwei MENG ; Cuimin DING ; Bin AI ; Yangchun GU ; Cuiying ZHANG ; Chengzhi ZHOU ; Yan WANG ; Yongjie SHUI ; Siyuan YU ; Dongming ZHANG ; Jia LIU ; Haoran ZHANG ; Qing ZHOU ; Xiaoxing GAO ; Minjiang CHEN ; Jing ZHAO ; Wei ZHONG ; Yan XU ; Mengzhao WANG
Chinese Medical Journal 2025;138(14):1730-1740
BACKGROUND:
This study aimed to investigate programmed death-ligand 1 tumor proportion score in predicting the safety and efficacy of PD-1/PD-L1 antibody-based therapy in treating patients with advanced non-small cell lung cancer (NSCLC) in a real-world setting.
METHODS:
This retrospective, multicenter, observational study enrolled adult patients who received PD-1/PD-L1 antibody-based therapy in China and met the following criteria: (1) had pathologically confirmed, unresectable stage III-IV NSCLC; (2) had a baseline PD-L1 tumor proportion score (TPS); and (3) had confirmed efficacy evaluation results after PD-1/PD-L1 treatment. Logistic regression, Kaplan-Meier analysis, and Cox regression were used to assess the progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) as appropriate.
RESULTS:
A total of 409 patients, 65.0% ( n = 266) with a positive PD-L1 TPS (≥1%) and 32.8% ( n = 134) with PD-L1 TPS ≥50%, were included in this study. Cox regression confirmed that patients with a PD-L1 TPS ≥1% had significantly improved PFS (hazard ratio [HR] 0.747, 95% confidence interval [CI] 0.573-0.975, P = 0.032). A total of 160 (39.1%) patients experienced 206 irAEs, and 27 (6.6%) patients experienced 31 grade 3-5 irAEs. The organs most frequently associated with irAEs were the skin (52/409, 12.7%), thyroid (40/409, 9.8%), and lung (34/409, 8.3%). Multivariate logistic regression revealed that a PD-L1 TPS ≥1% (odds ratio [OR] 1.713, 95% CI 1.054-2.784, P = 0.030) was an independent risk factor for irAEs. Other risk factors for irAEs included pretreatment absolute lymphocyte count >2.5 × 10 9 /L (OR 3.772, 95% CI 1.377-10.329, P = 0.010) and pretreatment absolute eosinophil count >0.2 × 10 9 /L (OR 2.006, 95% CI 1.219-3.302, P = 0.006). Moreover, patients who developed irAEs demonstrated improved PFS (13.7 months vs. 8.4 months, P <0.001) and OS (28.0 months vs. 18.0 months, P = 0.007) compared with patients without irAEs.
CONCLUSIONS
A positive PD-L1 TPS (≥1%) was associated with improved PFS and an increased risk of irAEs in a real-world setting. The onset of irAEs was associated with improved PFS and OS in patients with advanced NSCLC receiving PD-1/PD-L1-based therapy.
Humans
;
Carcinoma, Non-Small-Cell Lung/metabolism*
;
Male
;
Female
;
Retrospective Studies
;
Middle Aged
;
Lung Neoplasms/metabolism*
;
Aged
;
B7-H1 Antigen/metabolism*
;
Programmed Cell Death 1 Receptor/metabolism*
;
Adult
;
Aged, 80 and over
;
Immune Checkpoint Inhibitors/therapeutic use*
10.Influence of paravertebral muscles on spinopelvic sagittal plane in patients with isthmic spondylolisthesis:an evaluation of muscle quantity and quality
Hanlin SONG ; Tianyu HU ; Haoran GAO ; Yaozhou SHI ; Xiao GAO ; Hu FENG
Chinese Journal of Tissue Engineering Research 2025;29(21):4445-4451
BACKGROUND:Cross-sectional area and fat infiltration are the standard parameters for quantifying paravertebral muscle,but it is too cumbersome and time-consuming to introduce new quantifying indicators. OBJECTIVE:To investigate the relationship between paravertebral muscle and spinopelvic sagittal parameters and the predictive value of lumbar indentation value for sagittal balance in patients with isthmic spondylolisthesis.METHODS:The study included 87 patients diagnosed with spondylolisthesis,all of whom had grade Ⅱ spondylolisthesis according to Meyerding classification,including 40 males and 47 females,with a mean age of (51.4±9.1) years. The sagittal vertical axis,pelvic incidence angle,pelvic inclination angle,sacral inclination angle,lumbar lordosis,thoracic kyphosis,and the difference between pelvic incidence and lumbar lordosis were measured. The total cross-sectional area,functional cross-sectional area,and fat infiltration of lumbar paracolateral muscles were measured. Pearson correlation analysis was used to investigate the correlation between sagittal parameters and paravertebral muscle measurements. Multiple linear regression was used to analyze the effects of lumbar indentation value,age,sex,and body mass index on spinopelvic sagittal balance. The receiver operating characteristic curve was used to find the best cut-off point of the indentation value of the lumbar spine,and the relationship of sagittal vertical axis and pelvic incidence with lumbar lordosis was evaluated.RESULTS AND CONCLUSION:(1) According to Pearson correlation analysis,the total cross-sectional area of the multifidus muscle was significantly correlated with lumbar lordosis (r=0.464,P<0.01) and the difference between pelvic incidence and lumbar lordosis (r=-0.306,P<0.01). The functional cross-sectional area of multifidus muscle was significantly correlated with lumbar lordosis (r=0.367,P<0.01) and the difference between pelvic incidence and lumbar lordosis (r=-0.228,P<0.05). The indentation value of lumbar spine was significantly correlated with the sagittal vertical axis (r=-0.300,P<0.01),lumbar lordosis(P=0.417,P<0.01),thoracic kyphosis (r=0.351,P<0.01),and the difference between pelvic incidence and lumbar lordosis (r=-0.319,P<0.01). (2) According to multiple linear regression analysis,the indentation value of lumbar spine was independently correlated with the difference between pelvic incidence and lumbar lordosis and the sagittal vertical axis. 55% (11/20) of patients with lumbar indentation value ≤11.5 mm had sagittal vertical axis ≤ 50 mm,while 96%(64/67) of patients with lumbar indentation value>11.5 mm had sagittal vertical axis ≤ 50 mm. 30% (6/20) of patients with the difference between pelvic incidence and lumbar lordosis ≤ 11.5 mm had the difference between pelvic incidence and lumbar lordosis ≤ 10°,while 66% (44/67) of patients with lumbar indentation value>11.5 mm had the difference between pelvic incidence and lumbar lordosis ≤ 10°. (3) It is concluded that both total cross-sectional area and functional cross-sectional area were significantly correlated with lumbar lordosis and the difference between pelvic incidence and lumbar lordosis. Lumbar indentation value,as a new indicator for the evaluation of paravertebral degeneration,was independently correlated with the sagittal vertical axis and the difference between pelvic incidence and lumbar lordosis,and had certain predictive value for postoperative sagittal plane correction. It was a simple and practical method for the evaluation of spinopelvic sagittal plane and paravertebral muscle degeneration. The degeneration of the paravertebral muscle is related to spinopelvic sagittal balance.


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