1.Prognostic study of neoadjuvant therapy for pancreatic cancer based on propensity score matching and subgroup analysis
Xiaohao ZHENG ; Jingyu ZHANG ; Xiaojie CHEN ; Zhen HAO ; Jing LIU ; Zewen ZHANG ; Wanqing YU ; Yun YANG
International Journal of Surgery 2025;52(4):230-238
Objective:To investigate whether neoadjuvant therapy can improve the prognosis of patients with pancreatic cancer.Methods:A retrospective case-control study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database on 12, 103 patients who underwent surgical treatment between January 1, 2010, and December 31, 2021. Patients were divided into the neoadjuvant therapy group ( n=3 276) and the upfront surgery group ( n=8 827) based on whether they received neoadjuvant treatment. The neoadjuvant therapy group included 2 342 patients receiving neoadjuvant chemotherapy and 934 patients receiving neoadjuvant chemoradiotherapy. The upfront surgery group consisted of 4 335 patients receiving adjuvant chemotherapy, 1 987 patients receiving adjuvant chemoradiotherapy, 63 patients receiving adjuvant radiotherapy, and 2 442 patients undergoing surgery alone. Propensity score matching was used to eliminate group differences and create a cohort with no statistical differences in other clinicopathological features except for the grouping variable. Variables such as age, gender, tumor location, race, population of residence, tumor diameter, household income, TNM stage, and information on radiotherapy and chemotherapy were used for 1∶1 case matching. T stage, N stage, and the use of radiotherapy or chemotherapy were matched exactly. After matching, 1 182 patients were included in each group: the neoadjuvant therapy group contained 1 155 patients receiving neoadjuvant chemoradiotherapy and 27 receiving neoadjuvant chemotherapy, while the upfront surgery group comprised 848 patients receiving adjuvant chemotherapy and 334 receiving adjuvant chemoradiotherapy. TNM staging was reported according to the 7th edition of the AJCC guidelines. The primary outcome was overall survival. Measurement data with skewed distributions were expressed as M( Q1, Q3), and intergroup comparisons were conducted using the Wilcoxon rank-sum test. Categorical data were compared using the chi-square test or the Fisher′s exact test. The Log-rank test and subgroup analyses to assess interactions between neoadjuvant therapy and subgroup in COX regression models were used to compare survival benefits across variables. Landmark analysis was performed to create segmented survival curves, studying the impact of neoadjuvant therapy on prognosis during different follow-up periods. Results:The neoadjuvant therapy group had a higher proportion of T 4 tumor involving celiac axis, superior mesenteric artery, and/or common hepatic artery compared to the upfront surgery group (14.7% vs 2.8%, P<0.001). Additionally, significant differences were observed between groups in terms of race, location, population of residence, age, tumor diameter, tumor stage, and adjuvant therapy regimen ( P<0.05). The median overall survival time in the neoadjuvant therapy group was 30 months, compared to 22 months in the upfront surgery group ( P<0.001). In the neoadjuvant therapy group, the median survival was 30 months for both neoadjuvant chemotherapy and chemoradiotherapy patients; in the upfront surgery group, it was 26 months for both adjuvant chemotherapy and chemoradiotherapy patients, 17 months for adjuvant radiotherapy patients, and 12 months for surgery-only patients. After propensity score matching, there were no differences in the distribution of clinical characteristics between groups ( P>0.05), and all patients in the matched cohort had received chemotherapy. The matched neoadjuvant therapy group had a longer median overall survival compared to the upfront surgery group (30 months vs 27 months, P<0.001). Subgroup interaction analysis revealed that T stage had a significant interaction with neoadjuvant therapy, both before (T 4 stage: HR=0.382, 95% CI: 0.319-0.458; T 2-T 3 stages: HR=0.696, 95% CI: 0.656-0.738; T 1 stage: HR=1.199, 95% CI: 0.867-1.657; interaction P<0.001) and after matching (T 4 stage: HR=0.581, 95% CI: 0.414-0.814; T 2-T 3 stages: HR=0.827, 95% CI: 0.734-0.931; T 1 stage: HR=1.320, 95% CI: 0.716-2.433; interaction P=0.043). Subgroup interaction analysis indicated that T 1 patients did not benefit from neoadjuvant therapy; survival curves plotted for matched T 1 patients showed no difference in survival between the neoadjuvant therapy group and the upfront surgery group ( P=0.323). Conversely, non-T 1 (T 2-T 4) stage patients showed significant survival benefits in both unmatched and matched cohorts ( P<0.001). Landmark analysis showing that the survival benefits occurred mainly in the early postoperative period of up to 3 years ( P<0.001), but there was no difference in overall survival between the neoadjuvant therapy group and the upfront surgery group of >3 years ( P>0.05). Patients with Arterial invasion (T 4 stage compared to T 1-T 3 stages) showed a similarly significant interaction with the benefit of neoadjuvant therapy in both the pre-matching cohort (interaction P<0.001) and the post-matching cohort (interaction P=0.037). Patients with T 4 stage disease in the neoadjuvant therapy group had longer overall survival compared to the upfront surgery group (median overall survival in pre-matching cohort: 30 months vs 13 months, P<0.001; median overall survival in post-matching cohort: 28 months vs 18 months, P=0.001). Among T 4 stage patients in the post-matching cohort, neoadjuvant therapy provided significant survival benefits during the early postoperative period of up to 3 years ( P=0.001). However, there was no difference in overall survival between the neoadjuvant therapy group and the direct surgery group beyond 3 years( P=0.729). Conclusions:The prognosis in the neoadjuvant therapy group was better than in the upfront surgery group. Propensity score matching and subgroup interaction analysis showed that non-T 1 and T 4 stage patients benefited more from neoadjuvant therapy, with benefits mainly seen in the early postoperative period (≤3 years).
2.Exploration on the acupoint selection law of acupuncture and moxibustion in treating broca aphasia after stroke based on data mining
Hui MA ; Changchun JI ; Rongni ZHANG ; Xiang RAO ; Yu XING ; Jingyu ZHAO
International Journal of Traditional Chinese Medicine 2025;47(2):256-261
Objective:To explore the acupoint selection law of acupuncture and moxibustion in the treatment of broca aphasia after stroke.Methods:RCT articles about acupuncture and moxibustion treatment for broca aphasia after stroke were retrieved from CNKI, VIP, Wanfang Data, China Medical Journal Full-text Database, SinoMed, PubMed, Web of Science and Embase database from the establishment of the databases to May 31, 2024. Excel 2021, SPSS Statistics 27.0, SPSS Modeler 18.0 and Cytoscape 3.9.1 software were used to analyze the frequency of acupoint, clustering, association rules and core co-occurrence network.Results:A total of 87 articles were included, involving 100 acupuncture and moxibustion prescriptions and 101 acupoints/acupoint area, involving 6 types, including Lianquan (CV 23) (35 times), Jinjin (EX-HN12) (35 times) and Yuye (EX-HN13) (34 times). The selected acupoints were mainly distributed in the head, face, neck and lower limbs, and the meridians were mainly Governor Vessel and Conception Vessel; the specific acupoints were mainly original acupoints, followed by collaterals acupoints, and scalp acupuncture was used most frequently in special acupuncture (88 times). According to the clustering analysis of high-frequency acupoints/acupoint area, there were five effective groups, such as "Jinjin (EX-HN12)-Yuye (EX-HN13)-Lianquan (CV 23)-Baihui (GV 20)-Yamen (GV 15)". The core co-occurrence network analysis showed that the acupoints used most frequently were Lianquan (CV 23) and Jinjin (EX-HN12), and the highest correlation between the two acupoints was Jinjin (EX-HN12)-Yuye (EX-HN13).Conclusions:Acupuncture and moxibustion for the treatment of broca aphasia after stroke is often based on "awakening the brain as the outline, benefiting the marrow as the foundation, and resuscitation". Under the guidance of the theory of Zang-fu meridians and collaterals, through dredging the meridians and collaterals, tonifying the brain and opening and closing the sound, the recovery of language function can be achieved.
3.Transcriptome Sequencing and Bioinformatics Analysis of Herba Chlorophyti Laxi
Jingyu LI ; Yiheng DAI ; Yan GU ; Xuqiang LUO ; Yu MEI ; Jihua WANG
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(6):1485-1491
Objective To study the transcriptional expression of Chlorophyti Laxi R.Br.using high-throughput sequencing technology.Methods Total RNA of Chlorophtum laxum R.Br.was extracted,followed by library construction,sequencing,and de novo assembly to obtain unigene sequences.These sequences were then annotated and compared to acquire genetic information of the Chlorophtum laxum R.Br.transcriptome.Results A total of 29 325 unigene were identified,with an average length of 1 026 bp and an N50 of 1 697 bp.Among them,20 338 unigene were functionally annotated in at least one database,with Chlorophtum laxum R.Br.showing the highest sequence similarity to Asparagus officinalis.In the Kyoto Encyclopedia of Genes and Genomes(KEGG)database,13 392 unigene were annotated,including genes involved in flavonoid biosynthesis and ubiquinone and other terpenoid-quinone biosynthesis pathways.Thirty-five upstream genes related to Chlorophtum laxum R.Br.saponin biosynthesis were identified.In the Gene Ontology(GO)database,16 728 unigene were annotated,covering cellular anatomical entities,binding,and biological processes.Using the Microsatellite Identification Tool(MISA),11 486 assembled unigene longer than 1 000 bp were analyzed for simple sequence repeats(SSRs),resulting in the identification of 5 178 SSR loci,for which primers were designed using Primer 3.0.By comparing Chlorophtum laxum R.Br.unigene with the transcription factor database,657 transcription factors,including bHLH,MYB,and WRKY,were identified.Conclusion The transcriptome data provide a foundation for studying the biosynthetic pathways and functional genes of medicinal active components in Chlorophtum laxum R.Br.,and also contribute to the conservation and development of its resources.
4.Akkermansia muciniphila gavage improves gut-brain interaction disorders in gp120 transgenic mice
Jiachun LUO ; Batzaya SODNOMJAMTS ; Xuefeng GAO ; Jingyu CHEN ; Zhengying YU ; Shasha XIONG ; Hong CAO
Journal of Southern Medical University 2025;45(3):554-565
Objective To explore the effect of A.muciniphila gavage on intestinal microbiota and gut-brain interaction disorders(DGBIs)in gp120tg transgenic mouse models of HIV-associated neurocognitive disorder(HAND).Methods Intestinal microbiota was detected by 16S rRNA gene sequencing in 6-,9-,and 12-month-old wild-type(WT)mice and gp120tg transgenic mice.The 12-month-old WT and transgenic mice were divided into 2 groups for daily treatment with PBS or A.muciniphila gavage(2×108 CFU/mouse)for 6 weeks.After the treatment,immunohistochemistry,ELISA and qPCR were used to detect changes in colonic expression levels of glycosylated mucins,MBP and IL-1β,eosinophil infiltration,serum lipopolysaccharide(LPS)levels,and colonic expressions of occludin,ZO-1,IL-10,TNF-α and INF-γ mRNA.Morris water maze test and immunofluorescence assay were used to assess learning and spatial memory abilities and neuronal damage of the mice.Results Compared with WT mice,the transgenic mice exhibited significantly lowered Simpson's diversity of the intestinal microbiota with reduced abundance of Akkermansia genus,increased serum LPS levels and decreased colonic expression of glycosylated mucin.A.muciniphila gavage obviously ameliorated the reduction of glycosylated mucin in the transgenic mice without causing significant changes in body weight.The 12-month-old gp120tg mice had significantly decreased cdonic expressions of Occludin and ZO-1 with increased eosinophil infiltration and TNF-β,INF-γ and IL-1β levels and obviously lowered IL-10 level;all these changes were significantly mitigated by A.muciniphila gavage,which also improved cognitive impairment and neuronal loss in the hippocampus and cortex of the transgenic mice.Conclusion The gp120tg mice have lower intestinal microbiota richness and diversity than WT mice.The 12-month-old gp120tg mice have significantly reduced Akkermansia abundance with distinct DGBIs-related indexes,and A.muciniphila gavage can reduce intestinal barrier injury,colonic inflammation and eosinophil activation,cognitive impairment and brain neuron injury in these mice.
5.Impact of repeated sevoflurane anesthesia on hippocampal dendritic spine development in neonatal mice and the mechanism of microtubule polyglutamylation mediated by TTLL6
Yang YU ; Yue ZHAO ; Jingyu FENG ; Yue YANG ; Yanan LI ; Jiafeng YU ; Yonghao YU
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(3):193-200
Objective:To evaluate the role of tubulin tyrosin ligase like-6 (TTLL6)-mediated microtubule polyglutamylation and Spastin(a microtubule cleaving protein)-induced excessive microtubule cleavage in the developmental impairment of dendritic spines in neonatal mice following repeated sevoflurane anesthesia, by utilizing TTLL6 conditional knockout mice.Methods:Fifty SPF female TTLL6 brain tissue-specific knockout (TTLL6 CKO: Camk2-Cre + ; TTLL6 f/f) and fifty control (TTLL6 CON: TTLL6 f/f) mice with C57BL/6J background, aged 6 days old were selected.TTLL6 CKO mice were divided into TTLL6 CON control group and TTLL6 CON sevoflurane group, and TTLL6 CKO mice were divided into TTLL6 CKO control group and TTLL6 CKO sevoflurane group, with 25 mice in each group by random block method.Mice in the sevoflurane groups were exposed to 3% sevoflurane with 60% O 2 for 2 hours daily on postnatal days 6, 8, and 10.The mice in control groups received only 60% O 2 under the same condition.The polyGlu-Tubulin and postsynaptic density 95(PSD95) protein expression were detected using Western blot. The expressions of TTLL6, Spastin, and α-Tubulin were assessed via immunofluorescence.Golgi staining and electron microscopy were employed to observe the density of hippocampal dendritic spines and synaptic conditions. The Morris water maze test was used to evaluate spatial memory capabilities. Statistical analysis was performed using GraphPad Prism 8.0 software. Results:(1) Behavioral results showed significant time and group interactions among the four groups in terms of latency to find the platform ( F=8.22, P<0.001).Mice in the TTLL6 CON sevoflurane group had a significantly longer escape latency on days 3-7 compared with the TTLL6 CON control group (all P<0.05), while there was no significant difference between the TTLL6 CKO sevoflurane group and the TTLL6 CKO control group (all P>0.05). The number of platform crossings differed significantly among the four groups ( H=11.95, P=0.007).The TTLL6 CON sevoflurane group had significantly fewer crossing times than the TTLL6 CON control group ( P<0.05), but no significant difference was observed between the TTLL6 CKO sevoflurane group and the TTLL6 CKO control group ( P>0.05). (2) Golgi staining and electron microscopy results revealed significant differences in dendritic spine density and synapse number among the four groups( F=29.00, 41.94, both P<0.001). The dendritic spine density ((5.83±0.40)/10 μm) and the number of synapses ((3.67±0.58)/10 μm) in the TTLL6 CON sevoflurane group were both significantly lower than those in the TTLL6 CON control group ((12.87±1.70)/10 μm, (9.33±0.57)/10 μm)(both P<0.05). In contrast, there was no statistically significant difference between the TTLL6 CKO sevoflurane group and TTLL6 CKO control group (both P>0.05). (3) Immunofluorescence results showed significant differences in the percentage of TTLL6 and Spastin and α-Tubulin co-expressed positive cells in the CA3 region of the hippocampus among the four groups of mice ( F=215.20, 26.08, both P<0.001). The percentage of TTLL6 and Spastin and α-Tubulin co-expressed positive cells in the TTLL6 CON sevoflurane group ((16.75±1.81) %, (47.98±8.42) %) were significantly higher than those in the TTLL6 CON control group ((2.44±0.58) %, (20.07±4.54) %)(both P<0.05), while there was no statistically significant difference between the TTLL6 CKO sevoflurane group and TTLL6 CKO control group ( P>0.05). (4) Western blot results indicated significant differences in the expression of polyGlu-Tubulin and PSD95 proteins in the hippocampal tissue among the four groups of mice ( F=19.66, 8.57, both P<0.001). The TTLL6 CON sevoflurane group had higher polyGlu-Tubulin expression (0.86±0.19) and lower PSD95 expression (0.61±0.13) compared to the TTLL6 CON control group (0.51±0.11, 1.01±0.07) (both P<0.05).However, there was no significant difference between the TTLL6 CKO sevoflurane group and the TTLL6 CKO control group ( P>0.05). Conclusion:The mechanism underlying long-term cognitive impairment in developing brain of neonatal mice caused by repeated sevoflurane anesthesia may relate to the upregulation of TTLL6-induced microtubule polyglutamylation and accelerated Spastin-mediated microtubule severing, which ultimately leads to abnormal dendritic spine development.
6.HIC relationship of anterior-posterior and lateral-medial collisions based on the comprehensive evaluation of injury
Linna ZHU ; Guoxiang WANG ; Xun WANG ; Qinghang LUO ; Tao XIONG ; Qiuju CHEN ; Jingyu XU ; Jia YU ; Shengxiong LIU
Chinese Journal of Medical Physics 2025;42(3):406-414
Objective To explore the relationship between the head injury criterion(HIC)values in anterior-posterior(AP)collisions and lateral-medial(LM)collisions.Methods A total of 102 male SD rats were randomly divided into a control group of 0 m(6 rats),4 AP groups(12 rats/group)and 4 LM groups(12 rats/group).After adaptive training,the classical Marmarou model was used to execute the brain AP and LM collisions under a series of different height impacts,and the HIC values were calculated.The experimental group data of the walk-pole test and grip strength test were collected at 24 hours before and after injury,and the data of the proportion of hemorrhage in the corpus callosum and pyramidal tracts were collected at 24 hours after injury.Results As the collision heights increased in both AP and LM groups,there were positive correlations with changes in WP test time and peak GS,and corresponding increases in the proportion of hemorrhage in the cc and py.According to the mathematical relationships between the comprehensive injury degrees and HIC values,it was found that at the same injury degree,LM-HIC value was less than AP-HIC value.A mathematical relationship between AP-HIC and LM-HIC was fitted based on the comprehensive injury degrees.At the same HIC,LM group experienced more severe injuries,and AP group was more tolerant to head collision.Conclusion The injury severity in LM group is greater than that of AP group at the same HIC.Preliminary results show there is a linear mathematical relationship between AP-HIC and LM-HIC.These results can be expected to expand the application scope of HIC and achieve an accurate assessment of the LM collision severity.
7.Delayed physical growth and related factors in pediatric patients with transfusion-dependent thalassemia
Zhexiang KUANG ; Jingyu ZHAO ; Xiao YU ; Jing XU ; Zhen GAO ; Yanjie LIU ; Anni WANG ; Jin DONG ; Hong PAN ; Lele ZHANG ; Liwei FANG ; Guibin WU ; Xinli LI ; Jun SHI ; Li XU ; Wenjun XIE
Chinese Journal of Hematology 2025;46(4):328-335
Objectives:To investigate the physical growth status of pediatric patients with transfusion-dependent thalassemia (TDT) and analyze the effects of treatment-related and socioeconomic factors on physical growth.Methods:Based on the specialized thalassemia database from gene therapy clinical research at the Institute of Hematology & Hospital of Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, we collected data on height and weight development, family economic status, and medical records of 338 pediatric patients with TDT from October 2023 to May 2024. The length/height-for-age and body mass index (BMI) -for-age were classified based on the Growth Standard for Children under 7 Years of Age, Standard for Height Level Classification among Children and Adolescents Aged 7-18 Years, and Dietary Guidelines for Chinese Residents. Logistic regression analysis was conducted to assess the effects of family economic status and disease-related treatment on length/height-for-age and BMI-for-age.Results:Among the 338 patients, 118 were children and 220 were adolescents (192 males and 146 females), with a median age of 12 years (range: 0.8-18) and a median diagnosis duration of 10.3 years (range: 0.5-17.9). Subtypes included α-thalassemia [21 cases (6.2%) ], β-thalassemia [288 cases (85.2%) ], and combined αβ-thalassemia[29 cases (8.6%) ]. The monthly household income of patients was concentrated in 3 000-5 000 yuan (39.9%) and 5 001-10 000 yuan (34.9%), whereas 67.2% of the families had monthly medical expenses of <3 000 yuan. Of the patients, 75.5% received their first transfusion before 1 year of age. The proportions of children and adolescents with pretransfusion hemoglobin (HGB) of ≤70 g/L were 4.2% and 6.4%, respectively. Adolescents demonstrated significantly higher rates of transfusion frequency of <4 weeks/session, monthly red blood cell infusion of >2 U, serum ferritin (SF) of ≥5 000 μg/L, iron chelation therapy, and splenectomy compared with children (all P<0.05). Of the 338 patients, 26.0%, 22.8%, and 8.9% demonstrated stunted growth, underweight, and concurrent stunted growth with underweight, respectively. No significant difference was observed in the stunted growth rates between children (22.9%) and adolescents (27.7%) ( P=0.402). However, the underweight rate in adolescents (26.8%) was significantly higher than that in children (15.3%) ( P=0.023). The multivariate analysis determined the following risk factors for stunted growth: monthly household income of <10 000 yuan (5 001-10 000 yuan: OR=5.49, 95% CI: 1.48-35.76; 3 000-5 000 yuan: OR=6.87, 95% CI: 1.88-44.60; <3 000 yuan: OR=9.29, 95% CI: 2.20-64.77), pretransfusion HGB of ≤70 g/L ( OR=3.25, 95% CI: 1.07-10.18), and SF of ≥5 000 μg/L ( OR = 3.04, 95% CI: 1.20-7.70). Longer diagnostic duration was associated with underweight ( OR=1.10, 95% CI: 1.01-1.20) . Conclusions:Children and adolescents with TDT with pretransfusion SF of ≥5 000 μg/L, HGB of ≤70 g/L, low monthly household income, or longer diagnosis duration were significantly more likely to experience delayed physical growth.
8.Analysis of treatment response and post-discontinuation efficacy maintenance of cyclophosphamide monotherapy in T-cell large granular lymphocytic leukemia
Lele ZHANG ; Linzhu TIAN ; Hong PAN ; Zhen GAO ; Weiwang LI ; Ruonan LI ; Jingyu ZHAO ; Jinbo HUANG ; Xin ZHAO ; Jianping LI ; Neng NIE ; Xiao YU ; Liyun LI ; Zhexiang KUANG ; Liwei FANG ; Jun SHI
Chinese Journal of Hematology 2025;46(7):631-635
Objective:To evaluate the efficacy of cyclophosphamide in patients with T-cell large granular lymphocytic leukemia (T-LGLL) and the maintenance of treatment-free remission (TFR) following drug discontinuation.Methods:Clinical data were collected from 37 patients with T-LGLL who received oral cyclophosphamide at the Regenerative Medicine Clinic of the Institute of Hematology and Blood Diseases Hospital between June 2019 and March 2024. Patient clinical characteristics, treatment efficacy, and long-term TFR were analyzed.Results:The median age of the 37 patients was 60 years (range: 37-86), and 22 (59.5%) were male. Anemia was observed in 30 patients (81.1%), and 28 (75.7%) met the diagnostic criteria for secondary pure red cell aplasia. Neutropenia occurred in 15 patients (40.5%), lymphocytosis in 11 (29.7%), and thrombocytopenia in three (8.1%). Sixteen patients (43.2%) had not received prior immunosuppressive therapy (treatment-naive group), while 21 patients (56.8%) were refractory to or had relapsed after immunosuppressive treatment (refractory/relapsed group). All patients met the treatment criteria and received oral cyclophosphamide at doses of 50-100 mg/day. Among the 36 evaluable patients, hematologic remission was achieved in 25 (69.4%), with a median time of 2.0 months (range: 0.7-7.0). There was no statistically significant difference in remission rates between the treatment-naive and refractory/relapsed groups (68.5% vs. 66.7%, P=0.589). Among the 25 patients who achieved hematologic remission, 24 discontinued cyclophosphamide. With a median follow-up of 39.0 months (range: 8.0-56.0), the median TFR duration was not reached. The estimated TFR rates were (90.87± 6.16) % at 12 months and (75.72±11.04) % at 36 months. No significant difference in TFR was observed between the treatment-naive and refractory/relapsed groups ( P=0.451) . Conclusion:Oral cyclophosphamide is effective in the treatment of T-LGLL, and patients may maintain long-term TFR following drug discontinuation.
9.Mechanisms of Wuzi Yuye Decoction in the treatment of diabetic oligoasthenozoospermia:Based on network pharmacology
Dandan HE ; Junjie WU ; Jinying SHEN ; Binbin ZHAO ; Jingyu ZHU ; Yi YU
National Journal of Andrology 2025;31(10):921-931
Objective The aim of this study is to systematically analyze the therapeutic mechanisms of Wuzi Yuye Decoction in diabetic oligoasthenozoospermia based on network pharmacology and animal experiments.Methods Active components and therapeutic targets of Wuzi Yuye Decoction were screened by integrating multiple databases,and their inter-section with diabetic oligoasthenozoospermia-related targets was obtained.Common targets were identified using the Venny platform,and protein-protein interaction(PPI)networks were constructed via the STRING database.And key targets were screened through topological analysis with Cytoscape.Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed using the DAVID platform.A mouse model of diabetic oligoasthenozoospermia was established by high-fat diet combined with streptozotocin induction,followed by intervention with Wuzi Yuye Decoction.Body weight,testicular index,and sperm quality were assessed,while histopathological changes were evaluated by HE staining and transmission electron microscopy(TEM).In addition,ELISA,oxidative stress assays and Western blot were used to verify the changes in key pathway-related proteins.Results A total of 36 common targets were identified,including key nodes such as TNF,IL6 and IL1B.Enrichment analysis indicated that these targets were sig-nificantly involved in inflammatory responses,oxidative stress,autophagy-apoptosis regulation and reproduction-related pathways.Animal experiments confirmed that Wuzi Yuye Decoction markedly improved testicular mass and sperm motility in diabetic mice,reduced the levels of AGE,TNF-α,IL-6 and IL-1β in testicular tissues,alleviated oxidative stress damage,and restored autophagic flux and blood-testis barrier function by inhibiting the RAGE/NF-κB/mTOR signaling axis.Conclusion Wuzi Yuye Decoction improves the pathological progression of diabetic oligoasthenozoospermia by synergistically modulating multiple targets,including inflammation inhibition,antioxidant effects,autophagy regulation,and related pathways.
10.Analysis of the Correlation between Intrahepatic Cholestasis of Pregnancy and Adverse Pregnancy Outcomes
Huili ZHANG ; Yuan JIANG ; Peili DU ; Yuee CHEN ; Jingyu LIU ; Chuyi CHEN ; Xiuhua ZHOU ; Lin YU ; Dunjin CHEN ; Guangyi MA
Journal of Practical Obstetrics and Gynecology 2025;41(11):922-927
Objective:To explore the correlation between intrahepatic cholestasis of pregnancy(ICP)and ad-verse pregnancy outcomes.Methods:A total of 511 singleton pregnant women with ICP treated at The Third Affili-ated Hospital of Guangzhou Medical University from August 2017 to January 2024 were selected as the study sub-jects.Among them,patients were divided into the adverse pregnancy outcome group(n=49)and the control group without adverse pregnancy outcomes(n=462).The general and clinical data of the two groups were com-pared and analyzed.Results:①General situation:The number of pregnancies and deliveries,ICU transfer rate,total hospital stay,and total hospitalization costs were significantly higher in the adverse pregnancy outcome group compared to the control group(P<0.05).The number of prenatal check-ups,diagnostic gestational weeks,and gestational weeks at delivery were significantly lower compared to the control group(P<0.05).②Clinical symp-toms:The incidence of itching in the adverse pregnancy outcome group was lower compared to the control group(10.2%vs.26.6%,P<0.05),while other symptoms such as rash,fatigue,jaundice,and gastrointestinal symp-toms showed no significant difference between the two groups(P>0.05).③Laboratory examinations:Compared with the control group,patients in the adverse pregnancy outcome group had significantly the increased levels of alanine aminotransferase,aspartate aminotransferase,uric acid,urea nitrogen,and triglycerides,and significantly the decreased levels of alkaline phosphatase and fasting blood glucose,with statistical significance(P<0.05).Other biochemical indicators showed no significant difference between the two groups(P>0.05).④ICP grading and complications:The proportion of early-onset ICP,severe and very severe ICP in the adverse pregnancy out-come group was significantly higher compared to the control group(P<0.001);the proportion of adverse preg-nancy outcome group with pregnancy-induced hypertension was significantly higher compared to the control group;the incidence of preterm birth,fetal growth restriction,meconium-stained amniotic fluid,and fetal distress in the adverse pregnancy outcome group was significantly higher compared to the control group(P<0.001).⑤Neo-natal outcomes:The neonatal Apgar scores(1 min,5 min,10 min)and neonatal weight in the adverse pregnancy outcome group were lower compared to the control group(P<0.001),and the incidence of mild neonatal asphyx-ia was significantly higher,with a statistically significant difference(P<0.001).Conclusions:The severity of ICP is closely related to the occurrence of adverse pregnancy outcomes.Therefore,it is clinically necessary to pay at-tention to the grading of ICP,closely monitor the levels of total bile acids and liver enzymes,and try to avoid ad-verse pregnancy outcomes,especially intrauterine fetal death.

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