Objective To investigate the factors influencing the efficacy of intravesical Bacille Calmette-Guérin(BCG)instillation after transurethral resection of bladder tumor(TURBT)in patients with intermediate-and high-risk non-muscle invasive bladder cancer(NMIBC),and to construct a prediction model for recurrence after BCG treatment.Methods A retrospective cohort study was conducted on the subjected patients diagnosed with intermediate-and high-risk NMIBC undergoing TURBT followed by standard BCG instillation.The 110 patients treated in Department of Urology of Army Medical Center of PLA from January 2018 to December 2023 were assigned into a training set,while the 52 patients treated at Department of Urology of General Hospital of Central Theater Command from January 2015 to December 2020 were into an external validation set.A total of 17 variables were included and analyzed.Univariate and multivariate Cox regression analyses were performed to identify factors associated with recurrence after BCG instillation,and nomograms were plotted to predict 1-year,3-year,and 5-year recurrence-free survival(RFS).Calibration curve,decision curve analysis(DCA),and receiver operating characteristic(ROC)curve analysis were conducted for internal and external validation to evaluate the predictive performance and clinical utility of the model.Results In the training set,26 patients(23.64%)experienced recurrence during the follow-up period,with a median RFS of 32.00(18.00～50.50)months.Univariate Cox regression analysis suggested that platelet count,eosinophil to lymphocyte ratio(ELR),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),systemic immune inflammation(SII)index,and neutrophil-monocyte to lymphocyte ratio(NMLR),pathological T1 stage(pT1)tumor and hemoglobin,albumin,lymphocyte,and platelet(HALP)score were potential factors influencing recurrence after BCG instillation.Multivariate Cox regression analysis identified high HALP score(HR=0.185,95%CI:0.046～0.736,P=0.017)as an independent protective factor,while high ELR(HR=3.599,95%CI:1.505～8.608,P=0.004)and pT1 stage(HR=3.240,95%CI:1.191～8.818,P=0.021)were independent risk factors for recurrence.Based on this,a nomogram prediction model was constructed.The calibration curves demonstrated good agreement between predicted and actual 1-,3-,and 5-year recurrence risks.Decision curve analysis indicated clinical utility across a wide threshold probability range.In the training set,the model showed strong predictive performance for 1-(AUC=0.842),3-(AUC=0.847),and 5-year(AUC=0.887)recurrence risks,which was further validated in the external cohort.Conclusion Higher HALP score prior to BCG instillation therapy is a protective factor against tumor recurrence,while higher ELR and pT1 stage are risk factors.Our nomogram prediction model based on HALP score,ELR and pathological T stage,can identify individuals at high risk of recurrence after BCG instillation therapy.

Objective To explore the therapeutic effect of orthopedic robot assisted percutaneous cannulated screw internal fixation in the treatment of Tilt pelvic fractures.Methods A retrospective analysis was made on clinical data of 21 cases of Tilt pelvic fractures treated with"Tianji"orthopedic surgical robot combined with 3D C-arm fluoroscopy assisted percutaneous cannulated screw internal fixation from January 2020 to October 2023.The Tile classification included 11 cases of type B2.1,3 cases of type B2.2,2 cases of type B2.3,and 5 cases of type B3.Results The percutaneous insertion of cannulated screw was safe in all the 21 cases,with a total of 71 screws inserted,including 21 S1 screws,21 S2 screws,21 pubic branch screws(14 anterograde screws and 7 retrograde screws),4 LC-Ⅱ screws,and 4 modified LC-Ⅱ screws.The insertion time of a single screw was(31.1±10.8)min,the fluoroscopy time of a single screw was(5.9±1.7)min,the surgical time was(100.7±16.2)min,and the bleeding volume was(11.2±4.2)ml.According to the Matta criteria,8 cases had excellent fracture reduction quality,11 cases were good,and 2 cases were fair,with an excellent and good rate of 90.5％(19/21).According to the Gras classification,the quality of screw placement was excellent in 65 cases and good in 6 cases,with an excellent and good rate of 100％(71/71).The 21 cases were followed up for 4-18(mean,10.7±8.4)months.The bone healing was achieved in all the cases,with a fracture healing time of(12.7±1.8)weeks.At the last follow-up,according to the Majeed scoring system,7 cases were rated as excellent pelvic function,11 cases as good,and 3 cases as fair,with an excellent and good rate of 85.7％(18/21).Two cases of lateral femoral cutaneous nerve injury and two cases of intermuscular vein thrombosis were cured.Conclusion The use of orthopedic robot assisted percutaneous cannulated screw fixation for the treatment of Tilt pelvic fractures has satisfactory therapeutic effects,with accurate screw placement and no need for adjustment.

Objective·To investigate the bidirectional causal relationships between celiac disease(CeD)and Hashimoto thyroiditis(HT)as well as Graves disease(GD),using a two-sample Mendelian randomization(MR)approach.Methods·Single nucleotide polymorphisms(SNPs)related to CeD,HT and GD were extracted from publicly available Genome-Wide Association Studies(GWAS)databases and used as instrumental variables.The inverse-variance weighted(IVW)method served as the primary analytical approach,supplemented by MR-Egger,weighted median(WME)and weighted mode(WMO)methods,to evaluate the causal associations between CeD and both HT and GD.Replication analyses using alternative GWAS datasets were conducted to validate the robustness of the results.Heterogeneity was assessed using Cochran's Q test,and pleiotropy was evaluated via MR-Egger intercept test.Leave-one-out analyses were performed to assess the impact of individual SNPs on the results.Results·The IVW analysis results indicated that genetically predicted CeD significantly increased the risk of HT[discovery group:OR=1.186(95%CI 1.114?1.262),P<0.001;replication group:OR=1.218(95%CI 1.090?1.361),P<0.001]and GD[discovery group:OR=1.214(95%CI 1.155?1.276),P<0.001;replication group:OR=1.273(95%CI 1.161?1.396),P<0.001].However,reverse MR analyses did not provide evidence for a causal relationship between HT and CeD,while genetically predicted GD significantly increased the risk of CeD[discovery group:OR=1.259(95%CI 1.006?1.576),P=0.044;replication group:OR=1.387(95%CI 1.233?1.560),P<0.001].Sensitivity analyses suggested that the results were not influenced by horizontal pleiotropy.Conclusion·CeD may be causally associated with a higher risk of HT and GD,while GD may increase the risk of developing CeD.HT does not appear to have an impact on CeD.

Objective To explore the therapeutic effect of orthopedic robot assisted percutaneous cannulated screw internal fixation in the treatment of Tilt pelvic fractures.Methods A retrospective analysis was made on clinical data of 21 cases of Tilt pelvic fractures treated with"Tianji"orthopedic surgical robot combined with 3D C-arm fluoroscopy assisted percutaneous cannulated screw internal fixation from January 2020 to October 2023.The Tile classification included 11 cases of type B2.1,3 cases of type B2.2,2 cases of type B2.3,and 5 cases of type B3.Results The percutaneous insertion of cannulated screw was safe in all the 21 cases,with a total of 71 screws inserted,including 21 S1 screws,21 S2 screws,21 pubic branch screws(14 anterograde screws and 7 retrograde screws),4 LC-Ⅱ screws,and 4 modified LC-Ⅱ screws.The insertion time of a single screw was(31.1±10.8)min,the fluoroscopy time of a single screw was(5.9±1.7)min,the surgical time was(100.7±16.2)min,and the bleeding volume was(11.2±4.2)ml.According to the Matta criteria,8 cases had excellent fracture reduction quality,11 cases were good,and 2 cases were fair,with an excellent and good rate of 90.5％(19/21).According to the Gras classification,the quality of screw placement was excellent in 65 cases and good in 6 cases,with an excellent and good rate of 100％(71/71).The 21 cases were followed up for 4-18(mean,10.7±8.4)months.The bone healing was achieved in all the cases,with a fracture healing time of(12.7±1.8)weeks.At the last follow-up,according to the Majeed scoring system,7 cases were rated as excellent pelvic function,11 cases as good,and 3 cases as fair,with an excellent and good rate of 85.7％(18/21).Two cases of lateral femoral cutaneous nerve injury and two cases of intermuscular vein thrombosis were cured.Conclusion The use of orthopedic robot assisted percutaneous cannulated screw fixation for the treatment of Tilt pelvic fractures has satisfactory therapeutic effects,with accurate screw placement and no need for adjustment.

Objective·To investigate the bidirectional causal relationships between celiac disease(CeD)and Hashimoto thyroiditis(HT)as well as Graves disease(GD),using a two-sample Mendelian randomization(MR)approach.Methods·Single nucleotide polymorphisms(SNPs)related to CeD,HT and GD were extracted from publicly available Genome-Wide Association Studies(GWAS)databases and used as instrumental variables.The inverse-variance weighted(IVW)method served as the primary analytical approach,supplemented by MR-Egger,weighted median(WME)and weighted mode(WMO)methods,to evaluate the causal associations between CeD and both HT and GD.Replication analyses using alternative GWAS datasets were conducted to validate the robustness of the results.Heterogeneity was assessed using Cochran's Q test,and pleiotropy was evaluated via MR-Egger intercept test.Leave-one-out analyses were performed to assess the impact of individual SNPs on the results.Results·The IVW analysis results indicated that genetically predicted CeD significantly increased the risk of HT[discovery group:OR=1.186(95%CI 1.114?1.262),P<0.001;replication group:OR=1.218(95%CI 1.090?1.361),P<0.001]and GD[discovery group:OR=1.214(95%CI 1.155?1.276),P<0.001;replication group:OR=1.273(95%CI 1.161?1.396),P<0.001].However,reverse MR analyses did not provide evidence for a causal relationship between HT and CeD,while genetically predicted GD significantly increased the risk of CeD[discovery group:OR=1.259(95%CI 1.006?1.576),P=0.044;replication group:OR=1.387(95%CI 1.233?1.560),P<0.001].Sensitivity analyses suggested that the results were not influenced by horizontal pleiotropy.Conclusion·CeD may be causally associated with a higher risk of HT and GD,while GD may increase the risk of developing CeD.HT does not appear to have an impact on CeD.

Objective To explore the underlying mechanism of β2 adrenergic receptor(ADRB2)in fibrogenesis during wound healing.Methods Non-specific ADRB2 gene knockdown adeno-associated virus(AAV-ADRB2 group,6 mice)and control virus(AAV-NC group,6 mice)was injected randomly into the back skin of 12 mice for 21 days,a full-thickness skin defected wound healing murine model was established.Wound healing rates were recorded at the 1st,3rd,5th,and 7th day after operation.Histological examinations by H-E staining,Masson staining,and immunohistochemistry were conducted to observe wounded skin tissue structure,fibrosis,and α-SMA protein expression;quantitative PCR was employed to analyze ADRB2 and matrix metalloproteinase(MMP)mRNA levels;Western blotting was utilized to assess the protein expression levels of COL1A1,COL3A1,TGF-β1,and Smad3.Results On postoperative day 5 and 7,the wound healing rate of the AAV-ADRB2 group significantly decreased(P＜0.05),accompanied by a series pathological changes,including thickened epidermis,exaggerated inflammation,reduced fibroblast count,and inhibited collagen deposition;the α-SMA expression showed a significant decrease(P＜0.05),and the ratio of COL1A1 to COL3A1 decreased(P＜0.05);ADRB2 mRNA levels significantly decreased(P＜0.01),while MMP-1 and MMP-8 mRNA levels increased(P＜0.01);the protein levels of TGF-β1 and Smad3 exhibited a significant decrease(P＜0.05).Conclusions ADRB2 knockdown reduced fibrosis during wound healing and degenerated connective tissue content around the wound bed by inhibiting the TGF-β1/Smad3 signaling pathway,which leads to an increase in MMP mRNA levels and a decrease in the ratio of type Ⅰ to type Ⅲ collagen.

Objective:To explore the therapeutic efficacy of type B3 distal radius fractures treated with modified locking plate implantation through single minimally invasive volar approach of 15 mm.Methods:A retrospective case series study was conducted to analyze the clinical data of 14 patients with type B3 distal radius fractures admitted to Wuxi Ninth People′s Hospital from February 2021 to January 2024, including 6 males and 8 females, aged 21-78 years [(50.9±15.5)years]. The steel plate was inserted first through single minimally invasive volar approach of 15 mm, followed by reduction and temporary fixation of the fractures. Further adjustment of the reduction and final fixation were performed under fluoroscopy. The length of the incision was observed at the end of the surgery and at the last follow-up. The reduction quality of the articular surface was evaluated by CT at postoperative 3 days. The bone healing was observed and the healing time was recorded. The visual analogue scale (VAS) scores before surgery and at 7, 14 days after surgery and at the last follow-up were compared. The grip strengths, range of motions of the wrist joint (flexion-extension, pronation-supination and ulnar-radial deviation), and Gartland-Werley wrist scores at 3, 6 months after surgery and at the last follow-up were detected. The occurence of postoperative complications was observed.Results:All the patients were followed up for 6-34 months [(17.1±5.2)months]. The incision length was (20.3±6.9)mm at the end of the surgery and was (19.1±6.3)mm at the last follow-up. As shown in CT scan at postoperative 3 days, excellent reduction of the articular surface was observed in 9 patients, good in 4 and fair in 1, with an excellent and good rate of 92.9%. The fractures were all healed, with the healing time of 5-8 weeks [(5.9±0.6)weeks]. At 7, 14 days after surgery and at the last follow-up, the VAS scores were 3.0(3.0, 4.0)points, 3.0(2.0, 3.0)points and 0.0(0.0, 1.0)points respectively, significantly lower than 5.0(3.8, 6.0)points before surgery ( P<0.01), and the VAS scores significantly decreased over time after surgery ( P<0.05). At 3, 6 months after surgery and at the last follow-up, the grip strengths [(72.1±5.3)%, (78.9±4.0)% and (82.9±4.8)% respectively], ranges of wrist flexion-extension [(76.6±3.3)°, (80.9±3.6)° and (82.3±3.6)°respectively], ranges of pronation-supination [(159.4±5.7)°, (172.1±6.2)° and (173.9±3.7)° respectively], ranges of ulnar-radial deviation [(35.8±3.9)°, (37.6±4.0)° and (38.3±3.5)° respectively], and Gartland-Werley wrist scores [7.0(2.8, 8.0)points, 2.0(2.0, 4.5)points, 2.0(2.0, 2.0)points] were all significantly improved compared with the values preoperatively [(63.4±8.0)%, (74.9±5.4)°, (150.6±10.3)°, (32.7±4.9)° and 18.0(16.8, 20.0)points respectively] ( P<0.05). Moreover, the ranges of wrist motion were significantly improved over time after surgery ( P<0.05), while the grip strengths and Gartland-Werley wrist scores were significantly improved at postoperative 3 and 6 months ( P<0.05). According to their Gartland-Werley wrist scores at the last follow-up, 8 patients were rated excellent, 5 good, and 1 fair, with an excellent and good rate of 92.9%. There were 2 patients with delayed incision healing, one injury to the palmar cutaneous branch of the median nerve, and one with extensor tendon irritation because of the overlength of the screw. Conclusion:Modified locking plate implantation through single minimally invasive volar approach of 15 mm for type B3 distal radius fractures has advantages of small incision, fast bone healing, reduced pain, increased grip strengths and range of motions of the wrist joint, good wrist function recovery, and few complications.

Objective:To explore the therapeutic efficacy of type B3 distal radius fractures treated with modified locking plate implantation through single minimally invasive volar approach of 15 mm.Methods:A retrospective case series study was conducted to analyze the clinical data of 14 patients with type B3 distal radius fractures admitted to Wuxi Ninth People′s Hospital from February 2021 to January 2024, including 6 males and 8 females, aged 21-78 years [(50.9±15.5)years]. The steel plate was inserted first through single minimally invasive volar approach of 15 mm, followed by reduction and temporary fixation of the fractures. Further adjustment of the reduction and final fixation were performed under fluoroscopy. The length of the incision was observed at the end of the surgery and at the last follow-up. The reduction quality of the articular surface was evaluated by CT at postoperative 3 days. The bone healing was observed and the healing time was recorded. The visual analogue scale (VAS) scores before surgery and at 7, 14 days after surgery and at the last follow-up were compared. The grip strengths, range of motions of the wrist joint (flexion-extension, pronation-supination and ulnar-radial deviation), and Gartland-Werley wrist scores at 3, 6 months after surgery and at the last follow-up were detected. The occurence of postoperative complications was observed.Results:All the patients were followed up for 6-34 months [(17.1±5.2)months]. The incision length was (20.3±6.9)mm at the end of the surgery and was (19.1±6.3)mm at the last follow-up. As shown in CT scan at postoperative 3 days, excellent reduction of the articular surface was observed in 9 patients, good in 4 and fair in 1, with an excellent and good rate of 92.9%. The fractures were all healed, with the healing time of 5-8 weeks [(5.9±0.6)weeks]. At 7, 14 days after surgery and at the last follow-up, the VAS scores were 3.0(3.0, 4.0)points, 3.0(2.0, 3.0)points and 0.0(0.0, 1.0)points respectively, significantly lower than 5.0(3.8, 6.0)points before surgery ( P<0.01), and the VAS scores significantly decreased over time after surgery ( P<0.05). At 3, 6 months after surgery and at the last follow-up, the grip strengths [(72.1±5.3)%, (78.9±4.0)% and (82.9±4.8)% respectively], ranges of wrist flexion-extension [(76.6±3.3)°, (80.9±3.6)° and (82.3±3.6)°respectively], ranges of pronation-supination [(159.4±5.7)°, (172.1±6.2)° and (173.9±3.7)° respectively], ranges of ulnar-radial deviation [(35.8±3.9)°, (37.6±4.0)° and (38.3±3.5)° respectively], and Gartland-Werley wrist scores [7.0(2.8, 8.0)points, 2.0(2.0, 4.5)points, 2.0(2.0, 2.0)points] were all significantly improved compared with the values preoperatively [(63.4±8.0)%, (74.9±5.4)°, (150.6±10.3)°, (32.7±4.9)° and 18.0(16.8, 20.0)points respectively] ( P<0.05). Moreover, the ranges of wrist motion were significantly improved over time after surgery ( P<0.05), while the grip strengths and Gartland-Werley wrist scores were significantly improved at postoperative 3 and 6 months ( P<0.05). According to their Gartland-Werley wrist scores at the last follow-up, 8 patients were rated excellent, 5 good, and 1 fair, with an excellent and good rate of 92.9%. There were 2 patients with delayed incision healing, one injury to the palmar cutaneous branch of the median nerve, and one with extensor tendon irritation because of the overlength of the screw. Conclusion:Modified locking plate implantation through single minimally invasive volar approach of 15 mm for type B3 distal radius fractures has advantages of small incision, fast bone healing, reduced pain, increased grip strengths and range of motions of the wrist joint, good wrist function recovery, and few complications.

Renal interstitial fibrosis (RIF) is the crucial pathway in chronic kidney disease (CKD) leading to the end-stage renal failure. However, the underlying mechanism of Shen Qi Wan (SQW) on RIF is not fully understood. In the current study, we investigated the role of Aquaporin 1 (AQP1) in SQW on tubular epithelial-to-mesenchymal transition (EMT). A RIF mouse model induced by adenine and a TGF-β1-stimulated HK-2 cell model were etablished to explore the involvement of AQP 1 in the protective effect of SQW on EMT in vitro and in vivo. Subsequently, the molecular mechanism of SQW on EMT was explored in HK-2 cells with AQP1 knockdown. The results indicated that SQW alleviated kidney injury and renal collagen deposition in the kidneys of mice induced by adenine, increased the protein expression of E-cadherin and AQP1 expression, and decreased the expression of vimentin and α-smooth muscle actin (α-SMA). Similarly, treatmement with SQW-containing serum significantly halted EMT process in TGF-β1 stimulated HK-2 cells. The expression of snail and slug was significantly upregulated in HK-2 cells after knockdown of AQP1. AQP1 knockdown also increased the mRNA expression of vimentin and α-SMA, and decreased the expression of E-cadherin. The protein expression of vimentin increased, while the expression of E-cadherin and CK-18 significantly decreased after AQP1 knockdown in HK-2 cells. These results revealed that AQP1 knockdown promoted EMT. Furthermore, AQP1 knockdown abolished the protective effect of SQW-containing serum on EMT in HK-2 cells. In sum, SQW attentuates EMT process in RIF through upregulation of the expression of AQP1.
Drugs, Chinese Herbal/pharmacology* ; Humans ; Animals ; Mice ; Male ; Cell Line ; Rats ; Kidney/physiology* ; Fibrosis/drug therapy* ; Renal Insufficiency, Chronic/drug therapy* ; Adenine ; Epithelial-Mesenchymal Transition ; Aquaporin 1/metabolism*

Objective:To study the effect of trefoil factor family (TFF) 3 on the expression of tight junctions (TJs) in the nasal mucosa epithelium of eosinophilic chronic rhinosinusitis (eCRS) and its mechanism.Methods:From September to December 2020, eligible patients from the Department of Otorhinolaryngology of the First Affiliated Hospital of Nanchang University were recruited, including 11 control patients and 37 patients with chronic rhinosinusitis with nasal polyps (CRSwNP), from whom nasal mucosa and nasal polyp tissue samples were collected. Immunohistochemistry (IHC) was used to detect the localization and expression intensity of TFFs (TFF1, TFF2 and TFF3) and TJs (occudin, claudin-1 and ZO-1) in nasal mucosa. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and western blot (WB) were used to detect the mRNA and protein expression. A cell model of tight junction injury in human nasal epithelial cells (HNECs) through stimulation with interleukin (IL)-13 was also established. The optimal modeling concentration and time for HNECs were determined, which were subsequently treated with TFF3 and/or a phosphoinositide 3-kinase (PI3K)-specific inhibitor (LY294002). Finally, RT-qPCR and WB were used to assess the effects of TFF3 on tight junctions and the PI3K/serine/threonine kinase (Akt) signaling pathway. Data were analyzed statistically using GraphPad Prism 7 software.Results:IHC results showed that the expression of TFF1 and TFF3 in nasal mucosa of eCRS group was significantly higher than that of control group ( t=4.62, P=0.002; t=5.89, P<0.001), respectively, mainly expressed in goblet cell. The expression of occludin, claudin-1 and ZO-1 in the nasal mucosa of the eCRS group was lower than that of the control group (occludin t=3.98, P=0.019; claudin-1 t=5.15, P=0.002; ZO-1 t=5.42, P=0.001), respectively. WB results showed that the expression of TFF3 in non-eosinophilic chronic sinusitis (Non-eCRS) group and eCRS group was higher than that in the control group ( t=3.62, P=0.036; t=5.93, P<0.001). The expression of occludin, claudin-1 and ZO-1 in eCRS group was lower than that in the control group (occludin t=5.14, P=0.002; claudin-1 t=6.35, P<0.001; ZO-1 t=6.64, P<0.001), respectively. The RT-qPCR results showed that compared with the control group, the levels of TFF1 and TFF3 mRNA were increased in the nasal mucosal epithelium of the Non-eCRS and eCRS groups (TFF1 t=3.98, P=0.046, t=4.89, P=0.002; TFF3 t=3.50, P=0.044, t=6.78, P<0.001). There was no statistically significant difference in TFF2 mRNA levels between the Non-eCRS and eCRS groups ( t=1.34, P=0.061; t=3.37, P=0.055). Compared with the control group, Non-eCRS and eCRS groups showed a decrease in the mRNA levels of occludin, claudin-1 and ZO-1 (occludin t=4.27, P=0.011, t=5.61, P=0.007; claudin-1 t=3.62, P=0.036, t=6.80, P<0.001; ZO-1 t=3.47, P=0.047, t=7.86, P<0.001). The mRNA levels of TFF3 and TJs in eCRS nasal mucosa tissue showed a moderate positive correlation (occludin r=0.661, claudin-1 r=0.614, ZO-1 r=0.548, all P<0.001); TFF1 showed a low degree of positive correlation with the expression of occludin, claudin-1 and ZO-1 (occludin r=0.467, P=0.040; claudin-1 r=0.362, P=0.012; ZO-1 r=0.425, P=0.025). The establishment of cell models showed that compared with normal HNECs, the mRNA expression of TFF3 was most significantly increased at a concentration of 50 ng/ml stimulated by IL-13 ( t=3.72, P=0.013); The mRNA expression of occludin, claudin-1 and ZO-1 decreased (occludin t=3.18, P=0.031; claudin-1 t=3.86, P=0.010; ZO-1 t=5.16, P=0.002). The expression of TFF3 mRNA increased most significantly after 15 hours of IL-13 stimulation ( t=3.14, P=0.034); The mRNA expression of occludin, claudin-1 and ZO-1 decreased (occludin t=3.97, P=0.010; claudin-1 t=4.78, P=0.004; ZO-1 t=5.16, P=0.004). TJs damage model could be established by treating HNECs with 50 ng/ml IL-13 for 15 hours. Intervention experiments showed that compared with the IL-13 group, the IL-13+TFF3 group showed an increase in TJs mRNA expression (occludin t=6.10, P=0.009; claudin-1 t=5.90, P=0.013; ZO-1 t=9.44, P=0.007). Compared with the IL-13 group, the expression of TJs protein in the IL-13+TFF3 group increased (occludin t=3.23, P=0.013; claudin-1 t=9.40, P=0.017; ZO-1 t=2.23, P=0.032); The expression of TJs protein decreased in the IL-13+TFF3+LY294002 group (occludin t=4.73, claudin-1 t=8.77, ZO-1 t=3.51, all P<0.001). Compared with the IL-13+TFF3 group, the IL-3+TFF3+LY294002 group showed a decrease in PI3K and p-Akt/Akt protein expression (PI3K t=13.29, p-Akt/Akt t=10.30, all P<0.001). The increased mRNA and protein expression of occludin, claudin-1 and ZO-1 induced by TFF3 were also inhibited by LY294002. Conclusion:TFF3 can up-regulate the expression of occludin, claudin-1, and ZO-1 through PI3K/Akt pathway, and has a certain protective effect on the nasal mucosal epithelial barrier, providing a new idea for treating eCRS.