1.Mechanisms by which aerobic and resistance exercises improve obesity-related cognitive impairment
Yu LIU ; Senlin LEI ; Jintao ZHOU ; Hui LIU ; Xianhui LI
Chinese Journal of Tissue Engineering Research 2026;30(5):1171-1183
BACKGROUND:Obesity is not only related to metabolic diseases such as diabetes and cardiovascular disease,but also closely related to the increased risk of cognitive decline,dementia and other neurodegenerative diseases.Studies have found that aerobic exercise and resistance exercise can help improve obesity-related cognitive impairment,but their therapeutic effects and related mechanisms of action are still unclear.OBJECTIVE:To explore the protective effects of aerobic and resistance exercises on the nervous center of obesity-related cognitive impairment mice.METHODS:Forty-eight 8-week-old C57BL/6J wild-type male mice were randomly divided into four groups:a control group was fed normally for 20 weeks;a high fat group was fed with high fat diet(60%fat energy)for 20 weeks;an aerobic exercise group was fed with 12 weeks of high-fat diet followed by 8 weeks of aerobic exercise;and a resistance exercise group was fed with 12 weeks of high-fat diet followed by 8 weeks of resistance exercise.After the exercise intervention,body mass was weighed,insulin tolerance and glucose tolerance were tested to evaluate insulin resistance,and cognitive function of mice in each group was detected by new object recognition experiment and Y-maze experiment.The morphology of hippocampal and cortical tissue cells was observed by hematoxylin-eosin staining.The mRNA relative expression levels of tumor necrosis factor-α and interleukin-6 were detected by real-time fluorescence quantitative PCR,and the protein expressions of Bax,Bcl-2,nuclear factor-κB,Cleaved Caspase-1,Caspase-3,synapsin 1 and brain-derived neurotrophic factor were detected by western blot.RESULTS AND CONCLUSION:(1)Compared with the control group,the body mass of mice increased in the high-fat group(P<0.05),accompanied by insulin resistance and cognitive dysfunction,the expression levels of nuclear factor-κB,Bax,Caspase-3,Cleaved Caspase-1 in the hippocampus were significantly increased(P<0.05),the expression levels of brain-derived neurotrophic factor,synapsin 1and Bcl-2 proteins were significantly decreased(P<0.05),Bcl-2/Bax ratio was significantly decreased(P<0.05),and the mRNA levels of inflammatory cytokines,tumor necrosis factor-α and interleukin-6,were significantly up-regulated(P<0.05).(2)Compared with the high-fat group,the above indexes were significantly improved in the aerobic exercise group(P<0.05),while in the resistance exercise group,the body mass of mice was significantly decreased,the levels of inflammatory cytokines tumor necrosis factor-α and interleukin-6 mRNA were significantly decreased(P<0.05),the protein expression of Caspase-3 was significantly decreased(P<0.05),and the protein expression of brain-derived neurotrophic factor was significantly up-regulated(P<0.05),but no significant changes were observed in the other indexes(P>0.05).In conclusion,long-term exercise can reduce insulin resistance,down-regulate the expression of nuclear factor-κB pathway,weaken inflammatory response,inhibit neuronal apoptosis and improve synaptic plasticity,resulting in neuroprotective effects,and effectively alleviate obesity-related cognitive dysfunction in obese mice.The therapeutic effect of aerobic exercise is superior to that of resistance exercise.
2.Mechanisms by which aerobic and resistance exercises improve obesity-related cognitive impairment
Yu LIU ; Senlin LEI ; Jintao ZHOU ; Hui LIU ; Xianhui LI
Chinese Journal of Tissue Engineering Research 2026;30(5):1171-1183
BACKGROUND:Obesity is not only related to metabolic diseases such as diabetes and cardiovascular disease,but also closely related to the increased risk of cognitive decline,dementia and other neurodegenerative diseases.Studies have found that aerobic exercise and resistance exercise can help improve obesity-related cognitive impairment,but their therapeutic effects and related mechanisms of action are still unclear.OBJECTIVE:To explore the protective effects of aerobic and resistance exercises on the nervous center of obesity-related cognitive impairment mice.METHODS:Forty-eight 8-week-old C57BL/6J wild-type male mice were randomly divided into four groups:a control group was fed normally for 20 weeks;a high fat group was fed with high fat diet(60%fat energy)for 20 weeks;an aerobic exercise group was fed with 12 weeks of high-fat diet followed by 8 weeks of aerobic exercise;and a resistance exercise group was fed with 12 weeks of high-fat diet followed by 8 weeks of resistance exercise.After the exercise intervention,body mass was weighed,insulin tolerance and glucose tolerance were tested to evaluate insulin resistance,and cognitive function of mice in each group was detected by new object recognition experiment and Y-maze experiment.The morphology of hippocampal and cortical tissue cells was observed by hematoxylin-eosin staining.The mRNA relative expression levels of tumor necrosis factor-α and interleukin-6 were detected by real-time fluorescence quantitative PCR,and the protein expressions of Bax,Bcl-2,nuclear factor-κB,Cleaved Caspase-1,Caspase-3,synapsin 1 and brain-derived neurotrophic factor were detected by western blot.RESULTS AND CONCLUSION:(1)Compared with the control group,the body mass of mice increased in the high-fat group(P<0.05),accompanied by insulin resistance and cognitive dysfunction,the expression levels of nuclear factor-κB,Bax,Caspase-3,Cleaved Caspase-1 in the hippocampus were significantly increased(P<0.05),the expression levels of brain-derived neurotrophic factor,synapsin 1and Bcl-2 proteins were significantly decreased(P<0.05),Bcl-2/Bax ratio was significantly decreased(P<0.05),and the mRNA levels of inflammatory cytokines,tumor necrosis factor-α and interleukin-6,were significantly up-regulated(P<0.05).(2)Compared with the high-fat group,the above indexes were significantly improved in the aerobic exercise group(P<0.05),while in the resistance exercise group,the body mass of mice was significantly decreased,the levels of inflammatory cytokines tumor necrosis factor-α and interleukin-6 mRNA were significantly decreased(P<0.05),the protein expression of Caspase-3 was significantly decreased(P<0.05),and the protein expression of brain-derived neurotrophic factor was significantly up-regulated(P<0.05),but no significant changes were observed in the other indexes(P>0.05).In conclusion,long-term exercise can reduce insulin resistance,down-regulate the expression of nuclear factor-κB pathway,weaken inflammatory response,inhibit neuronal apoptosis and improve synaptic plasticity,resulting in neuroprotective effects,and effectively alleviate obesity-related cognitive dysfunction in obese mice.The therapeutic effect of aerobic exercise is superior to that of resistance exercise.
3.Correlation between peripheral blood CD4 T lymphocyte subsets and delayed graft function and short-term prognosis after kidney transplantation
Senlin YANG ; Yu HUI ; Xinping BAO ; Bin ZHOU ; Xuedong WEI ; Jianquan HOU
Journal of Modern Urology 2025;30(6):470-475
Objective: To investigate the correlation between peripheral blood CD4
T lymphocyte subsets and delayed graft function (DGF) and short-term prognosis in kidney transplant recipients, so as to help optimize preoperative assessment for kidney transplantation and provide insights into the immune mechanisms of DGF. Methods: A retrospective analysis was conducted on the clinical data of 103 kidney transplant recipients at the First Affiliated Hospital of Soochow University during Jun.2022 and Oct.2023. A total of 61 recipients were finally included in this study, and were categorized into two groups based on postoperative renal function recovery:the DGF group (n=20) and the immediate graft function (IGF) group (n=41).Flow cytometry was used to detect the proportions and absolute counts of various CD4
T lymphocyte subsets in the peripheral blood on postoperative day 7.The clinical data and peripheral blood lymphocyte subsets between the two groups were compared.For the subsets that exhibited significant differences, the correlation between their proportions and absolute counts and serum creatinine (Scr) levels on postoperative day 7 was further analyzed in the DGF group.Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the predictive performance of the most strongly correlated CD4
T lymphocyte subset in terms of proportion and absolute count for short-term renal function. Results: There were no statistically significant differences in the proportions and absolute counts of Th1, Th2, Th17, and regulatory T cells (Treg) between the DGF and IGF groups (P>0.05).The proportions and absolute counts of follicular helper T cells (Tfh) and PD-1
Tfh cells were significantly higher in the DGF group than in the IGF group (P<0.000 1). The Scr levels at 1 month and 1 year postoperatively were significantly higher in the DGF group than in the IGF group (P<0.01), while the estimated glomerular filtration rate (eGFR) was significantly lower in the DGF group compared with the IGF group (P<0.01, P=0.02).Spearman correlation analysis showed that the proportions and absolute counts of Tfh and PD-1
Tfh cell subsets were positively correlated with the Scr level on post-operative day 7 in the DGF group (P<0.05).The ROC curve demonstrated that the AUC for the proportion of PD-1
Tfh cells in predicting Scr and eGFR at 1 month after surgery was 0.73(95%CI:0.61-0.86) and 0.75 (95%CI:0.62-0.88), respectively.Additionally, the AUC for predicting Scr and eGFR at 1 year was 0.72(95%CI:0.59-0.86) and 0.70(95%CI:0.58-0.83), respectively. Conclusion: The increase in the proportions and absolute counts of Tfh and PD-1
Tfh cells is associated with postoperative DGF of renal transplant recipients, and the proportion of PD-1
Tfh cells may help predict the short-term renal function of recipients.
4.Application of Janus micro/nanoparticles in biomedicine
Senlin CHEN ; Zhou ZHU ; Qianbing WAN
Chinese Journal of Tissue Engineering Research 2025;29(28):6101-6109
BACKGROUND:Janus micro/nanoparticles are widely used in the field of tissue engineering,drug delivery,cancer therapy,bioimaging,and sensing due to their shape,structure,and functional anisotropy.OBJECTIVE:To elucidate the cutting-edge applications of Janus micro/nanoparticles in biomedicine.METHODS:Relevant literature published between 2010 and 2024 was retrieved from CNKI,WanFang Data,PubMed,and Web of Science databases.Searches were conducted using Chinese search terms"Janus nanoparticle,Janus particle,dual-faced particle,drug delivery,cancer therapy,bioimaging,biosensing,tissue engineering"and English search terms"Janus nanoparticle,Janus particle,drug delivery,cancer therapy,biosensing,bioimaging,tissue engineering."A total of 69 articles were selected for review after screening,organizing,summarizing,and synthesizing.RESULTS AND CONCLUSION:Janus micro/nanoparticles can be classified into three major categories based on their basic material properties:organic,inorganic,and organic-inorganic composites.Synthetic strategies consist of shielding,self-assembly,phase separation,microfluidics,and nucleation and growth techniques.Janus micro/nanoparticles exhibit high-efficiency drug delivery through characteristics such as high drug loading,gated release,and autonomous motion.In addition to enhancing traditional cancer treatment modalities(radiation and chemotherapy),Janus micro/nanoparticles can also be applied to emerging cancer treatment methods such as cell immunotherapy,protein drugs,and ferroptosis.Janus micro/nanoparticles serve as contrast agents to enhance bioimaging modalities(CT,MRI,and ultrasound)for high-quality imaging,guiding diagnosis and treatment.Janus micro/nanoparticles are utilized in tissue engineering for delivering growth factors,enhancing mechanical properties of biomaterials,and exhibiting antibacterial effects.Researchers have successfully tailored Janus micro/nanoparticles with desired functionalities by combining different organic polymers and inorganic materials using various synthetic strategies,enabling applications in complex biomedical fields.Despite current advancements,reports on the application of Janus micro/nanoparticles in tissue regeneration,large-scale production,and human clinical trials are relatively limited.Therefore,further research efforts are needed in the development,synthetic strategies,clinical safety assessment,and translation of such materials.
5.Application of Janus micro/nanoparticles in biomedicine
Senlin CHEN ; Zhou ZHU ; Qianbing WAN
Chinese Journal of Tissue Engineering Research 2025;29(28):6101-6109
BACKGROUND:Janus micro/nanoparticles are widely used in the field of tissue engineering,drug delivery,cancer therapy,bioimaging,and sensing due to their shape,structure,and functional anisotropy.OBJECTIVE:To elucidate the cutting-edge applications of Janus micro/nanoparticles in biomedicine.METHODS:Relevant literature published between 2010 and 2024 was retrieved from CNKI,WanFang Data,PubMed,and Web of Science databases.Searches were conducted using Chinese search terms"Janus nanoparticle,Janus particle,dual-faced particle,drug delivery,cancer therapy,bioimaging,biosensing,tissue engineering"and English search terms"Janus nanoparticle,Janus particle,drug delivery,cancer therapy,biosensing,bioimaging,tissue engineering."A total of 69 articles were selected for review after screening,organizing,summarizing,and synthesizing.RESULTS AND CONCLUSION:Janus micro/nanoparticles can be classified into three major categories based on their basic material properties:organic,inorganic,and organic-inorganic composites.Synthetic strategies consist of shielding,self-assembly,phase separation,microfluidics,and nucleation and growth techniques.Janus micro/nanoparticles exhibit high-efficiency drug delivery through characteristics such as high drug loading,gated release,and autonomous motion.In addition to enhancing traditional cancer treatment modalities(radiation and chemotherapy),Janus micro/nanoparticles can also be applied to emerging cancer treatment methods such as cell immunotherapy,protein drugs,and ferroptosis.Janus micro/nanoparticles serve as contrast agents to enhance bioimaging modalities(CT,MRI,and ultrasound)for high-quality imaging,guiding diagnosis and treatment.Janus micro/nanoparticles are utilized in tissue engineering for delivering growth factors,enhancing mechanical properties of biomaterials,and exhibiting antibacterial effects.Researchers have successfully tailored Janus micro/nanoparticles with desired functionalities by combining different organic polymers and inorganic materials using various synthetic strategies,enabling applications in complex biomedical fields.Despite current advancements,reports on the application of Janus micro/nanoparticles in tissue regeneration,large-scale production,and human clinical trials are relatively limited.Therefore,further research efforts are needed in the development,synthetic strategies,clinical safety assessment,and translation of such materials.
6.Antitumor Effect of Fagopyri Dibotryis Rhizoma Extract on Colorectal Cancer Cells Through ROS/MAPK Signaling Pathway
Guangya XU ; Wenyue ZHOU ; Senlin ZHOU ; Zheng SHI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):91-98
ObjectiveTo observe the effects and underlying mechanisms of Fagopyri Dibotryis Rhizoma extract on the proliferation, apoptosis, and autophagy of human colorectal cancer HCT-116 cells. MethodFirstly, cellular activity was detected by the cell proliferation and activity-8 (CCK-8) assay, and the half inhibition rate (IC50) was calculated. Blank group and Fagopyri Dibotryis Rhizoma group (2, 4, 8 mg·L-1) were set. The effect of Fagopyri Dibotryis Rhizoma on the proliferation of HCT-116 cells was observed by cloning experiments, and that of Fagopyri Dibotryis Rhizoma on apoptosis was observed by flow cytometry. The expressions of autophagy-related proteins, p38 mitogen-activated protein kinase (p38 MAPK), extracellular signal-regulated kinase (ERK), c-Jun amino-terminal kinase (JNK), phosphorylated (p)-p38, p-ERK, p-JNK, and other proteins were detected by Western blot. Finally, flow cytometry instrumentation and fluorescence microscopy were used to analyze the changes in reactive oxygen species (ROS), and a ROS scavenger (NAC) was adopted for verification. ResultCompared with the blank group, the activity of HCT-116 cells was significantly decreased in the Fagopyri Dibotryis Rhizoma group (P<0.05, P<0.01). The apoptosis rate of HCT-116 cells in the Fagopyri Dibotryis Rhizoma group was significantly increased (P<0.01). The expression of autophagy-related protein ubiquitin-binding protein (p62) was decreased, but that of autophagy-specific genes (Beclin1) and autophagic microtubule-associated protein 1 light-chain 3B (LC3B) was enhanced (P<0.05, P<0.01). Compared with the Fagopyri Dibotryis Rhizoma group, the apoptosis rate of HCT-116 cells in the Fagopyri Dibotryis Rhizoma + NAC group was significantly reduced (P<0.01). The expression of related autophagy protein Beclin1 was significantly reduced (P<0.01), and that of LC3B protein was reduced (P<0.01). In addition, the expression of MAPK pathway-related proteins ERK and JNK was decreased in the Fagopyri Dibotryis Rhizoma group (P<0.05, P<0.01), and that of p-ERK and p-JNK was enhanced (P<0.05, P<0.01). ConclusionFagopyri Dibotryis Rhizoma can inhibit the proliferation of HCT-116 cells and induce apoptosis and autophagy through the ROS/MAPK signaling pathway.
7.Safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography: A single-blind, multicenter, randomized controlled trial
Wenbo MENG ; W. Joseph LEUNG ; Zhenyu WANG ; Qiyong LI ; Leida ZHANG ; Kai ZHANG ; Xuefeng WANG ; Meng WANG ; Qi WANG ; Yingmei SHAO ; Jijun ZHANG ; Ping YUE ; Lei ZHANG ; Kexiang ZHU ; Xiaoliang ZHU ; Hui ZHANG ; Senlin HOU ; Kailin CAI ; Hao SUN ; Ping XUE ; Wei LIU ; Haiping WANG ; Li ZHANG ; Songming DING ; Zhiqing YANG ; Ming ZHANG ; Hao WENG ; Qingyuan WU ; Bendong CHEN ; Tiemin JIANG ; Yingkai WANG ; Lichao ZHANG ; Ke WU ; Xue YANG ; Zilong WEN ; Chun LIU ; Long MIAO ; Zhengfeng WANG ; Jiajia LI ; Xiaowen YAN ; Fangzhao WANG ; Lingen ZHANG ; Mingzhen BAI ; Ningning MI ; Xianzhuo ZHANG ; Wence ZHOU ; Jinqiu YUAN ; Azumi SUZUKI ; Kiyohito TANAKA ; Jiankang LIU ; Ula NUR ; Elisabete WEIDERPASS ; Xun LI
Chinese Medical Journal 2024;137(12):1437-1446
Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.
8.Clinical characteristics of choledocholithiasis combined with periampullary diverticulum and influencing factor analysis for difficult cannulation of endoscopic retrograde cholangiopan-creatography: a report of 1 920 cases
Ping YUE ; Zhenyu WANG ; Leida ZHANG ; Hao SUN ; Ping XUE ; Wei LIU ; Qi WANG ; Jijun ZHANG ; Xuefeng WANG ; Meng WANG ; Yingmei SHAO ; Kailin CAI ; Senlin HOU ; Kai ZHANG ; Qiyong LI ; Lei ZHANG ; Kexiang ZHU ; Haiping WANG ; Ming ZHANG ; Xiangyu SUN ; Zhiqing YANG ; Jie TAO ; Zilong WEN ; Qunwei WANG ; Bendong CHEN ; Yingkai WANG ; Mingning ZHAO ; Ruoyan ZHANG ; Tiemin JIANG ; Ke LIU ; Lichao ZHANG ; Kangjie CHEN ; Xiaoliang ZHU ; Hui ZHANG ; Long MIAO ; Zhengfeng WANG ; Jiajia LI ; Xiaowen YAN ; Ling'en ZHANG ; Fangzhao WANG ; Wence ZHOU ; Wenbo MENG ; Xun LI
Chinese Journal of Digestive Surgery 2023;22(1):113-121
Objective:To investigate the clinical characteristics of choledocholithiasis com-bined with periampullary diverticulum and influencing factor for difficult cannulation of endoscopic retrograde cholangiopancreatography (ERCP).Methods:The retrospective case-control study was conducted. The clinical data of 1 920 patients who underwent ERCP for choledocholithiasis in 15 medical centers, including the First Hospital of Lanzhou University, et al, from July 2015 to December 2017 were collected. There were 915 males and 1 005 females, aged (63±16)years. Of 1 920 patients, there were 228 cases with periampullary diverticulum and 1 692 cases without periampullary diverticulum. Observation indicators: (1) clinical characteristics of patients with choledocholithiasis; (2) intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis; (3) influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Clinical characteristics of patients with choledocholithiasis. Age, body mass index, cases with complications as chronic obstructive pulmonary disease, diameter of common bile duct, cases with diameter of common bile duct as <8 mm, 8?12 mm, >12 mm, diameter of stone, cases with number of stones as single and multiple were (69±12)years, (23.3±3.0)kg/m 2, 16, (14±4)mm, 11, 95, 122, (12±4)mm, 89, 139 in patients with choledocholithiasis combined with periampullary diverticulum, versus (62±16)years, (23.8±2.8)kg/m 2, 67, (12±4)mm, 159, 892, 641, (10±4)mm, 817, 875 in patients with choledocholithiasis not combined with periampullary diver-ticulum, showing significant differences in the above indicators between the two groups ( t=?7.55, 2.45, χ2=4.54, t=?4.92, Z=4.66, t=?7.31, χ2=6.90, P<0.05). (2) Intraoperative and postoperative situations of patients undergoing ERCP for choledocholithiasis. The balloon expansion diameter, cases with intraoperative bleeding, cases with hemorrhage management of submucosal injection, hemostatic clip, spray hemostasis, electrocoagulation hemostasis and other treatment, cases with endoscopic plastic stent placement, cases with endoscopic nasal bile duct drainage, cases with mechanical lithotripsy, cases with stone complete clearing, cases with difficult cannulation, cases with delayed intubation, cases undergoing >5 times of cannulation attempts, cannulation time, X-ray exposure time, operation time were 10.0(range, 8.5?12.0)mm, 56, 6, 5, 43, 1, 1, 52, 177, 67, 201, 74, 38, 74, (7.4±3.1)minutes, (6±3)minutes, (46±19)minutes in patients with choledocholithiasis combined with periampullary diverticulum, versus 9.0(range, 8.0?11.0)mm, 243, 35, 14, 109, 73, 12, 230, 1 457, 167, 1 565, 395, 171, 395, (6.6±2.9)minutes, (6±5)minutes, (41±17)minutes in patients with choledocholithiasis not combined with periampullary diverticulum, showing significant differences in the above indicators between the two groups ( Z=6.31, χ2=15.90, 26.02, 13.61, 11.40, 71.51, 5.12, 9.04, 8.92, 9.04, t=?3.89, 2.67, ?3.61, P<0.05). (3) Influencing factor analysis for difficult cannulation in patients undergoing ERCP for choledocholithiasis. Results of multivariate analysis showed total bilirubin >30 umol/L, number of stones >1, combined with periampullary diverticulum were indepen-dent risk factors for difficult cannulation in patients with periampullary diverticulum who underwent ERCP for choledocholithiasis ( odds ratio=1.31, 1.48, 1.44, 95% confidence interval as 1.06?1.61, 1.20?1.84, 1.06?1.95, P<0.05). Results of further analysis showed that, of 1 920 patients undergoing ERCP for choledocholithiasis, the incidence of postoperative pancreatitis was 17.271%(81/469) and 8.132%(118/1 451) in the 469 cases with difficult cannulation and 1 451 cases without difficult cannula-tion, respectively, showing a significant difference between them ( χ2=31.86, P<0.05). In the 1 692 patients with choledocholithiasis not combined with periampullary diverticulum, the incidence of postopera-tive pancreatitis was 17.722%(70/395) and 8.250%(107/1 297) in 395 cases with difficult cannula-tion and 1 297 cases without difficult cannulation, respectively, showing a significant difference between them ( χ2=29.00, P<0.05). In the 228 patients with choledocholithiasis combined with peri-ampullary diverticulum, the incidence of postoperative pancreatitis was 14.865%(11/74) and 7.143%(11/154) in 74 cases with difficult cannulation and 154 cases without difficult cannulation, respectively, showing no significant difference between them ( χ2=3.42, P>0.05). Conclusions:Compared with patients with choledocholithiasis not combined with periampullary divertioulum, periampullary divertioulum often occurs in choledocholithiasis patients of elderly and low body mass index. The proportion of chronic obstructive pulmonary disease is high in choledocholithiasis patients with periampullary diverticulum, and the diameter of stone is large, the number of stone is more in these patients. Combined with periampullary diverticulum will increase the difficult of cannulation and the ratio of patient with mechanical lithotripsy, and reduce the ratio of patient with stone complete clearing without increasing postoperative complications of choledocholithiasis patients undergoing ERCP. Total bilirubin >30 μmol/L, number of stones >1, combined with periampullary diverticulum are independent risk factors for difficult cannulation in patients of periampullary diverticulum who underwent ERCP for choledocholithiasis.
9.Betulinic acid enhances gefitinib-sensitivity of pancreatic cancer cells via inhibition of STAT3 activation
WU Haixia ; MAIMAITI Aikebaier ; WANG Shuai ; ZHOU Keting ; SHI Senlin
Chinese Journal of Cancer Biotherapy 2019;26(9):948-954
Objective: To investigate the effects and the underlying mechanisms of betulinic acid (BEA) on sensitizing pancreatic cancer cell lines Panc-1 and Miapaca-2 to gefitinib. Methods: After the cell culture was completed, Panc-1 and Miapaca-2 cells were randomly divided into 4 groups: control group (without treatment), BEAgroup, gefitinib group and BEAcombined with gefitinib group, respectively.The sensitization effect of BEAon gefitinib-insensitive pancreatic cancer cells was detected by MTS assay. The treatment effects of combined treatment of gefitinib and BEA against Panc-1 and Miapaca-2 cells were evaluated by colony formation assay. Flow cytometry was used to examine the effect of BEAon apoptosis of Panc-1 cells while WB was applied to determine the effect of BEAonapoptosis-related proteins. Surface plasmon resonance (SPR) experiment was used to detect the direct combination between signal transducer and activator of transcription 3(STAT3) and BEA; Molecular docking and molecular dynamics simulation experiments were adopted topredict the combining mode between STAT3 and BEA. Results: BEA synergistically enhanced the gefitinib-sensitivity of pancreatic cancer Panc-1 and Miapaca-2 cells (P<0.05), and IC50 of gefitinib on two cells were reduced by over 50%. Compared with single treatment, the combined treatment of BEA and gefitinib promoted the apoptosis and up-regulated the expressions of apoptosis-relatedproteins (cleaved-PARP and Bax), but reduced the apoptosis-inhibitory protein Bcl-2 (all P<0.05 or P<0.01). Moreover, the inhibitory effect of BEA on STAT3 activation in Panc-1 cells was in a dose-dependent mannar (P<0.01). BEA stabilizes its binding to STAT3 by forming hydrogen bonds with Lys-591 and Ser-613 of STAT3; in the meanwhile, BEA stabilized inthebinding site of STAT3, there by blocking STAT3 dimerization to enhance the drug sensitivity. Conclusion: Combined use of BEA and gefitinib could significantly inhibit the proliferation and induce apoptosis of Panc-1 and Miapaca-2 cells, which might be mediated by the inhibition of BEA on STST3.
10.Efficacy of 125I seed implantation combined with intravenous chemotherapy in treatment of stage Ⅲ b and Ⅳ non-small cell lung cancer
Senlin CHU ; Weifu LYU ; Chunze ZHOU ; Dong LU ; Xingming ZHANG ; Nan ZHU
Chinese Journal of Interventional Imaging and Therapy 2017;14(10):592-596
Objective To investigate the efficacy of implantation of radioactive iodine-125 (125I) seeds combined with chemotherapy in treatment of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC).Methods Ninety patients with stage Ⅲb and Ⅳ NSCLC were divided into two groups.The combined group (n=43) received chemotherapy with TP (paclitaxe plus cispla tin) or GP (gemcitabine plus cisplatin) 3 days after 125I particles implantation,and the control group (n=47) only received TP or GP chemotherapy.The effective rate,1-year and 2-year survival rate,the median survival time were compared between the 2 groups.Results The total effective rates of the combined group and the control group of stage Ⅲ b NSCLC were 84.00% and 48.28%,and the effective rates of stage Ⅵ NSCLC were 72.22% and 33.33% (both P<0.05).The 1-year and 2-year survival rate of the combined group and control group of stage Ⅲb NSCLC were 67.80%,36.00% and 37.90%,13.83%,respectively (both P<0.05).The median survival time was 15.7 months and 8.6 months.However,the survival rates of the combined group and the control group of stage Ⅳ NSCLC were 44.44%,16.70% and 22.22%,11.10%,respectively,while the difference was not statistically significant (P>0.05).The median survival time was 8.9 and 6.0 months.Conclusion The implantation of radioactive 125I seeds combined with chemotherapy can obtain a significant efficacy in the treatment of stage Ⅲb and stage Ⅳ NSCLC.For patients with stage Ⅲb NSCLC,combined therapy can improve the survival rate.

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