1.Interventional Effect of Active Ingredients of Chinese Medicine and Compound Formulas on Epithelial-mesenchymal Transition in Lung Cancer: A Review
Shanshan SONG ; Min JIANG ; Xinxin LIU ; Bozhen HUANG ; Siyi MA ; Guoyu WANG ; Wanqing WANG ; Luyao WANG ; Liang WANG ; Ruiqing BO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):336-346
Lung cancer is the leading cause of cancer-related deaths worldwide, and tumor metastasis is a key factor contributing to the mortality of most lung cancer patients. Aberrant activation of epithelial-mesenchymal transition (EMT) is a major driver of lung cancer progression and metastasis. EMT is characterized by the loss of apical-basal polarity and intercellular adhesion in highly differentiated, polarized, and organized epithelial cells, which acquire motility, migratory potential, and invasive properties. During this process, cells undergo cytoskeletal remodeling and transform into a mesenchymal phenotype, accompanied by associated changes in cellular markers. The EMT process is highly complex and is tightly regulated by intricate networks involving multiple transcription factors, post-translational controls, epigenetic modifications, and non-coding RNAs. Therefore, therapies targeting the mechanisms of malignant transformation and their associated pathways in lung cancer are of significant clinical importance. In recent years, EMT has attracted increasing attention as a potential target for cancer therapy. Chinese medicine, with its characteristics of multi-target action, low side effects, and good therapeutic efficacy, has demonstrated an important role in anticancer treatment. A series of studies have investigated the role of Chinese medicine in inhibiting EMT in lung cancer. Active ingredients of Chinese medicine, including flavonoids, glycosides, phenols, terpenoids, saccharides, and alkaloids, as well as Chinese medicine compound formulas, have shown significant regulatory effects on EMT. Their mechanisms mainly involve multiple pathways, targets, and links, including signaling pathways, exosomes, microRNAs (miRNAs), and the tumor-associated immune microenvironment. This article summarizes the mechanisms by which EMT promotes malignant tumor progression and reviews the current research on how Chinese medicine active ingredients, monomers, and compound formulas inhibit EMT and suppress lung cancer cell migration and invasion. This study is expected to provide comprehensive theoretical information for basic and translational research on lung cancer.
2.PET/CT imaging of PD-1 receptor probe targeting S180 sarcoma in mice
Haifeng HUANG ; Jiangnan SUN ; Huan ZOU ; Tao BAO ; Hua ZHU ; Xianteng YANG ; Shanshan LI
Acta Universitatis Medicinalis Anhui 2026;61(4):682-688
ObjectiveTo explore the feasibility of constructing a programmed death receptor-1(PD-1) molecular probe for non-invasive micro-positron emission tomography/computed tomography (Micro-PET/CT) imaging of PD-1 protein in mouse S180 sarcoma. MethodsA transgenic PD-1 C57 S180 sarcoma mouse model was established using the S180 sarcoma cell injection. Furthermore, 124I-anti-PD-1 monoclonal antibody probe was synthesized. 18.5 MBq of the 124I-anti-PD-1 probe was injected into the tail vein of transgenic PD-1 C57 mice. Subsequently, S180 sarcoma was imaged using Micro-PET/CT. ResultsStudy successfully established a transgenic PD-1 C57 S180 sarcoma mouse model. Immunohistochemical (IHC) results showed PD-1 protein expression in S180 sarcoma. Micro-PET/CT imaging successfully visualized the PD-1 protein receptor in S180 sarcoma at different time points (20, 48, 72, and 120 h) after probe injection. ConclusionThe 124I-anti-PD-1 monoclonal antibody molecular probe successfully targets the PD-1 receptor in S180 sarcoma of transgenic PD-1 C57 mice, and presents clear Micro-PET/CT immunoassay results, thus it potentially enables the non-invasive screening of patients with PD-1 positive malignant tumors.
3.COLEC12high tumor-associated macrophages orchestrate lenvatinib resistance and cancer stemness in hepatocellular carcinoma via paracrine NRG1-HER2/HER3 signaling
Jianxing ZHANG ; Liang QIAO ; Zongfeng WU ; Dinglan ZUO ; Shanshan HUANG ; Shaoru LIU ; Zhenkun HUANG ; Yi ZENG ; Yu LI ; Yichuan YUAN ; Chenwei WANG ; Wei HE ; Jiliang QIU ; Yunfei YUAN ; Yi NIU ; Binkui LI
Clinical and Molecular Hepatology 2026;32(2):772-786
Background/Aims:
Lenvatinib resistance remains a critical barrier in advanced hepatocellular carcinoma (HCC) therapy. However, the underlying mechanisms and strategies for reversing resistance remain incompletely understood.
Methods:
Integrated transcriptomics of lenvatinib-resistant patient tumors and an acquired-resistance murine model identified a novel macrophage subpopulation. Functional validation employed CRISPR-SAM screening, conditioned medium (CM) assays, subcutaneous/orthotopic xenografts, patient-derived organoids (PDOs), and patient-derived xenografts (PDXs). Mechanistic studies included ChIP-qPCR, co-immunoprecipitation, and pharmacologic targeting. Clinical relevance was assessed in a retrospective cohort.
Results:
Resistant HCC exhibited significant enrichment of a COLEC12high TAM subset , which correlated with poor survival and treatment response. These TAMs secreted neuregulin-1 (NRG1) , activating HER2/HER3-AKT signaling in tumor cells to drive cancer stemness and lenvatinib resistance. Mechanistically, in TAMs COLEC12 sequestered STAT1 in the cytoplasm, preventing its phosphorylation, and thereby derepressing STAT3-mediated NRG1 transcription. Depletion of NRG1 reversed the stemness phenotypes and resensitized tumors to lenvatinib both in vitro and in vivo. Clinically, high NRG1 expression predicted an inferior lenvatinib response and shorter survival. Crucially, the bispecific anti-HER2/HER3 antibody zenocutuzumab restored lenvatinib efficacy in PDOs, PDXs, and murine models.
Conclusions
Our work establishes the COLEC12high TAM/NRG1 axis as a master regulator of therapeutic resistance and identifies NRG1 as a predictive biomarker, providing a clinically actionable strategy to overcome lenvatinib resistance in HCC.
4.Effect of Electroacupuncture on Metabolism-Inflammation Network in Patients with Simple Obesity:A Randomized Controlled Trial
Qi SHU ; Qiumei PENG ; Zhihao XU ; Shanshan FANG ; Wenjing SHAO ; Hongliang CHENG ; Rilong HUANG ; Qing YU ; Ronglin CAI
Journal of Traditional Chinese Medicine 2026;67(13):1415-1421
ObjectiveTo observe the clinical efficacy of electroacupuncture in treatment of simple obesity patients and its effects on the metabolism-inflammation network. MethodsSeventy-two patients with simple obesity were randomly divided into a electroacupuncture group and a sham electroacupuncture group, with 36 patients in each group. In the electroacupuncture group, conventional acupuncture was applied at Zhongwan (CV 12), bilateral Tianshu (ST 25), bilateral Daheng (SP15), Qihai (CV 6), Guanyuan (CV 4), bilateral Zusanli (ST 36) and Fenglong (ST 40). The sham electroacupuncture group used placebo needle at same acupoints as the electroacupuncture group. Both groups were given sparse-dense waves with a frequency of 2/10 Hz, 30 minutes per session, 3 times a week, for a total of 8 weeks of treatment. The changes of human body parameters including body weight, body mass index (BMI), waist circumference, and body fat percentage (BFP), metabolic factors including serum fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), leptin, and ghrelin, and inflammatory factors including interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) were compared before and after treatment. Correlations between changes in leptin, ghrelin and inflammatory factors were further analyzed. ResultsWaist circumference was significantly reduced after treatment in both groups compared with baseline (P<0.05), and the post-treatment waist circumference was lower in the electroacupuncture group than in the sham electroacupuncture group (P<0.05); body weight, BMI and BFP decreased significantly after treatment compared to pretreatment levels in the electroacupuncture group (P<0.05). Serum leptin, IL-6 and TNF-α declined significantly after treatment in both groups versus baseline (P<0.05); the electroacupuncture group had lower post-treatment levels of leptin, IL-6 and TNF-α as well as larger pre-post changes than the sham group (P<0.05); ghrelin increased markedly after treatment in both groups (P<0.05), with higher post-treatment ghrelin and greater pre-post variation observed in the electroacupuncture group (P<0.05). In the electroacupuncture group, changes in ghrelin were negatively correlated with IL-6 and positively correlated with TNF-α (P<0.01); in the sham electroacupuncture group, ghrelin changes were negatively correlated with both IL-6 and TNF-α, whereas leptin changes were positively correlated with the two inflammatory markers (P<0.01). ConclusionElectroacupuncture can effectively improve clinical manifestations, as well as regulate serum metabolic and pro-inflammatory factors in patients with simple obesity, and discrepant correlation patterns of metabolism-inflammation are observed between the two groups.
5.Construction of a nomogram prediction model for the risk of non-suicidal self-injury behaviors in adolescents with depressive disorder
Shanshan ZHANG ; Xiaoe LI ; Youxi JIANG ; Xin WANG ; Qi WANG ; Peishan HUANG ; Tianhui HUANG ; Qiangli DONG
Sichuan Mental Health 2026;39(4):309-317
BackgroundNon-suicidal self-injury (NSSI) has become a public health concern of wide interest. Adolescents with depressive disorder are at high risk of NSSI behaviors. Previous studies have mostly focused on analyzing factors associated with NSSI behaviors, while research on developing visual models that are intuitive, quantifiable, and suitable for rapid clinical assessment is relatively limited. ObjectiveTo investigate the risk factors for NSSI behaviors in adolescents with depressive disorder, and to construct a nomogram prediction model for the risk of NSSI behaviors occurrence, so as to provide a quantitative tool for clinical rapid assessment of the occurrence risk of NSSI behaviors in this population. MethodsA cross-sectional study was conducted. A total of 448 adolescent patients diagnosed with depressive disorder who attended the Mental Health Department of The Second Hospital, Lanzhou University from February to December 2025 and met the diagnostic criteria for depressive disorder as specified in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) were enrolled. All participants were randomly divided into the modeling group (n=313) and the validation group (n=135) at a ratio of 7∶3. Assessments were performed using the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), the Barratt Impulsiveness Scale-11 (BIS-11), the Childhood Trauma Questionnaire-short form (CTQ-SF), and the Pittsburgh Sleep Quality Index (PSQI). Binary Logistic regression analysis was applied to screen independent predictors of NSSI behaviors in the modeling group, and a nomogram was constructed accordingly. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the discrimination, calibration and clinical utility of the model, respectively. ResultsBinary Logistic regression analysis revealed that younger age, female sex, higher SDS score, higher BIS-11 score, higher CTQ-SF score, and higher PSQI score were risk factors for NSSI behaviors in adolescent patients with depressive disorder (OR=0.816, 2.671, 1.131, 1.030, 1.064, 1.102, P<0.05 or 0.01). The Hosmer-Lemeshow test of the nomogram prediction model constructed based on these six indicators showed a good fit (χ²=15.144, P=0.056). Model validation showed that the AUC was 0.895 for the modeling group and 0.891 for the validation group. The calibration curves suggested that the mean absolute errors between the actual values and the predicted values were 0.043 and 0.023, respectively. Decision curve analysis indicated that the model provided a clear net clinical benefit when the risk threshold was greater than 0.11. ConclusionThe nomogram model based on six indicators (age, sex, depressive symptom severity, impulsivity, childhood trauma, and sleep quality) for predicting NSSI risk in adolescent patients with depressive disorder exhibits good discrimination, calibration, and clinical application value. [Funded by National Natural Science Foundation of China (number, 82560281); Gansu Provincial Science and Technology Program (number, 25JRRA618); Gansu Provincial Health Industry Research Project (number, GSWSKY2025-13); The College Students' Innovation and Entrepreneurship Training Program of the Second Clinical Medical College of Lanzhou University (number, 20250050060)]
6.Analysis of the current status and influencing factors of cognitive function and sleep quality of elderly people in Shanghai community
Yanli ZHANG ; Meng WANG ; Xuechun WANG ; Shanshan HUANG ; Jiaoqi REN ; Houguang ZHOU
Chinese Journal of Clinical Medicine 2025;32(1):58-64
Objective To analyze the cognitive function and sleep quality of the elderly in Shanghai community, and explore the related influencing factors. Methods A stratified cluster random sampling method was used to select 8 community health centers in Shanghai for a questionnaire survey, including 3 677 elderly individuals who completed the “Comprehensive Health Status Survey of Elderly Residents in Shanghai” from September 2023 to November 2023. Basic information of the elderly was collected, including age, gender, education level, smoking, drinking, mahjong playing behavior, and exercise habits. The Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality of the elderly, subjective cognitive decline (SCD) self-assessment questionnaire and Mini-Mental State Examination (MMSE) were used to evaluate cognitive function, while the Hamilton Anxiety Scale (HAMA) and patient health questionnaire-9 (PHQ-9) were used to assess anxiety and depression levels, and the mini nutritional assessment (MNA) was used to evaluate nutritional status. According to the MMSE scores, the elderly were divided into three groups: no cognitive impairment (MMSE ≥ 27), mild cognitive impairment (MMSE 21-26), and moderate to severe cognitive impairment (MMSE ≤ 20). The general data, lifestyle habits, and scale scores of the three groups were compared. Ordered logistic regression was used to analyze the influencing factors of sleep quality. Results There were statistically significant differences in age, gender, waist circumference, body mass index (BMI), education level, pet ownership, smoking, drinking, mahjong playing behavior, exercise habits, and scale scores among the three groups (P<0.05). Logistic regression analysis showed that age, waist circumference, gender, drinking habits, mahjong playing behavior, and chronic comorbidities are influencing factors for the PSQI grading in the elderly (P<0.05). The MMSE score (OR=1.037, P=0.001), SCD score (OR=1.123, P<0.001), HAMA score (OR=1.183, P<0.001), PHQ-9 score (OR=1.249, P<0.001) are positive influencing factors for PSQI grading, while the MNA score is a negative influencing factor (OR=0.960, P=0.037). Conclusions Advanced age, female gender, low education level, no pet ownership, no mahjong playing behavior, no exercise habits, and poor sleep quality are risk factors for cognitive impairment in the elderly. Advanced age, female gender, no mahjong playing behavior and poor nutritional status are influencing factors for poor sleep quality in the elderly, and severe comorbidities, anxiety, depression, and subjective decline in cognitive function all affect sleep quality.
7.Evaluation value of C-reactive protein/albumin ratio combined with platelet count and Glasgow coma scale for prognosis of patients with heat stroke.
Shanshan SHI ; Zhengzhen WU ; Yong HUANG ; Xianglei FU
Chinese Critical Care Medicine 2025;37(2):160-164
OBJECTIVE:
To explore the prognostic value of C-reactive protein (CRP)/albumin (Alb) ratio combined with platelet count (PLT) and Glasgow coma score (GCS) in patients with heat stroke (HS).
METHODS:
A retrospective analysis was conducted on the clinical data of HS patients admitted to the department of intensive care unit (ICU) of Nanchong Central Hospital from May 1, 2020 to October 31, 2023. This included general information, admission GCS, laboratory indicators and 28-day prognosis. The differences in the above indicators were compared between two groups of patients with different prognoses. Statistically significant indicators from univariate analysis were included in multivariate Logistic regression analysis to screen for factors influencing 28-day mortality in HS patients. The predictive value of various influencing factors on the 28 days prognosis of HS patients were analyzed by receiver operator characteristic curve (ROC curve).
RESULTS:
A total of 73 HS patients were included, of whom 41 survived for 28-day and 32 died. There were no statistically significant differences in gender and age between the two groups of HS patients with different prognoses. The white blood cell count (WBC), neutrophil count (NEU), aspartate aminotransferase (AST), alanine aminotransferase (ALT), CRP, and CRP/Alb ratio in the death group were significantly higher than those of the survival group, and the admission GCS score, platelet count (PLT), total bilirubin (TBil) and Alb were significantly lower than the survival group [WBC (×109/L): 14.80 (11.44, 17.15) vs. 11.96 (9.47, 14.82), NEU (×109/L): 13.05 (8.56, 15.67) vs. 9.50 (6.68, 12.09), AST (U/L): 108.00 (52.70, 291.50) vs. 64.50 (38.25, 110.50), ALT (U/L): 62.00 (19.50, 159.00) vs. 34.50 (20.75, 70.75), CRP (mg/L): 22.49 (3.42, 58.93) vs. 3.68 (1.01, 11.46), CRP/Alb ratio: 0.53 (0.08, 1.77) vs. 0.08 (0.02, 0.44), GCS score: 7.0 (5.0, 8.0) vs. 8.5 (7.0, 11.0), PLT (×109/L): 107.00 (73.50, 126.00) vs. 131.50 (107.50, 176.25), TBil (mmol/L): 15.60 (10.00, 25.30) vs. 21.40 (14.80, 30.05), Alb (g/L): 32.65 (32.53, 49.30) vs. 38.70 (36.20, 40.40), all P < 0.05]. Binary Logistic regression analysis showed that the GCS score [odds ratio (OR) = 0.686, 95% confidence interval (95%CI) was 0.491-0.959, P = 0.028], PLT (OR = 0.973, 95%CI was 0.954-0.992, P = 0.005), NEU (OR = 1.312, 95%CI was 1.072-1.606, P = 0.009) and CRP/Alb ratio (OR = 7.652, 95%CI was 1.632-35.881, P = 0.010) were independent influencing factors for 28-day mortality in HS patients. ROC curve analysis showed that the area under the curve (AUC) of GCS score, PLT, and CRP/Alb ratio for single prediction of 28-day prognosis in HS patients was 0.705, 0.752, and 0.729, and the combination of all three predicted the highest AUC of 28-day prognosis in HS patients (0.917), with a sensitivity and specificity of 86.2% and 81.2%, respectively.
CONCLUSION
CRP/Alb ratio, PLT, and GCS score are independent influencing factors affecting the prognosis of HS patients, and all of them have a certain predictive value for the prognosis of HS patients, in which the combination of the three has a higher predictive value for the prognosis of HS patients.
Humans
;
C-Reactive Protein/analysis*
;
Prognosis
;
Glasgow Coma Scale
;
Retrospective Studies
;
Heat Stroke/diagnosis*
;
Platelet Count
;
Male
;
Female
;
Serum Albumin/analysis*
;
Middle Aged
;
Aged
;
Adult
;
ROC Curve
8.Impact of critical care warning platform on the clinical prognosis of patients transferred from internal medical ward to intensive care unit: a real-world cohort study.
Changde WU ; Shanshan CHEN ; Liwei HUANG ; Songqiao LIU ; Yuyan ZHANG ; Yi YANG
Chinese Critical Care Medicine 2025;37(4):381-385
OBJECTIVE:
To evaluate the impact of critical care warning platform (CWP) on clinical outcomes of patients transferred from internal medical ward to intensive care unit (ICU) based on real-world data.
METHODS:
A retrospective cohort study was conducted. The patients transferred from internal medical ward to ICU of Zhongda Hospital, Southeast University, between January 2022 and October 2024, were enrolled. They were divided into critical care warning group and conventional treatment group based on whether they were connected to the CWP. The patients in the critical care warning group were connected to the CWP, which collected real-time vital signs and treatment data. The platform automatically calculated severity scores, generated individualized risk assessments, and triggered warning alerts, allowing clinicians to adjust treatment plans accordingly. The patients in the conventional treatment group were not connected to the CWP and relied on conventional clinical judgment and nursing measures for treatment management. Baseline characteristics [gender, age, body mass index (BMI), admission type, severity score of illness, underlying diseases, and disease type at ICU admission], primary clinical outcome (in-hospital mortality), and secondary clinical outcomes [ICU mortality, length of ICU stay, total length of hospital stay, and mechanical ventilation and continuous renal replacement therapy (CRRT) status] were collected. Multivariate Logistic regression was used to analyze the impact of CWP on in-hospital death, and subgroup analyses were performed based on different patient characteristics.
RESULTS:
A total of 1 281 patients were enrolled, with 768 in the critical care warning group and 513 in the conventional treatment group. Compared with the conventional treatment group, the proportion of patients in the critical care warning group with underlying diseases of diabetes and malignancy and transferred to ICU due to sepsis was lowered, however, there were no statistically significant differences in other baseline characteristics between the two groups. Regarding the primary clinical outcome, the in-hospital mortality in the critical care warning group was significantly lower than that in the conventional treatment group [17.6% (135/768) vs. 25.7% (132/513), P < 0.01]. For secondary clinical outcomes, compared with the conventional treatment group, the patients in the critical care warning group had significantly fewer days of mechanical ventilation within 28 days [days: 2 (1, 6) vs. 2 (1, 8), P < 0.05], significantly shorter length of ICU stay [days: 3 (2, 8) vs. 4 (2, 10), P < 0.01], and significantly lower ICU mortality [15.1% (116/768) vs. 21.4% (110/513), P < 0.01]. Multivariate Logistic regression analysis showed that, after adjusting for age and underlying diseases, the use of CWP was significantly associated with a reduction of in-hospital mortality among patients transferred from internal medical ward to ICU [odds ratio (OR) = 0.670, 95% confidence interval (95%CI) was 0.502-0.894, P = 0.006]. Further subgroup analysis revealed that, among patients transferred to ICU due to sepsis, the use of CWP significantly reduced in-hospital mortality (OR = 0.514, 95%CI was 0.367-0.722, P < 0.001). In patients aged ≥ 70 years old (OR = 0.587, 95%CI was 0.415-0.831, P = 0.003) and those with underlying diseases of malignancy (OR = 0.124, 95%CI was 0.046-0.330, P < 0.001), CWP also showed significant protective effects on in-hospital prognosis.
CONCLUSION
The use of CWP is significantly associated with a reduction in in-hospital mortality among patients transferred from internal medical ward to ICU, demonstrating its potential in assessing the deterioration of hospitalized patients.
Humans
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Intensive Care Units
;
Retrospective Studies
;
Hospital Mortality
;
Prognosis
;
Critical Care
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Male
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Female
;
Patient Transfer
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Middle Aged
;
Aged
;
Cohort Studies
9.Early warning method for invasive mechanical ventilation in septic patients based on machine learning model.
Wanjun LIU ; Wenyan XIAO ; Jin ZHANG ; Juanjuan HU ; Shanshan HUANG ; Yu LIU ; Tianfeng HUA ; Min YANG
Chinese Critical Care Medicine 2025;37(7):644-650
OBJECTIVE:
To develop a method for identifying high-risk patients among septic populations requiring mechanical ventilation, and to conduct phenotypic analysis based on this method.
METHODS:
Data from four sources were utilized: the Medical Information Mart for Intensive Care (MIMIC-IV 2.0, MIMIC-III 1.4), the Philips eICU-Collaborative Research Database 2.0 (eICU-CRD 2.0), and the Anhui Medical University Second Affiliated Hospital dataset. The adult patients in intensive care unit (ICU) who met Sepsis-3 and received invasive mechanical ventilation (IMV) on the first day of first admission were enrolled. The MIMIC-IV dataset with the highest data integrity was divided into a training set and a test set at a 6:1 ratio, while the remaining datasets were served as validation sets. The demographic information, comorbidities, laboratory indicators, commonly used ICU scores, and treatment measures of patients were extracted. Clinical data collected within first day of ICU admission were used to calculate the sequential organ failure assessment (SOFA) score. K-means clustering was applied to cluster SOFA score components, and the sum of squared errors (SSE) and Davies-Bouldin index (DBI) were used to determine the optimal number of disease subtypes. For clustering results, normalized methods were employed to compare baseline characteristics by visualization, and Kaplan-Meier curves were used to analyze clinical outcomes across phenotypes.
RESULTS:
This study enrolled patients from MIMIC-IV dataset (n = 11 166), MIMIC-III dataset (n = 4 821), eICU-CRD dataset (n = 6 624), and a local dataset (n = 110), with the four datasets showing similar median ages and male proportions exceeding 50%; using 85% of the MIMIC-IV dataset as the training set, 15% as the test set, and the rest dataset as the validation set. K-means clustering based on the six-item SOFA score was performed to determine the optimal number of clusters as 3, and patients were finally classified into three phenotypes. In the training set, compared with the patients with phenotype II and phenotype III, those with phenotype I had the more severe circulatory and respiratory dysfunction, a higher proportion of vasoactive drug usage, more obvious metabolic acidosis and hypoxia, and a higher incidence of congestive heart failure. The patients with phenotype II was dominated by respiratory dysfunction with higher visceral injury. The patients with phenotype III had relatively stable organ function. The above characteristics were consistent in both the test and validation sets. Analysis of infection-related indicators showed that the patients with phenotype I had the highest SOFA score within 7 days after ICU admission, initial decreases and later increases in platelet count (PLT), and higher counts of neutrophils, lymphocytes, and monocytes as compared with those with phenotype II and phenotype III, their blood cultures had a higher positivity rates for Gram-positive bacteria, Gram-negative bacteria and fungi as compared with those with phenotype II and phenotype III. The Kaplan-Meier curve indicated that in the training, test, and validation sets, the 28-day cumulative mortality of patients with phenotype I was significantly higher than that of patients with phenotypes II and phenotype III.
CONCLUSIONS
Three distinct phenotypes in septic patients receiving IMV based on unsupervised machine learning is derived, among which phenotype I, characterized by cardiorespiratory failure, can be used for the early identification of high-risk patients in this population. Moreover, this population is more prone to bloodstream infections, posing a high risk and having a poor prognosis.
Humans
;
Machine Learning
;
Sepsis/therapy*
;
Respiration, Artificial
;
Intensive Care Units
;
Organ Dysfunction Scores
;
Male
;
Female
;
Middle Aged
;
Adult
10.Cloning and functional analysis of GmMAX2b involved in disease resistance.
Jiahui FU ; Lin ZUO ; Weiqun HUANG ; Song SUN ; Liangyu GUO ; Min HU ; Peilan LU ; Shanshan LIN ; Kangjing LIANG ; Xinli SUN ; Qi JIA
Chinese Journal of Biotechnology 2025;41(7):2803-2817
The plant F-box protein more axillary growth 2 (MAX2) is a key factor in the signal transduction of strigolactones (SLs) and karrinkins (KARs). As the main component of the SKP1-CUL1-FBX (SCF) complex ubiquitin ligase E3, MAX2 is responsible for specifically recognizing the target proteins, suppressor of MAX2 1/SMAX1-like proteins (SMAX1/SMXLs), which would be degraded after ubiquitination. It can thereby regulate plant morphogenesis and stress responses. There exist homologous genes of MAX2 in the important grain and oil crop soybean (Glycine max). However, its role in plant defense responses has not been investigated yet. Here, GmMAX2b, a homologous gene of MAX2, was successfully cloned from stressed soybean. Bioinformatics analysis revealed that there were two MAX2 homologous genes, GmMAX2a and GmMAX2b, with a similarity of 96.2% in soybean. Their F-box regions were highly conserved. The sequence alignment and cluster analysis of plant MAX2 homologous proteins basically reflected the evolutionary relationship of plants and also suggested that soybean MAX2 might be a multifunctional protein. Expression analysis showed that plant pathogen infection and salicylic acid treatment induced the expression of GmMAX2b in soybean, which is consistent with that of MAX2 in Arabidopsis. Ectopic expression of GmMAX2b compensated for the susceptibility of Arabidopsis max2-2 mutant to pathogen, indicating that GmMAX2b positively regulated plant disease resistance. In addition, yeast two hybrid technology was used to explore the potential target proteins of GmMAX2b. The results showed that GmMAX2b interacted with SMXL6 and weakly interacted with SMXL2. In summary, GmMAX2b is a positive regulator in plant defense responses, and its expression is induced by pathogen infection and salicylic acid treatment. GmMAX2b might exert its effect through interaction with SMXL6 and SMXL2. This study expands the theoretical exploration of soybean disease resistant F-box and provides a scientific basis for future soybean disease resistant breeding.
Glycine max/metabolism*
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Disease Resistance/genetics*
;
Plant Diseases/immunology*
;
Plant Proteins/genetics*
;
Cloning, Molecular
;
Gene Expression Regulation, Plant
;
F-Box Proteins/genetics*
;
Arabidopsis/genetics*
;
Phylogeny

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