1.Jianpi Yiqi Prescription Inhibits Proliferation and Invasion of Hepatic Carcinoma Cells by Targeting PTPN1
Shanshan SUN ; Jing HONG ; Shufan SONG ; Zongxi SUN ; Chao WANG ; Shaoyuan ZHUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):80-88
ObjectiveTo investigate the key targets of Jianpi Yiqi prescription (JYP) in the treatment of hepatocellular carcinoma (HCC) based on network pharmacology and explore the effect of JYP on the invasion and proliferation of hepatocellular carcinoma cells via protein tyrosine phosphatase, non-receptor type 1 (PTPN1) by bioinformatics analysis and CRISPR/Cas9. MethodsThe potential targets of JYP in the treatment of HCC were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), SwissTargetPrediction, GeneCards, NCBI, and CTD. Additionally, the active components of JYP that could interact with PTPN1 were screened out, and then molecular docking between the targets and active components was performed in Autodock 4.0. UALCAN, HPA, and LinkedOmics were used to analyze the expression of PTPN1 in the HCC tissue, and the relationship of PTPN1 expression with the overall survival (OS) of HCC patients was discussed. CRISPR/Cas9 was used to knock down the expression of PTPN1 in HepG2 and SK-hep-1 cells, and the knockdown effect was examined by sequencing, Real-time PCR, and Western blot. HepG2 cells were classified into blank control, low-, medium-, and high-dose JYP (5.25, 10.5, 21 g·kg-1), and PTPN1 knockout groups. Real-time PCR and Western blot were employed to determine the mRNA and protein levels, respectively, of PTPN1 in HepG2 cells of each group. The effects of JYP and PTPN1 knockdown on the proliferation, invasion, and apoptosis of HepG2 cells were detected by Cell Counting Kit-8 (CCK-8), Transwell, and Annexin V-FITC/PI methods, respectively. ResultsJYP had the most active components targeting PTPN1, and 31 of the active components had the binding energy less than -5.0 kcal·mol-1 in molecular docking. The mRNA and protein levels of PTPN1 in the HCC tissue were higher than those in the normal tissue (P<0.01). Compared with that in the normal tissue, the mRNA level of PTPN1 in the HCC tissue was up-regulated at the pathological stages Ⅰ-Ⅲ and grades G1-G3 (P<0.01), and it was not significantly up-regulated at the stage Ⅳ or grade G4. The mRNA level of PTPN1 in the TP53-mutated HCC tissue was higher than that in the TP53-unmutated HCC tissue (P<0.01). The high mRNA level of PTPN1 was associated with the OS reduction (P<0.01). After treatment with the JYP-containing serum or knockdown of PTPN1, HepG2 cells demonstrated decreased proliferation and invasion and increased apoptosis (P<0.01). ConclusionPTPN1 may be one of the core targets of JYP in the treatment of HCC. It is highly expressed in the HCC tissue and cells, which is associated with the poor prognosis of patients. The expression level of PTPN1 is significantly up-regulated in the HCC tissue of the patients with TP53 mutation. However, TP53 mutation or deletion does not affect the expression of PTPN1 in HCC cells. JYP can significantly down-regulate the expression of PTPN1 to inhibit the proliferation and invasion and promote the apoptosis of HCC cells.
2.Influence of Gene Mutation on the Effectiveness of Arsenic-Containing Herbal Compound Formula in Treatment of Myelodysplastic Syndromes of Different TCM Patterns
Zichun WANG ; Zhuo CHEN ; Dexiu WANG ; Haiyan XIAO ; Weiyi LIU ; Ruibai LI ; Chi LIU ; Fengmei WANG ; Shanshan ZHANG ; Mingjing WANG ; Liu LI ; Xiaoqing GUO ; Hongzhi WANG ; Xudong TANG
Journal of Traditional Chinese Medicine 2025;66(14):1463-1472
ObjectiveTo observe the effect of gene mutation on the effectiveness of arsenic-containing Chinese herbal compound formulas in the treatment of myelodysplastic syndromes (MDS) of different traditional Chinese medicine (TCM) patterns, so as to provide the basis for the clinical application. MethodsClinical data of 442 MDS patients who were treated with arsenic-containing herbal compound formulas were retrospectively collected, including the baseline demographic and clinical characteristics of the patients. Based on the TCM four examinations, the patients were divided into the spleen-kidney deficiency group as well as the qi-yin deficiency group, and according to the results of the next-generation sequencing (NGS) test, they were divided into the group with and without gene mutation respectively. The influence of gene mutation on the clinical effectiveness of patients with different TCM patterns was analyzed, the baseline demographic and clinical characteristics of the patients with different outcomes of the two TCM patterns were compared, and multivariate Logistic regression analysis was conducted on the influencing factors of the effective rate of MDS patients with gene mutation. ResultsA total of 190 cases were included in the spleen-kidney deficiency group (119 cases with gene mutation) and 43 cases in the qi-yin deficiency group (23 cases with gene mutation). No statistically significant differences were noted in effectiveness assessment, total effective rate, and total response rate between the spleen-kidney deficiency group and the qi-yin deficiency group (P>0.05). In the spleen-kidney deficiency group, the total effective rate of MDS with gene mutation was 65.55% (78/119), which was lower than 80.28% (57/71) of MDS without gene mutation, with statistical significance (P = 0.033), while no statistical differences in effectiveness assessment and total response rate were noted (P>0.05). In the qi-yin deficiency group, no statistical differences were observed in effectiveness assessment, total effective rate, and total response rate of the patients in with or without gene mutation (P>0.05). In the spleen-kidney deficiency group with gene mutation, the rate of complex karyotype (P = 0.031) and the mutation rate of CBL gene (P = 0.032) in the ineffective population were higher than those in the effective population, while the mutation rate of DDX41 gene in the effective population was higher than that in the ineffective population (P = 0.033). No statistically significant differences were found in other gene mutations, age, gender distribution, number of gene mutations, bone marrow hyperplasia degree, blast cell range, reticular fiber tissue proliferation or not, and prognosis of chromosomal abnormalities between the effective and ineffective populations (P>0.05). In the qi-yin deficiency group with gene mutation, no statistically significant differences were found in various items between populations with different outcomes (P>0.05). Multivariate Logistic regression analysis showed that complex karyotype, CBL mutation, and DDX41 mutation were independently associated with the effective rate of MDS with spleen-kidney deficiency and gene mutation (P<0.05). DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group (OR>1), while complex karyotype and CBL mutation were independent risk factors (OR<1). ConclusionThe arsenic-containing TCM compound formulas exhibited better effectiveness in MDS with spleen-kidney deficiency pattern without mutation; and in MDS with spleen-kidney deficiency pattern without complex karyotypes, CBL mutation, and with DDX41 mutations. Furthermore, DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group, while complex karyotype and CBL mutation were independent risk factors. In MDS with qi-yin deficiency pattern, gene mutation-related factors showed no significant impact on the effectiveness of arsenic-containing TCM compound formulas.
3.Prognosis and treatment for giant placental chorioangioma: an analysis of literatures
Xiaomin ZHAO ; Yongmei SHEN ; Wen LI ; Liying YAO ; Lei ZHANG ; Shanshan LI ; Zhuo WEI ; Ying CHANG
Chinese Journal of Perinatal Medicine 2025;28(6):479-487
Objective:To analyze the impact of different intrauterine intervention methods and types of complications on fetal prognosis in cases of giant placental chorioangioma (CA), and determine the indications for various treatment methods by analyzing cases of adverse outcomes.Methods:Relevant articles were retrieved from China National Knowledge Infrastructure, VIP Database, Wanfang Database, and Yiigle using the keywords "placental chorioangioma" and "fetal edema" or "anemia" or "cardiomegaly" or "polyhydramnios," and from PubMed, Embase, and UpToDate databases using the keywords "placental chorionic angioma or chorioangioma" and "fetal edema" or "anemia" or "polyhydramnios" or "hyperdynamic circulation" up to June 30th 2023. The size of the angiomas, fetal complications, intrauterine intervention methods, gestational weeks at intervention, and pregnancy outcomes were analyzed. Fetal and neonatal deaths were defined as adverse outcomes. Statistical analysis was performed using an independent sample t-test, rank-sum test, or Chi-square test (continuity correction Chi-square test or Pearson Chi-square test). Results:(1) A total of 582 articles were retrieved, and 51 articles were finally included, comprising 65 cases. Based on the intrauterine intervention methods, these cases were divided into the symptomatic treatment group (17 cases) and the etiological treatment group (48 cases). There were no statistically significant differences between the two groups in the maximum diameter of the angiomas, the gestational weeks at intervention, or the gestational weeks at delivery. (2) The incidence of adverse outcomes was 3/17 in the symptomatic treatment group and 27.1% (13/48) in the etiological treatment group, with no statistically significant difference. In the etiological treatment group, the incidence of adverse outcomes in cases with fetal edema was 45.4% (10/22), which was significantly higher than the 11.5% (3/26) in cases without fetal edema, and the difference was statistically significant ( χ 2=6.94, P=0.008). (3) An analysis of 13 cases with adverse outcomes revealed that nine cases had highly vascularized chorioangiomas and/or blood supply vessels located close to the umbilical cord insertion point on the placenta, and nine were complicated by fetal edema. The incidence of adverse outcomes for fetoscopic laser coagulation/bipolar coagulation, radiofrequency or microwave ablation, bioglue embolization, anhydrous alcohol ablation, and microcoil embolization were 4/19, 3/4, 1/8, 2/9, and 3/6, respectively. Conclusions:Intrauterine treatment of CA should be individualized. Bioglue embolization may be the first-line treatment; Fetoscopic laser coagulation can be applied to cases where the blood supply vessels are small and superficial;Interstitial laser ablation and radiofrequency ablation can be used for branch-type CA when the main blood supply vessels are located within the hemangioma; Anhydrous alcohol ablation is contraindicated due to its risk of fetal circulation entry; Microcoil embolization has the risk of incomplete occlusion, which should be used with caution.
4.Impact of high-risk cytogenetic abnormalities on the efficacy of allogeneic hematopoietic stem cell transplantation with post-transplantation Cyclophosphamide in pediatric patients with acute myeloid leukemia
Fei LONG ; Zhi CHEN ; Li YANG ; Zhuo WANG ; Yan CHEN ; Yu DU ; Wenjie LU ; Ming SUN ; Shanshan QI ; Hao XIONG
Chinese Journal of Applied Clinical Pediatrics 2025;40(12):939-945
Objective:To explore the influence of initial high-risk cytogenetic abnormalities on the outcomes of children with acute myeloid leukemia (AML) after post-transplant Cyclophosphamide (PTCy)-based allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A retrospective cohort study.AML children who underwent PTCy-based allo-HSCT after the first complete remission at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2017 and April 2024 were enrolled.Patients were divided into intermediate-risk and high-risk groups based on their initial cytogenetic features.These patients were further divided into complex karyotype, 11q23 rearrangement, and other karyotype groups.Clinical characteristics and survival outcomes were compared among these groups.Measurement and count data were analyzed using Wilcoxon rank-sum/Kruskal-Wallis and χ2 tests, respectively.Survival and risk factor analyses were performed using Kaplan-Meier and Cox proportional hazards methods, respectively. Results:A total of 51 AML children who underwent allo-HSCT were included in this study.The median age at transplantation was 3.2 years and the median follow-up time was 4.6 years.There were 26 cases in the intermediate-risk group and 25 cases in the high-risk group; 8 cases in the complex karyotype group, 14 cases in the 11q23 rearrangement group, and 29 cases in the other karyotype groups.By the end of the follow-up on November 30, 2024, 11 patients relapsed, 8 patients died, and 13 patients developed grades Ⅱ-Ⅳ acute graft-versus-host disease (GVHD).The 3-year overall survival (OS), relapse-free survival (RFS), and grades Ⅱ-Ⅳ acute GVHD-free and relapse-free survival (GRFS) were 84.0% (95% CI: 74.4%-94.8%), 74.5% (95% CI: 63.4%-87.5%), and 58.8% (95% CI: 46.7%-74.0%), respectively.The 3-year OS of the high-risk group was significantly lower than that of the intermediate-risk group (71.8% vs.96.2%, P=0.022), while differences in 3-year RFS and GRFS between the 2 groups were not statistically significant (68.0% vs.80.8%, P=0.400; 52.0% vs.65.4%, P=0.420).The 3-year OS, RFS and GRFS of the complex karyotype group were significantly lower than those of 11q23 rearrangement and other karyotype groups (50.0% vs.85.7%, 93.1%, P=0.009; 37.5% vs.85.7%, 79.3%, P=0.022; 25.0% vs.64.3%, 65.5%, P=0.049).Multivariate analysis showed that a complex karyotype was an independent prognostic factor affecting 3-year OS and GRFS [OS: HR=6.79 (95% CI: 1.13-43.80), P=0.044; GRFS: HR=3.72(95% CI: 1.13-12.20), P=0.030]. Conclusions:High-risk cytogenetic features are significant predictors of survival outcomes in pediatric AML patients undergoing PTCy-based allo-HSCT.
5.Impact of high-risk cytogenetic abnormalities on the efficacy of allogeneic hematopoietic stem cell transplantation with post-transplantation Cyclophosphamide in pediatric patients with acute myeloid leukemia
Fei LONG ; Zhi CHEN ; Li YANG ; Zhuo WANG ; Yan CHEN ; Yu DU ; Wenjie LU ; Ming SUN ; Shanshan QI ; Hao XIONG
Chinese Journal of Applied Clinical Pediatrics 2025;40(12):939-945
Objective:To explore the influence of initial high-risk cytogenetic abnormalities on the outcomes of children with acute myeloid leukemia (AML) after post-transplant Cyclophosphamide (PTCy)-based allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A retrospective cohort study.AML children who underwent PTCy-based allo-HSCT after the first complete remission at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2017 and April 2024 were enrolled.Patients were divided into intermediate-risk and high-risk groups based on their initial cytogenetic features.These patients were further divided into complex karyotype, 11q23 rearrangement, and other karyotype groups.Clinical characteristics and survival outcomes were compared among these groups.Measurement and count data were analyzed using Wilcoxon rank-sum/Kruskal-Wallis and χ2 tests, respectively.Survival and risk factor analyses were performed using Kaplan-Meier and Cox proportional hazards methods, respectively. Results:A total of 51 AML children who underwent allo-HSCT were included in this study.The median age at transplantation was 3.2 years and the median follow-up time was 4.6 years.There were 26 cases in the intermediate-risk group and 25 cases in the high-risk group; 8 cases in the complex karyotype group, 14 cases in the 11q23 rearrangement group, and 29 cases in the other karyotype groups.By the end of the follow-up on November 30, 2024, 11 patients relapsed, 8 patients died, and 13 patients developed grades Ⅱ-Ⅳ acute graft-versus-host disease (GVHD).The 3-year overall survival (OS), relapse-free survival (RFS), and grades Ⅱ-Ⅳ acute GVHD-free and relapse-free survival (GRFS) were 84.0% (95% CI: 74.4%-94.8%), 74.5% (95% CI: 63.4%-87.5%), and 58.8% (95% CI: 46.7%-74.0%), respectively.The 3-year OS of the high-risk group was significantly lower than that of the intermediate-risk group (71.8% vs.96.2%, P=0.022), while differences in 3-year RFS and GRFS between the 2 groups were not statistically significant (68.0% vs.80.8%, P=0.400; 52.0% vs.65.4%, P=0.420).The 3-year OS, RFS and GRFS of the complex karyotype group were significantly lower than those of 11q23 rearrangement and other karyotype groups (50.0% vs.85.7%, 93.1%, P=0.009; 37.5% vs.85.7%, 79.3%, P=0.022; 25.0% vs.64.3%, 65.5%, P=0.049).Multivariate analysis showed that a complex karyotype was an independent prognostic factor affecting 3-year OS and GRFS [OS: HR=6.79 (95% CI: 1.13-43.80), P=0.044; GRFS: HR=3.72(95% CI: 1.13-12.20), P=0.030]. Conclusions:High-risk cytogenetic features are significant predictors of survival outcomes in pediatric AML patients undergoing PTCy-based allo-HSCT.
6.Prognosis and treatment for giant placental chorioangioma: an analysis of literatures
Xiaomin ZHAO ; Yongmei SHEN ; Wen LI ; Liying YAO ; Lei ZHANG ; Shanshan LI ; Zhuo WEI ; Ying CHANG
Chinese Journal of Perinatal Medicine 2025;28(6):479-487
Objective:To analyze the impact of different intrauterine intervention methods and types of complications on fetal prognosis in cases of giant placental chorioangioma (CA), and determine the indications for various treatment methods by analyzing cases of adverse outcomes.Methods:Relevant articles were retrieved from China National Knowledge Infrastructure, VIP Database, Wanfang Database, and Yiigle using the keywords "placental chorioangioma" and "fetal edema" or "anemia" or "cardiomegaly" or "polyhydramnios," and from PubMed, Embase, and UpToDate databases using the keywords "placental chorionic angioma or chorioangioma" and "fetal edema" or "anemia" or "polyhydramnios" or "hyperdynamic circulation" up to June 30th 2023. The size of the angiomas, fetal complications, intrauterine intervention methods, gestational weeks at intervention, and pregnancy outcomes were analyzed. Fetal and neonatal deaths were defined as adverse outcomes. Statistical analysis was performed using an independent sample t-test, rank-sum test, or Chi-square test (continuity correction Chi-square test or Pearson Chi-square test). Results:(1) A total of 582 articles were retrieved, and 51 articles were finally included, comprising 65 cases. Based on the intrauterine intervention methods, these cases were divided into the symptomatic treatment group (17 cases) and the etiological treatment group (48 cases). There were no statistically significant differences between the two groups in the maximum diameter of the angiomas, the gestational weeks at intervention, or the gestational weeks at delivery. (2) The incidence of adverse outcomes was 3/17 in the symptomatic treatment group and 27.1% (13/48) in the etiological treatment group, with no statistically significant difference. In the etiological treatment group, the incidence of adverse outcomes in cases with fetal edema was 45.4% (10/22), which was significantly higher than the 11.5% (3/26) in cases without fetal edema, and the difference was statistically significant ( χ 2=6.94, P=0.008). (3) An analysis of 13 cases with adverse outcomes revealed that nine cases had highly vascularized chorioangiomas and/or blood supply vessels located close to the umbilical cord insertion point on the placenta, and nine were complicated by fetal edema. The incidence of adverse outcomes for fetoscopic laser coagulation/bipolar coagulation, radiofrequency or microwave ablation, bioglue embolization, anhydrous alcohol ablation, and microcoil embolization were 4/19, 3/4, 1/8, 2/9, and 3/6, respectively. Conclusions:Intrauterine treatment of CA should be individualized. Bioglue embolization may be the first-line treatment; Fetoscopic laser coagulation can be applied to cases where the blood supply vessels are small and superficial;Interstitial laser ablation and radiofrequency ablation can be used for branch-type CA when the main blood supply vessels are located within the hemangioma; Anhydrous alcohol ablation is contraindicated due to its risk of fetal circulation entry; Microcoil embolization has the risk of incomplete occlusion, which should be used with caution.
7.Correlation Between Expression of HIF-1α and Prognosis of Arsenic-containing Chinese Herbal Compound in Treatment of Myelodysplastic Syndrome
Peizhen JIANG ; Xiupeng YANG ; Dexiu WANG ; Wenru WANG ; Yan LYU ; Weiyi LIU ; Zhuo CHEN ; Hongzhi WANG ; Xiaoqing GUO ; Shanshan ZHANG ; Yonggang XU ; Xudong TANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):101-107
ObjectiveMyelodysplastic syndromes (MDS) is a group of clonal hematopoietic stem cell disorders,and this study aims to investigate the expression of hypoxia-inducible factor-1α(HIF-1α) in the bone marrow cells of patients with MDS and its correlation with the clinical features of MDS,the therapeutic efficacy of arsenic-containing Chineseherbal compound,and the survival prognosis. MethodAccording to the inclusion and exclusion criteria,27 MDS patients treated with arsenic-containing Chinese herbal compound in the Department of Hematology,Xiyuan Hospital,China Academy of Chinese Medical Sciences from January 2022 to September 2022 were included,and their bone marrow samples were collected by myelotomy. HIF-1α expression level in bone marrow cells was detected by real-time polymerase chain reaction (PCR) to analyze its correlation with clinical features,and logistic and Cox regression was used to analyze the risk factors affecting the efficacy and prognostic survival of MDS patients. ResultThe HIF-1α mRNA expression level was lower in bone marrow cells of MDS patients than in healthy subjects. HIF-1α was positively correlated with the degree of myelodysplasia(r=0.384,P<0.05) and bone marrow granulocytic system%(G%)(r=0.560,P<0.01). Logistic regression showed that HIF-1α was a risk factor for the prognosis in the follow-up of the efficacy of treatment(P<0.05)and Cox regression showed that HIF-1α was an independent factor affecting the survival prognosis of MDS patients [odds ratio(OR)=398.968,95% confidence interval(CI)(1.281,116 858.743),P<0.05]. ConclusionThe level of HIF-1α expression in bone marrow cells of MDS patients was closely related to the degree of clinical myelodysplasia and G%,and HIF-1α was a risk factor for the efficacy for and survival prognosis of MDS patients.
8.Study on the mechanism of Yifei xuanfei jiangzhuo formula against vascular dementia
Guifeng ZHUO ; Wei CHEN ; Jinzhi ZHANG ; Deqing HUANG ; Bingmao YUAN ; Shanshan PU ; Xiaomin ZHU ; Naibin LIAO ; Mingyang SU ; Xiangyi CHEN ; Yulan FU ; Lin WU
China Pharmacy 2024;35(18):2207-2212
OBJECTIVE To investigate the mechanism of Yifei xuanfei jiangzhuo formula (YFXF) against vascular dementia (VD). METHODS The differentially expressed genes of YFXF (YDEGs) were obtained by network pharmacology. High-risk genes were screened from YDEGs by using the nomogram model. The optimal machine learning models in generalized linear, support vector machine, extreme gradient boosting and random forest models were screened based on high-risk genes. VD model rats were established by bilateral common carotid artery occlusion, and were randomly divided into model group and YFXF group (12.18 g/kg, by the total amount of crude drugs), and sham operation group was established additionally, with 6 rats in each group. The effects of YFXF on behavior (using escape latency and times of crossing platform as indexes), histopathologic changes of cerebral cortex, and the expression of proteins related to the secreted phosphoprotein 1 (SPP1)/phosphoinositide 3-kinase (PI3K)/protein kinase B (aka Akt) signaling pathway and the mRNA expression of SPP1 in cerebral cortex of VD rats were evaluated. RESULTS A total of 6 YDEGs were obtained, among which SPP1, CCL2, HMOX1 and HSPB1 may be high-risk genes of VD. The generalized linear model based on high-risk genes had the highest prediction accuracy (area under the curve of 0.954). Compared with the model group, YFXF could significantly shorten the escape latency of VD rats, significantly increase the times of crossing platform (P<0.05); improve the pathological damage of cerebral cortex, such as neuronal shrinkage and neuronal necrosis; significantly reduce the expressions of SPP1 protein and mRNA (P<0.05), while significantly increase the phosphorylation levels of PI3K and Akt (P<0.05). CONCLUSIONS VD high-risk genes SPP1, CCL2, HMOX1 and HSPB1 may be the important targets of YFXF. YFXF may play an anti-VD role by down-regulating the protein and mRNA expressions of SPP1 and activating PI3K/Akt signaling pathway.
9.Determination of Traditional Chinese Medicine Syndrome of Rat Model of Follicular Dysplasia Induced by Tripterygium Glycosides Based on Prescriptions via AMPK/mTOR/HIF-1/VEGF Pathway
Yingying HU ; Xuejuan LIN ; Zushun ZHUO ; Shanshan DING ; Mengting ZHANG ; Guorong LIN ; Long ZHU ; Yuyu XIE ; Yan XIONG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):46-54
ObjectiveTo determine the syndrome of a rat model of follicular dysplasia induced by Tripterygium glycosides based on prescriptions and investigate the mechanism of traditional Chinese medicine intervention via the adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR)/hypoxia-inducible factor-1 (HIF-1)/vascular endothelial growth factor (VEGF) pathway. MethodForty-eight rats with regular estrous cycles were randomly assigned into a normal group (n=8) and a modeling group (n=40). The rats in the modeling group were administrated with Tripterygium glycoside suspension (75 mL·kg-1) by gavage for 30 days. The modeled rats were assigned into model, Siwutang (3.69 g·kg-1), Youguiyin (3.11 g·kg-1), Zuoguiyin (7.29 g·kg-1), and Guishenwan (10.35 g·kg-1) groups, with 8 rats in each group. The drug intervention lasted for 14 days. The changes of estrous cycle were detected by Pap staining, and a stereoscope was used to observe the morphology of the ovarian tissue. Hematoxylin-eosin staining was employed to observe the pathological changes and follicle count in the ovarian tissue. Enzyme-related immunosorbent assay (ELISA) was used to measure the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) in the serum. Real-time fluorescence quantitative polymerase chain reaction and Western blot were employed to determine the mRNA and protein levels, respectively, of AMPK, mTOR, HIF-1, and VEGF in the ovarian tissue. ResultCompared with the normal group, the model group had a disordered estrous cycle, reduced secondary and mature follicles, increased atretic follicles, elevated FSH and LH levels, lowered E2 level, up-regulated mRNA and protein levels of AMPK, and down-regulated mRNA and protein levels of mTOR, HIF-1, and VEGF (P<0.01). Compared with the model group, Guishenwan increased secondary and mature follicles, decreased atretic follicles, lowered the FSH and LH levels, elevated the E2 level, down-regulated the mRNA and protein levels of AMPK, and up-regulated the mRNA and protein levels of mTOR, HIF-1, and VEGF (P<0.01). Compared with Guishenwan group, Siwutang, Youguiyin, and Zuoguiyin decreased mature follicles, increased atretic follicles (P<0.01), elevated the LH (P<0.01) and FSH (P<0.05) levels, and lowered the E2 level (P<0.05). In addition, Youguiyin up-regulated the protein level of AMPK (P<0.05) and down-regulated the mRNA levels of mTOR and HIF-1 (P<0.01) as well as the mRNA and protein levels of VEGF (P<0.01). Siwutang down-regulated the mRNA levels of mTOR and HIF-1 as well as the mRNA and protein levels of VEGF (P<0.05). Zuoguiyin down-regulated the mRNA level of mTOR and the protein and mRNA levels of VEGF (P<0.05). ConclusionGuishenwan may improve the ovarian function and promote follicle maturation in a rat model of follicular dysplasia by inhibiting the AMPK/mTOR/HIF-1/VEGF pathway, with the therapeutic effect superior to Zuoguiyin, Youguiyin, and Siwutang. It was hypothesized that this model presented the syndrome of kidney-essence deficiency.
10.Study on the effect of non-invasive correction of infants with congenital auricular deformity
Shanshan ZHUO ; Haitang REN ; Jing PANG ; Min WANG
Chinese Journal of Plastic Surgery 2024;40(8):870-877
Objective:To investigate the effect and influencing factors of non-invasive correction of infants with congenital auricular deformity.Methods:The data of infants with congenital auricular deformity were retrospectively analyzed, who were treated with domestic external ear orthosis in the Department of Otolaryngology Head and Neck Surgery of Tianjin Hospital from January 1, 2019 to June 30, 2023. Before treatment, the skin was prepared routinely. First, the orthosis base was installed and pressed to fit the skin around the ear. Then, according to the type of auricle deformity, the ear hook and ear cover were installed, and the adhesive tape was fixed. During the corrective treatment, the orthosis was worn all day, and the treatment was ended if there was no obvious rebound after 1 month of observation. The complications were closely observed during treatment. After the treatment, the treatment effect was evaluated and divided into markedly effective, effective and ineffective. The markedly effective rate (markedly effective ears/total ears × 100%) and effective rate [(markedly effective ears + effective ears)/ total ears × 100%] were calculated. At the same time, the cure time of the markedly effective children was recorded, and they were grouped according to different types of auricle deformities and the initial age of correction (<2, 2-6, >6 weeks groups), and the related indicators were compared. SPSS 23.0 software was used for statistical analysis. The measurement data were expressed by Mean±SD. The comparison between multiple groups was analyzed by one-way ANOVA. The pairwise comparison between groups was performed by LSD method. The counting data was expressed by frequency (% or ratio). The comparison between multiple groups was performed by χ 2 test, and the pairwise comparison between groups was performed by Fisher test with adjusted α value. Results:A total of 31 cases (55 ears) were included, including 13 males (23 ears) and 18 females (32 ears), aged 4 to 127 d. There were 13 lop ears, 6 constricted ears, 6 cup ears, 4 Stahl’s ears, 5 prominent ears, 18 helical rim deformity ears, 2 conchal crus ears and 1 Ⅱ degree microtia ear. During the treatment, 5 ears had skin lesions, 5 ears had mild allergic reactions, and 2 ears had severe allergic reactions, who improved significantly and continued treatment after removal of the external orthosis and use of erythromycin ointment. After noninvasive correction treatment, the auricle deformity of the children was improved to different extent. The overall markedly effective rate was 70.91% (39/55), and the overall effective rate was 90.91% (50/55). The markedly effective rate of lop ear, constricted ear, cup ear, Stahl’s ear, prominent ear, helical rim deformity ear, conchal ear and Ⅱ degree microtia ear were 13/13, 4/6, 4/6, 4/4, 4/5, 8/18, 2/2, 0/1 respectively. The average cure time of 39 markedly effective ears was (36.08±14.77) d. The cure time of different auricle deformity types was statistically significant ( P<0.01). Pairwise comparison between the groups showed that the cure time of lop ears was shorter than constricted ears, cup ears, Stahl’s ear, prominent ears, and that the cure time of prominent ears was longer than lop ears, constricted ears, cup ears, Stahl’s ears, helical rim deformity ears, conchal crus ears (all P<0.05). According to different initial ages of correction, the children were divided into <2-week-old group (12 cases, 21 ears), 2-6-week-old group (10 cases, 18 ears), and >6-week-old group (9 cases, 15 ears), excluding 1 Ⅱ degree microtia ear. The markedly effective rates were (90.5%) 19/21, 13/18, and 7/15, respectively, with statistically significant differences ( P<0.05). The comparison between groups showed that the markedly effective rate of <2-week-old group was significantly higher than that of >6-week-old group ( P<0.017), but there was no statistically significant difference in the cure time among the three groups ( P>0.05). Conclusion:The effect of non-invasive correction for congenital auricular deformity in infants is significant. The type of congenital auricular deformity is a key factor that affects the therapeutic effect and cure time. In lop ear, Stahl’s ear, prominent ear and conchal crus deformity, good therapeutic effects can be seen, but in constricted ear, cup ear, helical rim deformity ear and Ⅱ degree microtia, the effects are poor. The cure time of lop ear is short, while the cure time of prominent ear is long. The better effect can be acquired in the earlier non-invasive correction.

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