1.Sinicization of Evidence-Informed Decision-Making Competence Measure for nurses and its reliability and validity test
Yongting WEI ; Shumei TIAN ; Jiao YANG ; Lianghuan YU ; Fu NI ; Yuqing FAN ; Yao XIAO ; Zuyang XI ; Juyan SHA ; Cong LIU
Chinese Journal of Nursing 2025;60(6):736-742
Objective To translate Evidence-Informed Decision-Making Competence Measure for Chinese nurses and test its validity and reliability.Methods A research group was set up to use the Brislin translation model to translate the original scale into Chinese,and the back translation,cross-cultural adaptation,pre-experiment and cognitive interview were conducted to finally form the Chinese version of the Evidence-Informed Decision-Making Competence Measure for nurses.A total of 1 247 nurses from 7 tertiary A hospitals in Beijing,Hubei,Hunan and Xinjiang were selected by convenience sampling method in April 2024 to test its reliability and validity.Results 1 026 effective question-naires were collected,with an effective recovery rate of 82.28%.The Chinese version of the Evidence-Informed Decision-Making Competence Measure included 25 items,including knowledge/skill,attitude and behavior.A total of 3 common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 91.725%.The content validity index at the item level was 0.83-1.00;the content validity index at the scale level was 0.988;the calibration association validity was 0.496.The Cronbach's α coefficient of the whole scale was 0.992;the half-point reliability was 0.930;the retest reliability was 0.927.Conclusion The Chinese version of Evidence-Informed Decision-Making Competence Measure for nurses has good reliability and validity,and it can be used to evaluate the evidence-informed decision-making competence of Chinese nurses,provide references for promoting evidence-based nursing practice and evidence-informed decision-making.
2.Influences of FibroScan detection on the pregnancy outcomes of pregnant rats transfected with hepatitis B virus and the growth of their offspring rats
Keng CHEN ; Shumei ZHANG ; Yaping WANG ; Qian JIAO ; Pinghong LI ; Keli YANG ; Baolin LIAO ; Huiyuan LIU
Chinese Journal of Experimental and Clinical Virology 2025;39(4):427-433
Objective:To explore the influences of FibroScan detection on the pregnancy outcomes of pregnant rats transfected with hepatitis B virus and the growth of their offspring rats.Methods:Sixty SPF-grade SD rats with a male-to-female ratio of 5∶1 were selected,randomly divided the female rats into the groups of mid-pregnancy with hepatitis B,late-pregnancy with hepatitis B,normal mid-pregnancy,normal late-pregnancy,and control group,and the rats in the mid-pregnancy and late-pregnancy groups were subjected to FibroScan testing on the 10th and 15th days of gestation respectively. The number of offspring rats in each group was randomly reduced to 10 on the 3rd day after delivery,and the offspring rats were divided into the groups of mid-pregnancy with hepatitis B,late-pregnancy with hepatitis B,normal mid-pregnancy,normal late-pregnancy,and control group. The pregnancy outcome levels of pregnant rats were observed by adopting a stratified analysis strategy,including differences in weight changes,number of deliveries,fetal rat outcomes,lactation conditions,litter size,and litter weight. The growth levels of offspring rats,including differences in weight,body length,tail length,and the time of fur growth,tooth eruption,eye opening,and ear standing on the 21st day were observed,and the survival rate of the offspring rats was compared.Results:With regard to the pregnancy outcome levels of the pregnant rats,there were no statistically significant differences in weight changes during pregnancy among the five groups of pregnant rats[ F(4,45)=2.627,Adjusted P=0.222]. There were also no statistically significant differences in the number of deliveries,fetal rat outcomes,and lactation conditions(Adjusted P=1.000). The number of deliveries[ F(4,21.095)=2.280,Adjusted P=0.222]and litter weight[ F(4,20.128)=2.159,Adjusted P=0.222]showed no statistically significant differences. After correction using the BH method,none of the indicators showed significant differences( P>0.05). In terms of the growth levels of the offspring rats,among the five groups of offspring rats,there were no statistically significant differences in body weight on the 21st day[H(4)=11.623,Adjusted P=0.135],body length on the 21st day[H(4)=10.962,Adjusted P=0.135],and tail length on the 21st day[H(4)=9.126,Adjusted P=0.058]. Besides,the differences in the time of fur growth,tooth eruption,eye opening,and ear standing[H(4)=0.000,Adjust P=1.000]showed no statistical significance. The survival rate on the 7th day,14th day,and 21st day was 100%,with no significant differences(Adjusted P=1.000). After correction using the BH method,none of the indicators showed significant differences( P>0.05). Conclusion:FibroScan detection had no significant influences on the pregnancy outcomes of pregnant rats with hepatitis B or on the growth of their offspring rats in multiple stages,dimensions,and indicators,indicating that FibroScan detection is safe for pregnant rats. This research provides an animal experimental basis for the safe use of FibroScan in pregnant women with chronic HBV infection.
3.Analysis of prostate cancer screening results and exploration of screening model for elderly males in Songjiang Rural Areas of Shanghai City based on PSA preliminary screening under the community linkage mode
Daocheng FANG ; Lingfeng WU ; Lixin CHEN ; Chunhua TANG ; Yong WANG ; Hui LI ; Hui WANG ; Kui ZHANG ; Shuangquan SUN ; Qiang GAO ; Mingyuan DONG ; Chao WANG ; Yi YANG ; Zhiwei YANG ; Jing LIU ; Wendi DU ; Zhenbing SHI ; Shumei BI ; Hui WEN
Chinese Journal of Preventive Medicine 2025;59(2):230-234
This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.
4.Asiaticoside Alleviates Renal Fibrosis in Diabetic Nephropathy Rats by Regulating the Hippo-YAP/TAZ Signaling Pathway
Xiaodong ZHU ; Xiaoyu WANG ; Chuan JIANG ; Chengmei YANG ; Shumei SHI
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(6):1472-1477
Objective To observe the effects of asiaticoside on renal fibrosis in diabetic nephropathy(DN)rats by regulating the Hippo-yes-associated protein(YAP)/transcriptional co-activator with PDZ-binding motif(TAZ)signaling pathway.Methods A DN rat model was established by feeding a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin(STZ).The successfully modeled rats were randomly divided into model group,low-and high-dose asiaticoside groups,and high-dose asiaticoside+XMU-MP-1(Hippo-YAP/TAZ pathway activator)group,with a normal group set as control.After group intervention,blood urea nitrogen(BUN),serum creatinine(SCr),fasting blood glucose(FBG),and 24-hour urinary protein levels were measured.Hematoxylin-eosin(HE)staining was used to observe renal histopathological changes,Masson staining was used to assess renal fibrosis,and Western Blot was used to detect the protein expressions of YAP and TAZ in renal tissue.Results Compared with the normal group,the model group showed disordered renal tissue structure,enlarged and irregular cystic cavities,enlarged renal tubules with thickened basement membranes,inflammatory cell infiltration,and significant collagen deposition in the glomeruli,renal tubules,and vascular walls.The levels of FBG,BUN,SCr,24-hour urinary protein,and the protein expressions of YAP and TAZ in renal tissue were significantly increased(P<0.05).Compared with the model group,the low-and high-dose asiaticoside groups showed significant improvement in renal tissue damage and fibrosis,with reduced levels of FBG,BUN,SCr,24-hour urinary protein,and decreased protein expressions of YAP and TAZ in renal tissue(P<0.05).Compared with the high-dose asiaticoside group,the high-dose asiaticoside+XMU-MP-1 group showed a reversal in all the above indicators.Conclusion Asiaticoside may alleviate renal fibrosis and improve renal injury in DN rats by inhibiting the Hippo-YAP/TAZ pathway.
5.Analysis of prostate cancer screening results and exploration of screening model for elderly males in Songjiang Rural Areas of Shanghai City based on PSA preliminary screening under the community linkage mode
Daocheng FANG ; Lingfeng WU ; Lixin CHEN ; Chunhua TANG ; Yong WANG ; Hui LI ; Hui WANG ; Kui ZHANG ; Shuangquan SUN ; Qiang GAO ; Mingyuan DONG ; Chao WANG ; Yi YANG ; Zhiwei YANG ; Jing LIU ; Wendi DU ; Zhenbing SHI ; Shumei BI ; Hui WEN
Chinese Journal of Preventive Medicine 2025;59(2):230-234
This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.
6.Sinicization of Evidence-Informed Decision-Making Competence Measure for nurses and its reliability and validity test
Yongting WEI ; Shumei TIAN ; Jiao YANG ; Lianghuan YU ; Fu NI ; Yuqing FAN ; Yao XIAO ; Zuyang XI ; Juyan SHA ; Cong LIU
Chinese Journal of Nursing 2025;60(6):736-742
Objective To translate Evidence-Informed Decision-Making Competence Measure for Chinese nurses and test its validity and reliability.Methods A research group was set up to use the Brislin translation model to translate the original scale into Chinese,and the back translation,cross-cultural adaptation,pre-experiment and cognitive interview were conducted to finally form the Chinese version of the Evidence-Informed Decision-Making Competence Measure for nurses.A total of 1 247 nurses from 7 tertiary A hospitals in Beijing,Hubei,Hunan and Xinjiang were selected by convenience sampling method in April 2024 to test its reliability and validity.Results 1 026 effective question-naires were collected,with an effective recovery rate of 82.28%.The Chinese version of the Evidence-Informed Decision-Making Competence Measure included 25 items,including knowledge/skill,attitude and behavior.A total of 3 common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 91.725%.The content validity index at the item level was 0.83-1.00;the content validity index at the scale level was 0.988;the calibration association validity was 0.496.The Cronbach's α coefficient of the whole scale was 0.992;the half-point reliability was 0.930;the retest reliability was 0.927.Conclusion The Chinese version of Evidence-Informed Decision-Making Competence Measure for nurses has good reliability and validity,and it can be used to evaluate the evidence-informed decision-making competence of Chinese nurses,provide references for promoting evidence-based nursing practice and evidence-informed decision-making.
7.Influences of FibroScan detection on the pregnancy outcomes of pregnant rats transfected with hepatitis B virus and the growth of their offspring rats
Keng CHEN ; Shumei ZHANG ; Yaping WANG ; Qian JIAO ; Pinghong LI ; Keli YANG ; Baolin LIAO ; Huiyuan LIU
Chinese Journal of Experimental and Clinical Virology 2025;39(4):427-433
Objective:To explore the influences of FibroScan detection on the pregnancy outcomes of pregnant rats transfected with hepatitis B virus and the growth of their offspring rats.Methods:Sixty SPF-grade SD rats with a male-to-female ratio of 5∶1 were selected,randomly divided the female rats into the groups of mid-pregnancy with hepatitis B,late-pregnancy with hepatitis B,normal mid-pregnancy,normal late-pregnancy,and control group,and the rats in the mid-pregnancy and late-pregnancy groups were subjected to FibroScan testing on the 10th and 15th days of gestation respectively. The number of offspring rats in each group was randomly reduced to 10 on the 3rd day after delivery,and the offspring rats were divided into the groups of mid-pregnancy with hepatitis B,late-pregnancy with hepatitis B,normal mid-pregnancy,normal late-pregnancy,and control group. The pregnancy outcome levels of pregnant rats were observed by adopting a stratified analysis strategy,including differences in weight changes,number of deliveries,fetal rat outcomes,lactation conditions,litter size,and litter weight. The growth levels of offspring rats,including differences in weight,body length,tail length,and the time of fur growth,tooth eruption,eye opening,and ear standing on the 21st day were observed,and the survival rate of the offspring rats was compared.Results:With regard to the pregnancy outcome levels of the pregnant rats,there were no statistically significant differences in weight changes during pregnancy among the five groups of pregnant rats[ F(4,45)=2.627,Adjusted P=0.222]. There were also no statistically significant differences in the number of deliveries,fetal rat outcomes,and lactation conditions(Adjusted P=1.000). The number of deliveries[ F(4,21.095)=2.280,Adjusted P=0.222]and litter weight[ F(4,20.128)=2.159,Adjusted P=0.222]showed no statistically significant differences. After correction using the BH method,none of the indicators showed significant differences( P>0.05). In terms of the growth levels of the offspring rats,among the five groups of offspring rats,there were no statistically significant differences in body weight on the 21st day[H(4)=11.623,Adjusted P=0.135],body length on the 21st day[H(4)=10.962,Adjusted P=0.135],and tail length on the 21st day[H(4)=9.126,Adjusted P=0.058]. Besides,the differences in the time of fur growth,tooth eruption,eye opening,and ear standing[H(4)=0.000,Adjust P=1.000]showed no statistical significance. The survival rate on the 7th day,14th day,and 21st day was 100%,with no significant differences(Adjusted P=1.000). After correction using the BH method,none of the indicators showed significant differences( P>0.05). Conclusion:FibroScan detection had no significant influences on the pregnancy outcomes of pregnant rats with hepatitis B or on the growth of their offspring rats in multiple stages,dimensions,and indicators,indicating that FibroScan detection is safe for pregnant rats. This research provides an animal experimental basis for the safe use of FibroScan in pregnant women with chronic HBV infection.
8.Effect of Xiangsha Liu Junzitang Combined with Phlegm-removing and Detoxifying Traditional Chinese Medicine on Immune Escape in Lewis Lung Cancer Mice
Qian YANG ; Shumei WANG ; Shihan FENG ; Xue ZHAN ; Lintao XIA ; Mingxing WU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):78-86
ObjectiveTo study the effect and mechanism of Xiangsha Liu Junzitang combined with phlegm-removing and detoxifying traditional Chinese medicine on immune escape in Lewis lung cancer mice. MethodA total of 60 specific-pathogen-free (SPF)-grade C57BL/6J male mice were injected subcutaneously with 0.2 mL of Lewis cell suspension (containing 2×106 cells·mL-1) in the right mid-axillary line. After 7 days, the mice that had been successfully modeled were randomly divided into six groups: the model group, the cisplatin group, the Xiangsha Liu Junzitang low-, medium-, and high-dose groups, and the combined group, with 10 mice in each group. The Xiangsha Liu Junzitang low-, medium- and high-dose groups were gavaged with 17.88, 35.75, 71.50 g·kg-1 Xiangsha Liu Junzitang solution once a day, respectively, and the dosage of cisplatin intraperitoneally injected into the mice was converted to 5 mg·kg-1 twice a week, and the tumour volumes of each group were measured every two days. The intervention lasted for 14 consecutive days. At the end of treatment, the tumour mass of mice in each group was weighed and the tumour inhibition rate was calculated. The morphological characteristics of tumours in each group were observed by hematoxylin-eosin (HE) staining. Fluorescent quantitative real-time polymerase chain reaction (Real-time PCR) assay was used to detect messenger ribonucleic acid (mRNA) contents of the natural killer group 2 member D (NKG2D) receptor, ribonucleic acid export-1 (RAE-1), and γ interferon (IFN-γ) in the tumour tissues of each group. NKG2D, RAE-1, and IFN-γ mRNA in tumour tissues of each group. Immunohistochemistry (IHC) and Western blot were applied to detect the expressions of RAE-1, NKG2D, and IFN-γ in tumour tissues of each group, and Western blot was used to detect the expressions of interleukin-6 (IL-6), Janus kinase 2 (JAK2), p-JAK2, signal transducer and activator of transcription 3 (STAT3), and p-STAT3 in tumour tissues of each group, as well as the protein levels of NKG2D, and RAE-1 in spleen tissues of each group. ResultCompared with that in the model group, the tumour mass decreased in all dose groups of Xiangsha Liu Junzitang, with no statistically significant difference. The tumour volume was reduced (P<0.05, P <0.01). The pathological morphology was improved. The mRNA contents of NKG2D, RAE-1 and IFN-γ were increased in the medium-dose group (P<0.05, P<0.01), and the protein expressions of NKG2D, RAE-1, and IFN-γ in tumour tissues were elevated (P<0.05, P<0.01), and p-JAK2 and p-STAT3 protein expressions were decreased (P<0.05, P<0.01). In spleen tissues, the protein expressions of NKG2D and RAE-1 in all dose groups of Xiangsha Liu Junzitang were significantly elevated (P<0.01). Compared with those in the cisplatin group, NKG2D, RAE-1 and IFN-γ mRNA contents were elevated in the middle-dose group of Xiangsha Liu Junzitang, and the difference was not statistically significant. IHC showed that the protein expressions of NKG2D and IFN-γ in the combined group were significantly elevated (P<0.01), and Western blot results showed that the protein expressions of RAE-1, NKG2D and IFN-γ were elevated (P<0.05, P<0.01). p-JAK2 and p-STAT3 protein expressions were decreased in the combined group (P<0.05, P<0.01). NKG2D and RAE-1 protein expressions were significantly increased in spleen tissues of the medium-dose groups and the combined group (P<0.01). ConclusionXiangsha Liu Junzitang combined with phlegm-removing and detoxifying traditional Chinese medicine can inhibit the growth of tumours in Lewis lung cancer mice by up-regulating the expressions of RAE-1/NKG2D, promoting the activation of NK cells, and inhibiting immune escape, the mechanism of which may be related to down-regulation of the JAK2/STAT3 pathway.
9.Risk factors of apathy and correlations with cognitive function in patients with hypertension combined with cerebral small vessel disease
Jiali CAO ; Tianran WANG ; Yang LIU ; Duo ZHANG ; Jin'e XU ; Chong LIU ; Shumei WANG ; Yongchang HAN ; Lulu YANG
Chinese Journal of Interventional Imaging and Therapy 2024;21(3):145-149
Objective To explore the risk factors of apathy and correlations with cognitive function in patients with hypertension combined with cerebral small vessel disease(CSVD).Methods Totally 141 patients with hypertension combined with CSVD were prospectively enrolled and were divided into apathy group(n=43)and non-apathy group(n= 98)according to neuropsychiatric inventory-apathy scale(NPI-Apathy)scores.The general data,imaging marker scores and total imaging burden scores were compared between groups.In hypertension combined with CSVD patients,multivariate logistic regression analysis was performed to screen the independent risk factors of apathy,and Spearman correlation analysis was also performed to observe the correlation of apathy and cognitive function.Results The patients'age,high density lipoprotein cholesterol(HDL-C),Fazekas scores of lateral periventricular white matter hyper-intensity(WMH),cerebral microbleed of depth/infratentorial and total imaging burden scores of apathy group were all higher,while mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores were both lower than those of non-apathy group(all P<0.05).HDL-C and Fazekas scores of lateral periventricular WMH were both independent risk factors for apathy(both P<0.05),while NPI-Apathy scores were moderately negatively correlated with cognitive function in patients with hypertension combined with CSVD(r=-0.543,-0.484,both P<0.001).Conclusion HDL-C and Fazekas scores of lateral periventricular WMH were both independent risk factors for apathy in patients with hypertension combined with CSVD.The more severe the apathy,the lower the cognitive function.
10.Mechanisms on radiation resistance induced by an estrogen receptor in breast cancer cells
Tianpeng YANG ; Shinan ZHANG ; Huilin JI ; Linhui ZHU ; Yujie ZHANG ; Jin HUANG ; Yingren WEN ; Shumei MA ; Xiaodong LIU
Chinese Journal of Radiological Medicine and Protection 2024;44(2):88-95
Objective:To explore the effects of estrogen receptor α (ERα) encoded by protein encoding gene ESR1 on the radiation resistance of breast cancer cells and their molecular mechanisms.Methods:The ESR1 overexpression plasmid was transfected into estrogen receptor (ER)-negative breast cancer cells. Then, the shRNA-ESR1 vector was introduced into ER-positive cell to establish models with different phenotype. The ATG5 mRNA level and protein expression levels of LC3B-I, LC3B-II, P62, FIP200, ATG5, ATG7, ATG12, Beclin1, ULK1 were detected using qPCR and Western blot techniques. Cell death was measured using flow cytometry. The radiation sensitivity was determined through the colony formation assay. The mortality of breast cancer cells under the autophagy gene knockdown and overexpression or treated with estrogen receptor inhibitor (TAM) combined with ionizing radiation were detected by trypan blue staining.Results:Under the condition of 8 Gy X-ray irradiation, the knockdown of ESR1 in ER-positive ZR75 breast cancer cells promoted cell death ( t = 3.49, 3.13, P < 0.05), while the overexpression of ESR1 in ER-negative MDA-MB-231 breast cancer cells inhibited cell death ( t = 4.16, 7.48, P < 0.05). Compared to the control group, the treatment with chloroquine increased the number of formed colonies of ESR1 knockdown ZR75 cells ( t = 8.49, P < 0.05), and inhibiting autophagy could reduce the death of ZR75 cells caused by ESR1 silencing. Under the treatment with ionizing radiation, the overexpression of ESR1 in MDA-MB-231 cells promoted protective autophagy, which, however, was reduced after ESR1 knockdown in ZR75 cells. Furthermore, it was observed that the knockdown of ATG5 in ZR75 cells was associated with reduced autophagy and an increase in cell death ( t = 4.19, 6.39, P < 0.05). In contrast, the overexpression of ATG5 in ZR75 cells reversed the increase in cell death caused by ESR1 knockdown ( t = 1.70, 4.65, P < 0.05). After the treatment of ER-positive ZR75 breast cancer cells with TAM, the expressions of ATG5 and ATG12 decreased, suggesting inhibited autophagy and an increase in cell death ( t = 18.70, P < 0.05). Furthermore, these processes were promoted by ionizing radiation ( t = 16.82, P < 0.05). Conclusions:The estrogen receptor encoded by ESR1 promotes protective autophagy of ER-positive breast cancer cells by increasing ATG5, further leading to radiation resistance in ER-positive breast cancer cells. Treatment with tamoxifen combined with ionizing radiation can increase the radiation sensitivity of ER-positive breast cancer cells.

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