1.Effect and Mechanism of Icariin on Improving Spermatogenesis in Exercise-induced Fatigue Model Mice Through Regucalcin
Kunyang TANG ; Min XIAO ; Xiaocui JIANG ; Xiaoxue TAO ; Yue ZOU ; Chunchun ZHAO ; Zhipeng FANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):117-127
ObjectiveThis paper aims to investigate the effects of icariin on spermatogenesis in mice with exercise-induced fatigue and explore the underlying mechanisms. MethodsICR male mice were screened by swimming and randomly divided into normal group, model group, vitamin C group, icariin groups with low, medium, and high doses, and medium-dose icariin+N-nitro-L-arginine methyl ester (L-NAME) group, with 10 mice per group. Except for the normal group, all the other groups underwent weighted swimming training to establish an exercise-induced fatigue model. No gavage was administered during the first two weeks of the weighted training. From week three to four, the icariin groups with low, medium, and high doses received 0.03, 0.06, and 0.12 g·kg-1 icariin via gavage, respectively. The vitamin C group received 0.2 g·kg-1 vitamin C. The L-NAME group received 0.06 g·kg-1 icariin and 0.01 g·kg-1 L-NAME via intraperitoneal injection. The normal and model groups received equivalent physiological saline. After the experiment, body weight and the last exhaustive swimming time were recorded. Blood urea nitrogen (BUN), lactate (LA), lactate dehydrogenase (LDH), malondialdehyde (MDA), testicular testosterone (T), testicular Ca2+/Mg2+-adenosine triphosphatase (ATPase) (micro-assay), and the levels of testicular cyclic guanosine monophosphate (cGMP) were measured by using kits. Sperm CD46 levels were detected by flow cytometry. Testicular seminiferous tubules were observed via hematoxylin-eosin (HE) staining, and the testicular morphometric score (TMS) was used to evaluate the spermatogenic function. Protein expression of regucalcin (RGN, SMP30), cGMP-dependent protein kinase 1 (PKG), and cGMP-dependent protein kinase anchoring protein (GKAP1) was detected by Western blot. Testicular regucalcin expression was examined by immunofluorescence (IF). The epididymal sperm quality of mice was observed under a microscope. Fluorescence-stained sections of stimulated by retinoic acid gene 8 (STRA8), synaptonemal complex protein 3 (SCP3), and transition protein 1(TNP1) in testicular seminiferous tubules were assessed by immunohistochemistry (IHC). ResultsCompared with the normal group, the model group showed decreased body weight and exhaustive swimming time (P<0.01), significantly increased fatigue markers (LA, LDH, and BUN) and lipid peroxidation product MDA (P<0.01), reduced testicular RGN, PKG, GKAP1, testosterone, Ca2+/Mg2+-ATPase, and cGMP levels (P<0.01), decreased sperm motility, sperm count, and TMS scores, and downregulated the expression of STRA8, SCP3, and TNP1. Compared with the model group, the icariin group with high dose exhibited increased exhaustive swimming time (P<0.01), reduced LA, LDH, BUN, and MDA levels (P<0.01), elevated superoxide dismutase (SOD) (P<0.01), upregulated testicular RGN, PKG, GKAP1, testosterone, Ca2+/Mg2+-ATPase, and cGMP levels (P<0.01), improved sperm motility, sperm count, and TMS scores, and enhanced STRA8, SCP3, and TNP1 expression. Compared with the L-NAME group, the icariin group with medium dose showed increased expression of STRA8, SCP3, and TNP1 in the testicular tissue (P<0.01) and elevated cGMP and GKAP1 levels (P<0.01). ConclusionExercise-induced fatigue reduces the expression of RGN and cGMP/PKG/GKAP1 in mice, thereby causing abnormal spermatogenesis and impairing reproductive function in mice. Icariin ameliorates spermatogenic dysfunction in exercise-induced fatigue mice by promoting the expression of RGN and cGMP/PKG/GKAP1, thereby mitigating the damage of exercise-induced fatigue to the reproductive system.
2.Effect and Mechanism of Icariin on Improving Spermatogenesis in Exercise-induced Fatigue Model Mice Through Regucalcin
Kunyang TANG ; Min XIAO ; Xiaocui JIANG ; Xiaoxue TAO ; Yue ZOU ; Chunchun ZHAO ; Zhipeng FANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):117-127
ObjectiveThis paper aims to investigate the effects of icariin on spermatogenesis in mice with exercise-induced fatigue and explore the underlying mechanisms. MethodsICR male mice were screened by swimming and randomly divided into normal group, model group, vitamin C group, icariin groups with low, medium, and high doses, and medium-dose icariin+N-nitro-L-arginine methyl ester (L-NAME) group, with 10 mice per group. Except for the normal group, all the other groups underwent weighted swimming training to establish an exercise-induced fatigue model. No gavage was administered during the first two weeks of the weighted training. From week three to four, the icariin groups with low, medium, and high doses received 0.03, 0.06, and 0.12 g·kg-1 icariin via gavage, respectively. The vitamin C group received 0.2 g·kg-1 vitamin C. The L-NAME group received 0.06 g·kg-1 icariin and 0.01 g·kg-1 L-NAME via intraperitoneal injection. The normal and model groups received equivalent physiological saline. After the experiment, body weight and the last exhaustive swimming time were recorded. Blood urea nitrogen (BUN), lactate (LA), lactate dehydrogenase (LDH), malondialdehyde (MDA), testicular testosterone (T), testicular Ca2+/Mg2+-adenosine triphosphatase (ATPase) (micro-assay), and the levels of testicular cyclic guanosine monophosphate (cGMP) were measured by using kits. Sperm CD46 levels were detected by flow cytometry. Testicular seminiferous tubules were observed via hematoxylin-eosin (HE) staining, and the testicular morphometric score (TMS) was used to evaluate the spermatogenic function. Protein expression of regucalcin (RGN, SMP30), cGMP-dependent protein kinase 1 (PKG), and cGMP-dependent protein kinase anchoring protein (GKAP1) was detected by Western blot. Testicular regucalcin expression was examined by immunofluorescence (IF). The epididymal sperm quality of mice was observed under a microscope. Fluorescence-stained sections of stimulated by retinoic acid gene 8 (STRA8), synaptonemal complex protein 3 (SCP3), and transition protein 1(TNP1) in testicular seminiferous tubules were assessed by immunohistochemistry (IHC). ResultsCompared with the normal group, the model group showed decreased body weight and exhaustive swimming time (P<0.01), significantly increased fatigue markers (LA, LDH, and BUN) and lipid peroxidation product MDA (P<0.01), reduced testicular RGN, PKG, GKAP1, testosterone, Ca2+/Mg2+-ATPase, and cGMP levels (P<0.01), decreased sperm motility, sperm count, and TMS scores, and downregulated the expression of STRA8, SCP3, and TNP1. Compared with the model group, the icariin group with high dose exhibited increased exhaustive swimming time (P<0.01), reduced LA, LDH, BUN, and MDA levels (P<0.01), elevated superoxide dismutase (SOD) (P<0.01), upregulated testicular RGN, PKG, GKAP1, testosterone, Ca2+/Mg2+-ATPase, and cGMP levels (P<0.01), improved sperm motility, sperm count, and TMS scores, and enhanced STRA8, SCP3, and TNP1 expression. Compared with the L-NAME group, the icariin group with medium dose showed increased expression of STRA8, SCP3, and TNP1 in the testicular tissue (P<0.01) and elevated cGMP and GKAP1 levels (P<0.01). ConclusionExercise-induced fatigue reduces the expression of RGN and cGMP/PKG/GKAP1 in mice, thereby causing abnormal spermatogenesis and impairing reproductive function in mice. Icariin ameliorates spermatogenic dysfunction in exercise-induced fatigue mice by promoting the expression of RGN and cGMP/PKG/GKAP1, thereby mitigating the damage of exercise-induced fatigue to the reproductive system.
3.Effect of Zuoguiwan on Development of Skin Barrier in Neonatal Rat Model of Congenital Kidney Deficiency Based on Intercellular Connections
He YU ; Min XIAO ; Xiaocui JIANG ; Min ZHAO ; Yinjuan LYU ; Jian GONG ; Jigang CAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):11-18
ObjectiveTo study the effect of Zuoguiwan on the development of skin barrier in the neonatal rat model of congenital kidney deficiency and unveil the underlying mechanism. MethodsSixty rats were paired in a female-to-male ratio of 2∶1, and the pregnant rats were assigned into control, congenital kidney deficiency, and low- and high-dose (2 and 8 g·kg-1, respectively) Zuoguiwan groups. The pregnant rats in other groups except the control group were exposed to chronic unpredictable mild stress for the modeling of congenital kidney deficiency. The rats in the control group and congenital kidney deficiency group were administrated with normal saline by gavage, and those in Zuoguiwan groups with Zuoguiwan suspension by gavage from day 1 of pregnancy. The serum level of interleukin-6 (IL-6) in the neonatal rats on the day of birth was determined by enzyme-linked immunosorbent assay. The full-thickness skin of neonatal rats on the day of birth was removed from the same position on the back and stained with hematoxylin-eosin for observation of histopathological changes, measurement of skin thickness, and counting of hair follicles. Terminal deoxynucleotidyl transferase-mediated nick end labeling was used to detect the apoptosis of skin tissue cells. The expression of interleukin-6 receptor (IL-6R) and interleukin-17A (IL-17A) in the skin tissue was assessed by immunohistochemistry and Western blot, and the expression of occludin, connexin 43 (Cx43), and zonula occludens-1 (ZO-1) in the skin tissue was assessed by immunofluorescence and Western blot. ResultsCompared with those in the control group, the neonatal rats in the congenital kidney deficiency group showed a rise in the serum IL-6 level (P<0.01), decreases in stratum corneum thickness, skin thickness, and number of hair follicles (P<0.01), increases in the expression of IL-6R and IL-17A in the skin tissue (P<0.01) and the number of apoptotic cells (P<0.01), and decreases in the expression of occludin, Cx43, ZO-1 (P<0.05). Compared with the congenital kidney deficiency group, the low- and high-dose Zuoguiwan groups showed declines in serum IL-6 level (P<0.05). The low-dose group showed increased number of hair follicles (P<0.05), and the high-dose group presented thickened stratum corneum (P<0.01), increased number of hair follicles (P<0.01), and down-regulated expression of IL-6R and IL-17A in the skin tissue (P<0.05, P<0.01). Both Zuoguiwan groups showcased decreased number of apoptotic cells (P<0.05, P<0.01), and the high-dose group showed up-regulated expression of occludin, Cx43, and ZO-1 in the skin tissue (P<0.05, P<0.01). ConclusionZuoguiwan can reduce the levels of IL-6 in the serum and IL-6R and IL-17A in the skin tissue and improve the expression of intercellular junction proteins, thereby ameliorating the abnormal development of the skin barrier in the neonatal rat model of congenital kidney deficiency.
4.Effect of Zuoguiwan on Development of Skin Barrier in Neonatal Rat Model of Congenital Kidney Deficiency Based on Intercellular Connections
He YU ; Min XIAO ; Xiaocui JIANG ; Min ZHAO ; Yinjuan LYU ; Jian GONG ; Jigang CAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):11-18
ObjectiveTo study the effect of Zuoguiwan on the development of skin barrier in the neonatal rat model of congenital kidney deficiency and unveil the underlying mechanism. MethodsSixty rats were paired in a female-to-male ratio of 2∶1, and the pregnant rats were assigned into control, congenital kidney deficiency, and low- and high-dose (2 and 8 g·kg-1, respectively) Zuoguiwan groups. The pregnant rats in other groups except the control group were exposed to chronic unpredictable mild stress for the modeling of congenital kidney deficiency. The rats in the control group and congenital kidney deficiency group were administrated with normal saline by gavage, and those in Zuoguiwan groups with Zuoguiwan suspension by gavage from day 1 of pregnancy. The serum level of interleukin-6 (IL-6) in the neonatal rats on the day of birth was determined by enzyme-linked immunosorbent assay. The full-thickness skin of neonatal rats on the day of birth was removed from the same position on the back and stained with hematoxylin-eosin for observation of histopathological changes, measurement of skin thickness, and counting of hair follicles. Terminal deoxynucleotidyl transferase-mediated nick end labeling was used to detect the apoptosis of skin tissue cells. The expression of interleukin-6 receptor (IL-6R) and interleukin-17A (IL-17A) in the skin tissue was assessed by immunohistochemistry and Western blot, and the expression of occludin, connexin 43 (Cx43), and zonula occludens-1 (ZO-1) in the skin tissue was assessed by immunofluorescence and Western blot. ResultsCompared with those in the control group, the neonatal rats in the congenital kidney deficiency group showed a rise in the serum IL-6 level (P<0.01), decreases in stratum corneum thickness, skin thickness, and number of hair follicles (P<0.01), increases in the expression of IL-6R and IL-17A in the skin tissue (P<0.01) and the number of apoptotic cells (P<0.01), and decreases in the expression of occludin, Cx43, ZO-1 (P<0.05). Compared with the congenital kidney deficiency group, the low- and high-dose Zuoguiwan groups showed declines in serum IL-6 level (P<0.05). The low-dose group showed increased number of hair follicles (P<0.05), and the high-dose group presented thickened stratum corneum (P<0.01), increased number of hair follicles (P<0.01), and down-regulated expression of IL-6R and IL-17A in the skin tissue (P<0.05, P<0.01). Both Zuoguiwan groups showcased decreased number of apoptotic cells (P<0.05, P<0.01), and the high-dose group showed up-regulated expression of occludin, Cx43, and ZO-1 in the skin tissue (P<0.05, P<0.01). ConclusionZuoguiwan can reduce the levels of IL-6 in the serum and IL-6R and IL-17A in the skin tissue and improve the expression of intercellular junction proteins, thereby ameliorating the abnormal development of the skin barrier in the neonatal rat model of congenital kidney deficiency.
5.Mechanisms of Spermatogenic Dysfunction and Sperm Quality Degradation Induced by Propylthiouracil via Endoplasmic Reticulum Stress in Rats and Interventional Effect of Shugan Bushen Yulin Decoction
Yuhao MENG ; Xiaocui JIANG ; Min XIAO ; Chaoyang WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):79-89
ObjectiveTo investigate the mechanisms through which Shugan Bushen Yulin decoction ameliorates spermatogenic dysfunction and sperm quality degradation caused by propylthiouracil (PTU) via the endoplasmic reticulum stress pathway in rats. MethodsSixty male rats were randomly assigned into six groups: a control group, a model group, low- (6.75 g·kg-1), medium- (13.5 g·kg-1), and high-dose (27 g·kg-1) Shugan Bushen Yulin decoction groups, and an L-carnitine (0.27 g·kg-1) group, with ten rats in each group. Other groups except the control group were administrated with PTU (10 mg·kg-1) by gavage for 12 consecutive days. After the completion of modeling, rats were administrated with corresponding agents or normal saline (control group) via gavage for 28 consecutive days. Twenty-four hours after the last administration, rats were sacrificed, and the body and organ (testis, epididymis, and seminal vesicle) weights were measured to calculate the organ indices. Hematoxylin-eosin staining was employed to observe the pathological changes in the testes and epididymis, and the testicular spermatogenic function of rats was scored. Enzyme-linked immunosorbent assay was employed to measure the levels of thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2), and malondialdehyde (MDA) and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the rat serum. Terminal deoxynucleotidyl transferase dUTP nick end labeling was adopted to assess the rate of testicular cell apoptosis. Western blot was conducted to determine the expression levels of glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), phosphorylated protein kinase RNA-like endoplasmic reticulum kinase (p-PERK), protein kinase RNA-like endoplasmic reticulum kinase (PERK), phosphorylated eukaryotic translation initiation factor 2α kinase (p-EIF2α), eukaryotic translation initiation factor 2α kinase (EIF2α), and activating transcription factor 4 (ATF4) in the testicular tissue of rats. ResultsCompared with the control group, the model group exhibited reductions in volumes and indexes of testes, epididymides, and seminal vesicles (P<0.01), pathological damage of testes and epididymides, and declines in spermatogenic function and sperm density and motility (P<0.01). In addition, the model group demonstrated elevated serum levels of TSH and MDA, lowered levels of T3, T4, FSH, LH, T, and E2, decreased activities of SOD and GSH-Px (P<0.05, P<0.01), an increased apoptosis rate of testicular cells (P<0.01), and up-regulated expression of GRP78, CHOP, p-PERK/PERK, p-EIF2α/EIF2α, and ATF4 in the testicular tissue (P<0.01). Compared with the model group, Shugan Bushen Yulin decoction at different doses improved the morphology and indexes of testes, epididymides, and seminal vesicles (P<0.05), restored the spermatogenic function (P<0.05, P<0.01), increased the sperm density and motility (P<0.05, P<0.01), and decreased the percentage of apoptotic testicular cells (P<0.05). Furthermore, the decoction lowered the serum level of MDA, elevated the serum levels of FSH, LH, T, and E2, and increased the activities of SOD and GSH-Px (P<0.05, P<0.01). Moreover, the expression levels of GRP78, CHOP, p-PERK/PERK, p-EIF2α/EIF2α, and ATF4 in the testicular tissue were down-regulated (P<0.05, P<0.01). ConclusionShugan Bushen Yulin decoction can ameliorate the spermatogenic dysfunction and sperm quality degradation induced by PTU in a rat model of hypothyroidism by repairing the testicular oxidative damage and regulating the PERK/EIF2α/ATF4 signaling pathway, thereby alleviating spermatogenic cell apoptosis.
6.Diagnosis and treatment of colorectal liver metastases: Chinese expert consensus-based multidisciplinary team (2024 edition).
Wen ZHANG ; Xinyu BI ; Yongkun SUN ; Yuan TANG ; Haizhen LU ; Jun JIANG ; Haitao ZHOU ; Yue HAN ; Min YANG ; Xiao CHEN ; Zhen HUANG ; Weihua LI ; Zhiyu LI ; Yufei LU ; Kun WANG ; Xiaobo YANG ; Jianguo ZHOU ; Wenyu ZHANG ; Muxing LI ; Yefan ZHANG ; Jianjun ZHAO ; Aiping ZHOU ; Jianqiang CAI
Chinese Medical Journal 2025;138(15):1765-1768
7.Mechanism of salidroside in inhibiting expression of adhesion molecules in oxLDL-induced endothelial cells by regulating ferroptosis mediated by SIRT1/Nrf2.
Meng ZHANG ; Min XIAO ; Jing-Jing LI ; Jiang-Feng LI ; Guang-Hui FAN
China Journal of Chinese Materia Medica 2025;50(10):2787-2797
This article investigated the effect and mechanism of salidroside(SAL) on the expression of adhesion molecules in oxidized low-density lipoprotein(oxLDL)-induced mouse aortic endothelial cell(MAEC). The oxLDL-induced endothelial cell injury model was constructed, and the safe concentration and action time of SAL were screened. The cells were divided into control group, oxLDL group, low and high concentration groups of SAL, and ferrostatin-1(Fer-1) group. The cell viability was detected by CCK-8 assay; lactate dehydrogenase(LDH) leakage was measured by colorimetry; the expression of intercellular adhesion molecule 1(ICAM-1) and recombinant vascular cell adhesion molecule 1(VCAM-1) were detected by immunofluorescence; Fe~(2+),glutathione(GSH),malondialdehyde(MDA),and 4-hydroxynonenal(4-HNE) levels were detected by kit method; reactive oxygen species(ROS) was detected by DCFH-DA probe; the levels of glutathione peroxidase 4(GPX4),silent mating type information regulation 2 homolog 1(SIRT1), and nuclear factor erythroid 2-related factor 2(Nrf2) were determined by using Western blot. The inhibitors of Nrf2 and SIRT1 were used, and endothelial cell were divided into control group, oxLDL group, SAL group, ML385 group(Nrf2 inhibitor), and EX527 group(SIRT1 inhibitor). The ultrastructure of mitochondria was observed by electron microscope; mitochondrial membrane potential(MMP) was detected by flowcytometry; the expressions of SIRT1,Nrf2,solute carrier family 7 member 11(SLC7A11),GPX4,ferroportin 1(FPN1),ferritin heavy chain 1(FTH1),ICAM-1, and VCAM-1 were detected by Western blot. The results showed that similar to Fer-1,low and high concentrations of SAL could improve cell viability, inhibit LDH release and the expression of ICAM-1 and VCAM-1 in oxLDL-induced endothelial cells(P<0.05 or P<0.01). It was related to increase in GSH level, decrease in Fe~(2+),ROS,MDA, and 4-HNE level, and up-regulation of SIRT1,Nrf2, and GPX4 expression to inhibit ferroptosis(P<0.05 or P<0.01). The intervention effect of high concentration SAL was the most significant. ML385 and EX527 could partially offset the protection of SAL on mitochondrial structure and MMP and reverse the ability of SAL to up-regulate the expression of SIRT1,Nrf2,SLC7A11,GPX4,FPN1, and FTH1 and down-regulate the expression of ICAM-1 and VCAM-1(P<0.05 or P<0.01).To sum up, SAL could reduce the expression of ICAM-1 and VCAM-1 in oxLDL-induced endothelial cell, which may relate to activation of SLC7A11/GPX4 antioxidant signaling pathway mediated by SITR1/Nrf2, up-regulation of FPN1 and FTH1 expression, and inhibition of ferroptosis.
Sirtuin 1/genetics*
;
Animals
;
Ferroptosis/drug effects*
;
Lipoproteins, LDL/metabolism*
;
NF-E2-Related Factor 2/genetics*
;
Mice
;
Endothelial Cells/cytology*
;
Glucosides/pharmacology*
;
Phenols/pharmacology*
;
Cell Adhesion Molecules/genetics*
;
Reactive Oxygen Species/metabolism*
;
Intercellular Adhesion Molecule-1/genetics*
;
Vascular Cell Adhesion Molecule-1/genetics*
;
Cell Survival/drug effects*
8.Associations of Ureaplasma urealyticum infection with male infertility and intrauterine insemination outcomes.
Yang-Yang WAN ; Xiao-Yun SHI ; Wen-Jing LIU ; Shun BAI ; Xin CHEN ; Si-Yao LI ; Xiao-Hua JIANG ; Li-Min WU ; Xian-Sheng ZHANG ; Juan HUA
Asian Journal of Andrology 2025;27(2):219-224
Ureaplasma urealyticum (UU) is one of the most commonly occurring pathogens associated with genital tract infections in infertile males, but the impact of seminal UU infection in semen on intrauterine insemination (IUI) outcomes is poorly understood. We collected data from 245 infertile couples who underwent IUI at The First Affiliated Hospital of USTC (Hefei, China) between January 2021 and January 2023. The subjects were classified into two groups according to their UU infection status: the UU-positive group and the UU-negative group. We compared semen parameters, pregnancy outcomes, and neonatal birth outcomes to investigate the impact of UU infection on IUI outcomes. There were no significantly statistical differences in various semen parameters, including semen volume, sperm concentration, total and progressive motility, sperm morphology, leukocyte count, the presence of anti-sperm antibody, and sperm DNA fragmentation index (DFI), between the UU-positive and UU-negative groups of male infertile patients (all P > 0.05). However, the high DNA stainability (HDS) status of sperm differed between the UU-positive and UU-negative groups, suggesting that seminal UU infection may affect sperm nuclear maturation ( P = 0.04). Additionally, there were no significant differences in pregnancy or neonatal birth outcomes between the two groups (all P > 0.05). These results suggest that IUI remains a viable and cost-effective option for infertile couples with UU infection who are facing infertility issues.
Humans
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Male
;
Ureaplasma Infections/complications*
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Female
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Infertility, Male/therapy*
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Ureaplasma urealyticum/isolation & purification*
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Pregnancy
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Adult
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Pregnancy Outcome
;
Semen Analysis
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Insemination, Artificial
;
Semen/microbiology*
;
China
9.Clinical sub-phenotypes of acute kidney injury in children and their association with prognosis.
Lian FENG ; Min LI ; Zhen JIANG ; Jiao CHEN ; Zhen-Jiang BAI ; Xiao-Zhong LI ; Guo-Ping LU ; Yan-Hong LI
Chinese Journal of Contemporary Pediatrics 2025;27(1):47-54
OBJECTIVES:
To investigate the clinical sub-phenotype (SP) of pediatric acute kidney injury (AKI) and their association with clinical outcomes.
METHODS:
General status and initial values of laboratory markers within 24 hours after admission to the pediatric intensive care unit (PICU) were recorded for children with AKI in the derivation cohort (n=650) and the validation cohort (n=177). In the derivation cohort, a least absolute shrinkage and selection operator (LASSO) regression analysis was used to identify death-related indicators, and a two-step cluster analysis was employed to obtain the clinical SP of AKI. A logistic regression analysis was used to develop a parsimonious classifier model with simplified metrics, and the area under the curve (AUC) was used to assess the value of this model. This model was then applied to the validation cohort and the combined derivation and validation cohort. The association between SPs and clinical outcomes was analyzed with all children with AKI as subjects.
RESULTS:
In the derivation cohort, two clinical SPs of AKI (SP1 and SP2) were identified by the two-step cluster analysis using the 20 variables screened by LASSO regression, namely SPd1 group (n=536) and SPd2 group (n=114). The simplified classifier model containing eight variables (P<0.05) had an AUC of 0.965 in identifying the two clinical SPs of AKI (P<0.001). The validation cohort was clustered into SPv1 group (n=156) and SPv2 group (n=21), and the combined derivation and validation cohort was clustered into SP1 group (n=694) and SP2 group (n=133). After adjustment for confounding factors, compared with the SP1 group, the SP2 group had significantly higher incidence rates of multiple organ dysfunction syndrome and death during the PICU stay (P<0.001), and SP2 was significantly associated with the risk of death within 28 days after admission to the PICU (P<0.001).
CONCLUSIONS
This study establishes a parsimonious classifier model and identifies two clinical SPs of AKI with different clinical features and outcomes.The SP2 group has more severe disease and worse clinical prognosis.
Humans
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Acute Kidney Injury/diagnosis*
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Prognosis
;
Male
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Female
;
Child
;
Child, Preschool
;
Phenotype
;
Infant
;
Logistic Models
;
Adolescent
10.Relationship between polygenic risk scores for various psychiatric disorders and clinical and neuropsychological characteristics in children with attention-deficit/hyperactivity disorder.
Zhao-Min WU ; Peng WANG ; Chao DONG ; Xiao-Lan CAO ; Lan-Fang HU ; Cong KOU ; Jia-Jing JIANG ; Lin-Lin ZHANG ; Li YANG ; Yu-Feng WANG ; Ying LI ; Bin-Rang YANG
Chinese Journal of Contemporary Pediatrics 2025;27(9):1089-1097
OBJECTIVES:
To investigate the relationship between the polygenic risks for various psychiatric disorders and clinical and neuropsychological characteristics in children with attention-deficit/hyperactivity disorder (ADHD).
METHODS:
Using a cross-sectional design, 285 children with ADHD and 107 healthy controls were assessed using the Child Behavior Checklist, the Behavior Rating Inventory of Executive Function for parents, the Wechsler Intelligence Scale for Children, Fourth Edition, and the Cambridge Neuropsychological Test Automated Battery. Blood samples were collected for genetic data. Polygenic risk scores (PRSs) for various psychiatric disorders were calculated using the PRSice-2 software.
RESULTS:
Compared with the healthy controls, the children with ADHD displayed significantly higher PRSs for ADHD, major depressive disorder, anxiety disorder, and obsessive-compulsive disorder (P<0.05). In terms of daily-life executive function, ADHD-related PRS was significantly correlated with the working memory factor; panic disorder-related PRS was significantly correlated with the initiation factor; bipolar disorder-related PRS was significantly correlated with the shift factor; schizophrenia-related PRS was significantly correlated with the inhibition, emotional control, initiation, working memory, planning, organization, and monitoring factors (P<0.05). The PRS related to anxiety disorders was negatively correlated with total IQ and processing speed index (P<0.05). The PRS related to obsessive-compulsive disorder was negatively correlated with the processing speed index and positively correlated with the stop-signal reaction time index of the stop-signal task (P<0.05).
CONCLUSIONS
PRSs for various psychiatric disorders are closely correlated with the behavioral and cognitive characteristics in children with ADHD, which provides more insights into the heterogeneity of ADHD.
Humans
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Attention Deficit Disorder with Hyperactivity/genetics*
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Child
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Male
;
Female
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Cross-Sectional Studies
;
Neuropsychological Tests
;
Multifactorial Inheritance
;
Adolescent
;
Mental Disorders/etiology*
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Executive Function
;
Genetic Risk Score

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