1.Mechanism of icariin in promoting osteogenic differentiation of BMSCs and improving bone metabolism disorders through caveolin-1/Hippo signaling pathway.
Yi-Dan HAN ; Hai-Feng ZHANG ; Yun-Teng XU ; Yu-Huan ZHONG ; Xiao-Ning WANG ; Yun YU ; Yuan-Li YAN ; Shan-Shan WANG ; Xi-Hai LI
China Journal of Chinese Materia Medica 2025;50(3):600-608
Guided by the theory of "the kidney storing essence, governing the bones, and producing marrow", this study explored the mechanism of icariin(ICA) in regulating the osteogenic differentiation of rat bone mesenchymal stem cells(BMSCs) through caveolin-1(Cav1) via in vitro and in vivo experiments, aiming to provide a theoretical basis for the prevention and treatment of postmenopausal osteoporosis with traditional Chinese medicine(TCM). Primary cells were obtained from 4-week-old female SD rats using the whole bone marrow adherent method. Flow cytometry was used to detect the expression of surface markers CD29, CD90, CD11b, and CD45. The potential for osteogenic and adipogenic differentiation was assessed. The effect of ICA on cell viability was determined using the CCK-8 assay, and the impact of ICA on the formation of mineralized nodules was verified by alizarin red staining. A stable Cav1-silenced cell line was constructed using lentivirus. The effect of Cav1 silencing on osteogenic differentiation was observed via alizarin red staining. Western blot analysis was conducted to detect the expression of Cav1, Hippo/TAZ, and osteogenic markers such as Runt-related transcription factor 2(RUNX2) and alkaline phosphatase(ALP). The results showed that primary cells were successfully obtained using the whole bone marrow adherent method, positively expressing surface markers of rat BMSCs and possessing the potential for both osteogenic and adipogenic differentiation. The CCK-8 assay and alizarin red staining results indicated that 1×10~(-7) mol·L~(-1) was the optimal concentration of ICA for intervention in this experiment(P<0.05). During osteogenic induction, ICA inhibited Cav1 expression(P<0.05) while promoting TAZ expression(P<0.05). Alizarin red staining demonstrated that Cav1 silencing significantly promoted the osteogenic differentiation of BMSCs. After ICA intervention, TAZ expression was activated, and the expression of osteogenic markers ALP and RUNX2 was increased. In conclusion, Cav1 silencing significantly promotes the osteogenic differentiation of BMSCs, and ICA promotes this differentiation by inhibiting Cav1 and regulating the Hippo/TAZ signaling pathway.
Animals
;
Mesenchymal Stem Cells/metabolism*
;
Caveolin 1/genetics*
;
Osteogenesis/drug effects*
;
Rats, Sprague-Dawley
;
Rats
;
Cell Differentiation/drug effects*
;
Female
;
Signal Transduction/drug effects*
;
Flavonoids/administration & dosage*
;
Protein Serine-Threonine Kinases/genetics*
;
Drugs, Chinese Herbal/pharmacology*
;
Cells, Cultured
;
Humans
2.Improvement effect and mechanism of Wuling San on TGF-β1-induced fibrosis, inflammation, and oxidative stress damage in HK-2 cells.
Jun WU ; Xue-Ning JING ; Fan-Wei MENG ; Xiao-Ni KONG ; Jiu-Wang MIAO ; Cai-Xia ZHANG ; Hai-Lun LI ; Yun HAN
China Journal of Chinese Materia Medica 2025;50(5):1247-1254
This study investigated the effect of Wuling San on transforming growth factor-β1(TGF-β1)-induced fibrosis, inflammation, and oxidative stress in human renal tubular epithelial cells(HK-2) and its mechanism of antioxidant stress injury. HK-2 cells were cultured in vitro and divided into a control group, a TGF-β1 model group, and three treatment groups receiving Wuling San-containing serum at low(2.5%), medium(5.0%), and high(10.0%) doses. TGF-β1 was used to establish the model in all groups except the control group. CCK-8 was used to analyze the effect of different concentrations of Wuling San on the activity of HK-2 cells with or without TGF-β1 stimulation. The expression of key fibrosis molecules, including actin alpha 2(Acta2), collagen type Ⅰ alpha 1 chain(Col1α1), collagen type Ⅲ alpha 1 chain(Col3α1), TIMP metallopeptidase inhibitor 1(Timp1), and fibronectin 1(Fn1), was detected using qPCR. The expression levels of inflammatory cytokines, including tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), and interleukin-4(IL-4), were measured using ELISA kits. Glutathione peroxidase(GSH-Px), malondialdehyde(MDA), catalase(CAT), and superoxide dismutase(SOD) biochemical kits were used to analyze the effect of Wuling San on TGF-β1-induced oxidative stress injury in HK-2 cells, and the expression of nuclear factor E2-related factor 2(Nrf2), heme oxygenase 1(HO-1), and NAD(P)H quinone oxidoreductase 1(NQO1) was analyzed by qPCR and immunofluorescence. The CCK-8 results indicated that the optimal administration concentrations of Wuling San were 2.5%, 5.0%, and 10.0%. Compared with the control group, the TGF-β1 model group showed significantly increased levels of key fibrosis molecules(Acta2, Col1α1, Col3α1, Timp1, and Fn1) and inflammatory cytokines(TNF-α, IL-1β, IL-6, IL-8, and IL-4). In contrast, the Wuling San administration groups were able to dose-dependently inhibit the expression levels of key fibrosis molecules and inflammatory cytokines compared with the TGF-β1 model group. Wuling San significantly increased the activities of GSH-Px, CAT, and SOD enzymes in TGF-β1-stimulated HK-2 cells and significantly inhibited the level of MDA. Furthermore, compared with the control group, the TGF-β1 model group exhibited a significant reduction in the expression of Nrf2, HO-1, and NQO1 genes and proteins. After Wuling San intervention, the expression of Nrf2, HO-1, and NQO1 genes and proteins was significantly increased. Correlation analysis showed that antioxidant stress enzymes(GSH-Px, CAT, and SOD) and Nrf2 signaling were significantly negatively correlated with key fibrosis molecules and inflammatory cytokines in the TGF-β1-stimulated HK-2 cell model. In conclusion, Wuling San can inhibit TGF-β1-induced fibrosis in HK-2 cells by activating the Nrf2 signaling pathway, improving oxidative stress injury, and reducing inflammation.
Humans
;
Oxidative Stress/drug effects*
;
Transforming Growth Factor beta1/metabolism*
;
Fibrosis/genetics*
;
Cell Line
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Drugs, Chinese Herbal/pharmacology*
;
Epithelial Cells/immunology*
;
Inflammation/metabolism*
3.Clinical Applications of Circulating Tumor DNA in Response Evaluation and Relapse Monitoring of Primary Mediastinal Large B-Cell Lymphoma.
Lu PAN ; Xin-Miao JIANG ; Yan TENG ; Ning WANG ; Ling HUANG ; Han-Guo GUO ; Si-Chu LIU ; Xiao-Juan WEI ; Fei-Li CHEN ; Zhan-Li LIANG ; Wen-Yu LI
Journal of Experimental Hematology 2025;33(2):407-415
OBJECTIVE:
To explore the clinical significance of circulating tumor DNA (ctDNA) in response evaluation and relapse monitoring for patients with primary mediastinal large B-cell lymphoma (PMBCL).
METHODS:
The clinical characteristics, efficacy and survival of 38 PMBCL patients in our hospital from January 2010 to April 2020 were retrospectively analyzed. The ctDNA monitoring was conducted by targeted next-generation sequencing (NGS).
RESULTS:
Among the 38 patients, 26 cases were female, and 32 cases were diagnosed with Ann Arbor stage I-II. The 5-year overall survival (OS) rate and progression-free survival (PFS) rate were 74.7% and 61.7%, respectively. Males and those with high aaIPI scores (3 points) had a relatively poor prognosis. The NGS results of 23 patients showed that STAT6 (65.2%), SOCS1 (56.5%), and TNFAIP3 (56.5%) were the most common mutated genes. Patients with stable disease (SD)/progressive disease (PD) exhibited enrichment in cell cycle, FoxO, and TNF signaling pathways. A total of 29 patients underwent end-of-treatment PET/CT (EOT PET/CT), and 16 of them received ctDNA monitoring with 12 negative. Among 6 patients with EOT PET/CT positive (Deauville 4), 4 underwent ctDNA monitoring, and 3 of them were negative, being still in continuous remission without any subsequent anti-tumor therapy.
CONCLUSION
CtDNA may be combined with PET/CT to assess efficacy, monitor relapse, and guide treatment of PMBCL.
Humans
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Circulating Tumor DNA/blood*
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Female
;
Mediastinal Neoplasms
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Male
;
Retrospective Studies
;
High-Throughput Nucleotide Sequencing
;
Prognosis
;
Lymphoma, Large B-Cell, Diffuse/genetics*
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Middle Aged
;
Adult
;
Aged
;
Neoplasm Recurrence, Local
;
Mutation
4.Histaminergic Innervation of the Ventral Anterior Thalamic Nucleus Alleviates Motor Deficits in a 6-OHDA-Induced Rat Model of Parkinson's Disease.
Han-Ting XU ; Xiao-Ya XI ; Shuang ZHOU ; Yun-Yong XIE ; Zhi-San CUI ; Bei-Bei ZHANG ; Shu-Tao XIE ; Hong-Zhao LI ; Qi-Peng ZHANG ; Yang PAN ; Xiao-Yang ZHANG ; Jing-Ning ZHU
Neuroscience Bulletin 2025;41(4):551-568
The ventral anterior (VA) nucleus of the thalamus is a major target of the basal ganglia and is closely associated with the pathogenesis of Parkinson's disease (PD). Notably, the VA receives direct innervation from the hypothalamic histaminergic system. However, its role in PD remains unknown. Here, we assessed the contribution of histamine to VA neuronal activity and PD motor deficits. Functional magnetic resonance imaging showed reduced VA activity in PD patients. Optogenetic activation of VA neurons or histaminergic afferents significantly alleviated motor deficits in 6-OHDA-induced PD rats. Furthermore, histamine excited VA neurons via H1 and H2 receptors and their coupled hyperpolarization-activated cyclic nucleotide-gated channels, inward-rectifier K+ channels, or Ca2+-activated K+ channels. These results demonstrate that histaminergic afferents actively compensate for Parkinsonian motor deficits by biasing VA activity. These findings suggest that targeting VA histamine receptors and downstream ion channels may be a potential therapeutic strategy for PD motor dysfunction.
Animals
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Histamine/metabolism*
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Male
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Oxidopamine/toxicity*
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Rats
;
Ventral Thalamic Nuclei/physiopathology*
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Rats, Sprague-Dawley
;
Disease Models, Animal
;
Parkinson Disease/metabolism*
;
Neurons/physiology*
;
Humans
;
Optogenetics
5.Associations of Exposure to Typical Environmental Organic Pollutants with Cardiopulmonary Health and the Mediating Role of Oxidative Stress: A Randomized Crossover Study.
Ning GAO ; Bin WANG ; Ran ZHAO ; Han ZHANG ; Xiao Qian JIA ; Tian Xiang WU ; Meng Yuan REN ; Lu ZHAO ; Jia Zhang SHI ; Jing HUANG ; Shao Wei WU ; Guo Feng SHEN ; Bo PAN ; Ming Liang FANG
Biomedical and Environmental Sciences 2025;38(11):1388-1403
OBJECTIVE:
The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.
METHODS:
A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons (OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens, and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators.
RESULTS:
Urinary concentrations of 2-hydroxyphenanthrene (2-OH-PHE) ( β = 4.35% [95% confidence interval ( CI): 0.85%, 7.97%]), 3-hydroxyphenanthrene ( β = 3.44% [95% CI: 0.19%, 6.79%]), and 4-hydroxyphenanthrene (4-OH-PHE) ( β = 5.78% [95% CI: 1.27%, 10.5%]) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene (1-OH-PYR) ( β = 3.05% [95% CI: -4.66%, -1.41%]), 2-OH-PHE ( β = 2.68% [95% CI: -4%, -1.34%]), and 4-OH-PHE ( β = 3% [95% CI: -4.68%, -1.29%]) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function.
CONCLUSION
Exposure to multiple organic pollutants can adversely affect cardiopulmonary health. Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.
Humans
;
Oxidative Stress/drug effects*
;
Male
;
Cross-Over Studies
;
Female
;
Young Adult
;
Environmental Pollutants/toxicity*
;
Environmental Exposure/adverse effects*
;
Biomarkers/blood*
;
Adult
;
Blood Pressure/drug effects*
;
Polycyclic Aromatic Hydrocarbons/urine*
;
Beijing
6.Synthesis and characterization of matrix metalloproteinase-responsive BDNF controlled-release materials
Jun-Ru HEI ; Cui WANG ; Meng-Wen SONG ; Sheng-Qiang XIE ; Bing-Xian WANG ; Xiao-Juan LAN ; Han-Bo ZHANG ; Gang CHENG ; Zhi-Qiang LIU ; Xi-Qin YANG ; Jian-Ning ZHANG
Medical Journal of Chinese People's Liberation Army 2024;49(11):1319-1326
Objective To develop a matrix metalloproteinase(MMP)-responsive hyaluronic acid(HA)-based controlled-release material for brain-derived neurotrophic factor(BDNF)to provide a novel therapeutic strategy for intervention and repair of traumatic brain injury(TBI).Methods HA was modified with amination,followed by condensation with Suflo-SMCC carboxyl group to form amide,and then linked with glutathione(GSH)to synthesize HA-GSH.The recombinant glutathione S-transferase(GST)-tissue inhibitor of metalloproteinase(TIMP)-BDNF(GST-TIMP-BDNF)expression plasmid was constructed using molecular cloning technique with double enzyme digestion by Bam H Ⅰ and Eco R Ⅰ.The recombinant GST-TIMP-BDNF protein was expressed in the Escherichia coli prokaryotic expression system,and purified by ion exchange chromatography,confirmed by Western blotting.MMP diluents were supplemented with PBS,MMP inhibitor marimastat,and varing concentrations(0.4,0.6,0.8 mg/ml)of GST-TIMP-BDNF or GST-BDNF.MMP-2 activity was analyzed using an MMP activity detection kit to evaluate the inhibitory effect of the recombinant protein on MMP.Primary rat neurons were extracted and cultured to establish an iron death model induced by RSL3.The effect of recombinant protein GST-TIMP-BDNF on neuronal injury was detected by immunofluorescence staining.Results MRI hydrogen spectrum identification confirmed the successful synthesis of HA-GSH.Western blotting results showed the successful expression of the recombinant protein GST-TIMP-BDNF containing the GST tag using the E.coli prokaryotic expression system.MMP activity detection results indicated that the recombinant protein GST-TIMP-BDNF had a superior inhibitory effect on MMP-2 activity compared to GST-BDNF(P<0.05).Immunofluorescence staining results showed a significant increase in fluorescence intensity in rat neurons treated with GST-TIMP-BDNF after RSL3 induction(P<0.05).Conclusion A MMP-responsive HA-based BDNF controlled-release material has been successfully developed,exhibiting a protective effect on neuron damage.
7.Protective Effects of Danmu Extract Syrup on Acute Lung Injury Induced by Lipopolysaccharide in Mice through Endothelial Barrier Repair.
Han XU ; Si-Cong XU ; Li-Yan LI ; Yu-Huang WU ; Yin-Feng TAN ; Long CHEN ; Pei LIU ; Chang-Fu LIANG ; Xiao-Ning HE ; Yong-Hui LI
Chinese journal of integrative medicine 2024;30(3):243-250
OBJECTIVE:
To investigate the effects of Danmu Extract Syrup (DMS) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and explore the mechanism.
METHODS:
Seventy-two male Balb/C mice were randomly divided into 6 groups according to a random number table (n=12), including control (normal saline), LPS (5 mg/kg), LPS+DMS 2.5 mL/kg, LPS+DMS 5 mL/kg, LPS+DMS 10 mL/kg, and LPS+Dexamethasone (DXM, 5 mg/kg) groups. After pretreatment with DMS and DXM, the ALI mice model was induced by LPS, and the bronchoalveolar lavage fluid (BALF) were collected to determine protein concentration, cell counts and inflammatory cytokines. The lung tissues of mice were stained with hematoxylin-eosin, and the wet/dry weight ratio (W/D) of lung tissue was calculated. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-1 β in BALF of mice were detected by enzyme linked immunosorbent assay. The expression levels of Claudin-5, vascular endothelial (VE)-cadherin, vascular endothelial growth factor (VEGF), phospho-protein kinase B (p-Akt) and Akt were detected by Western blot analysis.
RESULTS:
DMS pre-treatment significantly ameliorated lung histopathological changes. Compared with the LPS group, the W/D ratio and protein contents in BALF were obviously reduced after DMS pretreatment (P<0.05 or P<0.01). The number of cells in BALF and myeloperoxidase (MPO) activity decreased significantly after DMS pretreatment (P<0.05 or P<0.01). DMS pre-treatment decreased the levels of TNF-α, IL-6 and IL-1 β (P<0.01). Meanwhile, DMS activated the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway and reversed the expressions of Claudin-5, VE-cadherin and VEGF (P<0.01).
CONCLUSIONS
DMS attenuated LPS-induced ALI in mice through repairing endothelial barrier. It might be a potential therapeutic drug for LPS-induced lung injury.
Mice
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Male
;
Animals
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Lipopolysaccharides
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Interleukin-1beta/metabolism*
;
Vascular Endothelial Growth Factor A/metabolism*
;
Tumor Necrosis Factor-alpha/metabolism*
;
Claudin-5/metabolism*
;
Acute Lung Injury/chemically induced*
;
Lung/pathology*
;
Interleukin-6/metabolism*
;
Drugs, Chinese Herbal
8.Construction of a prediction model for postoperative infection in elderly patients with hip fracture and analysis of economic burden
Hao-Ning SHI ; Ying DU ; Shuo QIAO ; Hao-Ran YANG ; Hui ZHANG ; Yi-Han SHI ; Xiao YANG ; Jing LI
Chinese Journal of Infection Control 2024;23(10):1220-1227
Objective To construct a prediction model for postoperative healthcare-associated infection(HAI)in elderly patients with hip fracture,analyze the economic burden,provide a reference and basis for the development of clinical prevention and control programs.Methods 627 elderly patients who underwent hip fracture surgery in a hospital from January 1,2017 to May 31,2023 were selected as the study subjects.Patients were randomly divided into a modeling group and a validation group at a 7:3 ratio.A logistic regression prediction model was constructed based on data from the modeling group,the discriminant and consistency of the model were evaluated by receiver ope-rating characteristic(ROC)curve and Hosmer-Lemeshow test,and the direct economic burden of postoperative HAI in patients was analyzed with 1∶1 propensity score matching(PSM).Results The incidence of postoperative HAI in elderly patients with hip fracture surgery was 12.1%,with pulmonary infection being the most common(52.6%).Logistic regression analysis showed that male,old age,perioperative disturbance of consciousness,gradeⅣ of American Society of Anesthesiologists(ASA)classification,low albumin level,and intensive care unit(ICU)admission were all independent risk factors for postoperative HAI in patients(all P<0.05).There was good model discrimination and consistency between the training and validation groups in predicting the risk of postoperative HAI.The direct economic burden of postoperative HAI in patients was 7 927.4 Yuan,of which the burden of wes-tern medicine was the largest(3 139.7 Yuan).HAI prolonged patients hospitalization time by 3.6 days.Conclusion Postoperative HAI increases the economic burden of patients,the nomogram model constructed in this study can effectively predict the risk of postoperative HAI in patients,which can provide a basis for the early identification,as well as the implementation of targeted preventive and diagnostic measures for high-risk patients in the clinic.
9.Establishment of a Prediction Model for Menstruation after the First Course of Hormone Replacement Therapy in Premature Ovarian Insufficiency Patients af-ter Allogeneic Hematopoietic Stem Cell Transplantation
Ning ZHANG ; Weizeyu LIU ; Jingjing ZHANG ; Xiaoyu LI ; Fangcan SUN ; Huiyun CHEN ; Xiao MA ; Bing HAN
Journal of Practical Obstetrics and Gynecology 2024;40(7):577-581
Objective:To establish a menstrual prediction model after the first course of hormone replacement therapy(HRT)in premature ovarian insufficiency(POI)patients after allogeneic hematopoietic stem cell transplan-tation(allo-HSCT),and to provide certain reference value for formulating HRT plans.Methods:The retrospective analysis recruited 154 POI patients after allo-HSCT in the First Affiliated Hospital of Soochow University from Jan-uary 2017 to October 2022.They were divided into ideal menstruation group(n=116)and unideal menstruation group(n=38)according to menstruation after the first course of HRT.Basic characteristics and clinical data were compared in single-factor analysis to select predictive factors.Patients were randomly divided into training set and test set.The menstrual prediction model was developed based on random forest algorithm on the training set and the prediction efficiency was verified by the test set.Finally,we made a user interaction interface and deployed to the server for sharing.Results:The single-factor analysis suggested statistic difference of age of visit,body mass index(BMI),gravidity,parity,hematologic diseases,transplantation age,donor gender,follicle-stimulating hormone(FSH),Luteinizing Hormone(LH),lumbar bone mineral density(BMD)and HRT plan(P<0.05).According to mean decrease accuracy,the predictive factors included visit age,transplantation age,BMI,FSH,HRT plans,gravidity and parity.After the initial establishment of the random forest model,we improved it by adjusting ntree to 500,mtry to 6 and training/test set division to 80%/20% .We also used tenfold cross validation to reduce over-fitting.The area under curve(AUC)of the final constructed menstrual prediction model was 0.768,a sensitiv-ity of 0.695 and a specificity of 0.735.Conclusions:This study successfully established a menstrual prediction model for amenorrhea patients after allo-HSCT when finished the first course of HRT.The false positive rate was low,suggesting that if the prediction result of the model is non-ideal menstruation,we may consider adjusting HRT plans to promote menstruation in time.
10.Establishment of a Prediction Model for Menstruation after the First Course of Hormone Replacement Therapy in Premature Ovarian Insufficiency Patients af-ter Allogeneic Hematopoietic Stem Cell Transplantation
Ning ZHANG ; Weizeyu LIU ; Jingjing ZHANG ; Xiaoyu LI ; Fangcan SUN ; Huiyun CHEN ; Xiao MA ; Bing HAN
Journal of Practical Obstetrics and Gynecology 2024;40(7):577-581
Objective:To establish a menstrual prediction model after the first course of hormone replacement therapy(HRT)in premature ovarian insufficiency(POI)patients after allogeneic hematopoietic stem cell transplan-tation(allo-HSCT),and to provide certain reference value for formulating HRT plans.Methods:The retrospective analysis recruited 154 POI patients after allo-HSCT in the First Affiliated Hospital of Soochow University from Jan-uary 2017 to October 2022.They were divided into ideal menstruation group(n=116)and unideal menstruation group(n=38)according to menstruation after the first course of HRT.Basic characteristics and clinical data were compared in single-factor analysis to select predictive factors.Patients were randomly divided into training set and test set.The menstrual prediction model was developed based on random forest algorithm on the training set and the prediction efficiency was verified by the test set.Finally,we made a user interaction interface and deployed to the server for sharing.Results:The single-factor analysis suggested statistic difference of age of visit,body mass index(BMI),gravidity,parity,hematologic diseases,transplantation age,donor gender,follicle-stimulating hormone(FSH),Luteinizing Hormone(LH),lumbar bone mineral density(BMD)and HRT plan(P<0.05).According to mean decrease accuracy,the predictive factors included visit age,transplantation age,BMI,FSH,HRT plans,gravidity and parity.After the initial establishment of the random forest model,we improved it by adjusting ntree to 500,mtry to 6 and training/test set division to 80%/20% .We also used tenfold cross validation to reduce over-fitting.The area under curve(AUC)of the final constructed menstrual prediction model was 0.768,a sensitiv-ity of 0.695 and a specificity of 0.735.Conclusions:This study successfully established a menstrual prediction model for amenorrhea patients after allo-HSCT when finished the first course of HRT.The false positive rate was low,suggesting that if the prediction result of the model is non-ideal menstruation,we may consider adjusting HRT plans to promote menstruation in time.

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