1.Analysis of factors affecting poor incision healing after breast cancer surgery
Xuran ZHU ; Bolin ZHANG ; Yanqi YANG ; NUERBANNU·TABUSIBIEKE ; Guoan SHAO ; Shu CHEN
Journal of Clinical Surgery 2025;33(7):722-726
Objective To analyze the influencing factors of poor incision healing in postoperative patients with breast cancer.Methods The clinical data of 150 patients with breast cancer diagnosed by the Department of Nail Milk surgery of the Fifth affiliated Hospital of Xinjiang Medical University from January 2016 to December 2023 were retrospectively analyzed.According to the postoperative wound healing,the patients were divided into two groups:good healing group(n=94)and poor healing group(n=56).The general data,operation-related data and clinicopathological characteristics of the two groups were collected for univariate analysis,and the single-factor indexes with statistical significance were analyzed by multivariate Logistic analysis to screen the risk factors of poor incision healing after operation.The statistically significant indexes of regression analysis were analyzed by receiver operating characteristic(ROC)curve to further explore its predictive value in poor incision healing after breast cancer operation.Results The data of the two groups were compared and analyzed.Multivariate Logistic regression analysis showed that BMI,diabetes,age,axillary lymph node dissection and hemoglobin were independent risk factors for poor incision healing(P<0.05).ROC curve analysis of independent risk factors showed that when the age was more than 57.5,the area under the curve(AUC)was 0.635,the sensitivity was 55.4%,the specificity was 68.1%,and the critical value was 57.5.When BMI>24.9 kg/m2,the area under the curve(AUC)was 0.735,the sensitivity was 87.5%,the specificity was 61.7%,and the critical value was 24.9(P<0.001).When hemoglobin<101.5 g/L,the area under the curve(AUC)was 0.829,the sensitivity was 57.1%,the specificity was 94.7%,and the critical value was 101.5 g/L(P<0.001).Conclusion BMI,diabetes,hemoglobin,age and axillary lymph node dissection are independent risk factors for poor wound healing after breast cancer operation.When BMI>24.9 kg/m2,age>57.5 years old and hemoglobin<101.5 g/L,it can predict the occurrence of poor incision healing in patients with breast cancer.
2.The short-term effects of Conbercept intravitreal injection on matrix metalloproteinase-2 and tissue inhibitor of metalloproteinases-2 expression in the aqueous humor of eyes with proliferative diabetic retinopathy
Wei ZHANG ; Kai ZHU ; Wen JIA ; Rui ZHANG ; Xuran LI ; Yonghao GU
Chinese Journal of Ocular Fundus Diseases 2025;41(1):7-14
Objective:To observe and analyze the short-term effects of intravitreal injection of Conbercept (IVC) on the expression levels of matrix metalloproteinase (MMP)-2 and MMP inhibitor-2 (TIMP-2) in the aqueous humor of eyes with proliferative diabetic retinopathy (PDR).Methods:A prospective clinical study. From March 2024 to June 2024, 30 consecutive patients with 30 eyes with PDR (PDR group) undergoing IVC combined with pars plana vitrectomy (PPV) at Department of Ophthalmology of The First Affiliated Hospital of University of Science and Technology were included in the study, along with 20 patients with 20 eyes undergoing cataract surgery (control group) during the same period. In the PDR group, IVC treatment was performed 3 to 7 days before PPV, and 0.05-0.10 ml aqueous humor was collected before IVC and before PPV. In the control group, 0.05-0.10 ml aqueous humor was collected before cataract surgery. The levels of vascular endothelial growth factor (VEGF), MMP-2, and TIMP-2 in the aqueous humor were measured using enzyme-linked immunosorbent assay. For normally distributed data, independent samples t-test were used for comparison between two groups; for non-normally distributed data, the Mann-Whitney U test was used. The correlation analysis of VEGF, MMP-2, TIMP-2 concentrations in aqueous humor of PDR patients was performed using Pearson's correlation coefficient. Results:There were no statistically significant differences in age ( Z=-1.810) and gender composition ( χ2=3.450) between the PDR group and the control group ( P>0.05). Before IVC, VEGF and MMP-2 expression levels were (0.23±0.10), (2.11±1.32) ng/ml and (0.12±0.03), (0.53±0.26) ng/ml in patients' aqueous fluid in PDR group and control group, respectively. The expression level of TIMP-2 and the ratio of MMP-2/TIMP-2 were (0.99±0.26), (1.76±0.11) ng/ml and 2.04 (1.19, 2.98), 0.36 (0.15, 0.39), respectively. Compared with the control group, the expression levels of VEGF and MMP-2 in aqueous humor in PDR group ( t=-5.030, -5.260) and the ratio of MMP-2/TIMP-2 ( Z=-5.740) were significantly increased, with statistical significance ( P<0.01). The expression level of TIMP-2 was significantly lower than that of control group, the difference was statistically significant ( t=12.120, P<0.01). After IVC, the expression levels of VEGF and MMP-2 in aqueous humor of PDR patients were (0.13±0.03) and (2.11±1.32) ng/ml, respectively. The expression level of TIMP-2 and the ratio of MMP-2/TIMP-2 were (0.95±0.28) ng/ml and 1.57 (1.02, 3.13), respectively. Compared with before IVC, the expression level of VEGF in aqueous humor in PDR group after IVC was significantly decreased, and the difference was statistically significant ( t=6.080, P<0.01). The expression levels of MMP-2 ( t=1.220), TIMP-2 ( t=0.290) and the ratio of MMP-2/TIMP-2 ( Z=-0.260) were not significantly different ( P=0.270, 0.780, 0.800). After IVC, there was no significant difference in VEGF expression level between PDR group and control group ( t=-1.200, P=0.240). The expression level of MMP-2 was still significantly increased ( t=-5.880), the expression level of TIMP-2 was still significantly decreased ( t=11.520), and the ratio of MMP-2/TIMP-2 was still significantly increased ( Z=-5.780), with statistical significance ( P<0.01). Correlation analysis showed that VEGF was positively correlated with MMP-2 in aqueous humor of PDR patients before IVC ( r=0.590, P<0.01). Conclusions:IVC can effectively reduce the level of VEGF in the aqueous humor of eyes with PDR in the short term, but it has no significant effect on the levels of MMP-2 and TIMP-2.
3.Dual syndrome differentiation and treatment for migraine based on the Ying-Wei theory
Journal of Beijing University of Traditional Chinese Medicine 2025;48(6):861-868
This study explores a dual syndrome differentiation and treatment system for migraine,based on the Ying-Wei theory in traditional Chinese medicine,proposing a systematic framework encompassing"three-dimensional physiological mechanisms,three-pronged pathological manifestations,and three-stage therapeutic interventions."Physiologically,the Ying-Wei system maintains internal homeostasis through the coordinated regulation of circadian rhythms,spatial distribution patterns,and functional state modulation.Pathologically,dysregulation within this system manifests in three principal forms:deficiency,stagnation,and dynamic imbalance.Deficiency syndrome results from spleen-stomach insufficiency,leading to inadequate nourishment of Ying-Wei.Stagnation syndrome stems from Sanjiao dysfunction,resulting in meridian obstruction by phlegm,blood stasis,and toxic turbidity.Dynamic imbalance reflects Ying-Wei,ultimately causing yin-yang inversion.In terms of pathogenesis evolution and treatment strategies,Ying-Wei dynamic imbalance induces yin-yang inversion and convergence of internal-external pathogenic factors during acute attacks.These episodes are addressed through therapeutic method that dredges the collaterals and eliminate pathogens,aiming to unblock stagnation,harmonize yingfen and weifen,and restore internal Ying-Wei balance.During the remission phase,latent pathogens rooted in Ying-Wei dysfunction interact with visceral deficiencies.Management during this phase focuses on regulating visceral and eliminating latent pathogens to strengthen the foundation,thereby reconstructing the functional dynamics of qi transformation.Innovatively integrating the temporal rhythm regulation of Ying-Wei,the paradigm synthesizes"unblocking-regulating-consolidating"therapeutic phases to achieve yin-yang equilibrium.This dual syndrome differentiation and treatment system can couple the multidimensional pathological networks of the acute and remission phases of migraine,providing new ideas for the integrated treatment of migraine with traditional Chinese and Western medicine.
4.Dual syndrome differentiation and treatment for migraine based on the Ying-Wei theory
Journal of Beijing University of Traditional Chinese Medicine 2025;48(6):861-868
This study explores a dual syndrome differentiation and treatment system for migraine,based on the Ying-Wei theory in traditional Chinese medicine,proposing a systematic framework encompassing"three-dimensional physiological mechanisms,three-pronged pathological manifestations,and three-stage therapeutic interventions."Physiologically,the Ying-Wei system maintains internal homeostasis through the coordinated regulation of circadian rhythms,spatial distribution patterns,and functional state modulation.Pathologically,dysregulation within this system manifests in three principal forms:deficiency,stagnation,and dynamic imbalance.Deficiency syndrome results from spleen-stomach insufficiency,leading to inadequate nourishment of Ying-Wei.Stagnation syndrome stems from Sanjiao dysfunction,resulting in meridian obstruction by phlegm,blood stasis,and toxic turbidity.Dynamic imbalance reflects Ying-Wei,ultimately causing yin-yang inversion.In terms of pathogenesis evolution and treatment strategies,Ying-Wei dynamic imbalance induces yin-yang inversion and convergence of internal-external pathogenic factors during acute attacks.These episodes are addressed through therapeutic method that dredges the collaterals and eliminate pathogens,aiming to unblock stagnation,harmonize yingfen and weifen,and restore internal Ying-Wei balance.During the remission phase,latent pathogens rooted in Ying-Wei dysfunction interact with visceral deficiencies.Management during this phase focuses on regulating visceral and eliminating latent pathogens to strengthen the foundation,thereby reconstructing the functional dynamics of qi transformation.Innovatively integrating the temporal rhythm regulation of Ying-Wei,the paradigm synthesizes"unblocking-regulating-consolidating"therapeutic phases to achieve yin-yang equilibrium.This dual syndrome differentiation and treatment system can couple the multidimensional pathological networks of the acute and remission phases of migraine,providing new ideas for the integrated treatment of migraine with traditional Chinese and Western medicine.
5.Analysis of factors affecting poor incision healing after breast cancer surgery
Xuran ZHU ; Bolin ZHANG ; Yanqi YANG ; NUERBANNU·TABUSIBIEKE ; Guoan SHAO ; Shu CHEN
Journal of Clinical Surgery 2025;33(7):722-726
Objective To analyze the influencing factors of poor incision healing in postoperative patients with breast cancer.Methods The clinical data of 150 patients with breast cancer diagnosed by the Department of Nail Milk surgery of the Fifth affiliated Hospital of Xinjiang Medical University from January 2016 to December 2023 were retrospectively analyzed.According to the postoperative wound healing,the patients were divided into two groups:good healing group(n=94)and poor healing group(n=56).The general data,operation-related data and clinicopathological characteristics of the two groups were collected for univariate analysis,and the single-factor indexes with statistical significance were analyzed by multivariate Logistic analysis to screen the risk factors of poor incision healing after operation.The statistically significant indexes of regression analysis were analyzed by receiver operating characteristic(ROC)curve to further explore its predictive value in poor incision healing after breast cancer operation.Results The data of the two groups were compared and analyzed.Multivariate Logistic regression analysis showed that BMI,diabetes,age,axillary lymph node dissection and hemoglobin were independent risk factors for poor incision healing(P<0.05).ROC curve analysis of independent risk factors showed that when the age was more than 57.5,the area under the curve(AUC)was 0.635,the sensitivity was 55.4%,the specificity was 68.1%,and the critical value was 57.5.When BMI>24.9 kg/m2,the area under the curve(AUC)was 0.735,the sensitivity was 87.5%,the specificity was 61.7%,and the critical value was 24.9(P<0.001).When hemoglobin<101.5 g/L,the area under the curve(AUC)was 0.829,the sensitivity was 57.1%,the specificity was 94.7%,and the critical value was 101.5 g/L(P<0.001).Conclusion BMI,diabetes,hemoglobin,age and axillary lymph node dissection are independent risk factors for poor wound healing after breast cancer operation.When BMI>24.9 kg/m2,age>57.5 years old and hemoglobin<101.5 g/L,it can predict the occurrence of poor incision healing in patients with breast cancer.
6.The short-term effects of Conbercept intravitreal injection on matrix metalloproteinase-2 and tissue inhibitor of metalloproteinases-2 expression in the aqueous humor of eyes with proliferative diabetic retinopathy
Wei ZHANG ; Kai ZHU ; Wen JIA ; Rui ZHANG ; Xuran LI ; Yonghao GU
Chinese Journal of Ocular Fundus Diseases 2025;41(1):7-14
Objective:To observe and analyze the short-term effects of intravitreal injection of Conbercept (IVC) on the expression levels of matrix metalloproteinase (MMP)-2 and MMP inhibitor-2 (TIMP-2) in the aqueous humor of eyes with proliferative diabetic retinopathy (PDR).Methods:A prospective clinical study. From March 2024 to June 2024, 30 consecutive patients with 30 eyes with PDR (PDR group) undergoing IVC combined with pars plana vitrectomy (PPV) at Department of Ophthalmology of The First Affiliated Hospital of University of Science and Technology were included in the study, along with 20 patients with 20 eyes undergoing cataract surgery (control group) during the same period. In the PDR group, IVC treatment was performed 3 to 7 days before PPV, and 0.05-0.10 ml aqueous humor was collected before IVC and before PPV. In the control group, 0.05-0.10 ml aqueous humor was collected before cataract surgery. The levels of vascular endothelial growth factor (VEGF), MMP-2, and TIMP-2 in the aqueous humor were measured using enzyme-linked immunosorbent assay. For normally distributed data, independent samples t-test were used for comparison between two groups; for non-normally distributed data, the Mann-Whitney U test was used. The correlation analysis of VEGF, MMP-2, TIMP-2 concentrations in aqueous humor of PDR patients was performed using Pearson's correlation coefficient. Results:There were no statistically significant differences in age ( Z=-1.810) and gender composition ( χ2=3.450) between the PDR group and the control group ( P>0.05). Before IVC, VEGF and MMP-2 expression levels were (0.23±0.10), (2.11±1.32) ng/ml and (0.12±0.03), (0.53±0.26) ng/ml in patients' aqueous fluid in PDR group and control group, respectively. The expression level of TIMP-2 and the ratio of MMP-2/TIMP-2 were (0.99±0.26), (1.76±0.11) ng/ml and 2.04 (1.19, 2.98), 0.36 (0.15, 0.39), respectively. Compared with the control group, the expression levels of VEGF and MMP-2 in aqueous humor in PDR group ( t=-5.030, -5.260) and the ratio of MMP-2/TIMP-2 ( Z=-5.740) were significantly increased, with statistical significance ( P<0.01). The expression level of TIMP-2 was significantly lower than that of control group, the difference was statistically significant ( t=12.120, P<0.01). After IVC, the expression levels of VEGF and MMP-2 in aqueous humor of PDR patients were (0.13±0.03) and (2.11±1.32) ng/ml, respectively. The expression level of TIMP-2 and the ratio of MMP-2/TIMP-2 were (0.95±0.28) ng/ml and 1.57 (1.02, 3.13), respectively. Compared with before IVC, the expression level of VEGF in aqueous humor in PDR group after IVC was significantly decreased, and the difference was statistically significant ( t=6.080, P<0.01). The expression levels of MMP-2 ( t=1.220), TIMP-2 ( t=0.290) and the ratio of MMP-2/TIMP-2 ( Z=-0.260) were not significantly different ( P=0.270, 0.780, 0.800). After IVC, there was no significant difference in VEGF expression level between PDR group and control group ( t=-1.200, P=0.240). The expression level of MMP-2 was still significantly increased ( t=-5.880), the expression level of TIMP-2 was still significantly decreased ( t=11.520), and the ratio of MMP-2/TIMP-2 was still significantly increased ( Z=-5.780), with statistical significance ( P<0.01). Correlation analysis showed that VEGF was positively correlated with MMP-2 in aqueous humor of PDR patients before IVC ( r=0.590, P<0.01). Conclusions:IVC can effectively reduce the level of VEGF in the aqueous humor of eyes with PDR in the short term, but it has no significant effect on the levels of MMP-2 and TIMP-2.
7.Research progress of related factors affecting poor response to wet age-related macular degeneration
Haitao PAN ; Ruizhuang LI ; Qiuli ZHANG ; Xuran CHEN
International Eye Science 2024;24(4):567-571
Wet age-related macular degeneration(wARMD)emerges as a primary contributor to irreversible vision impairment in the aging demographic. In clinical practice, anti-vascular endothelial growth factor(VEGF)therapies exhibit pronounced success in managing wARMD. However, in the actual clinical application, there are significant individual differences in the prognosis of anti-VEGF drug therapy, and some patients show poor response to the treatment, which may be related to the morphological differences of retinal layers in macular area, genetics, systemic conditions and other factors. It will help develop a more rational and individualized treatment plan to judge the prognosis of patients according to their different clinical manifestations in advance, so as to reduce overtreatment and the risk of retinal damage. In recent years, most studies on treatment response mainly focus on fundus morphology, genetics and so on. In this study, the relevant factors affecting adverse response to wARMD were reviewed, aiming to provide with more accurate treatment and prognostic monitoring programs for clinicians.
8.Effect of LAG3 deficiency on natural killer cell function and hepatic fibrosis in mice infected with Echinococcus multilocularis
Rousu ZIBIGU ; Ainiwaer ABIDAN ; Duolikun ADILAI ; Yinshi LI ; Xuejiao KANG ; Qian YU ; Bingqing DENG ; Xuran ZHENG ; Maolin WANG ; Jing LI ; Hui WANG ; Chuanshan ZHANG
Chinese Journal of Schistosomiasis Control 2024;36(1):59-66
Objective To investigate the effect of LAG-3 deficiency (LAG3-/-) on natural killer (NK) cell function and hepatic fibrosis in mice infected with Echinococcus multilocularis. Methods C57BL/6 mice, each weighing (20 ± 2) g, were divided into the LAG3-/- and wild type (WT) groups, and each mouse in both groups was inoculated with 3 000 E. multilocularis protoscoleces via the hepatic portal vein. Mouse liver and spleen specimens were collected 12 weeks post-infection, sectioned and stained with sirius red, and the hepatic lesions and fibrosis were observed. Mouse hepatic and splenic lymphocytes were isolated, and flow cytometry was performed to detect the proportions of hepatic and splenic NK cells, the expression of CD44, CD25 and CD69 molecules on NK cell surface, and the secretion of interferon γ (IFN-γ), tumor necrosis factor α (TNF-α), interleukin (IL)-4, IL-10 and IL-17A. Results Sirius red staining showed widening of inflammatory cell bands and hyperplasia of fibrotic connective tissues around mouse hepatic lesions, as well as increased deposition of collagen fibers in the LAG3-/-group relative to the WT group. Flow cytometry revealed lower proportions of mouse hepatic (6.29% ± 1.06% vs. 11.91% ± 1.85%, P < 0.000 1) and splenic NK cells (4.44% ± 1.22% vs. 5.85% ± 1.10%, P > 0.05) in the LAG3-/- group than in the WT group, and the mean fluorescence intensity of CD44 was higher on the surface of mouse hepatic NK cells in the LAG3-/- group than in the WT group (t = −3.234, P < 0.01), while no significant differences were found in the mean fluorescence intensity of CD25 or CD69 on the surface of mouse hepaticNK cells between the LAG3-/- and WT groups (both P values > 0.05). There were significant differences between the LAG3-/- and WT groups in terms of the percentages of IFN-γ (t = −0.723, P > 0.05), TNF-α (t = −0.659, P > 0.05), IL-4 (t = −0.263, P > 0.05), IL-10 (t = −0.455, P > 0.05) or IL-17A secreted by mouse hepatic NK cells (t = 0.091, P > 0.05), and the percentage of IFN-γ secreted by mouse splenic NK cells was higher in the LAG3-/- group than in the WT group (58.40% ± 1.64% vs. 50.40% ± 4.13%; t = −4.042, P < 0.01); however, there were no significant differences between the two groups in terms of the proportions of TNF-α (t = −1.902, P > 0.05), IL-4 (t = −1.333, P > 0.05), IL-10 (t = −1.356, P > 0.05) or IL-17A secreted by mouse splenic NK cells (t = 0.529, P > 0.05). Conclusions During the course of E. multilocularis infections, LAG3-/- promotes high-level secretion of IFN-γ by splenic NK cells, which may participate in the reversal the immune function of NK cells, resulting in aggravation of hepatic fibrosis.
9.Research progress in functional polarization of tumor-associated macrophages and targeting strategies
Bei WANG ; Wenbo LI ; Xuran ZHANG ; Weihong REN
Chinese Journal of Microbiology and Immunology 2024;44(3):265-273
Tumor-associated macrophages (TAMs) are the predominant immune cells in the tumor microenvironment (TME). They have been shown to play an important immunosuppressive role in the development of TME and promote tumor immune escape, growth and metastasis. It is a current research hotspot to regulate the functional polarization of TAMs through trained immunity (metabolic reprogramming, epigenetic remodeling) to affect the occurrence and development of tumors. Therefore, in-depth research in this field not only presents a more comprehensive perspective on the pathogenesis of immune-mediated diseases, but also can provide new strategies for clinical anti-tumor immunotherapy. This paper outlines the origin of TAMs and the phenotypes and mechanisms of TAMs polarization, discusses the mechanisms by which metabolic reprogramming and epigenetic remodeling regulate TAMs, summarizes the regulation of TAMs activation and polarization by them, and provides an overview of the progress in TAMs at the current stage of clinical practice, hoping to provide reference for the development of new immunoprevention and treatment strategies.
10.Analysis of individual monitoring results of occupational external exposure in a steel enterprise in Baotou city from 2018 to 2022
Jing WANG ; Shuchao SUN ; Xuran REN ; Xiaogang LU ; Jie ZHANG ; Shiyu PANG ; Rong JIN
Chinese Journal of Radiological Medicine and Protection 2024;44(8):675-680
Objective:To study the levels of individual dose of radiation workers in a steel enterprise in Baotou City from 2018 to 2022, and analyze the main factors affecting the annual dose, and provide basic data for revising relevant standards.Methods:According to the requirements of occupational external exposure personal monitoring standards (GBZ 128-2019), the personal dose monitoring of workers working in a steel enterprise in Baotou City from 2018 to 2022 was carried out, three months for a period, continuous monitoring 4 periods, and the results were analyzed.Results:A total of 1 360 workers from 10 employers within the enterprise were surveyed. The annual doses were in the range of 0.500 - 0.844 mSv, with an average annual individual dose of 0.676 mSv. Especially, the average annual individulal effective dose to workers for safety management and inspection was 0.986 mSv, hiher than 0.698 mSv to rolling workers, pump operators, and continuous casters ( Z = 56.89, P < 0.001). Additionally, female worders working with the radiation generators had a higher average annual individual effective dose of 0.821 mSv, than 0.691 mSv to the male workers who were exposed to sealed sources possibly in many cases as needed, with a statistically significant difference ( Z =-5.53, P < 0.001). Conclusions:The average annual individual effective dose to radiation workers in an iron and steel enterprise in Baotou City meets the requirements of the relevent national standard. The annual dose of women and some workers is relatively high, so the management of radiation workers should be strengthened and the radiation protection measures in the workplace should be improved.

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