1.Impact of birth weight on the trajectory of blood pressure among primary school students
CUI Chengpeng, YE Siyan, FANG Yanfei, LI Yan, PENG Zeqin, XIAO Yuqing, WU Meng, LIU Qin
Chinese Journal of School Health 2026;47(3):309-313
Objective:
To explore the early effects of birth weight at different gestational ages on blood pressure trajectory among primary school students, so as to provide evidence for incorporating gestational age birth weight into individualized early warning and intervention strategies for childhood hypertension.
Methods:
From May to November 2023, a purposeful sampling method was used to recruit 1 676 students in grade 1-3 from three primary schools in a certain urban district of Chongqing. Follow up assessments were conducted in May 2024(T1), November 2024(T2), and May 2025(T3). General demographic and birth related information were collected via self administered questionnaires, while height, weight and blood pressure were obtained through physical examinations. Linear mixed effects model was used to analyze the associations between birth weight at different gestational ages and blood pressure trajectories.
Results:
During the T1-T3 period, the systolic blood pressure of boys were 98.5 (93.0, 104.5 ),98.5 (93.5, 105.0), and 97.5 (92.5, 103.5)mmHg, respectively, while the diastolic blood pressure were 60.5 (56.5, 65.0), 61.5 ( 57.0 , 65.5), and 60.0 (56.0, 64.0)mmHg, respectively. For girls, the systolic blood pressure were 95.5 (90.0, 102.0),95.5 (90.5, 101.5), and 96.0 (90.5, 101.5)mmHg, respectively, and the diastolic blood pressure were 60.5 (56.0, 64.5 ),61.5 (57.5, 65.5), and 59.5 (56.0, 63.0)mmHg, respectively. Through Friedman test within both boys and girls, diostolic blood pressure were statistically significant across three measurements( χ 2=48.85,81.54,both P <0.01). The proportion of normal blood pressure increased , and the proportion of prehypertension and hypertension decreased with time( χ 2=39.72,25.62,both P < 0.01 ). Linear mixed effects model analysis revealed that after adjusting for age, sex, household income monthly, parental education, family history of hypertension and maternal pregnancy complications, large for gestational age had significantly higher trajectories of systolic ( β = 1.50) and diastolic( β =0.94) blood pressure compared to appropriate for gestational age(both P <0.01).
Conclusion
Large for gestational age is associated with elevated blood pressure trajectories during school age, and it may be considered as an early indicator for individualized screening and intervention for childhood hypertension.
2.Serological characteristics of individuals with hepatitis C virus/hepatitis B virus overlapping infection
Yanfei CUI ; Xia HUANG ; Chao ZHANG ; Yingjie JI ; Song QING ; Yuanjie FU ; Jing ZHANG ; Li LIU ; Yongqian CHENG
Journal of Clinical Hepatology 2026;42(1):74-79
ObjectiveTo investigate the status of overlapping hepatitis B virus (HBV) infection in patients with chronic hepatitis C virus (HCV) infection and the serological characteristics of such patients. MethodsA total of 8 637 patients with HCV infection who were hospitalized from January 1, 2010 to December 31, 2020 and had complete data of HBV serological markers were enrolled, and the composition ratio of patients with overlapping HBV serological markers was analyzed among the patients with HCV infection. The patients were divided into groups based on age and year of birth, and serological characteristics were analyzed, and the distribution of HBV-related serological characteristics were analyzed across different HCV genotypes. ResultsThe patients with HCV/HBV overlapping infection accounted for 5.85%, and the patients with previous HBV infection accounted for 48.10%; the patients with protective immunity against HBV accounted for 14.67%, while the patients with a lack of protective immunity against HBV accounted for 31.39%. The patients were divided into groups based on age: in the 0 — 17 years group, the patients with protective immunity against HBV accounted for 61.41% (304 patients); the 18 — 44 years group was mainly composed of patients with previous HBV infection (698 patients, 37.31%), the 45 — 59 years group was predominantly composed of patients with previous HBV infection (1 945 patients, 50.38%), and the ≥60 years group was also predominantly composed of patients with previous HBV infection (1 486 patients, 61.66%). The patients were divided into groups based on the year of birth: in the pre-1992 group, the patients with previous HBV infection accounted for 51.63% (4 112 patients); in the 1992 — 2005 group, the patients with protective immunity against HBV accounted for 54.72% (168 patients); in the post-2005 group, the patients with protective immunity against HBV accounted for 64.38% (235 patients). In this study, 6 301 patients underwent HCV genotype testing: the patients with genotype 1b accounted for the highest proportion of 51.71% (3 258 patients), followed by those with genotype 2a (1 769 patients, 28.07%), genotype 3b (63 patients, 1.00%), genotype 3a (10 patients, 0.16%), genotype 4 (21 patients, 0.33%), and genotype 6a (5 patients, 0.08%). ConclusionWith the implementation of hepatitis B planned vaccination program in China, there has been a significant reduction in the proportion of patients with previous HBV infection among the patients with HCV/HBV overlapping infection, but there is still a relatively high proportion of patients with a lack of protective immunity against HBV.
3.Effect and mechanism of action of Biejiajian Pills on a rat model of hepatic fibrosis induced by carbon tetrachloride
Longda WU ; Yuanqin DU ; Yanfei WEI ; Dewen MAO ; Yong LIN ; Lu LU ; Faming SHU
Journal of Clinical Hepatology 2026;42(8):1866-1877
ObjectiveTo investigate the therapeutic effect of Biejiajian Pills on rats with carbon tetrachloride (CCl4)-induced hepatic fibrosis and its mechanism based on the bile acid (BA)-short-chain fatty acid (SCFA) metabolic axis. MethodsThe method of CCl4 induction was used to establish a rat model of hepatic fibrosis, and 32 male Sprague-Dawley rats were randomly divided into control group, model group, Biejiajian Pills group (2.2 g/kg), and silymarin group (43.19 mg/kg), with 8 rats in each group. All rats except those in the control group were given intraperitoneal injection of CCl4 (diluted with corn oil at a ratio of 4∶6, 2 mL/kg) to induce a model of hepatic fibrosis for 8 consecutive weeks, and the rats in the drug administration groups were given the corresponding drug by gavage. An automatic biochemical analyzer was used to measure the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and albumin (Alb); chloramine-T colorimetry was used to measure the content of hydroxyproline (HYP) in liver tissue; HE staining and Masson staining were used to observe liver histopathological changes; UPLC-MS/MS and GC-MS were used to measure the levels of BAs and SCFAs. The Shapiro-Wilk test and the Levene test were performed for all data to determine normality and homogeneity of variance; a one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of Ishak score between groups, and the Dunn’s test was used for further comparison between two groups. The Benjamini-Hochberg method was used for multiple comparison correction in the screening of differentially expressed metabolites in metabolomics data. The variable importance in projection (VIP) values were obtained in combination with the orthogonal partial least squares-discriminant analysis (OPLS-DA) model, and metabolites with VIP>1 and P<0.05 were selected as significantly differentially expressed metabolites between groups. The robustness of the OPLS-DA model was evaluated through 200 permutation tests, and the main parameters of the model were reported, including the interpretation rate of the model for categorical variables (R2Y) and the predictive ability of the model (Q2). A Spearman’s rank correlation analysis was performed. ResultsThe results of staining showed ordered arrangement of hepatocytes in the Biejiajian Pills group, with significant alleviation of inflammatory cell infiltration and collagen fiber deposition. Compared with the control group, the model group had significant increases in the serum levels of TBil and HYP and a significant reduction in the serum level of Alb (all P<0.05). Compared with the control group, the Biejiajian Pills group had significant increases in the serum levels of AST, ALT, TBil, and HYP and a significant reduction in the serum level of Alb (all P<0.05), and the silymarin group had significant increases in the serum levels of ALT, TBil, and HYP and a significant reduction in the serum level of Alb (all P<0.05). Compared with the model group, the Biejiajian Pills group had significant reductions in the serum levels of ALT, AST, TBil, and HYP (all P<0.05), and the silymarin group had significant reductions in the serum levels of ALT, TBil, HYP, and AST and a significant increase in the serum level of Alb (all P<0.05). Mechanism studies showed that compared with the control group, the model group had significant reductions in the levels of taurolithocholic acid, tauro-α-muricholic acid, taurocholic acid, glycodeoxycholic acid, taurohyocholic acid, chenodeoxycholic acid, glycohyodeoxycholic acid, 7,12-diketolithocholic acid, taurochenodeoxycholic acid, and glycochenodeoxycholic acid and significant increases in the levels of hyodeoxycholic acid, norcholic acid, β-muricholic acid, and cholic acid (all P<0.05). Compared with the model group, the Biejiajian Pills group had significant increases in the levels of the protective BAs taurolithocholic acid, chenodeoxycholic acid, taurocholic acid, taurohyocholic acid, and taurodeoxycholic acid and significant reductions in the levels of tauro-α-muricholic acid, tauro-β-muricholic acid, taurohyodeoxycholic acid+tauroursodeoxycholic acid, α-muricholic acid, glycoursodeoxycholic acid, and norcholic acid (alll P<0.05). As for SCFAs, compared with the model group, the Biejiajian Pills group had significant increases in the levels of acetic acid, propionic acid, isobutyric acid, butyric acid, isopentanoic acid, pentanoic acid, and hexanoic acid (all P<0.05). Compared with the model group, the silymarin group had significant reductions in the levels of taurolithocholic acid, tauro-α-muricholic acid, norcholic acid, glycocholic acid, deoxycholic acid, tauro-β-muricholic acid, taurodeoxycholic acid, taurohyodeoxycholic acid+tauroursodeoxycholic acid, and α-muricholic acid and significant increases in the levels of taurocholic acid and chenodeoxycholic acid, as well as significant increases in the levels of the SCFAs acetic acid, propionic acid, pentanoic acid, and hexanoic acid (all P<0.05). The correlation analysis showed that the metabolism of BAs and SCFAs was correlated with the changes in serum indicators. ConclusionBiejiajian Pills can alleviate CCl4-induced hepatic fibrosis in rats by regulating the BA/SCFA metabolic axis.
4.Tocilizumab combined with hyperbaric oxygen therapy in treatment of children with antibody-negative autoimmune encephalitis: A case report and literature review
Journal of Apoplexy and Nervous Diseases 2026;43(4):363-368
Antibody-negative autoimmune encephalitis (AE) in children poses certain challenges for clinical diagnosis and treatment due to the lack of characteristic autoantibodies. This study conducts a retrospective analysis of the clinical data of a boy, aged 7 years, who had the main manifestations of “irritability, vomiting, pyrexia, and lethargy”. Video electroencephalography showed diffuse slow waves, with the presence of type 2 cerebrospinal fluid oligoclonal bands, and the boy was tested negative for related autoantibodies in blood and cerebrospinal fluid. Finally the boy was diagnosed with antibody-negative AE. After admission, the boy received first-line immunotherapy with methylprednisolone and intravenous immunoglobulin, combined with tocilizumab for intensive treatment, and the symptoms were rapidly relieved. At 1 week after discharge, the boy experienced memory loss, and head MRI suggested cerebral atrophy. After 1 month of adjuvant hyperbaric oxygen therapy, the boy’s memory recovered to the level before disease onset, and reexaminations of MRI and video electroencephalography obtained normal results.No recurrence was observed during follow-up for 6 months, and the boy achieved satisfactory academic performance.This case suggests that for children with antibody-negative AE, first-line immunotherapy combined with tocilizumab can rapidly control inflammation, and the addition of hyperbaric oxygen therapy can effectively improve subsequent cerebral structural and cognitive abnormalities, with few adverse reactions, which provides a new clinical approach for the treatment of this type of disease.
5.Polydatin Delays Progression of Colitis-associated Colorectal Cancer by Modulating IL-17A/Wnt/β-catenin Signaling Pathway
Jie LIU ; Mengmeng LYU ; Yanfei HONG ; Xinmei NAN ; Jialong SU ; Huachen LIU ; Qing WANG ; Guiying PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):144-154
ObjectiveTo investigate the effects and underlying mechanisms of polydatin in delaying the progression of colitis-associated colorectal cancer (CAC) by constructing an azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced CAC mouse model and conducting in vitro experiments. MethodsFifty-four male C57BL/6J mice were randomly divided into normal, model, and polydatin groups (0.045 g·kg-1). The CAC mouse model was established using AOM/DSS, and samples were collected at 4, 7, and 10 weeks. Body weight change rate, disease activity index (DAI), and tumor formation were assessed. Hematoxylin-eosin (HE) staining was used to observe pathological injury in intestinal tissues. Immunohistochemistry (IHC) was performed to detect zonula occludens-1 (ZO-1) expression in colonic tissues, and Western blot was used to detect the expression of E-cadherin, N-cadherin, and Vimentin in colonic epithelial cells. Real-time PCR was used to measure mRNA expression of interleukin-17A (IL-17A), Wnt3a, β-catenin, T cell factor 1 (Tcf1), E-cadherin, N-cadherin, and Vimentin in colonic tissues. Flow cytometry was used to analyze the proportion of CD8+T cells and the expression of exhaustion-related molecules in tumors. Human colon cancer DLD-1 cells were cultured in a polydatin-containing medium, and wound healing assays were performed to observe migration changes. Real-time PCR was used to detect mRNA expression of interleukin-17 receptor A (IL-17RA), Wnt3a, β-catenin, Tcf1, E-cadherin, N-cadherin, and Vimentin in DLD-1 cells. ResultsCompared with the normal group, the model group at all three time points showed significantly decreased body weight change rate (P<0.01), significantly shortened colon length (P<0.01), and markedly increased DAI scores (P<0.01). HE staining revealed significant inflammatory cell infiltration in the submucosa of the colon in the model group, accompanied by epithelial dysplasia. ZO-1 expression in colonic tissues was significantly reduced (P<0.01). The mRNA expression of the pro-inflammatory factor IL-17A and key molecules of the Wnt/β-catenin pathway (Wnt3a, β-catenin, Tcf1) was significantly elevated (P<0.05). The mRNA and protein expression of epithelial-mesenchymal transition (EMT) markers N-cadherin and Vimentin was significantly upregulated (P<0.05), while E-cadherin expression was significantly downregulated (P<0.05). The proportion of tumor-infiltrating CD8+T cells expressing immunosuppressive molecules (TIM-3, LAG-3, PD-1) was significantly increased (P<0.05). Compared with the model group, the polydatin group showed significant improvement in body weight and DAI score (P<0.01), as well as recovery of colon length and tissue injury. ZO-1 expression in colonic tissue was significantly increased (P<0.01), while IL-17A, Wnt3a, β-catenin, Tcf1, N-cadherin, and Vimentin expression levels were significantly decreased (P<0.05), and E-cadherin expression was significantly increased (P<0.01). Tumor-infiltrating CD8+ T cells expressing immunosuppressive molecules were significantly reduced (P<0.05). In vitro experiments showed that polydatin significantly inhibited migration of DLD-1 cells (P<0.01) and reversed the upregulation of IL-17RA, Wnt3a, β-catenin, N-cadherin, and Vimentin mRNA, as well as the downregulation of E-cadherin mRNA (P<0.05). ConclusionPolydatin inhibits IL-17A secretion and IL-17RA expression, improves the immune microenvironment, blocks activation of the Wnt/β-catenin signaling pathway, suppresses EMT markers (N-cadherin and Vimentin), and restores tight junction protein expression in intestinal epithelial cells, thereby delaying the progression from colitis to colorectal cancer in mice.
6.Clinical observation of cadonilimab plus chemotherapy in advanced gastric adenocarcinoma or adenocarcinoma of gastroesophageal junction with intermediate,low,or no HER2 expression
Ping ZHU ; Xiaofei LI ; Jia ZHU ; Yanfei TIAN ; Xing XU
China Pharmacy 2026;37(14):1868-1873
OBJECTIVE To evaluate the efficacy and safety of cadonilimab plus chemotherapy in patients with advanced gastric adenocarcinoma or adenocarcinoma of gastroesophageal junction (AEG) with intermediate, low, or no human epidermal growth factor receptor 2 (HER2) expression. METHODS Patients with advanced gastric adenocarcinoma or AEG with intermediate, low, or no HER2 expression who were treated at Liaoning Cancer Hospital between October 1, 2024 and June 30, 2025 were retrospectively included. According to the treatment regimen received, the patients were divided into group A [cadonilimab plus oxaliplatin and capecitabine (XELOX), n =54 ] , group B (sintilimab plus XELOX, n =68), and group C (tislelizumab plus XELOX, n =49). Short-term efficacy after 4 cycles of treatment, survival outcomes, and adverse events were compared among the three groups. Cox regression and Logistic regression analyses were further performed to evaluate the effects of the treatment regimen and baseline data on survival outcomes and the risk of grade 3-4 treatment related adverse events (TRAEs). RESULTS No statistically significant differences in objective response rate or disease control rate were observed among the three groups ( P >0.05). The median progression-free survival was 7.56 (5.62, 8.11) months in group A, 7.23 (5.33, 8.23) months in group B, and 7.33 (5.42, 8.19) months in group C, with no statistically significant difference among the three groups ( P >0.05). The median overall survival (mOS) was 11.67 (8.82, 13.88) months in group A, 9.78 (6.82, 12.73) months in group B, and 9.69 (6.78, 12.66) months in group C. The mOS was significantly longer in group A than in group B and group C ( P <0.05), whereas no statistically significant difference was observed between group B and group C ( P >0.05). The correlation analysis indicated that treatment regimen, Eastern Cooperative Oncology Group performance status (ECOG PS), number of metastatic organs, and peritoneal metastasis may be associated with overall survival (OS). No significant association was observed between treatment regimen and the risk of grade 3-4 TRAEs. The incidences of grade 1-2 or grade 3-4 TRAEs did not differ significantly among the three groups ( P >0.05). CONCLUSIONS In patients with advanced gastric adenocarcinoma or AEG with intermediate, low, or no HER2 expression, cadonilimab plus XELOX may provide a more significant OS benefit with a safety profile comparable to that of sintilimab or tislelizumab plus XELOX. Further studies with larger sample sizes are required to validate these findings.
7.Research on the implementation status of the provincial "Three Exemptions" policy for voluntary blood donation in China and analysis on the structural characteristics of beneficiaries
Xia GAI ; Yu ZHENG ; Yanfei ZHANG ; Bing FAN ; Junlei HUANG ; Huaizheng GONG ; Kun YIN
Chinese Journal of Blood Transfusion 2026;39(8):1083-1089
Objective: To analyze the implementation status of the “Three-Exemptions” policy for voluntary blood donation in China by taking Shandong Province as a case study, explore the sociodemographic characteristics of policy beneficiaries and the distribution differences in blood donation frequencies, so as to provide practical references for improving the honor incentive system of voluntary blood donation and stabilizing the blood donation team. Methods: Excel was used to sort out and summarize the policy documents from 31 provincial-level administrative regions of China (excluding Hong Kong, Macao and Taiwan), and its implementation models, temporal characteristics and implementation basis were analyzed. Using 238 193 policy beneficiaries in Shandong Province as the research objects, Stata was adopted for descriptive statistical analysis of sociodemographic characteristics including gender, age, educational background and occupation. The Mann-Whitney U test and Kruskal-Wallis H test were performed to compare the distribution differences of blood donation frequencies among populations with different characteristics. Results: The “Three Exemption” policy has been implemented in 29 provinces nationwide, forming five differentiated implementation models. Specifically, 45.16% of the regions adopted province-wide unified implementation, 32.26% adopted partial prefecture-level city implementation, 12.90% adopted partial clause implementation, 3.23% adopted encouraging implementation, and 6.45% had not implemented the policy. The period from 2023 to 2026 witnessed the concentrated promotion of the policy. In Shandong Province, the beneficiaries were mainly males (82.08%), middle-aged individuals aged 40-60 years (71.78%), groups with junior and senior high school education (56.57%), and staff employees (30.60%). The distribution of blood donation frequencies showed that nearly 60% (56.95%) of the beneficiaries had donated blood 20 to 29 times. Statistically significant differences in donation frequency distributions were observed across genders, age groups, educational backgrounds, and occupations (all P<0.05). Further analysis revealed that the proportion of males with 40 or more blood donations was higher than that of females (24.32% vs 15.60%), while females had a higher proportion of 20-29 blood donations than males (65.98% vs 54.99%). With the increase of age, the proportion of those with 20-29 blood donations gradually decreased, whereas the proportion of those with≥40 blood donations gradually increased. Conclusion: The coverage of the “Three Exemptions” policy for voluntary blood donation in China continues to expand. However, there is still room for optimization in terms of policy implementation standards, population structure adaptation and incentive gradient design. Future efforts should strengthen national top-level design to balance regional development gaps. Moreover, hierarchical and targeted incentive and publicity strategies combined with population structural characteristics should be implemented to enhance public enthusiasm for voluntary blood donation.
8.Correlation Between Gut Microbiota Characteristics and Immunotherapy Efficacy in Patients with Advanced Microsatellite Stable Gastrointestinal Tumors
Yanfei LIU ; Ting GE ; Xi XIE ; Yujie ZHOU ; Min CHENG ; Yan ZHANG ; Guang FU ; Hongyan JIN
Cancer Research on Prevention and Treatment 2026;53(8):600-608
Objective To investigate the correlation between gut microbiota characteristics and immunotherapy efficacy in patients with advanced microsatellite stable (MSS) advanced gastrointestinal tumors. Methods Thirty patients with advanced MSS gastrointestinal tumors, including fourteen cases of gastric cancer and sixteen cases of colorectal cancer, who were admitted from November 1, 2022, to July 31, 2025 were enrolled. All patients underwent gut microbiota testing and received corresponding interventions on the basis of the results, followed by treatment with antiangiogenic agents combined with immunotherapy. Some patients additionally received probiotics or fecal microbiota transplantation. The primary endpoints were disease control rate (DCR) and objective response rate (ORR). The secondary endpoints were progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox regression analyses were used to assess potential prognostic factors. Results Among the thirty patients, no complete response was observed. Two cases of partial response (PR), twelve cases of stable disease, and sixteen cases of progressive disease were recorded. The ORR was 6.7%, and the DCR was 46.7%. The median PFS was 6.4 months, and the median OS was 8.3 months. Both PR patients were classified as having a medium risk of gut microbiota dysbiosis and exhibited a Bacteroides-dominated enterotype. Multivariate analysis indicated that tumor type, liver metastasis, and bone metastasis were potential prognostic factors for PFS and OS. Conclusion Patients with a medium risk of gut dysbiosis may exhibit a relatively favorable response to immunotherapy, suggesting that gut microbiota status could serve as a potential biomarker for predicting treatment efficacy in advanced MSS gastrointestinal tumors.
9.Analysis of hyperopic reserve status and associated factors among preschool children in Jiading District, Shanghai
Chinese Journal of School Health 2026;47(7):1031-1035
Objective:
To investigate the current status of hyperopic reserve among preschool children and to determine the associations with genetic and behavioral factors, so as to provide evidence for early intervention strategies and the development of working protocols for myopia prevention with a forward shift of the prevention threshold.
Methods:
A total of 924 preschool children (3-6 years of age) from 6 kindergartens in Jiading District of Shanghai were enrolled by stratified random sampling from March to June 2024. Cycloplegic refraction using 1% atropine eye drops was performed to obtain accurate spherical equivalent (SE) values. Questionnaires were used to collect the genetic history and daily behavioral habits of the children. Refractive status was classified into three categories based on the SE:sufficient hyperopic reserve, relatively insufficient hyperopic reserve, and pre myopia.
Results:
The overall detection rate of insufficient hyperopic reserve among preschool children was 82.25%, consisting of 72.29% for relatively insufficient hyperopic reserve and 9.96% for pre myopia. Multivariate Logistic regression analysis showed that parental bilateral myopia was independently and positively associated with relatively insufficient hyperopic reserve ( OR =2.13) and pre myopia ( OR =4.35) compared to children with sufficient hyperopic reserve; electronic screen exposure time ≥2 h/d on school days was an independent and positive risk factor for pre myopia ( OR =2.83); all of the above associations were statistically significant (all P <0.05). No statistically significant association was noted between outdoor activity and hyperopic reserve (all P >0.05).
Conclusions
The insufficient hyperopic reserve detection rate is relatively high among preschool children in Jiading District, Shanghai. Early management of electronic device use with regular screening and monitoring for preschool children with a family history of myopia should be strengthened to shift the prevention threshold earlier and prevent childhood myopia.
10.Effect of Different Degrees of Blood Stasis on Cognitive Function and Plasma Differential Metabolites in Patients with Coronary Heart Disease
Shihan XU ; Yanfei LIU ; Fenglan LIU ; Qing WANG ; Fengqin XU ; Yue LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):167-176
ObjectiveTo explore the correlation between the blood stasis score of coronary heart disease(CAD) and mild cognitive impairment(MCI), as well as the changes in plasma metabolic profile of blood stasis in patients with CAD combined with MCI(CADMCI) through a cross-sectional study, and further explore the impact of different degrees of blood stasis on the plasma metabolite profile of CADMCI patients. MethodsAccording to the diagnostic criteria of CAD and CAD blood stasis, patients hospitalized in Xiyuan Hospital of China Academy of Chinese Medical Sciences from October 2022 to October 2023 were continuously included. According to the Montreal Cognitive Assessment(MoCA) scale score, the enrolled patients were divided into CADMCI blood stasis group and CAD blood stasis group. The association between blood stasis score and MCI was analyzed by multivariate Logistic regression model. The receiver operating characteristic(ROC) curve was drawn, and the area under the curve(AUC) was calculated to evaluate the sensitivity and specificity of the model. According to the blood stasis score, the first 30 patients in the CADMCI blood stasis group and CAD blood stasis group were divided into mild blood stasis and severe blood stasis. Ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS) was used to detect plasma metabolites in each group of patients. The differential metabolites were screened according to variable importance in the projection(VIP) value≥1, fold change(FC)<0.67 or >1.5, and P<0.05. ROC curve analysis was further used to evaluate the discriminatory efficiency of the screened differential metabolites for each group of samples. ResultsA total of 266 CAD patients were included in this study. Multivariate Logistic regression analysis showed that the CAD blood stasis score was significantly correlated with MCI[odds ratio(OR)=1.619, 95% confidence interval(CI) 1.223-2.142, P<0.001, ROC curve AUC was 0.615(95% CI 0.547-0.683, P=0.001)], indicating that the CAD blood stasis score has a certain predictive value for MCI. Plasma non-targeted metabolomics analysis showed that the main differential metabolites between CAD blood stasis and CADMCI blood stasis were lipid metabolites, among which phosphatidylcholine[20∶4(5Z, 8Z, 11Z, 14Z)/P-18∶1(11Z)] had the best discriminatory efficiency(ROC curve AUC=0.867, 95% CI 0.754-0.942). Further analysis of the differential metabolites between mild and severe blood stasis showed that lipid metabolites were also the main differential metabolites between mild and severe blood stasis. Among them, 1α,25-dihydroxy-2β-(2-hydroxyethoxy) vitamin D3 had the best efficacy in distinguishing mild and severe CAD blood stasis(AUC=0.813, 95% CI 0.649-0.951), and phosphatidylcholine 34∶2 had the best efficacy in distinguishing mild and severe CADMCI blood stasis(AUC=0.819, 95% CI 0.640-0.941). ConclusionThere is a significant correlation between CAD blood stasis score and MCI. Phosphatidylcholine metabolites play an important role in the pathogenesis of CADMCI blood stasis and severe blood stasis. The CAD blood stasis score combined with the detection of phosphatidylcholine metabolites can provide a reference for the development of early and efficient identification strategies for CADMCI.


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