1.Efficacy and safety of CT-guided radiofrequency ablation as a surgical alternative for multiple pulmonary nodules
Changhui MA ; Bin ZHANG ; Linxiang YU ; Zhong GUAN ; Junyi YANG ; Haiwen ZHEN
Chinese Journal of Clinical Medicine 2026;33(2):299-305
Objective To evaluate the efficacy and safety of CT-guided percutaneous radiofrequency ablation (RFA) as an alternative for video-assisted thoracoscopic surgery (VATS) in treating multiple pulmonary nodules. Methods A retrospective analysis was conducted on the clinical data of 113 patients with multiple pulmonary nodules admitted to Jiangsu Provincial Hospital of Traditional Chinese Medicine from October 2020 to October 2022. The patients were divided into the RFA group (n=50) and the VATS group (n=63) based on the treatment method. Perioperative indicators (operation time, intraoperative blood loss, postoperative length of hospital stay), oncological outcomes (recurrence-free survival [RFS], overall survival [OS]), and postoperative complication rates were compared between the two groups. Univariate and multivariate Cox regression analysis was performed to identify independent prognostic factors. Results The operation time in the RFA group was significantly shorter than that in the VATS group ([75.2±20.1] min vs [102.3±28.7]) min, P<0.001). No statistically significant differences were observed in intraoperative blood loss and postoperative length of hospital stay. After follow-up of 24 (12, 30) months, no statistically significant differences were found in RFS (HR=1.25, P=0.445) or OS (HR=1.42, P=0.402) between the two groups. Mixed ground-glass nodules with high solid component and solid nodule were identified as independent risk factors for RFS (HR=2.44, P=0.023; HR=2.97, P=0.007) and OS (HR=2.87, P=0.022; HR=3.43, P=0.005) in patients with multiple pulmonary nodules. The total complication rate in the RFA group was lower than that in the VATS group (12.0% vs 34.9%, P=0.009). Conclusions The efficacy of CT-guided RFA in treating multiple pulmonary nodules is comparable to that of VATS, with good safety, and it shows promise as an alternative to surgical treatment for multiple pulmonary nodules.
2.Analysis of the current situation and influencing factors of platelet supply in medical institutions
Xuan WU ; Ting ZHANG ; Xiaozhen GUAN ; Yang YU
Chinese Journal of Blood Transfusion 2026;39(3):339-345
Objective: To systematically analyze the current status and influencing factors of platelet supply in medical institutions across China, and to explore the problems and future development directions of the existing supply models. Methods: From February 25 to March 5, 2025, a web-based questionnaire survey was performed. A self-designed questionnaire was distributed to staff in the blood transfusion departments of medical institutions nationwide in China. Data on the current status and influencing factors of platelet supply were collected and analyzed. Results: A total of 2 268 responses were collected in this survey, with 1 366 valid questionnaires finally included, covering 33 provinces, autonomous regions, and municipalities directly under the central government across China. The survey revealed that platelet supply in Chinese medical institutions exhibited a pattern of "sufficient in the eastern region, stable in the central region, and scarce in the western region": adequate in East China; generally favorable in South China except Guangxi; centered on Beijing and Tianjin in North China; basically met but with insufficient reserves in Central China; subject to seasonal fluctuations in Northeast China; only meeting the baseline supply in Yunnan, Guizhou, and Sichuan in Southwest China; and notably short in Qinghai, Ningxia, and Xinjiang in Northwest China. Family donor mobilization was required in 81.2% (1 109/1 366) of institutions, whereas this proportion was only 12.7% (173/1 366) among institutions with sufficient supply. Tertiary hospitals constituted the main users, among which tertiary Class A hospitals had the highest sufficiency rate, and secondary Class B hospitals showed the most pronounced shortage. A total of 84% (1 147/1 366) of institutions lacked a professional management team; only 19% (266/1 366) had an inventory warning system, of which 88% (234/266) considered it effective. Platelet reservation required 3 days in 33% (458/1 366) of institutions. The mandatory transfusion rate was 30.55% (29/118) when the reservation lead time exceeded 3 days, representing an increase of 5.98% compared with 24.57% (55/180) in the same-day reservation group. For optimization, most institutions called for improved blood donation services, strengthened education and incentives, establishment of regional coordination and policy collaboration, and supplementary suggestions focused on technologies for extending platelet shelf life. Conclusion: Regional imbalance in platelet supply across China is prominent, with supply shortages in some provinces, reliance on family donor mobilization in most institutions, weak grassroots support capacity, imperfect management systems, and supply timeliness constraining clinical practice. Systematic improvements are needed in optimizing blood donation services, strengthening regional coordination, improving relevant policies, and developing platelet preservation technologies, so as to enhance the level of supply security and patient safety.
3.Study on the mechanism of Huatan qushi huoxue formula in improving metabolic dysfunction-associated steatohepatitis by inhibiting macrophage pyroptosis
Yajie GUAN ; Qizhen ZHANG ; Junjiao XU ; Yijia SONG ; Dongfang SHANG ; Wenxia ZHAO ; Minghao LIU
China Pharmacy 2026;37(7):864-869
OBJECTIVE To focus on the classic NOD-like receptor protein 3 (NLRP3)/Caspase-1/gasdermin D (GSDMD) pyroptosis pathway and explore the mechanism by which Huatan qushi huoxue formula (HQHF) inhibits macrophage pyroptosis to ameliorate metabolic dysfunction-associated steatohepatitis (MASH). METHODS RAW264.7 cells were divided into 5 groups: Control group (10% blank serum), Model group [10% blank serum+5 μg/mL lipopolysaccharide (LPS)], HQHF-L group (2.5% drug-containing serum+7.5% blank serum+5 μg/mL LPS), HQHF-M group (5% drug-containing serum+5% blank serum+5 μg/mL LPS), and HQHF-H group (10% drug-containing serum+5 μg/mL LPS). After 24 h of routine culture post-administration, cells and supernatants were collected for assays. Cell morphology was observed via scanning electron microscopy and phase-contrast microscopy; localization and expression of gasdermin D-N (GSDMD-N) were observed by immunofluorescence. Interleukin-1β (IL-1β) and IL-18 contents in supernatants were detected by ELISA; mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD were measured using real-time PCR and Western blot. RESULTS Compared with the Control group, the Model group showed typical pyroptotic morphology (cell membrane bulging and pore formation), increased aggregation and fluorescence intensity of GSDMD-N on the cell membrane ( P <0.05), significantly increased the contents of IL-1β and IL-18 in cell supernatants ( P <0.05), and significantly up-regulated mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD in cells ( P <0.05). Compared with the Model group, the HQHF-L, HQHF-M and HQHF-H groups showed improved pyroptotic morphology, reduced membrane localization and significantly weakened fluorescence intensity of GSDMD-N ( P <0.05), significantly decreased the contents of IL-1β and IL-18 in cell supernatants ( P <0.05), and significantly down-regulated mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD in cells ( P <0.05). CONCLUSIONS HQHF inhibits LPS-induced macrophage pyroptosis, and its mechanism of improving MASH may be associated with the suppression of the activation of the classical NLRP3/Caspase-1/GSDMD pyroptosis pathway.
4.Effectiveness of anatomical major nail implant guide in the treatment of senile intertrochanteric fracture with proximal femoral nail antirotation.
Yu-Xin YANG ; Shun-Li XU ; Xin WANG ; Cheng-Qi ZHANG ; Kai GUAN
China Journal of Orthopaedics and Traumatology 2025;38(7):668-675
OBJECTIVE:
To explore the application effect of self-developed anatomical main nail insertion guide in proximal femoral nail antirotation (PFNA) internal fixation for the treatment of intertrochanteric fractures (IFF) in elderly patients.
METHODS:
A retrospective analysis was performed on 62 patients with AO31-A2 intertrochanteric fractures who underwent PFNA surgery and met the inclusion criteria from January 2022 to December 2024. They were divided into the conventional PFNA insertion group (conventional operation group) and the anatomical main nail insertion guide-assisted PFNA insertion group(guide group). The conventional operation group (PFNA) included 31 patients, 14 males and 17 females, the age ranged from 64 to 90 with an average of (75.2±11.6) years old;the guide group (PFNA) included 31 patients, 10 males and 21 females, the age ranged fron 67 to 97 with an average of (78.6±13.4) years old. The incision length of the main nail entry, the number of fluoroscopies from satisfactory reduction to before main nail insertion, operation time, intraoperative blood loss, 3-day postoperative VAS score, postoperative hip function Harris score, complications, etc. were observed and compared between the two groups.
RESULTS:
All patients were followed up for a period ranging from 4 to 12 months, with an average follow-up duration of (6.8±1.6) months. Compared with the guide group, the conventional operation group showed significant differences in the following parameters:the entrance length of the main screw was (6.74±3.77) cm vs. (5.13±1.31) cm, the number of fluoroscopies before the insertion of the main screw was (10.32±3.08) times vs. (7.71±2.41) times, the operation time was (150.45±53.47) minutes vs. (127.48±30.37) minutes, and the intraoperative blood loss was (196.77±121.06) ml vs. (140.97±86.00) ml, with P<0.05 indicating statistical significance.There was no statistically significant difference in 3-day postoperative VAS between the two groups (P>0.05). There was a statistically significant difference in the Harris scores between the conventional operation group and the guided operation group one month post-surgery (60.61±6.60) vs. (65.48±5.19) points (P<0.05). and there was no statistically significant difference in hip Harris scores between the two groups at 3 months after operation (P>0.05). During the 3-month follow-up after operation, neither group had incision infection, screw loosening, cutting, pressure sores, deep vein thrombosis, etc., and there was no statistically significant difference in the complication rate between the two groups.
CONCLUSION
It is quickly and accurately to implant PFNA assisted by the anatomical major nail implant guide in treatment of osteoporotic intertrochanteric fracture in the elderly.Compared with the traditional operation, it can shorten the operation time and reduce the surgical and X-ray trauma, and beneficial to the rapid rehabilitation of patients.
Humans
;
Male
;
Female
;
Aged
;
Hip Fractures/surgery*
;
Bone Nails
;
Retrospective Studies
;
Aged, 80 and over
;
Middle Aged
;
Fracture Fixation, Intramedullary/instrumentation*
;
Fracture Fixation, Internal/instrumentation*
5.Prognostic value of quantitative flow ratio measured immediately after percutaneous coronary intervention for chronic total occlusion.
Zheng QIAO ; Zhang-Yu LIN ; Qian-Qian LIU ; Rui ZHANG ; Chang-Dong GUAN ; Sheng YUAN ; Tong-Qiang ZOU ; Xiao-Hui BIAN ; Li-Hua XIE ; Cheng-Gang ZHU ; Hao-Yu WANG ; Guo-Feng GAO ; Ke-Fei DOU
Journal of Geriatric Cardiology 2025;22(4):433-442
BACKGROUND:
The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.
METHODS:
All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR. The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs, composite of target vessel-related cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization). Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs, and all vessels were stratified by this optimal cutoff value. Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.
RESULTS:
Among 428 CTO vessels treated with PCI, 353 vessels (82.5%) were analyzable for post-PCI QFR. 31 VOCEs (8.7%) occurred at 2 years. Mean value of post-PCI QFR was 0.92 ± 0.13. Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91. The incidence of 2-year VOCEs in the vessel with post-PCI QFR < 0.91 (n = 91) was significantly higher compared with the vessels with post-PCI QFR ≥ 0.91 (n = 262) (22.0% vs. 4.2%, HR = 4.98, 95% CI: 2.32-10.70).
CONCLUSIONS
Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO. Achieving functionally optimal PCI results (post-PCI QFR value ≥ 0.91) tends to get better prognosis for patients with CTO lesions.
6.To Explore the Mechanism of Kanggan Mixture Intervene in Rats with Acute Lung Injury Based on Target Network
He HUANG ; Zhongying GUAN ; Decheng WANG ; Jinghe ZHU ; Boyu JING ; Yu ZHANG ; Xiaohu LIU ; Tiefa GUAN ; Yinglan FAN ; Yu GAN ; Lei ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(5):1447-1460
Objective To elucidate the molecular mechanisms underlying the effects of Kanggan Mixture(KGM)on key targets in rats with acute lung injury,network pharmacology and in vivo micro-CT experiments were employed.Methods Network pharmacology was utilized to forecast the target genes and principal pathways involved in the intervention of KGM in acute lung injury(ALI).Lipopolysaccharide(LPS)-induced ALI rat models were utilized,and micro-computed tomography(micro-CT)was employed to evaluate the extent of lung injury in vivo.Experiments were conducted to verify the intervention mechanism of KGM on ALI rats.Results The findings revealed that 190 chemical constituents were identified from KGM,and 579 potential targets and 204 pathways associated with KGM's impact on ALI were predicted.The principal components of KGM,such as quercetin,luteolin,kaempferol,betulin,and lupenone,exhibit anti-viral,anti-inflammatory,and immunomodulatory properties by targeting TP53,AKT1,SRC,EP300,and STAT3,and modulating the FoxO signaling pathway,TNF signaling pathway,PI3K-Akt signaling pathway,and MAPK signaling pathway,demonstrating an influence on acute lung injury.Micro-CT results suggest that KGM can improve lung texture enhancement and lung injury in ALI rats,with an increase in end-expiratory lung volume(inspiratory phase-expiratory phase).The HE and W/D ratio results indicate that KGM can improve lung tissue injury and reduce the lung tissue wet/dry weight ratio(P<0.01).Blood cell analysis results show that the anti-inflammatory agent can decrease the WBC(white blood cell count)and N%(neutrophil percentage)in ALI rats'blood(P<0.01),and increase lymphocytes(P<0.05).Real-time quantitative PCR,WES,and immunohistochemistry results suggest that KGM can decrease the mRNA expression,protein distribution,and protein expression levels of TP53,AKT1,SRC,EP300,and STAT3 in lung tissue of ALI rats(P<0.05).Conclusion KGM has a certain intervention effect on acute lung injury,mainly achieved through the core targets STAT3,EP300,SRC,AKT1,and TP53.
7.Study on the Mechanism of Acupuncture Protection of Quadriceps Muscle Cells in Knee Osteoarthritis Model Rats Based on Piezo1/YAP/Caspase3 Axis
Qu ZHENG ; Xingxing LIN ; Yu ZHANG ; Xuefeng GUAN ; Yiyan HAN ; Yu ZHANG ; Baoqiang DONG
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(8):2274-2283
Objective To explore the mechanism of acupuncture protection of quadriceps muscle cells in knee osteoarthritis model rats based on Piezo1/YAP/Caspase3 axis.Methods 40 SPF grade Wistar rats were selected and adaptively fed for 7 days before being divided into three groups:sham surgery group,model group,western medicine group,and acupuncture group,with 10 rats in each group,according to a random control table.The model group,Western medicine group,and acupuncture group used the modified Hulth method to construct knee osteoarthritis models,while the sham surgery group only cut open the joint cavity and sutured it.After successful model replication,the sham surgery group was given physiological saline by gavage,the western medicine group was given celecoxib solution by gavage,and the acupuncture group was given acupuncture at the infrapatellar,crane top,and blood sea levels.Each group was intervened once a day for 14 consecutive days.During the treatment period,the rats continued to undergo treadmill training.After the intervention,the hematoxylin eosin staining method(HE)was used to detect the morphological changes of various rat quadriceps muscle tissues and articular cartilage;TUNEL method was used to detect apoptosis of quadriceps muscle cells,immunofluorescence method was used to detect the protein expression of Piezo1,YAP,and p-YAP in quadriceps muscle cells,Western blot method was used to detect the expression of anti apoptotic proteins CTGF,AREG,Gli2,AFP in quadriceps muscle tissue,as well as the protein expression levels of apoptosis related proteins Bcl-2,Bcl-xl,Bax,cytc,and Caspase3.Results Compared with the model group,the western medicine group and the acupuncture group had higher thigh circumference,quadriceps wet weight,wet weight maintenance rate,and wet weight to body weight ratio(P<0.05).Compared with the western medicine group,the acupuncture group had higher thigh circumference,quadriceps wet weight,wet weight maintenance rate,and wet weight to body weight ratio(P<0.05).Compared with the model group,the apoptosis index of the quadriceps muscle in the Western medicine group and acupuncture group rats was lower,and the apoptosis index of the quadriceps muscle in the acupuncture group was lower(P<0.05).Compared with the model group,the Western medicine group and acupuncture group showed higher expression of Piezo1 and p-YAP proteins in the quadriceps femoris muscle tissue,lower expression of YAP protein,higher expression of CTGF,AREG,Gli2,AFP proteins,higher expression of Bcl-2 and Bcl-xl proteins,and lower expression of Bax,cytc,and Caspase3 proteins(P<0.05).Compared with the Western medicine group,the acupuncture group showed higher expression of Piezo1 and p-YAP proteins in the quadriceps muscle tissue,lower expression of YAP protein,higher expression of CTGF,AREG,Gli2,AFP proteins,higher expression of Bcl-2 and Bcl-xl proteins,and lower expression of Bax,cytc,and Caspase3 proteins(P<0.05).Conclusion Acupuncture increases the expression of Piezo1 protein in the quadriceps femoris muscle of knee osteoarthritis model rats,promotes the phosphorylation of YAP into the nucleus,thereby promoting proliferation,anti apoptotic proteins CTGF,AREG,Gli2,and AFP protein expression,inhibiting Caspase3-dependent mitochondrial apoptosis,and protecting muscle cells.
8.Observations on the effects of chronic persistent hypoxia on liver in aged mice and the protective role of pyrroloquinoline quinone
Hanyu LI ; Songbai ZHENG ; Guoyu GUAN ; Zhuoga SANGDAN ; Zhiliang YAN ; Zhang YU ; Dagui CHEN
Chinese Journal of Geriatrics 2025;44(6):808-815
Objective:To investigate the effects of chronic persistent hypoxia on hepatic function, histological morphology, and ultrastructure in aged mice, and to evaluate the protective role of pyrroloquinoline quinone(PQQ).Methods:Thirty-two 2-month-old (young group)and thirty-two 18-month-old(aged group)male C57BL6/J mice were each randomly divided into four groups (n=8 per group): normoxia+ normal saline (NS)group, normoxia+ PQQ group, hypoxia+ NS group, and hypoxia+ PQQ group.The normoxia+ NS and normoxia+ PQQ groups were housed under normoxic conditions[fraction of inspired oxygen(FiO 2)=21%], while the hypoxia+ NS and hypoxia+ PQQ groups were continuously exposed to a hypoxic environment[FiO 2=(10±0.5)%]simulated by a custom-made hypoxic chamber, maintaining a constant oxygen concentration for 24 hours per day.The normoxia+ NS and hypoxia+ NS groups received daily intragastric administration of NS, whereas the normoxia+ PQQ and hypoxia+ PQQ groups received daily intragastric administration of PQQ disodium salt(8 mg·kg -1·d -1).After 8 weeks of continuous intervention, blood samples were collected to measure red blood cell count, hemoglobin levels, and liver function-related biochemical indicators.Lung tissues were processed for HE staining, and liver tissues were processed for both HE staining and electron microscopy.The histological and ultrastructural features of each group were observed under light and electron microscopy, respectively, and the differences between the groups were compared and analyzed. Results:Compared with the normoxia+ NS groups, both young and aged hypoxia+ NS groups exhibited significant pulmonary arteriole narrowing( P<0.001), with markedly elevated red blood cell count and hemoglobin levels (all P<0.001), which were not alleviated by PQQ.Compared with the young normoxia+ NS group, the young hypoxia+ NS group showed significantly higher alanine aminotransferase (ALT)and lactate dehydrogenase (LDH)levels( Z=2.72, 2.53, P=0.007, 0.011), whereas the young hypoxia+ PQQ group exhibited LDH levels similar to those of the young normoxia+ NS group.The aged hypoxia+ NS group exhibited significant ALT elevation( t=2.66, P=0.013)compared with the aged normoxia+ NS group.Light microscopy revealed hepatocyte ballooning degeneration, mild fatty accumulation, and focal necrosis around central veins in the young hypoxia+ NS group, while the young hypoxia+ PQQ group exhibited no significant pathological damage but displayed numerous deeply stained binucleated hepatocytes.The aged normoxia+ NS group demonstrated hepatocyte ballooning degeneration and inflammatory cell infiltration around central veins, whereas the aged normoxia+ PQQ group exhibited no obvious pathological damage with scattered deeply stained binucleated hepatocytes.The aged hypoxia+ NS group exhibited significant necrosis following physiological oxygen concentration gradient distribution, while the aged hypoxia+ PQQ group displayed no obvious pathological damage with scattered deeply stained binucleated hepatocytes.Electron microscopy revealed that the aged normoxia+ NS group had reduced mitochondrial electron density ( P<0.001)and less developed rough endoplasmic reticulum compared with the young normoxia+ NS group.The young hypoxia+ NS group exhibited a smaller mitochondrial area( P<0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, inactive rough endoplasmic reticulum, and increased accumulation of glycogen and lipid droplets compared with the young normoxia+ NS group, while the young hypoxia+ PQQ group maintained mitochondrial matrix electron density comparable to the young normoxia+ NS group.The aged hypoxia+ NS group exhibited larger mitochondrial area( P=0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, mitochondrial edema, increased lysosomes, and elevated cytoplasmic electron density compared with the aged normoxia+ NS group.The aged hypoxia+ PQQ group exhibited reduced mitochondrial area( P<0.001)and restored mitochondrial matrix electron density to levels comparable with the aged normoxia+ NS group.The aged normoxia+ PQQ group demonstrated increased mitochondrial matrix electron density compared with the aged normoxia+ NS group( P<0.001). Conclusions:Chronic persistent hypoxia induces hepatic functional, histological and ultrastructural damage in mice, with more pronounced effects in aged animals.PQQ provides a certain degree of protection against these injuries.
9.Comparison of clinical features and related factors between pyogenic spondylitis and tuberculous spondylitis
Lijie GUO ; Yi ZHANG ; Baohui GUAN ; Yuanhao YANG ; Xiaohua CHEN ; Zhenghao TANG ; Yongsheng YU
Chinese Journal of General Practitioners 2025;24(5):594-602
Objective:To compare the clinical manifestations,laboratory results,and imaging features between pyogenic spondylitis(PS) and tuberculous spondylitis(TS).Methods:This was a cross-sectional study. A total of 88 patients with infectious diseases of spine(IDS) admitted to Shanghai Sixth People′s Hospital from January 2021 to December 2023 were analyzed,including 61 PS cases(PS group) and 27 TS cases(TS group). The clinical manifestations,laboratory results,and imaging features were compared between two groups. The factors associated with PS were analyzed by multivariate logistic regression. The diagnostic efficacy for pathogen identification was compared between metagenomics next-generation sequencing(mNGS) and bacterial culture methods in PS and TS patients.Results:Compared with the TS group,the PS group had a higher age-adjusted Charlson comorbidity index(aCCI)[3.0(1.5,4.0) points vs. 2.0(1.0,3.0) points, Z=-2.189, P=0.029],shorter onset time of disease[1.0(0.8,3.0) months vs. 6.0(2.0,12.0) months,Z=-4.353, P<0.001],and higher median blood leukocyte counts and serum ferritin(SF) level(7.2×10 9/L vs. 6.3×10 9/L, Z=-2.652, P=0.008; 571.3 ng/ml vs. 266.0 ng/ml, Z=-4.773, P<0.001). The proportions of lumbar spine involvement,non-collapsed involved vertebrae,and bone bridges formed were all higher in the PS group compared to the TS group[68.8%(99/144) vs. 41.4%(29/70), χ2=14.628, P<0.001; 68.9%(42/61) vs. 18.5%(5/27), χ2=19.055, P<0.001; 41.0%(25/61) vs. 7.4%(2/27), χ2=9.921, P=0.002]. The proportions of thoracic spine involvement,severe vertebral collapse,severe narrowing of the involved intervertebral space,sequestrum,and paravertebral soft tissue calcification were all higher in the TS group compared to the PS group[52.9%(37/70) vs. 18.1%(26/144), χ2=27.463, P<0.001; 55.6%(15/27) vs. 13.1%(8/61), χ2=17.462, P<0.001; 74.1%(20/27) vs. 37.7%(23/61), χ2=9.907, P=0.002; 74.1%(20/27) vs. 18.0%(11/61), χ2=25.761, P<0.001; 51.9%(14/27) vs. 6.6%(4/61), χ2=23.599, P<0.001]. Multivariate logistic regression analysis indicated that a symptom duration<5.5 months( OR=30.644,95% CI: 2.022-464.529, P<0.05) and a leukocyte count>7.35×10 9/L( OR=48.653,95% CI: 2.045-1 157.721, P<0.05) indicated a higher likelihood of PS; while the vertebral collapse indicated a higher likelihood of TS( OR=0.025,95% CI: 0.001-0.638, P<0.05). The most common pathogen in the PS group was Staphylococcus aureus(31 cases,50.8%),followed by Streptococcus species(10 cases,16.4%). The positive rates of mNGS testing in the PS and TS groups were 84.1%(37/44) and 12/13,respectively,which were higher than those of conventional bacterial culture[77.8%(42/54)] and Mycobacteriumtuberculosis culture(2/11). Conclusions:Compared with the TS patients,the PS patients have shorter onset time,higher aCCI scores,higher blood leukocyte counts and SF levels,less vertebral collapse and intervertebral space narrowing,and more bone bridge formation. The TS patients have more dead bones and calcifications. The mNGS has a higher diagnostic efficacy than bacterial cultures for PS and TS.
10.Research of Achyranthoside Ⅰ inhibiting pyroptosis in chondrocytes based on the NF-κB/NLRP3/caspase-1 signaling axis
Ze-xuan LIU ; Yi-yan HAN ; Xue-feng GUAN ; Yu ZHANG ; Jian-yu DAI
The Chinese Journal of Clinical Pharmacology 2025;41(2):198-202
Objective To investigate the mechanism of Achyranthoside Ⅰ inhibits pyroptosis in chondrocytes through the nuclear factor-κB(NF-κB)/NOD receptor protein structure domain related proteins 3(NLRP3)/cystine containing aspartate specific proteins-1(caspase-1)signaling pathway.Methods Primary mouse chondrocytes were divided into blank group(phosphate buffered solution with the same volume),model group[10 ng·mL-1 interleukin-1β(IL-1 β)],control group(10 ng·mL-1 IL-1β+20 μmol·L-1 celecoxib)and experimental group(10 ng·mL-1 IL-1β+3 μg·mL-1 Achyranthoside Ⅰ).After 24 hours of intervention,the cell proliferation was measured by cell counting kit 8,the levels of superoxide dismutase(SOD),malondialdehyde(MDA),IL-1 and IL-6 were detected by enzyme-linked immunosorbent assay,the protein expression levels of NF-κB p65,NLRP3 and caspase-1 were detected by Western Blot.Results The apoptosis rates in experimental,control,model and blank groups were(13.34±0.61)%,(15.64±1.01)%,(21.81±1.10)%and 0;the SOD levels were(147.03±16.49),(130.09±7.33),(122.03±10.71)and(164.40±22.74)nU·mL-1;the MDA levels were(6.43±0.71),(7.63±1.01),(8.89±1.84)and(5.69±0.81)nmol·L-1;the IL-1 levels were(338.69±40.95),(361.78±32.15),(391.44±30.59)and(289.23±25.19)pg·mL-1;the IL-6 levels were(89.96±8.81),(101.10±11.59),(120.39±14.71)and(60.29±6.03)pg·mL-1;the relative expression levels of NF-κB p65 were 0.68±0.05,0.97±0.05,1.26±0.05 and 0.57±0.05;the relative expression levels of NLRP3 were 0.71±0.08,1.02±0.10,1.50±0.06 and 0.31±0.05;the relative expression levels of caspase-1 were 0.70±0.07,1.29±0.08,1.66±0.07 and 0.51±0.07,respectively.Compared with the model group,the differences of above indexes were statistically significant in the experimental group(all P<0.05).Conclusion Achyranthoside Ⅰ can improve the oxidative stress status induced by IL-1 β in chondrocytes,reduce the expression of proteins related to the NF-κB signaling pathway,and thereby decrease the occurrence of caspase-1 dependent pyroptosis,providing a protective effect on chondrocytes.

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