1.Progress on diagnosis and treatment of sodium taurocholate cotransporting polypeptide deficiency
Chinese Pediatric Emergency Medicine 2025;32(4):315-318
Sodium taurocholate cotransporting polypeptide(NTCP)is a carrier protein expressed on the cell membrane transporting most of the plasma bound bile acids and a small amount of unbound bile acids into liver cells.It is an important transporter involved in enterohepatic circulation of bile acid.Sodium taurocholate cotransporting polypeptide deficiency(NTCPD)is caused by a mutation in its coding gene, SLC10A1,which affects the expression and/or function of NTCP.It leads to persistent hypercholanemia,temporary hyperbilirubinemia and cholestasis in early infancy.The disease lacks obvious clinical manifestations and diagnosis typically requires gene sequencing analysis.There is no large-scale epidemiological statistics,but due to the widespread development of clinical gene sequencing projects,the number of diagnosed children is increasing,indicating that the NTCPD is not rare in our country. At present,most clinicians have limited awareness of NTCPD,and often intervene excessively,leading to anxiety among parents.To improve clinicians' understanding of NTCPD,this article reviewed its pathogenesis,clinical consequences,diagnosis,treatment and prognosis.
2.Multi-target regulation of short-chain fatty acids in sepsis
Yunfen TIAN ; Bin WANG ; Fangxiang ZHANG
The Journal of Practical Medicine 2025;41(13):2105-2110
Sepsis,a systemic inflammatory disorder triggered by infection,is characterized by a complex pathophysiological mechanism that gives rise to high mortality rates and treatment bottlenecks.Short-Chain Fatty Acids(SCFAs),as the core metabolites of the intestinal flora,exhibit potential in organ protection during sepsis via a multi-target regulatory mechanism.In the realm of immunomodulation,SCFAs achieve a balance between pro-inflammatory and anti-inflammatory responses by activating G protein-coupled receptors,inhibiting the activation of NLRP3 inflammasomes,and suppressing the cascade reaction of pro-inflammatory factors.At the metabolic regu-lation level,SCFAs optimize mitochondrial function,mitigate the hypercatabolic state associated with sepsis,and relieve organ energy failure.Furthermore,SCFAs exert an organ-protective effect in multiple ways.They enhance the integrity of the intestinal barrier,inhibit pathogen translocation,and impede the systemic spread of inflammation through the synergistic mechanisms of the intestinal-organ axis.Animal and preclinical studies have demonstrated that exogenous supplementation of SCFAs or dietary fiber intervention may interact with the intestinal flora,offering a novel strategy for sepsis treatment.In this review,we systematically summarize the multi-target regulatory network of SCFAs in sepsis and the research progress regarding their organ-protective effects in sepsis.Additionally,we propose therapeutic strategies targeting microbial metabolites,thereby providing a new perspective for overcoming the limitations of traditional anti-infection and immunomodulation.
3.Progress on diagnosis and treatment of sodium taurocholate cotransporting polypeptide deficiency
Chinese Pediatric Emergency Medicine 2025;32(4):315-318
Sodium taurocholate cotransporting polypeptide(NTCP)is a carrier protein expressed on the cell membrane transporting most of the plasma bound bile acids and a small amount of unbound bile acids into liver cells.It is an important transporter involved in enterohepatic circulation of bile acid.Sodium taurocholate cotransporting polypeptide deficiency(NTCPD)is caused by a mutation in its coding gene, SLC10A1,which affects the expression and/or function of NTCP.It leads to persistent hypercholanemia,temporary hyperbilirubinemia and cholestasis in early infancy.The disease lacks obvious clinical manifestations and diagnosis typically requires gene sequencing analysis.There is no large-scale epidemiological statistics,but due to the widespread development of clinical gene sequencing projects,the number of diagnosed children is increasing,indicating that the NTCPD is not rare in our country. At present,most clinicians have limited awareness of NTCPD,and often intervene excessively,leading to anxiety among parents.To improve clinicians' understanding of NTCPD,this article reviewed its pathogenesis,clinical consequences,diagnosis,treatment and prognosis.
4.Multi-target regulation of short-chain fatty acids in sepsis
Yunfen TIAN ; Bin WANG ; Fangxiang ZHANG
The Journal of Practical Medicine 2025;41(13):2105-2110
Sepsis,a systemic inflammatory disorder triggered by infection,is characterized by a complex pathophysiological mechanism that gives rise to high mortality rates and treatment bottlenecks.Short-Chain Fatty Acids(SCFAs),as the core metabolites of the intestinal flora,exhibit potential in organ protection during sepsis via a multi-target regulatory mechanism.In the realm of immunomodulation,SCFAs achieve a balance between pro-inflammatory and anti-inflammatory responses by activating G protein-coupled receptors,inhibiting the activation of NLRP3 inflammasomes,and suppressing the cascade reaction of pro-inflammatory factors.At the metabolic regu-lation level,SCFAs optimize mitochondrial function,mitigate the hypercatabolic state associated with sepsis,and relieve organ energy failure.Furthermore,SCFAs exert an organ-protective effect in multiple ways.They enhance the integrity of the intestinal barrier,inhibit pathogen translocation,and impede the systemic spread of inflammation through the synergistic mechanisms of the intestinal-organ axis.Animal and preclinical studies have demonstrated that exogenous supplementation of SCFAs or dietary fiber intervention may interact with the intestinal flora,offering a novel strategy for sepsis treatment.In this review,we systematically summarize the multi-target regulatory network of SCFAs in sepsis and the research progress regarding their organ-protective effects in sepsis.Additionally,we propose therapeutic strategies targeting microbial metabolites,thereby providing a new perspective for overcoming the limitations of traditional anti-infection and immunomodulation.
5.Correlation of pathologic findings after radical prostatectomy and preoperative 18F-PSMA-1007 PET/CT parameters with the prognosis of patients with prostate cancer
Yunfen BO ; Rongrong TIAN ; Ming ZHAO ; Enwei XU ; Yanfeng XI ; Jie ZHOU ; He LI ; Hailong HAO
Cancer Research and Clinic 2025;37(4):255-261
Objective:To discuss the correlation of pathologic findings after radical prostatectomy and preoperative 18F-PSMA-1007 PET/CT parameters with the prognosis of patients with prostate cancer. Methods:A retrospective case series study was conducted. The clinicopathological data of 48 patients with prostate cancer who underwent radical prostatectomy in Shanxi Province Cancer Hospital between January 2019 and August 2023 were retrospectively analyzed. All patients underwent 18F-PSMA-1007 PET/CT imaging before surgery. The age, the preoperative serum total prostate-specific antigen (tPSA), prostate-specific antigen density (PSAD), prostate volume, tumor diameter, TNM staging, the pathologic data after radical prostatectomy [International Society of Urological Pathology (ISUP) grade, resection margin status, nerve invasion], and preoperative maximum standard uptake value (SUV max) were collected. The receiver operating characteristic (ROC) curves were used to evaluate the efficacy of PET/CT parameter SUV max in predicting tumor recurrence after prostate cancer surgery. The recurrence-free survival (RFS) was analyzed by using the Kaplan-Meier method and log-rank test was performed. Cox proportional risk model was used to analyze the factors influencing RFS after radical prostatectomy. Results:All 48 patients were acinar adenocarcinoma. The median level of the patients' serum tPSA was 19.16 (10.50, 30.99) ng/ml; the median prostate volume was 36.20 (31.83, 45.48) ml; the median tumor diameter was 2.80 (1.60, 4.00) cm; the median PSAD was 0.48 (0.31,1.02) ng·ml -1·cm -3. The primary SUV max of prostate cancer was 13.61 (8.10, 20.20) . Of the 48 patients, 1 case died of heart disease and 1 case died of COVID-19 within 3 to 6 months after surgery, and the rest 46 patients were analyzed for prognosis. Among 46 cases, 26 were in the ISUP low-grade group and 20 were in the high-grade group; 17 were positive and 29 were negative for nerve invasion; 7 were positive and 39 were negative for margin status. The median follow-up time was 18.5 (8-64) months. There were 30 recurrence-free patients and 16 recurrent patients by the follow-up in April 2024. The median RFS time was 15 months; and there were statistically significant differences in RSF among the ISUP high-grade and low-grade groups, preoperative SUV max ≥ 16.77 and < 16.77 groups, positive and negative resection margin groups (all P < 0.01). SUV max was positively correlated with ISUP pathological grade and tPSA level ( r value was 0.634, 0.584, respectively; both P < 0.01). The differences in preoperative serum tPSA level, PSAD, tumor diameter, and SUV max were statistically significant between the ISUP low-grade group and the high-grade group (all P < 0.01); the differences in preoperative serum tPSA, PSAD, and tumor diameter were statistically significant between the nerve invasion positive group and nerve invasion negative group (all P < 0.01); the differences in preoperative serum tPSA, PSAD, tumor diameter, and SUV max between patients with positive resection margins or not were not statistically significant (all P > 0.05). Multivariate Cox regression analysis showed that the tumor resection margin status (negativity vs. positivity: HR = 7.82,95% CI: 1.97-31.07, P < 0.01), ISUP pathological grade (low grade vs. high grade: HR = 4.34,95% CI:1.21-15.62, P < 0.05), and the preoperative SUV max (<16.77 vs. ≥ 16.77: HR = 4.18, 95% CI:1.36-12.85 , P < 0.05) were independent influencing factors for RFS in patients with prostate cancer after radical prostatectomy. Conclusions:Pathological grading after radical prostatectomy and the preoperative 18F-PSMA-1007 PET/CT parameters are associated with the prognosis of patients with prostate cancer.
6.Correlation of pathologic findings after radical prostatectomy and preoperative 18F-PSMA-1007 PET/CT parameters with the prognosis of patients with prostate cancer
Yunfen BO ; Rongrong TIAN ; Ming ZHAO ; Enwei XU ; Yanfeng XI ; Jie ZHOU ; He LI ; Hailong HAO
Cancer Research and Clinic 2025;37(4):255-261
Objective:To discuss the correlation of pathologic findings after radical prostatectomy and preoperative 18F-PSMA-1007 PET/CT parameters with the prognosis of patients with prostate cancer. Methods:A retrospective case series study was conducted. The clinicopathological data of 48 patients with prostate cancer who underwent radical prostatectomy in Shanxi Province Cancer Hospital between January 2019 and August 2023 were retrospectively analyzed. All patients underwent 18F-PSMA-1007 PET/CT imaging before surgery. The age, the preoperative serum total prostate-specific antigen (tPSA), prostate-specific antigen density (PSAD), prostate volume, tumor diameter, TNM staging, the pathologic data after radical prostatectomy [International Society of Urological Pathology (ISUP) grade, resection margin status, nerve invasion], and preoperative maximum standard uptake value (SUV max) were collected. The receiver operating characteristic (ROC) curves were used to evaluate the efficacy of PET/CT parameter SUV max in predicting tumor recurrence after prostate cancer surgery. The recurrence-free survival (RFS) was analyzed by using the Kaplan-Meier method and log-rank test was performed. Cox proportional risk model was used to analyze the factors influencing RFS after radical prostatectomy. Results:All 48 patients were acinar adenocarcinoma. The median level of the patients' serum tPSA was 19.16 (10.50, 30.99) ng/ml; the median prostate volume was 36.20 (31.83, 45.48) ml; the median tumor diameter was 2.80 (1.60, 4.00) cm; the median PSAD was 0.48 (0.31,1.02) ng·ml -1·cm -3. The primary SUV max of prostate cancer was 13.61 (8.10, 20.20) . Of the 48 patients, 1 case died of heart disease and 1 case died of COVID-19 within 3 to 6 months after surgery, and the rest 46 patients were analyzed for prognosis. Among 46 cases, 26 were in the ISUP low-grade group and 20 were in the high-grade group; 17 were positive and 29 were negative for nerve invasion; 7 were positive and 39 were negative for margin status. The median follow-up time was 18.5 (8-64) months. There were 30 recurrence-free patients and 16 recurrent patients by the follow-up in April 2024. The median RFS time was 15 months; and there were statistically significant differences in RSF among the ISUP high-grade and low-grade groups, preoperative SUV max ≥ 16.77 and < 16.77 groups, positive and negative resection margin groups (all P < 0.01). SUV max was positively correlated with ISUP pathological grade and tPSA level ( r value was 0.634, 0.584, respectively; both P < 0.01). The differences in preoperative serum tPSA level, PSAD, tumor diameter, and SUV max were statistically significant between the ISUP low-grade group and the high-grade group (all P < 0.01); the differences in preoperative serum tPSA, PSAD, and tumor diameter were statistically significant between the nerve invasion positive group and nerve invasion negative group (all P < 0.01); the differences in preoperative serum tPSA, PSAD, tumor diameter, and SUV max between patients with positive resection margins or not were not statistically significant (all P > 0.05). Multivariate Cox regression analysis showed that the tumor resection margin status (negativity vs. positivity: HR = 7.82,95% CI: 1.97-31.07, P < 0.01), ISUP pathological grade (low grade vs. high grade: HR = 4.34,95% CI:1.21-15.62, P < 0.05), and the preoperative SUV max (<16.77 vs. ≥ 16.77: HR = 4.18, 95% CI:1.36-12.85 , P < 0.05) were independent influencing factors for RFS in patients with prostate cancer after radical prostatectomy. Conclusions:Pathological grading after radical prostatectomy and the preoperative 18F-PSMA-1007 PET/CT parameters are associated with the prognosis of patients with prostate cancer.
7.Analysis of gut microbiota profile in children with nonalcoholic fatty liver disease
Lu LI ; Bining YANG ; Xuemin ZHANG ; Guixian LI ; Ruixue MA ; Wanrong LUO ; Yunfen TIAN
Chinese Pediatric Emergency Medicine 2024;31(8):608-613
Objective:To explore the structural characteristics of intestinal microflora in children with non-alcoholic fatty liver disease(NAFLD)and the relationship between intestinal microflora and the occurrence as well as development of NAFLD in children.Methods:Fifteen children with NAFLD diagnosed at the First People's Hospital of Yunnan Province from January 2022 to December 2022 were selected as subjects,and 15 healthy children who received routine physical examinations at the outpatient clinic during the same period were randomly selected as healthy control group.The height,weight,waist circumference,blood pressure,blood biochemistry of all children were collected.At the same time,the fresh fecal samples of all children were collected,and the biological information of intestinal flora was analyzed by 16S rRNA sequencing.Results:In the NAFLD group,there were eight males and seven females,with an average age of(11.13±1.77)years.In healthy control group,there were seven males and eight females,with an average age of(9.73±2.25)years.There were no significant differences in sex,age,blood pressure between two groups.Compared with the healthy control group,the levels of body mass index,waist circumference,waist-to-height ratio,alanine aminotransferase,aspartate transaminase,gamma-glutamyl transpeptidase,total bilirubin,direct bilirubin,unconjugated bilirubin,low density lipoprotein cholesterol,uric acid and serum insulin significantly increased and high density lipoprotein cholesterol significantly decreased in NAFLD group( P<0.05).The results of species diversity analysis showed that chaol index and observed-species index in NAFLD group were significantly higher than those in healthy control group( P<0.05).Species diversity analysis showed that the species with increased abundance in NAFLD group included:Proteobacteria,Gammaproteobacteria,Enterobacteriaceae,Klebsiella,Escherichia-Shigella,Escherichia-Shigella-unclassified.Differential species with increased abundance in the healthy control group included:Bifidobacterium species,Bifidobacterium,Bifidobacteriaceae,Bifidobacteriales,Actinobacteria,Actinobacteriota,Bacteroidia,Bacteroidales,Streptococcus-thermophilus. Conclusion:There are metabolic abnormalities and obvious changes in the structure of intestinal flora in children with NAFLD.Exogenous supplementation of Bifidobacterium,Streptococcus thermophilus and Bacteroides may prevent the occurrence of NAFLD,delay the progression of disease and improve fat deposition in the liver.
8.Clinical Analysis of the Spectrum of Upper Gastrointestinal Diseases in 424 Cases of Children in A Tertiary Hospital in Kunming
Yanjuan CHEN ; Wanrong LUO ; Ruixue MA ; Yilin DAI ; Guixian LI ; Yunfen TIAN
Journal of Kunming Medical University 2024;45(12):75-80
Objective To investigate the clinical features of the spectrum of upper gastrointestinal diseases in children and to provide assistance in the prevention,diagnosis and treatment of upper gastrointestinal diseases in children.Methods Clinical data of 424 children aged 2 months to 14 years who were hospitalised for gastroscopy in the paediatrics department of the First People's Hospital of Yunnan Province from January 2018 to June 2023 were collected,and retrospective analyses were performed for the children's clinical presentation,gastroscopy results,and HP infections.Results The symptoms of vomiting and diarrhea in infants were significantly different from those in preschool and school age groups(P<0.05).The positive rate of lesions under gastroscopy was 96.46%.The main diseases found were non-atrophic gastritis(222 cases),bile reflux gastritis(42 cases),non-atrophic gastritis with erosion(30 cases),duodenitis(25 cases),reflux esophagitis(15 cases)and others(75 cases).Helicobacter pylori(HP)was detected in 300 of the 424 cases,and 105 cases were HP positive,with a detection rate of 35.00%.Conclusion Abdominal pain was the main symptom of upper gastrointestinal diseases in school-age and pre-school children.Vomiting and diarrhea were the main symptoms of upper gastrointestinal diseases in infants.There was no gender difference in HP infection,but there was a difference in age.
9.Mechanism of short-chain fatty acids reducing cognitive dysfunction in septic mice: transcriptomic analysis
Meisha SUN ; Yunfen TIAN ; Lan LUO ; Fangxiang ZHANG ; Bin WANG
Chinese Journal of Anesthesiology 2024;44(6):723-728
Objective:To evaluate the mechanism of short-chain fatty acids (SCFAs) reducing cognitive dysfunction in septic mice through transcriptomic analysis.Methods:Sixty SPF healthy adult male C57BL/6 mice, aged 8-12 weeks, weighing 20-25 g, were divided into 3 groups ( n=20 each) using a random number table method: sham operation group (Sham group), sepsis group (SEP group), and SCFAs+ sepsis group (SCFAs+ SEP group). Cecal ligation and puncture (CLP)was used to simulate a sepsis model in anesthetized animals. In SCFAs+ SEP group, 67.5 mmol/L acetate, 40 mmol/L butyrate, and 25.9 mmol/L propionate were added to drinking water starting from 14 days before CLP until 14 days after CLP. Y maze tests were conducted on days 4, 7 and 14 after surgery, with the number of mice in the Y maze test being the number of surviving mice on that day. On day 14 after surgery, 4 mice were selected in SEP group and SCFAs+ SEP group and sacrificed after anesthesia, and brain tissues were obtained to perform transcriptome sequencing, and enrichment analysis was performed using GO database and KEGG database. Finally, 5 mice were randomly sacrificed in each group, and brain tissues were collected and Western blot analysis was performed to verify the sequencing results. Results:Compared with Sham group, the number of times they entered the novel arm on days 4, 7 and 14 after surgery were significantly reduced, and the time spent in the novel arm was shortened in SEP group ( P<0.05). Compared with SEP group, the number of times they entered the novel arm on days 4, 7 and 14 after surgery was significantly increased, and the time spent in the novel arm was prolonged in SCFAs+ SEP group ( P<0.05). The results of transcriptomic analysis showed that 438 significantly differentially expressed genes were identified in SCFAs+ SEP group, of which the expression of 175 genes was up-regulated and the expression of 263 genes was down-regulated compared with SEP group. The expression of gamma-aminobutyric acid receptor rho-2 (GABRR2) in the brain tissues was significantly up-regulated in SEP group as compared with Sham group ( P<0.05). Compared with SEP group, the expression of GABRR2 in the brain tissue was significantly down-regulated in SCFAs+ SEP group ( P<0.05). There was no significant difference in the expression of GABRR2 in brain tissues between Sham group and SCFAs+ SEP group ( P>0.05). Conclusions:SCFAs may reduce cognitive dysfunction by down-regulating the expression of GABRR2 in septic mice.
10.Two cases of Lophomonas blattarum infection combined with paragonimiasis and literature review
Yunfen TIAN ; Xiaoxiao DUAN ; Yan JIANG
Chinese Journal of Primary Medicine and Pharmacy 2023;30(6):806-809
Objective:To investigate the clinical manifestations, diagnosis, and treatment methods of Lophomonas blattarum infection combined with paragonimiasis in children, and improve pediatricians' understanding of the disease. Methods:The clinical data of two children with Lophomonas blattarum infection combined with paragonimiasis who received treatment in the Department of Pediatrics of The First People's Hospital of Yunnan Province were retrospectively analyzed. Children's clinical manifestation and diagnosis and treatment were analyzed. Relative literature was reviewed. Results:Case 1 had the onset of gastrointestinal symptoms. Case 2 had the onset of headache and liver dysfunction. Routine blood tests showed elevated eosinophils two cases and sputum examination results revealed the presence of live eggs of Lophomonas blattarum and paragonimiasis in two cases. Fecal roundworm eggs were also detected in case 1. Follow-up results showed that both cases were cured after treatment with metronidazole injection and praziquantel tablets. Conclusion:Lophomonas blattarum infection is a relatively rare opportunistic infection. Paragonimiasis is a natural parasitic disease that affects both humans and animals. Mixed infection of the two pathogens is rare. We hope that the findings from this paper will broaden clinical physicians' thoughts and guide clinical practice.

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