1.Sesquiterpene ZH-13 from Aquilariae Lignum Resinatum Improves Neuroinflammation by Regulating JNK Phosphorylation
Ziyu YIN ; Yun GAO ; Junjiao WANG ; Weigang XUE ; Xueping PANG ; Huiting LIU ; Yunfang ZHAO ; Huixia HUO ; Jun LI ; Jiao ZHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):139-145
ObjectiveTo study the pharmacological substances and mechanisms through which sesquiterpene ZH-13 from Aquilariae Lignum Resinatum improves neuroinflammation. MethodsBV-2 microglial cells were stimulated with lipopolysaccharide (LPS) to induce neuroinflammation. The cells were divided into the normal group, the model group, and the ZH-13 low- and high-dose treatment groups (10, 20 μmol·L-1). The model group was treated with 1 μmol·L-1 LPS. Cell viability was assessed using the cell proliferation and activity assay (CCK-8 kit). Nitric oxide (NO) release in the cell supernatant was measured using a nitric oxide kit (Griess method). The mRNA expression levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), inducible nitric oxide synthase (iNOS), and interleukin-6 (IL-6) were detected by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The phosphorylation of mitogen-activated protein kinase (MAPK) pathway proteins was assessed by Western blot. ResultsCompared with the model group, ZH-13 dose-dependently reduced NO release from BV-2 cells under LPS stimulation (P<0.05, P<0.01). In the 20 μmol·L-1 ZH-13 treatment group, the mRNA expression levels of IL-1β, TNF-α, iNOS, and IL-6 were significantly reduced compared to the model group (P<0.05, P<0.01). In both the low- and high-dose ZH-13 groups, the expression of the inflammatory factor TNF-α and the phosphorylation of c-Jun N-terminal kinase (JNK) in the upstream MAPK pathway were significantly reduced (P<0.05). After stimulation with the JNK agonist anisomycin (Ani), both low- and high-dose ZH-13 treatment groups showed reduced phosphorylation of JNK proteins compared to the Ani-treated group (P<0.01). ConclusionThe sesquiterpene compound ZH-13 from Aquilariae Lignum Resinatum significantly ameliorates LPS-induced neuroinflammatory responses in BV-2 cells by inhibiting excessive JNK phosphorylation and reducing TNF-α expression. These findings elucidate the pharmacological substances and mechanisms underlying the sedative and calming effects of Aquilariae Lignum Resinatum.
2.Human amniotic mesenchymal stem cells overexpressing neuregulin-1 promote skin wound healing in mice
Taotao HU ; Bing LIU ; Cheng CHEN ; Zongyin YIN ; Daohong KAN ; Jie NI ; Lingxiao YE ; Xiangbing ZHENG ; Min YAN ; Yong ZOU
Chinese Journal of Tissue Engineering Research 2025;29(7):1343-1349
BACKGROUND:Neuregulin 1 has been shown to be characterized in cell proliferation,differentiation,and vascular growth.Human amniotic mesenchymal stem cells are important seed cells in the field of tissue engineering,and have been shown to be involved in tissue repair and regeneration. OBJECTIVE:To construct human amniotic mesenchymal stem cells overexpressing neuregulin 1 and investigate their proliferation and migration abilities,as well as their effects on wound healing. METHODS:(1)Human amniotic mesenchymal stem cells were in vitro isolated and cultured and identified.(2)A lentivirus overexpressing neuregulin 1 was constructed.Human amniotic mesenchymal stem cells were divided into empty group,neuregulin 1 group,and control group,and transfected with empty lentivirus and lentivirus overexpressing neuregulin 1,or not transfected,respectively.(3)Edu assay was used to detect the proliferation ability of the cells of each group,and Transwell assay was used to detect the migration ability of the cells.(4)The C57 BL/6 mouse trauma models were constructed and randomly divided into control group,empty group,neuregulin 1 group,with 8 mice in each group.Human amniotic mesenchymal stem cells transfected with empty lentivirus or lentivirus overexpressing neuregulin-1 were uniformly injected with 1 mL at multiple local wound sites.The control group was injected with an equal amount of saline.(5)The healing of the trauma was observed at 1,7,and 14 days after model establishment.Histological changes of the healing of the trauma were observed by hematoxylin-eosin staining.The expression of CD31 on the trauma was observed by immunohistochemistry. RESULTS AND CONCLUSION:(1)Human amniotic mesenchymal stem cells overexpressing neuregulin-1 were successfully constructed.The mRNA and protein expression of intracellular neuregulin 1 was significantly up-regulated compared with the empty group(P<0.05).(2)The overexpression of neuregulin 1 promoted the migratory ability(P<0.01)and proliferative ability of human amniotic mesenchymal stem cells(P<0.05).(3)Human amniotic mesenchymal stem cells overexpressing neuregulin 1 promoted wound healing in mice(P<0.05)and wound angiogenesis(P<0.05).The results showed that overexpression of neuregulin 1 resulted in an increase in the proliferative and migratory capacities of human amniotic mesenchymal stem cells,significantly promoting wound healing and angiogenesis.
3.Effects of interval and continuous training on the quality of life in physically inactive adults:a meta-analysis
Huakun ZHENG ; Mingyue YIN ; Qian LIU
Chinese Journal of Tissue Engineering Research 2025;29(8):1727-1740
OBJECTIVE:High-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)can improve the quality of life of patients with clinical chronic diseases,but their application effects and regulatory factors in adults with insufficient physical activity are still unclear.This study aimed to explore the application effects and regulatory factors of HIIT and MICT on the quality of life of adults with insufficient physical activity. METHODS:A systematic literature search was conducted in databases including Web of Science Core Collection,Medline(EBSCO Host),PubMed,and Cochrane Library.The search time limit was from the establishment of each database to September 2023.The types of included literature were randomized controlled trials,and the research subjects were physically inactive adults.RevMan 5.4 software and the GRADE evidence evaluation framework were used to assess the quality of the included literature.Main effects pooling of random effects models was performed using R Studio(version 4.2.0).Subgroup analyses,regression analyses,and sensitivity analyzes were used to explore the sources of study heterogeneity and moderators. RESULTS:(1)Thirty-two randomized controlled trials of moderate to high quality were included,involving 2 083 physically inactive adults(HIIT group n=474;MICT group n=708;control group n=901).(2)Compared with the non-training control group,HIIT[Hedges'g=0.61;95%confidence interval(CI):0.40-0.83;I2=45%]and MICT(Hedges'g=0.66;95%CI:0.25-1.08;I2=89%)significantly improved the quality of life.Direct comparison studies of HIIT and MICT found no significant differences in the quality of life(Hedges'g=-0.01;95%CI:-0.23-0.21;I2=0%).(3)Subgroup analysis showed that HIIT and MICT were more effective in improving the physical components of the quality of life(HIIT:Hedges'g=0.82 vs.0.75;MICT:Hedges'g=0.74 vs.0.55),while cycling had a better trend in improving overall quality of life(HIIT:Hedges'g=0.74 vs.0.36;MICT:Hedges'g=1.08 vs.0.52).(4)Additionally,regression analysis did not identify any significant moderators(P>0.05 for all factors).(5)None of the above meta-analyses found publication bias(Egger test P>0.05). CONCLUSION:(1)Moderate to high level evidence shows that both HIIT and MICT can improve the quality of life of adults with insufficient physical activity,and the intervention effects between the two are similar.Therefore,when choosing between these two options,it is necessary to comprehensively consider factors such as time economy,scheduling flexibility,and application feasibility to formulate a personalized exercise plan.(2)This study recommends that when applying HIIT,a low-volume protocol(for example,5 groups each time,1 minute each),3 times/week,and ride at 80%-95%of the maximum heart rate is used to achieve the theoretical best improvement effect.(3)Although MICT improves the quality of life,there is insufficient evidence that increasing exercise duration brings additional benefits.Therefore,this study recommends that when MICT is conducted,it should be carried out more than three times a week,with each training duration controlled between 25 and 60 minutes,and cycling at 50%-75%of the maximum heart rate,in order to achieve the theoretically expected best improvement effect.
4.Traditional Chinese Medicine Syndromes in Depressive Episodes of Bipolar Disorder Based on Cluster Analysis and Bayesian Network:A Cross-sectional Study
Xinzi LIU ; Ziyan LI ; Sisi ZHENG ; Mingkang SONG ; Hong ZHU ; Dongqing YIN ; Hongxiao JIA
Journal of Traditional Chinese Medicine 2024;65(1):79-85
ObjectiveTo explore the elements, distribution and characteristics of traditional Chinese medicine (TCM) syndromes in depressive episodes of bipolar disorder (BD). MethodsBasic information, along with the four examination information, the Hamilton Depression Scale and Young Mania Rating Scale scores, were collected from 293 outpatients with BD at Beijing Anding Hospital, Capital Medical University. The four examination information with an occurrence rate greater than 12% were retained. The R language “dist” function was used to calculate the distances between samples using the Euclidean distance method. The hierarchical clustering of the four examination information was performed using the “hclust” function and the squared Euclidean distance method. A team of five researchers was formed to determine the nature and location of the essential elements of TCM syndrome in BD based on the clustering results. The PC algorithm was used to construct a Bayesian network model of the essential elements. The working group combined the essential elements of TCM syndromes in the Bayesian network according to the reference model results, and then extracted common TCM syndromes. The score of each patient based on the essential elements was matched with the common TCM syndromes to determine the syndrome type of each patient. The working group then performs conformity and revision based on this, obtaining the final distribution of TCM syndromes for the patients. ResultsThere were 77 common TCM symptoms in BD with a frequency greater than 12%. The top 15 symptoms with higher frequencies were slippery pulse, mental fatigue and lack of strength, wiry pulse, excessive rumination, preference for solitude, vexation, agitation and irritability, dry mouth, palpitations, profuse dreaming, unwarranted worries, chest oppression, thin white coating, amnesia, frequent sighing, and poor appetite. TCM syndrome elements of BD can be grouped into 11 categories. The nature of disease-related essential elements included fire, qi deficiency, blood deficiency, qi counterflow, yin deficiency, dampness, heat, fire from constraint, and phlegm. The location of disease-related essential elements included heart, liver, spleen, stomach, kidney, bladder channel, and gallbladder. By constructing a Bayesian network model and considering the opinions from the experts, six common syndromes of BD were identified, among which the highest proportion was heart-stomach heat accumulation, accounting for 27.99% (82 cases), followed by heart-spleen deficiency (55 cases, 18.77%), non-interaction between the heart and the kidney (49 cases, 16.72%), liver constraint and blood deficiency (42 cases, 14.33%), heart qi deficiency (37 cases, 12.63%), and damp-heat in the liver and gallbladder (28 cases, 9.56%). ConclusionsThe nature of disease-related elements of BD are predominantly fire and heat, while the location of disease-related essential elements are primarily associated with the heart, liver, and spleen. The most common TCM syndromes are heart-stomach heat accumulation and heart-spleen deficiency.
5.Not Available.
Weile YE ; Jiaojiao WANG ; Peter J LITTLE ; Jiami ZOU ; Zhihua ZHENG ; Jing LU ; Yanjun YIN ; Hao LIU ; Dongmei ZHANG ; Peiqing LIU ; Suowen XU ; Wencai YE ; Zhiping LIU
Acta Pharmaceutica Sinica B 2024;14(1):1-19
Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba, a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba, can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.
6.Association between subthreshold depression and psychotic like experiences with non suicidal self injury among adolescents in Shandong Province
MIN Linggui, LIU Xiaoqun,YIN Xunbao, YU Yue, WANG Zheng
Chinese Journal of School Health 2024;45(1):77-81
Objective:
To investigate the association between subthreshold depression, psychotic like experiences (PLEs), and their interactions with non suicidal self injury (NSSI) in adolescents from Shandong, so as to provide a reference for the prevention and early intervention of NSSI in adolescents.
Methods:
A random cluster sampling method was used to select a total of 6 090 adolescents aged 13-22 from two cities along the coast and inland of Shandong Province. Electronic surveys were administered using the SelfInjurious Behavior Questionnaire, Community Assessment of Psychic Experiencepositive 8 items(CAPE-P8), and the Center for Epidemiological Studies Depression Scale(CES-D). The relationship between subthreshold depression, PLEs, and their interaction with NSSI was analyzed using multivariate Logistic regression.
Results:
The detection rate of NSSI among adolescents was 21.3%. The highest NSSI reporting rate (27.9%) was found in the age group of 13-15 years.The NSSI reporting rates for those detected with subthreshold depression and PLEs were 49.9% and 30.7%, respectively. Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI [OR(95%CI)=3.47(2.68-4.50)]. Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences [OR(95%CI)=5.32(4.10-6.89)]. When both subthreshold depression and PLEs coexist, the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition [OR(95%CI)=18.47(14.75-23.13)] (P<0.01). The relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were 11.44, 0.61, and 2.89, respectively, indicating that the combined interaction of subthreshold depression and PLEs accounted for 61% of adolescent NSSI.
Conclusions
Subthreshold depression and psychoticlike experiences are associated NSSI in adolescents and exhibit an additive interaction. Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.
7.Basic and Clinical Research of Fecal Microbiota Transplantation in The Treatment of Central Nervous System Diseases
Hong-Ru LI ; Cai-Hong LEI ; Shu-Wen LIU ; Yuan YANG ; Hai-Xia CHEN ; Run ZHANG ; Yin-Jie CUI ; Zhong-Zheng LI
Progress in Biochemistry and Biophysics 2024;51(11):2921-2935
As a microbial therapy method, fecal microbiota transplantation (FMT) has attracted the attention of researchers in recent years. As one of the most direct and effective methods to improve gut microbiota, FMT achieves therapeutic benefits by transplanting functional gut microbiota from healthy human feces into the intestines of patients to reconstruct new gut microbiota. FMT has been proven to be an effective treatment for gastrointestinal diseases such as Clostridium difficile infection, irritable bowel syndrome, and inflammatory bowel disease. In addition, the clinical and basic research of FMT outside the gastrointestinal system is also emerging. It is worth noting that there is bidirectional communication between the gut microbial community and the central nervous system (CNS) through the gut-brain axis. Some gut bacteria can synthesize and release neurotransmitters such as glutamate, gamma-aminobutyric acid (GABA) and dopamine. Imbalanced gut microbiota may interfere with the normal levels of these neurotransmitters, thereby affecting brain function. Gut microbiota can also produce metabolites that may cross the blood-brain barrier and affect CNS function. FMT may affect the occurrence and development of CNS and its related diseases by reshaping the gut microbiota of patients through a variety of pathways such as nerves, immunity, and metabolites. This article introduces the development of FMT and the research status of FMT in China, and reviews the basic and clinical research of FMT in neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease), neurotraumatic diseases (spinal cord injury, traumatic brain injury) and stroke from the characteristics of three types of nervous system diseases, the characteristics of intestinal flora, and the therapeutic effect and mechanism of fecal microbiota transplantation, summarize the common mechanism of fecal microbiota transplantation in the treatment of CNS diseases and the therapeutic targets. We found that the common mechanisms of FMT in the treatment of nervous system diseases may include the following 3 categories through summary and analysis. (1) Gut microbiota metabolites, such as SCFAs, TMAO and LPS. (2) Inflammatory factors and immune inflammatory pathways such as TLR-MyD88 and NF-κB. (3) Neurotransmitter 5-HT. In the process of reviewing the studies, we found the following problems. (1) In basic researches on the relationship between FMT and CNS diseases, there are relatively few studies involving the autonomic nervous system pathway. (2) Clinical trial studies have shown that FMT improves the severity of patients’ symptoms and may be a promising treatment for a variety of neurological diseases. (3) The improvement of clinical efficacy is closely related to the choice of donor, especially emphasizing that FMT from healthy and young donors may be the key to the improvement of neurological diseases. However, there are common challenges in current research on FMT, such as the scientific and rigorous design of FMT clinical trials, including whether antibiotics are used before transplantation or different antibiotics are used, as well as different FMT processes, different donors, different functional analysis methods of gut microbiota, and the duration of FMT effect. Besides, the safety of FMT should be better elucidated, especially weighing the relationship between the therapeutic benefits and potential risks of FMT carefully. It is worth mentioning that the clinical development of FMT even exceeds its basic research. Science and TIME rated FMT as one of the top 10 breakthroughs in the field of biomedicine in 2013. FMT therapy has great potential in the treatment of nervous system diseases, is expected to open up a new situation in the medical field, and may become an innovative weapon in the medical field.
8.Advances in DNA origami intelligent drug delivery systems
Zeng-lin YIN ; Xi-wei WANG ; Jin-jing CHE ; Nan LIU ; Hui ZHANG ; Zeng-ming WANG ; Jian-chun LI ; Ai-ping ZHENG
Acta Pharmaceutica Sinica 2024;59(10):2741-2750
DNA origami is a powerful technique for generating nanostructures with dynamic properties and intelligent controllability. The precise geometric shapes, high programmability, and excellent biocompatibility make DNA origami nanostructures an emerging drug delivery vehicle. The shape, size of the carrier material, as well as the loading and release of drugs are important factors affecting the bioavailability of drugs. This paper focuses on the controllable design of DNA origami nanostructures, efficient drug loading, and intelligent drug release. It summarizes the cutting-edge applications of DNA origami technology in biomedicine, and discusses areas where researchers can contribute to further advancing the clinical application of DNA origami carriers.
9.Study on the Mechanism of Guanyuan Mingmen Sequential Acupuncture Activating FSHR/cAMP/PKA Pathway to Promote Granulosa Cell Proliferation in POI Model Rats
Jiang-Hong XU ; Yue-Lai CHEN ; Ping YIN ; Xue-Dan ZHAO ; Hui-Min ZHENG ; Jun-Wei HU ; Lu-Min LIU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(4):965-972
Objective To observe the therapeutic effects and mechanisms of Guanyuan Mingmen Sequential Acupuncture on rats with premature ovarian insufficiency(POI)model.Methods Female SD rats were divided into the blank group,the model group,the protein kinase A(PKA)inhibitor(H89)+acupuncture group,and the acupuncture group,with 12 rats in each group.Except for the blank group,the POI model was prepared by gavage with Tripterygium Glycosides Tablets in the other three groups of rats.After the model was successfully established,the blank group and the model group were bundled once a day;in the acupuncture group,Guanyuan(RN4)point was taken during the intermotility period,and in the pre-motility period,Mingmen(DU4)point was taken;in the H89+acupuncture group,the intervention was performed in accordance with the acupuncture protocol of the acupuncture group,and H89 was injected intraperitoneally for 30 minutes prior to each acupuncture session.Continuous intervention was performed for 20 days.Samples were taken from each group of rats in the first estrus period and in proestrus period after intervention.Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of follicle stimulating hormone(FSH)and estradiol(E2)during the estrous phase,Western Blot was used to measure the protein expressions of follicle stimulating hormone receptor(FSHR)and aromatase P450(P450arom)during the estrous phase,and the activity of granulocytes during the estrous phase and the proestrus phase were measured using the cell-counting kit 8(CCK-8)method.The immunohistochemistry method was used to detect the protein expression of pre-motility proliferating cell nuclear antigen(PCNA).Results(1)Compared with the blank group,the serum FSH level of the model group and H89+acupuncture group was significantly increased(P<0.01),and the E2 level was significantly decreased(P<0.001);there was no difference between the FSH level of the H89+acupuncture group and that of the model group(P>0.05),and the E2 level of the H89+acupuncture group was lower than that of the model group(P<0.05);the FSH level of the acupuncture group was lower than that of the model group and that of the H89+acupuncture group(P<0.05),had no difference with the blank group(P>0.05),E2 level was significantly higher than the model group and H89+ acupuncture group(P<0.01),still being lower than the blank group(P<0.05).(2)The protein expressions of FSHR and P450arom in the model group and H89 + acupuncture group was lower than those in the blank group;the protein expression of FSHR in the H89 + acupuncture group was not different from that in the model group(P>0.05),while the protein expression level of P450arom was lower than that in the model group(P<0.05);the protein expression levels of FSHR and P450arom in the acupuncture group were higher than those in the model group and H89 + acupuncture group,but still lower than those in the blank group(P<0.05).(3)Both GCs activity and average optical density value of PCNA in the model group and H89+acupuncture group were lower than the blank group(P<0.05);both GCs activity and average optical density value of PCNA in the H89+acupuncture group were lower than the model group(P<0.05);the activity of GCs and average optical density value of PCNA of the acupuncture group were significantly higher than that of the model group and H89+acupuncture group(P<0.05 or P<0.01).Conclusion Guanyuan Mingmen Sequential Acupuncture can regulate sex hormone levels,increase GCs activity and promote GCs cell proliferation by up-regulating protein expressions of follicle stimulating hormone receptor(FSHR)/cyclic adenosine monophosphate(cAMP)/protein kinase A(PKA)pathway FSHR,P450arom,thus improving POI.
10.Discomfort in the chest wall approach area in patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach (GUA)
Huihui WANG ; Detao YIN ; Yihao LIU ; Qingyan WANG ; Baozhen QI ; Yuan ZHENG
Chinese Journal of Endocrine Surgery 2024;18(1):63-68
Objective:To investigate the discomfort of chest wall approach area in patients undergoing endoscopic thyroidectomy by a gasless unilateral axillary approach (GUA), and to analyze its influencing factors. To provide a basis for the development of targeted improvement measures.Methods:A total of 153 patients with GUA from May. 2023 to Aug. 2023 in the Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. The general information questionnaire was collected one day before operation, the pain scales were assessed one day and three days after operation, and the pain and numbness scales were assessed one month after operation. The t test or χ2 test was used for comparison of baseline data between groups according to different types of variables. The patients were divided into two groups: less than moderate pain group (two postoperative average VAS scores<4) and more than moderate pain group (two postoperative average VAS scores ≥4). Mild numbness group (postoperative VAS score<4) ; Moderate and severe numbness group (postoperative VAS score ≥4). Multivariate binary Logistic regression was performed with pain discomfort and numbness discomfort as dependent variables to find possible influencing factors. Results:A total of 153 valid questionnaires were collected. There were 125 patients in the moderate pain group; There were 28 patients in the moderate and above pain group. There were 94 patients in the mild numbness group. There were 59 patients in the moderate to severe numbness group. Multivariate binary Logistic regression results showed that, exercise habits ( OR=0.07 95% CI=0.006, 0.409), operation duration ( OR=1.026 95% CI=1.001, 1.054), total drainage volume ( OR=1.122 95% CI=1.07, P<0.05), 1.198), and drainage tube indwelling time ( OR=0.012 95% CI=0.0, 0.187) had an impact on the discomfort of the chest wall approach area, and the difference was statistically significant ( P<0.05). Gender, BMI, marital status, education, occupation, handed-side surgery, handed-side axillary surgery, smokess and alcohol history, intraoperative blood loss, and length of hospital stay had no effect on the discomfort of chest wall approach area, and the difference was not statistically significant ( P>0.05) . Conclusion:Exercise habits, operation duration, total drainage volume, and drainage duration are independent predictors of discomfort in GUA patients.


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