1.Mechanism of Shenfukang capsule in ameliorating renal interstitial fibrosis by regulating cellular crosstalk via the STAT3/YAP pathway
Wei DU ; Yufang YANG ; Yanhong LIAO ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiangqian FENG ; Xiaobin ZHONG
China Pharmacy 2026;37(12):1547-1552
OBJECTIVE To investigate the mechanism by which Shenfukang capsule (SFK) ameliorates renal interstitial fibrosis (RIF) by regulating macrophage-fibroblast crosstalk via the signal transducer and activator of transcription 3 (STAT3)/Yes-associated protein (YAP) pathway. METHODS RAW264.7 macrophages were induced to polarize with transforming growth factor-β 1 (TGF-β 1 ). Subsequently, a non-contact co-culture system of macrophages with renal fibroblasts NRK-49F, as well as a non-contact co-culture system of macrophages with YAP-knockdown renal fibroblasts, were established. Cells were treated with low, medium, and high concentrations (4, 8, 16 μg/mL) of SFK, as well as a STAT3 inhibitor (STAT3-I,1.64 μg/mL) and losartan potassium tablets (positive control, 0.28 μg/mL), for 48 h. After intervention, the protein and mRNA expression levels of CD86, CD163, and STAT3 in macrophages, as well as CD86, F4/80, and STAT3 mRNA, were detected. In co-cultured renal fibroblasts, the protein and mRNA expression levels of α -smooth muscle actin ( α -SMA), Vimentin, collagen type Ⅰ (Col-Ⅰ), matrix metalloproteinase-1 (MMP-1), and YAP were detected. In co-cultured YAP-knockdown renal fibroblasts, the protein and mRNA expression levels of α -SMA, Vimentin, and MMP-1 were also detected. RESULTS Following TGF-β 1 induction, the protein expression levels of CD86, CD163, and STAT3, as well as the mRNA expression levels of CD86, F4/80, and STAT3 in macrophages were significantly increased ( P <0.05). The conditioned medium from polarized macrophages activated renal fibroblasts, as evidenced by significantly increased protein and mRNA expression levels of α -SMA, Vimentin, Col-Ⅰ, and YAP, and significantly decreased protein and mRNA expression levels of MMP-1 in renal fibroblasts ( P <0.05). Treatment with SFK and STAT3-I reversed the changes in the above indicators, with the medium concentration SFK group showing stronge r effects on some indicators than the low and high concentration groups. In the non-contact co-culture experiment of macrophages and YAP-knockdown renal fibroblasts, there were no statistically significant differences in the protein and mRNA expression of α-SMA, Vimentin, and MMP-1 among the groups. CONCLUSIONS SFK can inhibit macrophage-renal fibroblast crosstalk by blocking the STAT3/YAP pathway, thereby delaying the progression of RIF.
2.Analysis of influencing factors affecting the efficacy of Shenfukang capsule in the treatment of chronic kidney disease and construction of prediction model
Li TANG ; Mengyuan QIN ; Yufang YANG ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiaobin ZHONG
China Pharmacy 2026;37(13):1740-1745
OBJECTIVE To explore the influencing factors of Shenfukang capsule in the treatment of chronic kidney disease (CKD) and construct a nomogram prediction model for evaluating its therapeutic efficacy. METHODS CKD patients who were hospitalized from July 2019 to August 2022 in the First Affiliated Hospital of Guangxi Medical University and treated with Shenfukang capsule were selected as study subjects. Clinical data of the patients were collected from the hospital’s electronic medical record system, and they were divided into an effective group and an ineffective group based on treatment outcomes. Lasso-Logistic multivariate regression analysis was used to screen the influencing factors of the efficacy of Shenfukang capsule. Using the effectiveness of Shenfukang capsule treatment as the prediction outcome and the screened influencing factors as predictor variables, a nomogram prediction model was constructed using R software. All patients were randomly divided into a training cohort and a validation cohort. The discriminative ability, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, respectively. RESULTS Lasso-Logistic regression analysis revealed that concurrent diabetes mellitus, decreased levels of blood urea nitrogen, triglycerides, and serum phosphorus, as well as prolonged prothrombin time and elevated apolipoprotein AⅠ levels, were influencing factors for reduced efficacy of Shenfukang capsule in CKD treatment. The evaluation results of the nomogram prediction model showed that the area under curve values were 0.745 and 0.797 in the training and validation cohorts, respectively, which were close and both exceeded 0.70, indicating stable predictive performance. The calibration curves demonstrated good agreement in both datasets, suggesting satisfactory calibration performance. The clinical decision curves were positioned above the two extreme reference lines, indicating high clinical benefit of the model. CONCLUSIONS Diabetes mellitus, blood urea nitrogen, triglycerides, apolipoprotein AⅠ, serum phosphorus, and prothrombin time were factors associated with the efficacy of Shenfukang capsule in CKD patients. The nomogram prediction model established in this study may provide a basis for rational clinical application of Shenfukang capsule and for improving its therapeutic efficacy in CKD.
3.Analysis of influencing factors affecting the efficacy of Shenfukang capsule in the treatment of chronic kidney disease and construction of prediction model
Li TANG ; Mengyuan QIN ; Yufang YANG ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiaobin ZHONG
China Pharmacy 2026;37(13):1740-1745
OBJECTIVE To explore the influencing factors of Shenfukang capsule in the treatment of chronic kidney disease (CKD) and construct a nomogram prediction model for evaluating its therapeutic efficacy. METHODS CKD patients who were hospitalized from July 2019 to August 2022 in the First Affiliated Hospital of Guangxi Medical University and treated with Shenfukang capsule were selected as study subjects. Clinical data of the patients were collected from the hospital’s electronic medical record system, and they were divided into an effective group and an ineffective group based on treatment outcomes. Lasso-Logistic multivariate regression analysis was used to screen the influencing factors of the efficacy of Shenfukang capsule. Using the effectiveness of Shenfukang capsule treatment as the prediction outcome and the screened influencing factors as predictor variables, a nomogram prediction model was constructed using R software. All patients were randomly divided into a training cohort and a validation cohort. The discriminative ability, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, respectively. RESULTS Lasso-Logistic regression analysis revealed that concurrent diabetes mellitus, decreased levels of blood urea nitrogen, triglycerides, and serum phosphorus, as well as prolonged prothrombin time and elevated apolipoprotein AⅠ levels, were influencing factors for reduced efficacy of Shenfukang capsule in CKD treatment. The evaluation results of the nomogram prediction model showed that the area under curve values were 0.745 and 0.797 in the training and validation cohorts, respectively, which were close and both exceeded 0.70, indicating stable predictive performance. The calibration curves demonstrated good agreement in both datasets, suggesting satisfactory calibration performance. The clinical decision curves were positioned above the two extreme reference lines, indicating high clinical benefit of the model. CONCLUSIONS Diabetes mellitus, blood urea nitrogen, triglycerides, apolipoprotein AⅠ, serum phosphorus, and prothrombin time were factors associated with the efficacy of Shenfukang capsule in CKD patients. The nomogram prediction model established in this study may provide a basis for rational clinical application of Shenfukang capsule and for improving its therapeutic efficacy in CKD.
4.Application value of one-hour post-load glucose ≥8.6 mmol/L during oral glucose tolerance test in detecting prediabetes
Xin CHAI ; Dongli ZHU ; Yachen WANG ; Di LI ; Kaipeng LIANG ; Chunyu YANG ; Jinping WANG ; Zhiwei YANG ; Ruitai SHAO ; Qiuhong GONG ; Juan ZHANG
Chinese Journal of Preventive Medicine 2025;59(6):925-932
Objective:To assess the application value of one-hour post-load glucose (1hPG) for detecting prediabetes among individuals with high risk of type 2 diabetes mellitus (T2DM).Methods:The study was conducted between August 2023 and January 2024, and individuals with a high risk of T2DM were invited to receive an oral glucose tolerance test (OGTT), structural questionnaires, physical measurements, and other biochemical examinations. The fasting, one-, and two-hour glucose and insulin were tested. According to the 1hPG cut point on hyperglycemia suggested by International Diabetes Federation (IDF), normal glucose tolerance (NGT) and prediabetes were further divided into two subgroups, respectively, i.e., NGT with 1hPG<8.6 mmol/L (NGT-1hPG-normal), NGT with 1hPG≥8.6 mmol/L (NGT-1hPG-high), prediabetes with 1hPG<8.6 mmol/L (PDM-1hPG-normal), and prediabetes with 1hPG≥8.6 mmol/L (PDM-1hPG-high). The insulin release curve was drawn by the groups as above. Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR), and β-cell secretory function was evaluated by homeostasis model assessment for β cell function (HOMA-β)/HOMA-IR. Spearman rank correlation analysis was used to calculate the correlation coefficients among 1hPG, 2hPG and HOMA indices, and Steiger′s Z test was used to compare the difference between two correlation coefficients. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were used to assess the accuracy of 1hPG for detecting prediabetes. Results:A total of 2 469 subjects consisting of 1 485 men (60.1%) and 984 (39.9%) women, with a mean age of (45.76±6.20) years, of which 1 844 (74.7%) had 1hPG≥8.6 mmol/L. The prevalence of 1hPG≥8.6 mmol/L was 46.8%, 93.0% and 99.8% in individuals with NGT, prediabetes and newly diagnosed T2DM, respectively ( χ 2=763.78, P<0.001). The insulin release curve showed that insulin secretion increased rapidly in subjects with NGT-1hPG-high, and peaked at one hour, then decreased rapidly, with a significantly higher level of one- and two-hour insulin than those with NGT-1hPG-normal ( P<0.001). Compared to individuals with NGT-1hPG-normal, the counterparts with NGT-1hPG-high exhibited higher HOMA-IR and lower adjusted HOMA-β ( P<0.001). Spearman rank correlation analysis showed that the correlation coefficient of 1hPG with HOMA-IR was similar to the correlation coefficient of 2hPG with HOMA-IR (0.493 vs. 0.480, P=0.550), while the correlation of 1hPG with adjusted HOMA-β was significantly stronger than that of 2hPG (-0.692 vs. -0.587, P<0.001). Excluding patients with T2DM, according to the cut point recommended by IDF, the AUC of 1hPG≥8.6 mmol/L for detecting prediabetes was 0.731 (95% CI: 0.714-0.748), and the sensitivity and specificity were 0.930 and 0.532, respectively, with the kappa value of 0.45. Conclusion:1hPG is closely related to insulin resistance and islet function, and there′s substantial value for individuals with a high risk of T2DM to detect prediabetes by using the 1hPG cut points recommended by IDF.
5.Clinical and pathological features and prognostic analysis of early-onset intrahepatic cholangiocarcinoma
Delong QIN ; Yue TANG ; Zonglong LI ; Jialu CHEN ; Zhimin GENG ; Chuandong SUN ; Hong WU ; Yinghe QIU ; Tianqiang SONG ; Xianhai MAO ; Yu HE ; Zhangjun CHENG ; Wenlong ZHAI ; Jingdong LI ; Xiao LIANG ; Ruixin LIN ; Di TANG ; Zhaohui TANG ; Zhiwei QUAN
Chinese Journal of Surgery 2025;63(6):500-507
Objective:To explore the clinical and pathological features and survival outcomes of patients with early-onset intrahepatic cholangiocarcinoma (EOICC).Methods:This is a multicenter, retrospective cohort study. Data of 1 160 intrahepatic cholangiocarcinoma patients undergoing radical resection in 14 tertiary Grade A hospitals in China from January 2010 to November 2021 were retrospectively collected. The cohort included 632 males and 528 females, aged( M (IQR)) 61 (14) years (range: 22 to 93 years). ICC aged ≤50 years at the time of diagnosis was defined as EOICC and >50 years as late-onset intrahepatic cholangiocarcinoma (LOICC). Of these, there were 247 cases in the EOICC group and 913 cases in the LOICC. The clinical and pathological characteristics of both groups were analyzed and compared using the independent sample t-test, Mann-Whitney U test or Kaplan-Meier method. Univariate and multivariate Cox regression models for patient outcomes were constructed and forest graphed. Results:Compared with the patients in the LOICC group, patients in the EOICC group had lower carcinoembryonic antigen levels (2.5(4.0) μg/L vs. 3.1(5.2)μg/L, U=124 899, P=0.009) and CA19-9 level (63.4(524.7)U/ml vs. 77.9(611.3)U/ml, U=120 320, P=0.013), higher levels of ALT (29(35)U/L vs. 24(26)U/L, U=101 214, P=0.013), a lower score of the Eastern US Cooperative Oncology Group (0 score patients: 54.7% vs. 44.1%, χ2=12.472, P=0.014), higher TNM stage ( χ2=11.807, P=0.038), and proportion of lymph node dissection (62.3% vs. 54.1%, χ2=5.355, P=0.021). Patients in the two groups in sex, first diagnosis symptoms, intrahepatic bile duct stone history, nail protein, albumin, total bilirubin, transaminase, liver function Child-Pugh grade, T stage, stage, N stage, preoperative laparoscopic exploration proportion, tumor diameter, vascular invasion proportion, differentiation, margin, intraoperative bleeding, postoperative complications, postoperative hospital days were no statistical significance (all P>0.05). Patients in the EOICC group had better outcomes than the LOICC group (median survival time: 29.7 months vs. 25.0 months, 3-year overall survival: 45.1% vs. 37.8%, P=0.027). Conclusion:EOICC patients are better than LOICC patients in carcinoembryonic antigen, CA19-9, ALT, physical strength status and TNM stage, and the long-term prognosis is also better than LOICC patients.
6.The expression and clinical value of lncRNA GAS5 and MMP9 in the serum of patients with non-small cell lung cancer
Zhiwei LIANG ; Xing XIN ; Huimin YU
Journal of Clinical Surgery 2025;33(5):498-502
Objective To investigate the expression and clinical value of long non-coding RNA GAS5(lncRNA GAS5)and matrix metalloproteinase 9(MMP9)in the serum of patients with non-small cell lung cancer(NSCLC).Methods A total of 115 NSCLC patients who were treated in our hospital from December 2018 to December 2019 were collected as the NSCLC group.Based on prognosis,they were grouped into a survival group of 94 cases and a death group of 21 cases;another 115 volunteers who were physically healthy in our hospital during the same period were selected as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to measure serum lncRNA GAS5 level;Enzyme linked immunosorbent assay(ELISA)was applied to measure serum MMP9 level;Pearson was applied to analyze the correlation between serum lncRNA GAS5 level and MMP9 level in NSCLC patients;receiver operating characteristic curve(ROC)was applied to evaluate the value of serum lncRNA GAS5 and MMP9 levels in the diagnosis of NSCLC;multivariate Cox regression was applied to analyze the influencing factors of prognosis in NSCLC patients.Results Compared with the control group,the serum lncRNA GAS5 level in the NSCLC group obviously decreased,while the MMP9 level obviously increased(P<0.05);a negative correlation between serum lncRNA GAS5 level and MMP9 level in NSCLC patients(r=-0.523,P<0.05);the levels of serum lncRNA GAS5 and MMP9 were correlated with tumor diameter,TNM staging,and lymph node metastasis(P<0.05);the area under the curve(AUC)of serum lncRNA GAS5 and MMP9 levels for diagnosing NSCLC was 0.842 and 0.916,respectively,the AUC of the combined diagnosis of the two was 0.952,which was superior to their individual diagnoses(Z=3.904 and 1.982,P<0.05);the serum lncRNA GAS5 level in the death group was obviously lower than that in the survival group,while the serum MMP9 level in the death group was obviously higher than that in the survival group(P<0.05);Multivariate Cox regression analysis showed that high levels of lncRNAGAS5 were independent protective factors for poor prognosis in NSCLC while high levels of MMP9 and lymph node metastasis Migration is an independent risk factor for poor prognosis in NSCLC(P<0.05).Conclusion The serum lncRNA GAS5 level is significantly reduced and MMP9 level is significantly increased in NSCLC patients,both of which have certain potential value in the clinical diagnosis of NSCLC and are factors affecting the poor prognosis of NSCLC.
7.Ultrasonic morphological characteristics of superficial and deep thoracolumbar paraspinal muscles in patients with moderate adolescent idiopathic scoliosis
Shanshan ZHANG ; Yanjun WANG ; Zhiwei LIAN ; Yi XU ; Binbin YANG ; Qiuli LIANG ; Chuhuai WANG
Chinese Journal of Spine and Spinal Cord 2025;35(4):366-375
Objectives:To explore the morphological changes of the superficial and deep thoraolumbar paraspinal muscles on both convex and concave sides during rest and contraction states in patients with mod-erate adolescent idiopathic scoliosis(AIS),and their effects on scoliosis angle,to analyze the relations between scoliosis angle and the morphological changes of paraspinal muscles.Methods:21 AIS patients(thoracic Cobb angle 20°-45°,S-shaped with the main curve in thoracic segment,4 males and 17 females,aged 13.9±1.6 years old)treated in our hospital from July 2020 to December 2023 and 21 healthy subjects(7 males and 14 females,aged 14.6±1.4 years old)were prospectively enrolled.The morphological data of thoracolumbar paraspinal muscles were collected with musculoskeletal ultrasound,including the resting thickness and thick-ness during maximum voluntary isometric contraction(MVIC)of superficial erector spinae(ES)and multifidus(MF)muscles of AIS patients on both convex and concave sides(left and right sides of healthy controls).The differences in resting thickness,contraction thickness,change rate of contraction thickness,and total resting thickness and total contraction thickness(ES+MF)of superficial and deep thoracolumbar paravertebral muscles between the two groups were analyzed,and the structural characteristics of the thoracolumbar paravertebral muscles on the convex and concave sides of AIS were analyzed.The correlation between Cobb angle in tho-racolumbar segment and morphological indexes(resting thickness,contraction thickness change rates)of ES and MF muscles was analyzed,and the influence of scoliosis severity on the morphology of superficial and deep paravertebral muscle was further analyzed.Results:In AIS patients,the mean thoracic Cobb angle were 31.62°±7.68°,and mean lumbar Cobb angle were 19.52°±6.48°.Comparing with healthy controls,patients with AIS were significantly different in resting thickness,contraction thickness and thickness change rates of tho-racic paraspinal muscles on both convex and concave sides,and the resting thickness of ES in thoracic seg-ment on concave side was less than that on the convex side,which of MF was less on the convex side than on the concave side(P<0.01).The contraction thickness of thoracic MF muscles on the convex and concave sides in S-type AIS patients was smaller than that in healthy controls(P<0.05),while the contraction thickness of thoracic ES muscles on the convex and concave side wasn't statistically different from that of healthy con-trols,and the contraction thickness change rate of ES muscles on the convex and MF on the concave side of thoracic segment in AIS patients was significantly decreased(P<0.05).There was no significant difference in the total resting thickness of thoracic(convex and concave)paravertebral muscles(ES+MF)between AIS patients and the corresponding segments(left and right)of control group(P>0.05),and there was no statistically signifi-cant difference in the total resting thickness of thoracic paravertebral muscle between the convex and concave sides of AIS patients(P>0.05).The total contraction thickness of thoracic paravertebral muscle(ES+MF)in AIS patients was lower than that in control group(P<0.05).Compared with the control group,the resting thickness,contraction thickness and thickness change rate of lumbar MF muscle on the convex and concave sides in AIS patients were significantly reduced(P<0.05),and the contraction thickness change rate of the lumbar ES muscle on the concave side was less than that of the control group(P<0.05).There were no significant differ-ences in resting thickness and contraction thickness between the convex and concave paravertebral muscles in AIS patients(P>0.05).The total resting thickness(ES+MF)and total contraction thickness(ES+MF)of lumbar(convex and concave)paraspinal muscles in AIS patients were lower than those in control group(P<0.05).There was a significant negative correlation between the Cobb angle of the main thoracic curve and the rest-ing thickness of the thoracic MF muscle on the concave and the change rate of the contraction thickness of the thoracic ES muscle on the convex in S-type AIS patients(r=-0.53/-0.45,P<0.05).There was no signifi-cant correlation between the Cobb angle of lumbar segment and the change rates of the resting thickness and contraction thickness of ES and MF muscles on both convex and concave sides(P>0.05).Conclusions:In pa-tients with moderate S-type AIS,there are different muscle morphological changes in the paraspinal muscles on both convex and concave sides of the main thoracic curve,and the concave paravertebral muscle is more affected by scoliosis;The contraction function of the bilateral deep core stabilizing muscles in the lumbar re-gion is markedly decreased.Different patterns of superficial and deep muscle atrophy and contractility decline may be a key cause of spinal movement disorder and scoliosis progression in AIS patients.
8.Application value of one-hour post-load glucose ≥8.6 mmol/L during oral glucose tolerance test in detecting prediabetes
Xin CHAI ; Dongli ZHU ; Yachen WANG ; Di LI ; Kaipeng LIANG ; Chunyu YANG ; Jinping WANG ; Zhiwei YANG ; Ruitai SHAO ; Qiuhong GONG ; Juan ZHANG
Chinese Journal of Preventive Medicine 2025;59(6):925-932
Objective:To assess the application value of one-hour post-load glucose (1hPG) for detecting prediabetes among individuals with high risk of type 2 diabetes mellitus (T2DM).Methods:The study was conducted between August 2023 and January 2024, and individuals with a high risk of T2DM were invited to receive an oral glucose tolerance test (OGTT), structural questionnaires, physical measurements, and other biochemical examinations. The fasting, one-, and two-hour glucose and insulin were tested. According to the 1hPG cut point on hyperglycemia suggested by International Diabetes Federation (IDF), normal glucose tolerance (NGT) and prediabetes were further divided into two subgroups, respectively, i.e., NGT with 1hPG<8.6 mmol/L (NGT-1hPG-normal), NGT with 1hPG≥8.6 mmol/L (NGT-1hPG-high), prediabetes with 1hPG<8.6 mmol/L (PDM-1hPG-normal), and prediabetes with 1hPG≥8.6 mmol/L (PDM-1hPG-high). The insulin release curve was drawn by the groups as above. Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR), and β-cell secretory function was evaluated by homeostasis model assessment for β cell function (HOMA-β)/HOMA-IR. Spearman rank correlation analysis was used to calculate the correlation coefficients among 1hPG, 2hPG and HOMA indices, and Steiger′s Z test was used to compare the difference between two correlation coefficients. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were used to assess the accuracy of 1hPG for detecting prediabetes. Results:A total of 2 469 subjects consisting of 1 485 men (60.1%) and 984 (39.9%) women, with a mean age of (45.76±6.20) years, of which 1 844 (74.7%) had 1hPG≥8.6 mmol/L. The prevalence of 1hPG≥8.6 mmol/L was 46.8%, 93.0% and 99.8% in individuals with NGT, prediabetes and newly diagnosed T2DM, respectively ( χ 2=763.78, P<0.001). The insulin release curve showed that insulin secretion increased rapidly in subjects with NGT-1hPG-high, and peaked at one hour, then decreased rapidly, with a significantly higher level of one- and two-hour insulin than those with NGT-1hPG-normal ( P<0.001). Compared to individuals with NGT-1hPG-normal, the counterparts with NGT-1hPG-high exhibited higher HOMA-IR and lower adjusted HOMA-β ( P<0.001). Spearman rank correlation analysis showed that the correlation coefficient of 1hPG with HOMA-IR was similar to the correlation coefficient of 2hPG with HOMA-IR (0.493 vs. 0.480, P=0.550), while the correlation of 1hPG with adjusted HOMA-β was significantly stronger than that of 2hPG (-0.692 vs. -0.587, P<0.001). Excluding patients with T2DM, according to the cut point recommended by IDF, the AUC of 1hPG≥8.6 mmol/L for detecting prediabetes was 0.731 (95% CI: 0.714-0.748), and the sensitivity and specificity were 0.930 and 0.532, respectively, with the kappa value of 0.45. Conclusion:1hPG is closely related to insulin resistance and islet function, and there′s substantial value for individuals with a high risk of T2DM to detect prediabetes by using the 1hPG cut points recommended by IDF.
9.The expression and clinical value of lncRNA GAS5 and MMP9 in the serum of patients with non-small cell lung cancer
Zhiwei LIANG ; Xing XIN ; Huimin YU
Journal of Clinical Surgery 2025;33(5):498-502
Objective To investigate the expression and clinical value of long non-coding RNA GAS5(lncRNA GAS5)and matrix metalloproteinase 9(MMP9)in the serum of patients with non-small cell lung cancer(NSCLC).Methods A total of 115 NSCLC patients who were treated in our hospital from December 2018 to December 2019 were collected as the NSCLC group.Based on prognosis,they were grouped into a survival group of 94 cases and a death group of 21 cases;another 115 volunteers who were physically healthy in our hospital during the same period were selected as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to measure serum lncRNA GAS5 level;Enzyme linked immunosorbent assay(ELISA)was applied to measure serum MMP9 level;Pearson was applied to analyze the correlation between serum lncRNA GAS5 level and MMP9 level in NSCLC patients;receiver operating characteristic curve(ROC)was applied to evaluate the value of serum lncRNA GAS5 and MMP9 levels in the diagnosis of NSCLC;multivariate Cox regression was applied to analyze the influencing factors of prognosis in NSCLC patients.Results Compared with the control group,the serum lncRNA GAS5 level in the NSCLC group obviously decreased,while the MMP9 level obviously increased(P<0.05);a negative correlation between serum lncRNA GAS5 level and MMP9 level in NSCLC patients(r=-0.523,P<0.05);the levels of serum lncRNA GAS5 and MMP9 were correlated with tumor diameter,TNM staging,and lymph node metastasis(P<0.05);the area under the curve(AUC)of serum lncRNA GAS5 and MMP9 levels for diagnosing NSCLC was 0.842 and 0.916,respectively,the AUC of the combined diagnosis of the two was 0.952,which was superior to their individual diagnoses(Z=3.904 and 1.982,P<0.05);the serum lncRNA GAS5 level in the death group was obviously lower than that in the survival group,while the serum MMP9 level in the death group was obviously higher than that in the survival group(P<0.05);Multivariate Cox regression analysis showed that high levels of lncRNAGAS5 were independent protective factors for poor prognosis in NSCLC while high levels of MMP9 and lymph node metastasis Migration is an independent risk factor for poor prognosis in NSCLC(P<0.05).Conclusion The serum lncRNA GAS5 level is significantly reduced and MMP9 level is significantly increased in NSCLC patients,both of which have certain potential value in the clinical diagnosis of NSCLC and are factors affecting the poor prognosis of NSCLC.
10.Ultrasonic morphological characteristics of superficial and deep thoracolumbar paraspinal muscles in patients with moderate adolescent idiopathic scoliosis
Shanshan ZHANG ; Yanjun WANG ; Zhiwei LIAN ; Yi XU ; Binbin YANG ; Qiuli LIANG ; Chuhuai WANG
Chinese Journal of Spine and Spinal Cord 2025;35(4):366-375
Objectives:To explore the morphological changes of the superficial and deep thoraolumbar paraspinal muscles on both convex and concave sides during rest and contraction states in patients with mod-erate adolescent idiopathic scoliosis(AIS),and their effects on scoliosis angle,to analyze the relations between scoliosis angle and the morphological changes of paraspinal muscles.Methods:21 AIS patients(thoracic Cobb angle 20°-45°,S-shaped with the main curve in thoracic segment,4 males and 17 females,aged 13.9±1.6 years old)treated in our hospital from July 2020 to December 2023 and 21 healthy subjects(7 males and 14 females,aged 14.6±1.4 years old)were prospectively enrolled.The morphological data of thoracolumbar paraspinal muscles were collected with musculoskeletal ultrasound,including the resting thickness and thick-ness during maximum voluntary isometric contraction(MVIC)of superficial erector spinae(ES)and multifidus(MF)muscles of AIS patients on both convex and concave sides(left and right sides of healthy controls).The differences in resting thickness,contraction thickness,change rate of contraction thickness,and total resting thickness and total contraction thickness(ES+MF)of superficial and deep thoracolumbar paravertebral muscles between the two groups were analyzed,and the structural characteristics of the thoracolumbar paravertebral muscles on the convex and concave sides of AIS were analyzed.The correlation between Cobb angle in tho-racolumbar segment and morphological indexes(resting thickness,contraction thickness change rates)of ES and MF muscles was analyzed,and the influence of scoliosis severity on the morphology of superficial and deep paravertebral muscle was further analyzed.Results:In AIS patients,the mean thoracic Cobb angle were 31.62°±7.68°,and mean lumbar Cobb angle were 19.52°±6.48°.Comparing with healthy controls,patients with AIS were significantly different in resting thickness,contraction thickness and thickness change rates of tho-racic paraspinal muscles on both convex and concave sides,and the resting thickness of ES in thoracic seg-ment on concave side was less than that on the convex side,which of MF was less on the convex side than on the concave side(P<0.01).The contraction thickness of thoracic MF muscles on the convex and concave sides in S-type AIS patients was smaller than that in healthy controls(P<0.05),while the contraction thickness of thoracic ES muscles on the convex and concave side wasn't statistically different from that of healthy con-trols,and the contraction thickness change rate of ES muscles on the convex and MF on the concave side of thoracic segment in AIS patients was significantly decreased(P<0.05).There was no significant difference in the total resting thickness of thoracic(convex and concave)paravertebral muscles(ES+MF)between AIS patients and the corresponding segments(left and right)of control group(P>0.05),and there was no statistically signifi-cant difference in the total resting thickness of thoracic paravertebral muscle between the convex and concave sides of AIS patients(P>0.05).The total contraction thickness of thoracic paravertebral muscle(ES+MF)in AIS patients was lower than that in control group(P<0.05).Compared with the control group,the resting thickness,contraction thickness and thickness change rate of lumbar MF muscle on the convex and concave sides in AIS patients were significantly reduced(P<0.05),and the contraction thickness change rate of the lumbar ES muscle on the concave side was less than that of the control group(P<0.05).There were no significant differ-ences in resting thickness and contraction thickness between the convex and concave paravertebral muscles in AIS patients(P>0.05).The total resting thickness(ES+MF)and total contraction thickness(ES+MF)of lumbar(convex and concave)paraspinal muscles in AIS patients were lower than those in control group(P<0.05).There was a significant negative correlation between the Cobb angle of the main thoracic curve and the rest-ing thickness of the thoracic MF muscle on the concave and the change rate of the contraction thickness of the thoracic ES muscle on the convex in S-type AIS patients(r=-0.53/-0.45,P<0.05).There was no signifi-cant correlation between the Cobb angle of lumbar segment and the change rates of the resting thickness and contraction thickness of ES and MF muscles on both convex and concave sides(P>0.05).Conclusions:In pa-tients with moderate S-type AIS,there are different muscle morphological changes in the paraspinal muscles on both convex and concave sides of the main thoracic curve,and the concave paravertebral muscle is more affected by scoliosis;The contraction function of the bilateral deep core stabilizing muscles in the lumbar re-gion is markedly decreased.Different patterns of superficial and deep muscle atrophy and contractility decline may be a key cause of spinal movement disorder and scoliosis progression in AIS patients.

Result Analysis
Print
Save
E-mail