1.The Effect of Banxia Xiexin Decoction (半夏泻心汤) on the Expression of LXRα in Liver Tissue and the JAK2/STAT3 Signaling Pathway in Gastric Antrum Tissue of Diabetic Gastroparesis Model Rats
Qi XU ; Nuobing RUAN ; Jinju LI ; Xijuan LYU ; Zhaohui FANG
Journal of Traditional Chinese Medicine 2025;66(2):178-187
ObjectiveTo explore the potential mechanism of Banxia Xiexin Decoction (半夏泻心汤, BXD) in the treatment of diabetic gastroparesis (DGP). MethodsA total of 29 SD rats were randomly divided into four groups, blank group (5 rats) and model group, BXD group and metformin group (8 rats in each group). Except for the blank group, rats were administered intraperitoneally with 1% streptozotocin (STZ) solution and were fed a high-sugar, high-fat diet to establish the DGP rat model. After successful modeling, the BXD group was treated with BXD at 6.68 g/(kg·d) by gavage, the metformin group was treated with metformin hydrochloride at 105 mg/(kg·d) by gavage, and the blank group and the model group were treated with normal saline at 6.68 ml/(kg·d) by gavage, for 8 weeks. After the last administration, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG) were measured and gastric emptying rate was calculated. ELISA was used to detect the levels of gastrointestinal hormones motilin (MTL) and gastrin (GAS), as well as inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β) and interleukin-10 (IL-10) in gastric tissue. Oil red O staining was performed to observe liver pathological morphology. Hematoxylin and eosin (HE) staining was used to observe gastric antrum tissue morphology. Immunofluorescence staining was used to detect liver X receptor α (LXRα) levels in the liver. Western Blot was used to detect the protein levels of LXRα in liver tissue, and of janus kinase 2 (JAK2), phospho-janus kinase 2 (p-JAK2), signal transducer and activator of transcription 3 (STAT3) and phospho-signal transducer and activator of transcription 3 (p-STAT3) in gastric antrum tissue. Quantitative real-time polymerase chain reaction (qPCR) was used to measure the mRNA expression of LXRα in liver tissue and JAK2, STAT3 in gastric antrum tissue. ResultsCompared with the blank group, the model group showed significant hepatic fatty degeneration, gastric antrum tissue structure destruction, and increases in FBG, HbA1c, TC, and TG levels; the average fluorescence intensity, protein level, and mRNA expression of LXRα in liver tissue were reduced; the gastric emptying rate and gastric tissue GAS and MTL levels decreased; inflammatory factors including TNF-α, IL-6, IL-1β in gastric tissue increased, IL-10 decreased; in gastric antrum tissue, the mRNA expression of p-JAK2/JAK2, p-STAT3/STAT3, and JAK2 and STAT3 increased (P<0.01). Compared with the model group, both the BXD group and the metformin group showed improved liver and gastric antrum tissue pathology; FBG, HbA1c, TC, and TG levels decreased, while LXRα fluorescence intensity, protein level, and mRNA expression in liver tissue significantly increased; the gastric emptying rate and the levels of GAS and MTL in gastric tissue were markedly higher; the levels of TNF-α, IL-6, and IL-1β decreased, whereas IL-10 levels increased, p-JAK2/JAK2, p-STAT3/STAT3, and the mRNA expression of JAK2 and STAT3 in gastric antrum tissue decreased (P<0.05 or P<0.01). The BXD group showed higher level than the metformin group in FBG, HbA1c, and TG levels, lower level in gastric emptying rate and gastric tissue GAS content, and higher level in gastric tissue TNF-α, IL-6, IL-1β levels; there was also a decrease in IL-10 levels, and a reduction in LXRα fluorescence intensity and mRNA expression in liver tissue, as well as in p-JAK2/JAK2 levels in gastric antrum tissue (P<0.05 or P<0.01). ConclusionBXD can reduce blood glucose and lipid levels in DGP model rats while improving gastric function and alleviating gastric tissue inflammation. Its mechanism may be related to the regulation of LXRα expression in liver tissue and the JAK2/STAT3 pathway in gastric antrum tissue.
2.Application advantages of Brainlab Knee 3 navigation combined with gap balance in total knee arthroplasty
Jinghua SUN ; Zhiming QI ; Wenli RUAN ; Jiaguo ZHANG ; Zhitong YANG
Chinese Journal of Tissue Engineering Research 2024;33(33):5333-5339
BACKGROUND:In recent years,computer-assisted navigation has gradually attracted attention in the medical field.Some scholars have reported that the clinical effects of computer navigation in total knee arthroplasty vary.To explore the clinical effect of the new generation of Brainlab Knee 3 navigation system,this study is conducted. OBJECTIVE:To analyze the application effect of computer navigation system(Brainlab Knee 3)combined with gap balance technology in total knee arthroplasty. METHODS:A total of 71 patients received total knee arthroplasty at the Department of Joint Surgery of Dalian Second People's Hospital from November 2020 to May 2021.In the navigation group,35 patients underwent total knee arthroplasty by computer navigation combined with gap balance.In the traditional group,36 patients underwent osteotomy with traditional surgical instruments.The difference between medial and lateral joint spaces,knee range of motion,hospital for special surgery knee score,hip-knee-ankle angle,deviation values of coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle were compared between the two groups. RESULTS AND CONCLUSION:(1)In the navigation group,the differences of intraoperative medial and lateral joint gap at knee extension 0,1,and 2 mm were found in 19,14,and 2 cases,respectively.The gap difference was 0 mm in 18 cases,1 mm in 15 cases and 2 mm in 2 cases at 90° degree knee flexion.In the traditional group,the gap difference at knee extention was 0 mm in 10 cases,1 mm in 20 cases,and 2 mm in 6 cases.The gap difference at 90 degree knee flexion was 0 mm in 10 cases,1 mm in 15 cases and 2 mm in 8 cases.(2)The operation time in the navigation group was longer than that in the traditional group(P<0.05),and two patients in the navigation group developed lower limb intermuscular vein thrombosis after surgery,and none of the patients in the traditional group had complications.(3)The range of motion between the two groups increased significantly at 6 and 12 months after surgery,and the range of motion in the navigation group was higher than that in the traditional group(P<0.05).(4)At 12 months after surgery,the hospital for special surgery knee scores of both groups increased significantly,and the hospital for special surgery knee score in the navigation group was higher than that in the traditional group(P<0.05).(5)At 6 months after surgery,the deviation values of hip-knee-ankle angle,coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle of navigation group were significantly lower than those in the traditional group(P<0.05).(6)The results showed that computer navigation technique combined with gap balance in total knee arthroplasty had advantages in postoperative range of motion,lower limb alignment and the accuracy of tibial prosthesis component position,and joint function recovered well.
3.Analysis of risk factors for trauma-induced coagulopathy in elderly major trauma patients
Kang YANGBO ; Yang QI ; Ding HONGBO ; Hu YUFENG ; Shen JIASHENG ; Ruan FENG ; Chen BOJIN ; Feng YIPING ; Jin YUCHEN ; Xu SHANXIANG ; Jiang LIBING ; Wang GUIRONG ; Xu YONG'AN
World Journal of Emergency Medicine 2024;15(6):475-480
BACKGROUND:Trauma-induced coagulopathy(TIC)due to serious injuries significantly leads to increased mortality and morbidity among elderly patients.However,the risk factors of TIC are not well elucidated.This study aimed to explore the risk factors of TIC in elderly patients who have major trauma. METHODS:In this retrospective study,the risk factors for TIC in elderly trauma patients at a single trauma center were investigated between January 2015 and September 2020.The demographic information including gender,age,trauma parts,injury severity,use of blood products,use of vasopressors,need of emergency surgery,duration of mechanical ventilation,length of stay in the intensive care unit(ICU)and hospital,and clinical outcomes were extracted from electric medical records.Multivariate logistic regression analysis was performed to differentiate risk factors,and the performance of the model was evaluated using receiver operating characteristics(ROC)curves. RESULTS:Among the 371 elderly trauma patients,248(66.8%)were male,with the age of 72.5±6.8 years,median injury severity score(ISS)of 24(IQR:17-29),and Glasgow coma score(GCS)of 14(IQR:7-15).Of these patients,129(34.8%)were diagnosed with TIC,whereas 242(65.2%)were diagnosed with non-TIC.The severity scores such as ISS(25[20-34]vs.21[16-29],P<0.001)and shock index(SI),(0.90±0.66 vs.0.58±0.18,P<0.001)was significantly higher in the TIC group than in the non-TIC group.Serum calcium levels(1.97±0.19 mmol/L vs.2.15±0.16 mmol/L,P<0.001),fibrinogen levels(1.7±0.8 g/L vs.2.8±0.9 g/L,P<0.001),and base excess(BE,-4.9±4.6 mmol/L vs.-1.2±3.1 mmol/L,P<0.001)were significantly lower in the TIC group than in the non-TIC group.Multivariate logistic regression analysis revealed that ISS>16(OR:3.404,95%CI:1.471-7.880;P=0.004),SI>1(OR:5.641,95%CI:1.700-18.719;P=0.005),low BE(OR:0.868,95%CI:0.760-0.991;P=0.037),hypocalcemia(OR:0.060,95%CI:0.009-0.392;P=0.003),and hypofibrinogenemia(OR:0.266,95%CI:0.168-0.419;P<0.001)were independent risk factors for TIC in elderly trauma patients.The AUC of the prediction model included all these risk factors was 0.887(95%CI:0.851-0.923)with a sensitivity and specificity of 83.6%and 82.6%,respectively. CONCLUSION:Higher ISS(more than 16),higher SI(more than 1),acidosis,hypocalcemia,and hypofibrinogenemia emerged as independent risk factors for TIC in elderly trauma patients.
4.Association of serum adipokine CTRP6 in early pregnancy with gestational diabetes mellitus
Yaping XIN ; Qi ZHANG ; Yihan ZHU ; Mengmeng RUAN ; Xiaojing MA
China Modern Doctor 2024;62(9):26-29,32
Objective To study the expression levels of serum complement C1q/tumor necrosis factor-related protein 6(CTRP6)in women in early pregnancy and to explore its relationship with gestational diabetes mellitus(GDM).Methods Women at the Second Affiliated Hospital of Zhengzhou University from March 2021 to March 2022 were prospectively and consecutively selected from 10 to 13 weeks gestation for outpatient obstetric check-ups.The age,height,weight,and time of last menstruation of pregnant women were collected,and the levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS)and CTRP6 were measured in early pregnancy,and the pre-pregnancy body mass index(BMI),baseline BMI,prenatal BMI,and homeostatic model assessment of insulin resistance(HOMA-IR)were calculated.All pregnant women underwent a 75g oral glucose tolerance test at 24-28 weeks of gestation and were divided into GDM group and normal glucose tolerance(NGT)group according to the test results.The clinical data and laboratory indexes of the two groups in early pregnancy were compared,and the correlation between serum CTRP6 and various indexes in early pregnancy and its relationship with GDM were analyzed.Results A total of 213 maternal cases were enrolled,and 203 cases were completed for follow-up.Among them,52 mothers were diagnosed with GDM,with a GDM prevalence rate of 25.62%.Serum CTRP6,age,pre-pregnancy BMI,baseline BMI,antenatal BMI,TC,LDL,FPG,HbA1c,FINS,and HOMA-IR were higher in GDM group compared to NGT group,with a statistically significant difference(P<0.05).CTRP6 in early pregnancy was positively correlated with age,pre-pregnancy BMI,baseline BMI,prenatal BMI,TG,LDL,FPG,HbA1c,FINS,HOMA-IR,and negatively correlated with HDL(P<0.05).After correcting for age,BMI,glycolipid metabolism index and HOMA-IR,CTRP6 in early pregnancy remained an independent factor in the development of GDM.Conclusion Elevated serum CTRP6 in early pregnancy is associated with GDM and is an independent risk factor for GDM.
5.Intervention Effect and Molecular Mechanism of Dabufei Decoction in Dunhuang Formula Combined with Cisplatin on Lewis Lung Adenocarcinoma in Mice
Mengyong XIAO ; Yali LUO ; Xiaofeng QI ; Jing LUO ; Linna MA ; Linfeng RUAN ; Nini LIAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):95-104
ObjectiveTo explore the intervention effect and molecular mechanism of Dabufei decoction in Dunhuang formula combined with cisplatin on Lewis lung adenocarcinoma-bearing mice. MethodFifty C57BL/6J mice were used, with 10 randomly assigned to the blank group (without modeling), and 40 subcutaneously inoculated with Lewis cells to establish a Lewis lung adenocarcinoma-bearing mouse model. These 40 mice were randomly divided into the following four groups (with 10 mice in each group): Model group (equal volume of physiological saline), cisplatin group (5 mg·kg-1), Dabufei decoction group (14.35 g·kg-1·d-1), and Dabufei decoction combined with cisplatin group (Dabufei decoction 14.35 g·kg-1·d-1 + cisplatin 5 mg·kg-1). Each group was treated continuously for 14 days. The general condition of the mice was observed, body weight changes were recorded, and the tumor inhibition rate, spleen index, and thymus index were calculated. Peripheral blood white blood cell (WBC), platelet (PLT), and hemoglobin (HGB) were detected by routine blood tests. Flow cytometry was used to detect the expression of CD4+CD25+FoxP3+ regulatory T cells (Treg) and natural killer (NK) cells in the spleen. Western blot and real-time quantitative polymerase chain reaction (Real-time PCR) were used to determine the expression of proteins and mRNA related to the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway in tumor tissues. ResultCompared with the blank group, the model group showed decreased body weight (P<0.05), spleen index, and thymus index (P<0.05), decreased percentage of NK cells in the spleen (P<0.05), increased percentage of Treg cells (P<0.05), and decreased counts of WBC, PLT, and HGB (P<0.05). Compared with the model group, the Dabufei decoction group exhibited significant tumor growth inhibition, increased body weight, and reduced tumor weight (P<0.05), increased percentage of NK cells (P<0.05), decreased proportion of Treg cells (P<0.05), and increased counts of WBC, PLT, and HGB (P<0.05). In the cisplatin group, tumor growth was significantly inhibited, body weight significantly decreased (P<0.05), and tumor weight significantly reduced (P<0.05). The spleen index and thymus index decreased (P<0.05), and the percentage of Treg cells significantly decreased (P<0.05). The counts of WBC, PLT, and HGB significantly decreased (P<0.05). In the Dabufei decoction combined with cisplatin group, tumor growth was significantly inhibited, and tumor weight significantly reduced (P<0.05). The levels of phosphorylated PI3K, Akt, and mTOR proteins and mRNA in tumor tissues were significantly reduced in all medication groups (P<0.05). Compared with the cisplatin group, the Dabufei decoction combined with cisplatin group showed significantly inhibited tumor growth, reduced tumor weight (P<0.05), increased body weight (P<0.05), increased spleen index and thymus index (P<0.05), increased percentage of NK cells (P<0.05), decreased percentage of Treg cells (P<0.05), significantly increased counts of WBC, PLT, and HGB (P<0.05), and reduced levels of phosphorylated PI3K, Akt, and mTOR and their mRNA (P<0.05). ConclusionDabufei decoction combined with cisplatin has a synergistic effect with reduced toxicity, effectively regulating immune function, increasing the proportion of NK cells, reducing the proportion of Treg cells, improving bone marrow suppression, and downregulating the PI3K/Akt/mTOR signaling pathway to inhibit tumor growth in Lewis lung adenocarcinoma-bearing mice.
6.Porphyromonas gingivalis promotes the occurrence of esophageal squamous cell carcinoma via an inflammatory microenvironment
Haijun XU ; Yijun QI ; Dangrou WU ; Qiwei LIU ; Pan CHEN ; Mengxiang LI ; Yelin JIAO ; Haojie RUAN ; Zhitao LI ; Shegan GAO
Chinese Journal of Oncology 2024;46(8):746-754
Objective:To investigate the role of an inflammatory microenvironment induced by Porphyromonasgingivalis ( P. gingivalis) in the occurrence of esophageal squamous cell carcinoma (ESCC) in mice. Methods:A total of 180 C57BL/6 mice were randomly divided into 6 groups, i.e. control group, P. gingivalis group, 4NQO group, 4NQO + P. gingivalis group, 4NQO + P. gingivalis + celecoxib group, and 4NQO + P. gingivalis + antibiotic cocktail (ABC, including metronidazole, neomycin, ampicillin, and vancomycin) group, with 30 mice in each group, using the random number table. All mice were normalized by treatment with ABC in drinking water for 2 weeks. In the following 2 weeks, the mice in the control group and the P. gingivalis group were given drinking water, while the other 4 groups were treated with 30 μg/ml 4NQO in the drinking water. In weeks 11-12, the mice in the P. gingivalis group, the 4NQO + P. gingivalis group, the 4NQO + P. gingivalis + celecoxib group, and the 4NQO + P. gingivalis + ABC group were subjected to ligation of the second molar in oral cavity followed by oral P. gingivalis infection thrice weekly for 24 weeks in weeks 11-34. In weeks 13-34, the mice in 4NQO + P. gingivalis+celecoxib group and 4NQO + P. gingivalis + ABC group were administered with celecoxib and ABC for 22 weeks, respectively. At the end of 34 weeks, gross and microscopic alterations were examined followed by RT-qPCR and immunohistochemistry to examine the expression profiles of inflammatory- and tumor-molecules in esophagi of mice. Results:At 34 weeks, 4NQO treatment alone did not affect the foci of papillary hyperproliferation, diseased area, and the thickness of the esophageal wall, but significantly enhanced the foci of hyperproliferation (median 1.00, P<0.05) and mild/moderate dysplasia (median 2.00, P<0.01). In addition, the expression levels of IL-6 [8.35(3.45,8.99)], IL-1β [6.90(2.01,9.72)], TNF-α [12.04(3.31,14.08)], c-myc [2.21(1.80,3.04)], pSTAT3, Ki-67, and pH2AX were higher than those in the control group. The pathological changes of the esophageal mucosa were significantly more overt in the 4NQO + P. gingivalis group in terms of the foci of papillary hyperproliferation (median 2.00), diseased area (median 2.51 mm 2), the thickness of the esophageal wall (median 172.52 μm), the foci of hyperproliferation (median 1.00, P<0.05), and mild/moderate dysplasia (median 1.00, P<0.01). In mice of the 4NQO + P. gingivalis group, the expression levels of IL-6 [12.27(5.35,22.08)], IL-1β [13.89(10.04,15.96)], TNF-α [19.56(6.07,20.36)], IFN-γ [11.37(8.23,20.07)], c-myc [2.62(1.51,4.25)], cyclin D1 [4.52(2.68,7.83)], nuclear pSTAT3, COX-2, Ki-67, and pH2AX were significantly increased compared with the mice in the control group. In mice of the 4NQO + P. gingivalis group, the diseased area, invasive malignant foci as well as pSTAT3 and pH2AX expression were significantly blunted by celecoxib. Treatment with ABC markedly reduced the papillary hyperproliferative foci, invasive malignant foci, and pSTAT3 expression but not pH2AX. Conclusions:P. gingivalis promotes the occurrence of esophageal squamous cell carcinoma in mice by inducing an inflammatory microenvironment primed with 4NQO induced DNA damage. Clearance of P. gingivalis with ABC or anti-inflammatory intervention holds promise for prevention of esophageal squamous cell malignant pathogenesis via blockage of IL-6/STAT3 signaling and amelioration of inflammation.
7.Predictive effect of the dual-parametric MRI modified maximum diameter of the lesions with PI-RADS 4 and 5 on the clinically significant prostate cancer
Yuxuan TIAN ; Mingjian RUAN ; Yi LIU ; Derun LI ; Jingyun WU ; Qi SHEN ; Yu FAN ; Jie JIN
Journal of Peking University(Health Sciences) 2024;56(4):567-574
Objective:To assess the rationality of the maximum lesion diameter of 15 mm in prostate imaging reporting and data system(PI-RADS)as a criterion for upgrading a lesion from category 4 to 5 and improve it to enhance the prediction of clinically significant prostate cancer(csPCa).Methods:In this study,the patients who underwent prostate magnetic resonance imaging(MRI)and prostate biopsy at Peking University First Hospital from 2019 to 2022 as a development cohort,and the patients in 2023 as a validation cohort were reviewed.The localization and maximum diameter of the lesion were fully evalua-ted.The area under the curve(AUC)and the cut-off value of the maximum diameter of the lesion to pre-dict the detection of csPCa were calculated from the receiver operating characteristics(ROC)curve.Confounding factors were reduced by propensity score matching(PSM).Diagnostic efficacy was com-pared in the validation cohort.Results:Of the 589 patients in the development cohort,358(60.8%)lesions were located in the peripheral zone and 231(39.2%)were located in the transition zone,and 496(84.2%)patients detected csPCa.The median diameter of the lesions in the peripheral zone was smaller than that in the transition zone(14 mm vs.19 mm,P<0.001).In the ROC analysis of the maximal diameter on the csPCa prediction,there was no statistically significant difference between the peri-pheral zone(AUC=0.709)and the transition zone(AUC=0.673,P=0.585),and the cut-off values were calculated to be 11.5 mm for the peripheral zone and 16.5 mm for the migrating zone.By calcula-ting the Youden index for the cut-off values in the validation cohort,we found that the categorisation by lesion location led to better predictive results.Finally,the net reclassification index(NRI)was 0.170.Conclusion:15 mm as a criterion for upgrading the PI-RADS score from 4 to 5 is reasonable but too general.The cut-off value for peripheral zone lesions is smaller than that in transitional zone.In the future consideration could be given to setting separate cut-off values for lesions in different locations.
8.Progress in enteral nutrition implementation in critically ill patients receiving vasoactive medications
Hong-Yu ZHANG ; Li-Bing JIANG ; Hai-Long WANG ; Yong-An XU ; Cheng-Fei WANG ; Feng RUAN ; Wen-Qi QI ; Su-Min ZUO ; Shan-Xiang XU
Parenteral & Enteral Nutrition 2024;31(3):176-183
Nutritional therapy is a core component of critically ill patient management,and the enteral route has become the preferred method due to its dual roles of nutrition and non-nutrition. The use of vasoactive medications makes enteral nutrition decisions more challenging for these patients. This review systematically examines the pathophysiological effects of vasoactive medications on gastrointestinal tract of critically ill patients,the current value and safety of enteral nutrition in this patient's population,summarizes the optimal strategies for implementing enteral nutrition in these patients for clinical reference.
9.Analysis of the types and functions of CD34 + cells in full-thickness skin defect wounds of normal mice and diabetic mice by single-cell RNA sequencing
Jia HE ; Jingru WANG ; Wenjun GAN ; Guiqiang LI ; Qi XIN ; Zepeng LIN ; Shubin RUAN ; Xiaodong CHEN
Chinese Journal of Burns 2024;40(3):230-239
Objective:To analyze the types and functions of CD34 + cells in full-thickness skin defect wounds of normal mice and diabetic mice by single-cell RNA sequencing. Methods:This study was an experimental study. The CD34 + cell lineage tracing mouse was produced, and the visualization of CD34 + cells under the fluorescent condition was realized. Six male CD34 + cell lineage tracing mice aged 7-8 weeks (designated as diabetic group) were intraperitoneally injected with streptozotocin to establish a diabetic model, and full-thickness skin defect wounds were prepared on their backs when they reached 13 weeks old. Another 6 male CD34 + cell lineage tracing mice aged 13 weeks (designated as control group) were also subjected to full-thickness skin defect wounds on their backs. On post-injury day (PID) 4, wound tissue was collected from 3 mice in control group and 2 mice in diabetic group, and digested to prepare single-cell suspensions. CD34 + cells were screened using fluorescence-activated cell sorting, followed by single-cell RNA sequencing. The Seurat 4.0.2 program in the R programming language was utilized for dimensionality reduction, visualization, and cell clustering analysis of CD34 + cell types, and to screen and annotate the marker genes for each CD34 + cell subpopulation. Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology (GO) enrichment analysis was performed to analyze the differentially expressed genes (DEGs) of CD34 + fibroblasts (Fbs), smooth muscle cells (SMCs), keratinocytes (KCs), and chondrocyte-like cells (CLCs) in the wound tissue of two groups of mice for exploring cellular functions. Results:On PID 4, CD34 + cells in the wound tissue of both groups of mice were consisted of 7 cell types, specifically endothelial cells, Fbs, KCs, macrophages, T cells, SMCs, and CLCs. Among these, Fbs were further classified into 5 subpopulations. Compared with those in control group, the proportions of CD34 + endothelial cells, Fbs subpopulation 1, Fbs subpopulation 4, KCs, and CLCs in the wound tissue of mice were increased in diabetic group, while the proportions of CD34 + Fbs subpopulation 2, Fbs subpopulation 3, and SMCs were decreased. The marker genes for annotating CD34 + CLCs, endothelial cells, Fbs subpopulation 1, Fbs subpopulation 2, Fbs subpopulation 3, Fbs subpopulation 4, Fbs subpopulation 5, KCs, macrophages, SMCs, and T cells were respectively metastasis-associated lung adenocarcinoma transcript 1, fatty acid binding protein 4, Gremlin 1, complement component 4B, H19 imprinted maternally expressed transcript, Dickkopf Wnt signaling pathway inhibitor 2, fibromodulin, keratin 5, CD74 molecule, regulator of G protein signaling 5, and inducible T-cell co-stimulator molecule. KEGG and GO enrichment analysis revealed that, compared with those in control group, DEGs with significant differential expression (SDE) in CD34 + Fbs from the wound tissue of mice in diabetic group on PID 4 were significantly enriched in terms related to inflammatory response, extracellular matrix (ECM) organization, regulation of cell proliferation, and aging (with Pvalues all <0.05), DEGs with SDE in CD34 + SMCs were significantly enriched in terms related to cell migration, apoptotic process, positive regulation of transcription, and phagosome (with P values all <0.05), DEGs with SDE in CD34 + KCs were significantly enriched in terms related to mitochondrial function, transcription, and neurodegenerative diseases (with P values all <0.05), and DEGs with SDE in CD34 + CLCs were significantly enriched in terms related to rhythm regulation, ECM, and viral infection (with P values all <0.05). Conclusions:CD34 + cells display high heterogeneity in the healing process of full-thickness skin defect wounds in both normal mice and diabetic mice. The significantly enriched functions of DEGs with SDE in CD34 + cell subpopulations in the wound tissue of the two mouse groups are closely related to the wound healing process.
10.Clinical effect of Longqing tablets combined with antibiotics on improving stent-related symptoms and urinary tract infections in patients with indwelling ureteral stent
Qi WANG ; Xin CUI ; Jiangtao WU ; Hao YAN ; Jimeng RUAN
International Journal of Surgery 2024;51(10):654-659
Objective:To evaluate the effects of antibiotics alone and combined with Longqing tablets and antibiotics on stent-related symptoms (SRS), urinary tract infection (UTI), and quality of life in patients who underwent ureteroscopic lithotripsy (URL) with indwelling ureteral stents.Methods:The clinical data of 160 patients who underwent URL with indwelling ureteral stents in the Department of Urology, Xuanwu Hospital, Capital Medical University from January 2022 to December 2023 were retrospectively analyzed. According to the postoperative application of antibiotics and Longqing tablets, they were divided into two groups: control group and observation group, with 80 cases in each group. The control group took Levofloxacin tablets orally, and the observation group took Longqing tablets combined with Levofloxacin tablets orally. The SRS of the two groups was compared according to the degree of urinary tract irritation symptoms, low back pain, and dysuria. UTI was evaluated by the incidence of fever, hematuria, pyuria, positive rate of urine culture, and specific bacterial classes. The Chinese version of the ureteral stent symptom questionnaire (USSQ) and the quality of life score were evaluated in the two groups. Normally distributed quantitative data were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups; non-normally distributed quantitative data were expressed as median (interquartile range) [ M( Q1, Q3)], and the non-parametric test was used for comparison between groups. Count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Results:Among the 160 patients, 141 (88.13%) developed SRS, including 71 cases (88.75%) in the control group, and 70 cases (87.50%) in the observation group, there was no significant difference between the two groups ( P=0.724). In terms of SRS, the urinary tract irritation symptom scores [3.0 (1.0, 5.0) points vs 5.0 (3.0, 7.0) points], low back pain scores [1.5 (1.0, 2.0) points vs 2.5 (2.0, 3.0) points] and dysuria scores [1.5 (1.0, 2.0) points vs 3.5 (2.5, 4.0) points] of the observation group were significantly lower than those of the control group, the differences were statistically significant ( P<0.05). The Chinese version of USSQ showed that the urinary tract symptoms of the observation group were significantly relieved compared with the control group [15(12, 19) points vs 22 (15, 28) points], and the difference was statistically significant ( P=0.037). In terms of UTI, the incidence of fever (6.25% vs 7.50%), the incidence of hematuria (20.00% vs 22.50%), the incidence of pyuria (30.00% vs 33.75%), and positive rate of urine culture (11.25% vs 15.00%) between the two groups were not statistically significant ( P> 0.05), but the number was reduced to a certain extent. There was no statistically significant difference in the scores of physiological function, emotional function and social function between the two groups before surgery ( P> 0.05); however, the scores of the above three items in both groups were improved 2 weeks after surgery, and the improvement of the observation group was significantly higher than that of the control group, with statistical significance ( P<0.01). Conclusion:Longqing tablets combined with antibiotics are more effective in improving SRS in patients who receive URL and have indwelling ureteral stents than antibiotics alone, and can prevent UTI and improve the quality of life to a certain extent.

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