1.Mechanism of Qingre Huayu Jianpi Prescription Inhibiting Development of Colitis-associated Colorectal Cancer in Mice
Yanqiu ZHENG ; Yihui YOU ; Junyu KE ; Jinbin SONG ; Yongqiang WU ; Changhui LIU ; Yanwu LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(8):83-90
ObjectiveTo explore the effect of Qingre Huayu Jianpi prescription (QHJ) on colitis-associated colorectal cancer (CAC) in mice, and its related mechanism. MethodC57BL/6 mice were randomly divided into four groups including the normal, model, QHJ low-dose (QHJ-L, 10 g·kg-1), and QHJ high-dose (QHJ-H, 40 g·kg-1) groups. Azoxymethane (AOM) and dextran sodium sulfate (DSS) were combined to chemically build a CAC mouse model for 14 weeks. Each drug group was given intragastrically from the 5th week to the 14th week, once per day. An equal volume of water was fed to the normal and model groups. The mouse survival rate, colon length, weight, and pathological alterations were assessed. The protein expressions of Wnt-3a protein signaling (Wnt3a), β-catenin, Non-phosphor-β-catenin (Non-p-β-catenin), and cholesterol-binding glycoproteins 133 (CD133) were detected by Western blot. The localization and expression of the cluster of differentiation (CD) 80 and CD11 antigen-like family member B (CD11b) were detected by immunohistochemistry (IHC). The colon organoids derived from CAC mice were isolated and cultured to detect the expression of Wnt signaling pathway-related proteins. ResultThe survival rate of the CAC mice was improved by QHJ treatment and the number of colon tumors was inhibited significantly. Compared with those in the normal group, the expression levels of Wnt3a, β-catenin, Non-p-β-catenin, and CD133 in colon tissues in the model group were significantly increased (P<0.05, P<0.01). Compared with those in the model group, the levels of Wnt3a and β-catenin in the QHJ-L group were significantly decreased (P<0.01), and the protein levels of Wnt3a, β-catenin, Non-p-β-catenin, and CD133 in the QHJ-H group were significantly decreased (P<0.05, P<0.01). Meanwhile, the expression level of CD11b in the model group was significantly increased compared with that in the normal group while the CD80 level was significantly decreased (P<0.05, P<0.01). Compared with those in the model group, CD11b in QHJ-L and QHJ-H groups was significantly decreased, and CD80 was significantly increased(P<0.05, P<0.01). The expressions of Non-p-β-catenin and CD133 in colonic organoids of CAC model mice were significantly increased, while QHJ treatment could inhibit the expressions of Non-p-β-catenin and CD133 in colonic organoids (P<0.01). ConclusionQHJ could inhibit the inflammation-cancer development in CAC mice, the mechanism of which might be related to regulating the microenvironment and inhibiting the over-activation of Wnt signaling.
2. The application of positron emission tomography in the research and development of central nervous system drugs
Size LI ; Xiaojie WU ; Jing ZHANG ; Qi HUANG ; Yihui GUAN ; Fang XIE ; Qi HUANG ; Yihui GUAN ; Fang XIE ; Shaonan WANG ; Jing ZHANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(3):316-327
Positron emission tomography (PET) now plays an important role in the research and development (R&D) of central nervous system (CNS) drugs. PET could characterize the biodistribution, pharmacokinetics, and receptor binding of CNS drugs quantitatively. The present review summarized the quantitative methods of PET used in the pharmacokinetics and receptor occupancy analysis of CNS drugs. Moreover, the present review listed various applications of PET supporting R&D of CNS drugs, which could provide a new direction for the R&D of CNS drugs.
3.Primary biliary cholangitis with metabolic associated fatty liver disease:Clinical features and risk factors
Linna YUAN ; Yihui CHEN ; Hengbin NA ; Jie LU ; Ye LIU ; Wu LI
Journal of Clinical Hepatology 2024;40(8):1598-1604
Objective To investigate the clinical features and risk factors of primary biliary cholangitis(PBC)comorbid with metabolic associated fatty liver disease(MAFLD)and the interaction between the two diseases.Methods A total of 187 patients who were diagnosed with PBC,MAFLD,or PBC with MAFLD in The First Affiliated Hospital of Kunming Medical University from January 2019 to December 2022 were enrolled and divided into PBC group with 70 patients,PBC+MAFLD group with 38 patients,and MAFLD group with 79 patients.Related data were collected,including general information,clinical symptoms,serological parameters,transient elastography(FibroScan),and non-invasive fibrosis markers,which were compared between the three groups.A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups,the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups,and the binary Logistic regression analysis was used for multivariate analysis.Results There were significant differences between the three groups in sex,age,height,weight,body mass index(BMI),and history of autoimmune diseases(P<0.05).In the PBC+MAFLD group,female patients accounted for 89.5%,with a mean age of 57.26±12.72 years and a BMI of 23.35±3.70 kg/m2,and in the PBC group,the detection rate of autoimmune diseases was 25.7%(18 patients).There were significant differences between the three groups in the incidence rates of weakness,poor appetite,pruritus,jaundice,varices,ascites,and splenomegaly(all P<0.05).The PBC+MAFLD group had the common symptoms of weakness in 18 patients(47.4%),poor appetite in 15 patients(39.5%),abdominal pain in 14 patients(36.8%),and abdominal distension in 16 patients(42.1%);the MAFLD group had the common symptoms of abdominal pain in 34 patients(43%)and abdominal distension in 32 patients(40.5%);the PBC group had the common symptoms of weakness in 37 patients(52.9%),poor appetite in 25 patients(35.7%),jaundice in 25 patients(35.7%),abdominal pain in 18 patients(25.7%),abdominal distension in 25 patients(35.7%),varices in 19 patients(27.9%),ascites in 23 patients(32.9%),and splenomegaly in 44 patients(62.9%).The PBC+MAFLD group had a controlled attenuation parameter(CAP),which was higher than that of the PBC group,and the PBC group had significantly higher levels of liver stiffness measurement,aspartate aminotransferase-to-platelet ratio index(APRI),and fibrosis-4(FIB-4)than the MAFLD group(all P<0.05).The factors without multicollinearity were included in the regression analysis,and with the PBC group as the reference group,FIB-4(odds ratio[OR]=0.218,95%confidence interval[CI]:0.069-0.633,P<0.05)and history of autoimmune diseases(OR=0.229,95%CI:0.067-0.810,P<0.05)were influencing factors for the onset of PBC with MAFLD;with the MAFLD group as the reference group,ALT(OR=0.157,95%CI:0.025-1.000,P<0.05)and TBil(OR=0.995,95%CI:0.990-0.999,P<0.05)were influencing factors for the onset of PBC with MAFLD.Conclusion PBC with MAFLD lacks specific clinical manifestations,and PBC patients tend to have more severe clinical manifestations and a higher incidence rate of liver function decompensation.PBC comorbid with MAFLD may not aggravate the disease progression of PBC.
4.Study on the TCM Medication Law of Asymptomatic Hyperuricemia Based on Data Mining
Qin WU ; Yanan ZHANG ; Yixuan LIU ; Yuzhe CAI ; Jing CHEN ; Yihui DENG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(4):31-37
Objective To explore the characteristics of TCM in the treatment of asymptomatic hyperuricemia based on data mining.Methods Clinical literature on the TCM treatment of asymptomatic hyperuricemia in CNKI,Wanfang Data,VIP and SinoMed was retrieved.After screening,the prescriptions obtained were input into Excel 2019 database,and SPSS Modeler 18.0,SPSS Statistics 26.0 and Cytoscape 3.9.1 were used for frequency analysis,association rule analysis,clustering analysis and factor analysis.Results A total of 133 articles meeting the criteria were included,and 140 prescriptions were included,involving 202 kinds of Chinese materia medica,with a total frequency of 1 387 times.22 drugs,such as Smilacis Glabrae Rhizoma,Coicis Semen,Dioscoreae Spongiosae Rhizoma,Astrctylodis Rhizoma,were frequently used in the treatment of asymptomatic hyperuricemia.The commonly used drugs were drugs for urine excretion to strain off dampness,tonics,clearing heat,promoting blood circulation and removing blood stasis.The medicinal property was mainly warm,the medicinal taste was mainly sweet,and the meridians were mainly liver,spleen,stomach and kidney meridians.21 groups of medicinal combinations were obtained by high frequency drug association rule analysis,among which the core drug pairs were Coicis Semen-Astrctylodis Rhizoma,Smilacis Glabrae Rhizoma-Dioscoreae Spongiosae Rhizoma-Coicis Semen,Coicis Semen-Astrctylodis Rhizoma-Smilacis Glabrae Rhizoma,etc.Clustering analysis obtained 5 clustering methods,and factor analysis obtained 7 common factors.Conclusion In the TCM treatment of asymptomatic hyperuricemia,the main methods are urine excretion to strain off dampness,strengthening spleen and tonifying qi,and the main drugs are Smilacis Glabrae Rhizoma,Coicis Semen,Dioscoreae Spongiosae Rhizoma,Astrctylodis Rhizoma,which can provide reference for clinical treatment of asymptomatic hyperuricemia.
5.Evaluation of the efficacy and safety of intravenous infusion of ferric derisomaltose in the treatment of iron deficiency anemia: a single-center retrospective analysis
Shaoxue DING ; Yihui ZHAO ; Ting WANG ; Jing GUAN ; Limin XING ; Hong LIU ; Guojin WANG ; Xiaoming WANG ; Yuhong WU ; Wen QU ; Jia SONG ; Huaquan WANG ; Lijuan LI ; Zonghong SHAO ; Rong FU
Chinese Journal of Hematology 2024;45(2):178-183
Objective:To investigate the clinical efficacy and safety of ferric derisomaltose injection versus iron sucrose injection in the treatment of iron deficiency anemia (IDA) .Methods:A total of 120 patients with iron deficiency anemia admitted from June 2021 to March 2023 were given intravenous iron supplementation with ferric derisomaltose to assess the efficacy and safety of hemoglobin (HGB) elevation before and after treatment. Simultaneously, the clinical effects of iron supplementation with iron sucrose were compared to those of inpatient patients during the same period.Results:Baseline values were comparable in both groups. Within 12 weeks of treatment, the elevated HGB level in the ferric derisomaltose group was higher than that of the iron sucrose group, with a statistical difference at all time points, and the proportion of HGB increased over 20 g/L in the patients treated for 4 weeks was higher (98.7%, 75.9% ). During the treatment with ferric derisomaltose and iron sucrose, the proportion of mild adverse reactions in the ferric derisomaltose group was slightly lower than that of the iron sucrose group, and neither group experienced any serious adverse reactions. The patients responded well to the infusion treatment, with no reports of pain or pigmentation at the injection site.Conclusion:The treatment of IDA patients with ferric derisomaltose has a satisfactory curative effect, with the advantages of rapidity, accuracy, and safety. Therefore, it is worthy of widespread clinical use.
6.Study on TCM Medication Law in Acute Gouty Arthritis Based on Data Mining
Qin WU ; Yanan ZHANG ; Yixuan LIU ; Yuzhe CAI ; Jing CHEN ; Jingjing YANG ; Zheng LUO ; Yihui DENG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(7):25-31
Objective To explore the characteristics of TCM prescriptions for acute gouty arthritis based on data mining methods;To provide reference for clinical treatment.Methods The clinical literature on the TCM treatment of acute gouty arthritis was retrieved from CNKI,Wanfang Data,VIP and SinoMed.The obtained formulas were input into Excel 2019 to establish a database,and SPSS Modeler 18.0,SPSS Statistics 26.0 and Cytoscape 3.9.1 were used for frequency analysis,association rule analysis,clustering analysis and factor analysis.Results A total of 290 articles meeting the requirements were included,including 295 prescriptions,involving 218 kinds of Chinese materia medica,with a total frequency of 3 573 times.24 kinds of Chinese materia medica,including Coicis Semen,Phellodendri Chinensis Cortex,Atractylodis Rhizoma,Smilacis Glabrae Rhizoma,Dioscoreae Spongiosae Rhizoma,Glycyrrhizae Radix et Rhizoma,Achyranthis Bidentatae Radix were used frequently in the treatment of acute gouty arthritis.The commonly used drugs were heat-clearing drugs,moisture-clearing drugs,blood circulation-activating drugs for removing blood stasis,and wind-dampness drugs.The property was mainly cold,the taste was mainly bitter,and the meridians were mainly liver,stomach,spleen and kidney meridians.The analysis of high-frequency drug association rules obtained 22 drug combinations,among which the core drug pairs were Phellodendri Chinensis Cortex-Atractylodis Rhizoma,Coicis Semen-Atractylodis Rhizoma-Phellodendri Chinensis Cortex.Clustering analysis obtained 4 clustering methods,and factor analysis obtained 9 common factors.Conclusion The main treatment of acute gouty arthritis by TCM is clearing heat and dampness,removing blood stasis and clearing collaterals,tonifying liver and kidney,regulating spleen and stomach,which could provide reference for the clinical treatment of acute gouty arthritis.
7.Harmonization of 18F-FDG PET brain imaging based on ComBat method: a pilot study
Fangyang JIAO ; Dan WANG ; Yuhua ZHU ; Jiaying LU ; Zizhao JU ; Qian XU ; Jingjie GE ; Tao HUA ; Ping WU ; Kuangyu SHI ; Yihui GUAN ; Chuantao ZUO
Chinese Journal of Nuclear Medicine and Molecular Imaging 2024;44(7):412-416
Objective:To perform harmonization based on the ComBat method for PET brain imaging scanned by different types of scanners from the same manufacturer and explored its effect on center effect.Methods:The three-dimensional (3D) Hoffman brain model was scanned by two different PET/CT instruments (Siemens Biograph64 TruePoint and Biograph128 mCT). Fourteen healthy subjects (8 males, 6 females, age: (57.7±9.5) years) underwent 18F-FDG PET/CT on Siemens Biograph64 TruePoint and 12 healthy subjects (9 males, 3 females, age: (55.8±10.5) years) underwent 18F-FDG PET/CT on Siemens Biograph128 mCT (all from Huashan Hospital, Fudan University; from November 2020 to March 2023). The whole brain was divided into 116 brain regions based on the anatomical automatic labeling (AAL) brain template. The ComBat method was applied to harmonized the PET data from brain model and healthy subjects. Mann-Whitney U test was performed on the radioactive counts and SUV ratios (SUVR) before and after homogenization acquired by both PET/CT instruments. Voxel-based statistical parametric mapping (SPM) independent-sample t test was also performed on data of healthy subjects. Results:In 3D Hoffman brain model, radioactivity counts (5 590.33(4 961.67, 6 102.95) vs 6 116.03(5 420.97, 6 660.66); z=-9.35, P<0.001) and SUVR (1.35(1.19, 1.47) vs 1.37(1.21, 1.49); z=-3.63, P<0.001) were significantly different between the two PET/CT scanners before harmonization and not after harmonization (radioactivity counts: 5 845.95(5 192.68, 6 378.63) vs 5 859.17(5 193.84, 6 380.52); SUVR: 1.35(1.20, 1.48) vs 1.36(1.20, 1.49); both z=-0.68, both P=0.498). In the healthy subjects, radioactive counts in 19 brain regions (12 422.78(11 181.60, 13 424.28)-18 166.40(15 882.80, 18 666.27); z values: from -3.24 to -2.06, all P<0.05) and SUVR in 40 brain regions (1.46(1.41, 1.52)-2.28(2.16, 2.36); z values: from -3.65 to -1.70, all P<0.05) were significantly different between the two scanners before harmonization, while after homogenization there were no statistical differences for all 116 brain regions (radioactivity counts: 9 243.55(8 502.38, 9 854.87)-20 419.60(19 931.51, 21 179.43); z values: from -0.72 to 0, all P>0.05; SUVR: 1.04(1.01, 1.09)-2.32(2.24, 2.40); z values: from -0.82 to 0, all P>0.05). SPM showed that significant differences of glucose metabolism in the cerebral cortex, basal ganglia, midbrain and cerebellum were found in healthy subjects between the two PET/CT scanners before homogenization, and brain regions with obvious differences reduced after homogenization. Conclusion:ComBat harmonization method is efficient at removing the center effect among different types of PET/CT scanners from the same manufacturer and may provide a simple and easy-to-implement homogenization for multicenter brain imaging studies.
8.Effect and Mechanism of Qixian Tongluo Formula on Contralateral Corticospinal Tract Remodeling and Motor Functional Recovery in Rats with Cerebral Infarction
Shengqiang ZHOU ; Dahua WU ; Bo LI ; Yanjun CHEN ; Jia HUANG ; Qi WANG ; Wen ZENG ; Lingjuan TAN ; Yihui DENG ; Fang LIU
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(9):1319-1328
Objective To observe the effect of Qixian Tongluo Formula on contralateral corticospinal tract(CST)remodeling and motor functional recovery in rats with cerebral infarction,and to explore its potential molecular mechanism from the perspective of regulating factors related to never remodeling.Methods The rat middle cerebral artery occlusion(MCAO)model was established by silk thread ligation.Fifty model rats were randomly divided into model group,citicoline group(0.054 g·kg-1),Qixian Tongluo Formula low-,medium-and high-dose(7.83,15.66,31.32 g·kg-1)groups,and sham operation group,with 10 rats in each group.The intervention administration was started on the 3rd day after operation once a day for 26 consecutive days.On the 3rd,14th and 28th day after operation,the gross motor function was evaluated by Longa score,and the fine motor function was evaluated by beam-walking test(BWT)score.The contralateral motor cortex was injected with the nerve tracer biotin dextran amine(BDA)on the 14 th day after operation to anterogradely trace the CST.On the 28th day after operation,the expression of axonal growth associated protein-43(GAP-43)and BDA positive fibers in the contralateral motor cortex and cervical spinal cord were detected by immunohistochemistry.The co-localization areas of BDA positive fibers and presynaptic marker protein vesicular glutamate transporter 1(VGLUT1)in the cervical spinal cord gray matter were detected by immunofluorescence.The expressions of brain-derived neurotrophic factor(BDNF),glial cell-derived neurotrophic factor(GDNF),nerve growth factor(NGF)and nerve remodeling-associated inhibitory factor[Nogo-A,oligodendrocyte myelin glycoprotein(OMgp)and myelin-associated glycoprotein(MAG)]in the contralateral motor cortex were detected by Western Blot.Pearson correlation analysis was used to analyze the correlation between Longa score or BWT score and BDA/VGLUT1 co-localization area,respectively.Results Compared with the sham operation group,rats in the model group had obvious symptoms of motor function deficits,and the Longa scores were significantly increased(P<0.01)and the BWT scores were significantly decreased(P<0.05,P<0.01)at each time point.The expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was up-regulated(P<0.05),the number of edge-crossing fibers from the posterior funiculus in cervical cord was increased(P<0.05),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was increased(P<0.05),the expressions of BDNF,GDNF and NGF in the contralateral motor cortex were up-regulated(P<0.05),while the expressions of Nogo-A,OMgp and MAG were down-regulated(P<0.05).Compared with the model group,the Longa scores in each administration group on the 14th and 28th day after MCAO operation were significantly decreased(P<0.01),the BWT scores were significantly increased(P<0.01),the expression of GAP-43 in the contralateral motor cortex and cervical spinal cord was significantly up-regulated(P<0.01).The number of edge-crossing fibers from the posterior funiculus in cervical cord was significantly increased(P<0.01),the co-localization area of BDA/VGLUT1 in the gray matter of the cervical spinal cord was significantly increased(P<0.01).The expressions of BDNF,GDNF and NGF in the contralateral motor cortex were significantly up-regulated(P<0.01,P<0.05),while the expressions of Nogo-A,OMgp and MAG were significantly down-regulated(P<0.05),and the most significant effect was observed in the high dose group.The Longa score was negatively correlated with the co-localization area of BDA/VGLUT1(r=-0.89,P<0.01),and the BWT score was positively correlated with the co-localization area of BDA/VGLUT1(r=0.84,P<0.01).Conclusion Qixian Tongluo Formula can improve motor function through promoting contralateral CST remodeling in MCAO rats after cerebral infarction,and the molecular mechanism may be related to the regulation of the expression of nerve remodeling-associated factor in the contralateral motor cortex.
9.Mechanism of Xumingtang in Gu Jin Lu Yan for Treatment of Ischemic Stroke Based on HIF-1α/NLRP3 Pathway-mediated Pyroptosis
Yuzhe CAI ; Dingxiang LI ; Zheng LUO ; Yixuan LIU ; Jingjing YANG ; Qin WU ; Yanan ZHANG ; Jing CHEN ; Yihui DENG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(17):9-17
ObjectiveTo investigate the mechanism of Xumingtang in Gu Jin Lu Yan (《古今录验》) in regulating cell pyroptosis through the hypoxia-inducible factor-1α (HIF-1α)/NOD-like receptor pyrin domain-containing protein 3 (NLRP3) pathway in ischemic stroke (IS). MethodSD rats were randomly divided into a sham operation group, a model group, low- and high-dose Xumingtang groups, and a metformin group, with 20 rats in each group. Oral administration was performed for 3 days, and tissue samples were collected. Differential messenger RNA (mRNA) was screened using high-throughput sequencing, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed on key differentially expressed genes. The modified neurological severity score (mNSS) and 2,3,5-triphenyltetrazolium chloride (TTC) staining were used to evaluate the effect of brain infarction. Hematoxylin-eosin (HE) staining was used for pathological morphological observation of brain tissue. Enzyme-linked immunosorbent assay (ELISA) was used to compare the levels of interleukin-1β (IL-1β) and interleukin-18 (IL-18) in the ischemic cortical region. Double staining immunohistochemistry was used to detect the co-localization of HIF-1α and NLRP3. Real-time quantitative polymerase chain reaction (PCR) was performed to detect the mRNA expression of NLRP3, HIF-1α, Caspase-1 (CASP-1), and gasdermin D (GSDMD). Western blot was used to detect the protein expression of HIF-1α, NLRP3, CASP-1, and GSDMD. ResultA total of 5 705 differentially expressed genes (2 733 downregulated and 2 972 upregulated) were obtained by mRNA sequencing. After conversion to homologous genes and intersection with the pyroptosis gene set, 95 key differentially expressed pyroptosis genes were obtained. Compared with the sham operation group, the model group showed significantly increased mNSS scores, larger brain infarction areas (P<0.01), diverse neuronal morphology, disordered arrangement, widened cell gaps, significantly increased levels of IL-1β and IL-18 in the ischemic cortical region (P<0.01), enhanced co-localization fluorescence intensity, and significantly increased mRNA and protein expression levels of HIF-1α, NLRP3, CASP-1, and GSDMD (P<0.01). Compared with the model group, the high-dose Xumingtang group showed the most significant improvement in neurological function scores and brain infarction areas (P<0.01). The neuronal integrity and arrangement were more complete, and the cell gaps were narrower in all groups with drug treatment, with significantly reduced co-localization fluorescence intensity. Xumingtang could reduce the levels of IL-1β, IL-18, and the mRNA and protein expression of HIF-1α, NLRP3, CASP-1, and GSDMD (P<0.05, P<0.01), with the high-dose Xumingtang group showing the most significant effect (P<0.01). ConclusionXumingtang in Gu Jin Lu Yan can inhibit cell pyroptosis and promote neurological function recovery after IS, which may be related to the inhibition of the HIF-1α/NLRP3 pathway.
10.Effects of Backpack Types on Kinematics and Plantar Pressure in College Students During Stairs Walking
Ke YAN ; Yihui LIU ; Zeyi ZHANG ; Meizhen ZHANG ; Xiaogang WU ; Weiy CHEN
Journal of Medical Biomechanics 2023;38(3):E580-E586
Objective To analyze the influence of different backpack types and loads on kinematics and plantar pressure of college students during stair climbing, so as to provide references for choosing the appropriate backpack and carrying mode. Methods The Nokov infrared light point motion capture system and Podome plantar pressure system were used to analyze the differences in the range of motion ( ROM) of the trunk and lower limb joints, the kinematic parameters at the peak time, the peak pressure of each plantar partition, the contact time, the maximum pressure of the whole foot, the average pressure and the maximum contact area for 15 male college students during the support period of stair climbing. Results The 5% BW and 10% BW backpack loads reduced ROM of trunk rotation, increased ROM of ankle flexion/ extension and varus / valgus. The 10% BW backpack loads increased the peak pressure of the 1st and 3rd metatarsals bones and the maximum pressure of the whole foot ( P < 0. 05). Single-shoulder bag and handbag reduced ROM of trunk tilting and rotation, and increased ROM of ankle flexion and extension, hip flexion angle, peak pressure of foot arch and medial heel (P<0. 05). The double-shoulder bag loads increased peak pressure in the toe area (P<0. 05). Conclusions During walking on the stairs, the 5% BW and 10% BW backpack loads limited trunk rotation and increased ankle ROM. The 10% BW loads also increased the load in metatarsal area. The unilateral weight-bearing mode would make the trunk tilt to the unload side and rotate to the weight-bearing side. The pressure in toe area was higher when carrying double-shoulder bag, while single-shoulder bag and handbag mainly increased the pressure of arch foot and medial heel. It is suggested that college students choose symmetrical backpack scheme, and wisely allocate back weight to avoid the injury of foot area.

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