1.Total Saponins of Dioscoreae Nipponicae Rhizoma Alleviates Gouty Arthritis by Down-regulating COX-2-mediated M1 Macrophage Reprogramming
Lin HUANG ; Shumin LIU ; Huijuan SUN ; Geyu DENG ; Donghua YU ; Yu WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):200-207
ObjectiveTo explore the mechanism of total saponins of Dioscoreae Nipponicae Rhizoma (TSDN) in treating gouty arthritis (GA) by regulating cyclooxygenase-2 (COX-2)-mediated M1 macrophage reprogramming by in vivo and in vitro experiments. MethodsIn vivo experiment: 24 male SD rats were randomly allocated into blank, model (GA), TSDN, and celecoxib groups, with 6 rats in each group. After 7 days of administration, pathological changes in the ankle synovial tissue were observed via hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to quantify the mRNA levels of NOD-like receptor protein 3 (NLRP3) inflammasome, apoptosis-associated speck-like protein (ASC), Caspase-1, COX-2, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the synovial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the serum levels of inducible nitric oxide synthase (iNOS), IL-1β, CD86, CD80, CD206, and arginase-1 (Arg-1). In vitro experiment: The GA model was established by lipopolysaccharide (LPS) + MSU induction, and the inhibitor concentration was screened by the methyl thiazolyl tetrazolium (MTT) assay. RAW264.7 cells were allocated into blank, model, TSDN, dexamethasone, COX-2 inhibitor (celecoxib), and TSDN + COX-2 inhibitor groups. The levels of iNOS, IL-1β, CD86, CD80, CD206, and Arg-1 in the cell supernatant of each group were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in each group were determined by Real-time PCR and Western blot, respectively. ResultsIn vivo experiment: compared with the model group, TSDN reduced the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in the synovial tissue (P<0.05, P<0.01). ELISA results showed that TSDN lowered the serum levels of iNOS, IL-1β, CD86, and CD80 (P<0.01) while increasing the serum levels of CD206 and Arg-1 (P<0.01). In vitro experiment: compared with the model group, TSDN and inhibitor down-regulated the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α and the protein levels of NLRP3 inflammasome, COX-2, cleaved IL-1β, and TNF-α (P<0.01). Compared with TSDN alone, TSDN + COX-2 inhibitor further reduced the mRNA and protein levels of the markers above (P<0.01). Compared with the model group, TSDN and COX-2 inhibitor decreased the levels of IL-1β, iNOS, CD80, and CD86 (P<0.01) and increased the levels of CD206 and Arg-1 (P<0.01) in cells. Compared with TSDN alone, TSDN + COX-2 inhibitor reduced IL-1β, iNOS, CD80, and CD86 levels (P<0.05, P<0.01) and elevated CD206 and Arg-1 levels (P<0.01) in cells. ConclusionTSDN can alleviate GA by downregulating COX-2-mediated M1 macrophage reprogramming and suppressing the inflammatory factors.
2.Total Saponins of Dioscoreae Nipponicae Rhizoma Alleviates Gouty Arthritis by Down-regulating COX-2-mediated M1 Macrophage Reprogramming
Lin HUANG ; Shumin LIU ; Huijuan SUN ; Geyu DENG ; Donghua YU ; Yu WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):200-207
ObjectiveTo explore the mechanism of total saponins of Dioscoreae Nipponicae Rhizoma (TSDN) in treating gouty arthritis (GA) by regulating cyclooxygenase-2 (COX-2)-mediated M1 macrophage reprogramming by in vivo and in vitro experiments. MethodsIn vivo experiment: 24 male SD rats were randomly allocated into blank, model (GA), TSDN, and celecoxib groups, with 6 rats in each group. After 7 days of administration, pathological changes in the ankle synovial tissue were observed via hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to quantify the mRNA levels of NOD-like receptor protein 3 (NLRP3) inflammasome, apoptosis-associated speck-like protein (ASC), Caspase-1, COX-2, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the synovial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the serum levels of inducible nitric oxide synthase (iNOS), IL-1β, CD86, CD80, CD206, and arginase-1 (Arg-1). In vitro experiment: The GA model was established by lipopolysaccharide (LPS) + MSU induction, and the inhibitor concentration was screened by the methyl thiazolyl tetrazolium (MTT) assay. RAW264.7 cells were allocated into blank, model, TSDN, dexamethasone, COX-2 inhibitor (celecoxib), and TSDN + COX-2 inhibitor groups. The levels of iNOS, IL-1β, CD86, CD80, CD206, and Arg-1 in the cell supernatant of each group were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in each group were determined by Real-time PCR and Western blot, respectively. ResultsIn vivo experiment: compared with the model group, TSDN reduced the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in the synovial tissue (P<0.05, P<0.01). ELISA results showed that TSDN lowered the serum levels of iNOS, IL-1β, CD86, and CD80 (P<0.01) while increasing the serum levels of CD206 and Arg-1 (P<0.01). In vitro experiment: compared with the model group, TSDN and inhibitor down-regulated the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α and the protein levels of NLRP3 inflammasome, COX-2, cleaved IL-1β, and TNF-α (P<0.01). Compared with TSDN alone, TSDN + COX-2 inhibitor further reduced the mRNA and protein levels of the markers above (P<0.01). Compared with the model group, TSDN and COX-2 inhibitor decreased the levels of IL-1β, iNOS, CD80, and CD86 (P<0.01) and increased the levels of CD206 and Arg-1 (P<0.01) in cells. Compared with TSDN alone, TSDN + COX-2 inhibitor reduced IL-1β, iNOS, CD80, and CD86 levels (P<0.05, P<0.01) and elevated CD206 and Arg-1 levels (P<0.01) in cells. ConclusionTSDN can alleviate GA by downregulating COX-2-mediated M1 macrophage reprogramming and suppressing the inflammatory factors.
3.Underlying Mechanism of Wuwei Shenqintang in Amelioration of Pulmonary Fibrosis by Regulating "Lung-intestine Axis" Based on UPLC-Q-TOF-MS Metabolomics Technology
Mengdi SUN ; Fang LU ; Donghua YU ; Yu WANG ; Pingping CHEN ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):11-20
ObjectiveTo explore the mechanism of action of Wuwei Shenqintang in improving pulmonary fibrosis by using ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS) for metabolomic analysis of lung tissue and feces. MethodsA rat model with pulmonary fibrosis was established by intratracheal injection of 5 mg·kg-1 bleomycin. The successfully modeled rats were randomly divided into a blank group, a model group, a prednisone (3.15 mg·kg-1) group, and low-dose, medium-dose, and high-dose groups of Wuwei Shenqintang (4.586, 9.172, 18.344 g·kg-1). The rats were given intragastric administration once a day for 28 consecutive days. Hematoxylin-eosin (HE) staining was used to measure the pathological changes in lung and colon tissue, and Masson staining was used to detect the degree of pulmonary fibrosis. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNF-α), and secretory immunoglobulin A (SIgA) in bronchoalveolar lavage fluid and intestinal mucus. Immunohistochemistry and reverse transcription quantitative polymerase chain reaction (Real-time PCR) were used to detect the expression of type Ⅰ collagen (Col-Ⅰ), fibronectin (FN), and alpha smooth muscle actin (α-SMA) in lung tissue. UPLC-Q-TOF-MS was used to study the changes in the metabolic network of lung tissue and feces in rats with pulmonary fibrosis treated with Wuwei Shenqintang, screen potential biomarkers for the treatment of pulmonary fibrosis by Wuwei Shenqintang, and perform pathway enrichment analysis. ResultsCompared with the blank group, the model group showed extensive inflammatory cell infiltration and continuous fibrotic lesions in lung tissue, colonic mucosal damage, and connective tissue hyperplasia. The expression of IL-6, IL-8, IL-1β, TNF-α, and SIgA in bronchoalveolar lavage fluid and intestinal mucus was significantly increased (P<0.01). The expression of Col-Ⅰ, FN, and α-SMA proteins and mRNAs in lung tissue was significantly upregulated (P<0.01). Compared with the model group, the groups of Wuwei Shenqintang exhibited significantly reduced inflammatory infiltration and blue collagen deposition in lung tissue, alleviated colonic damage, decreased expression of IL-6, IL-8, IL-1β, TNF-α, and SIgA in bronchoalveolar lavage fluid and intestinal mucus (P<0.01), and reduced average absorbance values and mRNA expression of Col-Ⅰ, FN, and α-SMA in lung tissue (P<0.05, P<0.01), with the prednisone group and the medium-dose and high-dose groups of Wuwei Shenqintang showing the most significant effects. The metabolomics results for lung tissue showed that compared with the blank group, the model group had 19 significantly different compounds (P<0.05, P<0.01). Wuwei Shenqintang could normalize 17 of these compounds compared with the model group (P<0.05, P<0.01). Fecal metabolomics results showed that compared with those in the blank group, there were 42 compounds with significant differences in the model group (P<0.05, P<0.01). Compared with the model control group, Wuwei Shenqintang could normalize 41 of these compounds (P<0.05, P<0.01). The combined analysis results indicated that Wuwei Shenqintang might inhibit pulmonary fibrosis by regulating the biosynthesis of phenylalanine, tyrosine, and tryptophan as well as the retinol metabolism pathway. ConclusionWuwei Shenqintang can ameliorate pulmonary fibrosis, which may be related to the regulation of the "lung-intestine axis".
4.Underlying Mechanism of Wuwei Shenqintang in Amelioration of Pulmonary Fibrosis by Regulating "Lung-intestine Axis" Based on UPLC-Q-TOF-MS Metabolomics Technology
Mengdi SUN ; Fang LU ; Donghua YU ; Yu WANG ; Pingping CHEN ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):11-20
ObjectiveTo explore the mechanism of action of Wuwei Shenqintang in improving pulmonary fibrosis by using ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS) for metabolomic analysis of lung tissue and feces. MethodsA rat model with pulmonary fibrosis was established by intratracheal injection of 5 mg·kg-1 bleomycin. The successfully modeled rats were randomly divided into a blank group, a model group, a prednisone (3.15 mg·kg-1) group, and low-dose, medium-dose, and high-dose groups of Wuwei Shenqintang (4.586, 9.172, 18.344 g·kg-1). The rats were given intragastric administration once a day for 28 consecutive days. Hematoxylin-eosin (HE) staining was used to measure the pathological changes in lung and colon tissue, and Masson staining was used to detect the degree of pulmonary fibrosis. Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNF-α), and secretory immunoglobulin A (SIgA) in bronchoalveolar lavage fluid and intestinal mucus. Immunohistochemistry and reverse transcription quantitative polymerase chain reaction (Real-time PCR) were used to detect the expression of type Ⅰ collagen (Col-Ⅰ), fibronectin (FN), and alpha smooth muscle actin (α-SMA) in lung tissue. UPLC-Q-TOF-MS was used to study the changes in the metabolic network of lung tissue and feces in rats with pulmonary fibrosis treated with Wuwei Shenqintang, screen potential biomarkers for the treatment of pulmonary fibrosis by Wuwei Shenqintang, and perform pathway enrichment analysis. ResultsCompared with the blank group, the model group showed extensive inflammatory cell infiltration and continuous fibrotic lesions in lung tissue, colonic mucosal damage, and connective tissue hyperplasia. The expression of IL-6, IL-8, IL-1β, TNF-α, and SIgA in bronchoalveolar lavage fluid and intestinal mucus was significantly increased (P<0.01). The expression of Col-Ⅰ, FN, and α-SMA proteins and mRNAs in lung tissue was significantly upregulated (P<0.01). Compared with the model group, the groups of Wuwei Shenqintang exhibited significantly reduced inflammatory infiltration and blue collagen deposition in lung tissue, alleviated colonic damage, decreased expression of IL-6, IL-8, IL-1β, TNF-α, and SIgA in bronchoalveolar lavage fluid and intestinal mucus (P<0.01), and reduced average absorbance values and mRNA expression of Col-Ⅰ, FN, and α-SMA in lung tissue (P<0.05, P<0.01), with the prednisone group and the medium-dose and high-dose groups of Wuwei Shenqintang showing the most significant effects. The metabolomics results for lung tissue showed that compared with the blank group, the model group had 19 significantly different compounds (P<0.05, P<0.01). Wuwei Shenqintang could normalize 17 of these compounds compared with the model group (P<0.05, P<0.01). Fecal metabolomics results showed that compared with those in the blank group, there were 42 compounds with significant differences in the model group (P<0.05, P<0.01). Compared with the model control group, Wuwei Shenqintang could normalize 41 of these compounds (P<0.05, P<0.01). The combined analysis results indicated that Wuwei Shenqintang might inhibit pulmonary fibrosis by regulating the biosynthesis of phenylalanine, tyrosine, and tryptophan as well as the retinol metabolism pathway. ConclusionWuwei Shenqintang can ameliorate pulmonary fibrosis, which may be related to the regulation of the "lung-intestine axis".
5.Real-world efficacy and safety of azvudine in hospitalized older patients with COVID-19 during the omicron wave in China: A retrospective cohort study.
Yuanchao ZHU ; Fei ZHAO ; Yubing ZHU ; Xingang LI ; Deshi DONG ; Bolin ZHU ; Jianchun LI ; Xin HU ; Zinan ZHAO ; Wenfeng XU ; Yang JV ; Dandan WANG ; Yingming ZHENG ; Yiwen DONG ; Lu LI ; Shilei YANG ; Zhiyuan TENG ; Ling LU ; Jingwei ZHU ; Linzhe DU ; Yunxin LIU ; Lechuan JIA ; Qiujv ZHANG ; Hui MA ; Ana ZHAO ; Hongliu JIANG ; Xin XU ; Jinli WANG ; Xuping QIAN ; Wei ZHANG ; Tingting ZHENG ; Chunxia YANG ; Xuguang CHEN ; Kun LIU ; Huanhuan JIANG ; Dongxiang QU ; Jia SONG ; Hua CHENG ; Wenfang SUN ; Hanqiu ZHAN ; Xiao LI ; Yafeng WANG ; Aixia WANG ; Li LIU ; Lihua YANG ; Nan ZHANG ; Shumin CHEN ; Jingjing MA ; Wei LIU ; Xiaoxiang DU ; Meiqin ZHENG ; Liyan WAN ; Guangqing DU ; Hangmei LIU ; Pengfei JIN
Acta Pharmaceutica Sinica B 2025;15(1):123-132
Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T NANC), time to symptom improvement (T SI), and time of hospital stay (T HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.
7.Effect of Cannabidiol on Pulmonary Fibrosis Analyzed by UPLC-Q-TOF-MS
Mengdi SUN ; Feiyu ZHANG ; Huicong YANG ; Yu WANG ; Pingping CHEN ; Fang LU ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):185-193
ObjectiveTo investigate the mechanism of anti-pulmonary fibrosis of cannabidiol by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS). MethodSD rats were randomly divided into blank group, model group, prednisone group(3.15 mg·kg-1) and cannabidiol low, medium and high dose groups(12, 36, 108 mg·kg-1), with 8 rats in each group. The rat model of pulmonary fibrosis was established by intratracheal injection of bleomycin(5 mg·kg-1), which was administered continuously for 28 days after successful modeling. The pathological changes of rat lung tissue were observed, and enzyme-linked immunosorbent assay(ELISA) was used to detect the expression levels of matrix metalloproteinase-7(MMP-7), type Ⅱ alveolar cell surface antigen(KL-6), pulmonary surfactant-associated protein A(SP-A) and SP-D in serum. The expression levels of type Ⅰ collagen(Col-Ⅰ) and fibronectin(FN) in lung tissues were detected by immunohistochemistry, and the expression of mucin 5 subtype AC(MUC5AC) was detected by immunofluorescence. UPLC-Q-TOF-MS was used to search for potential biomarkers and related metabolic pathways of cannabidiol in treating pulmonary fibrosis. ResultCompared with the blank group, there were a large number of inflammatory cell infiltration and continuous fibrosis lesions in the lung tissue of rats in the model group. Compared with the model group, the inflammatory infiltration and blue collagen deposition in the lung tissue of rats in the prednisone and cannabidiol groups were reduced. Compared with the blank group, the expressions of MMP-7, KL-6, SP-A and SP-D in serum of the model group were significantly increased(P<0.01), while the expressions of MMP-7, KL-6, SP-A and SP-D in the prednisone and cannabidiol high dose groups were significantly decreased by comparing with the model group(P<0.05, P<0.01). Compared with the blank group, the expression levels of Col-Ⅰ and FN in the lung tissues of the model group were significantly increased, and the fluorescence intensity of MUC5AC was significantly increased(P<0.01). Compared with the model group, the expression levels of Col-Ⅰ and FN in the lung tissues of the prednisone and cannabidiol high dose groups were significantly decreased(P<0.05, P<0.01), and the expression of MUC5AC was significantly decreased(P<0.01). Compared with the blank group, a total of 18 differential compounds were screened out in the model group, which could be used as potential biomarkers, and cannabidiol could call back 16 of them, mainly involving 4 metabolic pathways(linoleic acid metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, arachidonic acid metabolism, and niacin and niacinamide metabolism). Compared with the blank group, the relative contents of potential biomarkers arachidonic acid and linoleic acid were significantly increased in the model group(P<0.05, P<0.01), while the relative contents of 5,6-EET, L-tyrosine and niacinamide were significantly decreased(P<0.01). Compared with the model group, cannabidiol could significantly reduce the relative contents of arachidonic acid and linoleic acid, and significantly increase the relative contents of 5,6-EET, L-tyrosine and niacinamide(P<0.01). ConclusionCannabidiol has an intervention and remission effect on pulmonary fibrosis, and its mechanism may be related to linoleic acid metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, arachidonic acid metabolism, niacin and niacinamide metabolism.
8.Temporal-spatial Generation of Astrocytes in the Developing Diencephalon.
Wentong HONG ; Pifang GONG ; Xinjie PAN ; Zhonggan REN ; Yitong LIU ; Guibo QI ; Jun-Liszt LI ; Wenzhi SUN ; Woo-Ping GE ; Chun-Li ZHANG ; Shumin DUAN ; Song QIN
Neuroscience Bulletin 2024;40(1):1-16
Astrocytes are the largest glial population in the mammalian brain. However, we have a minimal understanding of astrocyte development, especially fate specification in different regions of the brain. Through lineage tracing of the progenitors of the third ventricle (3V) wall via in-utero electroporation in the embryonic mouse brain, we show the fate specification and migration pattern of astrocytes derived from radial glia along the 3V wall. Unexpectedly, radial glia located in different regions along the 3V wall of the diencephalon produce distinct cell types: radial glia in the upper region produce astrocytes and those in the lower region produce neurons in the diencephalon. With genetic fate mapping analysis, we reveal that the first population of astrocytes appears along the zona incerta in the diencephalon. Astrogenesis occurs at an early time point in the dorsal region relative to that in the ventral region of the developing diencephalon. With transcriptomic analysis of the region-specific 3V wall and lateral ventricle (LV) wall, we identified cohorts of differentially-expressed genes in the dorsal 3V wall compared to the ventral 3V wall and LV wall that may regulate astrogenesis in the dorsal diencephalon. Together, these results demonstrate that the generation of astrocytes shows a spatiotemporal pattern in the developing mouse diencephalon.
Mice
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Astrocytes
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9.Application of exosomes in oral regenerative medicine
Shuyuan WANG ; Shumin PENG ; Zhenjie GAO ; Jingjing SUN
Chinese Journal of Stomatology 2024;59(6):627-633
In recent years, exosomes had been recognized as a potential cell-free therapeutic tool in the field of regenerative medicine due to their easy accessibility, low immunogenicity, and good therapeutic effect. As paracrine products of cells, exosomes not only have the functions of their donor cells but also involve fewer ethical disputes. They are more stable than traditional stem cell therapy, and easy to store, transport and sterilize, which are gradually applied in the field of oral regenerative medicine. This article provides a review of the general properties of exosomes and their application in the field of oral regeneration, with a view to exploring new pathways for functional regeneration of the stomatognathic system.
10.Prognostic Value of Soluble ST2 Combined With NT-proBNP in ST-segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention
Jiuyue YANG ; Shumin CHANG ; Yihan SUN ; Qian YU ; Guiming CHEN ; Wenqi BAO ; Aijie HOU
Chinese Circulation Journal 2024;39(6):568-573
Objectives:To investigate the prognostic value of soluble growth stimulation expressed gene 2 protein(sST2)combined with N-terminal pro-brain natriuretic peptide(NT-proBNP)in patients with ST-segment elevation myocardial infarction(STEMI)undergoing primary percutaneous coronary intervention(PCI). Methods:A total of 206 patients who were diagnosed with STEMI for the first time and underwent emergency PCI from August 2020 to February 2021 in the People's Hospital of Liaoning Province were enrolled.Patients were followed up for 3 years and divided into major adverse cardiac event(MACE,a composite endpoint event including cardiac death,stroke,heart failure,and ischemia-driven revascularization)group and MACE-free group.Multivariate cox analysis was performed to determine the independent risk factors for the prognosis of primary PCI in STEMI patients;the predictive value of sST2 and NT-proBNP for the occurrence of MACE in STEMI patients undergoing primary PCI was assessed by ROC analysis and the prediction of MACE by each factor by itself and the combined variables was analyzed with the Delong test. Results:There were 62 cases of MACE during the 3-year follow-up.Compared with the MACE-free group,patients in the MACE group had higher levels of sST2 and NT-proBNP,higher proportion of patients with left anterior descending branch lesions,anterior wall myocardial infarction,lower LVEF,and higher proportion of coronary artery slow flow(all P<0.05).Multivariate Cox analysis showed that sST2(HR=1.018,95%CI:1.012-1.024,P<0.001)and NT-proBNP(HR=1.001,95%CI:1.000-1.010,P<0.001)were independent predictors of MACE.According to the statistical analysis of ROC and Delong test,the AUC of combined sST2 and NT-proBNP in predicting MACE was 0.854,the sensitivity was 64.5%,the specificity was 93.1%,and the combined prediction of prognosis was better than that of individual prediction,with statistically significant difference(Z=2.119,P=0.034;Z=2.178,P=0.029). Conclusions:Serum sST2 and NT-proBNP are valuable predictors of MACE after emergency PCI in patients with STEMI,and the predictive efficacy increases with combined assessment of both sST2 and NT-proBNP.

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