1.Mechanism of astragalin in allevating ulcerative colitis in mice through modulation of the intestinal flora
Jing HUANG ; Yanhua LIAO ; Xinying MO ; Yuting YANG ; Weizhe JIANG
China Pharmacy 2025;36(14):1709-1716
OBJECTIVE To explore the potential mechanisms of astragalin (AG) in allevating ulcerative colitis (UC) in mice through modulation of the intestinal flora. METHODS Male C57BL/6 mice were randomly divided into normal group (CON group), model group [dextran sodium sulfate (DSS) group], 5-aminosalicylic acid group (5-ASA group), AG low-dose group and high-dose group (AGL and AGH groups), with 8 mice in each group. The mice UC model was established by drinking 3% DSS solution continuously for 7 days in all groups except the CON group. After that, 3% DSS solution was replaced by water, and the mice of each drug group were gavaged with the corresponding drug solution. Mice in the CON and DSS groups were gavaged with an equal volume of normal saline, once a day, for 7 days. After the last gavage, the body weight change index, disease activity index (DAI) score, colon length and spleen index, and levels of inflammatory factors (tumor necrosis factor-α, interleukin-1β, interleukin-6) were compared among the mice in each group; pathological changes in colonic tissues of the mice were observed in each group, and the pathological score and the percentage of goblet cells were compared; mRNA expressions of barrier-related factors [occludin and ZO-1] and inflammation-related factors [silencing information regulatory factor 1 (SIRT1), c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (p38 MAPK)] were detected in each group of mice; the changes in the intestinal flora of mice in each group were analyzed and the contents of intestinal metabolites short-chain fatty acids (SCFAs) was determined. Using DSS and AG-treated fecal bacterial liquid as an intervention, the mechanism of anti-UC effect of AG was further verified by a fecal microbiota transplant experiment. RESULTS Compared with the CON group, the intestinal mucosal structure of mice in the DSS group was severely damaged, with obvious infiltration of inflammatory cells collapsing the wall; their body weight change index, colon length, the percentage of goblet cells, mRNA expressions of occludin, ZO-1 and SIRT1, Chao1 and Shannon indexes, and contents of acetic acid and butyric acid were significantly reduced, shortened or down-regulated (P<0.05); however, DAI score, spleen index, levels of inflammatory factors, pathological score, as well as mRNA expressions of p38 MAPK and JNK, were all significantly increased or up-regulated (P<0.05). Compared with the DSS group, colon tissue lesions of AG mice in all dose groups showed different degrees of improvement, and the above quantitative indexes were generally regressed (P<0.05), and the intervention effect of AG-treated fecal bacterial fluid was basically the same as that of AG. CONCLUSIONS AG can improve relevant symptoms in UC mice and reduce their inflammatory response and colonic histopathological changes. The above effects may be related to regulating the diversity of intestinal flora in mice, increasing the contents of butyric acid and propionic acid, and promoting the repair of the colonic mucosal barrier, thus regulating the expressions of genes related to the SIRT1/p38 MAPK inflammatory pathway.
2.Analysis of Clinical Characteristics and Death Risk Factors in Patients with Community-acquired Pneumonia Complicated with Diabetes
Jianfang MA ; Xiaoling HUANG ; Yanhua LI ; Di MA ; Kaifen YUAN
Journal of Kunming Medical University 2024;45(2):123-130
Objective To explore the clinical characteristics and risk factors of death during hospitalization in patients with community-acquired pneumonia(CAP)complicated with diabetes mellitus(DM).Methods A retrospective analysis was performed on 566 patients with CAP hospitalized in the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2022.The patients were divided into simple CAP group(n=478)and CAP combined with diabetes(CAP+DM)group(n=88)according to whether they had diabetes,and then CAP+DM group(n=88)was divided into survival group(n=69)and death group(n =19)according to whether the patients died during hospitalization.The clinical data and laboratory test indicators of patients in different groups were compared.Cox regression analysis was used to screen the risk factors of death during hospitalization in the CAP+DM group.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of independent risk factors on hospitalization death.Results Compared with the simple CAP group,the CAP+DM group had significant differences in age,concomitant hypertension,coronary heart disease,CURB-65 score,neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP),procalcitonin(PCT),albumin(ALB),prealbumin(PA),glucose(GLU),serum potassium(K),calcium(Ca),phosphorus(P),magnesium(Mg),lactic acid(Lac),non-invasive ventilation time,ICU occupancy rate and mortality rate(P<0.05);Compared with the survival group,there were statistically significant differences in CURB-65 score,NLR,CRP,PCT,GIU,ALB,PA,serum iron(Fe),Ca,non-invasive ventilation time,and ICU admission rate among the death group patients(P<0.05).Cox regression analysis showed that the increase of NLR level and the decrease in PA level were the risk factors for in-hospital death in patients with CAP complicated with diabetes(P<0.05).When the PA cutoff value was 91 mg/L,the AUC,sensitivity,and specificity for predicting in-hospital death of CAP patients with diabetes were 0.849,84.2%and 81.2%,respectively.Conclusion Patients with CAP combined with diabetes are more serious and have worse prognosis than those with CAP alone.PA has a good predictive value for the prognosis of these patients.Early detection and active intervention should be carried out to reduce the in-hospital mortality of patients.
3.Effects of different culture media on quality and developmental potential of mouse oocytes after in vitro maturation
Yin TIAN ; Yanhua ZHAO ; Guoning HUANG ; Jingyu LI
Chinese Journal of Tissue Engineering Research 2024;28(13):2024-2029
BACKGROUND:In recent years,the demand for in vitro maturation of immature oocytes has increased.Oocyte maturation is affected by many factors,among which the selection of medium is particularly important,and there is currently no unified plan. OBJECTIVE:To compare the in vitro maturation of germinal vesicle stage oocytes with different maturation media and to investigate its effects on oocyte quality and developmental potential. METHODS:Germinal vesicle oocytes were matured in G-1TM PLUS medium,CZB medium and M16 medium,and mature oocytes in vivo were used as control group to compare in vitro fertilization and early embryo development among various groups.The immunofluorescence method was used to evaluate mitochondrial function in mature oocytes of each group.Calcium oscillation was detected by confocal microscopy real-time imaging system. RESULTS AND CONCLUSION:(1)There was no significant difference in the first polar body ejection rate among the three groups(P>0.05).(2)The rate of in vitro fertilization was higher in the G-1TM PLUS group(52.86±11.24)%than that in the M16 group(37.76±6.70)%and the CZB group(30.62±5.51)%.The blastocyst rate was lower in the CZB group(36.23±6.63)%than that in the control group(78.16±4.17)%,G-1TM PLUS group(55.75±7.63)%and M16 group(53.36±6.33)%.(3)Compared with the control group,the length-to-width ratio of the spindle in the CZB group increased(P<0.005).(4)The mitochondrial function of the CZB group was worse than that of the control group,G-1TM PLUS group and M16 group,and abnormal mitochondrial agglutination occurred in the CZB group.(5)The frequency of calcium oscillations in the CZB and M16 groups was significantly higher than that in the G1 and control groups.In conclusion,during in vitro maturation of mouse oocytes,in vitro maturation rate was not significantly different among G-1TM PLUS,CZB and M16 media,but the G-1TM PLUS medium had a higher rate of fertilization and blastocyst formation.
4.Antibacterial performance of cerium oxide nanoenzyme against Escherichia coli
Heishu ZHENG ; Yingjuan ZHANG ; Yanhua WEI ; Hui HUANG ; Xiangyu MA ; Hongbing LIAO
Chinese Journal of Tissue Engineering Research 2024;28(22):3496-3501
BACKGROUND:The increase in multi-drug resistant bacterial infections has become a major problem in modern healthcare due to the development of bacterial resistance to antibiotics and the development of new antibacterial alternative drug materials is of great importance. OBJECTIVE:To synthesize and perform a series of characterization of a CeO2 nanoenzyme to investigate its biocompatibility and antibacterial properties against Escherichia coli. METHODS:CeO2 nanoenzymes were synthesized using a hydrothermal method.The morphology,product composition,and chemical composition were analyzed using characterization methods such as X-ray diffraction,X-ray photoelectron spectroscopy,Fourier infrared analysis,Raman spectroscopy,scanning electron microscopy,and transmission electron microscopy.The peroxide-mimetic enzyme activity of CeO2 nanoenzymes was characterized using TMB color development assay.The toxic effect of CeO2 nanoenzymes at different concentrations(10,25,and 50 μg/mL)on mouse fibroblast L929 cells was evaluated using the CCK-8 assay.The antibacterial properties of CeO2 nanoenzymes against Escherichia coli under different conditions were evaluated using the plate coating method.Changes in intra-bacterial reactive oxygen species after treatment with different conditions were detected using a reactive oxygen species detection kit. RESULTS AND CONCLUSION:(1)The morphology of the synthesized CeO2 nanoparticles was rod-shaped,with Ce3+ accounting for 29.87%of the total Ce3+/Ce4+ and an average grain size of 7.4 nm.In a slightly acidic environment containing TMB and pH=5.5,CeO2 nanoenzymes mixed with H2O2 showed excellent peroxidase activity,but did not show peroxidase simulated activity at pH=7.4.(2)There was no statistically significant difference in the toxic effects of CeO2 nanoparticles at various mass concentrations on mouse fibroblast L929 cells.(3)In a slightly acidic environment at pH 5.5,Escherichia coli was inhibited to a certain extent in the presence of CeO2 nanoenzyme alone at a concentration of 10 μg/mL,with a decrease in CFU results of about 0.5 log(P<0.01);in a slightly acidic environment containing 50 μmol/L H2O2,CeO2 nanoenzyme showed excellent antibacterial effects against Escherichia coli,with a decrease in Escherichia coli CFU results of by about 1.5 log(P<0.001).After CeO2 nanoenzymes interacted with Escherichia coli,the level of reactive oxygen species in Escherichia coli increased(P<0.05);after CeO2 nanoenzymes interacted with Escherichia coli together with H2O2,the level of reactive oxygen species in Escherichia coli increased significantly(P<0.001).(4)The results show that the CeO2 nanoenzymes have good biocompatibility,are inherently antibacterial,and can exhibit peroxidase activity in a slightly acidic environment containing low concentrations of H2O2,and generate reactive oxygen species to kill bacteria,thus showing excellent antibacterial effects.
5.Effects of kinesio taping on the biomechanical characteristics of the lower limbs during side-step cutting
Jing YOU ; Wenqi HUANG ; Wei ZHENG ; Jieming LU ; Yanhua GUO ; Yuan GAO ; Zheyu XIONG
Chinese Journal of Tissue Engineering Research 2024;28(27):4383-4389
BACKGROUND:Kinesio taping has been widely used as a means of sports protection,but its role as a means to correct abnormal biomechanical changes of the lower limbs during side-step cutting remains unclear. OBJECTIVE:To analyze and compare the changes in lower limb kinematics and dynamics when the subjects complete the side-step cutting of the knee joint under the conditions of kinesio taping,placebo taping and blank control. METHODS:Thirty-nine male college students majoring in basketball were recruited as subjects.Each subject was tested with kinesio taping,placebo taping or no taping.The mechanical correction method was used to patch the dominant knee joint of each subject.The run-up speed of 4.5-5.5 m/s was selected to complete the 45° side-step cutting motion,and the kinematics and kinetics data were collected synchronously by the three-dimensional dynamic capture system and the force measuring platform.The kinematics and kinetics parameters at the moment of initial touchdown and peak ground reaction force were selected for data analysis.SPSS 27.0 software was used for statistical analysis of the test data. RESULTS AND CONCLUSION:Kinematic indexes:compared with no taping and placebo taping,the hip abduction and knee valgus angles at the initial touchdown moment were significantly decreased when kinesio taping was used(P<0.05);at the moment of peak lateral ground reaction force,the angles of hip abduction,knee valgus and ankle plantar flexion decreased significantly(P<0.05),and the knee flexion angle was significantly increased(P<0.05).Kinetic indexes:Compared with no taping,both kinesio taping and placebo taping significantly reduced hip abduction and external rotation torque,knee valgus and external rotation torque at the moment of initial touchdown(P<0.05),and significantly reduced peak vertical ground reaction force and peak horizontal backward ground reaction force(P<0.05);in addition,kinesio taping significantly reduced peak lateral ground reaction force compared with no taping and placebo taping(P<0.05).These results indicate that kinesio taping of the knee joint may improve some kinematic and kinetic indexes associated with lower limb injury risk factors during the completion of the side-step cutting in basketball specialized college students to some extent,and may have a positive effect on the prevention of injury during the side-step cutting.In addition,the trends in the effects of placebo taping and kinesio taping on the knee joint are more consistent in terms of changes in some indexes,suggesting that there may be a placebo effect on the mechanism of action of kinesio taping.
6.Application of B-ultrasound-guided transabdominal villus and amniocentesis in prenatal diagnosis of thalassemia
Lanlan ZHANG ; Fenfang HUANG ; Feifei GONG ; Haiyan CAI ; Xuemei HU ; Yanhua HUANG ; Pei LIANG ; Yijuan CHEN
China Modern Doctor 2024;62(3):13-15
Objective To explore the clinical application of ultrasound-guided transabdominal villus and amniocentesis in the prenatal diagnosis of thalassemia,and to find a suitable method for the prenatal diagnosis of thalassemia in Qinzhou.Methods A total of 531 high-risk pregnant women with severe or intermediate thalassemia during single pregnancy who were treated in the Department of Medical Genetics and Prenatal Diagnosis,Qinzhou Maternal and Child Health Hospital from March 2021 to April 2022 were selected for the study.According to different sampling methods,they were divided into control group(amniocentesis,n=415)and study group(transabdominal villus puncture,n=116).The success rate,complication rate of the two groups were compared.Results The success rate of puncture in the control group was 100%,2 cases were aborted within 2 weeks after surgery,17 cases were diagnosed with severe alpha-thalassemia,10 cases with severe β-thalassemia and 64 cases with intermediate thalassemia,48 cases with moderate and severe thalassemia induced labor.The success rate of puncture in the research group was 100%,10 cases were diagnosed with severe alpha-thalassemia,4 cases with severe β-thalassemia and 17 cases with intermediate thalassemia,and 26 cases with moderate severe thalassemia were induced labor.There was no significant difference in puncture success rate and abortion rate between the two methods(P>0.05).Conclusion Both methods are safe and effective.Transabdominal villus sampling can detect fetal thalassemia in early pregnancy,and it is worth promoting and applying in clinical practice.
7.Study on the relationship between HSP70 polymorphism and susceptibility to occupational noise-induced hearing loss
Chunjiao XIE ; Yanru LI ; Lili HUANG ; Yanhua LI ; Yingmei LIU ; Huifen FU ; Zhi WANG
China Occupational Medicine 2024;51(1):25-30
ObjectiveTo investigate the correlation between genetic polymorphism of heat shock proteins 70 (HSP70) and susceptibility to occupational noise-induced hearing loss (ONIHL). Methods A total of 229 ONIHL workers were selected as the case group and 229 healthy workers with similar age, years of noise exposure, and noise exposure levels were selected as the control group using the case-control study method. Occupational health examinations were conducted on both groups, and peripheral blood of individuals was collected for DNA extraction. The genotypes of three single nucleotide polymorphisms of the HSP70 were detected using the MassArray system. Results The allele frequency distribution of HSP70 rs2227956, rs1043618, and rs1061581 in the control group was in Hardy-Weinberg equilibrium (all P>0.05). The genotype and allele frequency distribution of rs2227956 was significantly different between the two groups (all P<0.05), while no significant difference was found for rs1043618 and rs1061581 (all P>0.05). After adjusting for age, years of noise exposure, individual noise exposure level, smoking, and drinking, individuals with AG and AG+GG genotypes of rs2227956 had a higher risk of ONIHL than those with AA genotype (all P<0.05). The risk of ONIHL was higher in individuals with G allele of rs2227956 than in those with A allele (P<0.05). No correlation was found between rs1043618 and rs1061581 polymorphisms and the risk of ONIHL (all P>0.05). Conclusion The rs2227956 polymorphism of the HSP70 gene is correlated with susceptibility to ONIHL in noise-exposed workers, and the G allele is a risk factor for ONIHL in this population.
8.Diagnostic value of Hp-IgG antibody combined with serum DKK1 and sB7-H3 in early gastric cancer
Journal of International Oncology 2024;51(6):338-343
Objective:To investigate the diagnostic value of Helicobacter pylori-immunoglobulin G (Hp-IgG) antibody combined with serum secretory protein Dikkopf-associated protein 1 (DKK1) and soluble B7 homolog 3 (sB7-H3) in early gastric cancer (EGC) . Methods:Forty-eight patients with EGC admitted to Nantong Haimen People's Hospital of Jiangsu Province from June 2020 to August 2023 were selected as the study objects (EGC group). Fifty patients with chronic atrophic gastritis (CAG) diagnosed in the same period were selected as CAG group, and 58 healthy subjects were selected as control group. Hp-IgG antibody was detected by colloidal gold method, and serum DKK1, sB7-H3 levels were determined by enzyme-linked immunosorbent assay. The value of serum Hp-IgG antibody, DKK1 and sB7-H3 in differential diagnosis of CAG and EGC was analyzed by receiver operating characteristic (ROC) curve, and the consistency of differential diagnosis was evaluated by Kappa consistency test.Results:The positive rates of Hp-IgG antibody in the control group, CAG group, and EGC group were 36.21% (21/58), 72.00% (36/50), and 89.58% (43/48), respectively. The levels of DKK1 in the three groups were (13.78±3.35), (21.36±4.52), and (38.86±7.24) μg/L, respectively, and the levels of sB7-H3 were (7.63±1.59), (12.34±3.64), and (25.35±5.27) μg/L, respectively. There were statistically significant differences ( χ2=34.51, P<0.001; F=316.95, P<0.001; F=314.22, P<0.001). Compared with the control group, the positive rates of Hp-IgG antibody, DKK1 and sB7-H3 levels were all higher in the CAG group and EGC group (all P<0.05). Compared with the CAG group, the positive rates of Hp-IgG antibody, as well as the levels of DKK1 and sB7-H3 were all higher in the EGC group (all P<0.05). Among the CAG patients, 36 had positive Hp-IgG antibody and 14 had negative results. The levels of DKK1 were (22.18±4.84), (16.33±3.57) μg/L in the positive and negative patients, respectively, and the levels of sB7-H3 were (12.83±3.84), (9.33±2.32) μg/L, respectively. There were statistically significant differences ( t=4.10, P<0.001; t=3.18, P=0.003). There were 43 positive and 5 negative cases of Hp-IgG antibody in EGC patients, with serum DKK1 levels of (39.66±7.61) μg/L and (30.05±5.23) μg/L, and sB7-H3 levels of (26.18±5.62) μg/L and (16.24±4.25) μg/L, respectively, and there were statistically significant differences ( t=2.74, P=0.009; t=3.82, P<0.001). ROC curve showed that, the area under the curve (AUC) of Hp-IgG antibody for differential diagnosis of CAG and EGC was 0.81 (95% CI: 0.72-0.88), with a sensitivity of 72.00% and a specificity of 89.58%, while the DKK1 AUC for the differential diagnosis of CAG and EGC was 0.90 (95% CI: 0.82-0.95), and the optimal cutoff value was 28.32 μg/L, with a sensitivity of 70.00% and a specificity of 95.83%; sB7-H3 AUC for the differential diagnosis of CAG and EGC was 0.86 (95% CI: 0.78-0.92), and the optimal cutoff value was 16.44 μg/L, with a sensitivity of 70.00% and a specificity of 95.83%; the AUC of the three combined for the differential diagnosis of CAG and EGC was 0.95 (95% CI: 0.89-0.98), with a sensitivity of 90.00% and a specificity of 87.50%; and the combination of the three was superior to each of the Hp-IgG antibody, DKK1, and sB7-H3 alone for the differential diagnosis of CAG and EGC ( Z=3.62, P<0.001; Z=2.13, P=0.035; Z=2.69, P=0.016). The Kappa consistency test showed that the serum Hp-IgG antibody combined with DKK1 and sB7-H3 for the differential diagnosis of CAG and EGC was in better agreement with histopathological examination (Kappa=0.78) . Conclusion:Hp-IgG antibody positive rate, serum DKK1 and sB7-H3 levels of EGC patients are high, and the combination of the three tests is more effective in the differential diagnosis of CAG and EGC.
9.Plasma microRNA-15a/16-1-based machine learning for early detection of hepatitis B virus-related hepatocellular carcinoma
Wei HUAN ; Luo SONGHAO ; Bi YANHUA ; Liao CHUNHONG ; Lian YIFAN ; Zhang JIAJUN ; Huang YUEHUA
Liver Research 2024;8(2):105-117
Background and aims:Hepatocellular carcinoma(HCC),which is prevalent worldwide and has a high mortality rate,needs to be effectively diagnosed.We aimed to evaluate the significance of plasma microRNA-15a/16-1(miR-15a/16)as a biomarker of hepatitis B virus-related HCC(HBV-HCC)using the machine learning model.This study was the first large-scale investigation of these two miRNAs in HCC plasma samples. Methods:Using quantitative polymerase chain reaction,we measured the plasma miR-15a/16 levels in a total of 766 participants,including 74 healthy controls,335 with chronic hepatitis B(CHB),47 with compensated liver cirrhosis,and 310 with HBV-HCC.The diagnostic performance of miR-15a/16 was examined using a machine learning model and compared with that of alpha-fetoprotein(AFP).Lastly,to validate the diagnostic efficiency of miR-15a/16,we performed pseudotemporal sorting of the samples to simulate progression from CHB to HCC. Results:Plasma miR-15a/16 was significantly decreased in HCC than in all control groups(P<0.05 for all).In the training cohort,the area under the receiver operating characteristic curve(AUC),sensitivity,and average precision(AP)for the detection of HCC were higher for miR-15a(AUC=0.80,67.3%,AP=0.80)and miR-16(AUC=0.83,79.0%,AP=0.83)than for AFP(AUC=0.74,61.7%,AP=0.72).Combining miR-15a/16 with AFP increased the AUC to 0.86(sensitivity 85.9%)and the AP to 0.85 and was significantly superior to the other markers in this study(P<0.05 for all),as further demonstrated by the detection error tradeoff curves.Moreover,miR-15a/16 impressively showed potent diagnostic power in early-stage,small-tumor,and AFP-negative HCC.A validation cohort confirmed these results.Lastly,the simulated follow-up of patients further validated the diagnostic efficiency of miR-15a/16. Conclusions:We developed and validated a plasma miR-15a/16-based machine learning model,which exhibited better diagnostic performance for the early diagnosis of HCC compared to that of AFP.
10.Comparison of clinical effects of endoscopic submucosal dissection and endoscopic mucosal resection in the treatment of elderly patients with early gastric cancer
Xiaobei ZHU ; Zheng CHEN ; Yanhua HUANG
Chinese Journal of Postgraduates of Medicine 2024;47(6):531-535
Objective:To compare the clinical efficacy of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) in the treatment of elderly patients with early gastric cancer.Methods:Ninety-two elderly patients with early gastric cancer admitted to the 923th Hospital of the Joint Service Support Force of PLA from June 2019 to February 2022 were enrolled, and they were divided into ESD group (60 cases) and EMR group (32 cases) according to different surgical methods. The ESD group was treated with ESD surgery, while the EMR group was treated with EMR surgery. The short-term clinical efficacy of the two groups was compared. The gastric function including pepsinogen Ⅰ(PGⅠ), pepsinogenⅡ(PGⅡ), PGⅠ /PGⅡ ratio and the tumor markers including carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), and invasion genes within the lesion including vascular endothelial growth factor C (VEGF-C), E-cadherin, microtubule depolymerin (Stathmin), Krüppel like factor 4 (KLF4) were detected before and 3 d after surgery. Followed up for 1 year, the recurrence rate and complications between the two groups were compared.Results:All of 92 patients successfully removed the diseased tissue as a whole, and the R0 and R1 resection rate between the two groups had no statistical differences ( P>0.05). At 3 d after surgery, the levels of PG Ⅰand PGⅠ/PG Ⅱin the both groups were higher than those before surgery, and the level of PG Ⅱ in the both groups was lower than that before surgery; the levels of PG Ⅰand PGⅠ/PG Ⅱ in the ESD group were higher than those in the EMR group: (86.50 ± 8.23) μg/L vs. (77.47 ± 7.40) μg/L, 5.29 ± 0.54 vs. 3.65 ± 0.50; the level of PG Ⅱ ratio in the ESD group was lower than that in the EMR group: (16.34 ± 3.05) μg/L vs. (21.20 ± 3.27) μg/L, there were statistical differences ( P<0.05). At 3 d after surgery, the levels of CEA, CA19-9 and CA125 in the two groups were decreased, and the levels of the above indicators in the ESD group were lower than those in the EMR group: (2.42 ± 0.45) μg/L vs. (3.29 ± 0.40) μg/L, (8.55 ± 2.10) kU/L vs. (10.62 ± 2.76) kU/L, (13.75 ± 4.28) kU/L vs. (17.20 ± 4.90) kU/L, there were statistical differences ( P<0.05). At 3 d after surgery, the mRNA expression of E-cadherin and KLF4 in the two groups were increased, and the mRNA expression of VEGF-C, Stathmin in the two groups were decreased, and the mRNA expression of E-cadherin and KLF4 in the ESD group were lower than those in the EMR group: 2.89 ± 0.31 vs. 3.03 ± 0.21, 2.90 ± 0.28 vs. 3.12 ± 0.37, and the mRNA expression of VEGF-C, Stathmin in the ESD group were higher than those in the EMR group: 0.45 ± 0.11 vs. 0.41 ± 0.07, 0.52 ± 0.23 vs. 0.43 ± 0.09, there were statistical differences ( P<0.05). The complication rate in the ESD group was lower than that in the EMR group: 5.00%(3/60) vs. 23.33% (14/60) , there was statistical difference ( χ2 = 8.32, P<0.01). The recurrence rate in the 1-year between the two groups had no statistical difference ( P>0.05). Conclusions:Compared with EMR, ESD is effective in the treatment of elderly early gastric cancer, which can better correct the abnormal secretion of pepsinogen, promote the functional recovery of gastric cells and glands, reduce the level of serum tumor markers, inhibit the metastasis and proliferation of tumor cells, and has good safety.

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