1.Stress distribution on the maxilla when wearing the Twin-block appliance for Class Ⅱ malocclusion
Shuai LI ; Hua LIU ; Yonghui SHANG ; Yicong LIU ; Qihang ZHAO ; Wen LIU
Chinese Journal of Tissue Engineering Research 2025;29(5):881-887
BACKGROUND:The Twin-block orthodontic appliance is commonly used for the correction of Class Ⅱ malocclusion.Its mechanism of action in stimulating mandibular growth has been confirmed in many studies,but its impact on maxillary growth is not very clear. OBJECTIVE:By establishing a finite element model to analyze the stress distribution of the maxillary complex,surrounding bone sutures,and maxillary dentition in patients with Class Ⅱ malocclusion wearing Twin-block orthodontic appliances. METHODS:One patient with Class Ⅱ malocclusion who underwent orthodontic treatment at Qingdao Hospital/Qingdao Municipal Hospital of Shandong Rehabilitation University was selected.The bite force data of the patient when wearing the Twin-block orthodontic appliance was measured,and CBCT data were collected.A finite element model was established,including the maxillary complex,peripheral sutures,Twin-block orthodontic appliance,and maxillary dentition.ABAQUS software was used to simulate the stress distribution in the maxilla and maxillary dentition when the patient was wearing the Twin-block appliance. RESULTS AND CONCLUSION:The equivalent stress on the maxillary anterior teeth was significantly smaller than that on the posterior teeth,and the maximum equivalent stress on both sides of the teeth were 4.797 5 Mpa and 8.716 1 Mpa,respectively,which were located at the first premolar.The maximum displacements were presented at the maxillary incisors on both sides of the teeth,which were 0.080 5 mm and 0.081 0 mm,respectively.The maximum equivalent stress on the bone suture was 1.284 Mpa,which was mainly concentrated in the pterygopalatine suture and the frontal-maxillary suture on both sides,and there was almost no difference in the force of the rest of bone sutures;the maximum displacement of the bone suture was 0.07 mm,with the pterygopalatine suture having the largest displacement,followed by the frontal-maxillary suture.The maximal equivalent stress on the maxillary complex was 27.18 Mpa,which was mainly concentrated on both sides of the anterior pyriform foramen of the maxilla,around the nasofrontal suture and around the pterygopalatine suture at the posterior part of the jaws.The maximal displacement of the maxilla was 0.07 mm,which was mainly concentrated on the maxillary alveolar bone.All these findings show that the occlusal force acts on the maxillary complex through the Twin-block appliance,resulting in clockwise rotation of the maxilla and steepening of the dentition plane.Measures should be taken to compensate for this tendency,for example,by considering maxillary molar elongation and intrusion in the process of occlusion,which are not only able to flatten the occlusal plane,but facilitate the mandibular protraction,thereby further improving Class Ⅱ malocclusion orthodontic treatment.
2.Zuoguiwan Regulates Pdx1 Pathway to Improve Pancreas Development in Offspring of Gestational Diabetes Mellitus Model Rats
Wanqiu LIANG ; Rang CHEN ; Le ZHAO ; Xiaoyi REN ; Qianhui SU ; Yonghui WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):10-19
ObjectiveTo explore the mechanism by which Zuoguiwan improves the pancreas development in the gestational diabetes mellitus (GDM) model by observing the effects of Zuoguiwan on the expression of key regulatory factors in different stages of pancreas development. MethodsPregnant Wistar rats were randomly assigned into blank, model, insulin detemir (20 U·kg-1) and Zuoguiwan (1.89 g·kg-1) groups (n=18). GDM was induced by peritoneal injection of streptozotocin on day 6.5 (E6.5d) in the embryonic stage, and the blank group was given an equal volume of sodium citrate buffer. The modeling performance was assessed by measuring the blood glucose of pregnant rats. Except the blank group and model group, pregnant rats in other groups were administrated with corresponding drugs from E9.5d to delivery. The random blood glucose of pregnant rats was monitored, and the embryos and offspring rats were measured for the length and weighed on E12.5d, E18.5d and day 21 after birth (B21d). The Lee's index of rats on B21d was calculated. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the fasting insulin (FINS) levels of B22d rats and the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) was calculated. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), total cholesterol (CHO), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) in E18.5d pregnant rats and B22d offspring were determined. The pathological changes in the pancreas of E12.5d, E18.5d and B22d rats were observed by hematoxylin-eosin (HE) staining. Western blot was used to determine the protein levels of pancreatic duodenal homeobox 1 (Pdx1), pancreas-specific transcription factor 1a (Ptf1a), and sex-determining region Y-box protein 9 (Sox9) in the pancreas of E12.5d embryos, Pdx1, Nkx2 homeobox 2 (Nkx2.2), and hairy and enhancer of split-1 (Hes1) in the pancreas of E18.5d embryos, and Pdx1, v-maf musculoaponeurotic fibrosarcoma oncogene homolog A (Mafa), and NK transcription factor-related homeobox gene family 6 locus 1 (Nkx6.1) in the pancreas of B22d rats. ResultsCompared with the blank group, the model group showed elevated blood glucose levels in pregnant rats on B0d, E9.5d, E12.5d, E15.5d, and E18.5d (P<0.05, P<0.01), decreased body weight and body length (P<0.01) and increased Lee's index in the offspring. In addition, the B22d offspring showed rising levels of FBG, FINS, HOMA-IR, AST, and TG (P<0.01), a declined level of HDL (P<0.01), and pancreatic acinous cells with edema and loose arrangement. The pregnant rats on E18.5d exhibited raised levels of ALT, AST, and TG (P<0.05, P<0.01) in the pancreas and a declined level of HDL (P<0.05). The E12.5d embryos showed up-regulated protein levels of Pdx1, Sox9, and Ptf1a in the pancreas (P<0.01) and the E18.5d embryos exhibited down-regulated protein levels of Pdx1, Nkx2.2, and Hes1 in the pancreas (P<0.01). The protein levels of Pdx1, Nkx6.1, and Mafa in the pancreas of B22d offspring were down-regulated (P<0.01). Compared with the model group, the insulin group exhibited lowered blood glucose in pregnant rats on B0d, E15.5d, and E18.5d (P<0.05, P<0.01). The offspring in all treatment groups showcased increased body weight and body length (P<0.01) and decreased Lee's index. The B22d offspring exhibited declined levels of FBG, FINS, and HOMA-IR in the insulin group (P<0.01) and lowered levels of FBG and HOMA-IR in the Zuoguiwan group (P<0.01). The B22d offspring in all the treatment groups showed reduced levels of ALT, AST, TBIL, CHO, TG, and LDL, a raised level of HDL, and alleviated edema of pancreatic acinous cells. The pregnant rats on E18.5d demonstrated declined levels of TG and ALT (P<0.05, P<0.01) and an elevated level of HDL (P<0.05). The pancreas of E12.5d embryos presented down-regulated protein levels of Pdx1 and Sox9 and an up-regulated protein level of Ptf1a in the insulin group (P<0.05). The pancreas of E12.5d embryos in the Zuoguiwan group presented down-regulated protein levels of Pdx1, Sox9, and Ptf1a (P<0.01). All the treatment groups showed up-regulated protein levels of Pdx1, Nkx2.2, and Hes1 in the pancreas of E18.5d embryos (P<0.01) and Pdx1, Nkx6.1, and Mafa in the pancreas of B22d embryos (P<0.05, P<0.01). ConclusionZuoguiwan can promote the growth and development and ameliorate the pathological changes in the pancreas of the offspring of GDM model by regulating the expression of Pdx1 pathway-related regulatory factors in different stages of pancreas development.
3.Effects of peripheral blood-derived exosomes intervened by Naozhenning on injury of neuron induced by microglia
Li GAO ; Le ZHAO ; Liya WU ; Weiyi ZHANG ; Nan LI ; Nannan WEI ; Yonghui WANG
China Pharmacy 2025;36(19):2393-2398
OBJECTIVE To study the effects of peripheral blood-derived exosomes (Exo) intervened by Naozhenning (NZN) on injury of neuron cells HT22 induced by microglia BV-2 cells. METHODS Wistar rats were selected to prepare peripheral blood- derived Exo intervened by NZN (66.83 g/kg), referred to as NZN-Exo; peripheral blood-derived Exo intervened by normal saline and piracetam (PLXT, 1.62 g/kg) were prepared using the same method, denoted as KB-Exo and PLXT-Exo respectively, and all Exo were subsequently identified. Meanwhile, BV-2 cells were stimulated with 1 μg/mL lipopolysaccharide (LPS) to prepare LPS- stimulated supernatant, and non-LPS-stimulated supernatant was prepared following the same protocol. HT22 cells were divided into four groups: KB-Exo group (treated with non-LPS-stimulated supernatant+KB-Exo), model group (treated with LPS-stimulated supernatant+KB-Exo), PLXT-Exo group (treated with LPS-stimulated supernatant+PLXT-Exo), and NZN-Exo group (treated with LPS-stimulated supernatant+NZN-Exo), with the concentration of the corresponding Exo in all groups being 50 μg/mL. After 24 hours of culture, the proliferation of HT22 cells was detected by the CCK-8 assay and EdU assay; the apoptosis of HT22 cells was detected; the microstructure of HT22 cells was observed; the contents of interleukin-1β (IL-1β), IL-10, nuclear factor-κB (NF- κB), and tumor necrosis factor-α (TNF-α) in HT22 cells were measured, as well as the expression levels of TNF-α, NOD-like receptor thermal protein domain associated protein 3 (NLRP3), Caspase-1, B-cell lymphoma-2( Bcl-2), and Bcl-2-associated X protein (Bax). RESULTS KB-Exo, PLXT-Exo and NZN-Exo were successfully prepared, and all Exo exhibited typical cup-shaped contours and membrane-enclosed characteristics. Compared with KB-Exo group, model group showed significantly decreased cell proliferation rates (detected by CCK-8 and EdU), intracellular IL-10 levels, and Bcl-2 protein expression levels (P<0.05); while the cell apoptosis rate, intracellular levels of IL-1β, TNF-α, and NF-κB, as well as the expression levels of NLRP3, TNF-α, Caspase-1, and Bax proteins were significantly increased (P<0.05). Additionally, in the model group, the cells showed volume swelling, incomplete cell membrane, nucleolar rupture, significant swelling and deformation of mitochondria, and severe vacuolization. Compared with model group, the above quantitative indicators in the PLXT-Exo group and NZN-Exo group were significantly reversed (P<0.05), with large and round cell nuclei, intact nuclear membranes, and reduced mitochondrial vacuolization. CONCLUSIONS Peripheral blood-derived Exo intervened by naozhenning can alleviate the injury of neuronal cells HT22 by inhibiting inflammatory responses and cell apoptosis.
4.Mechanism of Naozhenning granules in regulating mitochondrial energy metabolism in multiple cerebral concussion rats
Li GAO ; Le ZHAO ; Nannan WEI ; Liya WU ; Tiantian WANG ; Weiyi ZHANG ; Yonghui WANG
China Pharmacy 2024;35(9):1050-1056
OBJECTIVE To explore the mechanism of Naozhenning granules in regulating mitochondrial energy metabolism in hippocampal tissue of multiple cerebral concussion (MCC) model rats. METHODS SPF grade Wistar rats were used to prepare MCC models using the “free fall impact method”. The successfully modeled rats were divided into model group, piracetam group, and Naozhenning granule low-dose, medium-dose and high-dose groups, and a normal group was also set up, with 8 rats in each group. Rats in each treatment group orally administered corresponding drugs at doses of 0.324 g/kg for the piracetam group and 2.25, 4.5 and 9 g/kg for the Naozhenning granule low-dose, medium-dose and high-dose groups; the normal group and model group were given equal volumes of normal saline; once a day, for 14 consecutive days. The motor exploration ability, learning and memory ability of rats were tested; the adenosine triphosphate (ATP) content in the hippocampal tissue of rat was detected; the changes in the mitochondrial structure of hippocampal tissue was observed; the fluorescence intensity of mitochondrial dynamin- related protein 1 (Drp1), mitochondrial fission protein 1 (Fis1), mitochondrial fusion 1 (Mfn1), and optic atrophy protein 1 (Opa1) were detected in the hippocampal tissue of rat; the protein expression levels of peroxisome proliferator activated receptor gamma coactivator-1α(PGC-1α), nuclear respiratory factor-1(NRF-1),mitochondrial transcription factor A(TFAM), Wnt-3a,β-catenin in hippocampal tissue of rat were detected. RESULTS Compared with the normal group, the total exercise distance, number of central grid entries, number of upright positions, new object recognition index, mitochondrial ATP content, fluorescence intensity of Mfn1 and Opa1, the protein expression levels of PGC-1α、NRF-1、TFAM、Wnt-3a、 β-catenin in the model group were significantly reduced (P<0.01), while the rest time and fluorescence intensity of Drp1 and Fis1 in hippocampal tissue were significantly increased (P<0.01). The results of transmission electron microscopy showed that the mitochondria in the hippocampal tissue were significantly swollen, with a large number of broken and reduced cristae, and some mitochondria had myeloid changes in the membrane. Compared with the model group, the levels/contents of the above indicators in rats of each administration group showed varying degrees of reversal, and most of the differences were statistically significant (P<0.05 or P<0.01); the degree of mitochondrial swelling in the hippocampal tissue was reduced, with a small amount of broken and reduced cristae, fuzzy fractures appeared in local areas of the rough endoplasmic reticulum. CONCLUSIONS Naozhenning granules can improve the motor exploration, learning and memory abilities of MCC model rats, repair neuronal damage, and exert neuroprotective effects. Its mechanism may be related to activating Wnt/β-catenin signaling pathway,maintaining the balance of mitochondrial division and fusion,and promoting mitochondrial biosynthesis.
5.Effect of Naozhenning Granules on Energy Metabolism of Cortical Mitochondria in Rat Model of Post-concussion Syndrome
Nannan WEI ; Liya WU ; Tiantian WANG ; Qizhao LIU ; Weiyi ZHANG ; Yonghui WANG ; Li GAO ; Le ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):107-113
ObjectiveTo explore the effects of Naozhenning granules on the memory function and neuron cells in the rat model of post-concussion syndrome based on mitochondrial biosynthesis. MethodSPF-grade Wistar rats were used to establish the multiple cerebral concussion (MCC) model by the weight-drop method. The successfully modeled rats were assigned into model, piracetam (0.324 g·kg-1), and low-, medium-, and high-dose (2.25, 4.5, and 9 g·kg-1, respectively) Naozhenning groups. The rats were administrated with corresponding drugs by gavage and those in the blank group and model group were administrated the same volume of normal saline once a day for 14 days. The general state of rats was observed before and after treatment. The open field test and new object recognition test were conducted to examine the motor and memory abilities of rats. Hematoxylin-eosin staining was employed to observe the pathological changes of cortical neurons in rats. Western blot and real-time polymerase chain reaction were employed to determine the protein and mRNA levels, respectively, of peroxisome proliferator-activated receptor γ-coactivator-1α (PGC-1α), nuclear respiratory factor-1 (NRF-1), and transcription factor A mitochondrial (TFAM) in rat cortex. ResultCompared with the blank group, the model group showed anxious and manic mental status, yellow and messy fur, and reduced food intake. In the open field experiment, the model group showed reduced total movement distance, times of entering the central grid, and times of rearing decreased and increased resting time compared with the blank group (P<0.01). The model group had lower recognition index of new objects than the blank group (P<0.01). In addition, the modeling caused reduced neurons with sparse distribution and deformed, broken, and irregular nucleoli and down-regulated the mRNA and protein levels of PGC-1α, NRF-1, and TFAM in the cortex (P<0.01). Compared with the model group, piracetam and Naozhenning improved the mental state, coat color, food intake, and activities of rats. In the open field test, piracetam and Naozhenning increased the total movement distance, the times of entering the central grid, and the times of rearing and shortened the resting time (P<0.05, P<0.01). The piracetam and Naozhenning groups had higher recognition index of new objects than the model group (P<0.05, P<0.01). Compared with the model group, the piracetam and Naozhenning groups showed increased neurons with tight arrangement and large and round nuclei, and some cells with irregular morphology and turbid cytoplasm. Furthermore, piracetam and medium-dose Naozhenning upregulated the protein levels of PGC-1α, NRF-1, and TFAM (P<0.01). Low-dose Naozhenning upregulated the protein levels of NRF-1 and TFAM (P<0.01), and high-dose Naozhenning upregulated the protein levels of PGC-1α and TFAM in the cortex (P<0.01). The mRNA levels of PGC-1α, NRF-1, and TFAM in the cortex were upregulated in the piracetam group and Naozhenning groups (P<0.05, P<0.01). ConclusionNaozhenning granules can improve the motor, memory, and learning, repair the neuronal damage, and protect the nerve function in the rat model of MCC by promoting mitochondrial biosynthesis.
6.Conical beam CT measurement of alveolar bone structure remodeling in patients with skeletal class Ⅲ malocclusion after orthodontic-orthognathic treatment
Qihang ZHAO ; Xin LU ; Lei TONG ; Yonghui SHANG ; Shuai LI ; Wen LIU ; Jianhua ZHOU ; Rongtao YUAN ; Qingyuan GUO
Chinese Journal of Tissue Engineering Research 2024;28(23):3729-3735
BACKGROUND:Most of the studies on combined orthodontic-orthognathic treatment of skeletal class Ⅲ malocclusions have focused on the improvement of the patient's lateral appearance and recovery in the later stages of the treatment,while there are fewer studies observing the microcosmic nature of the alveolar bone remodeling of the lower anterior teeth. OBJECTIVE:To evaluate the therapeutic effect of lower anterior tooth decompensation and alveolar bone remodeling in patients with skeletal class Ⅲ malocclusion before and after orthodontic-orthognathic treatment based on oral X-ray lateral films and oral cone-beam CT. METHODS:From January 2015 to May 2023,15 patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgery at Qingdao Hospital of Rehabilitation University were enrolled.All patients underwent lateral cephalography and cone beam computed tomography before and after treatment.Cephalometric measurement items related to the angle and line distance,lip/lingual bone cracking length(d-La/d-Li)and bone cracking/bone fenestration of the lower anterior teeth before and after treatment were measured. RESULTS AND CONCLUSION:Lateral X-ray films showed that the amount of alveolar bone remodeling after decompensation of the lower anterior teeth showed significant changes compared to before treatment.The root of the tooth moved significantly towards the center of the alveolar bone,and the specific data was closer to normal data,but there were still some differences compared with normal individuals.Based on the cone-beam CT measurement,the bone cracking/bone fenestration length and width of the alveolar bone were improved in almost all the teeth after orthodontic-orthognathic combined treatment,alveolar bone remodeling in some teeth even reached the level of healthy individuals.Before treatment,most patients often experienced bone fenestration/cracking on the lip/lingual side of the lower incisor due to compensatory tooth growth.However,during the preoperative orthodontic stage,decompensation triggered alveolar bone remodeling and significant changes in tooth angle.Preoperative orthodontic treatment caused the upper anterior teeth to retract and the lower anterior teeth to tilt and control the root,but the amount of decompensation before surgery was often insufficient.In the orthognathic surgery stage,the jaw was removed through the positioning guide plate,the maxilla moved forward,and the mandible retreated.During the postoperative orthodontic process,the effect of fine adjustment was better.Although there is a certain degree of recurrence trend in the position of teeth and jawbones,the postoperative orthodontic treatment is closer to the normal value.
7.Three-dimensional finite element study on the effect of posterior tooth forward movement on temporomandibular joint stress in orthodontic reduction patients
Yonghui SHANG ; Shuai LI ; Yicong LIU ; Qihang ZHAO ; Wen LIU
Chinese Journal of Tissue Engineering Research 2024;28(34):5516-5520
BACKGROUND:Temporomandibular joint disorders are closely related to high stress in temporomandibular joint.With the change of molar position after tooth reduction extraction,the establishment of new occlusal relationship often leads to the change of internal stress environment of the temporomandibular joint. OBJECTIVE:To analyze the stress distribution of temporomandibular joint in patients undergoing orthodontic reduction tooth extraction with different degrees of molar forward movement using the three-dimensional finite element model of the maxillary complex and temporomandibular joint. METHODS:A case of individual normal occlusal patient was selected from the Orthodontics Department of Qingdao Municipal Hospital,Shandong Province,and the finite element models of 1/3 anterior molar space(extraction of four second premolar teeth)before and after reduction and 2/3 anterior molar space(extraction of 4 second premolar teeth)after reduction were established based on the cone-beam CT and MRI data.ABAQUS software was used to analyze the stress distribution of various parts of the temporomandibular joint during the interposition of tooth tips. RESULTS AND CONCLUSION:The stress distribution of the condyle,articular disc,and osteoarticular fossa in the model before and after the reduction was basically the same.The stress of the condyle was mainly distributed in the anterior and apical part of the condyle,the stress of the articular disc was mainly distributed in the middle band and lateral part of the articular disc,and the stress of the articular fossa was mainly concentrated in the anterior and apical part of the articular fossa.However,the equivalent stress value of the condyle,articular disc and articular fossa decreased after reduction.After orthodontic reduction extraction,the equivalent stress values of condyle and articular disc in the 1/3 anterior molar space model were smaller than those in the 2/3 anterior molar space model.From the perspective of biomechanics,orthodontic reduction extraction can reduce the stress of the temporomandibular joint and provide a good biomechanical environment.
8.Association between congenital hypothyroidism and in-hospital adverse outcomes in very low birth weight infants
Sha ZHU ; Jing XU ; Ranran SHI ; Xiaokang WANG ; Maomao SUN ; Shina LI ; Lingling GAO ; Yuanyuan LI ; Huimin WEN ; Changliang ZHAO ; Shuai LI ; Juan JI ; Cuihong YANG ; Yonghui YU
Chinese Journal of Pediatrics 2024;62(1):29-35
Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.
9.Expression of CK5/6 and Ki-67 in apocrine triple negative breast cancer and their relationship with clinicopathological features
Xiaoxiao ZHAO ; Yonghui XIE ; Hongfeng ZHANG
Chongqing Medicine 2024;53(19):3002-3007
Objective To study the the expression of cytokeratin 5/6(CK5/6)and cell proliferation an-tigen(Ki-67)in apocrine triple-negative breast carcinoma(ATNBC)and their relationship with clinicopatho-logical features and prognosis.Methods Twenty-one patients with pathologically diagnosed invasive apocrine breast cancer and negative estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor-2(Her-2)in this hospital were selected as the ATNBC group,Twenty-two cases in non-ATNBC(NATNBC)were randomly selected as negative control(NATNBC group).The clinical pathological data and follow-up data of all patients were collected,and the expressions of CK5/6 and Ki-67,as well as their relation-ship with clinicopathological characteristics was analyzed.The prognosis in the patients with ATNBC was ana-lyzed.Results There were statistically significant differences in age(P<0.001),age distribution(P=0.001),histological grading(P<0.001),and distant metastasis(P=0.020)between the ATNBC group and the NATNBC group(P=0.020).There were 7 cases(33.33%)of CK5/6 positive expression in the ATNBC group and 17 cases(80.95%)in NATNBC group.There was statistically significant difference in the positive expression rate of CK5/6 between the ATNBC group and NATNBC group(P<0.05).There were 3 cases(14.29%)of Ki-67 high proliferation in the ATNBC group and 17 cases(77.27%)in the NATNBC group.The high proliferation rates of Ki-67 had statistically significant difference between the ATNBC group and NATNBC group(P<0.05).The positive expression rate of CK5/6 was correlated with the tumor sites and lymph node metastasis in ATNBC patients(P<0.05).The high proliferation rate of Ki-67 was correlated with nerve invasion in ATNBC patients(P<0.05).The survival analysis showed that there was statistically significant difference in the 5 years disease-free survival(DFS)rate between the ATNBC group and NATNBC group(P<0.05).Conclusion ATNBC has its unique clinicopathological features,CK5/6 is less expressed in ATN-BC,the high proliferation of Ki-67 is also less,and the prognosis of ATNBC is better than that of NATNBC.
10.Relationship between serum levels of ADAM-10,suPAR and the severity in hyperten-sion patients with atherosclerosis
Junhong LIU ; Yonghui SHEN ; Linyan ZHAO ; Bianxiang GUO ; Qunchao WANG
Chinese Journal of Arteriosclerosis 2024;32(8):677-682
Aim To investigate the levels of a disintegrin and metalloprotease 10(ADAM-10)and soluble uro-kinase plasminogen activator receptor(suPAR)in the serum of hypertension patients with atherosclerosis and their relation-ship with the severity of disease.Methods From February 2021 to February 2023,125 hypertension patients with atherosclerosis who visited our hospital were collected as the study group,and 76 healthy people were collected as control group.The patients in the study group were grouped into mild group(n=40),moderate group(n=42)and severe group(n=43)according to the degree of atherosclerosis,after 60 days of treatment,the patients were grouped into a good prog-nosis group(n=74)and a poor prognosis group(n=51)based on their prognosis.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum ADAM-10 and suPAR levels;Clinical data of patients with different prognosis were compared;Pearson method was applied to analyze the relationship between serum ADAM-10,suPAR levels and carotid in-tima-media thickness(IMT)in patients with hypertension and atherosclerosis;Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with hypertension and atherosclerosis;Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of ADAM-10 and suPAR alone and jointly for poor prognosis of hypertension with atherosclerosis.Results The levels of serum ADAM-10 and suPAR were significantly higher in the study group than those in control group(P<0.05);The serum ADAM-10 and suPAR levels in moderate group and severe group were obviously higher than those in mild group(P<0.05),while the serum ADAM-10 and suPAR levels were obviously higher in severe group than those in moderate group(P<0.05);The serum ADAM-10 and suPAR levels,left and right IMT,systolic blood pressure,and diastolic blood pressure of patients with poor prognosis were signifi-cantly higher than those of patients with good prognosis(P<0.05);Pearson correlation analysis showed that serum ADAM-10 and suPAR levels in patients with hypertension and atherosclerosis were positively correlated with systolic blood pres-sure,diastolic blood pressure and IMT(P<0.001);Logistic regression analysis showed that the increased levels of systolic blood pressure,diastolic blood pressure,ADAM-10,suPAR and IMT were risk factors for poor prognosis of hypertension patients with atherosclerosis(P<0.05);ROC curve analysis showed that the area under the curve(AUC)of serum AD-AM-10 and suPAR levels alone and jointly predicting poor prognosis of hypertension with atherosclerosis was 0.819,0.830 and 0.900,respectively,the combination of the two was superior to their individual predictions(Zcombination-AD AM-10=2.766,P=0.006;Zcombination-suPAR=2.602,P=0.009).Conclusion The levels of serum ADAM-10 and suPAR in patients with hypertension and atherosclerosis are significantly increased,and are positively correlated with the severity of atherosclero-sis.Both of them have a high predictive value for evaluating the prognosis of patients with hypertension and atherosclerosis.

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