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Purpose/Significance To review the knowledge discovery methods based on knowledge graph in the biomedical field,and to provide references for researchers.Methods/Process The paper summarizes the knowledge discovery methods based on knowledge graph by systematically searching and analyzing the relevant literatures,and compares the advantages and disadvantages of various knowl-edge discovery methods.It points out that the limitations and challenges of knowledge discovery methods based on knowledge graph in the biomedical field,and puts forward suggestions and prospects.Result/Conclusion In the future research,it is suggested to improve the in-terpretability of knowledge discovery results,build an effective result evaluation framework,and establish a standardized knowledge dis-covery process with multi-domain experts'collaboration,so as to improve the quality and efficiency of knowledge discovery research.
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OBJECTIVE To investigate the potential mechanism of the effect of ginkgo flavone aglycone (GA) against doxorubicin (DOX)-induced cardiotoxicity. METHODS The male ICR mice were randomized into control group (CON group), model group (DOX group) and GA+DOX group (GDOX group), with 12 mice in each group. The DOX group was injected with DOX solution at a dose of 3 mg/kg via tail vein every other day, and the GDOX group was given GA suspension intragastrically at a dose of 100 mg/kg every day+DOX solution at a dose of 3 mg/kg via tail vein every other day, for 15 consecutive days. After the end of administration, the serum levels of aspartate aminotransferase(AST), creatine kinase(CK), creatine kinase isoenzyme(CK- MB) and lactate dehydrogenase(LDH) in mice were detected in each group. Based on the metabolomics method, UHPLC-Q- Exactive Orbitrap HRMS method was used; based on principal component analysis (PCA) and orthogonal partial least squares- discriminant analysis (OPLS-DA), the differentially expressed metabolites (DEMs) were screened using the criteria of variable importance in the projection≥1, fold change of peak area>1 and P<0.05; biological analysis was conducted based on databases such as HMDB and PubChem. RESULTS Compared with CON group, serum levels of AST, CK, CK-MB and LDH were increased significantly in DOX group (P<0.05); compared with DOX group, the serum levels of the above indicators (except for CK-MB) were decreased significantly in GDOX group (P<0.05). PCA and OPLS-DA showed that myocardial tissue samples of CON group, DOX group and GDOX group were isolated completely. After database matching, 37 common DEMs were identified, among which 17 DEMs were significantly up-regulated in the DOX group and significantly down- regulated in the GDOX group, and 8 DEMs were significantly down-regulated in the DOX group and significantly up-regulated in the GDOX group; pathway enrichment involved the biosynthesis of unsaturated fatty acids, arachidonic acid metabolism, linoleic acid metabolism, taurine and hypotaurine metabolism; the key metabolites in the above pathways included docosahexaenoic acid, arachidonic acid, phosphatidylcholine (16∶0/18∶3) and taurine. CONCLUSIONS GA may regulate the biosynthesis of unsaturated fatty acids, arachidonic acid metabolism and other metabolic pathways by acting on the core metabolites such as docosahexaenoic acid and arachidonic acid, thus alleviating the cardiotoxic effects of DOX.
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Retinal vein occlusion (RVO) is a common retinal vascular disease that causes painless visual impairment in clinical practice.Currently, fluorescein fundus angiography (FFA) is the gold standard for its diagnosis.However, FFA is an invasive examination, which has poor reproducibility and lacks the ability to distinguish and depict deep capillaries.Optical coherence tomography angiography (OCTA) has the characteristics of the non-invasive, safe, simple, efficient, and high axial resolution, making it a powerful tool for the diagnosis and efficacy evaluation of RVO.OCTA not only rapidly analyzes microvascular images of RVO patients, but also evaluates the morphologic structure and perfusion status of capillaries qualitatively and quantitatively in each layer in the macular and optic disc area of both eyes.The article comprehensively reviewed the application of OCTA in RVO patients, including the detection of changes in retinal structure and blood flow in the macula and optic disc area of the affected eye and healthy contralateral eye, the evaluation of visual prognosis and the effect of anti-vascular endothelial growth factor treatment, the investigation of the recurrence mechanism of macular edema, and the limitations and development prospects.The article aimed to help ophthalmologists have a more comprehensive understanding of the characteristics of RVO disease and lay an important foundation for accurately and effectively guiding disease treatment and predicting patients' prognosis vision.
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Objective:To design a tracheotomy cannula cuff filling device for hyperbaric oxygen therapy, which is convenient for clinical operation, improves work efficiency and reduces the incidence of aspiration pneumonia.Methods:This study was a randomized controlled trial. From July 2020 to June 2022, 90 patients with tracheotomy who were treated with hyperbaric oxygen in the First Hospital of Jiaxing were selected as the research objects. According to the random number table method, the patients were divided into the experimental group and the control group, with 45 cases in each group. In the experimental group, the cuff pressure was maintained by the tracheotomy cannula cuff filling device, and in the control group, the traditional water injection method was used to maintain the cuff pressure. The operation time, infection index and incidence of aspiration pneumonia were compared between the two groups.Results:The operation time in the experimental group was (6.33 ± 1.31) s lower than that in the control group (40.96 ± 3.70) s, and the difference was statistically significant ( t=-59.11, P<0.05). Body temperature, C-reactive protein and procalcitonin after treatment in the experimental group were (36.91 ± 0.83) ℃, (34.59 ± 16.25) mg/L, (1.57 ± 0.82) μg/L, respectively, lower than those in the control group (37.42 ± 0.72) ℃, (44.18 ± 18.10) mg/L, (2.45 ± 0.92) μg/L, the differences were statistically significant ( t=-3.09, -2.64, -4.73, all P<0.05). The difference of white blood cell count post-treatment between the two groups was not statistically significant ( P>0.05). The incidence of aspiration pneumonia in the experimental group was 11.11%(5/45) lower than 31.11%(14/45) in the control group, and the difference was statistically significant ( χ2=5.17, P<0.05). Conclusions:The application of tracheotomy cannula cuff filling device can simplify the operation process, reduce the incidence of infection and aspiration pneumonia, and optimize the clinical work.
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Ultra-high performance liquid chromatography-quadrupole-Exactive Orbitrap high resolution mass spectrometry(UHPLC-Q-Exactive Orbitrap HRMS) was employed to systematically analyze the chemical constituents in Lysionoti Herba, and high perfor-mance liquid chromatography-ultraviolet(HPLC-UV) to determine the content of main compounds. A Synergi~(TM) Hydro-RP 100 Å colu-mn(2 mm×100 mm, 2.5 μm) was used for gradient elution with acetonitrile-0.1% aqueous formic acid as the mobile phase at a flow rate of 0.2 mL·min~(-1) and a column temperature of 40 ℃. MS and MS/MS were conducted with electrospray ionization(ESI) in both positive and negative modes. The chemical components in Lysionoti Herba were identified by comparison with the retention time and mass spectra of reference compounds and the relevant mass spectral data reported in MS databases and relevant literature. Furthermore, the content of five constituents(neochlorogenic acid, chlorogenic acid, forsythoside B, acteoside, and nevadensin) in different Lysiono-ti Herba samples was simultaneously determined by HPLC-UV at the wavelength of 330 nm. A total of 84 compounds were identified in Lysionoti Herba, including 27 flavonoids, 20 phenylethanoid glycosides, 5 amino acids, 18 organic acids, 1 alkaloid, 6 nucleosides, and 7 others. The content of neochlorogenic acid, chlorogenic acid, forsythoside B, acteoside, and nevadensin showed good linear relationship(r>0.999) with the peak area within certain concentration ranges, which were 3.22-102.90, 12.84-410.82, 31.63-1 012.01, 25.00-800.11, and 4.08-130.51 μg·mL~(-1), respectively. The instrument precision, method repeatability, and solution stability all met requirement, and the average recovery rate was 97.31%-100.2%, with RSD ranging from 0.95% to 2.4%. The content of the five components varied among different Lysionoti Herba samples collected from different regions of Guizhou, and the average content of forsythoside B was the highest. The established qualitative method can rapidly and efficiently identify the chemical components of Lysionoti Herba, and the developed HPLC-UV method can simultaneously determine the content of five components in a simple, ra-pid, and accurate manner, providing a scientific basis for the quality evaluation of Lysionoti Herba.
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Chromatography, High Pressure Liquid/methods , Tandem Mass Spectrometry/methods , Chlorogenic Acid , Drugs, Chinese Herbal/chemistryABSTRACT
Hepatic stellate cells (HSCs) represent a significant component of hepatocellular carcinoma (HCC) microenvironments which play a critical role in tumor progression and drug resistance. Tumor-on-a-chip technology has provided a powerful in vitro platform to investigate the crosstalk between activated HSCs and HCC cells by mimicking physiological architecture with precise spatiotemporal control. Here we developed a tri-cell culture microfluidic chip to evaluate the impact of HSCs on HCC progression. On-chip analysis revealed activated HSCs contributed to endothelial invasion, HCC drug resistance and natural killer (NK) cell exhaustion. Cytokine array and RNA sequencing analysis were combined to indicate the iron-binding protein LIPOCALIN-2 (LCN-2) as a key factor in remodeling tumor microenvironments in the HCC-on-a-chip. LCN-2 targeted therapy demonstrated robust anti-tumor effects both in vitro 3D biomimetic chip and in vivo mouse model, including angiogenesis inhibition, sorafenib sensitivity promotion and NK-cell cytotoxicity enhancement. Taken together, the microfluidic platform exhibited obvious advantages in mimicking functional characteristics of tumor microenvironments and developing targeted therapies.
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Enzyme-driven micro/nanomotors consuming in situ chemical fuels have attracted lots of attention for biomedical applications. However, motor systems composed by organism-derived organics that maximize the therapeutic efficacy of enzymatic products remain challenging. Herein, swimming proteomotors based on biocompatible urease and human serum albumin are constructed for enhanced antitumor therapy via active motion and ammonia amplification. By decomposing urea into carbon dioxide and ammonia, the designed proteomotors are endowed with self-propulsive capability, which leads to improved internalization and enhanced penetration in vitro. As a glutamine synthetase inhibitor, the loaded l-methionine sulfoximine further prevents the conversion of toxic ammonia into non-toxic glutamine in both tumor and stromal cells, resulting in local ammonia amplification. After intravesical instillation, the proteomotors achieve longer bladder retention and thus significantly inhibit the growth of orthotopic bladder tumor in vivo without adverse effects. We envision that the as-developed swimming proteomotors with amplification of the product toxicity may be a potential platform for active cancer treatment.
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Chronic pancreatitis (CP) is a progressive and irreversible fibroinflammatory disorder, accompanied by pancreatic exocrine insufficiency and dysregulated gut microbiota. Recently, accumulating evidence has supported a correlation between gut dysbiosis and CP development. However, whether gut microbiota dysbiosis contributes to CP pathogenesis remains unclear. Herein, an experimental CP was induced by repeated high-dose caerulein injections. The broad-spectrum antibiotics (ABX) and ABX targeting Gram-positive (G+) or Gram-negative bacteria (G-) were applied to explore the specific roles of these bacteria. Gut dysbiosis was observed in both mice and in CP patients, which was accompanied by a sharply reduced abundance for short-chain fatty acids (SCFAs)-producers, especially G+ bacteria. Broad-spectrum ABX exacerbated the severity of CP, as evidenced by aggravated pancreatic fibrosis and gut dysbiosis, especially the depletion of SCFAs-producing G+ bacteria. Additionally, depletion of SCFAs-producing G+ bacteria rather than G- bacteria intensified CP progression independent of TLR4, which was attenuated by supplementation with exogenous SCFAs. Finally, SCFAs modulated pancreatic fibrosis through inhibition of macrophage infiltration and M2 phenotype switching. The study supports a critical role for SCFAs-producing G+ bacteria in CP. Therefore, modulation of dietary-derived SCFAs or G+ SCFAs-producing bacteria may be considered a novel interventive approach for the management of CP.
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Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.
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With the changes of lifestyle, type 2 diabetes mellitus(T2DM) is spreading among the adolescents. T2DM in adolescents is distinct from type 1 diabetes mellitus and T2DM in adults. T2DM in adolescent progresses more rapidly and is more difficult to treat than that in adults. The prevention and therapy of T2DM in youth is facing severe challenges. This article reviews the epidemiology, pathophysiology, risk factors, comorbidities and complications of T2DM in adolescents as well as evidence-based clinical trials for the management of this disease based on the related hot spots of the 81 st annual meeting of the American Diabetes Association and the results from the latest clinical trials, so as to provide enough reference for the formulation of clinical strategies of T2DM in adolescents.
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Objective:To prospectively guide the change of chemotherapy regimen in mouse 5-fluorouracil (5-FU) resistance subcutaneous xenograft tumor model derived from gastric cancer patients by the early changes of MRI apparent diffusion coefficient (ADC), and to compare the difference of tumor load between ADC guided dressing change group and volume guided dressing change group.Methods:From January to June 2020, thirty patient-derived xenografts mouse models were established using 5-FU resistant gastric cancer cells coming from patients, and were randomly divided into experimental group and control group by AdaBoost algorithm, with 15 mice in each group. On the 26th day after transplantation, all mice began chemotherapy with 5-FU as the first-line chemotherapy drug, and underwent MR examination once every two days, including T 2WI and diffusion weighted imaging (DWI). Volumes of tumors were measured using an open-source software ITK-SNAP and values of ADC were measured on ADC maps. According to the change rate of tumor ADC value in the experimental group and the tumor volume growth rate in the control group, the replacement time of chemotherapy drugs was determined, and 5-FU was replaced by paclitaxel. The end point of the experiment was the day that the mice entered the cachexia state. Independent-sample t test was used to compare the difference of tumor load between the two groups. Results:After 5-FU treatment, the ADC value of the two groups both increased. The ADC value began to decline on the 4th day after chemotherapy, and the experimental group continued chemotherapy with paclitaxel instead of 5-FU at this time point. The tumor volume growth rate of the control group increased significantly on the 6th day after chemotherapy (from 8.6% to 16.1%), and the control group used paclitaxel instead of 5-FU chemotherapy at this time point. The observed end point was on the 18th day after chemotherapy. The tumor load of the experimental group [(1.82±0.09) cm 3] was lower than that of the control group [(2.01±0.09) cm 3], and the difference was statistically significant ( t=2.25, P=0.033). On the 16th day after chemotherapy in the experimental group and the 18th day after chemotherapy in the control group, the time of paclitaxel administration in both groups was 12 days. The tumor load in the experimental group [(1.61±0.12) cm 3] was also lower than that in the control group [(2.01±0.09) cm 3], and the difference was statistically significant ( t=2.03, P=0.040). Conclusions:For the subcutaneous transplantation model of 5-FU resistant gastric cancer mice, according to the early changes of tumor ADC value after chemotherapy, the replacement of chemotherapy drugs can obtain a lower tumor load, suggesting that it is a feasible method to optimize the chemotherapy regimen.
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OBJECTIVE To compare the phar macokinetics o f ligustrazine hydrochlori de,salvianic acid and rosemarinic acid from Shenxiong glucose injection (SGI)in normal and acute myocardial ischemia (AMI)rats. METHODS Male SD rats were randomly divided into normal group and model group ,with 9 rats in each group. AMI model was established by isoproterenol hydrochloride modeling method. Three rats in each group were selected for model verification. The remaining 6 rats in each group were given SGI (1.2 mL/kg)or equal volum of normal saline via tail vein ;0.3 mL blood was collected through orbital venous bush 0.083,0.167,0.333,0.5,0.75,1,1.5,2,3,5 h after administration. Using luteoloside as internal standard ,the plasma concentrations of ligustrazine hydrochloride ,salvianic acid and rosemarinic acid were determined by ultra performance liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were fitted by WinNonlin 8.1 software,and statistical analysis was performed by SPSS 18.0 software. RESULTS The linear ranges of ligustrazine hydrochloride ,salvianic acid and rosmarinic acid were 0.06-29.96,0.01-5.15 and 0.006-3.09 μ g/mL(all r>0.99),respectively. The results of methodological investigation were all in line with the requirements of Chinese Pharmacopoeia (2020 edition). Compared with normal rats ,CLz of ligustrazine hydrochloride in AMI model rats was significantly increased (P<0.05);t1/2 and Vz of salvianic acid were significantly prolonged or increased (P<0.05);but the cmax and AUC 0-5 h were significantly decreased (P<0.05);AUC0-5 h of rosmarinic acid was significantly decreased (P<0.05). CONCLUSIONS The exposure levels of salvianic acid and rosmarinic acid in SGI are lower in AMI model rats than in normal rats ,and the elimination of ligustrazine hydrochloride in AMI model rats is stronger than that in normal rats.
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OBJECTIVE To study the metabolites of four diterpenoids of Euphorbia fischeriana in liver microsomes of rats and to investigate its metabolic regularity. METHODS In vitro incubation system of liver microsomes of rats was built. The jolkinolide A,jolkinolide B ,17-hydroxyl jolkinolide A and 17-hydroxyl jolkinolide B were added into incubation system of liver microsomes in rats activated by reduced nicotinamide adenine dinucleotide phosphate ,incubated at 37 ℃ for 30 min,and then terminated the reaction with acetonitrile. Taking the negative group (adding acetonitrile firstly and then starting incubation for 30 min)as the reference,the ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry was used ;Anaylyst®TF 1.7.1、PeakView® 2.2,MetabolitePilot 1.5 and MasterView 1.2 software were used to speculate and identify the fragmentation law of mass spectrometry and metabolites. RESULTS Four diterpenoids were easy to lose neutral fragments such as H 2O and CO in secondary mass spectrometry. Jolkinolide A and 17-hydroxyl jolkinolide A showed similar metabolism pathway ,including dihydroxylation,dehydrogenation,and monohydroxylation ;six and five metabolites were identified respectively. Jolkinolide B and 17-hydroxyl jolkinolide B showed similar metabolism pathway ,including monohydroxylation ,hydration and isomerization. Five metabolites were identified. CONCLUSIONS Both jolkinolide A and 17-hydroxyl jolkinolide A produce the metabolites of hydroxylation and dehydrogenation in liver microsomes of rats ;both jolkinolide B and 17-hydroxyl jolkinolide B produce the metabolites of hydroxylation ,hydration and isomerization in liver microsomes of rats. The metabolites of four diterpenoids are phase Ⅰ metabolites.
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OBJECTIVE To establis h the fingerprint of Cynanchum auriculatum,to conduct its chemical pattern recognition analysis,and to determine the contents of four components at the same time. METHODS High performance liquid chromatography (HPLC)method was adopted. The determination was performed on ACE UExcel C 18 column with mobile phase consisted of acetonitrile-0.1% phosphoric acid solution (gradient elution )at the flow rate of 1.2 mL/min. The determination wavelength was set at 210 nm,and the column temperature was 40 ℃. The sample size wa s 10 μL. Taking qingyang shengenin as the reference ,HPLC fingerprints of 16 batches of C. auriculatum medicinal materials were drawn and similarity was evaluated by using the Similarity Evaluation of Chromatographic Fingerprints of Traditional Chinese Medicine (2012 edition), and the common peaks were determined. SPSS 26.0 software andSIMCA 14.0 software were used for cluster analysis ,principal component analysis and orthogonal partial least squares- discriminant analysis. The differential components affecting the quality of C. auriculatum were screened by taking the value of variable importance in projection (VIP)greater than 1 as the standard ;same HPLC method was used to determine the contents of syringic acid ,acyl asclepiadelenin ,baishouwubenzophenone and qingyang shengenin. RESULTS There were 29 common peaks in 16 batches of C. auriculatum ,with a similarity of 0.723-0.998. Four common peaks were identified ,namely syringic acid (peak 7),acyl asclepiadoidin (peak 9),baishouwubenzophenone(peak 13)and qingyang shengenin(peak 15). The results of cluster analysis showed that 16 batches of C. auriculatum could be clustered into three categories ,among which S 1 were grouped into one category,S3 were grouped into one c ategory,S2,and S 4-S16 were grouped into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the five principal components was 88.706%,and the classification results were consistent with the results of cluster analysis. The results of orthogonal partial least squares-discriminant analysis showed that the common peaks (from large to small )with VIP value greater than 1 were peak 20,peak 10,peak 25,peak 12, peak 15(qingyangshengenin),peak 21,peak 14,peak 16,peak 26,peak 22 and peak 17. The linear ranges of syringic acid,acyl asclepterin,baishouwubenzophenone and qingyangshengenin were 0.715 3-45.778 0,2.379 4-152.281 0,0.642 0- 41.085 0,14.541 6- 930.662 0 µg/mL respectively (all R 2>0.999). The quantitative limits were 0.357 7,0.475 9,0.642 0 and 2.423 6 μg/mL;the detective limits were 0.146 0,0.164 1,0.248 8 and 0.833 3 μg/mL,respectively. RSDs of precision ,repeatability and stability (24 h)tests were less than 3%;the average recoveries were 99.11%(RSD=2.00%,n=9),98.54%(RSD=2.21%,n=9), 96.33%(RSD=2.54%,n=9)and 95.96%(RSD=2.93%,n=9);the contents were 17.12-147.80,95.23-583.10(S8 below the quantitative limit ),16.91-210.88 and 211.68-3 587.15(S1 below the quantitative limit )μg/g,respectively. CONCLUSIONS Established HPLC fingerprint and the method of content determination are stable ,reliable,accurate and reproducible. Combined with analysis of chemical pattern recognition ,it can be used for the quality control of C. auriculatum .
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Objective: To investigate the efficacy and safety of enhanced recovery after surgery (ERAS) in perioperative management of patients with gallbladder carcinoma. Methods: The data of the patients with gallbladder carcinoma admitted at Peking Union Medical College Hospital between January 2017 and December 2021 were analyzed retrospectively. There were 69 males(42.1%) and 95 females(57.9%),with age of (64.0±10.3) years(range:37 to 89 years). Patients were divided into ERAS group(n=53) and normal group(n=111) according to whether they were treated with ERAS measures during the perioperative period.The basic characteristics of the two groups were matched by propensity score matching,and then the perioperative information was compared between the two groups. Categorical variables were presented as absolute numbers or frequencies. Differences between study groups were analyzed using χ2 test, Fisher's exact test, t-test, or Mann-Whitney U test, as appropriate. Results: Each group had 45 patients after propensity score matching with well-balanced basic characteristics. There was no difference in basic characteristics, operation time,bleeding,complication,and hospitalization expenses between two groups(all P>0.05). Compared with the normal group,time of ambulation (M(IQR)) (1(1) day vs. 2(2) days;Z=-3.839,P<0.01),postoperative anal exhaust time (2(1) days vs. 3(1) days;Z=-3.013,P=0.003),feeding time(2(1) days vs. 2(1) days;Z=-3.647,P<0.01),postoperative (5(2) days vs. 7(4) days;Z=-3.984,P<0.01) and total(8(4) days vs. 13(6) days;Z=-3.605,P<0.01) hospitalization time were shorter in ERAS group. Postoperative complications occurred in 12 patients. According to the Clavien-Dindo classification,6,4,and 2 patients were classified as grade Ⅰ,Ⅱ,and Ⅲa,respectively. Conclusion: The ERAS measures is safe and effective for perioperative management of patients with gallbladder carcinoma, enhancing patient recovery and shortening hospitalization time without increasing complication or hospitalization cost.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Enhanced Recovery After Surgery , Gallbladder Neoplasms/surgery , Length of Stay , Postoperative Complications , Propensity Score , Retrospective Studies , Treatment OutcomeABSTRACT
ObjectiveTo explore the mechanism of Shenxiong glucose injection (SGI) in inhibiting hydrogen peroxide (H2O2)-induced oxidative damage in H9c2 cells by tandem mass tags (TMT)-labeled quantitative proteomics. MethodH9c2 cells cultured in vitro were exposed to H2O2 for inducing oxidative damage. The cell viability was measured by cell proliferation and cytotoxicity assay (MTS), followed by peptide fractionation by high performance liquid chromatography (HPLC) and protein expression detection in H9c2 cells by ultrahigh performance liquid chromatography-mass spectrometry. MaxQuant (v1.5.2.8) was utilized for data retrieval, and the high-resolution mass spectrometry was conducted to screen out differentially expressed proteins, which were then subjected to gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis. The protein expression levels of perilipin 2 (Plin2) and tropomyosin 1 (Tpm1) in cells were measured by Western blot. ResultThe spectral analysis yielded 48 608 specific peptide fragments and 5 903 quantifiable proteins. Compared with the model group,the SGI group exhibited 82 differentially expressed proteins,of which 22 were up-regulated and 60 were down-regulated. GO analysis results showed that the differentially expressed proteins were mainly involved in biological processes such as programmed cell death regulation,regulation of cell proliferation,cardiovascular system development, and cell migration. As revealed by KEGG analysis, these proteins were mainly related to peroxisome proliferator-activated receptor (PPAR),focal adhesion,phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt),and Ras-related protein 1 (Rap1) pathways. Western blot results demonstrated that compared with the model group,SGI significantly increased the Plin2 protein expression and decreased the Tpm1 protein expression (P<0.01),consistent with the proteomics results. ConclusionSGI may inhibit cell apoptosis and antagonize H2O2-induced cell oxidative damage by regulating PPAR,focal adhesion,PI3K/Akt and Rap1 pathways,which should be further verified by subsequent experiments.
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ObjectiveTo analyze the effective components of Periploca forrestii against rheumatoid arthritis(RA)by targeting tumor necrosis factor (TNF)-α based on network pharmacology and experimental verification. MethodThe preliminary research of the research group found that the alcohol extracts of P. forrestii (CDLF and CQAF) had significant anti-RA activities,and 10 monomers with such activities were identified. The anti-RA activities of active monomers,CDLF, and CQAF were compared by the enzyme-linked immunosorbent assay (ELISA)with interleukin(IL)-6,nitric oxide (NO),IL-1β, and prostaglandin E2(PGE2)as indicators. Network pharmacology was employed to analyze the possible molecular mechanism of P. forrestii against RA. The targeting ability of P. forrestii chemical monomers to TNF-α was verified by TNF-α molecular docking,surface plasmon resonance (SPR), and TNF-α-induced L929 injury model. ResultELISA showed that the anti-RA activities of CDLF and CQAF were significantly stronger than those of identified 10 active monomers. Network pharmacology analysis showed that the core targets of P. forrestii against RA were signal transducer and activator of transcription protein 3 (STAT3),TNF, and IL-6. Gene Ontology(GO) analysis revealed collagen catabolism,inflammatory response,positive regulation of nuclear factor kappa-B(NF-κB) transcription factor activity,and positive regulation of B cell proliferation. Kyoto Encyclopedia of Genes and Genomes (EKGG) pathway enrichment analysis demonstrated TNF signaling pathway,phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt) signaling pathway,NF-κB signaling pathway,Toll-like receptor signaling pathway,mitogen-activated protein kinase(MAPK) signaling pathway, etc. Verification experiments by TNF-α molecular docking,SPR, and TNF-α-induced L929 injury model found that CDLF and CQAF had good binding activities and could manifestly antagonize TNF-α. However, the active components separated and identified from CDLF and CQAF did not show the same anti-TNF-α activity. ConclusionThe CDLF and CQAF of P. forrestii may treat RA by targeting TNF-α. The experiments found that the isolated chemical components had weaker binding activity to TNF-α than CDLF and CQAF. Meanwhile,the research group isolated chemical components with a minimum mass fraction of 0.25 ng·g-1 from P. forrestii, which suggested that the active components generated by binding to TNF-α with anti-RA activities were presumedly trace components .
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Aim To construct Flp-In CHO cell line(CYP2A13-CHO)stably expressing cytochrome P450 family 2 subfamily A member 13(CYP2A13)and Flp-In CHO cell line(CYP2A13-POR-CHO)stably co-expressing CYP2A13 and cytochrome P450 oxidoreductase(POR), from which a cell line with better metabolic activity is selected.Method In our previous study, we had constructed a Flp-In CHO cell line(POR-Flp-In CHO)stably expressing POR using lentiviral vector.The recombinant plasmids of pcDNA5/FRT-CYP2A13 were constructed and transfected into Flp-In CHO cells and POR-Flp-In CHO cells through LipofectamineTM 2000.The expression and activity of CYP2A13 were detected by real-time quantitative PCR(qRT-PCR), Western blot and Aflatoxin B1(AFB1)/4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone(NNK)cytotoxicity assay and the metabolic activity was compared between CYP2A13-CHO and CYP2A13-POR-CHO.Results Compared with non-transfected cells, the mRNA and protein expression of CYP2A13 in CYP2A13-CHO and CYP2A13-POR-CHO cells both increased significantly.Besides, compared with CYP2A13-POR-CHO, CYP2A13-CHO cells were more sensitive to AFB1 and NNK.Conclusions The Flp-In CHO cell line stably expressing CYP2A13 and with better metabolic activity has been established successfully, which provides a tool for screening of pre-carcinogens that can be metabolically activated by CYP2A13.
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Objective:To investigate the diagnostic value of independent and combined subtests of the psychometric hepatic encephalopathy score (PHES) in mild hepatic encephalopathy(MHE) of patients with liver cirrhosis, so as to optimize the PHES.Methods:This was a prospective, multicenter and real-world study which was sponsored by the National Clinical Research Center of Infectious Diseases and the Portal Hypertension Consortium. Twenty-six hospitals from 13 provinces, autonomous regions and municipalities countrywide participated in this study, induding Tianjin Third Central Hospital, the Fourth People′s Hospital of Qinghai Province, the Second Affiliated Hospital of Baotou Medical College, the Third People′s Hospital of Taiyuan, the Fifth Medical Center of PLA General Hospital and so on. From October 2021 to February 2022, outpatients and hospitalized patients with liver cirrhosis and no obvious hepatic encephalopathy were consecutively enrolled. All patients received 5 PHES subjects in the same order: number connection test(NCT)-A, NCT-B, digit symbol test(DST), line tracing test(LTT) and serial dotting test(SDT), and the scores were calculated. The total score of PHES <-4 was taken as the cut-off value for diagnosing MHE. Compare the differences in each subtest between MHE group and non-MHE group. Receiver operating characteristic curve(ROC) and area under the curve(AUC) was performed to assess the diagnostic value of independent and combined subtests in MHE. Mann-Whitney U test and DeLong test were used for statistical analysis. Results:A total of 581 patients with liver cirrhosis were enrolled, 457 were diagnosed as MHE, and the incidence of MHE was 78.7%. The results of NCT-A, NCT-B, SDT, LTT, DST of MHE group were 60.00 s(47.01 s, 88.00 s), 90.45 s(69.32 s, 125.35 s), 74.00 s(57.65 s, 96.60 s), 74.72(60.00, 98.61) and 27.00(20.00, 36.00), respectively. Compared those of non-MHE group(34.00 s(29.15 s, 44.48 s), 50.00 s(40.98 s, 60.77 s), 50.00 s(41.07 s, 63.03 s), 46.23(38.55, 59.42) and 42.00(34.00, 50.75)), the differences were statistically significant( Z=12.37, 12.98, 9.83, 11.56, 10.66; all P<0.001). The AUC(95% confidence interval(95% CI)) of subtests of PHES NCT-B, NCT-A, LTT, DST and SDT alone in MHE diagnosis were 0.880(0.849 to 0.910), 0.862(0.828 to 0.896), 0.838(0.799 to 0.877), 0.812(0.772 to 0.851) and 0.788(0.743 to 0.832), respectively. The combination of 2 PHES subtests significantly increased the diagnostic efficacy. Among them the diagnostic efficacy of the combination of NCT-B and LTT was the best, the AUC(95% CI) was 0.924(0.902 to 0.947), the specificity was 91.9% and the sensitivity was 79.2%, which was better than a single PHES subtest (NCT-A, NCT-B, SDT, LTT and DST) and the combination of NCT-A and DST(AUC was 0.879, 95% CI0.847 to 0.910) which was recommended by guidelines on the management of hepatic encephalopathy in cirrhosis, the differences were statistically significant ( Z=3.78, 3.83, 5.57, 5.51, 5.38, 2.93; all P<0.01). Furthermore, compared between the combination of NCT-B and LTT and the combination of 3 subests of PHES, only the diagnostic efficacy of combination of NCT-B, LTT and SDT (AUC was 0.936, 95% CI 0.916 to 0.956) was better than that of the combination of NCT-B and LTT, the difference was statistically significant( Z=2.32, P=0.020). Conclusion:Based on the diagnostic efficacy and clinical feasibility of PHES subtests and their combinations, the combination of NCT-B and LTT is recommended for the diagnosis of MHE.
ABSTRACT
OBJECTIVE@#To compare the therapeutic effect on type 2 diabetes mellitus (T2DM) complicated with angina pectoris of coronary heart disease between the combined therapy of acupuncture and western medication and the simple administration of western medication.@*METHODS@#A total of 134 patients with T2DM and angina pectoris of coronary heart disease were randomly divided into two groups, i.e. an acupuncture plus medication group (67 cases, 3 cases dropped off) and a medication group (67 cases, 4 cases dropped off). The routine western medication was used according to symptoms in the patients of both groups. In the acupuncture plus medication group, on the base of medication, acupuncture was applied to Jianshi (PC 5), Quchi (LI 11), Neiguan (PC 6), etc. The needles were retained for 20 min in each treatment and 3 treatments of acupuncture were required weekly. The treatment was given consecutively for 8 weeks in the two groups. Separately, before and after treatment, the symptom scores of TCM were observed and the indexes were detected, including glycolipid metabolism [fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), glucosylated hemoglobin (HbA1c), triacylglycerol (TG) and total cholesterol (TC)], islet β cell function [homeostasis model assessment-β (HOMA-β), homeostasis model assessment-IR (HOMA-IR), fasting insulin (FINS) and insulin sensitivity index (ISI)], cardiac function indexes [cardiac output (CO), early diastolic peak velocity/late diastolic peak velocity (E/A), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)], as well as electrocardiogram QT dispersion (QTd). Besides, the clinical therapeutic effects were compared between the two groups.@*RESULTS@#After treatment, the TCM symptom scores and the values of FPG, 2hPG, HbA1c, TG, TC, HOMA-IR, FINS, E/A and LVEDD as well as QTd were all lower than those before treatment in the two groups (@*CONCLUSION@#The combined therapy of acupuncture and medication is effective in treatment of T2DM complicated with angina pectoris of coronary heart disease. Such therapy effectively improves glucolipid metabolism, islet β cell function, cardiac function and myocardial blood supply. Its curative effect is better than the simple administration of western medicine.