Table of Content

05 December 2023, Volume 43 Issue 12

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Original Articles

Apelin alleviates the damage of renal podocytes induced by high glucose

WANG Liyan, AN Fei, DIAO Zongli, HUANG Hongdong, LIU Wenhu

2023, 43(12):  1771-1777.  doi:10.16352/j.issn.1001-6325.2023.12.1771

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Objective To explore the protective effect of polypeptide Apelin on podocyte mitochondria in diabetic nephropathy and underling mechanisms. Methods Human renal podocytes were divided into four experimental groups: control group, high glucose(HG) group(glucose 25 mmol/L, 48 h), Apelin intervention HG group (Apelin-13 1 μmol/L, 48 h) and Apelin group (Apelin-13 1 μmol/L, 48 h). The podocyte apoptosis was observed by TUNEL staining, the expression of mitochondrial membrane protein FUNDC1 was detected by Western blot, and the binding of mitochondrial fission protein DRP1 to FUNDC1 was examined by immunoprecipitation. The 8-week-old male mice were divided into three experimental groups: control group, diabetes group (intraperitoneal injection of streptozotocin 150 mg/kg, only one time) and Apelin intervention DM group (intraperitoneal injection of Apelin-13 0.3 μmol/kg, daily). The morphology of renal was observed by PAS staining and transmission electron microscopy. Plasma creatinine (Cr), urea nitrogen, urinary albumin and creatinine were detected by ELISA kit. The level of creatinine clearance rate (Ccr) and urinary albumin/creatinine (ACR) was calculated. Results Compared with the control group, the podocyte apoptosis and expression of FUNDC1 in the HG group increased significantly (P＜0.05), and the combination of mitochondrial fission division protein DRP1 to FUNDC1 raised. Meanwhile, compared with the HG group, the number of apoptosis, the expression of FUNDC1 (P＜0.05), and the combination of DRP1 to FUNDC1 all reduced in Apelin intervention HG group. Animal experiments showed that the kidney structure of the control group was intact. In the DM group, the number of podocytes decreased significantly, the foot processes were fused and dropped off. In the Apelin intervention DM group, podocyte lesions were less severe than those in the DM group. Compared with the control group, the level of plasma Cr, BUN and urine ACR in the DM group increased, while the level of Ccr decreased significantly (P＜0.05). However, compared with the DM group, the level of above biomarkers in the Apelin intervention DM group was improved(P＜0.05).Conclusions Apelin keeps mitochondrial homeostasis and reduces podocyte apoptosis by inhibiting the expression of mitochondrial membrane protein FUNDC1, which may contribute to alleviation of diabetic nephropathy.

Screening for NOTCH2NLC gene dynamic mutation in patients with essential tremor

ZHANG Xinyi, ZHAO Ximeng, YANG Yingmai, WAN Xinhua, CUI Liying, ZHANG Xue, LIU Qing

2023, 43(12):  1778-1783.  doi:10.16352/j.issn.1001-6325.2023.12.1778

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Objective To identify the pathogenic variants in 110 patients with essential tremor (ET). Methods Clinical data and peripheral blood samples of ET patients were collected from the Department of Neurology of Peking Union Medical College Hospital and then the genomic DNA was extracted. Dynamic mutation detection of NOTCH2NLC was performed in patients with essential tremor by triplet repeat primed PCR(TP-PCR). Since ET is associated with multiple mechanisms of neuro-degeneration, the next generation sequencing (NGS) panel targeting neurodegenerative associating genes were performed to check pathogenic variants in additional genes. Results A total of 110 ET patients and 187 matched control individuals were recruited. The age of onset in the current ET group was (36.30±17.64)years, and 74.8% patients had a family history. No abnormal trinucleotide repeat expansion in NOTCH2NLC was identified. The repeat number of (GGC)n lied within normal ranges between 10-47 (average 18.6±5.4). Variants burden analysis showed association of ET with PLA2G6. Three rare variants in four patients in PLA2G6 were identified with unknown significance. Conclusions Dynamic mutations of NOTCH2NLC are uncommon in ET patients and that suggests need of more researches for further exploring the genetic mechanism of ET.

The role of GPS2 in regulating proliferation, migration and invasion of hepatocellular carcinoma cell line MHCC-97H

LIU Aixia, ZHANG Hao, SUN Jie, YANG Lihua, ZHAO Xiaotao

2023, 43(12):  1784-1791.  doi:10.16352/j.issn.1001-6325.2023.12.1784

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Objective To explore the role of G protein pathway suppressor 2(GPS2)in regulating proliferation, migration and invasion in hepatocellular carcinoma cell line MHCC-97H.Methods The expression of GPS2 in hepatocellular carcinoma (HCC) cells were detected using quantitative PCR or Western blot; GPS2 was either over-expressed or knocked down in HCC cells using over-expression vectors or short hairpin RNAs (shRNAs) for GPS2, respectively. Clone formation assay, scratch assay and Transwell assay were used to detect the effects of GPS2 on proliferation, migration and invasion of HCC cells. Results In HCC cells, over-expression of GPS2 was found to inhibit the proliferation, migration and invasion of HCC cells MHCC-97H, while knockdown of GPS2 up-regulated proliferation, migration and invasion of MHCC-97H(P＜0.05). The over-expression of GPS2 in MHCC-97H cells was found to inhibit the expression of cell proliferation, migration and invasion-related factors such as EGFR, MMP1, MMP3 and MMP9, while knockdown of GPS2 upregulated the expression of these factors(P＜0.05). Conclusions GPS2 is a novel HCC regulatory factor that inhibits proliferation, migration and invasion of HCC cells.

Chemokine CX3CL1 has potential anti-fibrosis effect in mouse liver fibrosis

CHENG Qi, LI Ning, YU Kangkang, SHI Guangfeng

2023, 43(12):  1792-1795.  doi:10.16352/j.issn.1001-6325.2023.12.1792

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Objective To explore the effect and mechanism of chemokine CX3CL1 on mouse liver fibrosis model. Methods C57BL/6 mice were randomly divided into CCl-4 model group and normal control group with 8 animals in each group. The model group was injected with 10% CCl-4 intra peritoneally for 6 weeks. After 6 weeks, the mice were sacrificed, and the pathological changes of the mouse liver were observed by HE staining. The level of CX3CL1 in peripheral blood of the mice was measured, and the expression level of CX3CL1 mRNA in the liver tissue of the mice was detected. In addition, in order to explore the mechanism of CX3CL1, the level of IFN-γ in mouse serum was detected as well. Results After the 6-week modeling, the liver pathology microscopy showed a successful modeling of liver fibrosis. The serum CX3CL1 level and liver tissue CX3CL1 expression in the model group were found to be significantly up-regulated, which suggested a potential impact on the pathogenesis of liver fibrosis. In addition, the level of IFN-γ in the serum of mice in the model group increased significantly. Conclusions CX3CL1 is related to liver fibrosis in mice, and its mechanism might be explained by promoting the production of IFN-γ so to prevent liver fibrosis.

Establishment of reference intervals of squamous cell carcinoma antigen for healthy population in Nanning region

ZHOU Dongyi, WEI Yuhong, YI Liling, WEI Shangmou, ZHU Chunling, YANG Sufang, PENG Qiliu

2023, 43(12):  1796-1800.  doi:10.16352/j.issn.1001-6325.2023.12.1796

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Objective To establish a reference intervals (RIs) of serum squamous cell carcinoma antigen(SCC-Ag) in healthy population in Nanning region and provide clinical evidence to support diagnosis and prognosis of squamous cell carcinoma. Methods A total of 10 197 reference individuals who joined a routine physical examination in the Health Management Center of Guangxi International Zhuang Medical Hospital from March 2019 to December 2021 were collected. The level of serum SCC-Ag was detected by chemiluminescence microparticle immunoassay. The Mann-Whitney U test was applied to compare the differences in serum SCC level between genders or adjacent age groups. The unilateral 95th percentile determined the upper limit of the RIs by the nonparametric method. Another 1 035 healthy subjects with the same conditions as the reference population were selected for refer- ence validation. Results The serum SCC-Ag level showed a skewed distribution (Z=0.08, P＜0.05). The serum SCC-Ag level of males was considerably higher than that of females. There was significant difference in serum SCC-Ag level between males aged 18-30 and 31-40, 51-60 and 61-90 (P＜0.05). There was significant difference in serum SCC-Ag level between females aged 18-30 and 31-40, 31-40 and 41-50, 51-60 and 61-90 (P＜0.05). The reference intervals of serum SCC-Ag was as follows: 0-1.64 ng/mL for males and females aged 18-30 years; 0-1.57 ng/mL and 0-1.70 ng/mL for males aged 31-60 years and 61-90 years, respectively; 0-1.50 ng/mL, 0-1.52 ng/mL and 0-1.42 ng/mL for females aged 31-40 years, 41-60 years and 61-90 years, respectively. Conclusions The RIs of serum SCC-Ag in healthy population in the Nanning region are successfully established according to different genders and ages.

Daidzein alleviates high glucose-induced pyroptosis of renal tubular epithelial cells

CHEN Caiwei, WU Yueping, WANG Zhuansuo, LUO Qiang, XING Bozhen

2023, 43(12):  1801-1807.  doi:10.16352/j.issn.1001-6325.2023.12.1801

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Objective To investigate the impact of daidzein (DAI) on the pyroptosis of renal tubular epithelial cells induced by high glucose by regulating NOD-like receptor protein 3 (NLRP3)/caspase-1 signal pathway. Methods HK-2 cells were divided into control group (NC group) (5.5 mmol/L D-glucose), HG group(30 mmol/L D-glucose), DAI-L, DAI-M, DAI-H groups (HK-2 cells were incubated with 30 mmol/L D-glucose and 25, 50, 100 μmol/L DAI,respectively), and DAI-H+LPS group (HK-2 cells were incubated with 30 mmol/L D-glucose, 100 μmol/L DAI and 1 μg/mL LPS). MTT assay was applied to detect the cytotoxicity and proliferation of HK-2 cells; the apoptosis of HK-2 cells was detected by flow cytometry. The level of interleukin-1β (IL-1β) and inter-leukin-18 (IL-18) in HK-2 cells was detected by ELISA. The morphology of pyroptosis cells was observed by scanning electron microscope. Immunofluorescence staining was applied to detect pyroptosis related proteins. The expression of NLRP3, cleaved casase-1 and GSDMD-N was detected by Western blot. Results In NC group, the cells were spherical with regular boundaries, while in HG group, the cells swelled and became larger with irregular boundaries; the OD value (490 nm) of HK-2 cells in HG group was obviously lower than that in NC group(P＜0.05), the apoptosis rate, IL-1β, IL-18 contents, NLRP3, cleaved casase-1, GSDMD-N protein level of HK-2 cells were obviously higher (P＜0.05); After DAI treatment, the swelling of cells was alleviated, the A value (490 nm) of HK-2 cells increased significantly (P＜0.05), the apoptosis rate of HK-2 cells, IL-1 β, IL-18 content, NLRP3, cleaved-caspase-1 and GSDMD-N protein levels were significantly decreased(P＜0.05) and the therapeutic effect of DAI was dose-dependent; LPS eliminated the beneficial effect of DAI-H on high glucose induced apoptosis of renal tubular epithelial cells. Conclusions DAI may alleviate pyroptosis of renal tubular epithelial cells induced by high glucose through inhibition of NLRP3/caspase-1 signaling pathway.

Effects of miR-34a on polarization and inflammatory factor content of mouse macrophage cell line RAW264.7 under high glucose conditions

ZHANG Fengyun, ZHAO Zhihao, ZHANG Zhuoqi

2023, 43(12):  1808-1813.  doi:10.16352/j.issn.1001-6325.2023.12.1808

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Objective To detect the role of miR-34a on macrophage inflammation and polarization under high glucose conditions. Methods Mouse macrophages were collected and cultured during high glucose for 3-28 days. RT-qPCR was used to detect the expression of miR-34a, iNOS, MCP-1 and Arg-1 mRNA. Then miR-34a was over-expressed or silenced, ELISA was used to detect the expression of IL-6, IL-1β,TNF-α and qRT-PCR was used to detect the expression of iNOS and MCP-1 mRNA. Western blot was used to detect the expression of Notch1. Results Expression of miR-34a increased under high glucose conditions in RAW264.7 cells continuously. Over-expression of miR-34a promoted the expression of MCP-1 and iNOS observed by RT-qPCR and increased the expression of IL-6, IL-1β and TNF-α detected by ELISA. Further studies showed that siRNA-Notch1 down-regulated the expression of miR-34a, MCP-1, iNOS, IL-6, IL-1β and TNF-α. Conclusions Chronic high glucose condition stimulates the expression of miR-34a which promotes M1 macrophage polarization and releasing of pro-inflammatory factors.

Over-expression of APMAP alleviates glomerular podocyte injury in adriamycin nephropathy

WU Jingyi, FAN Wenjing, YAN Donghua

2023, 43(12):  1814-1821.  doi:10.16352/j.issn.1001-6325.2023.12.1814

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Objective To investigate the effects of adipocyte plasma membrane-associated protein (APMAP) over-expression on glomerular podocyte injury in adriamycin (ADR) nephropathy. Methods The rat model of adriamycin nephropathy was constructed by tail vein injection of adriamycin, the expression of APMAP and NF-κB p65 in renal tissue was measured by immunohistochemistry. A mouse glomerular podocytes MPC-5 cell line with APMAP gene over-expression was constructed, then podocyocytes injury model was induced by 0.5 μmol/L ADR and treated with NF-κB signaling pathway activator CU-T12-9. The proliferation of cells was checked by CCK-8. The activity of lactate dehydrogenase (LDH) was determined by ELISA. The apoptosis of podocytes was determined by flow cytometry. Western blot was used to detect protein expressions of NF-κB p65, p-NF-κB p65 and TNF-α. Results APMAP was expressed in kidney tissue of doxorubicin nephropathy rats at a low level, while NF-κB p65 was significantly high expressed (P＜0.05). Over-expression of APMAP increased proliferation of MPC-5 cells and decreased LDH activity, apoptosis rate, and also down-regulated protein expression of NF-κB p65, P-NF-κB p65 and TNF-α under ADR exposure (P＜0.05). However, combined treatment with CU-T12-9 significantly inhibited the ameliorative effect of APMAP over-expression on the damage of MPC-5 cells exposed to ADR. Conclusions The over-expression of APMAP can inhibit ADR-induced glomerular podocyte injury, and its mechanism might be related to the inhibition of NF-κB signaling pathway.

Esketamine reduces ischemia-reperfusion injury of skeletal muscle of rats

YUAN Peigen, CHEN Shunli, SHAN Yuanlu, XUE Binbin, YE Yuzhu, LIN Lina

2023, 43(12):  1822-1826.  doi:10.16352/j.issn.1001-6325.2023.12.1822

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Objective To investigate the role of low dose esketamine in pretreated limb ischemia-reperfusion injury. Methods The rats were divided into sham-operated group (Sham group), ischemia-reperfusion group (I/R group, 3 h of ischemia and 2 h of reperfusion), esketamine group (ESK group, ip, 5 mg/kg). The plasma concentrations of creatine kinase (CK) and lactate dehydrogenase (LDH) were measured. The wet/dry weight ratio of skeletal muscle was immediately detected. The gastrocnemius muscle was harvested and the level of malondialdehyde (MDA) and superoxide dismutase (SOD) was detected by colorimetric assay. The expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were detected by Western blot and immunohistochemical staining. Results Compared with Sham group, the index of wet/dry weight ratio, MDA, CK, LDH, Nrf2 and HO-1 were all increased, but SOD was decreased in I/R group(P＜0.05). Compared with I/R group, the index of wet/dry weight ratio, MDA, CK and LDH were significantly lower, but SOD and Nrf2 and HO-1 were significantly higher in ESK group (P＜0.05). Conclusions ESK may increase Nrf2 in the nucleus, thereby increase the HO-1 protein as an antioxidant agent.

Alpinetin alleviates bleomycin-induced pulmonary fibrosis in mice

SI Changxing, DING Yanyan, YIN Fengxian

2023, 43(12):  1827-1833.  doi:10.16352/j.issn.1001-6325.2023.12.1827

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Objective To investigate the effect and potential mechanism of alpinetin (ALPN) on bleomycin (BLM)-induced pulmonary fibrosis in mice. Methods The mice were randomly divided into control group, model group (intratracheally instilled BLM), low-dose (L-ALPN group) and high-dose ALPN groups (H-ALPN group) (10 mg/kg or 30 mg/kg ALPN daily, respectively) with 10 in each. Lung tissues were collected, and the alveolar structure and pathological morphology weremicroscopied by HE and Masson staining; mRNA and protein expressions of collagen Ⅰ, TGF-β1, E-cadherin, α-SMA, p-PERK, PERK, CHOP and GRP78 in lung tissue were detected by RT-qPCR, immunohistochemistry and Western blot, respectively. Results Compared with control group, the lung of the model group showed fibrotic changes, and the expression of collagenⅠ, TGF-β1, α-SMA, p-PERK/PERK, CHOP and GRP78 in lung tissue was significantly increased (P＜0.01). E-cadherin expression was significantly decreased (P＜0.01). Compared with model group, pulmonary fibrosis was significantly alleviated in low and high doses ALPN groups, the expression of collagen Ⅰ, TGF-β1, α-SMA, p-PERK/PERK, CHOP and GRP78 in lung tissue were significantly decreased (P＜0.05 or P＜0.01), and the expressionof E-cadherin was significantly increased (P＜0.05 or P＜0.01). Conclusions ALPN may alleviate BLM-induced pulmonary fibrosis, and this effect may be attributed to the inhibition of endoplasmic reticulum stress.

Sodium hydrosulfide alleviates mitochondrial injury of rat myocardial cell line H9C2 induced by high glucose and high fat

ZHANG Weicai, LIU Siren, WANG Shangnong

2023, 43(12):  1834-1840.  doi:10.16352/j.issn.1001-6325.2023.12.1834

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Objective To investigate the function of sodium hydrosulfide (NaHS) to regulate mitochondrial fusion/fission in diabetic cardiomyopathy and underlying mechanism. Methods Db/db mice as type 2 diabetes animal model were treated by NaHS. H9C2 cells incubated with glucose (40 mmol/L), palmitic acid (200 μmol/L, Pal) and oleate (200 μmol/L, Ole) were intervened by NaHS (100 μmol/L). H2C9 cells were divided into control, HG+Pal+Ole, HG+Pal+Ole+NaHS and Pal+Ole+DJ-1 siRNA+NaHS groups. The protein level of Mfn2, Fis1, CSE, and DJ-1 was determined by Western blot. Mitotracker staining was used to observe the morphology of mitochondria. The ultra-structural alteration of cardiac tissues was detected by transmission electron microscopy. The cardiac functions were detected by echocardiography. Results Expression of Fis1 was increased (P＜0.05) and expression of Mfn2 was decreased (P＜0.05) in db/db and H9C2 treated by HG+Pal+Ole compared to control group. NaHS could upregulate the expression DJ-1, enhance the expression of Mfn2, and reduce the expression of Fis1. In db/db mice, cardiac systolic function was reduced. Disordered arrangement of myofilament, loss of cristae and mitochondrial fission were observed. NaHS could ameliorate these alterations. Conclusions NaHS may alleviate mitochondria injury by promoting mitochondrial fusion.

Clinical Sciences

Homocysteine level of Tibetan population settled down at different altitudes

LI Pengchang, ZOU Yutong, LIU Zhijuan, LIU Xiaoxing, Zejipuchi, TIAN Liping, WU Jie, QIU Ling

2023, 43(12):  1841-1846.  doi:10.16352/j.issn.1001-6325.2023.12.1841

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Objective To investigate and analyze the level of homocysteine (Hcy) in Tibet and to analyze the differences of Hcy level in different altitude regions, genders and ages, and thus to provide the prevalence profile of hyperhomocysteine and the differences in relevant tests between HHcy(hyperhomocysteinemia) and non-HHcy populations. Methods Totally 1 615(male n=585) subjects were selected from Ngari, Lhasa, Shigatse and Nyingchi plateau areas of Tibet by stratified cluster sampling. Serum Hcy level was analyzed and the difference of Hcy level in populations located at different altitude plateau areas, gender groups were found. The prevalence of hyperhomocysteine and related test were analyzed. Kruskal Wallis test was used to compare Hcy levels in different altitudes, genders and age groups, and Pearson Chi-square test was used to compare HHcy prevalence. Variance analysis was used for the differences of different test indicators between non-HHcy and HHcy populations. Results The level of Hcy in different regions and different genders were statistically significant, which was higher in males than that in females, and higher in Lhasa and Shigatse than in Nyingchi and Ngari. There was difference in serum HHcy prevalence among different genders, regions and age groups. Males showed a higher level than females, people from Lhasa and Shigatse showed a higher level than those from Nyingchi and Ngari. Conclusions The incidence of hyperhomocysteinemia in Tibet is statistically significant in different areas, different genders and different age groups. So this study provides a scientific basis for the rational use of Hcy as an indicator in clinical practice of prevention and treatment of related diseases in plateau areas.

Risk factors analysis of pulmonary complications after video-assisted thoracoscopic surgery in elderly patients

ZHANG Yu, HAN Yue, ZHU Qianmei, ZHOU Huiying, MIAO Xuhan, YAO Jingman, LIU Zijia, SHEN Le

2023, 43(12):  1847-1851.  doi:10.16352/j.issn.1001-6325.2023.12.1847

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Objective To analyze the incidence and risk factors of postoperative pulmonary complications (PPCs) in elderly patients undergoing video-assisted thoracoscopic surgery(VATS). Methods Elderly patients aged≥65 years who underwent VATS in Peking Union Medical College Hospital from January 2013 to December 2017, were reviewed retrospectively and divided into non-PPCs group and PPCs group. General information, past medical history, and postoperative complications were recorded in a uniform case report form. The clinical factors with statistical significance in univariate analysis and important clinical significance according to experience were analyzed with Logistic regression to evaluate the independent risk factors for PPCs. Results A total of 900 patients were included, and 48(5.3%) of them suffered PPCs. Multivariate logistic regression showed that pre-operative smoking history,history of stroke, chronic obstructive pulmonary disease (COPD) and pulmonary lobectomy were independent risk factors for PPCs in elderly patients after VATS. Conclusions Elderly patient is a high-risk group for PPCs after VATS. The risk factors include smoking history, stroke, COPD and scope of surgery. Therefore, perioperative management needs to optimize, and monitoring should be strengthened for these high-risk patients.

A case of congenital systemic lipodystrophy with exfoliated xanthoma caused by AGPAT2 gene mutation

LUO Yunyun, ZHANG Liyuan, WANG Xinyi, LIU He, DU Hanze, PAN Hui

2023, 43(12):  1852-1856.  doi:10.16352/j.issn.1001-6325.2023.12.1852

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Objective To analyze the clinical characteristics and genotype of a patient with congenital systemic lipodystrophy (CGL) type 1 associated with exudative xanthoma caused by AGPAT2 gene mutation, and to provide evidence for clinical and genetic diagnosis of the disease.Methods Clinical data of the patient such as medical history, physical examination and laboratory examination were collected. Peripheral venous blood was collected for whole exome sequencing analysis and Sanger sequencing verification, and treatment was provided to patients according to the changes of condition. Results The clinical manifestations of the patient were subcutaneous fat reduction, fatty liver, spleen enlargement, kidney enlargement, high blood sugar and lipids, severe insulin resistance, scattered yellow rash on limbs, which was confirmed as xanthoma. The results of whole exon sequencing showed that the AGPAT2 gene of the patient had a heterozygous nonsense mutation of c.202C＞T:p.R68* and c.646A＞T:p.K216*, and the former was the pathogenic mutation site. Follow-up therapy covers improvement of lifestyle, low-fat diet and regular exercise. The rashes subsided after active lipid-lowering therapy. Conclusions Apart from typical lipody-strophy, the patient was accompanied by exanthemous xanthoma. No CGL1 patient with exanthemous xanthoma has been reported in the domestic literature database up to now, and the genetic test results showed that there was a c.202C＞T heterozygous mutation of AGPAT2 gene. This gene site has not been reported in the literature, and its functional verification needs to be further studied.

Effect of two types of anesthesia on obturator nerve reflex and postoperative recovery in patients undergoing transurethral resection for bladder tumors

LI Yan, WANG Yanan, ZHANG Liang, TIAN Cuili, ZHAO Jianhua

2023, 43(12):  1857-1860.  doi:10.16352/j.issn.1001-6325.2023.12.1857

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Objective To observe the effects of ultrasound-guided modified obturator nerve block (ONB) combined with remazolam anesthesia on obturator nerve reflex (ONR) and postoperative recovery of patients with transurethral resection of bladder tumors (TURBT). Methods One hundred patients with bladder tumor admitted to Qinhuangdao Hospital from June 2019 to June 2021 were treated with TURBT. They were divided into conventional group (intraspinal anesthesia + traditional ONB anesthesia) and ultrasound group (intraspinal anesthesia + improved ONB combined with remidazolam anesthesia under ultrasound guidance) with 50 cases in each according to different ONB methods. Perioperative indexes, hemodynamic indexes at different time points, intraoperative ONR occurrence, complications and adverse anesthesia reactions were compared between the two groups. Results Compared with conventional group, ONB time, operation time, catheter indwelling time and hospital stay were shortened, and intraoperative blood loss was decreased in ultrasound group (P＜0.05). Compared with the conventional group at 30 min after administration (T1) and at the end of operation (T2), the mean arterial pressure (MAP) and oxygen saturation (SaO₂) were increased in the ultrasound group (P＜0.05). Compared with the conventional group, the incidence of ONR and bladder bleeding was decreased, and the incidence of postoperative bradycardia, nausea and vomiting were decreased in the ultrasound group (P＜0.05). Conclusions Ultrasound-guided modified ONB combined with remazolam anesthesia can effectively improve perioperative indexes of TURBT, reduce intraoperative ONR and bladder bleeding, and have little influence on hemodynamics with few postoperative adverse anesthesia reactions.

Effects of paclitaxel combined with carboplatin on expression of VEGF and tumor markers in ovarian cancer

TAN Shufen, YANG Xielan, YANG Linlin, LI Shuqing

2023, 43(12):  1861-1865.  doi:10.16352/j.issn.1001-6325.2023.12.1861

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Objective To explore the effect of paclitaxel with carboplatin combined chemotherapy on hemocyte related indexes,vascular endothelial growth factor (VEGF) and tumor markers in ovarian cancer (OC) patients. Methods OC patients combined chemotherapy (CC) group and ovarian benign tumor control group with 50 cases in each. The pathological changes in the ovarian cells were observed by HE staining and the expression of VEGF was observed by immunohistochemical staining (IHC).Blood cell was counted by flow cytometry (FC). Serum carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4) were measured by electrochemical luminescence (ECL). Results Compared with control group, the ovarian tissue structure was disordered and the cell atypia was obvious in OC.VEGF expression was significantly enhanced. Platelet count (PLT), CA125 and HE4 were significantly increased (P＜0.01). However,necrotic cells were observed in ovarian tissue of CC group.VEGF expression was inhibited.PLT count and the level of CA125 and HE4 were significantly lower than those of control group after chemotherapy(P＜0.01). Conclusions Combined chemotherapy may regulate the level of VEGF, CA125 and HE4 in OC patients.

Effects of different radiation doses on the accuracy of quantitative iodine concentration and CT value of virtual monochromatic image in second-generation dual-layer detector spectral CT

WU Qiaoling, TIAN Junping, ZHANG Daming, JIN Zhengyu, LU Xiaomei, YU Shenghui, WANG Yun

2023, 43(12):  1866-1870.  doi:10.16352/j.issn.1001-6325.2023.12.1866

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Objective To investigate the effect of different radiation doses on the accuracy of iodine quantification and CT value of virtual monochromatic image with a muti-spectral CT iodine phantom using second-generation dual-layer detector spectral CT (DLCT). Methods The second-generation DLCT scan abdominal phantom was used, which consisted of six different concentrations of iodine rods at 4, 8 and 12 g/L. The scan parameters were set at 100, 120 and 140 kVp tube voltages, and six radiation exposure sequences were scanned at each tube voltage: 5, 10, 15, 20, 25 and 30 mGy. Measure the iodine concentration value and the CT value at the single level of 50, 70 and 100 keV, and calculate the absolute error value of iodine concentration and CT value under different radiation exposure. SPSS 22.0 software single factor analysis of variance was used to compare the difference between the iodine concentration and the absolute error of CT value under different Radiation exposure, and LSD method was used to compare the two groups. Results The absolute error of CT value of 4 g/L iodine rod with 10~30 mGy scanning at 100 keV energy level was significantly higher than that of 12 g/L and 8 g/L(P＜0.05), and the absolute error of iodine concentration measurement of other iodine rods with different concentrations at different Radiation exposure had no statistical difference. Conclusions The second-generation double-layer detector spectral CT has high measurement stability for iodine concentration quantification and CT value accuracy under conditions of radiation dose greater than 5 mGy.

Mini Reviews

Research progress of microRNAs suppressing tumorigenesis through Hippo signaling

CHA Na, HAO Dandan, LI Tianzhu

2023, 43(12):  1871-1875.  doi:10.16352/j.issn.1001-6325.2023.12.1871

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The aberrant activation of yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), downstream effectors of the Hippo signaling pathway, has been implicated in hepatocellular carcinoma(HCC). The microRNAs (miRNAs) works as a tumor suppressors that influence the proliferation, migration and apoptosis of tumor cells by modulating Hippo-YAP/TAZ signaling during hepatic tumorigenesis. Exploring the role of miRNAs in regulating Hippo YAP/TAZ pathway in HCC can provide new ideas for the diagnosis and treatment of HCC.

Lentivirus vector in gene therapy of β-thalassemia

LIU Yize, CHAN Ying, ZHU Baosheng

2023, 43(12):  1876-1880.  doi:10.16352/j.issn.1001-6325.2023.12.1876

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β-thalassemia is a common monogenic inherited blood disorder caused by mutations of β-globin gene which results to synthesis obstacles or abnormal structure of β-globin. Gene therapy mediated by lentiviral vector(LVV) is divided into gene-integration strategies using LVV to add fully functional β-hemoglobin(HBB) genes to chromosomes and gene-editing strategies using LVV to deliver specific ribozymes to hematopoietic stem cells for in situ repair of HBB genes. Improving viral titration and transduction efficiency, reducing target loss and advancing clinical trials are the main targets of these two strategies.

Research progress on the role of thrombospondin 2 in malignant tumors

MA Jiajunyan, RUI Tiannan, ZHANG Yongsheng

2023, 43(12):  1881-1885.  doi:10.16352/j.issn.1001-6325.2023.12.1881

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Thrombospondin 2 (THBS2) is a matrix cell calcium-binding glycoprotein that interacts with a variety of growth factors, receptors, matrix molecules or proteases on the extracellular matrix and cell surface. THBS2 can be activated by N⁶-methyladenosyl RNA methylase, and mediates tumor proliferation, migration and invasion by remodeling the tumor microenvironment and participating in multiple cell signaling pathways. THBS2 could be used as a diagnostic and prognostic indicator for a variety of tumors, and is expected to become a new target for malignant tumor treatment.

Progress of research on role of lipotoxicity in pathogenesis of sarcopenia

JIANG Qi, YANG Liu, HE Jiaojiao, LI Weixin

2023, 43(12):  1886-1890.  doi:10.16352/j.issn.1001-6325.2023.12.1886

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Sarcopenia is a serious health concern that must be payed attention by aged people. The occurrence of sarcopenia in obese older individuals may be intricately linked to lipotoxic substances such as free fatty acids (FFA), diacylglycerols (DAG), and ceramides, which are toxic to skeletal muscle cells. Lipotoxic substances induce inflammatory responses, oxidative stress, endoplasmic reticulum stress, and insulin resistance in skeletal muscle cells, disrupting protein metabolism and impairing regeneration and then lead to the onset of sarcopenia. Up to the present, the precise mechanisms by which lipotoxicity in skeletal muscle results in the development of sarcopenia remain incompletely understood. Further research may highlight the orientation for the prevention and treatment of sarcopenia.

Research progress on the mechanism of mesenchymal stem cells therapy for premature ovarian failure

Bayalige, HAN Xia, YUN Sheng

2023, 43(12):  1891-1895.  doi:10.16352/j.issn.1001-6325.2023.12.1891

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Premature ovarian failure (POF) is a gynecological endocrine disease caused by ovarian dysfunction. Mesenchymal stem cells (MSCs) can effectively treat premature ovarian failure, and play a role in repairing ovarian structure and improving ovarian function. The specific mechanism can be a direct differentiation into granulosa cells or inhibition of their apoptosis through the homing effect of MSCs or differentiate into primordial germ cells. Benefit of MSCs can also be attributed to ovarian angiogenesis promotion, immune regulation, reduce oxidative stress response and paracrine, all potentially promote recovery of ovarian function, and thus improve the fertility of women of childbearing age.

Medical Education

Teaching practice of “Precision Treatment for Oncology” course in Peking Union Medical College

JIA Nan, TAN Hourui, YAN Yifei, HE Zhong, YAO Shunyu, WANG Yingyi

2023, 43(12):  1896-1900.  doi:10.16352/j.issn.1001-6325.2023.12.1896

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Objective To investigate the “Precision Treatment for Oncology” course, which is offered by Peking Union Medical College.The course is aiming for collecting students′ opinions and suggestions to optimize the course setting and improve the teaching quality. Methods This investigation collected data by questionnaire survey and interviewing from Dec.2021 to Feb.2022. The questionnaire data and interview data were analysed. Results Thirty-six quantitative questionnaires and five qualitative questionnaires were included. Improving professional knowledge and personal interests were two main reasons for students to choose courses, which existed statistical differences on different aspects of course evaluation. The overall score evaluated by medical students was 9.22 and 94.4% of the students thought the course achieved the desired goal. The scores of teachers′ teaching attitude, frontier and practicality of course content were 9.81, 9.08 and 8.86 points respectively. The students hoped to increase the case analysis practice and thematic discussion activities to enrich the teaching form. Conclusions This elective course for graduate is recognized and accepted by students. More efforts are needed in future to optimize curriculum settings, innovate teaching methods, improve teaching quality and explore new pathways for medical graduate education matching the needs of students.

Practice of video-assisted teaching ward rounds for typical cases of ophthalmology

ZHANG Yang, BIAN Ailing, XU Haiyan, ZOU Xuan, WANG Xuqian, CHEN Di, ZHANG Meifen

2023, 43(12):  1901-1904.  doi:10.16352/j.issn.1001-6325.2023.12.1901

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Objective To investigate the efficacy of video-assisted teaching ward rounds for typical cases of ophthalmology in clinical practice for medical undergraduates. Methods A total of 45 students from clinical medicine in Peking Union Medical College were enrolled. They were randomly divided into the experimental group (23 students) and control group (22 students). Primary angle closure glaucoma(PACG)was selected as the learning content, the experimental group was trained by video-assisted teaching ward rounds, while the control group was trained by internship in outpatient clinic. All students joined the test of typical case PACG and a questionnaire survey was implemented for the experimental group. Results The average score of experimental group was higher than control group[(84.30±4.53) vs. (78.05±5.76), t=4.05, P＜0.001]. For video-assisted teaching ward rounds, in experimental group, 86.9% (20/23) students believed it was more practical, 95.6% (22/23) students thought it was very helpful and 91.3% (21/23) students considered it was conductive to improve interest of learning and clinical thinking ability. Conclusions Video-assisted teaching ward rounds improves students′ understanding memory of ophthalmic typical cases, which is a potential supplement teaching method in clinical practice training of ophthalmology for medical undergraduates.

Three-scene medication process simulation and its application in teaching of nursing pharmacology

JU Rui, WANG Yucheng, ZHU Lei, YU Xiaoli, DONG Yan, GUO Lei

2023, 43(12):  1905-1910.  doi:10.16352/j.issn.1001-6325.2023.12.1905

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Objective To explore the effectiveness of a refined three-scene medication simulation teaching in nursing pharmacology course for nursing undergraduates. Methods Undergraduates of four-year curriculum in School of Nursing, Peking Union Medical College enrolled in 2020 and 2021 were selected as objects in control group and experimental group, respectively. Students in control group learned medication knowledge in a patient case simulation scene, while a refined three-scene medication process (before, during and after medication) simulation was applied in experimental group. The learning outcome was evaluated in forms of both test of key knowledge points and a questionnaire survey at the end of the semester. Results The scores of nursing pharmacology in experimental group were significantly higher than in control group (P＜0.001). The rates of right answer for knowledge associated with the refined class in experimental group were also significantly higher than in control group (P＜0.001). However, for knowledge that has not been adjusted for instructional design, there is no significant difference in answer accuracy between two groups. The survey by questionnaire showed that the students believed the three-scene medication simulation as good learning method and may support to strengthen professional quality of clinical performance. Conclusions Compared with the unrefined simulation class, the three-scene (before, during and after medication) class further simulated the real work flow, connected the knowledge points more reasonably, and enhanced the knowledge mastery and professional responsibility awareness.