Table of Content

05 April 2024, Volume 44 Issue 4

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Special Issues:Nutrition in Pregnancy

Nutrition research and clinical practice in pregnancy

LIU Yanping

2024, 44(4):  421-421.  doi:10.16352/j.issn.1001-6325.2024.04.0421

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Zinc deficiency during pregnancy and its effect on pregnancy outcome

LI Yunlong, LI Rui, ZHANG Yuping, WANG Rui, LIU Yanping

2024, 44(4):  422-427.  doi:10.16352/j.issn.1001-6325.2024.04.0422

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Zinc deficiency during pregnancy is common and has been significantly associated with adverse pregnancy outcomes such as spontaneous preterm birth(PTB), recurrent abortion(RA), low birth weight(LBW), small-for-gestational-age infant(SGA), preeclampsia(PE), and gestational diabetes mellitus(GDM). Unfortunately, there is no specific biomarkers which are sensitive, easy-to-collect and detect available for the clinical evaluation of zinc nutritional status. However, recent studies have identified metallothionein and the ratio of oleic acid to dihydroxymethyl gamma-linolenic acid(LA/DGLA) as potentially candidates of biomarkers.This article focuses on summarizing and discussing the progress of domestic and international researches on zinc deficiency during pregnancy and adverse pregnancy outcomes, potential zinc biomarkers, and zinc deficiency treatments, aiming at providing ideas for perinatal nutritional guidance.

Research progress of strontium and pregnancy and pregnancy diseases

WANG Rui, LI Rui, LI Yunlong, ZHANG Yuping, YU Kang, LIU Yanping

2024, 44(4):  428-433.  doi:10.16352/j.issn.1001-6325.2024.04.0428

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Strontium(Sr) is a trace element naturally found in the human skeletal system. In recent years, the potential impact of strontium on bone and cardiovascular health has called significant attention, particularly during pregnancy, when alterations in mineral metabolism may affect the health of both the mother and the fetus. This comprehensive review assesses the current understanding of the role of strontium as a nutritional substance during pregnancy, its effects on maternal health and fetal development, and its potential associations with pregnancy complications such as preeclampsia, gestational hypertension, and lactation-induced osteoporosis. The review also summarizes the possible effects of strontium deficiency, excess, and supplementation, and provides information for developing prenatal nutrition supplementation guideline.

Effect of comprehensive nutrition management on blood glucose and pregnancy outcome of individuals with gestational diabetes mellitus

WANG Rui, QI Mingming, YANG Weitao, HUANG Jian, XIAO Jinyan, LI Yichun, WANG Yonghong, LIU Yanping

2024, 44(4):  434-439.  doi:10.16352/j.issn.1001-6325.2024.04.0434

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Objective To investigate the effects of comprehensive nutrition management on glycolipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus(GDM). Methods A total of 121 pregnant women with GDM at 24-28 weeks gestation who were registered in the obstetrics department of 6 sub-central hospitals in China from May 2021 to July 2021 were included in this study and were randomly divided into intervention group(n=74) and control group(n=47). The intervention group received intensive comprehensive nutrition management, including at least 6 outpatient interventions, individualized nutrition management and a half-day standardized outpatient education on gestational diabetes mellitus, continuous dynamic blood glucose monitoring and micro-blood glucose monitoring,and routine check of glycated albumin and urine every 4 weeks. Body weight, body composition and diet and exercise implementation procedures and fetal development as well as complications were recorded. The control group received conventional nutritional guidance. The two groups were compared for difference in blood glucose related indicators at 37 weeks of gestation, weight gain before delivery, some lipid metabolism indicators, pregnancy outcomes, and oral glucose tolerance test(OGTT) at 42 days postpartum. Results Compared with the control group, the level of prenatal fasting blood glucose(P=0.006), intravenous plasma glucose(P=0.009) and blood ketone(P=0.044) in the intervention group was significantly reduced. There was no significant difference in weight gain and weight attainment rate between the two groups. The 2-hour postpartum OGTTs of pregnant women in the intervention group(P=0.006) were significantly lower than those in the control group, and the incidence of preeclampsia and postpartum blood loss were lower than those in the control group but no statistical difference was found. For newborns, the incidence of macrosomia(P=0.042) and planation(P=0.048) in the intervention group was slightly lower than that in the control group, and the results were statistically different. Other adverse pregnancy outcomes were not statistically different between the two groups. Conclusions Intensive comprehensive nutrition management has a positive impact on the control of the blood glucose in pregnant women and improves the maternal and neonatal outcomes of women with GDM.

Original Articles

Effect of carboxyamidotriazole-orotate on proliferation and fatty acid anabolism of human pancreatic cancer cell lines

GUO Hongjiang, XU Yeting, ZHANG Diya, QIU Jiaxing, WANG Yucheng, JU Rui, GUO Lei

2024, 44(4):  440-446.  doi:10.16352/j.issn.1001-6325.2024.04.0440

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Objective To study the effect of carboxyamidotriazole-orotate(CTO) on the proliferation and fatty acid anabolism regulation of human pancreatic cancer cells. Methods Human pancreatic cancer cell lines AsPC-1, AsPC-1/GEM(AR), PANC-1 and MiaPaCa-2 were used as the study subjects; cell survival rate was detected by sulfonylrhodamine B(SRB); the mRNA level of key genes for fatty acid synthesis was detected by qPCR; the protein level of the AMPK/ACC pathway was detected by Western blot; intracellular lipid metabolites were examined by liquid chromatography-mass spectrometry(LC-MS). Results Comparing to control group, CTO significantly decreased the cell viability of AsPC-1, AR, PANC-1, and MiaPaCa-2(P＜0.05). CTO down-regulated the mRNA level of key fatty acid synthesis genes(P＜0.05). CTO significantly reduced the protein expression of AMPK, ACC and c-Myc(P＜0.05), while increasing the protein expression of p-AMPK and p-ACC(P＜0.05). CTO decreased lipid metabolite content in AR cells(P＜0.05). Conclusions CTO attenuates cellular fatty acid anabolism by inhibition of oncogene c-Myc expression and AMPK/ACC pathway, down-regulates the expression of fatty acid synthesis-related genes, and then inhibits proliferation of the human pancreatic cancer cell lines AsPC-1, AR, PANC-1 and MiaPaCa-2.

lncRNA VIM-AS5 expression and its effect on proliferation and migration of human breast cancer cell lines

LU Kai, LU Jianju, GUO Wenli, HUANG Jianqi, LI Zhihua

2024, 44(4):  447-453.  doi:10.16352/j.issn.1001-6325.2024.04.0447

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Objective To explore the clinical significance of long non-coding RNA(lncRNA) VIM-AS5 expression in human breast cancer tissues and its regulatory mechanism involved in cancer cell proliferation and migration. Methods The Lnc2Cancer 3.0 database was used to analyze the expression of VIM-AS5 in breast cancer tissues and its correlation with the clinical stage and survival time of breast cancer patients. RT-qPCR was used to detect the expression of VIM-AS5 in breast cancer cell lines BT-549, MDA-MB-435, MDA-MB-231 and CAL-51. Plasmid with VIM-AS5 overexpression and negative control were all transfected into CAL-51 cells through liposome recorded as VIM-AS5 group and NC group, respectively. The proliferation and migration of CAL-51 cells were detected by colony formation assay and scratch healing method, respectively. Dual-luciferase reporter gene experiment verified the targeting relationship between VIM-AS5 and miR-500a. RT-qPCR was used to detect the expression of miR-500a in CAL-51 cells. Western blot was used to detect the expression of JAK/STAT3 pathway in CAL-51 cells. Results The expression of VIM-AS5 in breast cancer tissues was significantly lower than that in adjacent tissues(P＜0.01). VIM-AS5 expression was negatively correlated with the clinical stage of breast cancer patients(P＜0.01). The survival time of breast cancer patients with low VIM-AS5 expression was significantly shorter than that of breast cancer patients with high VIM-AS5 expression(P＜0.01). Compared with mammary epithelial cell line MCF-10A cells, VIM-AS5 expression was significantly reduced in breast cancer cells(P＜0.01). The counting number of colony formed in the VIM-AS5 group was significantly lower than that in the NC group(P＜0.01). The cell migration rate in the VIM-AS5 group was significantly lower than that in the NC group(P＜0.01). Dual-luciferase reporter gene experiment confirmed that miR-500a was the target gene of VIM-AS5(P＜0.01). VIM-AS5 can negatively regulate the expression of miR-500a(P＜0.01). Compared with the NC group, the expression of JAK/STAT3 pathway proteins JAK, p-STAT3, c-Myc, Bcl-2, and CDK3 in CAL-51 cells of the VIM-AS5 group were significantly decreased. Conclusions VIM-AS5 is low-expressed in breast cancer cells, and up-regulation of VIM-AS5 may inhibit the proliferation and migration of breast cancer cells CAL-51 by targeting at miR-500a/JAK/STAT3 pathway.

The epidemiology and prediction of brain tumors incidence and mortality in China

LEI Shaoyuan, LI Yulong, SUN Fei, LIU Hongjun, WU Yue, GUO Yansu

2024, 44(4):  454-458.  doi:10.16352/j.issn.1001-6325.2024.04.0454

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Objective To describe the incidence and mortality of brain tumors in China in 2020 and to predict the disease burden up to 2040. Methods The brain tumor incidence and mortality in 2020 were recorded based on the data from International Agency for Cancer Research(IARC), Cancer Today database. The incidence and mortality were standardized by age using Segi's world standard population. The burden of brain tumors in 2040 was predicted with assuming that national rates remained constant in 2020. Results It was estimated there were approximately 79 600 new brain tumors cases and 65 200 deaths in China in 2020. The age-standardized incidence and mortality rates of brain tumors in China were 4.1/100 000 and 3.2/100 000, respectively, which were lower than the United States of America, most of European countries and Australia. The incidence and mortality were higher than Africa, central America, and the Caribbean. From 2020 to 2040, the brain tumors cases and deaths are predicted to have an increase as 32.1% and 41.5% respectively. Conclusions The disease burden of brain tumors was still heavy in China. Further studies are urgently needed to clarify the epidemic trend of tissue typing and risk factors of brain tumors, which may support the development of effective prevention strategies.

Midazolam alleviates neuronal damage induced by oxygen glucose deprivation/restoration in mice

CHEN Tao, CHEN Lingjun, LI Yuan

2024, 44(4):  459-466.  doi:10.16352/j.issn.1001-6325.2024.04.0459

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Objective To investigate the impact of midazolam on neuronal injury induced by oxygen glucose deprivation/reoxygenation(OGD/R) in mice. Methods An injury model of neuronal cell line HT22 was established by OGD/R induction. HT22 cells were divided into OGD/R group, low-dose group, medium-dose group and high-dose group, midazolam+KG-501(CREB inhibitor)group and control group. ELISA was applied to detect TNF-α and IL-6 levels; Commercialy available reagent kits were applied to detect superoxide dismutase(SOD), catalase(CAT), and malondialdehyde(MDA) levels; MTT and Edu experiments were applied to detect cell proliferation; flow cytometry was applied to detect cell apoptosis rate; RT-qPCR method was applied to detect the expression levels of CREB mRNA and PGC-1α mRNA; Western blot was applied to detect the expression levels of Ki-67, Bcl-2, Bax, CREB, and PGC-1α proteins. Results Compared with the control group, the A₄₉₀ value(24, 48 hours), proliferation rate, SOD and CAT activity, CREB mRNA and PGC-1α mRNA expression, Ki-67, Bcl-2, CREB, and PGC-1α protein level in the OGD/R group were all significantly reduced(P＜0.05); The apoptosis rate, TNF-α, IL-6, MDA, and Bax protein expression were significanty increased(P＜0.05). Compared with the OGD/R group, the A₄₉₀ values(24, 48 hours), proliferation rate, SOD, CAT activity, CREB mRNA and PGC-1α mRNA expression, and Ki-67, Bcl-2, CREB, and PGC-1α protein expression were significantly increased in low, medium, and high dose midazolam groups;The apoptosis rate, TNF-α, IL-6, MDA, and Bax protein expression were obviously reduced(P＜0.05). Compared with the high-dose midazolam group, A₄₉₀ value(24, 48 hours), proliferation rate, activity of SOD and CAT, CREB mRNA and PGC-1α mRNA expression as well as Ki-67, Bcl-2, CREB, and PGC-1α protein expression were all significantlu reduced in the high-dose midazolam+KG-501 group while the apoptosis rate, TNF-α, IL-6, MDA, and Bax protein expression were obviously increased(P＜0.05). Conclusions Midazolam might alleviate nerve cell injury potentially through the mechaninsms of promoting OGD/R-induced proliferation and reducing cell apoptosis in HT22 cells.

Effect of sorafenib induced apoptosis and autophagy on drug resistance in HeLa cells

YANG Kaifei, ZHU Jingge, ZHANG Yangyang, ZHAO Junguo, GAO Yuyue, HU Huanhuan, JI Guojie

2024, 44(4):  467-473.  doi:10.16352/j.issn.1001-6325.2024.04.0467

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Objective To explore the effect of sorafenib on HeLa cell proliferation by inducing cell apoptosis and autophagy and its impact on drug resistance. Methods The drug-resistant cell strains were constructed through intermittent induction method, with concentrations of 0, 2.5, 5.0, 7.5, 10.0, 15.0, 20.0 μmol/L. HeLa cells were incubated with increasing concentrations of sorafenib with each concentration for 1 week. The drug-resistant cell strains with stable passages were collected. MTT assay was used to detect the effect of sorafenib on cell proliferation. Cell cycle distribution was analyzed by flow cytometry. The change in the expression of drug-resistant and apoptotic genes in the parents and drug-resistant cell strains under different drug concentrations was examined by semi-quantitative PCR. The changes of apoptotic related marker proteins LC3-Ⅰ and LC3-Ⅱ were detected by Westernblot. Results Stable drug-resistant strains were successfully obtained; Drug-treated cells were more blocked in the G1 phase. In drug-resistant cells, the expression of apoptosis suppressor gene Bcl-2 was significantly decreased and the apoptotic gene Bax as well as the drug-resistant genes were all significantly increased(P＜0.05). The LC3-Ⅱ/LC3-Ⅰ ratio of drug-resistant cells was significantly higher than that of parent cells(P＜0.05). Conclusions Sorafenib may block the cell cycle, suppress malignant cell proliferation and promote autophage. On one hand, autophagy participates in the development of cell drug resistance and promotes cell survival. On the other hand, drug-induced autophagy may activate some of apoptotic signaling pathway in drug-resistant cells and promote the reversal of cell drug resistance.

Chitosan oligosaccharides alleviates the formation of atherosclerotic plaque through up-regulating core-fucosylation of SRBI in mice

CHEN Linmu, HUANG Yunxiu

2024, 44(4):  474-482.  doi:10.16352/j.issn.1001-6325.2024.04.0474

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Objective To explore the mechanism of chitosan oligosaccharides(COS) in reducing atherosclerotic plaque formation from the perspective of protein glycosylation modification. Methods Totally 40 ApoE^-/- mice were randomly divided into control group and COS group. The control group was given a high-fat diet for 12 weeks, and COS group was given a high-fat diet plus COS(gavage per day, 500 mg/kg) for 12 weeks. Serum lipid detection, HE staining and Oil red O staining were used to detect plaque formation. Lectin chip, liquid chromatography tandem-mass spectrometry and ELISA were used to detect potential changes of glycoprotein in serum. Cholesterol ester outflow and free cholesterol ester determination experiment were used to evaluate the effect of changes in scavenger receptor class B type Ⅰ(SRBI) protein glycosylation modification site on cholesterol effluence in macrophages. Results COS significantly reduced the level of TC and LDL-C(P＜0.05) in mice, but had no effect on the level of TG,HDL-C,ApoA1 and ApoB100. The intima thickness and plaque size of the aorta were significantly thinner and smaller(P＜0.05)in the COS group compared with the control group. The molecular weight of lens culinaris agglutinin(LCA)binding protein with the most obvious change is 80-90 ku, and SRBI was one of them. COS promoted the cholesterol outflow and inhibited the accumulation of free cholesterol ester in RAW264.7 cell(P＜0.05). Knockdown or glycosylation site mutation with SRBI inhibited cholesterol outflow caused by COS, and increased the accumulation of intracellular free cholesterol(P＜0.05). Conclusions COS promotes lipid efflux by increasing SRBI glycosylation and expression, thereby alleviating atherosclerotic plaque formation.

Honokiol inhibits the proliferation of human adipose-derived mesenchymal stem cells

LI Na, LI Tao, YANG Dongli, YAO Yuan

2024, 44(4):  483-488.  doi:10.16352/j.issn.1001-6325.2024.04.0483

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Objective To investigate the effects of honokiol on proliferation and apoptosis of human adipose-derived mesenchymal stem cells(hADSCs), and to investigate the effect of the drug on the tumor microenvironment. Methods hADSCs were incubated with different concentrations of honokiol, the proliferation of hADSCs was detected by MTS and Trypan blue staining, and cell apoptosis was assessed by annexin V/PI double staining. In the meantime, expression of mRNA and protein related to cell proliferation and apoptosis were detected by qPCR and Western blot, respectively. The expression of total MEK, phosphorylated MEK, total ERK and phosphorylated ERK proteins in the MEK-ERK1/2 signaling pathway were detected by Western blot. Results The effect of honokiol on inhibiting proliferation and promoting apoptosis of hADSCs was significantly enhanced with the increase of concentration. The expressions of proliferation-related genes CCND1, MKI67 and PCNA were down-regulated. The expressions of pro-apoptotic genes BAX and TP53 was up-regulated, and the expressions of anti-apoptotic gene BCL2 was down-regulated. Honokiol inhibited MEK and ERK1/2 phosphorylation in a concentration-dependent manner. Conclusions Honokiol inhibits proliferation and promotes apoptosis of hADSCs, and the specific mechanism is potentially related to the inhibition of MEK-ERK1/2 pathway.

Therapeutic effect of pachymic acid on Helicobacter pylori-associated gastritis in rats by regulating the PI3K/AKT/NF-κB signaling pathway

XU Lu, ZHANG Dongyu, WANG Ruifeng

2024, 44(4):  489-495.  doi:10.16352/j.issn.1001-6325.2024.04.0489

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Objective To explore the therapeutic effect and mechanism of pachymic acid(PA) on Helicobacter pylori(Hp)-associated gastritis in rats. Methods A rat model of Hp-associated gastritis was established; all rats were separated into control group(CT group), model group(group M), PA low-dose group(PA L group), PA high-dose group(PA H group), and PA H+phosphatidylinositol 3-kinase(PI3K) activator(740 Y-P) group; the gastric mucosal injury index(UI) of rats in each group was evaluated, transmission electron microscopy was applied to observe the morphology of gastric mucosal cells. HE staining was applied to evaluate the pathological characteristics of gastric mucosa. ELISA was applied to detect the levels of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), IL-10, inducible nitric oxide synthase(iNOS), and superoxide dismutase(SOD) in gastric tissue. Western blot method was applied to detect the expression of PI3K, phosphorylated PI3K(p-PI3K), protein kinase B(AKT), p-AKT, nuclear factor(NF)-κB p65, and p-NF-κB p65 proteins. Results Compared with the CT group, the gastric mucosa erosion, epithelial edema, congestion, and severe ulcers were observed in the group M, with epithelial cell pyknosis and inflammatory cell infiltration, the UI, IL-6, TNF-α, iNOS, and the expression levels of p-PI3K/PI3K, p-AKT/AKT, p-NF-κB p65/NF-κB p65 proteins increased, the levels of IL-10 and SOD decreased(P＜0.05); compared with group M, the gastric mucosal damage and inflammatory cell infiltration in the PA L and PA H groups were improved, the UI, IL-6, TNF-α, iNOS by the host animal and the expression of p-PI3K/PI3K, p-AKT/AKT, p-NF-κB p65/NF-κB p65 proteins all decreased, the level of IL-10 and SOD was increased(P＜0.05); compared with the PA H group, the pathological damage of the gastric mucosa in the PA H+740 Y-P group was aggravated, with epithelial cell pyknosis. The UI, IL-6, TNF-α, iNOS, and the expression of p-PI3K/PI3K, p-AKT/AKT, p-NF-κB p65/NF-κB p65 proteins increased, the levels of IL-10 and SOD decreased(P＜0.05). Conclusions PA might facilitate the treatment of Hp-associated gastritis in rats by inhibiting the PI3K/AKT/NF-κB signaling pathway.

Effects of biological clock gene Bmal1 on the expression of cell cycle-associated genes in chondrocytes

YANG Chunsheng, WANG Tianxing, ZHANG Tiecheng, WU Hengmin, WANG Baolan

2024, 44(4):  496-502.  doi:10.16352/j.issn.1001-6325.2024.04.0496

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Objective To explore the intrinsic relationship between circadian clock and cell cycle in osteoarthritis(OA) chondrocytes, especially the regulation of cell cycle-related genes by the clock gene Bmal1. Methods The chondroid ATDC5 cells induced by insulin-transfering-selenium(ITS) were divided into control group, OA group and LV-Bmal1 group. The cell viability of each group was detected by CCK8 method. The expression of Bmal1, Per1, Wee1, Cdk1, Ccnb1 and Mmp13 mRNA in each group was detected by RT-qPCR. The expression of BMAL1, PER1, WEE1, CDK1, CCNB1 and MMP13 protein in each group was detected by Western blot. The effects of Bmal1 on different stages of cell cycle and apoptosis was analyzed by flow cytometry. The regulation of Bmal1 on Per1, Wee1, Cdk1, Ccnb1 and Mmp13 and their roles in OA were analyzed. Results Compared with the normal group, the cell viability of the OA group was increased, the relative mRNA expression of Bmal1 and Wee1 in the OA group decreased, and the relative mRNA expression of Per1, Cdk1, Ccnb1 and Mmp13 increased significantly. The cell viability of LV-Bmal1 group decreased, the relative expression of Bmal1 and Wee1 mRNA increased, and the relative expression of Per1, Cdk1, Ccnb1 and Mmp13 mRNA decreased(P＜0.05). Correlation analysis showed that Bmal1 was positively correlated with Wee1 and they were negatively correlated with Per1, Cdk1, Ccnb1 or Mmp13. The results of Western blot showed that protein expression in different groups were consistent with the trend of PCR. The results of cell cycle and apoptosis showed that compared with the normal group, the S phase and G2/M phase of the OA group were shortened, the proportion of cells decreased significantly, and the proportion of early and late apoptosis increased. The S phase and G2/M phase of the LV-Bmal1 group were prolonged, the proportion of cells was increased, and the proportion of early and late apoptosis was decreased. Conclusions Circadian clock gene Bmal1 in inflammatory chondrocytes might regulate the expression of cell cycle-related genes.

Anlotinib inhibits proliferation and promotes apoptosis of human non-small cell lung cancer cell lines through miR-16-5p/PD-1 axis

LIANG Xiangcun, WEI Xiaoyu, LIANG Jian, WANG Qing, GENG Guang

2024, 44(4):  503-512.  doi:10.16352/j.issn.1001-6325.2024.04.0503

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Objective To investigate the effect of Anlotinib on proliferation and apoptosis in non-small cell lung cancer(NSCLC) cells and its molecular mechanism. Methods Non-small cell lung cancer cell lines A549 and H1299 were incubated with Anlotinib, miR-16-5p agonist and/or PD-1 overexpression vector respectively. CCK-8 assay and EDU assay were applied to detect the proliferation. Flow cytometry was performed to detect the cell apoptosis. The relative expression of miR-16-5 p in A549 and H1299 was detected by real-time quantitative polymerase chain reaction(RT-qPCR). The relative protein expression of PD-1 in A549 and H1299 was detected by Western blot assay. The interaction between miR-16-5p and PD-1 was determined by dual luciferase reporter assay. Finally, A549 cell xenograft model was established to assess the effect of Anlotinib on tumor growth in vivo. Results Anlotinib significantly increased miR-16-5p expression and decreased PD-1 expression in A549 cells and H1299 cells, inhibited cell proliferation and promoted apoptosis in a dose-dependent manner(P＜0.05). The highly-expressed miR-16-5p inhibited proliferation and promoted cell apoptosis(P＜0.05). Also, miR-16-5p targeted at PD-1 and negatively regulated PD-1 expression. Knockdown of PD-1 inhibited proliferation and promoted cell apoptosis(P＜0.05). PD-1 over-expression reversed the Anlotinib-mediated pro-proliferation and anti-apoptosis of miR-16-5p in A549 cells and H1299 cells(P＜0.05). Anlotinib significantly reduced tumor growth in vivo(P＜0.05). Conclusions Anlotinib may inhibit cell proliferation, anti-apoptosis, and reduce tumor growth for NSCLC, which is involved in miR-16-5p/PD-1 axis.

Analysis of micronutrient elements in female patients with diffuse hair loss

WANG Lei, WU Jinjin

2024, 44(4):  513-517.  doi:10.16352/j.issn.1001-6325.2024.04.0513

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Objective To analyze micronutrient levels in three types of female patients with diffuse hair loss. Methods The clinical data of 299 female patients with diffuse alopecia from January 2018 to June 2021 in the Department of Dermatology of Daping Hospital were analyzed retrospectively. Results The level of serum 25-hydroxyvitamin D in patients with diffuse alopecia was significantly lower than that in the control group, and had no impact to the type of diffuse alopecia. The concentration of serum zinc in patients with diffuse alopecia areata was also significantly lower than that in the control group. When ferritin ≤50 ng/mol was taken as the threshold of iron deficiency and 25-hydroxyvitamin D≤20 ng/mol, as the indicator level of serum 25-hydroxyvitamin D deficiency, the proportion of serum 25-hydroxyvitamin D and serum ferritin deficiency in all the three types of diffuse hair loss patients was higher than that in the control group(P＜0.05). So, lack of iron and serum 25-hydroxyvitamin D were belived to be related to the occurrence of diffuse alopecia of women. Conclusions Iron metabolism disorder and serum 25-hydroxyvitamin D level play a key role in female diffuse alopecia, while the effects of copper and zinc on hair growth and hair loss cycle are not well identified yet.

Safety and efficacy of linaclotide combined with polyethylene glycol for bowel preparation

LI Xinlei, CHEN Xi, ZHANG Haiyan, JIANG Na, ZHANG Shan, CI Xiangnan, LIU Xishuang

2024, 44(4):  518-522.  doi:10.16352/j.issn.1001-6325.2024.04.0518

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Objective To evaluate safety and efficacy of linaclotide combined with polyethylene glycol(PEG) for bowel preparation. Methods A total of 612 patients from Department of Gastroenterology at the Affiliated Hospital of Qingdao University for colonoscopy examination from January to June 2023 were selected. They were divided into group 1(1 L PEG+2 L PEG), group 2(linaclotide+2 L PEG) and group 3(1 L PEG+linaclotide+1 L PEG) by random number table method, with 204 cases in each group. The Ottawa Bowel Preparation Quality Scale(OBPS), the insertion time of colonoscopy, the time of the first defecation, the frequency of defecations, the occurrence of adverse effects and patients' tolerability were compared among the three groups. Results A total of 601 patients completed bowel preparation and accepted colonoscopy. Group 1 exhibited no statistically significant differences to group 2 with regards to OBPS and insertion time. However, Group 2 demonstrated a shorter duration for the time of the first defecation in comparison to both group 1 and group 3(P＜0.05). Group 1 displayed a higher frequency of defecations as compared to Group 2 and Group 3(P＜0.05) . The incidence of adverse reactions was significantly lower in group 2 and group 3 than in group 1(P＜0.05). The overall tolerance score of patients in group 1 was lower than that in group 2 and group 3(P＜0.05). Conclusions The effect of combining 2 L PEG with 290 μg of linaclotide for bowel preparation before colonoscopy is similar to that of 3 L PEG. It can reduce the incidence of adverse reactions and patients exhibit good tolerance. For patients who are intolerant to a single high-dose administration of PEG, they need divided-dose regimen of 2 L PEG in combination with linaclotide.

Clinical Sciences

Analysis of cell mutation types of colorectal neuroendocrine tumors

WANG Tingting, GUO Dan, LU Junyang, XU Lai, DONG Haitao, LIN Dianxin, XIAO Yi

2024, 44(4):  523-527.  doi:10.16352/j.issn.1001-6325.2024.04.0523

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Objective To investigate the mutation types of colorectal neuroendocrine tumors(NETs) and better understand the pathogenesis of colorectal nets. Methods Patients undergoing colorectal NETs surgery were recruited, colorectal NETs and corresponding adjacent cancerous tissues were collected, and whole genome sequencing(WGS) was performed and further deeply analyzed. Results WGS sequencing showed that the mutation types of colorectal NETs included single nucleotide mutations, insertion and deletion mutations(InDel, less than 50 bp in length), copy number variations(CNV), and large structural variations(SV, more than 50 bp in length), such as insertion(INS), deletion(DEL), intra chromosomal translocation(ITX), inter chromosomal translocation(CTX) and inversion(INV). Conclusions A large number of somatic mutations occur in colorectal NETs, especially chromosome translocation

Expression levels and clinical significance of autophagy related proteins in placenta tissues of pregnant women with fetal growth restriction

ZHANG Yuling, ZHANG Ke, XU Ting, ZHANG Qing

2024, 44(4):  528-532.  doi:10.16352/j.issn.1001-6325.2024.04.0528

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Objective To explore the expression and clinical significance of autophagy related proteins Beclin-1, microtubule-associated protein 1 light chain 3(LC3) in placenta tissues of pregnant women with fetal growth restriction(FGR). Methods A total of 40 pregnant women undergoing delivery due to FGR and 40 pregnant women undergoing normal delivery in the Second Affiliated Hospital of Zhengzhou University were enrolled as FGR group and healthy group between August 2022 and August 2023. The general clinical data in the two groups were collected. The levels of Beclin-1 and LC3 mRNA in placenta tissues were detected by PCR, and expressions of Beclin-1 and LC3 proteins were detected by immunohistochemistry. The differences in positive of Beclin-1 and LC3 proteins among patients with different clinical data were analyzed. Results The placental thickness, placental mass and neonatal weight in FGR group were lower than those in healthy group(P＜0.05). The mRNA levels of Beclin-1 and LC3 in FGR group were higher than those in healthy group(P＜0.05) and positive expression rates of Beclin-1 and LC3 proteins were significantly higher than those in healthy group(P＜0.05). There was significant difference in positive expression profile of Beclin-1 and LC3 proteins among patients with different placental thickness, placental mass and neonatal weight(P＜0.05). Conclusions The positive expressions of autophagy genes(Beclin-1 and LC3) are related to FGR, and their specific expression levels are closely related to fetal growth and development.

Association of NSE level with clinical features in pheochromocytoma/paraganglioma

LI Tianyi, ZHANG Wenqian, CHEN Yinghan, ZHOU Yue, CUI Yunying, WANG Yu, TONG Anli

2024, 44(4):  533-538.  doi:10.16352/j.issn.1001-6325.2024.04.0533

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Objective To study the relationship between serum neuron-specific enolase(NSE) and clinical features of pheochromocytoma/paraganglioma(PPGL). Methods Totally 501 PPGL patients diagnosed from January 2019 to December 2022 were divided into normal NSE group(NSE≤16.3 ng/mL) and elevated NSE group(NSE>16.3 ng/mL). The clinical characteristics were compared between the two groups. Results Compared with normal NSE group, patients in the elevated NSE group had larger diameter in primary tumor(5.00 cm vs. 4.60 cm), higher 24-hour urinary norepinephrine(NE) and 24-hour urinary dopamine(DA) levels, and a higher rate of metastasis(31.6% vs. 13.7%)(P＜0.05). NSE level was positively correlated with the primary tumor size(r=0.131, P＜0.05),24-hour urinary NE level(r=0.195, P＜0.05) and 24-hour urinary DA level(r=0.119, P＜0.05). Conclusions The level of NSE is related to tumor size, secretion function and metastasis in PPGL patients.

Clinical efficacy of pyrimidolast potassium combined with praprofen in the treatment of allergic conjunctivitis

WEN Xiaoou

2024, 44(4):  539-543.  doi:10.16352/j.issn.1001-6325.2024.04.0539

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Objective To investigate the clinical effect of pyrimidolast potassium combined with praprofen eye drops in the treatment of allergic conjunctivitis(AC). Methods From March 2021 to March 2023, 186 patients with AC were selected from Beijing Gulou Hospital of Traditional Chinese Medicine.The patients were randomly assigned to a observation group and a control group with 93 in each. Pyrimidolast potassium eye drops (1-2 drops, b.i.d,) was given to both groups, and praprofen eye drops (1-2 drops, q.i.d) was given only to the observation group. Both groups of patients were treated for 14 days. Clinical symptoms, signs scores, tear film stability and corneal epithelium injury were compared between the two groups. Results After treatment,the total effective rate of observation group(93.54%) was higher than that of control group(80.65%). Symptom scores in observation group and control group were 0.19±0.66 and 0.70±0.69, respectively. The scores of physical signs were 0.09±0.51 and 0.42±0.40, respectively. Tear film stability was 10.81±2.58 and 9.39±1.87, respectively. The injury of corneal epithelium was 0.98±0.46 and 2.05±0.90, respectively, and the difference was statistically significant(P＜0.05). Conclusions Compared with the patients treated with pyriferast potassium eye drops only, the combined application of pralprofen eye drops can synergically enhance the efficacy of drugs, improve the symptoms and signs of patients, effectively repair corneal injury and stabilize tear film.

Mini Reviews

Research progress on the roles of angiopoietin-like protein 8 in the pathogenesis of cardiovascular diseases

HAN Lijie, HU Chaowei, YU Huahui, QIN Yanwen

2024, 44(4):  544-547.  doi:10.16352/j.issn.1001-6325.2024.04.0544

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Angiopoietin-like protein 8(ANGPTL8) secreted by liver and adipose tissue, is a glycoprotein exerting paramount effects on facilitation of vascular remodeling and regulation of inflammatory response; ANGPTL8 is involved in the initiation and progression of cardiovascular diseases including coronary artery disease, hypertension, aortic aneurysm and pathological cardiac hypertrophy, and holds promise for being a new target for the prevention and treatment of cardiovascular diseases.

Advances on reprogramming of fatty acid metabolism in pulmonary fibrosis

BAI Lu, WANG Jiaxin, WANG Xue, ZENG Wei, SONG Meiyue, ZHANG Tiantian, WANG Jing

2024, 44(4):  548-552.  doi:10.16352/j.issn.1001-6325.2024.04.0548

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Pulmonary fibrosis is a progressive interstitial fibrotic lung disease with high mortality. Its pathogenesis is complex and involves the reprogramming of fatty acid metabolism. This reprogramming includes changes in de novo fatty acid synthesis, uptake, oxidation, and derivatives. It crucially influences alveolar epithelial cell survival, macrophage polarization, and fibroblast activation, thereby playing a significant role in either exacerbating or mitigating the disease. Understanding and intervening in the reprogramming of fatty acid metabolism offers potential strategies for prevention, diagnosing and treatment of pulmonary fibrosis.

Research advances on the age-related macular degeneration

WEI Dandan, SONG Yuhan, WANG Qi, SU Shulan, ZHU Yue, DUAN Jin'ao

2024, 44(4):  553-557.  doi:10.16352/j.issn.1001-6325.2024.04.0553

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Age-related macular degeneration(AMD) is a serious threat to the visual health of the elderly, and the dysfunction of retinal pigment epithelial cells(RPE) is a significant etiology risk. Aging process leads to RPE replication senescence, and some environment factors like light exposure and cigarette exposure may lead to RPE stress premature aging, and the decreased lysosomal digestion ability of senescent RPE cells may lead to the accumulation of lipofuscin, triggering the occurrence of early AMD. A series of homeostatic imbalances in aging retina, such as cell senescence-renewal imbalance, oxidative stress-antioxidant imbalance, chronic inflammatory-anti-inflammatory imbalance, intestinal barrier and intestinal microbiota imbalance and pro-angiogenesis-antiangiogenic imbalance all contribute to the development of AMD.

Research progress on the role of Asprosin in germ cell development

XU Zhiqin, TAN Xiao

2024, 44(4):  558-561.  doi:10.16352/j.issn.1001-6325.2024.04.0558

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Asprosin is a protein-like hormone composed of 140 amino acids, which is mainly secreted by adipocytes. Polycystic ovary syndrome(PCOS) and asthenospermia are common causes of infertility. Asprosin promotes the production of estradiol in small granular cells induced by follicle stimulating hormone(FSH )and progesterone in small granular cells induced by insulin-like growth factor 1(IGF-1), which functions in the growth of ovarian follicles and ovulation of dominant follicles. Asprosin promotes the secretion of sex hormones and the production of nutrients, increasing the number, survival time and motility of sperms by acting on the hypothalamus and testicles. Asprosin is involved in regulation of follicle growth and spermatogenesis, so this finding may potentially support the development of new strategies for the treatment of infertility.

Research progress of metabolomics in the diagnosis and treatment of severe injuries

WEI Bin, DUAN Hongjie, CHAI Jiake

2024, 44(4):  562-567.  doi:10.16352/j.issn.1001-6325.2024.04.0562

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Metabolomics is a novel emerging technology recently applied in management of severe diseases and trauma, and has been widely used in gene analysis of disease metabolic disorders, clinical biomarker screening and disease diagnosis. This review comprehensively summarizes the latest research progress of the metabolomics in severe trauma and burns recently like traumatic brain injury(TBI), traumatic hemorrhagic shock, severe burns and so on. The paper elaborates the metabolomic technology which can quickly reflect the real-time metabolic changes of severely injured patients at different stages after injury, and uncovers new clinical biomarkers and potential drug targets of the patients with severe injuries thus improves the diagnosis and treatment strategies. Finally, we look forward to the current metabolomics research projects and tackling challenges on the burn-blast combined injuries, and the simultaneous development of multi-omics technology as well as artificial intelligence algorithms, which promotes the development of precision medicine.

Research progress on the role of the TMEM family of transmembrane proteins in the human reproductive system

YANG Liu, TIAN Hui, JI Yuanyuan, HAN Xiaofang

2024, 44(4):  568-571.  doi:10.16352/j.issn.1001-6325.2024.04.0568

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The transmembrane protein(TMEM) family exhibits widespread distribution across both the plasma membrane and organelle membranes, actively participating in the intricate regulation of diverse pathophysiological processes. Contemporary investigations have uncovered the pivotal involvement of the TMEM family in the human reproductive system. This family is found to play a crucial role in regulating spermatogenesis, sperm-egg fusion, endometrial receptivity, as well as tumor invasion and migration. These findings highlight its intricate association with the onset and progression of various diseases. A comprehensive identification of the function of TMEM family in human reproductive system holds significant importance, offering profound insights into the nuanced biological functions of this protein family. This in-depth examination not only supports our understanding about the complex mechanisms controlling reproductive processes but also lay a foundation for potential advancements in medical research.

Medical Education

Effect of ultrasound scanning route map on the learning effectiveness of cervical ultrasound for beginners

CHEN Si, ZHANG Jiao, ZHANG Yuelun, CUI Xulei, TAN Gang

2024, 44(4):  572-576.  doi:10.16352/j.issn.1001-6325.2024.04.0572

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Objective Using our team's recent research achievement “the cervical ultrasound scanning route map” as a teaching tool, to evaluate its impact on the learning effectiveness and confidence of beginners in the process of learning cervical spinal ultrasonography. Methods This study is a before and after self-control study. After recruitment of 40 cervical ultrasound beginners, they had completed questionnaire 1. The questionnaire was designed with three self-assessment questions on theoretical knowledge of cervical spinal ultrasound, three self-assessment questions on practical skills of cervical spinal ultrasound and one question on willingness to use cervical spinal ultrasound in the future. After traditional teaching without involving the route map, beginners completed questionnaire 2 with the same content. After a 20 min break, teacher introduced and explained the route map to the beginners, then the beginners completed questionnaire 3. Questions related to satisfaction with this learning experience had been added to questionnaire 3. The answers to all questions were scored on a scale of 1-10. In this study, the main outcome was the comprehensive learning score, calculated as(sum score of theoretical knowledge + sum score of practical skills + score of willingness to use cervical ultrasound in the future)/7. Results Beginners'comprehensive learning score at the three time points were 2.9±1.3, 4.8±1.8, 5.7±1.8,F(2,22)=52.11,P＜0.001,partial Eta squared=0.83. After introducing the route map, their comprehensive learning score increased 1.0(95% CI:0.46-1.49)(P＜0.001) compared to scores after traditional training. Conclusions The route map may significantly improve learning effectiveness and confidence of beginners in the field of cervical spinal ultrasonography and can be used as a routine training tool in the teaching of cervical spinal ultrasonography.

Application and evaluation of diversified teaching mode in clinical teaching for medical students

LI Ran, SONG An, WANG Linjie, DUAN Lian, ZHU Huijuan, LI Mei, XIA Weibo

2024, 44(4):  577-581.  doi:10.16352/j.issn.1001-6325.2024.04.0577

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Objective To investigate the needs and feedback from clinical medical students on the diversified teaching mode adopted by the Department of Endocrinology in Peking Union Medical College Hospital. Methods Questionnaires were distributed to the medicine students who were in clinical rotation in Peking Union Medical College, and the teaching status and teaching effect was investigated. Results A total of 95 valid questionnaires were received. The attending physicians and the teaching resident physicians performed well in the daily teaching activities. The medical students believed that outpatient training was necessary in addition to ward rotations. After the rotation in the endocrinology department, the self-evaluated score of mastery of endocrinology knowledge had been significantly improved, especially in those who rotated in outpatient clinic, suggesting that outpatient teaching was of great significance. In addition, the establishment of a self-learning platform including clinical cases and videos in endocrinology could be used as an important supplementary means for clinical teaching. Conclusions Outpatient training improves learning outcomes of medical students, so must be kept and further strengthened in the future. Building a database of typical clinical cases and teaching videos can improve the training quality.

Significance and role of apprenticeship education in Traditional Chinese Medicine curriculum of western medical institutions

YANG Dan, YU Ziman, LIU Yi, SHI Xiaohu, JIANG Lan, ZHANG Yamin, JING Guangchan, WU Qunli

2024, 44(4):  582-584.  doi:10.16352/j.issn.1001-6325.2024.04.0582

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The apprenticeship education of Traditional Chinese medicine(TCM) is an important pathway for the cultivation of talents in TCM education. The combination of institutional education and apprenticeship education is considered to be the most suitable educational model that aligns with the inherent characteristics of TCM education. The current status of TCM education in western medical institutions and the main challenges include the difficulty in transitioning between western and Chinese medical reasoning and limited clinical internship hours for TCM. The strengths and features of TCM apprenticeship education lie in cultural heritage, classical teachings, mentorship, practice orientation and personalized education. Therefore, integration of TCM apprenticeship education and clinical internships for western medical students represents a new educational model for medical undergraduates.