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25 September 2023, Volume 44 Issue 9

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Invited Monographs

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Effects of recombinant human growth hormone on palmitic acid induced lipid deposition in HepG2 cells

Fang ZHANG, Liyuan RAN, Jinjin ZHANG, Yingjie WU

2023, 44(9): 641-646. DOI: 10.3969/j.issn.2097-0005.2023.09.001

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ObjectiveTo explore the effect of recombinant human growth hormone （rhGH） on the lipid metabolism of fatty liver cell model induced in vitro， and to provide theoretical support for further expanding the application of rhGH in clinical practice.MethodsPalmitic acid （PA） was combined to induce lipid accumulation in HepG2 cells， and a fatty liver cell model was constructed. The cell model was treated with different concentrations of rhGH， and CCK8 assay was used to detect the effects of different concentrations of PA and rhGH on the survival of HepG2 cells. The lipid accumulation level in HepG2 cells was evaluated by oil red O staining， the expression levels of genes and proteins related to lipid metabolism in HepG2 cell lines were evaluated by RT-qPCR and Western blot， and the mechanism of action of rhGH was preliminarily explored.ResultsIn this study， 0.2 mmol/L PA successfully induced a fatty liver cell model， which showed significant accumulation of lipid droplets in the cytoplasm. After being stimulated by rhGH， the accumulation of intracellular lipid droplets decreased with the increase of rhGH concentration， and the rhGH concentration of 40 ng/mL achieved a significant lipid-lowering effect. The results of RT-qPCR and Western blot showed that the expression of genes and proteins related to lipid synthesis in cells were significantly down-regulated after rhGH treatment， while the expressions of genes and proteins related to lipolysis had no significant changes.ConclusionrhGH can alleviate the lipid deposition in HepG2 cells induced by PA by inhibiting the de novo fatty acid synthesis pathway.

Basic Researches

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Bioactive secondary metabolites of rhizosphere fungiPenicilliumsp. XYR-9 ofCynanchum bungeiDecne

Fujin LV, Daqing KONG, Jingzhi QU, Xijin LIU, Xiaoyu LI, Guojun PAN

2023, 44(9): 647-651. DOI: 10.3969/j.issn.2097-0005.2023.09.002

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ObjectiveTo study a new natural product with good antibacterial activity from the rhizosphere fungiPenicilliumsp. XYR-9 ofCynanchum bungei Decneand provide a theoretical guidance and a material basis for the discovery of novel antibacterial lead compounds with high efficiency and low toxicity.MethodsOn the basis of optimizing the fermentation conditions， rice culture medium was used as the optimal fermentation scheme to enrich the secondary metabolites， further isolated and purified by activity-oriented and the monomer compounds were confirmed by nuclear magnetic resonance and mass spectrometry methods.ResultsFive indole diterpenoids were isolated， identified， and tested for antibacterial activity. The antimicrobial activity of compounds 1， 3 and 5 was tested， and the results showed that the MIC values of compounds 1， 3 and 5 against the standard strains ofS.aureusATCC33591 were 95.70， 106.40 and 118.65 mg·L^-1respectively， and 54.12， 43.54 and 42.74 mg·L^-1against the standard strains ofE.coliATCC25922.ConclusionThe five indole terpenes obtained fromPenicilliumsp. XYR-9 secondary metabolite， antimicrobial activity tests indicate that these compounds have weak antibacterial activity against bacteria.

Clinical Researches

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Comparative analysis of the predictive value of quick Pitt bacteremia score and early clinical failure criteria in secondary bloodstream infection caused by urinary tract infection

Changxiu LI, Jing WANG, Heqin DANG, Jin LI, Beibei LIU, Dapeng HOU

2023, 44(9): 652-658. DOI: 10.3969/j.issn.2097-0005.2023.09.003

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ObjectiveTo compare the predictive value of qpitt score and ECFC in the prognosis and death of patients with secondary bloodstream infection caused by urinary tract infection.MethodsThe medical record data of patients aged ≥ 18 years with secondary bloodstream infection caused by urinary tract infection treated in our hospital from January 2018 to December 2020 were collected retrospectively. ROC curve was used to evaluate the predictive efficacy of qPitt score and ECFC for poor prognosis and death.ResultsA total of 266 patients， 116 males and 150 females， aged from 27 to 91 years， with an average age of （63.92 ± 14.52） years， were included. The pathogens of blood culture accounted for 77.44% of Gram-negative bacteria， 19.55% of Gram-positive bacteria and 3.01% of fungi. ECFC had good predictive value for death and poor prognosis （the areas under ROC curve were 0.964 and 0.772， respectively，P< 0.001）. The value of qpitt score in predicting death and poor prognosis was ordinary （the areas under ROC curve were 0.890 and 0.648， respectively，P< 0.001）. The results of consistency test showed that ECFC ≥ 2 had good predictive value for poor prognosis and death （Kappa values were 0.503 and 0.580， respectively）. For patients with qpitt ≥ 2 and ECFC ≥ 2， the mortality of carbapenem antibiotics used at 72-96 hours after admission was significantly reduced （χ²= 6.769，P= 0.014）.ConclusionFor patients with secondary bloodstream infection caused by urinary tract infection， ECFC is better than qPitt score in predicting death and adverse prognosis. ECFC ≥ 2 as a critical value has some guiding significance in predicting death.

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Efficacy and safety of TCH neoadjuvant chemotherapy in Chinese patients with HER2 positive breast cancer： a Meta-analysis

Yihao ZHAO, Dongbin ZHANG

2023, 44(9): 659-664. DOI: 10.3969/j.issn.2097-0005.2023.09.004

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ObjectiveTo systematically evaluate the efficacy and safety of docetaxel combined with carboplatin and trastuzumab （TCH） neoadjuvant chemotherapy in Chinese patients with HER2 positive breast cancer.MethodsThis study was done througth the registeration of INPLASY website （DOI：10.37766/inplasy2022.10.0003）. PubMed， Embase， Cochrane Library， Wanfang， CNKI and other databases were searched. Randomized controlled trials （RCT） of TCH neoadjuvant chemotherapy in Chinese patients with HER2 positive breast cancer were included， the retrieval period was from the establishment of the database to September 2022， and RevMan5.3 was used for statistical analysis.ResultsNine articles were collected， including 731 patients. The total effective rate of trastuzumab combined with neoadjuvant chemotherapy in Chinese patients with HER2 positive breast cancer was significantly better than that of docetaxel combined with carboplatin （TC） alone （OR= 3.07， 95%CI： 2.11 ? 4.46，P< 0.001）， and subgroup analysis showed that there was no difference in the improvement of total effective rate between northern and southern regions in China. Consequences also showed that the negative rate of HER2 and pathological effective rate in the observation groups were better than those in the control groups （OR= 2.73， 95%CI： 1.48 ? 5.03，P= 0.001） and （OR= 2.68， 95%CI： 1.59 ? 4.52，P <0.001）.ConclusionCompared with neoadjuvant chemotherapy alone， TCH chemotherapy can significantly improve the efficacy of HER2 positive breast cancer patients in China without increasing the incidence of adverse events.

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Analysis of the pregnancy outcomes and influencing factors of emergency cervical cerclage for singleton and twin pregnancy

Zongxin SUN, Xin LV, Chunlei TIAN, Hao FENG

2023, 44(9): 665-669. DOI: 10.3969/j.issn.2097-0005.2023.09.005

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ObjectiveTo investigate the pregnancy outcomes after emergency cervical cerclage for singleton and twin pregnancy women and to analyze the influencing factors.MethodsThe clinical data of 109 patients with single and twin pregnancy who underwent emergency cervical cerclage in Qianfoshan Hospital of Shandong Province in 2022 were retrospectively analyzed.ResultsUsing univariate analysis the differences between the two groups of success and failure in singleton pregnancies，were statistically significant （P <0.05） in terms of polycystic ovary syndrome （PCOS）， adverse maternal history， postoperative premature rupture of membranes （PROM）， degree of dilatation of the uterine orifice and preoperative C-reactive protein （CRP）， Multivariate logistic analysis showed that degree of dilatation （OR= 8.262）， and circumcision gestational week （OR= 0.062） were independent influencing factors on the outcome of emergency cervical cerclage surgery （P <0.05）； among pregnant women with twin pregnancies， the differences were statistically significant （P <0.05） in terms of postoperative CRP levels and circumcision gestational week in both groups， and multifactorial logistic analysis showed that postoperative CRP （OR= 7.056） level was an independent factor influencing the outcome of emergency cervical cerclage in twin pregnancies （P <0.05）.ConclusionEmergency cervical cerclage is an important tool to prevent late miscarriage and preterm delivery in singleton and twin pregnancies

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Study on the relationship between diabetes kidney diseas and thyroid functionn

Mei LIANG, Jianye JIANG, Ruikui MAO, Xiaopang RAO

2023, 44(9): 670-674. DOI: 10.3969/j.issn.2097-0005.2023.09.006

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ObjectiveTo study the relationship between thyroid hormone level and diabetes kidney disease （DKD）.MethodsThis study retrospectively analyzed the patients with diabetes （DM） and the healthy people who received medical examination in the Department of Endocrinology， Chengyang District People's Hospital， Qingdao from March to September 2019， including 250 cases of DM with normal proteinuria （DM group）， 250 cases of DM with microalbuminuria （microalbuminuria group）， and 250 cases of DM with clinical albuminuria （clinical albuminuria group）. The control group was 250 healthy people who received medical examination. The anthropometric indexes such as systolic blood pressure， diastolic blood pressure， height and weight were collected. Collect the blood glucose， blood lipids， serum creatinine （Scr）， thyroid stimulating hormone （TSH）， free triiodothyronine （FT3） and free thyroxine （FT4） of the subjects who were tested after 8-10 hours of fasting， collect and take the morning random urine to test the urine creatinine and urine microalbumin， and calculate the urine albumin/creatinine （UACR） and estimated glomerular filtration rate （eGFR）， and compare the differences and correlations between the groups.ResultsThere was a statistically significant difference in TSH levels among the four groups （P< 0.001）， with the trend of clinical albuminuria group > microalbuminuria group > DM group > control group； There was a statistically significant difference in the levels of FT3 and FT4 among the four groups （P< 0.001）. The trend was that the clinical albuminuria group < microalbuminuria group < DM group < control group. The results of rank correlation analysis showed that the positive correlation of TSH level with Scr and UACR in microalbuminuria group showed statistical difference （P< 0.001）， and the negative correlation with eGFR showed statistical difference （P< 0.001）； The positive correlation between FT3 level and the levels of Scr， UACR and eGFR in microalbuminuria group showed statistical difference （P< 0.001）； The positive correlation between TSH level and Scr and UACR in clinical albuminuria group showed statistical difference （P< 0.001）， and the negative correlation with eGFR showed statistical difference （P< 0.001）； The positive correlation between the levels of FT4， FT3 and the levels of Scr， UACR and eGFR in clinical albuminuria group showed statistical differences （P< 0.001）.ConclusionDKD is accompanied by the increase of TSH level and the decrease of FT3 and FT4 levels， and the abnormality of these hormone levels is more significant with the aggravation of renal damage.

Public Health & Preventive Medicine

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Investigation on the habitat and resistance ofCulex tritaeniorhynchusin Weishan Lake area

Ziwei LOU, Xiuxia GUO, Yiting WANG, Linlin YANG, Wenqian WANG, Maoqing GONG, Peng CHENG

2023, 44(9): 675-678. DOI: 10.3969/j.issn.2097-0005.2023.09.007

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ObjectiveTo investigate and determine the breeding ground species and drug resistance ofCulex tritaeniorhynchusin Weishan Lake area， so as to provide scientific basis for rational selection and use of pesticides and prevention and control of Japanese encephalitis.MethodsFrom July to September 2022， the larvae ofCulex tritaeniorhynchuswere collected by scooping method at the monitoring point in Weishan Lake area. The resistance of the larvae ofCulex tritaeniorhynchusto four commonly used insecticides was tested according to the larval impregnation method recommended by the World Health Organization， and the resistance level of adult mosquitoes was determined by the contact tube method.ResultsThe larvae ofCulex tritaeniorhynchusmainly breed in rice fields and irrigation canals. The resistance multiples to dichlorvos， propoxur， deltamethrin， and cypermethrin were 6.53， 3.27， 98.75 and 295.50 respectively. The resistance to deltamethrin and cypermethrin was the highest， showing a high resistance， while the resistance to dichlorvos and propoxur turned into a medium resistance. When the adult mosquitoes ofCulex tritaeniorhynchuswere exposed to 0.05% deltamethrin， 0.15% cypermethrin， 0.5% malathion and 0.1% propoxur for 1h respectively， the 24 h mortality rates were 21.05%， 19.35%， 45.45% and 94.11% respectively.ConclusionTheCulex tritaeniorhynchusin Weishan Lake area has developed resistance to four commonly used insecticides， among which pyrethroid insecticides have the highest resistance level. The local vector control department should reasonably select and use insecticides to better control the mosquito vector density and the epidemic of infectious diseases.

Reviews

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Research progress of chimeric antigen receptor T cells therapy for colorectal cancer

Chirong LONG, Lu ZHANG, Shang PENG, Jingting MIN, Zhenghong LI

2023, 44(9): 682-686. DOI: 10.3969/j.issn.2097-0005.2023.09.009

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Currently， the clinical treatment methods for colon cancer are still mainly surgery and chemotherapy. However， the traditional therapies have many limitations， including drug resistance， cancer recurrence and severe adverse reactions. Immunology has made great breakthroughs in the treatment of colon cancer， among which chimeric antigen receptor T cell （CAR-T） therapy is the most significant. CAR-T cell therapy is a new genetically engineered immunotherapy method for cancer， which has made great progress in the treatment of tumors. This paper reviews the advantages and limitations of CAR-T cell therapy， from potential targets for colon cancer treatment to preclinical studies and clinical trials.

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Recent advances in the treatment of Helicobacter pylori infection

Ruirui WANG, yan LU

2023, 44(9): 687-690. DOI: 10.3969/j.issn.2097-0005.2023.09.010

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Helicobacter pylori （HP） is a kind of gram-negative bacteria that can cause gastritis， peptic ulcer， gastric cancer and lymphatic tissue lymphoma associated with gastric mucosa and other diseases. Its presense increases the incidence of gastric diseases， therefore， the treatment of HP infection has become a research hotspot of many scholars. This article summarizes the treatment progress of HP based on the latest literature. The results show that potassiumcompetitive acid blocker， probiotics， vitamin D， traditional Chinese medicine and myricetin have significant advantages in anti-HP or synergistic anti-HP

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Research progress of ultrasound in the diagnosis of Metabolic associated fatty liver disease and related diseases

Sen WANG, Yixin ZHANG, Yuli ZHAO, Huimin GUO, Li FENG

2023, 44(9): 691-695. DOI: 10.3969/j.issn.2097-0005.2023.09.011

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With the improvement of living standards， the prevalence of metabolic associated fatty liver disease （MAFLD） is increasing， and MAFLD has become the most common chronic liver disease. In recent years， people's understanding of MAFLD has gradually deepened， and MAFLD has a high prevalence of type 2 diabetes mellitus （T2DM）， a significant proportion of them have non-alcoholic steatohepatitis （NASH）， people are paying more and more attention to the impact of MAFLD on T2DM-related complications， such as diabetic nephropathy， cardiovascular disease.and with the development of some new technologies in ultrasound， ultrasound is gradually being used in these complications. At present， ultrasound is the most common imaging method for the diagnosis of MAFLD and liver fibrosis， and this paper mainly reviews the diagnosis of MAFLD by ultrasound and the new progress of ultrasound in patients with MAFLD and T2DM.

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Influential factors of cerebral edema after intravascular treatment of acute ischemic stroke

Yanping SHEN, Zhichao LI, Yanxin ZHAO

2023, 44(9): 696-701. DOI: 10.3969/j.issn.2097-0005.2023.09.012

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Acute ischemic stroke has high disability and lethality. When acute large blood vessel occlusion causes cerebral infarction， endovascular treatment can quickly open the occluded vessels， realize ischemia tissue reperfusion， timely rescue ischemic penumbra， and improve the prognosis of patients. However， some patients still have malignant cerebral edema after endovascular treatment， and have a high mortality rate.To investigate the influencing factors of malignant cerebral edema after endovascular treatment of acute ischemic stroke，the pathogenesis of cerebral edema， the imaging markers and the effects of time window， neutrophil count， collateral circulation， blood glucose level， glycosylated hemoglobin and B-type natriuretic peptide on cerebral edema are reviewed， and explores the early clinical intervention methods are explored to provide theoretical basis for clinical treatment.

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Smac mimics and treatment of breast cancer

Yuli ZHAO, Yixin ZHANG, Sen WANG, Huimin GUO, Li FENG

2023, 44(9): 702-706. DOI: 10.3969/j.issn.2097-0005.2023.09.013

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Second mitochondria-derived activator of caspase （Smac） protein is a natural antagonist of inhibitor of apoptosis protein （IAP） present in mitochondria.Smac protein is released from mitochondria during tumor cell apoptosis and binds to IAP to inhibit its function. Smac mimetics have now emerged as a promising class of targeted therapies in cancer and are being tested in the clinic.Breast cancer is the most common cancer among women in the world， and its treatment is widely concerned.In this review， the research progress related to Smac mimics in breast cancer treatment is summarized.

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Research progress of sepsis associated encephalopathy

Wenyu LI, Hongna YANG, Wei FANG, Xuan SONG, Chunting WANG

2023, 44(9): 707-711. DOI: 10.3969/j.issn.2097-0005.2023.09.014

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Sepsis associated encephalopathy （SAE） is a nervous system complication caused by systemic inflammatory reaction of sepsis， which is an important reason for the high mortality and poor long-term recovery of patients with sepsis. Clinically， it is divided into acute phase and chronic phase. The main clinical manifestations in the acute phase are changes in the level of consciousness， including attention deficit， delirium， lethargy and coma. In the chronic phase， cognitive dysfunction and even dementia occur. The clinical diagnosis of SAE lacks a unified clinical standard. Researchers should strive to better understand the pathophysiological mechanism of sepsis and explore possible effective intervention and treatment measures. This article reviews the pathophysiological mechanism， diagnosis， treatment and prevention of SAE.

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Research progress of contrast-enhanced ultrasound combined with O-RADS in the diagnosis of ovarian tumors

Ruijuan LI, Yanhong MENG

2023, 44(9): 712-715. DOI: 10.3969/j.issn.2097-0005.2023.09.015

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Ovarian tumors are common gynecological malignant tumors with diverse histopathological manifestations. Early diagnosis is crucial to improve the survival rate of patients. For some tumors with unclear malignant indications， contrast-enhanced ultrasound and other comprehensive evaluation are needed. The author summarizes the literature on contrast-enhanced ultrasound and ovarian-adnexal reporting and data system （O-RADS） in the diagnosis of ovarian tumors， and describes the latest progress in the differential diagnosis of ovarian tumors in order to carry out better clinical work.

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Research progress of Wnt/β-catenin signaling pathway in tumor immunity

Huanhuan ZHANG, Lei ZHANG, Jie CUI, Yinpan LIANG, Shuying YI

2023, 44(9): 716-720. DOI: 10.3969/j.issn.2097-0005.2023.09.016

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The Wnt/β-catenin signaling pathway is a highly conserved pathway that regulates cell proliferation， differentiation， apoptosis， stem cell self-renewal， tissue homeostasis， and wound healing. Dysregulation of the Wnt pathway is involved in almost all stages of tumorigenesis in various cancers.Abnormal activation of Wnt/β-catenin signal transduction contributes to immune rejection and inhibits T cell-mediated antitumor immune responses through direct or indirect effects on immune cells. In this review， we summarize the processes by which Wnt/β-catenin signaling influences tumor progression and immune surveillance， as well as strategies for targeting this signaling pathway at different levels for cancer therapy.