Chinese Medical Sciences Journal最新文献_第2页

Alignment Techniques in Total Knee Arthroplasty: Where do We Stand Today? 全膝关节置换术中的对位技术：我们的现状如何？

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004372

Hemanta Dhungana, Subhash Jangid, Meghal Goyal

Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral postoperative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery have augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation.

在全膝关节置换术（TKA）中实现最佳对位是确保最佳治疗效果和植入物长期存活的关键因素。传统上，人们倾向于采用机械式对位来实现术后关节的中性对位。然而，运动学对位和混合技术（包括调整机械对位、限制性运动学对位、反向运动学对位和功能性对位）等现代方法因其能够恢复原始关节运动学和解剖学对位而日益受到关注，并有可能提高功能性治疗效果和患者满意度。目前关于最佳对位策略的争论主要考虑以下因素：植入物的长期耐久性、功能改善以及个体解剖变异的解决。此外，计算机导航和机器人辅助手术的发展也提高了种植体定位的精确度和软组织平衡的客观测量。尽管人们一直在争论如何平衡种植体的寿命和功能效果，但越来越多的人主张根据个体解剖变异制定个性化的对位策略。本综述评估了 TKA 中的各种对位技术，包括机械对位、患者特异性运动学方法和新兴的混合方法。每种技术都根据其基本原理、程序技术、固有优势和潜在局限性进行了仔细研究，同时找出了临床上的重大差距，强调了进一步研究的必要性。

{"title":"Alignment Techniques in Total Knee Arthroplasty: Where do We Stand Today?","authors":"Hemanta Dhungana, Subhash Jangid, Meghal Goyal","doi":"10.24920/004372","DOIUrl":"10.24920/004372","url":null,"abstract":"<div><div>Achieving optimal alignment in total knee arthroplasty (TKA) is a critical factor in ensuring optimal outcomes and long-term implant survival. Traditionally, mechanical alignment has been favored to achieve neutral postoperative joint alignment. However, contemporary approaches, such as kinematic alignments and hybrid techniques including adjusted mechanical, restricted kinematic, inverse kinematic, and functional alignments, are gaining attention for their ability to restore native joint kinematics and anatomical alignment, potentially leading to enhanced functional outcomes and greater patient satisfaction. The ongoing debate on optimal alignment strategies considers the following factors: long-term implant durability, functional improvement, and resolution of individual anatomical variations. Furthermore, advancements of computer-navigated and robotic-assisted surgery have augmented the precision in implant positioning and objective measurements of soft tissue balance. Despite ongoing debates on balancing implant longevity and functional outcomes, there is an increasing advocacy for personalized alignment strategies that are tailored to individual anatomical variations. This review evaluates the spectrum of various alignment techniques in TKA, including mechanical alignment, patient-specific kinematic approaches, and emerging hybrid methods. Each technique is scrutinized based on its fundamental principles, procedural techniques, inherent advantages, and potential limitations, while identifying significant clinical gaps that underscore the need for further investigation.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"39 3","pages":"Pages 217-225"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dissecting Causal Relationships Between Plasma Metabolites and Osteoporosis: A Bidirectional Mendelian Randomization Study 剖析血浆代谢物与骨质疏松症之间的因果关系：双向孟德尔随机化研究

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004356

Hao Lv , Ge Zhang , Zhi-Mu Hu , Qing-Song Chu , Jiu-Xiang Wang , Ting Jiang

Objective

To investigate the causal relationships between plasma metabolites and osteoporosis via Mendelian randomization (MR) analysis.

Methods

Bidirectional MR was used to analyze pooled data from different genome-wide association studies (GWAS). The causal effect of plasma metabolites on osteoporosis was estimated using the inverse variance weighted method, intersections of statistically significant metabolites obtained from different sources of osteoporosis-related GWAS aggregated data was determined, and then sensitivity analysis was performed on these metabolites. Heterogeneity between single nucleotide polymorphisms was evaluated by Cochran's Q test. Horizontal pleiotropy was assessed through the application of the MR-Egger intercept method and the MRPRESSO method. The causal effect of osteoporosis on plasma metabolites was also evaluated using the inverse variance weighted method. Additionally, pathway analysis was conducted to identify potential metabolic pathways involved in the regulation of osteoporosis.

Results

Primary analysis and sensitivity analysis showed that 77 and 61 plasma metabolites had a causal relationship with osteoporosis from the GWAS data in the GCST90038656 and GCST90044600 datasets, respectively. Five common metabolites were identified via intersection. X-13684 levels and the glucose-to-maltose ratio were negatively associated with osteoporosis, whereas glycoursodeoxycholate levels and arachidoylcarnitine (C20) levels were positively associated with osteoporosis (all P < 0.05). The relationship between X-11299 levels and osteoporosis showed contradictory results (all P < 0.05). Pathway analysis indicated that glycine, serine, and threonine metabolism, valine, leucine, and isoleucine biosynthesis, galactose metabolism, arginine biosynthesis, and starch and sucrose metabolism pathways were participated in the development of osteoporosis.

Conclusion

We found a causal relationship between plasma metabolites and osteoporosis. These results offer novel perspectives with important implications for targeted metabolite-focused interventions in the management of osteoporosis.

目的通过孟德尔随机分析（MR）研究血浆代谢物与骨质疏松症之间的因果关系。方法采用双向 MR 分析不同全基因组关联研究（GWAS）的汇总数据，研究血浆代谢物与骨质疏松症之间的因果关系。利用反方差加权法估计了血浆代谢物对骨质疏松症的因果效应，确定了从不同来源的骨质疏松症相关 GWAS 汇总数据中获得的具有统计学意义的代谢物的交叉点，然后对这些代谢物进行了敏感性分析。单核苷酸多态性之间的异质性通过 Cochran's Q 检验进行评估。横向多效性通过应用 MR-Egger 截距法和 MR-PRESSO 法进行评估。骨质疏松症对血浆代谢物的因果效应也通过逆方差加权法进行了评估。此外，还进行了通路分析，以确定参与调控骨质疏松症的潜在代谢通路。结果经过初步分析和一系列敏感性分析，从 GCST90038656 和 GCST90044600 数据集中的 GWAS 数据中分别鉴定出 77 和 61 个血浆代谢物与骨质疏松症有因果关系。通过交集确定了五种常见代谢物。X-13684水平（GCST90038656：OR = 0.999，95% CI，0.998-1.000，P = 0.004；GCST90044600：OR = 0.834，95% CI，0.700-0.993，P = 0.042）和葡萄糖-麦芽糖比值（GCST90038656：OR = 0.998，95% CI，0.997-1.000，P = 0.025；GCST90044600：OR = 0.752，95% CI，0.998-1.000，P = 0.004）：OR = 0.752，95% CI，0.576-0.981，P = 0.036）与骨质疏松症呈负相关，而糖脱氧胆酸水平（GCST90038656：OR = 1.002，95% CI，1.000-1.003，P = 0.032；GCST90044600：OR = 1.331，95% CI，1.036-1.709，P = 0.025）和花生四烯酸肉碱（C20）水平（GCST90038656：OR = 1.001，95% CI，1.000-1.003，P = 0.039；GCST90044600：OR = 1.237; 95% CI, 1.008-1.518, P = 0.042）与骨质疏松症呈正相关。X-11299 水平与骨质疏松症的关系显示出矛盾的结果（GCST90038656：OR= 0.998，95% CI，0.997-1.000，P = 0.026；GCST90044600：OR=1.402，95% CI，1.071-1.834，P=0.014）。通路分析表明，甘氨酸、丝氨酸和苏氨酸代谢，缬氨酸、亮氨酸和异亮氨酸生物合成，半乳糖代谢，精氨酸生物合成，淀粉和蔗糖代谢通路参与了骨质疏松症的发生。结论我们发现血浆代谢物与骨质疏松症之间存在因果关系。这些结果提供了新的视角，对在骨质疏松症的治疗中针对代谢物采取有针对性的干预措施具有重要意义。

{"title":"Dissecting Causal Relationships Between Plasma Metabolites and Osteoporosis: A Bidirectional Mendelian Randomization Study","authors":"Hao Lv , Ge Zhang , Zhi-Mu Hu , Qing-Song Chu , Jiu-Xiang Wang , Ting Jiang","doi":"10.24920/004356","DOIUrl":"10.24920/004356","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the causal relationships between plasma metabolites and osteoporosis <em>via</em> Mendelian randomization (MR) analysis.</div></div><div><h3>Methods</h3><div>Bidirectional MR was used to analyze pooled data from different genome-wide association studies (GWAS). The causal effect of plasma metabolites on osteoporosis was estimated using the inverse variance weighted method, intersections of statistically significant metabolites obtained from different sources of osteoporosis-related GWAS aggregated data was determined, and then sensitivity analysis was performed on these metabolites. Heterogeneity between single nucleotide polymorphisms was evaluated by Cochran's Q test. Horizontal pleiotropy was assessed through the application of the MR-Egger intercept method and the MRPRESSO method. The causal effect of osteoporosis on plasma metabolites was also evaluated using the inverse variance weighted method. Additionally, pathway analysis was conducted to identify potential metabolic pathways involved in the regulation of osteoporosis.</div></div><div><h3>Results</h3><div>Primary analysis and sensitivity analysis showed that 77 and 61 plasma metabolites had a causal relationship with osteoporosis from the GWAS data in the GCST90038656 and GCST90044600 datasets, respectively. Five common metabolites were identified <em>via</em> intersection. X-13684 levels and the glucose-to-maltose ratio were negatively associated with osteoporosis, whereas glycoursodeoxycholate levels and arachidoylcarnitine (C20) levels were positively associated with osteoporosis (all <em>P</em> < 0.05). The relationship between X-11299 levels and osteoporosis showed contradictory results (all <em>P</em> < 0.05). Pathway analysis indicated that glycine, serine, and threonine metabolism, valine, leucine, and isoleucine biosynthesis, galactose metabolism, arginine biosynthesis, and starch and sucrose metabolism pathways were participated in the development of osteoporosis.</div></div><div><h3>Conclusion</h3><div>We found a causal relationship between plasma metabolites and osteoporosis. These results offer novel perspectives with important implications for targeted metabolite-focused interventions in the management of osteoporosis.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"39 3","pages":"Pages 182-188"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic Evidence for Causal Association Between Hypertension and Chronic Pain: A Bidirectional Two-Sample Mendelian Randomization Study 高血压与慢性疼痛之间因果关系的遗传证据：双向双样本孟德尔随机研究

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004380

Shuai-Lei Wang, Wei-Yun Chen, Zi-Jia Liu, Yu-Guang Huang

Objective

The extent to which the association between hypertension and chronic pain in observational studies is either causally linked or influenced by other shared risk factors has not been substantially addressed. In the present study, Mendelian randomization (MR) was employed to examine the potential causal relationship between hypertension and risk of chronic pain.

Methods

The study data were derived from the pooled dataset of the genome-wide association study (GWAS), enabling the evaluation of the causal effects of hypertension on various types of chronic pain including chronic headache as well as chest, abdominal, joint, back, limb, and multisite chronic pain. We performed a bidirectional two-sample MR analysis using random effect inverse variance weighting (IVW), MR-Egger, weighted median, and weighted mode, quantified by odds ratio (OR).

Results

Genetically predicted essential hypertension was associated with an increased risk of chronic headache (OR = 1.007, 95% CI: 1.003–1.011, P = 0.002) and limb pain (OR = 1.219, 95% CI: 1.033–1.439, P = 0.019). No potential causal associations were identified between chronic pain and essential hypertension in the reverse direction MR (P > 0.05). In addition, there was no potential causal association between secondary hypertension and chronic pain (P > 0.05).

Conclusion

This study provided genetic evidence that a unidirectional causal relationship exists between essential hypertension and the increased risks of chronic headache and limb pain, and no causal relationship was found between secondary hypertension and chronic pain. These findings offer theoretical underpinnings for future research on managing hypertension and chronic pain.

目的在观察性研究中，高血压与慢性疼痛之间的关联在多大程度上存在因果关系或受其他共同风险因素的影响尚未得到实质性探讨。本研究采用孟德尔随机法（Mendelian randomization，MR）来检验高血压与慢性疼痛风险之间的潜在因果关系。方法研究数据来自全基因组关联研究（GWAS）的集合数据集，从而能够评估高血压对各种慢性疼痛（包括头痛以及胸部、腹部、关节、背部、肢体和多部位慢性疼痛）的因果效应。我们使用随机效应逆方差加权（IVW）、MR-Egger、加权中位数和加权模式进行了双向双样本 MR 分析，并用几率比（OR）进行了量化。结果基因预测的原发性高血压与慢性头痛（OR = 1.007，95% CI：1.003-1.011，P = 0.002）和肢体疼痛（OR = 1.219，95% CI：1.033-1.439，P = 0.019）的风险增加有关。没有发现慢性疼痛与高血压之间存在反向的潜在因果关系（P > 0.05）。此外，继发性高血压与慢性疼痛之间也没有潜在的因果关系（P > 0.05）。结论本研究提供了遗传学证据，证明本质性高血压与慢性头痛和肢体疼痛风险增加之间存在单向因果关系，而继发性高血压与慢性疼痛之间没有因果关系。这些发现为今后管理高血压和慢性疼痛的研究提供了重要的理论基础。

{"title":"Genetic Evidence for Causal Association Between Hypertension and Chronic Pain: A Bidirectional Two-Sample Mendelian Randomization Study","authors":"Shuai-Lei Wang, Wei-Yun Chen, Zi-Jia Liu, Yu-Guang Huang","doi":"10.24920/004380","DOIUrl":"10.24920/004380","url":null,"abstract":"<div><h3>Objective</h3><div>The extent to which the association between hypertension and chronic pain in observational studies is either causally linked or influenced by other shared risk factors has not been substantially addressed. In the present study, Mendelian randomization (MR) was employed to examine the potential causal relationship between hypertension and risk of chronic pain.</div></div><div><h3>Methods</h3><div>The study data were derived from the pooled dataset of the genome-wide association study (GWAS), enabling the evaluation of the causal effects of hypertension on various types of chronic pain including chronic headache as well as chest, abdominal, joint, back, limb, and multisite chronic pain. We performed a bidirectional two-sample MR analysis using random effect inverse variance weighting (IVW), MR-Egger, weighted median, and weighted mode, quantified by odds ratio (OR).</div></div><div><h3>Results</h3><div>Genetically predicted essential hypertension was associated with an increased risk of chronic headache (<em>OR</em> = 1.007, 95% <em>CI</em>: 1.003–1.011, <em>P</em> = 0.002) and limb pain (<em>OR</em> = 1.219, 95% <em>CI</em>: 1.033–1.439, <em>P</em> = 0.019). No potential causal associations were identified between chronic pain and essential hypertension in the reverse direction MR (<em>P</em> > 0.05). In addition, there was no potential causal association between secondary hypertension and chronic pain (<em>P</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>This study provided genetic evidence that a unidirectional causal relationship exists between essential hypertension and the increased risks of chronic headache and limb pain, and no causal relationship was found between secondary hypertension and chronic pain. These findings offer theoretical underpinnings for future research on managing hypertension and chronic pain.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"39 3","pages":"Pages 155-161"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthesia Management in Hereditary Pheochromocytoma and Paraganglioma: Updated Insights into Clinical Features and Perioperative Care 遗传性嗜铬细胞瘤和副神经节瘤的麻醉管理：临床特征和围术期护理的最新见解。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004360

Yao-Han Li , Le Shen

Approximately 40% of pheochromocytoma and paraganglioma (PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau (VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2 (MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1 (NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team (MDT) approach is often invaluable in perioperative management.

大约 40% 的嗜铬细胞瘤和副神经节瘤 (PPGL) 病例是家族性的，通常发病较早，症状较为复杂。本文综述了相关文献和指南，为 PPGL 的临床特征和围手术期护理提供参考。von Hippel-Lindau（VHL）病中的嗜铬细胞瘤分泌活动增强，但围术期血流动力学无明显变化。多发性内分泌肿瘤 2 型（MEN2）的肿瘤具有较强的内分泌功能，可能会在手术过程中引起血流动力学波动。因此，嗜铬细胞瘤筛查在 MEN2 的各个阶段都至关重要。神经纤维瘤病 1 型（NF1）通常表现为多系统病变，可导致呼吸困难。当 NF1 患者出现高血压时，应评估嗜铬细胞瘤。嗜铬细胞瘤和副神经节瘤 5 型可能表现为嗜铬细胞瘤或副神经节瘤的多重病变。总之，遗传性 PPGL 除了肿瘤功能外，还可能伴有其他系统的严重病变。多学科团队（MDT）方法在围手术期管理中通常非常重要。

引用次数: 0

Linggui Zhugan Decoction Improves High Glucose-Induced Autophagy in Podocytes 灵桂术甘煎剂能改善高血糖诱导的荚膜细胞自噬现象

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004330

Objective

To explore the influence of Linggui Zhugan Decoction (LGZGD) on high glucose induced podocyte autophagy.

Methods

LGZGD containing serum was prepared by intragastric administation of 4.2 g/kg (low dose), 8.4 g/kg (medium dose), and 12.6 g/kg (high dose) LGZGD into SD rats respectively. MPC5 and AB8/13 podocyte cells were treated with 60 mmol/L glucose to establish diabetic nephropathy podocyte model in vitro. Both podocytes were divided into control group, high glucose group, low dose LGZGD group, medium dose LGZGD group, and high dose LGZGD group, respectively. For the three LGZGD groups, before LGZGD intervention, podocytes were treated with 60 mmol/L glucose for 3 days. After treated with LGZGD containing serum, cells were collected to analyze cell migration using Transwell assay, proliferation using CCK8, apoptosis and cell cycle using flow cytometry, autophagosome formation using transmission electron microscopy, and expression levels of Beclin-1, Atg5, LC3II/I, and P62 proteins using Western blot.

Results

Compared with the control group, the proliferation and migration of MPC5 and AB8/13 cells in the high glucose group slightly decreased, whereas these parameters restored after intervention with low and medium concentrations of LGZGD, with the medium dose LGZGD having the better effect (P < 0.05). Flow cytometry showed that the medium dose LGZGD group had a significantly lower apoptosis rate (P < 0.05) and higher survival rate (P > 0.05) compared to the high dose LGZGD group. High glucose arrested podocytes in G1 phase, whereas LGZGD shifted podocytes from being predominant in G1 phase to G2 phase. High dose LGZGD significanly reduced high glucose-increased autophagosome formation in both podocytes (P < 0.05). Western blot analysis showed that Beclin-1, Atg5, LC3II/I, and P62 expressions were increased in MPC5 cells treated with high glucose and reversed after adminstration of low and medium doses of LGZGD (P < 0.05).

Conclusion

LGZGD reduced apoptosis and enhanced autophagy in high glucose treated podocytes via regulating Beclin-1/LC3II/I/Atg5 expression.

方法分别给 SD 大鼠胃内注射 4.2 g-kg-1（低剂量）、8.4 g-kg-1（中剂量）和 12.6 g-kg-1（高剂量）含血清的 LGZGD。用 60 mmol/L 葡萄糖处理 MPC5 和 AB8/13 细胞，在体外建立糖尿病肾病荚膜细胞模型。荚膜细胞、MPC5和AB8.13分别被分为对照组、高葡萄糖组、低剂量LGZGD组、中剂量LGZGD组和高剂量LGZGD组。三个 LGZGD 组在使用 LGZGD 之前，先用 60 mmol/L 葡萄糖处理荚膜细胞 3 天。用含血清的 LGZGD 处理后，收集细胞，用 Transwell 试验分析细胞迁移，用 CCK8 分析细胞增殖，用流式细胞术分析细胞凋亡和细胞周期，用透射电子显微镜分析自噬体的形成，用 Western 印迹分析 Beclin-1、Atg5、LC3II/I 和 P62 蛋白的表达水平。结果与对照组相比，高糖组 MPC5 和 AB8.13 细胞的增殖和迁移能力略有下降，而使用中低浓度 LGZGD 干预后，这些指标均得到恢复，其中中剂量 LGZGD 的效果最好。流式细胞术分析表明，与高剂量组相比，中剂量 LGZGD 组的凋亡率较低（P < 0.05），存活率较高（P > 0.05）。高糖使荚膜细胞停滞在 G1 期，而 LGZGD 则使荚膜细胞从 G1 期占优势转变为进入 G2 期。高剂量 LGZGD 显著减少了两种荚膜细胞因高糖而增加的自噬体形成（P < 0.05）。Western印迹分析表明，高糖处理的MPC5细胞中Beclin-1、Atg5、LC3Ⅱ/Ⅰ和P62表达增加，而中低剂量的LGZGD可逆转这些表达（P < 0.05）。结论 LGZGD通过调节Beclin-1/LC3Ⅱ/I/Atg5的表达，减少了高糖处理的荚膜细胞的凋亡并增强了其自噬能力。

{"title":"Linggui Zhugan Decoction Improves High Glucose-Induced Autophagy in Podocytes","authors":"","doi":"10.24920/004330","DOIUrl":"10.24920/004330","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the influence of Linggui Zhugan Decoction (LGZGD) on high glucose induced podocyte autophagy.</div></div><div><h3>Methods</h3><div>LGZGD containing serum was prepared by intragastric administation of 4.2 g/kg (low dose), 8.4 g/kg (medium dose), and 12.6 g/kg (high dose) LGZGD into SD rats respectively. MPC5 and AB8/13 podocyte cells were treated with 60 mmol/L glucose to establish diabetic nephropathy podocyte model <em>in vitro</em>. Both podocytes were divided into control group, high glucose group, low dose LGZGD group, medium dose LGZGD group, and high dose LGZGD group, respectively. For the three LGZGD groups, before LGZGD intervention, podocytes were treated with 60 mmol/L glucose for 3 days. After treated with LGZGD containing serum, cells were collected to analyze cell migration using Transwell assay, proliferation using CCK8, apoptosis and cell cycle using flow cytometry, autophagosome formation using transmission electron microscopy, and expression levels of Beclin-1, Atg5, LC3II/I, and P62 proteins using Western blot.</div></div><div><h3>Results</h3><div>Compared with the control group, the proliferation and migration of MPC5 and AB8/13 cells in the high glucose group slightly decreased, whereas these parameters restored after intervention with low and medium concentrations of LGZGD, with the medium dose LGZGD having the better effect (<em>P</em> < 0.05). Flow cytometry showed that the medium dose LGZGD group had a significantly lower apoptosis rate (<em>P</em> < 0.05) and higher survival rate (<em>P</em> > 0.05) compared to the high dose LGZGD group. High glucose arrested podocytes in G1 phase, whereas LGZGD shifted podocytes from being predominant in G1 phase to G2 phase. High dose LGZGD significanly reduced high glucose-increased autophagosome formation in both podocytes (<em>P</em> < 0.05). Western blot analysis showed that Beclin-1, Atg5, LC3II/I, and P62 expressions were increased in MPC5 cells treated with high glucose and reversed after adminstration of low and medium doses of LGZGD (<em>P</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>LGZGD reduced apoptosis and enhanced autophagy in high glucose treated podocytes <em>via</em> regulating Beclin-1/LC3II/I/Atg5 expression.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"39 3","pages":"Pages 189-197"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

UBE2C as an Immune-Related Biomarker for Breast Cancer: A Study Based on Multiple Databases UBE2C 作为乳腺癌的免疫相关生物标记物：基于多个数据库的研究。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004340

Objective

To screen the target genes that are associated with survival of breast cancer (BRCA) and explore their prognostic values and immune correlations with BRCA using multiple databases..

Methods

The microarray expression datasets of BRCA were downloaded from the Gene Expresssion Omnibus database (GEO) and analyzed to obtain differentially expressed genes (DEGs). Hub genes were obtained by constructing and visualizing the protein-protein interaction network of DEGs. The key gene was determined using R language, STRING, and Cytoscape, and the differential expression of the key gene was verified using external datasets The Cancer Genome Atlas (TCGA) and quantitative real-time PCR (qRT-PCR) for BRCA tissues of 37 patients. The prognostic value and immunological correlation of UBE2C in BRCA were explored using R language, TIMER, and Gene Set Enrichment Analysis (GSEA).

Results

Of 10 hub genes seleceed from 302 DEGS, UBE2C was identified as the gene associated with BRCA survival. The expression of UBE2C was differentially upregulated in BRCA, as verified by TCGA and qRT-PCR. Prognostic analysis revealed that UBE2C served as an independent prognostic factor. High expression of UBE2C was associated with decreased immune infiltration levels of B cells, CD4+ T cells, CD8+ T cells, macrophages, and myeloid dendritic cells in BRCA tissue. The expression of UBE2C in BRCA showed a significant correlation with immune checkpoints genes PDCD1, CD274, and CTLA4 expressions. There was a positive correlation between the expression of UBE2C and the tumor mutational burden and microsatellite instability. GSEA demonstrated that UBE2C expression significantly enriched 786 immune-related gene sets.

Conclusions

UBE2C expression in BRCA tissues is closely related to the BRCA immune microenvironment and showes predictive values on the survivals and prognosis of BRCA patients and the effecacy of immunotherapy. UBE2C may be an potential immune-related prognostic biomarker for BRCA.

目的利用多个数据库筛选乳腺癌（BRCA）的靶基因 UBE2C 并探讨其预后价值和免疫相关性。方法从基因表达综合数据库（Gene Expresssion Omnibus database，GEO）下载 BRCA 的微阵列表达数据集，并对其进行分析，以获得差异表达基因（DEGs）。通过构建和可视化 DEGs 的蛋白质-蛋白质相互作用网络，获得枢纽基因。然后利用 R 语言、STRING 和 Cytoscape 确定了关键基因 UBE2C，并利用外部数据集、癌症基因组图谱（TCGA）和定量实时 PCR（qRT-PCR）验证了 UBE2C 的差异表达。使用 R 语言、TIMER 和基因组富集分析（Gene Set Enrichment Analysis，GSEA）探讨了 UBE2C 在 BRCA 中的预后价值和免疫学相关性。预后分析表明，UBE2C是一个独立的预后因素。UBE2C 的高表达与 BRCA 组织中 B 细胞、CD4+ T 细胞、CD8+ T 细胞、巨噬细胞和髓树突状细胞的免疫浸润水平下降有关。UBE2C 在 BRCA 中的表达与 PDCD1、CD274 和 CTLA4 的表达有显著相关性。UBE2C 的表达与肿瘤突变负荷和微卫星不稳定性呈正相关。结论 BRCA组织中UBE2C的表达可预测BRCA患者的存活率和预后。结论 UBE2C 在 BRCA 组织中的表达可预测 BRCA 患者的存活率和预后，而且与 BRCA 免疫微环境密切相关，可预测 BRCA 患者免疫治疗的效果。因此，UBE2C可能是一种潜在的与免疫相关的BRCA预后生物标志物。

{"title":"UBE2C as an Immune-Related Biomarker for Breast Cancer: A Study Based on Multiple Databases","authors":"","doi":"10.24920/004340","DOIUrl":"10.24920/004340","url":null,"abstract":"<div><h3>Objective</h3><div>To screen the target genes that are associated with survival of breast cancer (BRCA) and explore their prognostic values and immune correlations with BRCA using multiple databases..</div></div><div><h3>Methods</h3><div>The microarray expression datasets of BRCA were downloaded from the Gene Expresssion Omnibus database (GEO) and analyzed to obtain differentially expressed genes (DEGs). Hub genes were obtained by constructing and visualizing the protein-protein interaction network of DEGs. The key gene was determined using R language, STRING, and Cytoscape, and the differential expression of the key gene was verified using external datasets The Cancer Genome Atlas (TCGA) and quantitative real-time PCR (qRT-PCR) for BRCA tissues of 37 patients. The prognostic value and immunological correlation of <em>UBE2C</em> in BRCA were explored using R language, TIMER, and Gene Set Enrichment Analysis (GSEA).</div></div><div><h3>Results</h3><div>Of 10 hub genes seleceed from 302 DEGS, <em>UBE2C</em> was identified as the gene associated with BRCA survival. The expression of <em>UBE2C</em> was differentially upregulated in BRCA, as verified by TCGA and qRT-PCR. Prognostic analysis revealed that <em>UBE2C</em> served as an independent prognostic factor. High expression of <em>UBE2C</em> was associated with decreased immune infiltration levels of B cells, CD4+ T cells, CD8+ T cells, macrophages, and myeloid dendritic cells in BRCA tissue. The expression of <em>UBE2C</em> in BRCA showed a significant correlation with immune checkpoints genes <em>PDCD1</em>, <em>CD274</em>, and <em>CTLA4</em> expressions. There was a positive correlation between the expression of <em>UBE2C</em> and the tumor mutational burden and microsatellite instability. GSEA demonstrated that <em>UBE2C</em> expression significantly enriched 786 immune-related gene sets.</div></div><div><h3>Conclusions</h3><div><em>UBE2C</em> expression in BRCA tissues is closely related to the BRCA immune microenvironment and showes predictive values on the survivals and prognosis of BRCA patients and the effecacy of immunotherapy. <em>UBE2C</em> may be an potential immune-related prognostic biomarker for BRCA.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"39 3","pages":"Pages 171-181"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vascular Calcification: Where is the Cure? 血管钙化：治疗方法在哪里？

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-09-01 DOI: 10.24920/004367

Wen-Wen Liu, Mei-Lin Liu

With the progress of aging, the incidence of vascular calcification (VC) gradually increases, which is correlated with cardiovascular events and all-cause death, aggravating global clinical burden. Over the past several decades, accumulating approaches targeting the underlying pathogenesis of VC have provided some possibilities for the treatment of VC. Unfortunately, none of the current interventions have achieved clinical effectiveness on reversing or curing VC. The purpose of this review is to make a summary of novel perspectives on the interventions of VC and provide reference for clinical decision-making.

随着年龄的增长，血管钙化（VC）的发病率逐渐升高，它与心血管事件和全因死亡相关，加重了全球的临床负担。过去几十年来，针对血管钙化潜在发病机制的方法不断积累，为血管钙化的治疗提供了一些可能性。遗憾的是，目前还没有一种干预措施能在临床上有效逆转或治愈 VC。本综述的目的是总结有关VC干预措施的新观点，为临床决策提供参考。

引用次数: 0

Vertebral Artery Stenting for Acute Multiple Cerebral Infarctions Caused by Vertebral Artery Dissection After Massage: A Case Report 椎动脉支架植入术治疗按摩后椎动脉离断引起的急性多发性脑梗塞：病例报告。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-06-01 DOI: 10.24920/004336

Vertebral artery dissection is a rare pathology that can cause ischemic stroke in young people. Cervical massage, especially improper pulling manipulation, is a cause of vertebral artery dissection. We present a case of 32-year-old woman who developed acute multiple posterior circulation ischemic cerebral infarctions as a result of left vertebral artery V4 segment dissection after receiving neck massage. She underwent emergency vertebral artery stent implantation at the site of the dissection. Symptoms were relieved the day after treatment. The patient recovered without adverse complications or endovascular restenosis in the following year.

椎动脉夹层是一种导致年轻人缺血性中风的罕见病变。颈椎按摩，尤其是不当的牵拉手法，是导致椎动脉夹层的原因之一。我们报告了一例 32 岁女性患者，她在接受颈部按摩后因左侧椎动脉 V4 节段夹层导致急性多发性后循环缺血性脑梗死。她在夹层部位接受了急诊椎动脉支架植入术。治疗后第二天症状就得到了缓解。次年，患者康复，未出现不良并发症或血管内再狭窄。

引用次数: 0

A Brief Overview of the Development and Significance of Modern Scientific Medicine in China: Take Chinese Academy of Medical Science and Peking Union Medical College as an Example 简述中国现代科学医学的发展及其意义：以中国医学科学院和中国协和医科大学为例。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-06-01 DOI: 10.24920/004316

Since the early 20th century, China has gradually established a clinical, educational, and research system centered around modern scientific medicine, which has now become the dominant force in China's medical and health system and services, with the construction and development of the Chinese Academy of Medical Sciences and Peking Union Medical College as the most prominent symbol. The scientific medicine in the new era requires close cooperation across multiple disciplines and fields to build a high-quality and efficient medical and health service system. It also involves combining the excellent traditional Chinese culture with Western medicine to explore a unique path of modern scientific medicine with Chinese characteristics.

自 20 世纪初以来，中国逐步建立起了以现代科学医学为核心的临床、教育和科研体系，目前已成为中国医疗卫生体系和服务的主导力量，中国医学科学院和中国协和医科大学的建设和发展就是最突出的标志。新时代的科学医疗需要多学科、多领域的紧密合作，构建优质高效的医疗卫生服务体系。同时，还需要将中华优秀传统文化与西方现代医学相结合，探索出一条独具中国特色的现代科学医学之路。

引用次数: 0

The “4+4” Medical Doctor (MD) Pilot Program at PUMC: Implementation, Performance, and Prospects PUMC 的 "4+4 "医学教育试点项目：实施、绩效和前景。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2024-06-01 DOI: 10.24920/004378

Peking Union Medical College (PUMC) launched the “4+4” Medical Doctor (MD) pilot program in 2018, admitting students with non-medical backgrounds from top universities, aligning with national medical talent training policies to foster diverse and eager learners in medicine. On the occasion of the graduation of the first class of the “4+4” MD pilot class at PUMC in 2023, we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students, faculties, and management staff of the pilot class. This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting, and demonstrates the achievements of the pilot class in terms of student academic background structure, knowledge acquisition and skill learning, scientific research ability, and course evaluation. The results indicated that the pilot class had met the national demand for the “Medicine + X” talent training model. More specifically, with a diverse academic backgrounds, the pilot class graduates had academic levels comparable to the eight-year medical education graduates, and their scientific research abilities were satisfactory. The pilot program at PUMC will optimize the curriculum setting, strengthen the construction of faculty, learning resources, and teaching facilities, and reform the academic evaluation methods, thus deepening the reform of medical education and improving the “4+4” MD program as a novel medical education model.

北京协和医学院于2018年启动 "4+4 "临床医学实验班，招收来自一流大学的非医学专业背景学生，与国家医学人才培养政策接轨，培养多元化、好学上进的医学人才。在2023年北京大学医学部 "4+4 "临床医学实验班首届学生毕业之际，我们对实验班的教学改革进行了回顾，并对实验班的学生、教师和管理人员进行了系统的调查和访谈。本文报告了浦医大试点班在招生、课程设置等方面采取的措施，展示了试点班在学生学科背景结构、知识掌握与技能学习、科学研究能力、课程评价等方面取得的成绩。结果表明，试点班满足了国家对 "医学+x "人才培养模式的需求。具体而言，试点班毕业生学历背景多元，学术水平与八年制医学教育毕业生相当，科研能力令人满意。北京大学医学部试点班将优化课程设置，加强师资队伍、学习资源和教学设施建设，改革学业评价方式，从而深化医学教育改革，完善 "4+4 "医学博士项目这一新型医学教育模式。

{"title":"The “4+4” Medical Doctor (MD) Pilot Program at PUMC: Implementation, Performance, and Prospects","authors":"","doi":"10.24920/004378","DOIUrl":"10.24920/004378","url":null,"abstract":"<div><p>Peking Union Medical College (PUMC) launched the “4+4” Medical Doctor (MD) pilot program in 2018, admitting students with non-medical backgrounds from top universities, aligning with national medical talent training policies to foster diverse and eager learners in medicine. On the occasion of the graduation of the first class of the “4+4” MD pilot class at PUMC in 2023, we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students, faculties, and management staff of the pilot class. This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting, and demonstrates the achievements of the pilot class in terms of student academic background structure, knowledge acquisition and skill learning, scientific research ability, and course evaluation. The results indicated that the pilot class had met the national demand for the “Medicine + X” talent training model. More specifically, with a diverse academic backgrounds, the pilot class graduates had academic levels comparable to the eight-year medical education graduates, and their scientific research abilities were satisfactory. The pilot program at PUMC will optimize the curriculum setting, strengthen the construction of faculty, learning resources, and teaching facilities, and reform the academic evaluation methods, thus deepening the reform of medical education and improving the “4+4” MD program as a novel medical education model.</p></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"39 2","pages":"Pages 144-148"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0