Objective To assess the prevalence of malnutrition in patients with advanced non-small cell lung cancer (NSCLC) using the Global Leadership Initiative on Malnutrition (GLIM) criteria, analyze its associated factors, and explore the adverse effects of malnutrition on advanced NSCLC patients in multiple aspects. Methods Patients with NSCLC who were hospitalized for the first time in the Department of Oncology, Shangjin Hospital, West China Hospital, Sichuan University between January and December 2021 were retrospectively selected as the study objects. Malnutrition assessment was carried out in all patients according to GLIM criteria, and the current situation and related factors of malnutrition were analyzed. The Barthel index scale was used to compare the daily activity ability between the malnourished group and the non-malnourished group, the Quality-of-Life Questionnaire-Core 30 scale was used to compare the quality of life between the two groups, and the adverse reactions of the two groups were compared by the hospital information system course records. Results According to GLIM diagnostic criteria, 134 of 285 patients (47.0%) were diagnosed with malnutrition. The results of binary multiple logistic regression analysis showed that age [60-69 vs. <60 years old: odds ratio (OR)=2.323, 95% confidence interval (CI) (1.277, 4.397); ≥70 vs. <60 years old: OR=10.816, 95%CI (4.185, 27.959)], previous medical history [OR=2.740, 95%CI (1.313, 5.717)], and albumin level [OR=0.905, 95%CI (0.848, 0.965)] were associated with malnutrition in patients with advanced NSCLC (P<0.05). The daily activity ability and quality of life in the malnourished group were significantly worse than those in the non-malnourished group (87.57±12.48 vs. 91.82±6.77, P<0.05; 76.22±11.52 vs. 83.96±9.75, P<0.05), and the incidence of adverse reactions in the malnourished group was higher than that of the non-malnourished group (50.7% vs. 31.8%, P<0.05). Conclusions The prevalence of malnutrition in patients with advanced NSCLC is high, and advanced age, previous medical history and albumin are related factors of malnutrition in patients with advanced NSCLC. Combined malnutrition may have adverse effects on mobility, quality of life and adverse effects of anti-tumor therapy in advanced NSCLC patients.
Objective To explore the correlation between the levels of serum nuclear factor-erythroid 2-related factor 2 (Nrf2) as well as heme oxygenase-1 (HO-1) and cognitive dysfunction by determining the levels of Nrf2 and HO-1 in patients with obstructive sleep apnea (OSA) to different degrees and combining Montreal cognitive assessment (MoCA). Methods Serum levels of Nrf2 and HO-1 were determined in 32 patients with mild-moderate OSA, 23 patients with severe OSA and 20 healthy controls. The differences of Nrf2 and HO-1 levels among groups were compared. All subjects were evaluated by MoCA score. According to MoCA score, OSA patients were divided into two groups: OSA with mild cognitive impairment (MCI) group and OSA with normal cognition group. Serum Nrf2 and HO-1 levels were compared between the two groups, and the differences in the OSA patients with or without cognitive impairment were understood. Spearman correlation coefficient was used to explore the correlation between serum Nrf2 and HO-1 levels and cognitive function of OSA patients. The diagnostic value of serum Nrf2 and HO-1 in the OSA patients with cognitive impairment was determined by receiver operating characteristic curve. Results Serum levels of Nrf2 and HO-1 in the mild-moderate and severe OSA groups were higher than those in the control group, and those in the severe OSA group were higher than those in the mild-moderate OSA group (P<0.05). Compared with the OSA with normal cognition group, the serum HO-1 level in the OSA patients with MCI was higher (P<0.05), but the serum NRF2 level had no significant difference between the two groups (P>0.05). There was a negative correlation between serum HO-1 level and total MoCA score in the OSA patients (r=–0.495, P=0.000), but there was no significant correlation between serum Nrf2 and total MoCA score in the OSA patients (P>0.05). Serum Nrf2 and HO-1 were 0.791 and 0.818 for predicting OSA patients with cognitive impairment. The sensitivity was 84.20% and 86.80%, and the specificity was 67.60% and 73.00%, respectively. Conclusions Serum Nrf-2 and serum HO-1 play important role in the pathogenesis of OSA. Serum HO-1 level may be closely related to cognitive dysfunction in OSA patients. Detection of serum HO-1 may be helpful in early identification of cognitive dysfunction in OSA patients, which has potential clinical application value.
Objective To investigate the expression of transcriptional factors zinc finger Krüppel like transcription factor 2 ( Klf2) and NF-E2 related factor 2 ( Nrf2) /BTB CNC homology 1 ( Bach1) in rat bronchial epithelial cells stimulated by cigarette smoke extract ( CSE) , and explore the regulatingmechanism of γ-glutamylcysteine synthetase ( γ-GCS) expression in the oxidative condition. Methods Rat bronchial epithelial cells were harvested using enzyme digestion method, and intervened by 10% CSE for 6 hours. Then γ-GCS activity was detected by two enzymes method, and the nuclear transfer of Nrf2 /Bach1 in cells was detected by immunohistochemistry. Western blot and reverse transcription-polymerase chain reaction ( RT-PCR) techniques were used for detecting the protein and mRNA expressions of Klf2, Nrf2, Bach1, and γ-GCS in the cells. Results The γ-GCS activity was elevated in the CSE group. Immunohistochemical results showed that Nrf2 translocated from cytoplasm to nucleus in response to stimulation by CSE. On the contrary, Bach1 translocated from nucleus to cytoplasm in the same condition. Western blot results showed that protein levels of Klf2, Nrf2, Bach1, and γ-GCS were higher in the CSE group than those in the control group ( Plt;0.05) . RT-PCR results were the same as the Western blot results ( Plt;0.05) . Linear correlation analysis showed that γ-GCS expression was positively correlated with Klf2, Nrf2, and Bach1 ( Plt;0. 05) . Conclusion CSE might regulate the expression of γ-GCS through the transcription factors of Klf2, Nrf2, and Bach1.
Objective To observe the therapeutic effect of vitrectomy on Eales disease and the correlated factors affecting the visual prognosis and disease outcomes. Methods The clinical and follow-up data from 128 patients (142 eyes) with Eales disease undergone vitrectomy were retrospec tively analyzed. The statistical methods including t test,chi;2test, one-way Anova method of square-deviation(SD), and logistic regression were used to analyze the relationship between the general data of the patients (including age, sex, laterality of the eye, visual acuity before the treatment, stages of disease, duration from vitreous hemorrhage to vitrectomy, neovascularization and proliferative vitreoretinopathy, and whether or not combined with retinal detachment and other complications) and the prognosis of the visual acuity after surgery (including the surgical method, techniques, and times and complications after the surgery). The patients were 18-45 years old (mean 28.5 years) with single vitreous hemorrhage in 28 and proliferative changes in 114 in whom 59 had retinal detachment. The follow-up period after the surgery was more than 3 months (mean 35.8 months). The success criteria of the surgery were complete or part retinal reattachment, and failure of retinal reattachment, eye-ball atrophy or excis ion of the affected eye were the failure criteria. Results Successful vitrectomies had been performed on 129 eyes (90.8%) and unsuccessful ones on 13 eyes (9.2%). The difference between the stages of the disease and prognosis of visual acuity after the surgery was significant (chi;2=64.0, Plt;0.01); the duration of vitreous hemorrhage obviously affected the prognosis of visual acuity (OR=11.6，Plt;0.01); the degree, quality, curable possibility, and recurrent probability of combined retinal detachment were the key factors affecting the visual acuity after vitrectomy; the visual acuity before and after the surgery was interrelated; the method and techniques of the surgery and the different filling matters affected the visual acuity after the surgery; the difference between multiple times and once of surgery was significant (chi;2=66.84，Plt;0.01); the degree of complexity of the operative procedure, especially repetitious vitrectomies obviously affected the surgical prognosis and the improvement of visual acuity; the possibility of fa ilure of the surgery differs 7 times in patients with or without post-operative complications ( chi;2=67.23，Plt;0.01); whether the post-operative complications occurred or not significantly affected the prognosis of the visual acuity a-fter the surgery. Conclusions Vitrectomy is effective for Eales disease. The important factors affecting the prognosis of visual acuity after the operation include stages of disease, degree and extent of proliferative vitreoretinopathy, whether or not combined with retinal detachment and other complic ations, duration from vitreous hemorrhage to vitrectomy, the degree of complexity of the operation, and the complications during or after the operation. (Chin J Ocul Fundus Dis, 2006, 22:291-294)
Objective To observe the effect of melatonin (MT) on retinal apoptosis in rats with ischemia-reperfusion injury (RIRI). Methods A total of 54 male healthy Sprague-Dawley adult rats were randomly divided into the normal control (CON) group (6 rats), RIRI group (24 rats) and MT group (24 rats). The rats of RIRI and MT group were induced using suture-occluded methods to establish RIRI model. The rats of MT group were injected with MT in the left carotid artery 30 minutes after RIRI, and RIRI group was injected with the same amount of saline. On 6, 24 hours and 3, 7 days after RIRI, the morphological changes of retina were evaluated by hematoxylin and eosin (HE) staining; the effects of MT on retinal cell apoptosis and Nrf2, HO-1 proteins were examined by immunohistochemistry staining. The correlation between active Caspase-3 and Nrf2 protein, active Caspase-3 and HO-1 protein in MT group were analyzed by linear regression analysis. Results HE staining results showed that the morphology of retinal cells was regular and retinal cells were well arranged in the CON and MT group. In the RIRI group, both the thickness of inner retinal layer and the number of retinal ganglion cells (RGC) were decreased. On 6, 24 hours and 3, 7 days after RIRI, the thickness of inner retinal layer (F=16.710, 62.303, 68.389, 57.132; P＜0.01) and RGC number (F=24.250, 11.624, 14.155, 32.442; P＜0.05) in MT group were more than those in RIRI group. Immunohistochemistry staining results showed that less active Caspase-3+ cells were observed in MT group as compared with those in RIRI group at each time points (F=49.118, 134.173, 76.225, 18.385; P＜0.01). There were more Nrf2+ (F=11.041, 31.480, 59.246, 6.740; P＜0.05) and HO-1+ cells (F=128.993, 21.606, 51.349, 8.244; P＜0.05) in MT group as compared with those in RIRI group at each time points. Linear regression analysis results showed that the difference of active Caspase-3+ cells were all linearly correlated with the Nrf2+ cells and HO-1+cells in the MT group (r2=0.810, 0.730; P＜0.01). Conclusion MT could reduce retinal cell apoptosis in RIRI rats, and its mechanism may be associated with increased Nrf2 and HO-1 expression, reduced active Caspase-3 expression.
Objective To investigate the cellular viability and mitochondrial reactive oxygen species (ROS) production of the Müller cells under high glucose condition, and explore the protection role of the 5,6-dihydrocyclopenta-1, 2-dithiole-3-thione (CPDT) on Müller cells. Methods Müller cells from Sprague Dawley rats were divided into 5 groups randomly, including 25 mmol/L normal glucose group (group A) and 65 mmol/L high glucose group (group B). High glucose group with 45, 60, 70 μmol/L CPDT and cultured them 72 hour was set as group C, D and E. Water soluble tetrazolium salt (WST)-8 was used to measure the cellular viability. Flow cytometry was used to measure the active oxygen and apoptosis index. The expression of nuclear factor erythroid 2-related factor 2 (Nrf2), hemeoxygenase-1 (HO-1), Bcl-2 and Bax protein were measured by Western blot. Results Compared with group A, the WST-8 showed that the viability of Müller cells apparently decreased in group B (t=39.59,P＜0.05). Compared with the group B, the viability of Müller cells had changes in group C (t=0.97,P＞0.05), but recovered in group D and E (t=−4.17, −7.52;P＜0.05). Compared with group A, the FCM showed that the mitochondrial ROS levels was higher in group B (t=−30.99,P＜0.05). Compared with group B, the mitochondrial ROS levels were decreased in group D (t=27.68,P＜0.05). Compared with group A, Bax, Nrf2 and HO-1 increased (t=–11.03, –63.17, –11.44;P＜0.05), while the bcl-2 decreased in group B (t=7.861,P＜0.05). Compared with the group B, Nrf2, HO-1 and Bax decreased (t=15.11, 26.59, 6.27;P＜0.05), while the bcl-2 increased in group D (t=−6.53,P＜0.05). Conclusions Under the high glucose, CPDT may reduce the mitochondrial ROS levels and the expression of Nrf2, HO-1 and Bax protein of Müller cells. It may inhibit apoptosis through activating the Nrf2/HO-1 pathway and balancing of level of Bcl-2 protein and mitochondrial ROS.
ObjectiveTo investigate the protective effect and the regulation mechanism of oxaloacetate (OAA) on myocardial ischemia reperfusion injury in rats. MethodsSixty rats, weight ranged from 200 to 250 grams, were randomly divided into 6 groups:a negative control group, a sham operation control group, a model control group, an OAA pretreatment myocardial ischemia-reperfusion model group (three subgroups:15 mg/kg, 60 mg/kg, 240 mg/kg). We established the model of myocardial ischemia reperfusion of rats and recorded the internal pressure of left ventricle (LVSP), the maximal rate of left ventricular pressure change (±dp/dtmax) and left ventricular end diastolic pressure (LVEDP). We restored reperfusion 180 minutes after ligating the left anterior descending coronary artery 30 minutes and determinated cardiac troponin Ⅰ (cTn-I), lactate dehydrogenase (LDH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px). We took out heart tissues, stained it and calculated the infarcted size. We used the Western blot to detect the expression of NF-E2 related factor 2 (Nrf2), Kelch-like ECH-associated protein-1 (Keap1) and heme oxygenase-1 (HO-1). ResultsCompared with the sham operation group, heart function indexes in the negative control group had no significant difference (P>0.05). But in the model control group there was a decrease (P<0.05) And the serum levels of LDH, cTn-I, and myocardial infarcted size were significantly increased (P<0.01). Compared with the model control group, heart function indexes in the OAA pretreatment groups improved, the serum LDH, cTn-I activity, and infarct size decreased (P<0.05), SOD and GSH-Px activity increased (P<0.05). And these results were statistically different (P<0.01) in the high dose OAA pretreatment groups. Compared with the model control group, the expression of Keap1 in the OAA pretreatment group was down-regulated (P<0.001) while total Nrf2, nucleus Nrf2 and its downstream HO-1 was up-regulated (P<0.001), which suggested that OAA enhanced antioxidant capacity by (at least in part) Keap1-Nrf2 pathway, resulting in reducing myocardial damage and protecting myocardium after acute myocardial ischemia reperfusion injury. ConclusionOxaloacetate can provide protective effects on myocardial ischemia reperfusion injury through down-regulating the expression of Keap1 and up-regulating the expression of Nrf2 and its downstream peroxiredoxins to improve antioxidant capacity.
Objective To explore the regulation of peroxisome proliferator-activated receptor γ coactivator 1α( PGC-1α) and NF-E2-related factor 2( Nrf2) on expression of γ-glutamylcysteine synthetase ( γ-GCS) , and their roles in chronic obstructive pulmonary disease( COPD) . Methods Twenty-four SD rats were randomly divided into a COPD group and a normal control group. COPD model was established by intratracheal instillation of lipopolysaccharide ( LPS) and daily exposure to cigarette smog in the COPD group. The lung function was measured and the pathological changes were observed. The protein and mRNA expressions of PGC-1α, Nrf2, and γ-GCS in lung tissue were measured by immunohistochemistry, Western blot, in site hybridization ( ISH) , and reverse transcription-polymerase chain reaction ( RT-PCR ) ,respectively. Results In the COPD group, the pulmonary function ( FEV0. 3, FEV0. 3 /FVC, PEF) damage and lung pathological changes were conformed as morphological characteristics of COPD. The mRNA of PGC-1α and Nrf2 expressed in lung tissues of two group rats in the region consistent with γ-GCS mRNA. The protein and mRNA expressions of PGC-1αand γ-GCS were markedly increased in the COPD group( all P lt;0. 05) ,and the protein expression of Nrf2 was obviously up-regulated ( P lt; 0. 01) , while Nrf2 mRNA had no significant difference between the two groups( P gt;0. 05 ) . Linear correlation analysis showed that the level ofPGC-1αprotein was positively correlated with the levels of Nrf2 protein and mRNA ( r = 0. 775, 0. 515, all P lt; 0. 01) , and the levels of PGC-1αand Nrf2 protein were positively correlated with the levels of γ-GCS protein ( r = 0. 531, 0. 575, all P lt; 0. 01) and mRNA ( r = 0. 616, 0. 634, all P lt; 0. 01) . Conclusions PGC-1α, which may serve as a co-activator of Nrf2, can up-regulate the expression of γ-GCS gene cooperatively with Nrf2 through a common pathway, which might involve in the oxidative and antioxidative mechanism in the pathogenesis of COPD.
ObjectiveTo summarize the research progress of risk factors related to early recurrence and late recurrence of hepatocellular carcinoma (HCC) after radical resection.MethodsReviewed and summarized recent literatures on factors related to early and late recurrence of HCC after radical resection.ResultsRadical resection was the most effective treatment for HCC, but the postoperative recurrence rate was high, which seriously affected the treatment effect. Current research divided the recurrence after radical resection of HCC into early recurrence (≤2 years) and late recurrence (>2 years). Early recurrence was considered to be mainly caused by intrahepatic metastasis (IM), which was related to the tumor itself, while late recurrence was mainly caused by multicentric occurrence (MO) and was related to background liver factors. Factors of the tumor itself, including tumor diameter and number, invasion of tumor large vessels and microvessels, anatomical and non-anatomical resection, tumor margin, residual liver ischemia (RLI), intermittent total entry hepatic blood flow interruption method (IPM), the expression level of circulating microRNA in serum and long-chain non-coding RNA, circulating tumor cells, and circulating tumor DNA were related to early recurrence; background liver factors, including liver cirrhosis, high viral load, and liver inflammatory activity, were associated with late recurrence.ConclusionsBoth the tumor factors associated with early recurrence and the background liver factors associated with late recurrence can affect the recurrence after radical resection of HCC.
Nuclear factor-erythroid 2-related factor 2 (Nrf2) is an important factor for cells to resist oxidative stress and electrophilic attack. It is involved in the formation and control of oxidative stress defense pathways. It is associated with oxidative stress-related diseases, including cancer, neurodegenerative diseases, cardiovascular diseases and aging, and is a potential pharmacological target for the treatment of chronic diseases. This article will review the important role of Nrf2 in the regulation of cell proliferation, including direct regulation of cell proliferation, regulation of reactive oxygen species, intracellular metabolism, regulation of mitochondrial function, cell lifespan and inflammatory response. The aim is to provide a theoretical basis for further research on how to use Nrf2 to regulate cell proliferation.