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Upregulated lncRNA PRNT promotes progression and oxaliplatin resistance of colorectal cancer cells by regulating HIPK2 transcription 被引量:2
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作者 Sai-Nan Li Shan Yang +5 位作者 Hao-Qi Wang Tian-Li Hui Meng Cheng Xi Zhang Bao-Kun Li Gui-Ying Wang 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第4期1564-1577,共14页
BACKGROUND Colorectal cancer(CRC)is the third most common cancer and a significant cause of cancer-related mortality globally.Resistance to chemotherapy,especially during CRC treatment,leads to reduced effectiveness o... BACKGROUND Colorectal cancer(CRC)is the third most common cancer and a significant cause of cancer-related mortality globally.Resistance to chemotherapy,especially during CRC treatment,leads to reduced effectiveness of drugs and poor patient outcomes.Long noncoding RNAs(lncRNAs)have been implicated in various pathophysiological processes of tumor cells,including chemotherapy resistance,yet the roles of many lncRNAs in CRC remain unclear.AIM To identify and analyze the lncRNAs involved in oxaliplatin resistance in CRC and to understand the underlying molecular mechanisms influencing this resistance.METHODS Gene Expression Omnibus datasets GSE42387 and GSE30011 were reanalyzed to identify lncRNAs and mRNAs associated with oxaliplatin resistance.Various bioinformatics tools were employed to elucidate molecular mechanisms.The expression levels of lncRNAs and mRNAs were assessed via quantitative reverse transcription-polymerase chain reaction.Functional assays,including MTT,wound healing,and Transwell,were conducted to investigate the functional implications of lncRNA alterations.Interactions between lncRNAs and trans-cription factors were examined using RIP and luciferase reporter assays,while Western blotting was used to confirm downstream pathways.Additionally,a xenograft mouse model was utilized to study the in vivo effects of lncRNAs on chemotherapy resistance.RESULTS LncRNA prion protein testis specific(PRNT)was found to be upregulated in oxaliplatin-resistant CRC cell lines and negatively correlated with homeodomain interacting protein kinase 2(HIPK2)expression.PRNT was demonstrated to sponge transcription factor zinc finger protein 184(ZNF184),which in turn could regulate HIPK2 expression.Altered expression of PRNT influenced CRC cell sensitivity to oxaliplatin,with overexpression leading to decreased sensitivity and decreased expression reducing resistance.Both RIP and luciferase reporter assays indicated that ZNF184 and HIPK2 are targets of PRNT.The PRNT/ZNF184/HIPK2 axis was implicated in promoting CRC progression and oxaliplatin resistance both in vitro and in vivo.CONCLUSION The study concludes that PRNT is upregulated in oxaliplatin-resistant CRC cells and modulates the expression of HIPK2 by sponging ZNF184.This regulatory mechanism enhances CRC progression and resistance to oxaliplatin,positioning PRNT as a promising therapeutic target for CRC patients undergoing oxaliplatin-based chemotherapy. 展开更多
关键词 Colorectal cancer Oxaliplatin resistance Prion protein testis specific Zinc finger protein 184 Homeodomain interacting protein kinase 2
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Thioridazine reverses trastuzumab resistance in gastric cancer by inhibiting S-phase kinase associated protein 2-mediated aerobic glycolysis
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作者 Zheng-Yan Yang Yi-Wei Zhao +5 位作者 Jing-Rui Xue Ran Guo Zhi Zhao Han-Di Liu Zhi-Guang Ren Ming Shi 《World Journal of Gastroenterology》 SCIE CAS 2023年第45期5974-5987,共14页
BACKGROUND Trastuzumab constitutes the fundamental component of initial therapy for patients with advanced human epidermal growth factor receptor 2(HER-2)-positive gastric cancer(GC).However,the efficacy of this treat... BACKGROUND Trastuzumab constitutes the fundamental component of initial therapy for patients with advanced human epidermal growth factor receptor 2(HER-2)-positive gastric cancer(GC).However,the efficacy of this treatment is hindered by substantial challenges associated with both primary and acquired drug resistance.While S-phase kinase associated protein 2(Skp2)overexpression has been implicated in the malignant progression of GC,its role in regulating trastuzumab resistance in this context remains uncertain.Despite the numerous studies investigating Skp2 inhibitors among small molecule compounds and natural products,there has been a lack of successful commercialization of drugs specifically targeting Skp2.AIM To discover a Skp2 blocker among currently available medications and develop a therapeutic strategy for HER2-positive GC patients who have experienced progression following trastuzumab-based treatment.METHODS Skp2 exogenous overexpression plasmids and small interfering RNA vectors were utilized to investigate the correlation between Skp2 expression and trastuzumab resistance in GC cells.Q-PCR,western blot,and immunohistochemical analyses were conducted to evaluate the regulatory effect of thioridazine on Skp2 expression.A cell counting kit-8 assay,flow cytometry,a amplex red glucose/glucose oxidase assay kit,and a lactate assay kit were utilized to measure the proliferation,apoptosis,and glycolytic activity of GC cells in vitro.A xenograft model established with human GC in nude mice was used to assess thioridazine's effectiveness in vivo.RESULTS The expression of Skp2 exhibited a negative correlation with the sensitivity of HER2-positive GC cells to trastuzumab.Thioridazine demonstrated the ability to directly bind to Skp2,resulting in a reduction in Skp2 expression at both the transcriptional and translational levels.Moreover,thioridazine effectively inhibited cell proliferation,exhibited antiapoptotic properties,and decreased the glucose uptake rate and lactate production by suppressing Skp2/protein kinase B/mammalian target of rapamycin/glucose transporter type 1 signaling pathways.The combination of thioridazine with either trastuzumab or lapatinib exhibited a more pronounced anticancer effect in vivo,surpassing the efficacy of either monotherapy.CONCLUSION Thioridazine demonstrates promising outcomes in preclinical GC models and offers a novel therapeutic approach for addressing trastuzumab resistance,particularly when used in conjunction with lapatinib.This compound has potential benefits for patients with Skp2-proficient tumors. 展开更多
关键词 Gastric cancer Trastuzumab resistance THIORIDAZINE S-phase kinase associated protein 2 GLYCOLYSIS
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Effects of Cold Acclimation and CaCl_2 on Total Soluble Protein, CaM and Freezing Resistance of Populus tomentosa Seedlings 被引量:6
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作者 林善枝 张志毅 《Forestry Studies in China》 CAS 2002年第1期5-12,共8页
Populus tomentosa seedlings used for cold acclimation at -3℃ were pretreated with or without 10?mmol·L -1 CaCl 2, 3?mmol·L -1 of Ca 2+ chelator EGTA, 0 1?mmol·L -1 of Ca 2+ ... Populus tomentosa seedlings used for cold acclimation at -3℃ were pretreated with or without 10?mmol·L -1 CaCl 2, 3?mmol·L -1 of Ca 2+ chelator EGTA, 0 1?mmol·L -1 of Ca 2+ channel inhibitor LaCl 3,and 0 05?mmol·L -1 of CaM antagonist CPZ. The changes in the contents of total soluble protein and CaM, and freezing resistance in all pretreated seedlings in various periods ( viz: following cold acclimation, chilling stress and recovery) were investigated. Results showed that cold acclimation increased the contents of total soluble protein and CaM, and freezing resistance of seedlings, which could be strongly reduced by the pretreatments of EGTA CPZ and LaCl 3 Cold acclimation combined with CaCl 2 pretreatment enhanced the effect of cold acclimation on freezing resistance, and obviously increased the contents of total soluble protein and CaM, reduced the declining degree of the contents of total soluble protein and CaM caused by chilling stress as compared with cold acclimation, augmented the increase in the level of total soluble protein and CaM during the recovery periods. Further analysis found that an increase in total soluble protein content during cold acclimation with or without CaCl 2 pretreatment mainly resulted from the increase in content of heat stable protein in total soluble protein. It is suggested that Ca 2+ calmodulin may be involved in the synthesis of total soluble protein, and the induction of freezing resistance of seedlings. 展开更多
关键词 Populus tomentosa cold acclimation CaCl 2 total soluble protein CAM freezing resistance
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JNK1,JNK2,and JNK3 are involved in P-glycoprotein-mediated multidrug resistance of hepatocellular carcinoma cells 被引量:14
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作者 Yan, Feng Wang, Xiao-Min +3 位作者 Liu, Zhong-Chen Pan, Chao Yuan, Si-Bo Ma, Quan-Ming 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2010年第3期287-295,共9页
BACKGROUND:Multidrug resistance(MDR)is extremely common in hepatocellular carcinoma(HCC)and is a major problem in cancer eradication by limiting the efficacy of chemotherapy.Modulation of c-Jun NH2-terminal kinase(JNK... BACKGROUND:Multidrug resistance(MDR)is extremely common in hepatocellular carcinoma(HCC)and is a major problem in cancer eradication by limiting the efficacy of chemotherapy.Modulation of c-Jun NH2-terminal kinase(JNK)activation could be a new method to reverse MDR.However,the relationship between JNK activity and MDR in HCC cells is unknown.This study aimed to explore the relationship between MDR and JNK in HCC cell lines with different degrees of MDR.METHODS:A MDR human HCC cell line,SMMC-7721/ ADM,was developed by exposing parental cells to gradually increasing concentrations of adriamycin.The MTT assay was used to determine drug sensitivity.Flow cytometry was used to analyze the cell cycle distribution and to measure the expression levels of P-glycoprotein(P-gp)and MDR-related protein(MRP)-1 in these cells.JNK1,JNK2 and JNK3 mRNA expression levels were quantified by real-time PCR.Expression and phosphorylation of JNK1,JNK2,and JNK3 were analyzed by Western blotting.RESULTS:The MDR of SMMC-7721/ADM cells resistant to 0.05 mg/L adriamycin was mainly attributed to the overexpression of P-gp but not MRP1.In addition,these cells had a significant increase in percentage in the S phase,accompanied by a decrease in percentage in the G0/G1 phase,which is likely associated with a reduced ability for cell proliferation and MDR generation.We found that JNK1,JNK2,and JNK3 activities were negatively correlated with the degree of MDR in HCC cells.CONCLUSION:This study suggests that JNK1,JNK2,and JNK3 activities are negatively correlated with the degree of MDR in HCC cells. 展开更多
关键词 MULTIDRUG resistance c-Jun NH2-terminal kinase hepatocellular carcinoma P-GLYCOprotein MULTIDRUG resistance-associated protein
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Relationship between Methylation Status of Multi-drug Resistance Protein(MRP) and Multi-drug Resistance in Lung Cancer Cell Lines 被引量:3
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作者 柳瑞军 钟竑 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2007年第4期277-282,共6页
Objective: To study the relationship between the methylation status of multi-drug resistance protein (MRP) gene and the expression of its mRNA and protein in lung cancer cell lines. Methods: Human embryo lung cell... Objective: To study the relationship between the methylation status of multi-drug resistance protein (MRP) gene and the expression of its mRNA and protein in lung cancer cell lines. Methods: Human embryo lung cell line WI-38, lung adenocarcinoma cell line SPCA-1 and its drug-resistant cells induced by different concentrations of doxorubicin were treated with restriction endonuclease Eco47III. The methylation status of MRP was examined by PCR, and the expressions of its mRNA and protein were evaluated by in situ hybridization and immunohistochemistry. Results: MRP gene promoter region of WI-38 cells was in hypermethylation status, but the promoter region of MRP in SPCA-1 cells and their resistant derivatives induced by different concentrations of doxorubicin were in hypomethylation status. There were significant differences in the expression of MRP mRNA among WI-38 cell line, SPCA-1 cells and their drug-resistant derivatives induced by different concentration of doxorubicin. Consistently, MRP immunostaining presented similar significant differences. Conclusion: The promoter region of MRP in SPCA-1 lung adenocarcinoma cells was in hypomethylation status. The hypomethylation status of 5' regulatory region of MRP promoter is an important structural basis that can increase the activity of transcription and results in the development of drug resistance in lung cancer. 展开更多
关键词 Lung cancer multi-drug resistance protein(MRP) METHYLATION multi-drug resistance(MDR)
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超重/肥胖合并2型糖尿病患者血清ANGPTL4、HSP70、IL-34水平与胰岛素抵抗的相关性
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作者 李芳 李志红 +1 位作者 姚明言 尹飞 《检验医学》 CAS 2024年第4期358-362,共5页
目的 探讨超重/肥胖合并2型糖尿病(T2DM)患者血清血管生成素样蛋白4(ANGPTL4)、热休克蛋白(HSP)70、白细胞介素-34(IL-34)水平与胰岛素抵抗的相关性。方法 选取2020年5月—2022年5月保定市第一中心医院T2DM患者182例(T2DM组)。参考相关... 目的 探讨超重/肥胖合并2型糖尿病(T2DM)患者血清血管生成素样蛋白4(ANGPTL4)、热休克蛋白(HSP)70、白细胞介素-34(IL-34)水平与胰岛素抵抗的相关性。方法 选取2020年5月—2022年5月保定市第一中心医院T2DM患者182例(T2DM组)。参考相关诊断标准,将T2DM患者分为超重/肥胖T2DM组(90例)和体重正常T2DM组(92例)。另选取同期健康体检者90名作为正常对照组,其中超重/肥胖者40名(超重/肥胖对照组)、体重正常者50名(体重正常对照组)。检测所有研究对象血清ANGPTL4、HSP70、IL-34、胰岛素和血糖水平,计算稳态模型胰岛素抵抗指数(HOMA-IR)。T2DM患者治疗3个月后,再次检测其血清ANGPTL4、HSP70、IL-34水平和HOMA-IR。采用Pearson相关分析评估血清ANGPTL4、HSP70、IL-34与HOMA-IR的相关性。结果 与正常对照组和体重正常T2DM组比较,超重/肥胖T2DM组血清ANGPTL4和HSP70显著降低(P<0.05),血清IL-34和HOMA-IR显著升高(P<0.05)。与正常对照组比较,体重正常T2DM组血清ANGPTL4和HSP70显著降低(P<0.05),血清IL-34和HOMA-IR显著升高(P<0.05)。Pearson相关分析结果显示,血清ANGPTL4、HSP70与HOMA-IR呈负相关(r值分别为-0.733、-0.758,P<0.001),IL-34和HOMA-IR呈正相关(r=0.705,P<0.001)。治疗后,超重/肥胖T2DM组和体重正常T2DM组血清ANGPTL4和HSP70均明显升高,血清IL-34和HOMA-IR明显降低;且相对于超重/肥胖T2DM组,体重正常T2DM组血清ANGPTL4和HSP70升高更显著(P<0.05),血清IL-34和HOMA-IR降低更显著(P<0.05)。结论 超重/肥胖合并T2DM患者ANGPTL4、HSP70和IL-34与胰岛素抵抗显著相关,或可作为超重/肥胖合并T2DM的疗效监测指标。 展开更多
关键词 血管生成素样蛋白4 热休克蛋白70 白细胞介素-34 胰岛素抵抗 超重 肥胖 2型糖尿病
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赤眼鳟LGP2序列结构、组织表达及与MDA5互作特征
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作者 李耀国 廖依静 +1 位作者 王静安 肖调义 《水产学报》 CSCD 北大核心 2024年第1期26-39,共14页
为探究赤眼鳟遗传学和生理学实验室蛋白2(laboratory of genetics and physiology 2,LGP2)的功能特征及抗草鱼呼肠孤病毒(grass carp reovirus,GCRV)育种参考潜力,实验克隆获得了2940 bp的赤眼鳟lgp2(Sclgp2)全长cDNA和721 bp的5′端上... 为探究赤眼鳟遗传学和生理学实验室蛋白2(laboratory of genetics and physiology 2,LGP2)的功能特征及抗草鱼呼肠孤病毒(grass carp reovirus,GCRV)育种参考潜力,实验克隆获得了2940 bp的赤眼鳟lgp2(Sclgp2)全长cDNA和721 bp的5′端上游序列。Sclgp2 cDNA编码680个氨基酸,包含DEXDc(DExD/H-box helicase domain)、HELICc(helicase superfamily C-terminal domain)和CTD(C-terminal regulatory domain)结构域;其5′端上游序列含有MafB(muscle aponeurosis fibromatosis B)和IRF3(interferon regulatory factor 3)等转录因子结合位点。不同物种LGP2的功能结构域、磷酸化修饰位点数具有相似性,同时也存在结构域排布位置及序列的差异。赤眼鳟和草鱼lgp2 cDNA序列比较初步发现2个位于RNA结合功能区的GCRV抗性关联位点。系统进化分析显示,赤眼鳟LGP2先与草鱼、鲫和青鱼聚在一起,再与鲤科鱼类等聚为一大支。荧光定量表达分析显示,赤眼鳟脾脏中sclgp2表达水平显著高于其他组织,肌肉、心脏中表达量次之,而肠中表达量最低。GCRV感染后,肝脏中ifn1表达水平在24~72 h显著下降,其他组织sclgp2和ifn1表达水平未有显著变化。相关性分析结果显示,赤眼鳟肌肉sclgp2与ifn1表达水平呈极显著正相关(0.999)。酵母双杂交互作检测发现,赤眼鳟LGP2与MDA5存在弱相互作用,而其DEXDc(1~201 aa)、HELICc(390~476 aa)以及CTD(553~668 aa)结构域与MDA5无互作。该研究成功获得了sclgp2全长cDNA及5′端上游序列,明确了其序列结构、免疫表达及与MDA5的互作特征,为赤眼鳟LGP2免疫功能属性研究奠定了基础,并为草鱼抗GCRV育种提供了参考。 展开更多
关键词 赤眼鳟 生理学实验室蛋白2(LGP2) 序列结构 表达特征 蛋白互作 GCRV抗性
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miR-93-5p通过PI3K/AKT通路调控HepG2细胞自噬
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作者 周曼 曹萍 +4 位作者 侯以琳 干定云 李广利 陈婉 吴军 《现代肿瘤医学》 CAS 2024年第16期2969-2974,共6页
目的:探究miR-93-5p对HepG2细胞增殖、自噬、葡萄糖消耗以及磷脂酰肌醇3-激酶(phosphatidylinositol 3-kinases,PI3K)/蛋白激酶B(protein kinase B,AKT)通路的影响。方法:高浓度葡萄糖诱导构建胰岛素抵抗(insulin resistance,IR)细胞模... 目的:探究miR-93-5p对HepG2细胞增殖、自噬、葡萄糖消耗以及磷脂酰肌醇3-激酶(phosphatidylinositol 3-kinases,PI3K)/蛋白激酶B(protein kinase B,AKT)通路的影响。方法:高浓度葡萄糖诱导构建胰岛素抵抗(insulin resistance,IR)细胞模型,设计合成miR-93-5p inhibitor和NC,结合自噬抑制剂3-MA,将细胞分为Control组、IR组、IR+inhibitor NC组、IR+inhibitor组、IR+3-MA+inhibitor组。CCK8法检测各组细胞增殖活力,试剂盒检测各组细胞葡萄糖消耗量和细胞糖原合成情况,Western-Blot法检测细胞自噬基因微管相关蛋白1轻链3(autophagy genes microtubule-associated protein 1 light chain 3,LC3)-I、LC3-II、肝细胞生长因子(hepatocyte growth factor,HGF)蛋白、PI3K/AKT通路蛋白(AKT、p-AKT)的表达。结果:与对照组相比,IR组细胞增殖活力、葡萄糖消耗量和细胞糖原合成量、HGF蛋白、LC3-II蛋白表达下降(P<0.01),LC3-I蛋白和p-AKT/AKT值表达均增加(P<0.01)。与IR组和IR+inhibitor NC组相比,IR+inhibitor组细胞增殖活力、葡萄糖消耗量和细胞糖原合成量、HGF蛋白、LC3-II蛋白表达增加(P<0.01),LC3-I蛋白和p-AKT/AKT值表达均下降(P<0.01)。与IR+inhibitor组相比,3-MA能逆转miR-93-5p inhibitor的作用。结论:miR-93-5p通过PI3K/AKT通路促进HepG2细胞自噬,进而抑制胰岛素抵抗,缓解糖尿病造成的机体损伤。 展开更多
关键词 2型糖尿病 胰岛素抵抗 miR-93-5p 磷脂酰肌醇3-激酶/蛋白激酶B通路 细胞自噬
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Molecular mechanisms of insulin resistance in type 2 diabetes mellitus 被引量:24
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作者 Vandana Saini 《World Journal of Diabetes》 SCIE CAS 2010年第3期68-75,共8页
Free fatty acids are known to play a key role in promoting loss of insulin sensitivity in type 2 diabetes mellitus but the underlying mechanism is still unclear.It has been postulated that an increase in the intracell... Free fatty acids are known to play a key role in promoting loss of insulin sensitivity in type 2 diabetes mellitus but the underlying mechanism is still unclear.It has been postulated that an increase in the intracellular concentration of fatty acid metabolites activates a serine kinase cascade,which leads to defects in insu-lin signaling downstream to the insulin receptor.In addition,the complex network of adipokines released from adipose tissue modulates the response of tissues to insulin.Among the many molecules involved in the intracellular processing of the signal provided by insulin,the insulin receptor substrate-2,the protein kinase B and the forkhead transcription factor Foxo 1a are of particular interest,as recent data has provided strong evidence that dysfunction of these proteins results in insulin resistance in vivo.Recently,studies have revealed that phosphoinositidedependent kinase 1-independent phosphorylation of protein kinase Cε causes a reduction in insulin receptor gene expression.Additionally,it has been suggested that mitochondrial dysfunction triggers activation of several serine kinases,and weakens insulin signal transduction.Thus,in this review,the current developments in understanding the pathophysiological processes of insulin resistance in type 2 diabetes have been summarized.In addition,this study provides potential new targets for the treatment and prevention of type 2 diabetes. 展开更多
关键词 ADIPOKINES Forkhead box protein O INSULIN RECEPTOR INSULIN resistance INSULIN signaling INSULIN RECEPTOR substrate proteins Type 2 diabetes mellitus PHOSPHATIDYLINOSITOL 3-kinase protein KINASE B
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Long interspersed nuclear element ORF-1 protein promotes proliferation and resistance to chemotherapy in hepatocellular carcinoma 被引量:8
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作者 Fan Feng Yin-Ying Lu +14 位作者 Fan Zhang Xu-Dong Gao Chuan-Fu Zhang Alex Meredith Zhong-Xian Xu Yu-Tao Yang Xiu-Juan Chang Hong Wang Jian-Hui Qu Zhen Zeng Jun-Lan Yang Chun-Ping Wang Yun-Feng Zhu Jia-Jun Cui Yong-Ping Yang 《World Journal of Gastroenterology》 SCIE CAS 2013年第7期1068-1078,共11页
AIM:To clarify the specific roles and mechanisms of long interspersed nuclear element-1 ORF-1 protein [human long interspersed nuclear element-1(LINE-1),ORF-1p] in chemotherapeutic drug resistance and cell proliferati... AIM:To clarify the specific roles and mechanisms of long interspersed nuclear element-1 ORF-1 protein [human long interspersed nuclear element-1(LINE-1),ORF-1p] in chemotherapeutic drug resistance and cell proliferation regulation in hepatocellular carcinoma(HCC) cells.METHODS:MTT assays were performed to identify the effect of the chemotherapeutic drug toxicity on HepG2 cells.Cell proliferation inhibition and the IC 50 were calculated by the Origin 8.0 software.Western blotting assays were performed to investigate whether LINE-1 ORF-1p modulates the expression of some important genes,including p53,p27,p15,Bcl-2,mdr,and p-gp.To corroborate the proliferation and anchor-independent growth results,the HepG2 cells were analyzed by flow cytometry to investigate the effect of LINE-1 ORF1p on the apoptosis regulation.RESULTS:LINE-1 ORF-1p contributed to the resistance to several chemotherapeutic drugs(cisplatin and epirubicin) in HepG2 cells.The IC 50 of the epirubicin and cisplatin increased from 36.04 nmol/L to 59.11 nmol/L or from 37.94 nmol/L to 119.32 nmol/L.Repression of LINE-1 ORF-1p expression by the siRNA could markedly enhance the response of HepG2 cells to the epirubicin and cisplatin.The IC 50 correspondingly decreased from 28.06 nmol/L to 3.83 nmol/L or from 32.04 nmol/L to 2.89 nmol/L.Interestingly,down-regulation of LINE-1 ORF-1p level by siRNA could promote the response of HepG2 cells to the paclitaxel.The IC 50 decreased from 35.90 nmol/L to 7.36 nmol/L.However,overexpression of LINE-1 ORF-1p did not modulate the paclitaxel toxicity in HepG2 cells.Further Western blotting revealed that LINE-1 ORF-1p enhanced mdr and p-gp gene expression.As a protein arrested in the nucleus,LINE-1 ORF-1p may function through modulating transcriptional activity of some important transcription factors.Indeed,LINE-1 ORF-1p promoted HepG2 cell proliferation,anchor-independent growth and protected the cells against apoptosis through modulating the expression of p15,p21,p53,and Bcl-2 genes.CONCLUSION:LINE-1 ORF-1p promotes HepG2 cell proliferation and plays an important role in the resistance of chemotherapeutic drugs.By establishing novel roles and defining the mechanisms of LINE-1 ORF1p in HCC chemotherapeutic drug resistance and cell proliferation regulation,this study indicates that LINE-1 ORF-1p is a potential target for overcoming HCC chemotherapeutic resistance. 展开更多
关键词 LONG interspersed NUCLEAR element-1 ORF-1 protein Hepatocellular carcinoma Chemotherapeutic drugs multi-drug resistance
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lncRNA AC092718.4对HER2阳性乳腺癌耐药性的影响及其可能机制
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作者 石雪枫 余繁荣 +3 位作者 廖春淮 卢晓渟 王强 卓睿 《广西医学》 CAS 2024年第1期96-102,共7页
目的探讨长链非编码RNA(lncRNA)AC092718.4对人类表皮生长因子受体2(HER2)阳性乳腺癌耐药性的影响及其可能机制。方法(1)获取曲妥珠单抗非耐药及耐药HER2阳性乳腺癌患者的乳腺癌组织(设为非耐药组、耐药组),检测其lncRNA AC092718.4、mi... 目的探讨长链非编码RNA(lncRNA)AC092718.4对人类表皮生长因子受体2(HER2)阳性乳腺癌耐药性的影响及其可能机制。方法(1)获取曲妥珠单抗非耐药及耐药HER2阳性乳腺癌患者的乳腺癌组织(设为非耐药组、耐药组),检测其lncRNA AC092718.4、miR-135a-5p、S100钙结合蛋白P(S100P)mRNA和蛋白的表达水平。(2)以对曲妥珠单抗不敏感的HER2阳性乳腺癌细胞系MDA-MB-361细胞作为原发耐药细胞模型,以乳腺癌细胞株BT-474细胞为亲本,构建对曲妥珠单抗继发耐药的细胞模型(BT-474/TRA细胞)。检测3种细胞中lncRNA AC092718.4、miR-135a-5p、S100P mRNA和蛋白的表达水平。经同一浓度曲妥珠单抗干预48 h后,检测3种细胞的活力。(3)取MDA-MB-361细胞分为sh-AC092718.4组、sh-NC组、对照组进行实验,其中sh-AC092718.4组细胞和sh-NC组分别转染sh-AC092718.4和sh-NC,对照组细胞未经任何处理。经同一浓度曲妥珠单抗干预48 h后,检测3组细胞的活力。(4)采用starBase和TargetScan分别预测lncRNA AC092718.4和miR-135a-5p的潜在靶标。通过双荧光素酶报告基因实验验证lncRNA AC092718.4与miR-135a-5p之间、miR-135a-5p与S100P之间的靶向结合情况。结果(1)与非耐药组相比,耐药组lncRNA AC092718.4、S100P mRNA、S100P蛋白表达水平升高,miR-135a-5p表达水平降低(P<0.05)。(2)与BT-474细胞相比,BT-474/TRA细胞及MDA-MB-361细胞的lncRNA AC092718.4、S100P mRNA、S100P蛋白表达水平升高,miR-135a-5p表达水平降低,曲妥珠单抗干预48 h后的细胞活力更大(P<0.05)。(3)与对照组和sh-NC组比较,sh-AC092718.4组MDA-MB-361细胞活力降低(P<0.05)。(4)starBase预测结果显示,lncRNA AC092718.4与miR-135a-5p有靶向结合位点;TargetScan预测结果显示,miR-135a-5p与S100P有靶向结合位点。荧光素酶报告基因实验结果提示,lncRNA AC092718.4可与miR-135a-5p直接结合,S100P是miR-135a-5p的靶基因。结论LncRNA AC092718.4促进乳腺癌细胞对曲妥珠单抗产生耐药性,下调lncRNA AC092718.4表达可减轻MDA-MB-361细胞对曲妥珠单抗的耐药性,其机制可能涉及lncRNA AC092718.4作为竞争性内源RNA竞争性结合miR-135a-5p,从而上调S100P的表达。 展开更多
关键词 乳腺癌 人类表皮生长因子受体2阳性 长链非编码RNA AC092718.4 耐药性 曲妥珠单抗 微小RNA-135a-5p S100钙结合蛋白P
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益肾活络汤联合二甲双胍治疗老年2型糖尿病疗效研究
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作者 杨丰贤 张静 陈风彩 《陕西中医》 CAS 2024年第11期1504-1507,共4页
目的:探究益肾活络汤联合二甲双胍对老年2型糖尿病(T2DM)患者血糖、胰岛素抵抗的影响。方法:选取104例老年T2DM患者,按照随机数字表法分为西药组(n=52)和联合组(n=52),所有患者均给予常规治疗,西药组给予二甲双胍治疗,联合组在西药组基... 目的:探究益肾活络汤联合二甲双胍对老年2型糖尿病(T2DM)患者血糖、胰岛素抵抗的影响。方法:选取104例老年T2DM患者,按照随机数字表法分为西药组(n=52)和联合组(n=52),所有患者均给予常规治疗,西药组给予二甲双胍治疗,联合组在西药组基础上予以益肾活络汤治疗。比较两组患者临床疗效、中医症状积分,治疗前后糖代谢、胰岛素抵抗指数(IR)、体重指数(BMI)、血清视黄醇结合蛋白-4(RBP-4)、血清胱抑素C(CYS-C)、同型半胱氨酸(HCY)及不良反应。结果:联合组治疗总有效率90.38%高于西药组的76.92%,差异有统计学意义(P<0.05)。治疗后两组患者咽干舌燥、倦怠无力、多饮、多食、气短、五心烦热评分均下降,且治疗后联合组症状评分低于西药组,差异有统计学意义(均P<0.05)。治疗后,两组患者糖代谢相关指标、HOMA-IR、BMI、RBP-4、CYS-C、HCY下降,且联合组低于西药组,差异有统计学意义(均P<0.05)。西药组中1例轻度低血糖、1例消化不良,联合组1例轻度低血糖、2例胃肠道不适,两组不良反应发生率比较,差异无统计学意义(χ^(2)=0.210,P=0.647)。结论:益肾活络汤联合二甲双胍可改善老年T2DM患者临床症状,稳定其糖代谢,延缓T2DM及其并发症进展。 展开更多
关键词 2型糖尿病 益肾活络汤 二甲双胍 胰岛素抵抗 糖代谢 血清视黄醇结合蛋白-4
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芪地糖肾颗粒对2型糖尿病大鼠胰岛素抵抗、脂代谢及AdipoR1、AMPK蛋白的影响 被引量:1
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作者 张颖 靳亦龙 周立新 《陕西中医》 CAS 2024年第2期176-180,共5页
目的:探究芪地糖肾颗粒对2型糖尿病大鼠胰岛素抵抗、脂代谢以及脂联素受体1(AdipoR1)、腺苷酸激活蛋白激酶(AMPK)蛋白等相关指标的影响。方法:取50只健康大鼠,分为健康组,模型组,低、中、高剂量组,除健康组外均建立糖尿病模型。建模后... 目的:探究芪地糖肾颗粒对2型糖尿病大鼠胰岛素抵抗、脂代谢以及脂联素受体1(AdipoR1)、腺苷酸激活蛋白激酶(AMPK)蛋白等相关指标的影响。方法:取50只健康大鼠,分为健康组,模型组,低、中、高剂量组,除健康组外均建立糖尿病模型。建模后低、中、高剂量组分别灌胃芪地糖肾颗粒1.31、2.62、5.24 g/kg;健康组、模型组给予等量0.9%氯化钠溶液灌胃,1次/d,均干预30 d。采用ELISA检测血清高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG),酶联免疫法测定空腹血糖(FBG),放免法测定空腹胰岛素(FINS),免疫印迹与PCR分别检测脂联素受体1(AdipoR1)、腺苷酸激活蛋白激酶(AMPK)蛋白、肾小管间质p38激活丝裂原活化蛋白激酶(p38MAPK)。结果:与健康组比较,模型组大鼠血清中HDL-C及AdipoR1、AMPK、p38MAPK蛋白/mRNA降低,LDL-C、TC、TG、FBC、FINS均升高(P<0.05);与模型组比较,低剂量组大鼠血清中HDL-C及AdipoR1、AMPK、p38MAPK蛋白/mRNA升高,LDL-C、TC、TG及FBC、FINS均降低(P<0.05);与低剂量组比较,中剂量组大鼠血清中HDL-C及AdipoR1、AMPK、p38MAPK蛋白/mRNA升高,LDL-C、TC、TG及FBC、FINS均降低(P<0.05);与中剂量组比较,高剂量组大鼠血清中HDL-C及AdipoR1、AMPK、p38MAPK蛋白/mRNA升高,LDL-C、TC、TG及FBC、FINS均降低(P<0.05)。结论:芪地糖肾颗粒可改善2型糖尿病的脂质代谢及胰岛素抵抗,可能与提高AdipoR1、AMPK、p38MAPK表达相关。 展开更多
关键词 2型糖尿病 芪地糖肾颗粒 胰岛素抵抗 脂代谢 脂联素受体1 腺苷酸激活蛋白激酶
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Osmotic Stress Resistance of Transgenic Tobacco Expressed Soybean Lysine-rich Protein Gene
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作者 LI Peiqing SHUANG Bao JIA Huiyong LV Yang LI Jie 《Journal of Northeast Agricultural University(English Edition)》 CAS 2010年第1期43-47,共5页
PM2 gene (accession number: M80664) with high lysine content from soybean (Glycine max) was found in GenBank by changing three BLASTp parameters. Amino acid composition analysis of PM2 showed that Lys content was... PM2 gene (accession number: M80664) with high lysine content from soybean (Glycine max) was found in GenBank by changing three BLASTp parameters. Amino acid composition analysis of PM2 showed that Lys content was on the high level of 18.22%. Protein encoded by PM'2 also belonged to the family of late embryogenesis abundant (LEA) proteins, which was considered that it had a strong relation with the abiotic stress resistance. In this experiment, PM2 gene was obtained from dry soybean seeds by RT-PCR, plant expression vector pEMTPM2 was constructed, and then transformed into tobacco by using agrobacterium-mediated method. Eight salt and drought tolerant lines were obtained from 31 differentiated lines. Real-time PCR showed that PM2 gene overexpressed in all four PCR positive lines with the osmotic stress resistance. These results confirmed that the overexpression of PM2 gene enhanced the osmotic stress resistance of transgenic tobacco. 展开更多
关键词 PM2 gene lysine-rich protein LEA protein osmotic stress resistance
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消渴方加减联合达格列净治疗2型糖尿病临床研究 被引量:1
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作者 金徐燕 童海航 谢妙时 《新中医》 CAS 2024年第2期79-83,共5页
目的:观察消渴方加减联合达格列净治疗2型糖尿病(T2DM)气阴两虚夹瘀证的临床疗效,以及对白细胞计数(WBC)、C-反应蛋白(CRP)水平的影响。方法:选取102例T2DM气阴两虚夹瘀证患者,依据简单随机法分为观察组与对照组各51例。对照组给予达格... 目的:观察消渴方加减联合达格列净治疗2型糖尿病(T2DM)气阴两虚夹瘀证的临床疗效,以及对白细胞计数(WBC)、C-反应蛋白(CRP)水平的影响。方法:选取102例T2DM气阴两虚夹瘀证患者,依据简单随机法分为观察组与对照组各51例。对照组给予达格列净治疗,观察组在对照组基础上联合消渴方加减治疗,2组均治疗2个月。比较2组临床疗效、中医证候积分、糖代谢指标[空腹血糖(FBG)、餐后2 h血糖(P2hBG)]、胰岛功能指标[空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、炎症指标(WBC、CRP)及不良反应发生率。结果:治疗后,观察组总有效率96.08%,高于对照组86.27%(P<0.05)。2组咽干口燥、倦怠乏力、多食易饥、口渴喜饮积分均较治疗前降低(P<0.05),观察组上述4项中医证候积分均低于对照组(P<0.05)。2组FBG、P2hBG、FINS水平及HOMA-IR均较治疗前降低(P<0.05),观察组上述4项指标水平均低于对照组(P<0.05)。2组外周血WBC、血清CRP水平均较治疗前降低(P<0.05),观察组外周血WBC、血清CRP水平均低于对照组(P<0.05)。治疗期间,观察组不良反应发生率7.84%,与对照组5.88%比较,差异无统计学意义(P>0.05)。结论:消渴方加减联合达格列净治疗T2DM气阴两虚夹瘀证疗效确切,可缓解患者的临床症状,改善胰岛素抵抗,降低血糖及炎症指标水平。 展开更多
关键词 2型糖尿病 气阴两虚夹瘀证 消渴方 达格列净 胰岛素抵抗 白细胞计数 C-反应蛋白
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C反应蛋白与白蛋白比值、血管生成素-2、晚期糖基化终末产物受体与碳青霉烯耐药肠杆菌科细菌感染患者病情转归的相关性及意义
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作者 陈妮 赵翠英 《新乡医学院学报》 CAS 2024年第11期1080-1085,共6页
目的探讨C反应蛋白(CRP)与白蛋白(ALB)比值(CRP/ALB)、血管生成素-2(Ang-2)、晚期糖基化终末产物受体(RAGE)与碳青霉烯耐药肠杆菌科细菌(CRE)感染患者病情转归的相关性及意义。方法选择2020年1月至2023年5月陕西省森林工业职工医院收治... 目的探讨C反应蛋白(CRP)与白蛋白(ALB)比值(CRP/ALB)、血管生成素-2(Ang-2)、晚期糖基化终末产物受体(RAGE)与碳青霉烯耐药肠杆菌科细菌(CRE)感染患者病情转归的相关性及意义。方法选择2020年1月至2023年5月陕西省森林工业职工医院收治的103例重症及长时间反复住院CRE感染患者为研究对象,根据患者28 d内转归不同分为转归不良组(n=23)和转归良好组(n=80)。通过查阅电子医疗记录系统收集患者的临床资料,包括:年龄、性别、体质量指数、病史、感染菌种、体温、是否行有创机械通气、是否合并感染性休克等。应用全自动电化学发光免疫分析仪检测患者血清CRP水平,应用全自动生化分析仪检测ALB水平,计算CRP/ALB;应用多功能酶标仪检测血清Ang-2、RAGE水平。比较2组患者临床资料及治疗前、治疗3 d和治疗7 d后CRP/ALB、Ang-2、RAGE水平,应用Cox回归分析CRE感染患者病情转归的相关影响因素,受试者操作特征曲线分析治疗前CRP/ALB、Ang-2、RAGE预测CRE感染患者病情转归价值,卡普兰-迈耶曲线(K-M)分析不同CRP/ALB、Ang-2、RAGE水平患者28 d的预后情况。结果转归不良组行有创机械通气、合并感染性休克患者占比显著高于转归良好组(P<0.05)。转归良好组患者治疗3 d和7 d后CRP/ALB、Ang-2、RAGE显著低于治疗前,且治疗7 d后较治疗3 d后显著降低(P<0.05);转归不良组患者各时间点CRP/ALB、Ang-2、RAGE比较差异均无统计学意义(P>0.05);治疗3、7 d后,转归不良组患者CRP/ALB、Ang-2、RAGE显著高于转归良好组(P<0.05)。行有创机械通气、合并感染性休克、CRP/ALB升高、Ang-2升高、RAGE升高是影响CRE病情转归的独立危险因素(P<0.05)。治疗7 d后CRP/ALB+Ang-2+RAGE预测病情转归的曲线下曲积最大(0.931),敏感度为86.96%,特异度为88.75%。CRP/ALB、Ang-2、RAGE高表达组患者生存率显著低于低表达组(P<0.05)。结论CRP/ALB、Ang-2、RAGE与CRE感染患者病情转归有关,联合检测可作为患者病情转归的一个早期预测方案,为临床分层管理提供精准量化的指导信息。 展开更多
关键词 C反应蛋白与白蛋白比值 血管生成素-2 晚期糖基化终末产物受体 碳青霉烯耐药肠杆菌科 细菌感染 病情转归
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理脾降浊方治疗2型糖尿病的网络药理学和蛋白质组学研究
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作者 潘琳琳 相宏杰 +1 位作者 逯艳婷 刘桂荣 《世界中医药》 CAS 北大核心 2024年第12期1708-1719,共12页
目的:研究理脾降浊方(LPJZF)治疗2型糖尿病(T2DM)的潜在分子机制。方法:首先,基于网络药理学筛选出LPJZF中的活性成分和作用靶点,通过基因表达综合数据库筛选出与T2DM相关的差异表达基因,并运用蛋白质-蛋白质相互作用、基因本体(GO)和... 目的:研究理脾降浊方(LPJZF)治疗2型糖尿病(T2DM)的潜在分子机制。方法:首先,基于网络药理学筛选出LPJZF中的活性成分和作用靶点,通过基因表达综合数据库筛选出与T2DM相关的差异表达基因,并运用蛋白质-蛋白质相互作用、基因本体(GO)和京都基因与基因组百科全书(KEGG)分析LPJZF在治疗T2DM中的作用靶点和通路。其次,用LPJZF对T2DM大鼠进行干预,采用蛋白质组学鉴定差异蛋白,然后用KEGG和GO分析探究LPJZF干预T2DM的潜在机制。最后,运用分子对接技术评估T2DM潜在靶点与LPJZF活性成分之间的结合亲和力。结果:网络药理学分析共筛选出LPJZF干预T2DM的63个有效成分和135个靶点;蛋白质组学共鉴定出LPJZF干预T2DM的964个差异表达蛋白,以及磷脂酰肌醇3激酶/蛋白激酶B(PI3K-AKT)、丝裂原活化蛋白激酶(MAPK)、核因子κB和叉头框蛋白O(FoxO)等4条关键通路;分子对接结果显示,T2DM相关蛋白细胞周期蛋白依赖性激酶2(CDK2)、表皮生长因子受体(EGFR)、肿瘤蛋白P53(TP53)、热休克蛋白90 kDa αA类成员1(HSP90AA1)和小鼠双微体2(MDM2)与LPJZF中的黄芩素、芒柄花黄素、山柰酚、汉黄芩素、β-谷甾醇和豆甾醇具有良好的亲和力。结论:LPTZF能有效改善胰岛素抵抗,促进胰腺B细胞再生,是治疗T2DM的有效方剂。 展开更多
关键词 理脾降浊方 2型糖尿病 网络药理学 蛋白质组学 分子对接 活性成分 差异蛋白 胰岛素抵抗
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达格列净联合吡格列酮治疗2型糖尿病的效果及对FABP4、PPARγ的影响
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作者 冯朵 《临床医学研究与实践》 2024年第20期47-50,共4页
目的分析达格列净联合吡格列酮治疗2型糖尿病(T2DM)的效果及对脂肪酸结合蛋白4(FABP4)、过氧化物酶体增殖物激活受体γ(PPARγ)的影响。方法选取2020年5月至2022年5月收治的90例T2DM患者为研究对象,按照随机数字表法将其分为对照组与观... 目的分析达格列净联合吡格列酮治疗2型糖尿病(T2DM)的效果及对脂肪酸结合蛋白4(FABP4)、过氧化物酶体增殖物激活受体γ(PPARγ)的影响。方法选取2020年5月至2022年5月收治的90例T2DM患者为研究对象,按照随机数字表法将其分为对照组与观察组,每组45例。对照组采用吡格列酮治疗,观察组在对照组基础上加服达格列净治疗。比较两组的治疗效果。结果观察组的治疗总有效率明显高于对照组(P<0.05)。治疗后,观察组的FABP4水平低于对照组,PPARγ水平高于对照组(P<0.05)。治疗后,观察组的稳态模型胰岛β细胞分泌功能指数(HOMA-β)、胰岛素敏感指数(ISI)高于对照组,稳态模型评估-胰岛素抵抗指数(HOMA-IR)低于对照组(P<0.05)。治疗后,观察组的糖化血红蛋白(HbA1c)、内脏脂肪面积、三酰甘油(TG)水平均低于对照组(P<0.05)。结论达格列净联合吡格列酮治疗T2DM不仅能够提升治疗效果,还能调节FABP4、PPARγ水平,改善胰岛素抵抗(IR),下调患者血糖、血脂水平,值得临床进一步推广应用。 展开更多
关键词 达格列净 吡格列酮 2型糖尿病 脂肪酸结合蛋白4 过氧化物酶体增殖物激活受体Γ 胰岛素抵抗
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MRSA感染SP患者T细胞亚群及TLR4、TLR2、TP、ALB诊断价值
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作者 蒲发晓 任婷远 张宇 《分子诊断与治疗杂志》 2024年第7期1246-1250,共5页
目的 探讨耐甲氧西林金黄色葡萄球菌(MRSA)感染重症肺炎(SP)患者外周血T细胞亚群变化,并分析外周血Toll样受体4(TLR4)、Toll样受体2(TLR2)及血清总蛋白(TP)、白蛋白(ALB)联合检测对其的诊断价值。方法 于2020年1月至2022年12月从河西学... 目的 探讨耐甲氧西林金黄色葡萄球菌(MRSA)感染重症肺炎(SP)患者外周血T细胞亚群变化,并分析外周血Toll样受体4(TLR4)、Toll样受体2(TLR2)及血清总蛋白(TP)、白蛋白(ALB)联合检测对其的诊断价值。方法 于2020年1月至2022年12月从河西学院附属张掖人民医院选取MRSA感染SP患者179例为感染组,另选MRSA未感染SP患者181例为对照组。分析MRSA耐药情况,比较两组外周血T细胞亚群、TLR4、TLR2及血清TP、ALB水平,并分析外周血TLR4、TLR2、血清TP、ALB诊断MRSA感染SP的价值。结果 MRSA耐药率较高的抗菌药物包括青霉素、苯唑西林、红霉素、克林霉素、四环素、环丙沙星;完全敏感的抗菌药物包括替加环素、呋喃妥因、利奈唑胺、奎努普汀。较对照组,感染组外周血CD19^(+)、TLR4、TLR2水平更高(t=15.378、13.408、12.113,P<0.05);外周血CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)及血清TP、ALB水平更低(t=23.295、26.320、17.810,P<0.05)。以感染组为阳性,对照组为阴性绘制ROC曲线进行分析,结果显示血清TLR4、TLR2、TP、ALB联合检测诊断MRSA感染SP的曲线下面积(AUC)值高于四者单一检测(P<0.05)。结论 MRSA感染SP患者外周血T细胞亚群异常变化,且外周血TLR4、TLR2呈高表达,血清TP、ALB呈低表达,四者联合检测的诊断价值更高。 展开更多
关键词 耐甲氧西林金黄色葡萄球菌 重症肺炎 T细胞亚群 Toll样受体4 TOLL样受体2 总蛋白 白蛋白
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抗阻训练联合高乳蛋白营养在老年2型糖尿病伴肌少症病人中的应用研究 被引量:4
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作者 张林英 梅群超 +1 位作者 张炜琦 胡一兰 《实用老年医学》 CAS 2023年第10期995-999,共5页
目的探究抗阻训练联合高乳蛋白营养对老年T2DM伴肌少症病人的应用效果。方法选择2021年1月至2022年1月期间我院收治的老年T2DM伴肌少症病人78例作为研究对象,随机分成2组,每组39例,对照组予以常规治疗,研究组在对照组的基础上进行抗阻... 目的探究抗阻训练联合高乳蛋白营养对老年T2DM伴肌少症病人的应用效果。方法选择2021年1月至2022年1月期间我院收治的老年T2DM伴肌少症病人78例作为研究对象,随机分成2组,每组39例,对照组予以常规治疗,研究组在对照组的基础上进行抗阻训练联合高乳蛋白营养干预。比较2组病人静息状态下骨骼肌质量指数、握力、FPG和HbA1c水平、生活质量及跌倒发生率。结果干预后研究组骨骼肌质量指数与握力均高于干预前,且与对照组比较,差异均有统计学意义(P<0.05);2组干预后FPG和HbA1c水平均明显降低,且研究组改善更明显,差异有统计学意义(P<0.05);研究组干预后生活质量各维度得分均高于干预前(P<0.05),且研究组生理功能、生理职能、总体健康、精神健康各维度得分均高于对照组(P<0.05);研究组跌倒发生率明显低于对照组(5.13%比23.08%,P<0.05)。结论抗阻训练联合高乳蛋白营养能显著提高老年T2DM伴肌少症病人骨骼肌质量指数与握力,降低病人血糖,提高病人生活质量且降低跌倒发生率。 展开更多
关键词 抗阻训练 高乳蛋白营养 2型糖尿病 肌少症
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