OBJECTIVE:To identify oxidative stress(OS)-related genes involved in type 2 diabetes mellitus(T2DM)and screen potential Traditional Chinese Medicine(TCM)candidates for therapeutic use.METHODS:Gene expression data from...OBJECTIVE:To identify oxidative stress(OS)-related genes involved in type 2 diabetes mellitus(T2DM)and screen potential Traditional Chinese Medicine(TCM)candidates for therapeutic use.METHODS:Gene expression data from the GSE23343 dataset were obtained from the Gene Expression Omnibus(GEO)database.Differentially expressed genes(DEGs)between healthy and T2DM patients were identified.Weighted gene co-expression network analysis(WGCNA)was performed to select modules highly correlated with clinical traits,and core genes within these modules were identified.OS-related genes were retrieved from the Gene Cards database,and the overlapping DEGs,WGCNA genes,and OS-related genes were considered as hub genes in OS-related T2DM.These hub genes were validated in GSE15653 dataset.Potential TCMs were identified by mapping the hub genes to the Coremine Medical database.In vivo validation was performed using a T2DM rat model established by a high-fat diet and streptozotocin injection.The effects of Wedelolactone were evaluated by assessing gene expression via real-time quantitative reverse transcription PCR(q RT-PCR)and Western blot,alongside metabolic and liver function parameters,including fasting blood glucose,glycated serum protein,insulin resistance,and lipid profiles.RESULTS:A total of 394 DEGs(136 up-regulated and 258 down-regulated DEGs.)were identified in the GSE23343 cohort.WGCNA results showed that the turquoise module(cor=-0.56,P=0.02)and the brown module(cor=0.66,P=0.004)were the most correlated with T2DM.Six hub genes[interleukin 33(IL33),S100 calcium binding protein A8(S100A8),Golgi membrane protein 1(GOLM1),small nuclear ribonucleoprotein U1 subunit 70(SNRNP70),hepatocyte growth factor activator(HGFAC),and oxidative stress induced growth inhibitor 1(OSGIN1)]were identified,with IL33,S100A8,and GOLM1 being up-regulated,and SNRNP70,HGFAC,and GOLM1 being down-regulated.These genes distinguished T2DM from healthy controls with AUC values greater than 0.8.Experimental verification using a T2DM rat model confirmed the expression patterns of the hub genes.In vivo data demonstrated that Wedelolactone significantly reduced oxidative stress,inflammation hepatic lipid accumulation,and improved metabolic parameters such as fasting blood glucose,glycated serum protein,and insulin resistance.CONCLUSION:These findings highlight the critical roles of IL33,S100A8,GOLM1,SNRNP70,HGFAC,and OSGIN1 as biomarkers in OS-related T2DM and suggest that Wedelolactone may be a promising TCM-based therapeutic candidate for T2DM.展开更多
目的梳理按病种付费引起住院向门诊服务转移行为的实证研究,为进一步深化我国医疗保险(以下简称“医保”)支付方式改革提供参考。方法系统检索PubMed、Web of Science、中国知网、万方等数据库中有关住院向门诊服务转移的实证研究,检索...目的梳理按病种付费引起住院向门诊服务转移行为的实证研究,为进一步深化我国医疗保险(以下简称“医保”)支付方式改革提供参考。方法系统检索PubMed、Web of Science、中国知网、万方等数据库中有关住院向门诊服务转移的实证研究,检索时限为建库至2025年1月1日。由2名研究者独立筛选文献,提取资料。采用描述性分析方法对纳入研究进行定性评价。结果共纳入11项研究,研究时间集中于医保支付方式改革的早期阶段,部分研究针对特定病种或术式。研究指标主要包括住院服务和门诊服务的总量、费用、效率等3个方面,特别关注患者出院入院前(或后)的门诊服务利用变化,如出院入院前(或后)特定时间范围(如14天、30天)的门诊率、次数、费用等。多数实证研究结果提示,按病种付费易引起住院向门诊服务转移。从深层机制来看,医保支付方式改革的制度塑造力、住院与门诊的分立支付激励机制是行为动因。结论按病种付费改革对医疗服务结构产生影响,并伴随住院服务向门诊服务转移的风险。建议深化多元复合医保支付方式改革,探索门诊创新支付策略,加强对转移行为的动态监测。展开更多
基金Scientific Research Project of Hebei Administration of Traditional Chinese Medicine:Study on the Pharmacodynamic Material Basis and Mechanism of Cyanotis arachnoidea in the Treatment of Type 2 Diabetes Mellitus(No.2024009)。
摘要OBJECTIVE:To identify oxidative stress(OS)-related genes involved in type 2 diabetes mellitus(T2DM)and screen potential Traditional Chinese Medicine(TCM)candidates for therapeutic use.METHODS:Gene expression data from the GSE23343 dataset were obtained from the Gene Expression Omnibus(GEO)database.Differentially expressed genes(DEGs)between healthy and T2DM patients were identified.Weighted gene co-expression network analysis(WGCNA)was performed to select modules highly correlated with clinical traits,and core genes within these modules were identified.OS-related genes were retrieved from the Gene Cards database,and the overlapping DEGs,WGCNA genes,and OS-related genes were considered as hub genes in OS-related T2DM.These hub genes were validated in GSE15653 dataset.Potential TCMs were identified by mapping the hub genes to the Coremine Medical database.In vivo validation was performed using a T2DM rat model established by a high-fat diet and streptozotocin injection.The effects of Wedelolactone were evaluated by assessing gene expression via real-time quantitative reverse transcription PCR(q RT-PCR)and Western blot,alongside metabolic and liver function parameters,including fasting blood glucose,glycated serum protein,insulin resistance,and lipid profiles.RESULTS:A total of 394 DEGs(136 up-regulated and 258 down-regulated DEGs.)were identified in the GSE23343 cohort.WGCNA results showed that the turquoise module(cor=-0.56,P=0.02)and the brown module(cor=0.66,P=0.004)were the most correlated with T2DM.Six hub genes[interleukin 33(IL33),S100 calcium binding protein A8(S100A8),Golgi membrane protein 1(GOLM1),small nuclear ribonucleoprotein U1 subunit 70(SNRNP70),hepatocyte growth factor activator(HGFAC),and oxidative stress induced growth inhibitor 1(OSGIN1)]were identified,with IL33,S100A8,and GOLM1 being up-regulated,and SNRNP70,HGFAC,and GOLM1 being down-regulated.These genes distinguished T2DM from healthy controls with AUC values greater than 0.8.Experimental verification using a T2DM rat model confirmed the expression patterns of the hub genes.In vivo data demonstrated that Wedelolactone significantly reduced oxidative stress,inflammation hepatic lipid accumulation,and improved metabolic parameters such as fasting blood glucose,glycated serum protein,and insulin resistance.CONCLUSION:These findings highlight the critical roles of IL33,S100A8,GOLM1,SNRNP70,HGFAC,and OSGIN1 as biomarkers in OS-related T2DM and suggest that Wedelolactone may be a promising TCM-based therapeutic candidate for T2DM.
摘要目的梳理按病种付费引起住院向门诊服务转移行为的实证研究,为进一步深化我国医疗保险(以下简称“医保”)支付方式改革提供参考。方法系统检索PubMed、Web of Science、中国知网、万方等数据库中有关住院向门诊服务转移的实证研究,检索时限为建库至2025年1月1日。由2名研究者独立筛选文献,提取资料。采用描述性分析方法对纳入研究进行定性评价。结果共纳入11项研究,研究时间集中于医保支付方式改革的早期阶段,部分研究针对特定病种或术式。研究指标主要包括住院服务和门诊服务的总量、费用、效率等3个方面,特别关注患者出院入院前(或后)的门诊服务利用变化,如出院入院前(或后)特定时间范围(如14天、30天)的门诊率、次数、费用等。多数实证研究结果提示,按病种付费易引起住院向门诊服务转移。从深层机制来看,医保支付方式改革的制度塑造力、住院与门诊的分立支付激励机制是行为动因。结论按病种付费改革对医疗服务结构产生影响,并伴随住院服务向门诊服务转移的风险。建议深化多元复合医保支付方式改革,探索门诊创新支付策略,加强对转移行为的动态监测。