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Xu MM, Qiu WH, Ma QY, Yu ZY, Yang WM, Hu TN, Guo Y, Chen XY. Improving precision management of anxiety disorders: a Mendelian randomization study targeting specific gut microbiota and associated metabolites. Front Microbiol 2024; 15:1380912. [PMID: 38655090 PMCID: PMC11035889 DOI: 10.3389/fmicb.2024.1380912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Background There is growing evidence of associations between the gut microbiota and anxiety disorders, where changes in gut microbiotas may affect brain function and behavior via the microbiota-gut-brain axis. However, population-level studies offering a higher level of evidence for causality are lacking. Our aim was to investigate the specific gut microbiota and associated metabolites that are closely related to anxiety disorders to provide mechanistic insights and novel management perspectives for anxiety disorders. Method This study used summary-level data from publicly available Genome-Wide Association Studies (GWAS) for 119 bacterial genera and the phenotype "All anxiety disorders" to reveal the causal effects of gut microbiota on anxiety disorders and identify specific bacterial genera associated with anxiety disorders. A two-sample, bidirectional Mendelian randomization (MR) design was deployed, followed by comprehensive sensitivity analyses to validate the robustness of results. We further conducted multivariable MR (MVMR) analysis to investigate the potential impact of neurotransmitter-associated metabolites, bacteria-associated dietary patterns, drug use or alcohol consumption, and lifestyle factors such as smoking and physical activity on the observed associations. Results Bidirectional MR analysis identified three bacterial genera causally related to anxiety disorders: the genus Eubacterium nodatum group and genus Ruminococcaceae UCG011 were protective, while the genus Ruminococcaceae UCG011 was associated with an increased risk of anxiety disorders. Further MVMR suggested that a metabolite-dependent mechanism, primarily driven by tryptophan, tyrosine, phenylalanine, glycine and cortisol, which is consistent with previous research findings, probably played a significant role in mediating the effects of these bacterial genera to anxiety disorders. Furthermore, modifying dietary pattern such as salt, sugar and processed meat intake, and adjusting smoking state and physical activity levels, appears to be the effective approaches for targeting specific gut microbiota to manage anxiety disorders. Conclusion Our findings offer potential avenues for developing precise and effective management approaches for anxiety disorders by targeting specific gut microbiota and associated metabolites.
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Affiliation(s)
- Ming-Min Xu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Wen-Hui Qiu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Qing-Yu Ma
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zhi-Yun Yu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Wen-Miao Yang
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Tian-Nuo Hu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Yu Guo
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xiao-Yin Chen
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
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Deng W, Yi P, Xiong Y, Ying J, Lin Y, Dong Y, Wei G, Wang X, Hua F. Gut Metabolites Acting on the Gut-Brain Axis: Regulating the Functional State of Microglia. Aging Dis 2024; 15:480-502. [PMID: 37548933 PMCID: PMC10917527 DOI: 10.14336/ad.2023.0727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023] Open
Abstract
The gut-brain axis is a communication channel that mediates a complex interplay of intestinal flora with the neural, endocrine, and immune systems, linking gut and brain functions. Gut metabolites, a group of small molecules produced or consumed by biochemical processes in the gut, are involved in central nervous system regulation via the highly interconnected gut-brain axis affecting microglia indirectly by influencing the structure of the gut-brain axis or directly affecting microglia function and activity. Accordingly, pathological changes in the central nervous system are connected with changes in intestinal metabolite levels as well as altered microglia function and activity, which may contribute to the pathological process of each neuroinflammatory condition. Here, we discuss the mechanisms by which gut metabolites, for instance, the bile acids, short-chain fatty acids, and tryptophan metabolites, regulate the structure of each component of the gut-brain axis, and explore the important roles of gut metabolites in the central nervous system from the perspective of microglia. At the same time, we highlight the roles of gut metabolites affecting microglia in the pathogenesis of neurodegenerative diseases and neurodevelopmental disorders. Understanding the relationship between microglia, gut microbiota, neuroinflammation, and neurodevelopmental disorders will help us identify new strategies for treating neuropsychiatric disorders.
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Affiliation(s)
- Wenze Deng
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Pengcheng Yi
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Yanhong Xiong
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Jun Ying
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Yue Lin
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Yao Dong
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Gen Wei
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
| | - Xifeng Wang
- Department of Anesthesiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Fuzhou Hua
- Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
- Key Laboratory of Anesthesiology of Jiangxi Province, Nanchang City, Jiangxi, China.
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Feng S, Wan Q, Wu W, Zhang C, Lu H, Lu X. Effect of gut microbiome regulated Taohong Siwu Decoction metabolism on glioma cell phenotype. Front Cell Infect Microbiol 2023; 13:1192589. [PMID: 37342242 PMCID: PMC10277651 DOI: 10.3389/fcimb.2023.1192589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/16/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction To establish a new model for exploring the mechanism of the gut microbiome and drug metabolism, we explored whether Taohong Siwu Decoction acts after metabolism by intestinal flora under the premise of clarifying the interaction between intestinal flora and drug metabolism. Methods Taohong Siwu Decoction (TSD) was fed to germ-free mice and conventional mice, respectively. The serum from both groups of mice was removed and co-cultured with glioma cells in vitro. The co-cultured glioma cells were compared separately for changes at the RNA level using RNA-seq technology. The genes of interest in the comparison results were selected for validation. Results The differences in the phenotypic alterations of glioma cells between serum from TSD-fed germ-free mice and normal mice were statistically significant. In vitro experiments showed that Taohong Siwu Decoction-fed normal mouse serum-stimulated glioma cells, which inhibited proliferation and increased autophagy. RNA-seq analysis showed that TSD-fed normal mouse serum could regulate CDC6 pathway activity in glioma cells. The therapeutic effect of TSD is significantly influenced by intestinal flora. Conclusion The treatment of tumors by TSD may be modulated by intestinal flora. We established a new method to quantify the relationship between intestinal flora and the regulation of TSD efficacy through this study.
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Affiliation(s)
- Suyin Feng
- Department of Neurosurgery, Affiliated Hospital of Jiangnan University, Wuxi, China
- Neuroscience Center, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Quan Wan
- Jiangnan University Medical Center, Wuxi, China
| | - Weijiang Wu
- Department of Neurosurgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Chenyang Zhang
- Neuroscience Center, Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Institute of Integrative Chinese and Western Medicine, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Hua Lu
- Department of Neurosurgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xiaojie Lu
- Neuroscience Center, Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Jiangnan University Medical Center, Wuxi, China
- Wuxi Neurological Institute, Wuxi No.2 People’s Hospital, Wuxi, China
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4
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Zhao M, Meng Y, Cao B, Tong J, Liu X, Yan H, Yang H, Han H, Liang X, Chen H. A bibliometric analysis of studies on gut microbiota in attention-deficit and hyperactivity disorder from 2012 to 2021. Front Microbiol 2023; 14:1055804. [PMID: 37007507 PMCID: PMC10050751 DOI: 10.3389/fmicb.2023.1055804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundAn increasing number of studies have focused on the role of gut microbiota in the treatment of ADHD, but its related molecular mechanisms are not yet clear, and there is still room for development of studies targeting this area. This study analyzes publications from 2012 to 2021 in a comprehensive and multi-faceted visualization, with the aim of grasping the existing research profile and guiding scholars to make more in-depth studies.MethodsThe 1,677 articles and 298 review articles on gut microbiota in ADHD were retrieved from the Web of Science Core Collection. CiteSpace, VOSviewer, Microsoft Excel 2019, Scimago Graphica, Bibliometrix and Pajek metrics software were used for visualization and analysis of the included literature.ResultsOn August 3, 2022, a total of 1975 English-language articles on gut microbiota in ADHD were retrieved from Web of Science Core Collection (WoSCC) from January 2012 to December 2021, with a steady upward trend in the number of articles published in this field over the decade. The top three countries in terms of the number of articles published are the United States, China, and Spain. Meanwhile, CONSEJO SUPERIOR DE INVESTIGACIONES CIENTIFICAS CSIC, UNIV OF CALIFORNIA SYSTEM, and UDICE FRENCH RESEARCH UNIV have made significant contributions in this field. In the analysis of the published journals, PLoS One was not only the first in terms of number of articles published but also the most cited. Wang J was the most prolific author and CAPORASO JG ranked first in terms of co-cited authors. In addition, “Diet rapidly and reproducibly alters the human gut microbiome,” published by David LA et al., has the highest citation frequency in this field. The most frequently occurring keyword was “gut microbiota.”ConclusionThe results of this paper clarify the current status of research on gut microbiota in ADHD. Based on the research on the mechanism of gut microbiota in other diseases, there is reason to believe that the exploration of gut microbiota in ADHD must be increasingly mature. And the study speculates that future research may focus on “nutrition supplements,” “lipid metabolism,” and “gut brain axis.” It is imperative to promote a closer international cooperation among scholars in this field.
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Affiliation(s)
- Mingyi Zhao
- Department of Pediatrics, The Third Xiangya Hopsital, Central South University, Changsha, Hunan, China
| | - Yang Meng
- Department of Pediatrics, The Third Xiangya Hopsital, Central South University, Changsha, Hunan, China
| | - Buzi Cao
- Department of Pediatrics, The Third Xiangya Hopsital, Central South University, Changsha, Hunan, China
- Medical School, Hunan Normal University, Changsha, China
| | - Jianbin Tong
- Department of Anesthesiology, The Third Xiangya Hopsital, Central South University, Changsha, Hunan, China
- Hunan Province Key Laboratory of Brain Homeostasis, The Third Xiangya Hopsital, Central South University, Changsha, Hunan, China
| | - Xiaoying Liu
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hao Yan
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hanqi Yang
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Houzhi Han
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiaobing Liang
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Chen
- Department of Clinical Laboratory, The Third Xiangya Hopsital, Central South University, Changsha, Hunan, China
- *Correspondence: Hui Chen,
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Wang L, Xie Z, Li G, Li G, Liang J. Two-sample Mendelian randomization analysis investigates causal associations between gut microbiota and attention deficit hyperactivity disorder. Front Microbiol 2023; 14:1144851. [PMID: 37168108 PMCID: PMC10166206 DOI: 10.3389/fmicb.2023.1144851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
Previous research has suggested a link between gut microbiota and attention deficit hyperactivity disorder (ADHD), but their causal relationship has not been elucidated. Aiming to comprehensively investigate their causal relationship and to identify specific causal microbe taxa for ADHD, we conducted a two-sample Mendelian randomization (MR) analysis. Instrumental variables of 211 gut microbiota taxa were obtained from gene wide association study (GWAS), and Mendelian randomization study was carried out to estimate their effects on ADHD risk from PGC GWAS (20,183 ADHD cases and 35,191 controls) and FinnGen GWAS (830 ADHD cases and 215,763 controls). Wald ratio (WR), inverse variance weighted (IVW), MR-Egger, and weighted median were the main methods to analyze causality, and MR results are verified by several sensitivity analysis analyses. At locus-wide significance level (p < 1 × 10-5), IVW results confirmed that genus Eubacteriumhalliigroup (p = 0.013) and genus RuminococcaceaeUCG013 (p = 0.049) were correlated with the risk of ADHD and genus Butyricicoccus (p = 0.009), genus Roseburia (p = 0.009), genus Desulfovibrio (p = 0.015), genus LachnospiraceaeNC2004group (p = 0.026), genus Romboutsia (p = 0.028) and family Oxalobacteraceae (p = 0.048) were protective factors of ADHD. Weighted median results indicated that genus Butyricicoccus (p = 0.018) was negatively correlated with the risk of ADHD. At genome-wide statistical significance level (p < 5 × 10-8), Wald ratio results demonstrated that genus Ruminococcustorquesgroup (p = 0.003) was a risk factor for ADHD, while genus Romboutsia (p = 0.006) and family Peptostreptococcaceae (p = 0.006) had a negative correlation with the risk of ADHD. In reverse MR analysis, IVW results showed that ADHD may lead to an increase in the abundance of genus Roseburia (p = 0.020). Analysis of heterogeneity (p > 0.05) and pleiotropy (p > 0.05) confirmed the robustness of MR results. We demonstrated that there was a potential causal relationship between gut microbiota and ADHD. Our research provides a foundation for understanding the causal relationship between gut microbiota and ADHD, and the several gut bacteria found in this study that may reduce the occurrence of ADHD may have potential in the prevention and treatment of ADHD.
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Affiliation(s)
- Lei Wang
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, China
| | - Zhihao Xie
- The Second Hospital of Jilin University, Changchun, China
| | - Guoliang Li
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, China
| | - Guangyao Li
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, China
| | - Jianmin Liang
- Department of Pediatric Neurology, The First Hospital of Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, China
- *Correspondence: Jianmin Liang,
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6
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Lai J, Jiang F, Zhuo X, Xu X, Liu L, Yin K, Wang J, Zhao J, Xu W, Liu H, Wang X, Jiang W, Wang K, Yang S, Guo H, Qi F, Yuan X, Lin X, Fu G. Effects of Shenling Baizhu powder on pyrotinib-induced diarrhea: analysis of gut microbiota, metabonomics, and network pharmacology. Chin Med 2022; 17:140. [PMID: 36528679 PMCID: PMC9759852 DOI: 10.1186/s13020-022-00696-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Shenling Baizhu Powder (SBP) is a traditional Chinese medicine (TCM) prescription, which has the good efficacy on gastrointestinal toxicity. In this study, we used gut microbiota analysis, metabonomics and network pharmacology to investigate the therapeutic effect of SBP on pyrotinib-induced diarrhea. METHODS 24 Rats were randomly divided into 4 groups: control group, SBP group (3.6 g/kg /bid SBP for 10 days), pyrotinib model group (80 mg/kg/qd pyrotinib) and pyrotinib + SBP treatment group. A 16S rRNA sequencing was used to detect the microbiome of rat fecal bowel. Metabolic profiles were collected by non-targeted metabolomics and key metabolic pathways were identified using MetaboAnalyst 5.0. The antitumor effect of SBP on cells treated with pyrotinib was measured using a CCK-8 assay. Network pharmacology was used to predict the target and action pathway of SBP in treating pyrotinib-related diarrhea. RESULTS In vivo study indicated that SBP could significantly alleviate pyrotinib-induced diarrhea, reaching a therapeutic effect of 66.7%. SBP could regulate pyrotinib-induced microbiota disorder. LEfSe research revealed that the SBP could potentially decrease the relative abundance of Escherichia, Helicobacter and Enterobacteriaceae and increase the relative abundance of Lachnospiraceae, Bacilli, Lactobacillales etc. In addition, 25-Hydroxycholesterol, Guanidinosuccinic acid, 5-Hydroxyindolepyruvate and cAMP were selected as potential biomarkers of SBP for pyrotinib-induced diarrhea. Moreover, Spearman's analysis showed a correlation between gut microbiota and metabolite: the decreased 25-hydroxycholesterol in the pyrotinib + SBP treatment group was negatively correlated with Lachnospiraceae while positively correlated with Escherichia and Helicobacter. Meanwhile, SBP did not affect the inhibitory effect of pyrotinib on BT-474 cells and Calu-3 cells in vitro. Also, the network analysis further revealed that SBP treated pyrotinib-induced diarrhea through multiple pathways, including inflammatory bowel disease, IL-17 signaling pathway, pathogenic Escherichia coli infection and cAMP signaling pathway. CONCLUSIONS SBP could effectively relieve pyrotinib-induced diarrhea, revealing that intestinal flora and its metabolites may be involved in this process.
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Affiliation(s)
- Jingjiang Lai
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.464402.00000 0000 9459 9325The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250002 People’s Republic of China
| | - Fengxian Jiang
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.464402.00000 0000 9459 9325The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250002 People’s Republic of China
| | - Xiaoli Zhuo
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.410638.80000 0000 8910 6733The Clinical Medical College, Shandong First Medical University (Shandong Academy of Medicine), Jinan, 250117 People’s Republic of China
| | - Xiaoying Xu
- grid.27255.370000 0004 1761 1174Department of Pathology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China
| | - Lei Liu
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.410638.80000 0000 8910 6733The Clinical Medical College, Shandong First Medical University (Shandong Academy of Medicine), Jinan, 250117 People’s Republic of China
| | - Ke Yin
- grid.27255.370000 0004 1761 1174Department of Pathology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China
| | - Jingliang Wang
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.464402.00000 0000 9459 9325The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250002 People’s Republic of China
| | - Jing Zhao
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.410638.80000 0000 8910 6733The Clinical Medical College, Shandong First Medical University (Shandong Academy of Medicine), Jinan, 250117 People’s Republic of China
| | - Wei Xu
- grid.27255.370000 0004 1761 1174Department of Oncology, Shandong Provincial Hospital Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China
| | - Hongjing Liu
- grid.464402.00000 0000 9459 9325The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250002 People’s Republic of China
| | - Xuan Wang
- grid.464402.00000 0000 9459 9325The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250002 People’s Republic of China
| | - Wen Jiang
- grid.460018.b0000 0004 1769 9639Traditional Chinese Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Ke Wang
- grid.460018.b0000 0004 1769 9639Traditional Chinese Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Shuping Yang
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China
| | - Honglin Guo
- grid.27255.370000 0004 1761 1174Department of Central Laboratory, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China ,grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China
| | - Fanghua Qi
- grid.460018.b0000 0004 1769 9639Traditional Chinese Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Xiaotian Yuan
- grid.460018.b0000 0004 1769 9639Laboratory Animal Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China
| | - Xiaoyan Lin
- grid.27255.370000 0004 1761 1174Department of Pathology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China ,grid.460018.b0000 0004 1769 9639Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China
| | - Guobin Fu
- grid.460018.b0000 0004 1769 9639Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 People’s Republic of China ,grid.27255.370000 0004 1761 1174Department of Oncology, Shandong Provincial Hospital Cheeloo College of Medicine, Shandong University, Jinan, 250021 People’s Republic of China
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