The biologically active constituents in Gynostemma pentaphyllum are dammarane-type glycosides,called gypenosides.They are believed to be the highest contents of this herb,easy to obtain,and mainly active in anti-tumor,controlling the blood glucose,lipid-lowering,cardiovascular protection,etc.The saponins may change into sub-glucoside after hydrolysis,for the intemal acetal glucoside structure is vulnerable to acid,alkali,and enzyme degradation.Through searching the literatures in recent years,this paper summarized the chemical constituents in the hydrolyzed products of gypenosides,for providing references to discover novel and more active lead compounds.

Co2EDTA-DMAP.HCl.

Objective:To explore effects of early long-term exercise training on learning and memory impairment induced by recurrent seizures in neonatal rats.Method:Eighteen Sprague-Dawley rats at postnatal days 8 (P8) were randomly divided into control group (CONT),convulsion group (EXP1),and convulsion plus physical exercise group (EXP2)(Six in each group).Rats were fed for 1 day before the study.From P9,rats in EXP1 and EXP2 were subjected to flurothyl induced recurrent seizures 30min daily for 7 days.The rats of EXP2 were physical exercise from P16 to P57.The rats in control group were placed into the container for an equal amount of time to their counterpart without exposing to flurothyl.On P58-P64,subjects of the three groups were tested with Morris water maze.Result:①Place navigation test:there were significant differences among three groups [F=429.90,P＜0.05],day [F=282.30,P＜0.05],interaction [F=12.71,P＜0.05] by repeated two-way ANOVA analysis.Compared with CONT group,the escape latency in EXP1 was longer (P＜0.05).Compared with EXP1,the escape latency in EXP2 was shorter (P＜ 0.05).②Spatial probe test:Compared with CONT group,the frequency of passing through the platform in EXP1 was much less (P＜0.05).While compared with EXP1,the frequency of passing through the platform in EXP2 was much more (P ＜ 0.05).Conclusion:Physical exercise could significantly reduce the escape latency time and increase the number of crossing the platform in the recurrent seizure group,which may be due to the improvement of learning and memory ability of convulsive rats by physical exercise.

Objective Using an in vivo adeno-associated virus(AAV)-mediated gene transfer technique,this study was designed to evaluate the protective effects of human osteoprotegerin(OPG)transgene against joint destruction in collagen induced arthritis(CIA)model.MethodsAfter CIA was established in the Sprague-Dawley rats,the experimental animals were treated with PBS or rAAV-EGFP or rAAV-hOPG (100μl/d)intra-articular injection 25 days after arthritis induction for 10 days.Paraffin-embedded joints were then analyzed histologically.The joint destruction was evaluated by Larsen Score.The protein expression of OPG,IL-1,MMP-3 was identified by enzyme-linked immunosorbent assay(ELISA).Results Suecessful trans-gene expression was confirmed by the detection of OPG by ELISA and positive fluorescence of the frozen joint section. Image analysis revealed that the expression of OPG significantly protected against joint destruction by 30% compared with the CIA group. Conclusion OPG gene transfer mediated by rAAV effectively protects against bone destruction induced by CIA model. Those data suggest that gene transferring using rAAV-OPG may be a feasible and effective therapeutic approach to treat or prevent joint destruction in inflammatory arthritis.

Objective This study was designed to investigate the expression changes of osteopro-tegerin (OPG), tartrate-resistant acid phosphatase (TRAP) and vascular endothelial growth factor (VEGF) mRNA in collagen induced arthritis(CIA) rats. Methods After CIA was induced in Sprague-Dawley rats, the experimental animals were treated with PBS or rAAV-EGFP or rAAV-hOPG (100 μl/day) intra-articular injection for 10 days. Messenger RNAs (mRNAs) were obtained from CIA synovium 40days after first immun-ization. Reverse transcriptase-polymerase chain reactions (RT-PCR) were carried out to detect the mRNA encoding OPG, TRAP, VEGF and β-actin, which acted as inner control. The genes detected clearly by RT-PCR were quantified using real-time PCR. Results The expression of all genes was confirmed by specific single bands in RT-PCR. Real-time PCR showed that the expression levels of TRAP and VEGF were increased, whereas those of OPG mRNA were decreased in CIA group compared with normal controls. The intra-articular gene transduction markedly increased the gene copies of OPG by 128.21% (P<0.01). The expression change of OPG in synovium also caused the decrease of the expression levels of TRAP and VEGF by 58.79% (P<0.01)and 17.85% (P>0.05) respectively, however, the expression change of VEGF was not statistically significant. Conclusion OPG gene mediated by rAAV can be successfully tranfered to knee joint synovium in vivo. The results of this study suggest that gene transfer using rAAV-OPG may be a feasible and effective therapeutic approach to treat or prevent joint destruction in inflammatory arthritis.

Objective:To investigate the effect of Xuefu Zhuyu Decoction on myocardial protection and the interaction between Cadherin-NrF2 pathway and ferroptosis in patients with chronic heart failure resulting from qi deficiency and blood stasis. Methods:A case-control study was conducted on 100 patients with heart failure resulting from qi deficiency and blood stasis who received treatment at The First People's Hospital of Huzhou from February 2021 to May 2022. These patients were divided into a basic western medicine group and a Xuefu Zhuyu Decoction group with 50 patients per group using the random number table method. The basic western medicine group received conventional treatment, while the Xuefu Zhuyu Decoction group received treatment with Xuefu Zhuyu Decoction in addition to conventional treatment. Both groups were treated continuously for 8 weeks. Interleukin-13, intercellular adhesion molecule-1, nitric oxide, cystatin C, thromboxane B2, soluble cluster of differentiation 40 ligand, vascular endothelial cadherin were detected before and after treatment, and soluble tyrosine kinase receptor AXL (sAXL), soluble stromal lysin-2, and ferric ion levels were determined. The mRNA expression levels of glutathione peroxidase 4 and NrF2 were detected. Syndrome scores were evaluated. Clinical efficacy was compared between the two groups. Results:After treatment, the levels of interleukin-13 [(7.63 ± 1.85) ng/L], intercellular adhesion molecule-1 [(41.71 ± 6.25) ng/L], and cystatin C [(0.61 ± 0.17) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(10.56 ± 2.13) ng/L, (50.11 ± 8.34) ng/L, (1.03 ± 0.22) ng/L, t = 7.34, 5.69, 10.68, all P < 0.05]. The levels of soluble cluster of differentiation 40 ligand [(14.61 ± 1.19) μg/L] and thromboxane B2 [(40.18 ± 7.24) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(16.03 ± 1.47) μg/L, (53.37 ± 10.16) ng/L, t = 5.30, 7.47, both P < 0.05], while the level of nitric oxide [(59.92 ± 6.16) μmol/L] in the Xuefu Zhuyu Decoction group was significantly higher than that in the basic Western medicine group [(53.17 ± 5.49) μmol/L, t = 5.78, P < 0.05]. The level of ferric ion [(0.23 ± 0.08) μg/L] in the Xuefu Zhuyu Decoction group was significantly higher than that in the basic western medicine group [(0.16 ± 0.05) μg/L, t = 5.24, P < 0.05]. The levels of vascular endothelial cadherin [(3.02 ± 0.72) ng/L], NrF2 mRNA [(2.11 ± 0.43)], and glutathione peroxidase 4 mRNA [(4.65 ± 0.74)] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(4.34 ± 1.05) ng/L, (2.93 ± 0.56), (5.16 ± 0.88), t = 7.33, 8.21, 3.13, all P < 0.05]. The levels of Galectin-3 [(62.48 ± 6.09) μg/L], soluble stromal lysin-2 [(0.98 ± 0.24) ng/L], and sAXL [(42.16 ± 7.54) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(70.96 ± 8.15) μg/L, (1.57 ± 0.46) ng/L, (56.11 ± 10.02) ng/L, t = 5.89, 8.04, 7.86, all P < 0.05]. The Xuefu Zhuyu Decoction group had lower scores for shortness of breath or wheezing [(1.06 ± 0.24) points], palpitations [(0.92 ± 0.15) points], fatigue [(0.75 ± 0.17) points], low voice [(0.68 ± 0.16) points], spontaneous sweating [(0.83 ± 0.21) points], fatigue and laziness [(0.73 ± 0.20) points], prone to fatigue [(0.66 ± 0.14) points], and dark complexion or lips [(0.61 ± 0.16) points] compared with the basic western medicine group [(1.65 ± 0.49) points, (1.15 ± 0.27) points, (1.16 ± 0.31) points, (1.12 ± 0.29) points, (1.28 ± 0.32) points, (1.28 ± 0.37) points, (1.01 ± 0.21) points, (0.96 ± 0.25) points, t = 7.64, 5.26, 8.20, 9.39, 8.31, 9.24, 9.80, 8.33, all P < 0.05]. The total response rate of the Xuefu Zhuyu Decoction group was significantly higher than that of the basic western medicine group [(96.00% (48/50) vs. 88.00% (44/50), Z = 1.91, P < 0.05). Conclusion:Treating patients with heart failure with Xuefu Zhuyu Decoction can inhibit inflammation, improve vascular endothelial cell function, regulate Cadherin-NrF2 pathways, reduce oxidative stress injury, further inhibit ferroptosis, reduce the levels of Galectin-3, soluble stromal lysin-2, and sAXL, protect myocardium, relieve clinical symptoms, and improve its efficacy.

Objective:To investigate the clinical efficacy of Yiqi Yangyin decoction combined with metformin and irbesartan in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. Methods:A case-control study was performed to retrospectively analyze the clinical data of 92 patients with type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. These patients received treatment at the First People's Hospital of Huzhou from February 2021 to April 2023. They were divided into two groups, with 46 patients in each group, based on different treatment methods. The control group received metformin and irbesartan, while the observation group was treated with Yiqi Yangyin decoction in addition to the treatment provided to the control group. Both groups underwent treatment for 1 month. The clinical efficacy of the two groups was evaluated, and the changes in traditional Chinese medicine symptom scores, blood glucose levels, blood pressure, and the occurrence of adverse reactions were compared between the two groups before and after treatment. Results:The total response rate of the observation group was 93.48% (43/46), which was significantly higher than that of the control group [82.61% (38/46), χ2 = 5.63, P < 0.05). After treatment, the traditional Chinese medicine symptom score for the observation group was (9.43 ± 2.11) points, which was significantly lower than that of the control group [(12.11 ± 2.32) points, t = 11.34, P < 0.001]. The fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin levels in the observation group were (7.51 ± 1.34) mmol/L, (9.06 ± 2.11) mmol/L, and (6.23 ± 0.76)%, respectively, all of which were significantly lower than those in the control group [(8.75 ± 2.12) mmol/L, (11.15 ± 2.43) mmol/L, (7.11 ± 1.02)%, t = 4.13, 6.14, 4.01, all P < 0.05]. The systolic blood pressure in the observation group was (125.48 ± 8.14) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than that in the control group [(131.32 ± 9.22) mmHg, t = 6.76, P < 0.001]. The difference in the incidence of adverse reactions between the two groups was not statistically significant ( P > 0.05). Conclusion:Yiqi Yangyin decoction combined with metformin and irbesartan is highly effective in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. This combined therapy can effectively lower the traditional Chinese medicine symptom score, improve patients' blood glucose and blood pressure levels, and has a low incidence of adverse reactions.

Objective To examine the distribution,volume and glucose-uptake activity of brown adipose tissue (BAT) in adults and investigate their correlations with metabolic indicators.Methods 18F-flurodeoxyglucose (FDG) PET/CT was used to analyze the distribution,volume and glucose-uptake activity of BAT.The clinical and metabolic differences between BAT positive group (n =121) and BAT negative group (n=257) were compared.The influences of metabolic indicators (fast blood glucose (FBG),triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),uric acid (UA)) on the distribution,volume and activity of BAT were investigated.Logistic regression analysis,two-sample t test,x2 test and multiple linear regression were used to analyze the data.Results The distribution,volume and glucose-uptake activity of BAT were found to be significantly higher in subjects being tested in colder seasons than those who were tested in warmer seasons:2.91％ (87/2 991) vs 1.68％(34/2018),(433±402) vs (329±298) ml,(212±183) vs (169±145) g (x2=7.66,t values:3.36 and 2.98,all P＜0.05).The female proportion was significantly higher in BAT positive group than that in BAT negative group:68.60％ (83/121) vs 31.91％ (82/257) (x2 =16.10,P＜0.01).The average levels of age,body mass index (BMI),FBG,TG,TC,LDL-C and UA in BAT positive group were significantly low-er than those in BAT negative group:(41.30±10.90) vs (48.70±9.60) years,(21.30±2.40) vs (24.50± 3.10) kg/m2,(4.56±0.74) vs (5.34±1.33) mmol/L,(0.94±0.36) vs (2.06±1.64) mmol/L,(4.42± 0.79) vs (4.88±0.87) mmol/L,(1.99±0.58) vs (3.10±0.77) mmol/L,(285.11±70.00) vs (347.70± 101.10) μmol/L (t values:from-6.25 to-2.94,all P＜0.01).Logistic regression analysis revealed that season,gender,age,BMI,FBG,TG and LDL-C levels were all independent influencing factors of BAT distribution in adults (odds ratios:5.36,2.06,0.95,0.79,0.49,0.23,0.02;P＜0.01 or P＜0.05).Among BAT positive adults,gender and FBG levels were found to be strongly affected by the volume and glucose-uptake activity of BAT (β values:0.28,-0.21,both P＜0.05).Conclusions The distribution,volume and glucose-uptake activity of BAT in adults are associated with multiple metabolic indicators including BMI,levels of glucose,lipid and UA.The distribution of BAT is affected by gender,age,season,BMI,blood glucose,and blood lipids.

Objective:To investigate the value of radiomics signatures based on 18F-FDG PET/CT for predicting molecular classification and Ki-67 expression of breast cancer. Methods:A total of 134 female patients ((55.4±13.3) years) who underwent 18F-FDG PET/CT examination and were diagnosed with breast cancer by pathology in the First Affiliated Hospital of Soochow University from April 2016 to May 2023 were retrospectively enrolled. LIFEx software was used to extract radiomics features and the least absolute shrinkage and selection operator (LASSO) algorithm and independent-sample t test were used to screen potentially meaningful features and calculate the radiomics score, which were considered as radiomics models. Clinical characteristics were selected by supervised logistic regression and clinical models were established. Radiomics features and clinical characteristics were incorporated to logistic regression analysis to establish combined models. ROC curves were drawn and the differences among AUCs were analyzed by Delong test. Results:Among 134 patients, 22 were with triple negative breast cancer (TNBC), 47 were human epidermal growth factor receptor 2 (HER2) over-expression type, 37 were Luminal A type and the rest 28 were Luminal B type. The expression of Ki-67 was high in 85 patients, and was low in the rest 49 patients. The AUCs (95% CI) of the combined models for predicting TNBC, HER2 overexpression type, Luminal A type and Ki-67 expression were 0.843(0.770-0.900), 0.808(0.723-0.876), 0.825(0.711-0.908) and 0.836(0.762-0.894), respectively, which were higher than those of clinical models ( z values: 1.97-3.06, all P<0.05). Conclusion:The predictive model combining radiomics signatures based on 18F-FDG PET/CT and clinical characteristics can well predict the molecular classification and Ki-67 expression level of breast cancer.

Objective To investigate the relationship between hemoglobin glycation index(HGI)and metabolic syndrome(MS)and its components.Methods A cross-sectional study was conducted to randomly select 823 patients from the First People's Hospital of Huzhou from September 2022 to September 2023.HGI is calculated based on fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)values.The patients were divided into low HGI group(HGI<-0.250%,274 cases),medium HGI group(-0.250%≤HGI≤0.214%,275 cases)and high HGI group(HGI>0.214%,274 cases)by HGI quantile method.The general data and metabolic indexes of each group were compared,and the correlation between HGI and MS and its components was analyzed by multiple Logistic regression.Results With the increase of HGI level,the prevalence rate of MS showed an upward trend(P<0.05).The prevalence rate of MS in low,medium and high HGI groups was 24.8%,42.5%and 55.5%,respectively.Multiple Logistic regression analysis showed that elevated HGI level was risk factor for MS,central obesity,hypertension,hyperglycemia,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia(P<0.05).The risk of MS,central obesity,hypertension,hyperglycemia,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia in high HGI group was 4.005 times(95%CI:2.763-5.808),3.765 times(95%CI:2.604-5.443),1.596 times(95%CI:1.089-2.337),2.655 times(95%CI:1.809-3.895),2.024 times(95%CI:1.404-2.918)and 2.247 times(95%CI:1.537-3.284)of that in low HGI group,respectively.Conclusion HGI is related to MS and its components,and HGI may be a new indicator to prevent and monitor MS.