ObjectiveTo investigate the mechanisms by which Dahuang Gancaotang （DHGC） alleviates ferroptosis in chronic kidney disease （CKD） via silent information regulator 3 （SIRT3）-mediated deacetylation of tumor protein p53 （p53）. MethodsIn vivo， a CKD mouse model was established by feeding a 0.2% adenine-containing diet. Seventy-two C57BL/6 mice were randomly divided into six groups： blank group， model group， DHGC low-， medium-， and high-dose groups （0.975， 1.95， 3.90 g·kg^-1）， and valsartan group （0.025 g·kg^-1）， with 12 mice in each group. Renal function was evaluated by measuring serum blood urea nitrogen （BUN） and creatinine （SCr）. Renal pathological changes were assessed using hematoxylin-eosin （HE）， periodic acid-Schiff （PAS）， and Masson staining. Immunohistochemistry was used to detect the expression of collagen type （Col）Ⅰ， ColⅢ， and α-smooth muscle actin （α-SMA） in renal tissue to evaluate renal fibrosis. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） to assess inflammatory responses. Colorimetric assays were used to determine superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione （GSH）， and renal total iron content to evaluate lipid peroxidation and iron metabolism. Western blot was used to detect the protein expression of the SIRT3/p53 signaling pathway， acetylated p53 （ac-p53）， and glutathione peroxidase 4 （GPX4） in renal tissue. In vitro， a ferroptosis model of HK-2 cells was induced using erastin. Cells were divided into six groups： blank group， model group， DHGC-containing serum low-， medium-， and high-dose groups （15 rats were randomly divided into three groups， n = 5 per group， and gavaged with 0.675， 1.35， 2.70 g·kg^-1 to prepare medicated serum）， and ferrostatin-1 （Fer-1） group （5 μmol·L^-1）. The cell counting Kit-8 （CCK-8） assay was used to determine cell viability and to screen the optimal concentrations of erastin and DHGC-containing serum. Western blot was used to detect SIRT3/p53 pathway proteins， ac-p53， and GPX4 expression. Immunofluorescence confocal microscopy was used to observe p53 nuclear translocation. ResultsIn vivo， compared with the blank group， the model group showed significantly increased BUN and SCr levels （P<0.01）. Severe renal pathological injury and aggravated renal fibrosis were observed. Lipid peroxidation and iron metabolism disorders were evident， as shown by significantly decreased SOD and GSH levels and significantly increased MDA and renal total iron levels （P<0.05， P<0.01）. Compared with the model group， all the above indices were significantly improved after DHGC intervention in a dose-dependent manner （P<0.05， P<0.01）. In vitro， compared with the blank group， HK-2 cell viability was significantly decreased in the model group. A concentration of 0.4 μmol·L^-1 erastin was identified as the optimal induction dose， and high-dose DHGC-containing serum was identified as the optimal treatment condition. Compared with the model group， cell viability was significantly increased in all DHGC-containing serum groups （P<0.05， P<0.01）. Mechanistically， compared with the blank group， protein expression of SIRT3 and GPX4 was significantly decreased in both in vivo and in vitro model groups， while p53 and ac-p53 expression and p53 nuclear translocation were significantly increased （P<0.01）. Compared with the model group， these changes were significantly reversed after DHGC intervention （P<0.05， P<0.01）. ConclusionDHGC exerts a protective effect against adenine-induced CKD in mice and erastin-induced ferroptosis in HK-2 cells. The mechanism is associated with its anti-ferroptosis effect mediated via the SIRT3/p53 signaling pathway.

ObjectiveTo investigate the protective effects of Zuogui Wan （ZGW） decoction on nephrotic syndrome （NS） through the regulation of gut microbiota. MethodsThirty male Sprague-Dawley （SD） rats were randomly divided into five groups， with 6 rats in each group： The control group， model group， low-dose group， medium-dose group， and high-dose group. The NS rat model was induced by tail vein injection of 6.5 mg·kg^-1 doxorubicin. After successful modeling， the control and model groups were gavaged with normal saline （10 mL·kg^-1） twice daily， while the low- （50 mg·kg^-1）， medium- （100 mg·kg^-1）， and high-dose （200 mg·kg^-1） groups were gavaged with ZGW （10 mL·kg^-1） twice daily. All rats were administered at fixed intervals daily for 8 consecutive weeks. The therapeutic effects of ZGW on NS in rats were observed， and the optimal dose was screened. Renal and intestinal pathological changes in rats were examined. Fecal samples were collected， and 16S rDNA sequencing technology was used to detect the diversity and abundance of gut microbiota in each group. ResultsCompared with the control group， 24-hour urinary protein， serum creatinine， urea nitrogen， and cholesterol levels significantly increased in the model group （P<0.01）， while serum albumin levels decreased （P<0.01）. These changes were ameliorated in the treatment groups （P<0.05， P<0.01）. Renal pathology revealed intact and orderly arranged glomeruli and renal tubules in the control group. In the model group， glomerular atrophy， widened mesangial areas， podocyte swelling， disordered renal tubular arrangement， and numerous casts were observed. Varying degrees of glomerular atrophy and disordered renal tubular arrangement were seen in the treatment groups. Specific protein assays revealed increased serum levels of kidney injury molecule-1（KIM-1） and α1-microglobulin （P<0.01）， and significantly decreased levels of E-cadherin， Podocin， and Nephrin in renal tissues （P<0.01）， along with a significant increase in transforming growth factor-β（TGF-β） （P<0.01） in the model group. In the treatment groups， serum KIM-1 and α1-microglobulin levels decreased， E-cadherin levels significantly increased （P<0.01）， and TGF-β levels significantly decreased （P<0.01）. Podocin and Nephrin levels increased in the high-dose group （P<0.05）. Additionally， intestinal mucosal atrophy， epithelial cell edema， decreased goblet cells， and multiple inflammatory infiltrations were observed in the model group. The sequencing results of gut microbiota demonstrate that ZGW can significantly ameliorate intestinal dysbiosis in rats， restore the abundance of beneficial bacteria， and exert a profound influence on the compositional profile of gut microbiota. ConclusionZGW can alleviate renal injury in rats with nephrotic syndrome by improving gut microbiota and protecting the intestinal barrier.

Urate oxidase (Uox) plays a pivotal role in uric acid (UA) degradation, and it has been applied in controlling serum UA level in clinical treatment of hyperuricemia (HUA). However, because Uox is a heterogenous protein to the human body, the immune rejections typically occur after intravenous administration, which greatly hampers the application of Uox-based agents. In this study, we used Lactococcus lactis NZ9000, a food-grade bacterium, as a host to express exogenous Uox genes, to generate the Uox-expressing engineered strains to treat HUA. Aspergillus flavus-derived Uox (aUox) and the "resurrected" human-derived Uox (hUox) were cloned into vector and expressed in NZ9000, to generate engineered strains, respectively. The engineered NZ9000 strains were confirmed to express Uox and showed UA-lowering activity in a time-dependent manner in vitro. Next, in an HUA mice model established by oral gavage of yeast paste, the UA levels were increased by 85.4% and 106.2% at day 7 and day 14. By contrast, in mice fed with NZ9000-aUox, the UA levels were increased by 39.5% and 48.3% while in mice fed with NZ9000-hUox were increased by 57.0% and 82.9%, suggesting a UA-lowering activity of both engineered strains. Furthermore, compared with allopurinol, the first-line agent for HUA treatment, mice fed with NZ9000-aUox exhibited comparable liver safety but better kidney safety than allopurinol, indicating that the use of engineered NZ9000 strains not only alleviated kidney injury caused by HUA, but could also avoided the risk of kidney injury elicited by using allopurinol. Collectively, our study offers an effective and safe therapeutic approach for HUA long-term treatment and controlling.
Animals ; Lactococcus lactis/metabolism* ; Urate Oxidase/genetics* ; Mice ; Uric Acid/blood* ; Hyperuricemia ; Humans ; Administration, Oral ; Aspergillus flavus/genetics* ; Male

OBJECTIVE To study the sp ectrum-effect relationship of anti-gastric ulcer effect of Shaoyao gancao decoction. METHODS Eleven batches of Shaoyao gancao decoction were prepared ；gastric ulcer model was established by anhydrous ethanol modeling method. Using Weikangling as positive control ，the effects of Shaoyao gancao decoction on the contents of defensive factors [nitric oxide （NO），epidermal growth factor （EGF），superoxide dismutase （SOD）] and attack factor [malondialdehyde （MDA）] in gastric tissue of model rats were investigated. HPLC fingerprints of 11 batches of Shaoyao gancao decoction were established and similarity evaluation was performed with Similarity Evaluation System of Traditional Chinese Medicine Chromatographic Fingerprint （2004A edition ）； common peaks were identified by comparing with mixed control. The spectrum-effect relationship of Shaoyao gancao decoction against gastric ulcer was analyzed based on the grey correlation analysis. RESULTS Eleven batches of Shaoyao ganyao decoction could significantly decrease the content of MDA in gastric tissue ，while increased the contents of NO ，EGF and SOD in gastric ulcer model rats （P＜0.01），and had a certain inhibitory effect on the gastric ulcer. There were 23 common peaks in chromatograms of 11 batches of samples ，and the similarity with the control fingerprint was not less than 0.9. By comparing with mixed control ，7 common peaks were identified ，namely gallic acid （peak 5），albiflorin（peak 9），paeoniflorin（peak 10），liquiritin（peak 12），isoliquiritin apioside （peak 14），isoliquiritoside（peak 15）， glycyrrhizic acid （peak 22）. The average correlation degree of 7 identified common peaks and pharmacodynamic indexes were greater than 0.6，of which peak 22（glycyrrhizic acid ），peak 10（paeoniflorin）and peak 12（liquiritin）had the largest correlation ， and their values were 0.807，0.772 and 0.770 respectively. RESULTS The anti-gastric ulcer effect of Shaoyao gancao decoction is the result of the synergistic effect of multiple components ，among which glycyrrhizic acid ，paeoniflorin and liquiritin may be the main pharmacodynamic components.

The coronavirus disease 2019 (COVID-19) pandemic is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is spread primary via respiratory droplets and infects the lungs. Currently widely used cell lines and animals are unable to accurately mimic human physiological conditions because of the abnormal status of cell lines (transformed or cancer cells) and species differences between animals and humans. Organoids are stem cell-derived self-organized three-dimensional culture in vitro and model the physiological conditions of natural organs. Here we showed that SARS-CoV-2 infected and extensively replicated in human embryonic stem cells (hESCs)-derived lung organoids, including airway and alveolar organoids which covered the complete infection and spread route for SARS-CoV-2 within lungs. The infected cells were ciliated, club, and alveolar type 2 (AT2) cells, which were sequentially located from the proximal to the distal airway and terminal alveoli, respectively. Additionally, RNA-seq revealed early cell response to virus infection including an unexpected downregulation of the metabolic processes, especially lipid metabolism, in addition to the well-known upregulation of immune response. Further, Remdesivir and a human neutralizing antibody potently inhibited SARS-CoV-2 replication in lung organoids. Therefore, human lung organoids can serve as a pathophysiological model to investigate the underlying mechanism of SARS-CoV-2 infection and to discover and test therapeutic drugs for COVID-19.
Adenosine Monophosphate/therapeutic use* ; Alanine/therapeutic use* ; Alveolar Epithelial Cells/virology* ; Antibodies, Neutralizing/therapeutic use* ; COVID-19/virology* ; Down-Regulation ; Drug Discovery ; Human Embryonic Stem Cells/metabolism* ; Humans ; Immunity ; Lipid Metabolism ; Lung/virology* ; RNA, Viral/metabolism* ; SARS-CoV-2/physiology* ; Virus Replication/drug effects*

Objective: Apolipoprotein E (ApoE) is mainly synthesized in the liver. So far, it is unknown the relationship among APOE gene polymorphisms and WML, brain atrophy. Therefore, the aim of the study was to assess the associations of APOE gene polymorphisms in patients with WML and brain atrophy. Methods: A total of 58 patients with WML, 128 patients with brain atrophy, 112 patients with co-occurrence of WML and brain atrophy and 95 healthy elderly volunteers were recruited from Renmin Hospital of WuHan University. Results: Allele E3 was the most common allele. The alleles E2 had significantly higher levels of ApoB and lower age in WML group. The alleles E2 was associated with the lower level of ApoB, LDL-Ch, TCh, and sdLDL in co-occurrence group. The E3/E3 genotype has higher level of sdLDL, but lower age and female frequency in WML. The E3/E4 genotype had higher level of TG, but lower age in WML. Gender, Age, E2, Hyperhomocysteinemia and UA were also significantly associated with disease progression. Conclusion This study found that clinical data, lipids and metabolic complications were closely related to ApoE genotypes and alleles, and also disease progression and type.

Drug stability is closely related to drug safety and needs to be considered in the process of drug production, package and storage. To investigate the stability of epalrestat, a carboxylic acid derivative, a reversed-phase high-performance liquid chromatography (RP-HPLC) method was developed in this study and applied to analyzing the degradation kinetics of epalrestat in aqueous solutions in various conditions, such as dif-ferent pH, temperatures, ionic strengths, oxidation and irradiation. The calibration curve was A=1.6 × 105C–1.3 × 103 (r=0.999) with the liner range of 0.5–24 μg/mL, the intra-day and inter-day precision was less than 2.0%, as was the repeatibility. The average accuracy for different concentrations was more than 98.5%, indicating that perfect recoveries were achieved. Degradation kinetic parameters such as degradation rate constants (k), activation energy (Ea) and shelf life (t0.9) under different conditions were calculated and discussed. The results indicated that the degradation behavior of epalrestat was pH-dependent and the stability of epalrestat decreased with the rised irradiation and ionic strength;however, it was more stable in neutral and alkaline conditions as well as lower temperatures. The results showed that the degradation kinetics of epalrestat followed first-order reaction kinetics. Furthermore, the degradation products of epalrestat under stress conditions were identified by UHPLC-PDA-MS/MS, with seven degradation products being detected and four of them being tentatively identified.

This study was aimed to establish an HPLC method to simultaneous determine 6 kinds of monoester and diester aconitum alkaloids. The content of alkaloids in aconite roots, black and white prepared lateral root of aconite and the compatibility of aconite roots with rhubarb were determined. This study provided reference for the interpreta-tion of the attenuation of processing and compatibility of medicines from chemical component aspect. The HPLC analysis was performed on a Phenomenex Gemini C18 (4.6 mm í 250 mm, 5 μm) with 40 mmol·L-1 ammonium ac-etate (adjusted to pH 9.8 with ammonia water) and acetonitrile as mobile phase, with a gradient elution at the flow rate of 1.0 mL·min-1 and a detection wavelength of 235 nm. The results showed that 6 alkaloids in aconite roots achieved favorable separation and a good linearity relationship (r > 0.999) over the studied concentration range. The extraction recoveries were ranged from 96.9% to 102.4% for the 6 alkaloids. The content of diester alkaloids de-creased markedly in processed products and the compatibility of aconite roots with rhubarb compared with the raw a-conite roots. It was concluded that this method was stable, reliable, simple and practical. It can be used for the si-multaneous determination of 6 kinds of monoester and diester aconitum alkaloids in aconite roots. This processing and compatibility can significantly reduce the content of alkaloids in aconite roots in order to reduce its toxicity.

A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.

Objective To study on 24 hours hernia grassroots level in the district hospital management model practices. Methods The subjects were 283 cases of inguinal hernia patients selected from January 2008 to December 2010 in our hospital as the traditional model of the group , the treatment in the traditional management model , our hospital im-proved the management mode after January 2011 , 326 cases of inguinal hernia patients selected from January 2011 to December 2013 in our hospital as a new model group , that under the new model in 24 hours hernia treatment mode. Results Under the new model,patients waiting for surgery, hospitalization time and the days of antibiotic use were sig-nificantly shorten than the traditional model , the cost of hospitalization was significantly reduced , the difference was statistically significant (P<0.05). Under the new model, patient satisfaction was significantly higher than the traditional model, and the complication rate was significantly lower than the traditional model, the difference was statistically sig-nificant (P<0.05). Conclusion 24 h hernia is safe, effective, and economic characteristics, enabling a more rational use of health care resources and deployment , significantly reducing health care costs , can promote the application in district hospitals.