1.Active Components in Chinese Medicinal Herbs Regulate AMPK/mTOR Pathway to Mediate Autophagy in Diabetic Kidney Disease: A Review
Menghan REN ; Lixia YANG ; Yonglin LIANG ; Ciyan LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(18):277-282
Diabetic kidney disease (DKD) is one of the typical microvascular complications in patients with diabetes and a major cause of end-stage renal disease, with the pathogenesis remains to be elucidated. It may be associated with hemodynamic effects, genetic factors, kidney inflammatory injury, oxidative stress, autophagy dysregulation, metabolic disorders and so on. Because of its complex mechanism, there are no specific prevention and treatment measures in clinical practice. AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) signaling pathway is a classical pathway involved in the regulation of autophagy. This pathway can be activated for treating DKD. Recent studies have demonstrated that the active components in Chinese medicinal herbs play a role in the prevention and treatment of DKD by directly acting on targeted cells and autophagy targets, which has attracted extensive attention. Researchers have extensively studied the occurrence and development of DKD and the mechanism of drug intervention in DKD, and the results prove that AMPK/mTOR pathway plays a role in the development of this disease. The active components in Chinese medicinal herbs regulate the AMPK/mTOR signaling pathway to affect autophagy, alleviate oxidative stress, inflammation, and extracellular matrix aggregation, and promote the generation of autophagosomes, thus mitigating kidney injury. This paper mainly reviews the relationship between AMPK/mTOR signaling pathway, autophagy, and DKD and the mechanism of active components in Chinese medicinal herbs in mediating autophagy via the AMPK/mTOR pathway, aiming to provide a theoretical basis for the clinical prevention and treatment of DKD.
2.Treatment strategies of vertical vein during correction for total anomalous pulmonary venous connection in newborns
Xiaohua LI ; Jimei CHEN ; Ciyan XIE ; Hailong QIU ; Jianzheng CEN ; Shusheng WEN ; Gang XU ; Jian ZHUANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(06):640-644
Objective To compare the effect of different treatment strategies of vertical vein on the postoperative efficacy of total anomalous pulmonary venous connection (TAPVC) in newborns. Methods The clinical data of 72 TAPVC newborns who underwent correction in our hospital from June 2008 to January 2018 were retrospectively analyzed. There were 59 males and 13 females, with an average age of 9.93±8.13 d. According to different vertical vein treatment strategies, the patients were divided into an unligated group (22 patients), a partially ligated group (23 patients) and a completely ligated group (27 patients). The mortality and incidence of common complications among the groups were compared. Results In the completely ligated group, the aortic cross-clamp time was longer (P=0.001), intraoperative circulatory arrest cases were less (P=0.005), and the early velocity of pulmonary vein was faster (P=0.029), but there was no significant difference in the velocity of pulmonary vein for the last follow-up among three groups (P=0.393). There was no significant difference in other perioperative indicators among groups, including the early mortality, the incidence of pulmonary vein obstruction and the non-closure of vertical vein after surgery (P>0.05). The mean follow-up time was 4.47±2.63 years. The follow-up mortality was not significantly different among groups (P>0.05). The cardiac function (NYHA) of all the 64 survived patients was classⅠ-Ⅱ. Conclusion Proper vertical vein treatment strategies may be conducive to a smooth transition after surgery, ensuring the success of surgeries.