BACKGROUND:Triptolide,a bioactive component of the traditional Chinese medicine Tripterygium wilfordii,has a certain protective effect on neurons.OBJECTIVE:To investigate the effect of triptolide on cerebral ischemia/reperfusion injury.METHODS:(1)Cell experiment:Hippocampal neurons(HT22 cells)were randomly divided into control group,glucose oxygen deprivation/reoxygenation(OGD/R)group,OGD/R+triptolide group,OGD/R+triptolide+si-TIGAR group,OGD/R+si-TIGAR group,and OGD/R+triptolide+rapamycin group.HT22 cell viability was detected by cell counting kit 8.Tp53-induced glycolysis and apoptosis factors,glutathione peroxidase 4,7 members of the solsolic vector family 11,sphingosine kinase 1(SPHK1)and(mTOR)were detected by western blot assay.Glutathione,malondialdehyde and iron level were detected using the biochemical kit.(2)Animal experiment:Rats were randomly divided into sham surgery group,model group,and triptolide group.Cerebral artery occlusion/reperfusion rat models were prepared in the latter two groups.Rats in the triptolide group were orally administered 50 mg/kg triptolide for 7 days.Twenty-four hours after administration,LONGA method was used to evaluate the neurological impairment of rats,TTC method was used to observe the conditions of cerebral infarction,TUNEL staining was used to detect cell apoptosis,and western blot was performed to detect the expression level of related proteins.RESULTS AND CONCLUSION:(1)At the cellular level,triptolide promoted cell viability and inhibited apoptosis in HT22 cells treated with OGD/R.Triptolide also increased the expression levels of Tp53-induced glycolysis and apoptosis factors,glutathione peroxidase 4,and 7 members of the solsolic vector family 11,activated the SPHK1/mTOR pathway,increased glutathione content,inhibited malondialdehyde content and iron levels.Rapamycin treatment counteracted the protective effect of triptolide on HT22 cells.(2)At the animal level,triptolide significantly reduced neurological deficits,infarct volume,and cell apoptosis,and inhibited neuronal ferroptosis in brain tissue of rats.To conclude,triptolide can inhibit ferroptosis by upregulating the expression level of Tp53-induced glycolysis and apoptosis factors and activating the SPHK1/mTOR signaling,and thereby reduced cerebral ischemia/reperfusion injury.These findings suggest that triptolide may be a candidate drug for the treatment of cerebral ischemia/reperfusion injury.

BACKGROUND:Triptolide,a bioactive component of the traditional Chinese medicine Tripterygium wilfordii,has a certain protective effect on neurons.OBJECTIVE:To investigate the effect of triptolide on cerebral ischemia/reperfusion injury.METHODS:(1)Cell experiment:Hippocampal neurons(HT22 cells)were randomly divided into control group,glucose oxygen deprivation/reoxygenation(OGD/R)group,OGD/R+triptolide group,OGD/R+triptolide+si-TIGAR group,OGD/R+si-TIGAR group,and OGD/R+triptolide+rapamycin group.HT22 cell viability was detected by cell counting kit 8.Tp53-induced glycolysis and apoptosis factors,glutathione peroxidase 4,7 members of the solsolic vector family 11,sphingosine kinase 1(SPHK1)and(mTOR)were detected by western blot assay.Glutathione,malondialdehyde and iron level were detected using the biochemical kit.(2)Animal experiment:Rats were randomly divided into sham surgery group,model group,and triptolide group.Cerebral artery occlusion/reperfusion rat models were prepared in the latter two groups.Rats in the triptolide group were orally administered 50 mg/kg triptolide for 7 days.Twenty-four hours after administration,LONGA method was used to evaluate the neurological impairment of rats,TTC method was used to observe the conditions of cerebral infarction,TUNEL staining was used to detect cell apoptosis,and western blot was performed to detect the expression level of related proteins.RESULTS AND CONCLUSION:(1)At the cellular level,triptolide promoted cell viability and inhibited apoptosis in HT22 cells treated with OGD/R.Triptolide also increased the expression levels of Tp53-induced glycolysis and apoptosis factors,glutathione peroxidase 4,and 7 members of the solsolic vector family 11,activated the SPHK1/mTOR pathway,increased glutathione content,inhibited malondialdehyde content and iron levels.Rapamycin treatment counteracted the protective effect of triptolide on HT22 cells.(2)At the animal level,triptolide significantly reduced neurological deficits,infarct volume,and cell apoptosis,and inhibited neuronal ferroptosis in brain tissue of rats.To conclude,triptolide can inhibit ferroptosis by upregulating the expression level of Tp53-induced glycolysis and apoptosis factors and activating the SPHK1/mTOR signaling,and thereby reduced cerebral ischemia/reperfusion injury.These findings suggest that triptolide may be a candidate drug for the treatment of cerebral ischemia/reperfusion injury.

Age-related macular degeneration (AMD) represents a predominant cause of blindness among older adults, with limited therapeutic options currently available. Oxidative stress, inflammation, and retinal pigment epithelium injury are recognized as key contributors to the pathogenesis of AMD. Regulated cell death plays a pivotal role in mediating cellular responses to stress, maintaining tissue homeostasis, and contributing to disease progression. Recent research has elucidated several regulated cell death pathways-such as apoptosis, ferroptosis, pyroptosis, necroptosis, and autophagy-that may contribute to the progression of AMD owing to cell death in the retinal pigment epithelium. These discoveries open new avenues for therapeutic interventions in patients with AMD. In this review, we provide a comprehensive summary and analysis of the latest advancements regarding the relationship between regulated cell death and AMD. Moreover, we examined the therapeutic potential of targeting regulated cell death pathways for the treatment and prevention of AMD, highlighting their roles as promising targets for future therapeutic strategies.

Guided by the concept of quality by design(QbD), this study optimizes the calcination and quenching process of calcined Magnetitum and establishes the XRD characteristic spectra of calcined Magnetitum, providing a scientific basis for the formulation of quality standards. Based on the processing methods and quality requirements of Magnetitum in the Chinese Pharmacopoeia, the critical process parameters(CPPs) identified were calcination temperature, calcination time, particle size, laying thickness, and the number of vinegar quenching cycles. The critical quality attributes(CQAs) included Fe mass fraction, Fe~(2+) dissolution, and surface color. The weight coefficients were determined by combining Analytic Hierarchy Process(AHP) and the criteria importance though intercrieria correlation(CRITIC) method, and the calcination process was optimized using orthogonal experimentation. Surface color was selected as a CQA, and based on the principle of color value, the surface color of calcined Magnetitum was objectively quantified. The vinegar quenching process was then optimized to determine the best processing conditions. X-ray diffraction(XRD) was used to establish the characteristic spectra of calcined Magnetitum, and methods such as similarity evaluation, cluster analysis, and orthogonal partial least squares-discriminant analysis(OPLS-DA) were used to evaluate the quality of the spectra. The optimized calcined Magnetitum preparation process was found to be calcination at 750 ℃ for 1 h, with a laying thickness of 4 cm, a particle size of 0.4-0.8 cm, and one vinegar quenching cycle(Magnetitum-vinegar ratio 10∶3), which was stable and feasible. The XRD characteristic spectra analysis method, featuring 9 common peaks as fingerprint information, was established. The average correlation coefficient ranged from 0.839 5-0.988 1, and the average angle cosine ranged from 0.914 4 to 0.995 6, indicating good similarity. Cluster analysis results showed that Magnetitum and calcined Magnetitum could be grouped together, with similar compositions. OPLS-DA discriminant analysis identified three key characteristic peaks, with Fe_2O_3 being the distinguishing component between the two. The final optimized processing method is stable and feasible, and the XRD characteristic spectra of calcined Magnetitum was initially established, providing a reference for subsequent quality control and the formulation of quality standards for calcined Magnetitum.
X-Ray Diffraction/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control ; Particle Size

Objective:This study aimed to examine the association between malnutrition diagnosed by the Global Leadership Initiative on Malnutrition(GLIM)criteria and clinical outcomes in surgical patients,as well as to assess its prognostic impact on postoperative adverse clinical outcomes.Methods:Electronic databases,including PubMed,Embase,Web of Science,CINAHL,Scopus,The Cochrane Library,Clinical Trials,CNKI,Wanfang Data Knowledge Service Platform,and the Chinese Biomedical Literature Database,were systematically searched.Relevant cohort studies utilizing GLIM criteria to preoperatively diagnose malnutrition in surgical inpatients were included.The exposed group comprised surgical patients diagnosed with preoperative malnutrition using GLIM criteria,while the control group consisted of surgically treated patients without malnutrition as per GLIM criteria.Literature quality was evaluated using the Newcastle-Ottawa Scale(NOS),and meta-analysis was performed using Review Manager 5.4 software.Results:Fourteen literatures were included,with a total sample size of 10,045 patients.Meta-analysis revealed that the malnourished group had a higher incidence of postoperative complications compared to the non-malnourished group[risk ratio(RR)=1.81,95%CI:1.66～1.98),P<0.00001].Additionally,the incidence of severe complications was significantly higher in GLIM-diagnosed malnourished patients.The malnourished group exhibited poorer overall survival[hazard ratio(HR)=1.90,95%CI:1.55～2.34,P<0.00001]and disease-free survival[HR=2.25,95%CI:1.02～4.93,P=0.04]compared to the non-malnourished group.Conclusion:GLIM-diagnosed malnutrition is significantly associated with adverse clinical outcomes in surgical patients,increasing postoperative complication rates and reducing overall and disease-free survival.The GLIM criteria demonstrate value in predicting adverse clinical outcomes in this population.Further high-quality studies are warranted to validate these findings.

Objective:To determine appropriate cutoff values for evaluating hypoxemia severity in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study selected data from 1, 781 young patients with obstructive sleep apnea (OSA) who underwent polysomnography in the Department of Otorhinolaryngology Head and Neck Surgery of the Sixth Medical Center of PLA General Hospital from January 2015 to June 2023. The cohort included 1, 604 males and 177 females, with a mean age of (32.6±5.3) years. The relationship between the minimum arterial oxygen saturation (MSaO 2) and the prevalence of hypertension in this population was investigated. Subjects were categorized into seven groups based on MSaO 2 levels: Group 1 (MSaO 2≥90%), Group 2 (85%≤MSaO 2<90%), Group 3 (80%≤MSaO 2<85%), Group 4 (75%≤MSaO 2<80%), Group 5 (70%≤MSaO 2<75%), Group 6 (65%≤MSaO 2<70%), and Group 7 (MSaO 2<65%). The prevalence of hypertension in each group was statistically analyzed, and the chi-square test was used to identify significant differences in hypertension prevalence. The diagnostic performance of the new versus traditional grouping methods was evaluated using receiver operating characteristic (ROC) curve analysis. Results:Among the 1, 781 OSA patients, 915 had hypertension. The prevalence of hypertension in Groups 1 to 7 was 27.8%, 42.4%, 52.2%, 54.1%, 59.5%, 70.5%, and 75.4%, respectively. Significant differences in hypertension prevalence were observed between Group 1 and other groups, Group 2 and Groups 5-7, Group 3 and Groups 6-7, and Group 4 and Group 7( χ2=187.94, P<0.001). After merging the groups based on MSaO 2 thresholds of≥90%, 90%>MSaO 2≥85%, 85%>MSaO 2≥75%, and MSaO 2<75%, the prevalence of hypertension in the new groups was 27.8%, 42.4%, 53.0%, and 71.2%, respectively, with significant differences between adjacent groups( χ2=178.99, P<0.001). ROC curve analysis revealed that the area under the curve (AUC) for the new grouping method (0.676) was higher than that for the original grouping method (0.664). Conclusions:As hypoxemia severity increases in OSA, so does the prevalence of comorbid hypertension. Using MSaO 2 cutoff values of 90%, 85%, and 75% to categorize hypoxemia severity appears more appropriate compared to the existing guideline values of 90%, 85%, and 80%.

Objective:A retrospective analysis was conducted on the clinical characteristics and polysomnography (PSG) features of patients with obstructive sleep apnea (OSA) of different ages.Methods:From January 2015 to March 2024, the patients who underwent overnight PSG monitoring at the Sleep Respiratory Disease Diagnosis and Treatment Center, Department of Otolaryngology, Head and Neck Surgery, Sixth Medical Center of the PLA General Hospital were sequentially enrolled.A total of 4 396 patients[aged from 18 to 97(46.04±12.60)years] with OSA who met the criteria were finally enrolled and divided into the youth group (18-44 years old, n=2 099), middle-aged group (45-59 years old, n=1 641), and elderly group (≥60 years old, n=656).The differences in general condition, Epworth sleepiness Scale (ESS) score, rapid eye movement sleep (REM) sleep time in total sleep time, micro-awakening index, apnea hypopnea index (AHI), minimum oxygen saturation at night (LSpO 2), oxygen hypoxia index (ODI) and so on were compared.Multivariate Logistic regression was used to analyze the relationship between age stratification and different severity of OSA (mild 5≤AHI≤15, moderate 1530, Times per hour). Results:The neck circumference [(39.11±3.71) cm], body mass index [BMI, (26.63±3.70) kg/m2], total sleep time [(386.13±66.09) min], the percentage of deep sleep in total sleep time [(3.05±4.80)%], the percentage of REM sleep time in total sleep time [(16.73±6.83)%], apnea-hypopnea index [AHI, (31.17±19.20) events/h], oxygen desaturation index [ODI, (46.57±33.54) events/h], microarousal index [(14.82±12.27) events/h], and Epworth Sleepiness Scale (ESS) score (8.29±5.92) in the elderly group were all lower than those in the young group [neck circumference (41.36±3.37) cm, BMI (28.55±4.21) kg/m2, total sleep time [(424.67±62.21) min], the percentage of deep sleep in total sleep time (5.89±6.79)%, the percentage of REM sleep time in total sleep time (17.95±6.67)%, AHI (39.55±27.89) events/h, ODI (61.88±34.60) events/h, microarousal index (22.77±19.31) events/h, ESS score (9.63±5.82)] and the middle-aged group [neck circumference (40.75±3.59) cm, BMI (27.89±3.55)kg/m2, total sleep time [(410.98±63.02)min], the percentage of deep sleep in total sleep time (3.59±5.11)%, the percentage of REM sleep time in total sleep time (17.47±6.63)%, AHI (36.01±23.63) events/h, ODI (57.20±34.75) events/h, microarousal index (19.23±15.59) events/h, ESS score (9.98±6.11)], with F values of 102.62, 62.15, 95.87, 95.94, 8.71, 29.60, 49.72, 59.11, and 19.03, respectively, and all P values were <0.001. The proportion of females [29.57% (94/656)], the proportion of patients with hypertension [37.20% (244/656)], and the nocturnal LSpO 2 [(79.09±9.88)%] in the elderly group were all higher than those in the young group [proportion of females [6.48% (136/2 099)], proportion of patients with hypertension 18.10% (380/2 099), nocturnal LSpO 2(75.19±12.90)%] and the middle-aged group [proportion of females [15.84%(260/1 641)], proportion of patients with hypertension 33.09% (543/1 641), nocturnal LSpO 2(76.15±12.44)%], with F values of 242.62, 150.90, and 25.05, respectively, and all P values were <0.001.There were no significant differences in neck circumference, percentage of REM sleep time in total sleep time, AHI and LSpO 2 at night between young and middle-aged groups ( P>0.05). After adjusting for gender, neck circumference, BMI, and hypertension confounders, the risk of severe OSA in the older group was increased by 27.4% compared with the younger group ( OR=1.274, 95% CI=1.036-1.566, P<0.05). Further stratified analysis showed that neck circumference and BMI were independent factors for severe OSA in the young and middle-aged groups ( P<0.01), while, only neck circumference was independently associated with severe OSA in the elderly group (OR=1.119, 95% CI=1.039-1.207, P<0.01). Conclusion:The severity of OSA in young and middle-aged patients is more serious than that in elderly patients. Obesity is an important factor affecting the degree of OSA in young and middle-aged patients. After controlling for confounding factors such as obesity, the risk of severe OSA in elderly patients is higher than that in young patients, which is considered to be related to factors such as pharyngeal collapse and relaxation of pharyngeal muscles.

To identify factors associated with the recurrence of polymyalgia rheumatica(PMR) within one year.

This study aims to investigate the effect of Chaijin Jieyu Anshen Formula on the neuroinflammation of rats with insomnia complicated with depression through the regulation of triggering receptor expressed on myeloid cells 2(TREM2)/complement protein C1q signaling pathway. Rats were randomly divided into a normal group, a model group, a positive drug group, as well as a high, medium, and low-dose groups of Chaijin Jieyu Anshen Formula, with 10 rats in each group. Except for the normal group, the other groups were injected with p-chlorophenylalanine and exposed to chronic unpredictable mild stress to establish the rat model of insomnia complicated with depression. The sucrose preference experiment, open field experiment, and water maze test were performed to evaluate the depression in rats. Enzyme-linked immunosorbent assay was employed to detect serum 5-hydroxytryptamine(5-HT), dopamine(DA), and norepinephrine(NE) levels. Hematoxylin and eosin staining and Nissl staining were used to observe the damage in nucleus accumbens neurons. Western blot and immunofluorescence were performed to detect TREM2, C1q, postsynaptic density 95(PSD-95), and synaptophysin 1(SYN1) expressions in rat nucleus accumbens, respectively. Golgi-Cox staining was utilized to observe the synaptic spine density of nucleus accumbens neurons. The results show that, compared with the model group, Chaijin Jieyu Anshen Formula can significantly increase the sucrose preference as well as the distance and number of voluntary activities, shorten the immobility time in forced swimming test and the successful incubation period of positioning navigation, and prolong the stay time of space exploration in the target quadrant test. The serum 5-HT, DA, and NE contents in the model group are significantly lower than those in the normal group, with the above contents significantly increased after the intervention of Chaijin Jieyu Anshen Formula. In addition, Chaijin Jieyu Anshen Formula can alleviate pathological damages such as swelling and loose arrangement of tissue cells in the nucleus accumbens, while increasing the Nissl body numbers. Chaijin Jieyu Anshen Formula can improve synaptic damage in the nucleus accumbens and increase the synaptic spine density. Compared to the normal group, the expression of C1q protein was significantly higher in the model group, while the expression of TREM2 protein was significantly lower. Compared to the model group, the intervention with Chaijin Jieyu Anshen Formula significantly downregulated the expression of C1q protein and significantly upregulated the expression of TREM2. Compared with the model group, the PSD-95 and SYN1 fluorescence intensity is significantly increased in the groups receiving different doses of Chaijin Jieyu Anshen Formula. In summary, Chaijin Jieyu Anshen Formula can reduce the C1q protein expression, relieve the TREM2 inhibition, and promote the synapse-related proteins PSD-95 and SNY1 expression. Chaijin Jieyu Anshen Formula improves synaptic injury of the nucleus accumbens neurons, thereby treating insomnia complicated with depression.
Animals ; Male ; Rats ; Nucleus Accumbens/metabolism* ; Drugs, Chinese Herbal/administration & dosage* ; Depression/complications* ; Membrane Glycoproteins/genetics* ; Rats, Sprague-Dawley ; Sleep Initiation and Maintenance Disorders/complications* ; Neurons/metabolism* ; Receptors, Immunologic/genetics* ; Signal Transduction/drug effects* ; Synapses/metabolism*