Paeoniflorin is one of the bioactive components of Paeonia lactiflora, a traditional Chinese herbal medicine. Some recent studies prove its distinguished neuroprotective effect. These neuroprotective mechanisms have become hot points and show closely correlated to activating adenosine A1 receptor, ameliorating the function of cholinergic nerve, regulating ion channel homeostasis, retarding oxidative stress and apoptosis of the neurocytes, promoting nerve growth, having an influence on astrocytes and being ableto penetrate though blood brain barrier. In this review, we present the neuroprotective mechanisms of paeoniflorin in the following eight aspects.
Animals ; Apoptosis ; drug effects ; Benzoates ; analysis ; pharmacology ; Bridged-Ring Compounds ; analysis ; pharmacology ; Drugs, Chinese Herbal ; analysis ; pharmacology ; Glucosides ; analysis ; pharmacology ; Humans ; Monoterpenes ; Neurons ; cytology ; drug effects ; metabolism ; Neuroprotective Agents ; analysis ; pharmacology ; Oxidative Stress ; drug effects ; Paeonia ; chemistry

OBJECTIVETo investigate the role of nuclear factor-κB (NF-κB) activation in bilirubin-induced apoptosis of rat hippocampal neurons and the effect of TAT-NBD intervention on bilirubin neurotoxicity.

METHODSPrimary-cultured rat hippocampal neurons were treated with TAT-NBD in the initial 6 or 24 h or in the latter 6 h during a 24-h bilirubin exposure of the cells (early, continuous and late intervention groups, respectively). Immunocytochemistry was performed to detect NF-κB p65 protein expression, and the cell survival and apoptosis were assessed with a modified MTT assay, Annexin V-FITC/PI and TUNEL assay. IL-1β concentration in the supernatant was determined with ELISA.

RESULTSCompared with the control cells, bilirubin-treated cells showed a significantly increased NF-κB p65 protein expression (P<0.01), which reached the peak level at 6 and 24 h (P<0.01). The cell survival rate in early TAT-NBD intervention group was (80.784∓9.767)%, significantly lower than that of the control group (P<0.01) but higher than that of bilirubin group (P<0.01); the apoptotic rate in early TAT-NBD intervention group was significantly higher than that of control group (P<0.01) but lower than that of bilirubin group (P<0.01). IL-1β concentration was significantly lower in early TAT-NBD intervention group (15.348∓0.812 pg/ml) than in bilirubin group (P<0.05). The continuous and late TAT-NBD intervention groups showed comparable cell survival rate, apoptotic rate and IL-1β concentration with bilirubin group (P>0.05).

CONCLUSIONNF-κB bidirectionally regulates bilirubin-induced apoptosis of rat hippocampal neurons. Selective inhibition of the early peak of NF-κB by TAT-NBD offers neuroprotective effect. TAT-NBD can be potentially used for prophylaxis of bilirubin-induced brain injury.

Animals ; Apoptosis ; drug effects ; Bilirubin ; toxicity ; Cell Survival ; Cells, Cultured ; Female ; Hippocampus ; cytology ; Interleukin-1beta ; metabolism ; Male ; Neurons ; cytology ; drug effects ; metabolism ; Neuroprotective Agents ; pharmacology ; Peptides ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Transcription Factor RelA ; metabolism

Objective:To study the levels of serum ferritin (SF) in preterm infants of different gestational ages and analyze the influencing factors.Method:From October 2018 to October 2020, preterm infants hospitalized in our hospital were included for prospective study. According to the gestational age, the infants were assigned into 3 groups: 34~36 w group, 32~33 w group and <32 w group. The SF levels were compared among the groups and the influencing factors were analyzed.Result:A total of 919 preterm infants were included, including 481 in the 34~36 w group, 293 in the 32~33 w group and 145 in the <32 w group. The incidence of Cesarean section in the <32 w group was lower than the other two groups ( P<0.001). The incidence of twin birth in the 32~33 w group was higher than the other two groups ( P<0.05). No significant differences existed in gender among the three groups ( P>0.05). The serum SF levels in the 34~36 w group, 32~33 w group and <32 w group were (240.1±167.4), (216.2±137.0) and (204.4±112.8)μg/L, respectively. The serum SF levels in the 34~36 w group were higher than the other two groups ( P<0.05). No significant differences existed in serum SF levels between the 32~33 w group and the <32 w group ( P>0.05). Multiple　linear　regression　analysis　showed　that SF levels were lower in premature infants with small gestational age and Cesarean section delivery ( P<0.05). Conclusion:SF levels in premature infants with small gestational age and Cesarean section delivery are lower and more monitoring of SF are needed.

Objective To evaluate the effect of of home-care orthopedic nursing platform in rehabilitation exercise of patients after knee replacement.Methods A total of 60 patients with knee joint replacement were randomly divided into experimental group (n =30) and control group (n =30).The control group adopted conventional nursing,while the experimental group was added home care platform for orthopedics.Joint function recovery (HSS score),quality of life score (SF-36) and daily living ability (Barthel index) between the two groups were compared on admission,and at 6 months after discharge.Results No statistical differences in culture and knowledge absorption and understanding ability were found between the two groups before intervention (P ＞ 0.05).After intervention,the score of knee function,quality of life and ability of daily living of the patients in the experimental group were significantly higher than that in the control group (P ＜ 0.01).Conclusion Home care platform of orthopedics provides a new extension nursing mode for patients after total knee arthroplasty.It is a scientific and reliable rehabilitation consultation platform,which significantly improves postoperative rehabilitation and quality of life.

Objective To evaluate the effect of of home-care orthopedic nursing platform in rehabilitation exercise of patients after knee replacement.Methods A total of 60 patients with knee joint replacement were randomly divided into experimental group (n =30) and control group (n =30).The control group adopted conventional nursing,while the experimental group was added home care platform for orthopedics.Joint function recovery (HSS score),quality of life score (SF-36) and daily living ability (Barthel index) between the two groups were compared on admission,and at 6 months after discharge.Results No statistical differences in culture and knowledge absorption and understanding ability were found between the two groups before intervention (P ＞ 0.05).After intervention,the score of knee function,quality of life and ability of daily living of the patients in the experimental group were significantly higher than that in the control group (P ＜ 0.01).Conclusion Home care platform of orthopedics provides a new extension nursing mode for patients after total knee arthroplasty.It is a scientific and reliable rehabilitation consultation platform,which significantly improves postoperative rehabilitation and quality of life.

Objective:To investigate the effect of quality improvement (QI) project on delayed cord clamping (DCC) implementation in very preterm infants.Methods:This study retrospectively collected the clinical data and assessed the QI indices of very preterm infants born in the Women and Children's Hospital of Chongqing Medical University and transferred to the Neonatology Department from January 2017 to January 2021. The indices for QI assessment included three types: (1) process indices: the implementation rate and timing of DCC; (2) outcome indices: hemoglobin level and hematocrit, etc; (3) balancing indices: the proportion of neonates requiring endotracheal intubation in the delivery room and chest compressions, Apgar score body temperature, and blood pH value on admission, etc. There were four phases for the implementation of QI, the pre-QI period (January to December of 2017), the QI period (January to December of 2018), the post-QI period (January to December of 2019), and the sustained-QI period (January 2020 to January 2021). The QI project was performed since August 2018. Control charts or statistical tests were used for statistical analysis.Results:(1) Process indices: After the implementation of the QI project, the practice of DCC increased from 0 to 82.2%, and the timing of umbilical cord clamping was from 0 s to a delay of 47.1 s. (2) Outcome indices: The levels of hemoglobin in the QI period, the post-QI period, and the sustained-QI period were significantly higher than those in the pre-QI period [(202.22±28.84), (210.10±33.52), (210.52±32.27) g/L vs. (187.94±35.29) g/L; F=8.61, P<0.001]. The hematocrit values in the post-QI period and the sustained-QI period were significantly higher than those in the pre-QI period [(58.99±8.71) %, (60.18±8.06)% vs. (55.41±9.17)%; χ2=5.13, P=0.002]. The other indices showed no statistical differences in different phases. (3) Balancing indices: The proportions of neonates receiving endotracheal intubation in the delivery room in the post-QI period and the sustained-QI period were significantly lower than those in the pre-QI period [16.0% (19/119), 13.2% (25/191) vs. 42.3% (30/71); χ2=29.08, P<0.001]. The body temperature on admission increased gradually through the four periods [pre-QI period: 35.3 ℃ (34.5-36.1 ℃); QI period: 36.0 ℃ (34.0-37.7 ℃); post-QI period: 36.0 ℃ (35.6-37.4 ℃); sustained-QI period: 37.0 ℃ (35.9-38.1 ℃); H=277.88, P<0.001]. The blood pH value on admission in the sustained-QI period [7.32 (6.85-7.50)] was significantly higher than those in the other three periods [7.26 (7.07-7.46), 7.26 (7.04-7.43), and 7.25 (6.91-7.49); H=34.46, P<0.001]. Conclusion:The interventions in this QI project significantly increase the practice of DCC and enable a longer DCC in very preterm infants.

OBJECTIVE To explore whether Yinjia tablets improve infertility in rats with chronic salpingitis by correcting the peripheral blood Th17/Treg balance. METHODS One hundred female Wistar rats, 82 of which were constructed as a rat model of chronic salpingitis. After successful modeling, the rats were randomly divided into model group, levofloxacin group (20 mg·kg-1), low-dose Yinjia tablets group(0.38 g·kg-1·d-1), medium-dose Yinjia tablets group(0.76 g·kg-1·d-1) and high-dose Yinjia tablets group(1.52 g·kg-1·d-1), 16 rats in each group, and other 16 rats were set up as control group. The treatment groups were administered by gavage at different doses, and the model group and the control group were given the same amount of saline(20 mL·kg-1·d-1), once a day. The gavage was stopped for 1 d after 7 d, and 7 d was one cycle, with a total of 3 cycles of gavage. After administration, the rats were observed for conception and blood samples and oviductal tissues were collected. HE staining was used to observe the pathological changes of fallopian tube tissues; transmission electron microscopy was used to observe the ultrastructural changes of fallopian tube tissues; ELISA was used to detect TNF-α and IL-6 in serum; flow cytometry was used to detect the ratio of Treg and Th17 cells in peripheral blood; RT-qPCR and Western blotting were used to detect IL-17, IL-10, Foxp3, RORγt mRNA and protein expression. RESULTS Compared with the control group, the cilia and microvilli in the model group were sparse and the mitochondria were swollen; the TNF-α and IL-6 contents, the proportion of Th17 cells, and the expression of IL-17 and RORγt mRNA and protein in the oviduct tissues were significantly higher, and the fertility rate, IL-10, the proportion of Treg cells, and the expression of Foxp3 mRNA and protein in the rats were significantly lower(P<0.05). Compared with the model group, the high-dose group of Yinjia tablets improved the structure of oviduct of rats; significantly reduced the TNF-α, IL-6 content, Th17 cell proportion and IL-17, RORγt mRNA and protein expression in oviduct tissue of model rats; and significantly increased the conception rate and IL-10, Treg cell proportion and Foxp3 mRNA and protein expression of rats(P<0.05). CONCLUSION Yinjia tablets can effectively regulate Th17/Treg balance, which in turn regulates Treg and Th17 cell-mediated inflammatory responses and improves the conception rate in chronic salpingitis rats.