1.Single-center analysis of unplanned reoperation case after liver transplantation
Zhi CHEN ; Qingqing DAI ; Fan HUANG ; Guobin WANG ; Xiaojun YU ; Ruolin WU ; Liujin HOU ; Zhenghui YE ; Xinghua ZHANG ; Wei WANG ; Xiaoping GENG ; Hongchuan ZHAO
Organ Transplantation 2026;17(3):452-459
Objective To analyze the main causes and risk factors of unplanned reoperation after liver transplantation. Methods The clinical data of 242 liver transplant recipients in the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2024 were retrospectively analyzed. According to whether unplanned reoperation was performed during the same hospitalization after surgery, the recipients were divided into the reoperation group (n=36) and the non-reoperation group (n=206). The preoperative, intraoperative and postoperative data of the two groups, as well as donor and graft-related data, were compared to analyze the risk factors of unplanned reoperation after liver transplantation and the survival status of the two groups. Results Among the 242 liver transplant recipients, 36 underwent unplanned reoperations, with a total of 54 procedures including various laparotomies, endoscopic and interventional surgeries, among which there were 20 laparotomies, 18 endoscopic surgeries and 16 interventional surgeries. The most common cause of unplanned reoperation was biliary complications (20 times), followed by vascular complications (17 times). Compared with the non-reoperation group, the reoperation group had longer graft cold ischemia time, higher postoperative fatality rate of recipients, longer length of stay in the intensive care unit and postoperative hospital stay, and higher total hospitalization costs (all P<0.05). The incidence of unplanned reoperation was higher in recipients who underwent split liver transplantation (P<0.05). Multivariate analysis showed that intraoperative blood loss ≥1 000 mL, positive culture of graft perfusate and split liver transplantation were independent risk factors for unplanned reoperation (all P<0.05). The postoperative 7-day, 1-month, 3-month and 6-month survival rates of recipients in the reoperation group and the non-reoperation group were 100% vs. 98.1%, 88.9% vs. 94.2%, 69.4% vs. 90.8% and 66.7% vs. 90.8%, respectively, and the postoperative survival rate of recipients in the reoperation group was lower than that in the non-reoperation group (P<0.05). Conclusions The main causes of unplanned reoperation after liver transplantation are biliary complications, vascular complications, abdominal incision infection and intra-abdominal hemorrhage. Intraoperative massive blood loss, positive culture of graft perfusate and split liver transplantation are the risk factors associated with unplanned reoperation after liver transplantation.
2.Preparation,characterization,and in vitro antitumor activity of Gambogic acid-loaded intelligent responsive liposome-hydrogel nanopreparation
Yu CHEN ; Shengnan HUANG ; Ziang WANG ; Yunlong ZHAO ; Gaojian WEI ; Sinan WU ; Yanbin GUAN ; Xiali ZHU
China Pharmacy 2026;37(5):613-619
OBJECTIVE To prepare an intelligent responsive liposome-hydrogel nanopreparation co-loaded with gambogic acid (GA), and characterize its antitumor activity in vitro . METHODS GA-ICG-Lip-gel was prepared by ethanol injection and cold dissolution, incorporating GA and the photosensitizer indocyanine green (ICG). The appearance and microscopic morphology of GA-ICG-Lip-gel were observed, its encapsulation efficiency and drug loading capacity were measured, and its photothermal conversion performance, photothermal stability, and infrared imaging properties were investigated, along with the determination of its in vitro release profile. Human breast cancer MCF-7 cells were used as objects to investigate the effects of GA-ICG-Lip-gel (or with near-infrared light irradiation) on cell viability, migration ability, and the cellular uptake capacity of GA-ICG-Lip-gel. RESULTS GA-ICG-Lip-gel existed in a solution state at room temperature and transformed into a gel state at 37 ℃. Its microstructure was dense with small pores, and its encapsulation efficiency and drug loading were (96.07±0.86) % and (6.28±1.16) %, respectively. After exposure to near-infrared light, the temperature of GA-ICG-Lip-gel rose above 42 ℃, with no significant attenuation observed in the heating curve. The heating efficiency was dependent on both the irradiation time and drug concentration. Compared to media without gelatinase, the cumulative release rate of GA-ICG-Lip-gel increased in media containing gelatinase. In vitro studies showed that GA-ICG-Lip-gel could be efficiently taken up by MCF-7 cells; GA-ICG-Lip-gel significantly inhibited the viability and migration ability of MCF-7 cells ( P <0.05), and this inhibitory effect was further enhanced under near-infrared light irradiation. CONCLUSIONS This study successfully prepares GA-ICG-Lip-gel, which exhibits favorable photothermal conversion properties and temperature/enzyme dual-responsive drug release characteristics, and demonstrates significant inhibitory effects on the proliferation and migration of breast cancer cells.
3.Experimental study on interferon-stimulated gene myxovirus resistance protein 2-mediated restriction of tumor cell sensitivity to reovirus oncolysis
LIANG Dan1,2 ; YANG Zailing1,2 ; YU Jiani1,2 ; LI Xinlan2,3 ; SHEN Tao1,2 ; SUN Yongshun2,4 ; WEI Yongzhu2,4 ; ZHAO Xing1,2
Chinese Journal of Cancer Biotherapy 2026;33(2):132-139
[摘 要] 目的:探讨干扰素刺激基因家族成员黏病毒抵抗蛋白2(MX2)在调控肿瘤细胞对呼肠孤病毒(Reo)溶瘤敏感性中的作用及其机制。方法:选取4株具有不同耐药特征的人源肿瘤细胞,通过CCK-8法评估其对Reo的溶瘤敏感性;通过转录组测序筛选出差异表达基因MX2,qPCR法及WB法验证MX2在4株人源肿瘤细胞中的表达;使用siRNA敲低溶瘤低敏感的COC1/DDP细胞中的MX2基因。在细胞感染Reo病毒后,通过CCK-8法检测细胞存活率;qPCR法检测细胞中Reo病毒S1基因表达;免疫荧光法检测细胞内Reo病毒蛋白的积累;半数组织培养感染剂量(TCID50)法测定病毒滴度;流式细胞术分别检测细胞内Reo病毒dsRNA、活性氧(ROS)水平以及细胞凋亡率;透射电镜观察细胞内质网形态变化并采用WB法检测内质网应激相关蛋白(JNK、p-JNK、eIF2α、p-eIF2α、CHOP、PERK)的表达。结果:在4株肿瘤细胞中,SKOV3细胞对Reo溶瘤作用高度敏感,而COC1/DDP、HuH-7SRB及SNU-398细胞均为溶瘤低敏感性。转录组测序结果显示,MX2在溶瘤低敏感肿瘤细胞中的表达水平显著高于溶瘤高敏感细胞(P < 0.01);在溶瘤低敏感性的COC1/DDP细胞中,敲低MX2显著促进Reo病毒复制、诱导细胞凋亡增加,并升高细胞内活性氧水平(均P < 0.001)。透射电镜观察显示,敲低MX2的COC1/DDP细胞感染Reo病毒后出现内质网肿胀、扩张及断裂等典型内质网应激超微结构改变。WB结果显示,内质网应激关键标志物eIF2α/p-eIF2α、PERK、CHOP及凋亡相关调节蛋白JNK/p-JNK的表达均显著上调(P < 0.05或P < 0.01)。结论:肿瘤细胞对Reo的溶瘤敏感性与其细胞内MX2表达水平密切相关。敲低MX2可显著增强Reo在细胞内的复制,进而促进ROS积累,触发内质网应激并促进凋亡。病毒复制增加与细胞凋亡激活的双重作用,最终协同增强Reo的溶瘤作用。
4.Construction of A Conceptual Framework for the Integration of Traditional Chinese and Western Medicine in Evolutionary Syndrome Differentiation and Treatment Across Full-cycle of Parkinson's Disease
Yu WANG ; Jianing MEI ; Hongping ZHAO ; Yunzhe TANG ; Zijun WEI ; Qinliang TAO ; Xueyi HAN ; Jiyuan HU ; Yunyun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):270-279
Parkinson's disease (PD) is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD,it is urgent to establish a comprehensive and long-term traditional Chinese medicine (TCM) management model. In this paper,the conceptual framework of full-cycle management of PD is preliminarily constructed:based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD,the three-stage syndrome characteristics of the prodromal stage (predominant healthy Qi with subtle pathogenic factors),the early clinical stage (declining healthy Qi with growing pathogenic factors) and the middle and late stages (overwhelming pathogenic factors with deficient healthy Qi) are longitudinally described. Through the syndrome differentiation of visceral manifestations,the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed,while the matching treatment methods and prescriptions were inferred,and the modular scheme of the combining main symptoms,accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications ('variable syndrome') and PD-related hyperpyrexia syndrome ('critical syndrome') was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion,and provides new theories and research ideas for individualized and whole-process management of PD in TCM.
5.Construction of A Conceptual Framework for the Integration of Traditional Chinese and Western Medicine in Evolutionary Syndrome Differentiation and Treatment Across Full-cycle of Parkinson's Disease
Yu WANG ; Jianing MEI ; Hongping ZHAO ; Yunzhe TANG ; Zijun WEI ; Qinliang TAO ; Xueyi HAN ; Jiyuan HU ; Yunyun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):270-279
Parkinson's disease (PD) is a complex neurodegenerative disease involving multiple systems and neurotransmitters. Due to the high clinical heterogeneity of PD,it is urgent to establish a comprehensive and long-term traditional Chinese medicine (TCM) management model. In this paper,the conceptual framework of full-cycle management of PD is preliminarily constructed:based on the evolution of the pathophysiological mechanisms of protein deposition and neurotransmitter disorder in PD,the three-stage syndrome characteristics of the prodromal stage (predominant healthy Qi with subtle pathogenic factors),the early clinical stage (declining healthy Qi with growing pathogenic factors) and the middle and late stages (overwhelming pathogenic factors with deficient healthy Qi) are longitudinally described. Through the syndrome differentiation of visceral manifestations,the etiology and pathogenesis of PD motor and non-motor symptoms were comprehensively analyzed,while the matching treatment methods and prescriptions were inferred,and the modular scheme of the combining main symptoms,accompanying symptoms and secondary symptoms was proposed. The conceptual gap of TCM regarding motor complications ('variable syndrome') and PD-related hyperpyrexia syndrome ('critical syndrome') was explained. This framework reflects the characteristics of combination of disease and syndrome and overall constant motion,and provides new theories and research ideas for individualized and whole-process management of PD in TCM.
6.Differences in deltamethrin resistance and kdr gene mutation in Culex tritaeniorhynchus population in and outside the Yellow Sea wetland
Xiao-er ZHANG ; Zhi-ming WU ; Ye TIAN ; Qian CUI ; Yu-qian JI ; Huan WANG ; Shu-juan YANG ; Yi-chao ZHAO ; Yu WANG ; Hua-yu YIN ; Yu DING ; Guo-jin YAN ; Min-sen ZHAO ; Shou-gang ZHANG ; Bing-dong SONG ; Hong-na CHEN ; Jian GAO ; Wei-fang YANG ; Yu-fu ZHANG ; Hui LIU ; Hong-liang CHU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):101-107
Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.
7.Regulatory effect of Shugan Yunpi Decoction on depressive and anxiety symptoms in colorectal cancer patients with depressive disorder based on the PI3K-AKT signaling pathway
Jing MENG ; Jingman ZHAO ; Fang TIAN ; Dong WEI ; Hairu YU ; Chaonan FENG ; Yanan LI ; Ying YANG
Sichuan Mental Health 2026;39(4):324-330
BackgroundPatients with colorectal cancer are frequently comorbid with depression, which severely affects the quality of life and treatment compliance, while compromising the efficacy of anticancer treament and prognosis. Current therapeutic strategies still have notable limitations, particularly the lack of systematic and targeted synergistic regimens that integrate oncological management and anti-depressive intervention. It is of great clinical significance to explore a safe and effective new comprehensive intervention protocol and clarify its underlying mechanism of action. ObjectiveTo explore the effectiveness and safety of Shugan Yunpi Decoction in alleviating depressive and anxiety symptoms in colorectal cancer patients with depressive disorder through the PI3K-AKT signaling pathway, in order to provide references for the comprehensive treatment of colorectal cancer and depressive disorder. MethodsThis study was a randomized controlled trial. A total of 106 patients admitted to the Baoding No.1 Hospital of traditional Chinese medicine from November 2023 to July 2025 were enrolled, who met the diagnostic criteria for the Chinese protocol of diagnosis and treatment of colorectal cancer (2023 edition) and the diagnostic criteria for depressive disorder as specified in the Chinese Classification and Diagnostic Criteria of Mental Disease, third edition (CCMD-3). Patients were divided into the study group and the control group using a random number table, with 53 cases in each group. The control group received conventional chemotherapy combined with traditional Chinese medicine five-element music therapy, while the study group received conventional chemotherapy combined with Shugan Yunpi Decoction therapy. Both groups were treated for 8 weeks. Depressive and anxiety symptoms were assessed using the Hamilton Depression Scale-17 item(HAMD-17) and Hamilton Anxiety Scale (HAMA), respectively. Western blot protein immunoblotting was used to detect the expression levels of PI3K, AKT, and pAKT. Real-time fluorescence quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression levels of PI3K mRNA and AKT mRNA. Adverse reactions were recorded using a self-designed adverse reaction record form. ResultsRepeated measures analysis of variance showed that the time effects (F=139.336, 234.747), group effects (F=43.900, 101.266), and time-group interaction effects (F=13.409, 43.216) for HAMD-17 and HAMA scores in both groups were statistically significant (P<0.01). After 4 and 8 weeks of treatment, the HAMD-17 and HAMA scores in both groups were lower than those before treatment, with statistically significant differences (P<0.05). HAMD-17 and HAMA scores in the study group were lower than those in the control group (P<0.05). The time effects (F=571.356, 309.266, 414.492), group effects (F=6.901, 26.361, 39.362), and time-group interaction effects (F=18.592, 19.266, 33.484) for the protein expression levels of PI3K, AKT, and pAKT in both groups were all statistically significant (P<0.01). After 8 weeks of treatment, the protein expression levels of PI3K and pAKT in the study group were lower than those in the control group, while the AKT protein expression level was higher than that in the control group(P<0.01). The time effects (F=338.555, 225.059), group effects (F=5.429, 9.726), and time-group interaction effects (F=12.953, 21.214) for PI3K mRNA and AKT mRNA expression levels in two groups were all statistically significant (P<0.01). After 8 weeks of treatment, the expression levels of PI3K mRNA and AKT mRNA in the study group were lower than those in the control group (P<0.05). The incidence of adverse reactions in the study group was lower than that in the control group (χ2=4.810, P<0.05). ConclusionShugan Yunpi Decoction may help to ameliorate depressive and anxiety symptoms in colorectal cancer patients with depressive disorder by regulating the PI3K-AKT signaling pathway, decreasing the levels of PI3K, pAKT, PI3K mRNA, and AKT mRNA, with a favorable safety profile. [Funded by Baoding City Science and Technology Planning Project (number, 2341ZF291)]
8.Mechanistic Study on Effect of Cycloastragenol in Improving Mitochondrial Function and Inhibiting Cardiac Remodeling via GPCR/cAMP/PKA/CREB Signaling Pathway
Dongsheng WEI ; Menglan ZHAO ; Wenhao GU ; Jinpu LIANG ; Yu LIU ; Xiaoqing ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):112-121
ObjectiveThis study aimed to evaluate the effects of cycloastragenol (CAG) on mitochondrial dysfunction during cardiac remodeling and to elucidate its regulatory role in myocardial energy metabolic homeostasis and the associated transcriptional regulatory axis. MethodsA rat model of heart failure (HF) was established by ligation of the left anterior descending coronary artery. Rats were randomly divided into a control group, a model group, a captopril group (3.25 mg·kg-1), a low-dose CAG group (10 mg·kg-1, CAG-L), and a high-dose CAG group (20 mg·kg-1, CAG-H). After 28 days of treatment, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVIDd), and left ventricular end-systolic diameter (LVIDs) were assessed by echocardiography. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), creatine kinase-MB (CK-MB), cardiac troponinⅠ (cTnI), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and cyclic adenosine monophosphate (cAMP) were measured by enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) and Masson's trichrome staining were used to evaluate myocardial histopathology and fibrosis. Wheat germ agglutinin (WGA), reactive oxygen species (ROS), and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining were performed to assess cardiomyocyte hypertrophy, oxidative stress, and apoptosis. Adenosine triphosphate (ATP) content and the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ were determined by colorimetric assays. The mRNA expression of α-smooth muscle actin (α-SMA), Col Ⅰ, and Col Ⅲ was detected by Real-time quantitative polymerase chain reaction (Real-time PCR), while the protein levels of β2-adrenergic receptor (ADRB2), protein kinase A (PKA), phosphorylated cAMP response element-binding protein/total cAMP response element-binding protein (p-CREB/CREB), peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), nuclear respiratory factor 1 (NRF1), and mitochondrial transcription factor A (TFAM) were analyzed by Western blot. ResultsCompared with the control group, the model group exhibited significantly decreased LVEF, LVFS, and ATP levels (P<0.05), and markedly increased LVIDd, LVIDs, NT-proBNP, CK-MB, cTnI, IL-1β, IL-6, TNF-α, ROS levels, TUNEL-positive rate, Col deposition area, and the mRNA expression of α-SMA, Col Ⅰ, and Col Ⅲ (P<0.05). In addition, the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ, the protein expression of ADRB2, PKA, p-CREB, PGC-1α, NRF1, and TFAM, as well as the cAMP content, were significantly reduced (P<0.05). Compared with the model group, both low- and high-dose CAG significantly increased LVEF and LVFS, and decreased LVIDd, LVIDs, and the levels of NT-proBNP, CK-MB, and cTnI (P<0.05). CAG treatment alleviated myocardial disarray and Collagen deposition, and downregulated the mRNA expression of α-SMA, Col Ⅰ, and Col Ⅲ. The treatment markedly reduced ROS generation and the TUNEL-positive rate (P<0.05), thereby attenuating cardiomyocyte hypertrophy and inflammatory responses. Furthermore, CAG treatment increased ATP content and the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ, accompanied by upregulation of PGC-1α, NRF1, TFAM, ADRB2, PKA, and p-CREB protein expression as well as cAMP levels (P<0.05). The CAG-H group showed the most pronounced improvements, which were superior to those of the captopril group and the CAG-L group. ConclusionCycloastragenol delays adverse cardiac remodeling and improves cardiac function by activating the ADRB2-mediated GPCR/cAMP/PKA/CREB signaling pathway, enhancing the PGC-1α/NRF1/TFAM activity, promoting mitochondrial energy metabolism remodeling, and suppressing oxidative stress, inflammation, and myocardial fibrosis.
9.Mechanistic Study on Effect of Cycloastragenol in Improving Mitochondrial Function and Inhibiting Cardiac Remodeling via GPCR/cAMP/PKA/CREB Signaling Pathway
Dongsheng WEI ; Menglan ZHAO ; Wenhao GU ; Jinpu LIANG ; Yu LIU ; Xiaoqing ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):112-121
ObjectiveThis study aimed to evaluate the effects of cycloastragenol (CAG) on mitochondrial dysfunction during cardiac remodeling and to elucidate its regulatory role in myocardial energy metabolic homeostasis and the associated transcriptional regulatory axis. MethodsA rat model of heart failure (HF) was established by ligation of the left anterior descending coronary artery. Rats were randomly divided into a control group, a model group, a captopril group (3.25 mg·kg-1), a low-dose CAG group (10 mg·kg-1, CAG-L), and a high-dose CAG group (20 mg·kg-1, CAG-H). After 28 days of treatment, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVIDd), and left ventricular end-systolic diameter (LVIDs) were assessed by echocardiography. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), creatine kinase-MB (CK-MB), cardiac troponinⅠ (cTnI), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and cyclic adenosine monophosphate (cAMP) were measured by enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) and Masson's trichrome staining were used to evaluate myocardial histopathology and fibrosis. Wheat germ agglutinin (WGA), reactive oxygen species (ROS), and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining were performed to assess cardiomyocyte hypertrophy, oxidative stress, and apoptosis. Adenosine triphosphate (ATP) content and the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ were determined by colorimetric assays. The mRNA expression of α-smooth muscle actin (α-SMA), Col Ⅰ, and Col Ⅲ was detected by Real-time quantitative polymerase chain reaction (Real-time PCR), while the protein levels of β2-adrenergic receptor (ADRB2), protein kinase A (PKA), phosphorylated cAMP response element-binding protein/total cAMP response element-binding protein (p-CREB/CREB), peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), nuclear respiratory factor 1 (NRF1), and mitochondrial transcription factor A (TFAM) were analyzed by Western blot. ResultsCompared with the control group, the model group exhibited significantly decreased LVEF, LVFS, and ATP levels (P<0.05), and markedly increased LVIDd, LVIDs, NT-proBNP, CK-MB, cTnI, IL-1β, IL-6, TNF-α, ROS levels, TUNEL-positive rate, Col deposition area, and the mRNA expression of α-SMA, Col Ⅰ, and Col Ⅲ (P<0.05). In addition, the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ, the protein expression of ADRB2, PKA, p-CREB, PGC-1α, NRF1, and TFAM, as well as the cAMP content, were significantly reduced (P<0.05). Compared with the model group, both low- and high-dose CAG significantly increased LVEF and LVFS, and decreased LVIDd, LVIDs, and the levels of NT-proBNP, CK-MB, and cTnI (P<0.05). CAG treatment alleviated myocardial disarray and Collagen deposition, and downregulated the mRNA expression of α-SMA, Col Ⅰ, and Col Ⅲ. The treatment markedly reduced ROS generation and the TUNEL-positive rate (P<0.05), thereby attenuating cardiomyocyte hypertrophy and inflammatory responses. Furthermore, CAG treatment increased ATP content and the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ, accompanied by upregulation of PGC-1α, NRF1, TFAM, ADRB2, PKA, and p-CREB protein expression as well as cAMP levels (P<0.05). The CAG-H group showed the most pronounced improvements, which were superior to those of the captopril group and the CAG-L group. ConclusionCycloastragenol delays adverse cardiac remodeling and improves cardiac function by activating the ADRB2-mediated GPCR/cAMP/PKA/CREB signaling pathway, enhancing the PGC-1α/NRF1/TFAM activity, promoting mitochondrial energy metabolism remodeling, and suppressing oxidative stress, inflammation, and myocardial fibrosis.
10.Mechanism of Shengxian Yixin Granule (升陷益心颗粒) in the Treatment of Heart Failure with Preserved Ejection Fraction Based on Macrophage-Mediated Inflammatory Response
Zhengwei DONG ; Rui YU ; Qiaozhi LI ; Huan ZHAO ; Jingjing WEI ; Genhao FAN ; Xinlu WANG ; He WANG ; Yongxia WANG ; Mingjun ZHU
Journal of Traditional Chinese Medicine 2026;67(19):2086-2094
ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule (升陷益心颗粒, SYG) in treating heart failure with preserved ejection fraction (HFpEF). MethodsExperiment 1: Forty male C57BL/6 mice were randomly divided into control group, model group, low-dose [25 mg/(kg·d)], medium-dose [50 mg/(kg·d)], and high-dose [(75 mg/(kg·d)] SYG groups, with 8 mice per group. Except for the control group, HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling, treatment groups received corresponding doses of SYG by gavage, while the control group and model group received equal volume of normal saline, for 6 weeks. After 6 weeks of administration, the body weight, blood pressure including systolic blood pressure (SBP) and diastolic blood pressure (DBP), and heart weight-to-tibia length ratio (HW/TL) were recorded. Echocardiography was used to evaluate left ventricular ejection fraction (LVEF) and the ratio of early to late diastolic transmitral flow velocity (E/A). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels were measured by ELISA. The expression level of brain natriuretic peptide (BNP) in heart tissue was detected by qRT-PCR. Blood lipid levels, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), were determined by a biochemical analyzer. Splenic proportions of M1 macrophages, M2 macrophages, T helper 17 (Th17) cells, and regulatory T (Treg) cells were analyzed by flow cytometry. Experiment 2: RAW 264.7 cells were stimulated with lipopolysaccharide (LPS) to establish an M1 macrophage polarization model, and then treated with SYG-containing serum for 24 h. The cells were divided into four groups, including blank serum group, high-dose SYG-containing serum group, LPS group, and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 (Stat3) inhibitor for 24 h, the cells were divided into a lipopolysaccharide group, a high-dose SYG-containing serum group, an inhibitor group, and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase (iNOS) and interleukin-1β (IL-1β) in each group were detected by qRT-PCR. The protein levels of iNOS, IL-1β, Stat3, and phosphorylated Stat3 (p-Stat3) were detected by Western Blotting. ResultsExperiment 1: Compared to the control group, the model group showed significantly decreased E/A ratio, and increased cardiac BNP expression, plasma NT-proBNP,HW/TL ratio, body weight, TC, LDL-C, SBP, and DBP, as well as shortened exhaustion distance and exhaustion time (P<0.05 or P<0.01). Compared to the model group, the E/A ratio increased in the low-, medium-, and high-dose SYG groups; cardiac BNP expression decreased in the low- and high-dose groups, and plasma NT-proBNP levels decreased in the high-dose group; the HW/TL ratio and body weight decreased, while exhaustion distance and exhaustion time increased in the medium- and high-dose groups; TG levels decreased in the low- and medium-dose groups, and LDL-C levels decreased in the medium- and high-dose groups; SBP and DBP decreased in the low-, medium-, and high-dose groups (P<0.05 or P<0.01). Compared to the low-dose SYG group, body weight decreased, and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups (P<0.05 or P<0.01). Compared to the medium-dose SYG group, the exhaustion time increased in the high-dose SYG group (P<0.01). Experiment 2: In the LPS‑induced M1 macrophage polarization model, compared to the blank serum group, the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.01). Compared to the LPS group, the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β, as well as the p‑Stat3/Stat3 ratio (P<0.05 or P<0.01). Compared to the LPS group, the inhibitor group also showed significantly reduced these parameters (P<0.05 or P<0.01). ConclusionSYG can improve cardiac function, ventricular remodeling, exercise capacity, and lipid metabolism in HFpEF mice, while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.


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