1.Qiangjing Tablets Regulate CDK4-E2F Signaling Pathway to Delay Aging of Leydig Cells and Testicular Tissue in Rats
Xiucheng LAN ; Meijing WANG ; Jingyi ZHANG ; Junjun LI ; Liang DONG ; Xujun YU ; Fang YANG ; Degui CHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):328-336
ObjectiveTo reveal the molecular mechanism by which the traditional Chinese medicine compound prescription Qiangjing tablets regulate the aging of the testicular tissue and Leydig cells in rats through the cyclin-dependent kinase 4 (CDK4)-early 2 factor (E2F) signaling pathway. MethodsFor the cell experiment, 2-month-old SPF-grade SD male rats were selected and randomly assigned into a blank control group (administrated with an equal volume of 0.9% sodium chloride injection) and a Qiangjing tablets group (20 rats in each group) according to body weight. The Leydig cell model of aging was established by treatment of TM3 cells with 100 μmol·L-1 H2O2, and the modeling performance was evaluated based on the levels of p16 and p21 determined by Western blot. The antioxidant NAC (1 mmol·L-1) was used as the positive control for eliminating reactive oxygen species (ROS). Cells were intervened with Qiangjing tablets-containing serum at low (2.5%), medium (5%), and high (10%) concentrations. The testosterone level in the cell supernatant was determined by enzyme-linked immunosorbent assay (ELISA), and the protein levels of CDK4, E2F1, and E2F2 were analyzed by Western blot. In the animal experiment, 19-month-old naturally aging rats were used as the model group, and 2-month-old rats as the young control group. The positive control group was subcutaneously injected with 5.21 mg·kg-1·d-1 testosterone propionate. Qiangjing tablets were administered by gavage at low, medium, and high doses of 0.72, 1.44, 2.88 g·kg-1·d-1, respectively. The general conditions of rats were observed, and the protein levels of CDK4, E2F1, and E2F2 in the testicular tissue were determined by Western blot. ResultsIn the cell experiment, compared with the blank control group, the model group showed upregulated expression of CDK4 and E2F1 (P<0.05) and slightly downregulated expression of E2F2. Compared with that in the model group, the expression of CDK4 was upregulated in the NAC group and the low-dose Qiangjing tablets group (P<0.05), slightly upregulated in the medium-dose Qiangjing tablets group, and downregulated in the high-dose Qiangjing tablets group (P<0.05). The NAC group showed downregulated expression of E2F1 (P<0.05) and E2F2, and the low-, medium-, and high-dose Qiangjing tablets groups showed downregulated expression of both E2F1 and E2F2 (P<0.05). Compared with that in the NAC group, the expression of CDK4 was upregulated in the low-dose Qiangjing tablets group and downregulated in the medium-dose and high dose (P<0.05) groups. The expression of E2F1 was down-regulated in all the three dose groups, with statistically significance in the high dose group (P<0.05), and that of E2F2 were downregulated in all the three dose groups (P<0.05). In the animal experiment, compared with the young control group, the model group exhibited downregulated expression of CDK4 (P<0.05) and slightly upregulated expression of E2F1 and E2F2. Compared with that in the model group, the expression of CDK4 decreased in the testosterone propionate group and the low-dose Qiangjing tablets group (P<0.05) but increased in the medium-dose (P<0.05) and high-dose groups. In addition, the expression of E2F1 decreased (P<0.05), and that of E2F2 was slightly elevated. Compared with that in the NAC group, CDK4 expression was elevated in the Qiangjing tablets groups, with statistical significance in the medium- and high-dose groups (P<0.05). Similarly, the E2F1 expression was also upregulated in the Qiangjing tablets groups, with statistical significance in the medium-dose group (P<0.05). The expression of E2F2 was downregulated in all the Qiangjing tablets groups. ConclusionQiangjing tablets delay the aging process of Leydig cells and testicular tissue by up-regulating the expression of CDK4 and lowering the levels of E2F1 and E2F2.
2.Qiangjing Tablets Alleviate Oxidative Stress Damage in Varicocele by Regulating Keap1/Nrf2 Signaling Pathway
Liang DONG ; Fang YANG ; Jingyi ZHANG ; Xinyi TANG ; Yulin LI ; Xujun YU ; Degui CHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):347-359
ObjectiveTo explore the mechanism by which Qiangjing tablets (QJT) alleviate the spermatogenic function damage caused by varicocele (VC) based on the Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway-mediated oxidative stress. MethodsTen Sprague-Dawley (SD) rats were randomly assigned into a control group and a model group. Pathological examination confirmed the stability of the model. Thirty-six SD rats were randomized into control, model, low-dose (0.23 g·kg-1) QJT, medium-dose (0.46 g·kg-1) QJT, high-dose (0.92 g·kg-1) QJT, and mazhilin (61.7 mg·kg-1) groups, with 6 rats in each group. A rat model of experimental left varicocele (ELV) was established by partially ligating the left renal vein to simulate the human nutcracker syndrome. The rats were administrated with corresponding agents once a day for 28 consecutive days. The in vitro testicular culture model of rats was established through the Transwell chamber method and intervened with QJT-containing sera (2.3, 4.6, and 9.2 g·kg-1). Microscopic observation was carried out for the morphology of the left kidney. A micrometer was used to measure the diameter of the left spermatic vein (LSV). The body weights of rats were recorded weekly, and the epididymis and testis weights were measured. The pathological changes of the testicular tissue was observed via hematoxylin-eosin (HE) staining. The levels of testosterone (T) in the cell culture supernatant and reactive oxygen species (ROS) in the rat testicular tissue were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was employed to determine the ROS content. Immunohistochemical staining was conducted to analyze Keap1, Nrf2, 3β-hydroxysteroid dehydrogenase (3β-Hsd), GATA-binding protein-4 (Gata-4), and proto-oncogene receptor tyrosine kinase (C-kit). The ultrastructure of the tissue was observed by transmission electron microscopy (TEM). Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining. The expression of Keap1, Nrf2, glutathione S-transferase α2 (Gsta2), glutathione S-transferase μ1 (Gstm1), heme oxygenase-1 (HO-1), quinone oxidoreductase 1 (Nqo1), and thioredoxin reductase 1 (Txnrd1) was quantified by Real-time quantitative polymerase chain reaction(Real-time PCR) and Western blot. ResultsCompared with the control group, the ROS content and the percentage of apoptotic cells in the model group were significantly increased (P<0.01), the T concentration was significantly decreased (P<0.01), the mRNA and protein expressions of Keap1 were significantly increased (P<0.01), and the mRNA and protein expressions of Nrf2, Gsta2, Gstm1, HO-1, Nqo1 and Txnrd1 were significantly decreased (P<0.05). Compared with the model group, the ROS content and the percentage of apoptotic cells in each dose group of the Qiangjing Tablets were significantly reduced (P<0.05), and the mRNA and protein expressions of Keap1 were significantly decreased (P<0.05), while the mRNA and protein expressions of Nrf2, Gsta2, Gstm1, HO-1, Nqo1 and Txnrd1 were significantly increased (P<0.05). ConclusionQJT improves sperm motility in the rat model of VC by modulating the Keap1/Nrf2 signaling pathway and reducing oxidative stress injury.
3.Mechanism of Quercetin-loaded Exosomes in Improving Testosterone Synthesis in Leydig Cells from Correlation Perspective of "Disease, Syndrome, Formula, and Medicine"
Meijing WANG ; Xiucheng LAN ; Fangyue WANG ; Jingyi ZHANG ; Guangsen LI ; Degui CHANG ; Xujun YU ; Fang YANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):360-370
ObjectiveBased on the multidimensional correlation analysis framework of "disease, syndrome, formula, and medicine", this study aims to systematically elucidate the regulatory effects of effective components in Qiangjing tablet on testosterone synthesis pathways in testicular Leydig cells under oxidative stress, providing a theoretical basis for the treatment of male infertility with traditional Chinese medicine and modern research on compounds. MethodsDisease targets for male infertility were obtained from The Human Gene Database (GeneCards, score ≥20), the Comparative Toxicogenomics Database (CTD, score ≥150), DrugBank (score ≥0.2), and DisGeNET (score ≥0.2). Targets related to the syndrome of kidney deficiency and blood stasis were acquired from the traditional Chinese medicine syndrome association database SymMap. Components of Qiangjing tablet were retrieved based on The Encyclopedia of Traditional Chinese Medicine (ETCM) database and the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP), and they were screened according to a quantitative estimate of drug-likeness (QED ≥ 0.49) and a target confidence index>0.8. Intersecting targets were taken to construct a protein-protein interaction (PPI) network using the STRING database. The network was visualized with Cytoscape software and subjected to the functional annotation of gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis. Quality markers (Q-markers) were predicted via the ADMETlab 2.0 platform based on Lipinski's rule, Pfizer's rule, GSK's rule, and the Golden Triangle. For experimental validation, rats' testicular Leydig cells were used. Exosomes were extracted and loaded with active components via the ultrasonic method. Exosome concentration was determined using a BCA protein quantification kit. Morphology was observed using a transmission electron microscope. The particle size was analyzed with a particle size analyzer. The surface marker proteins such as cluster of differentiation 9 (CD9), cluster of differentiation 63 (CD63), and cluster of differentiation 81 (CD81) were identified by Western blot, and drug loading capacity was measured by high-performance liquid chromatography (HPLC). An oxidative stress model was induced by alpha, alpha'-azodiisobutyramidine dihydrochloride (AAPH), and Leydig cells were divided into the following groups: A control group, an AAPH group, a quercetin group (Que group), an exosome group (Exo group), and a QUE-loaded Exo group (Que-Exo group). The cell viability was detected using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) thiazolyl blue assay. The reactive oxygen species (ROS) levels and mitochondrial membrane potential were measured by flow cytometry. The levels of oxidative indicators, including malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and testosterone (T), were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of steroidogenic enzymes such as cytochrome p450 family 11 subfamily a member 1 (CYP11A1), hydroxy-delta-5-steroid dehydrogenase, 3 beta- and steroid delta-isomerase 1 (HSD3B1), and hydroxysteroid 17-beta dehydrogenase 3 (HSD17B3), regulatory factors such as steroidogenic factor 1 (SF-1) and steroidogenic acute regulatory protein (StAR), and miR-145-5p content, were detected by Western blot and real-time polymerse chain reaction (Real-time PCR). ResultsNetwork pharmacology analysis reveals that the main active components of Qiangjing tablet for intervening in male infertility with kidney deficiency and blood stasis syndrome were Que, luteolin, etc., with the core mechanism involving pathways such as steroid hormone biosynthesis. Experimental results show that compared with the control group, the AAPH group exhibits significantly reduced cell viability (P<0.01), decreased mitochondrial membrane potential (P<0.01), significantly elevated levels of ROS, MDA, and miR-145-5p (P<0.01), significantly reduced activities of SOD, GSH-Px, and CAT, as well as reduced testosterone content (P<0.01), and significantly downregulated protein and mRNA expressions of steroidogenic enzymes, SF-1, and StAR (P<0.01). The above indicators were reversed in the Que and Que-Exo groups (P<0.05). Compared with the Que group, the Que-Exo group showed more significant effects in enhancing cell viability, mitochondrial membrane potential, testosterone level, antioxidant enzyme activities, and expressions of key molecules in the steroidogenic pathway (P<0.05). ConclusionThis study demonstrates that Que, an active component of Qiangjing tablet, inhibits oxidative stress reaction, improves mitochondrial function in Leydig cells, upregulates steroidogenic enzyme expression, and restores testosterone production. As a carrier for Que, Exo enhance its stability, delivery efficiency, and biological effect. Additionally, miR-145-5p may be closely associated with testosterone synthesis, though its precise molecular mechanism requires further exploration. By integrating traditional Chinese medicine compounds with modern scientific technology, this research expands the paths for the modernized research of traditional Chinese medicine and opens a novel therapeutic direction with translational potential for clinical intervention of male infertility.
4.Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins
Yuanjie FU ; Fuhao LI ; Chenghua PENG ; Dong XU ; Guoan YIN ; Xiaopeng HUANG ; Degui CHANG ; Liang DONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):141-147
ObjectiveTo observe the clinical efficacy of tonifying kidney and replenishing essence on asthenozoospermia patients with the syndrome of kidney essence deficiency and the effects of this method on the adenosine 5′-monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin complex 1 (mTORC1) signaling pathway. MethodsSeventy-two eligible asthenozoospermia patients with the syndrome of kidney essence deficiency treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from February 2023 to January 2024 were selected and randomly assigned into an observation group and a control group, with 36 patients in each group. The observation group received oral administration of Guilu Tianjing capsules, while the control group received oral administration of L-carnitine oral solution. The treatment course lasted for 4 weeks in both groups. The observed indicators included sperm progressive motility rate (PR), total sperm motility (PR+NP), percentage of normal mitochondrial membrane potential (MMP), and traditional Chinese medicine (TCM) symptom scores before and after treatment in both groups. A three-month follow-up was instituted to record the conception status of the patients’ spouses. Additionally, eight patients were randomly selected from the eligible patients in the observation group, and four healthy males with normal semen routine examination results were included as the control group for the determination of protein expression. Western blotting was conducted to assess the expression of AMPK, phosphorylated (p)-AMPK, regulatory-associated protein of mTOR (RAPTOR) and p-RAPTOR, and PTEN-induced putative kinase 1 (PINK1) in sperms from the observation group before and after treatment, as well as in the sperms of the control group. ResultsThe pregnancy rate of spouses in the observation group was 9.09% (3/33), which was higher than that (3.33%, 1/30) in the control group. The total response rate was 84.8% (28/33) in the observation group and 66.7% (20/30) in the control group, with no statistically significant difference. After treatment, both groups were improved considering PR, PR+NP, MMP, and TCM symptom scores (P<0.01). Moreover, the observation group exhibited more pronounced decreases in TCM symptom scores than the control group (P<0.05), while the changes in PR, PR+NP, and MMP showed no statistical significance between groups. Compared with the control group, the asthenozoospermia group exhibited upregulations in phosphorylation levels of AMPK and RAPTOR and protein level of PINK (P<0.01). The administration of Guilu Tianjing Capsules led to downregulations in the phosphorylation levels of AMPK and RAPTOR and protein level of PINK1 (P<0.01). However, the protein levels of AMPK and RAPTOR demonstrated no significant difference between before and after treatment. During the study period, neither group of patients exhibited any notable adverse reactions. ConclusionGuilu Tianjing capsules can enhance the sperm motility and percentage of normal mitochondrial membrane potential in asthenozoospermia patients with the syndrome of kidney essence deficiency by downregulating the AMPK/mTORC1 signaling pathway, lowering the protein level of PINK1, and inhibiting excessive activation of mitophagy.
5.Clinical Efficacy of Tonifying Kidney and Replenishing Essence on Asthenospermia Patients with Syndrome of Kidney Essence Deficiency and Effect of This Method on Expression Levels of AMPK/mTORC1 Signaling Pathway-associated Proteins
Yuanjie FU ; Fuhao LI ; Chenghua PENG ; Dong XU ; Guoan YIN ; Xiaopeng HUANG ; Degui CHANG ; Liang DONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):141-147
ObjectiveTo observe the clinical efficacy of tonifying kidney and replenishing essence on asthenozoospermia patients with the syndrome of kidney essence deficiency and the effects of this method on the adenosine 5′-monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin complex 1 (mTORC1) signaling pathway. MethodsSeventy-two eligible asthenozoospermia patients with the syndrome of kidney essence deficiency treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from February 2023 to January 2024 were selected and randomly assigned into an observation group and a control group, with 36 patients in each group. The observation group received oral administration of Guilu Tianjing capsules, while the control group received oral administration of L-carnitine oral solution. The treatment course lasted for 4 weeks in both groups. The observed indicators included sperm progressive motility rate (PR), total sperm motility (PR+NP), percentage of normal mitochondrial membrane potential (MMP), and traditional Chinese medicine (TCM) symptom scores before and after treatment in both groups. A three-month follow-up was instituted to record the conception status of the patients’ spouses. Additionally, eight patients were randomly selected from the eligible patients in the observation group, and four healthy males with normal semen routine examination results were included as the control group for the determination of protein expression. Western blotting was conducted to assess the expression of AMPK, phosphorylated (p)-AMPK, regulatory-associated protein of mTOR (RAPTOR) and p-RAPTOR, and PTEN-induced putative kinase 1 (PINK1) in sperms from the observation group before and after treatment, as well as in the sperms of the control group. ResultsThe pregnancy rate of spouses in the observation group was 9.09% (3/33), which was higher than that (3.33%, 1/30) in the control group. The total response rate was 84.8% (28/33) in the observation group and 66.7% (20/30) in the control group, with no statistically significant difference. After treatment, both groups were improved considering PR, PR+NP, MMP, and TCM symptom scores (P<0.01). Moreover, the observation group exhibited more pronounced decreases in TCM symptom scores than the control group (P<0.05), while the changes in PR, PR+NP, and MMP showed no statistical significance between groups. Compared with the control group, the asthenozoospermia group exhibited upregulations in phosphorylation levels of AMPK and RAPTOR and protein level of PINK (P<0.01). The administration of Guilu Tianjing Capsules led to downregulations in the phosphorylation levels of AMPK and RAPTOR and protein level of PINK1 (P<0.01). However, the protein levels of AMPK and RAPTOR demonstrated no significant difference between before and after treatment. During the study period, neither group of patients exhibited any notable adverse reactions. ConclusionGuilu Tianjing capsules can enhance the sperm motility and percentage of normal mitochondrial membrane potential in asthenozoospermia patients with the syndrome of kidney essence deficiency by downregulating the AMPK/mTORC1 signaling pathway, lowering the protein level of PINK1, and inhibiting excessive activation of mitophagy.
6.Systematic Review of Chinese Medicine in Improving Sperm Quality in Animal Experiments Based on Structure and Function of Sertoli Cells
Yifeng SHEN ; Kun ZHU ; Wenyuan LI ; Liang DONG ; Yaodong YOU ; Degui CHANG ; Xujun YU
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(21):201-211
ObjectiveTo systematically review the intervention effect of Chinese medicine on the structure and function of testicular Sertoli cells in animal models of impaired spermatogenesis. MethodThe databases, such as China National Knowledge Infrastructure (CNKI),VIP,Wanfang Data,EMbase,and Pubmed,were searched for experimental studies on the effect of Chinese medicine on the structure and function of testicular Sertoli cells in animal models with impaired spermatogenesis. The included studies were evaluated for risks of bias,and the outcome indicators were analyzed with RevMan and Stata software. ResultThirty studies were included,involving 37 randomized controlled trials (RCTs). As indicated by the Meta-analysis results, compared with the model group,Chinese medicine increased sperm density(SMD=2.42,95% confidence interval(CI)[1.47,3.37],P<0.000 01), promoted sperm motility(SMD=2.35,95%CI [1.70, 2.99],P<0.000 01), up-regulated the protein and mRNA levels of Vimentin (related to Sertoli cell cytoskeleton), elevated the levels of Occludin and Claudin-11 (related to tight junction of blood-testis barrier), boosted the levels of β-catenin and N-cadherin (related to adherens junction of blood-testis barrier), raised the level of connexin 43 (Cx43, related to gap junction of blood-testis barrier), improved the function of Sertoli cells, increased the serum content of Inhibin B (INHB), and up-regulated the levels of testicular follicle-stimulating hormone receptor (FSHR), INHB mRNA, androgen-binding protein (ABP) mRNA, transferrin(TF),stem cell factor(SCF),SCF mRNA,glial cell line-derived neurotrophic factor (GDNF),GDNF mRNA,bone morphogenetic protein 4(BMP4),and BMP4 mRNA (P<0.05). ConclusionChinese medicine can effectively increase sperm density and motility of animal models of impaired spermatogenesis,and improve the structure and function of testicular Sertoli cells. However,affected by the quality of the included studies,the above conclusion needs to be further verified by relevant high-quality studies.
7.Knockout of glutathione peroxidase 5 down-regulates the piRNAs in the caput epididymidis of aged mice.
Chen CHU ; Lu YU ; Joelle HENRY-BERGER ; Yan-Fei RU ; Ayhan KOCER ; Alexandre CHAMPROUX ; Zhi-Tong LI ; Miao HE ; Sheng-Song XIE ; Wu-Bin MA ; Min-Jie NI ; Zi-Mei NI ; Yun-Li GUO ; Zhao-Liang FEI ; Lan-Tao GOU ; Qiang LIU ; Samanta SHARMA ; Yu ZHOU ; Mo-Fang LIU ; Charlie Degui CHEN ; Andrew L EAMENS ; Brett NIXON ; Yu-Chuan ZHOU ; Joël R DREVET ; Yong-Lian ZHANG
Asian Journal of Andrology 2020;22(6):590-601
The mammalian epididymis not only plays a fundamental role in the maturation of spermatozoa, but also provides protection against various stressors. The foremost among these is the threat posed by oxidative stress, which arises from an imbalance in reactive oxygen species and can elicit damage to cellular lipids, proteins, and nucleic acids. In mice, the risk of oxidative damage to spermatozoa is mitigated through the expression and secretion of glutathione peroxidase 5 (GPX5) as a major luminal scavenger in the proximal caput epididymidal segment. Accordingly, the loss of GPX5-mediated protection leads to impaired DNA integrity in the spermatozoa of aged Gpx5
8.Comparision of the treatment and short-term and one-year prognosis from acute heart failure in tertiary hospitals versus secondary hospitals-findings from Beijing Acute Heart Failure Registry (Beijing AHF Registry)
Xiaolu SUN ; Guogan WANG ; Jian QIN ; Chunsheng LI ; Xuezhong YU ; Hong SHEN ; Lipei YANG ; Yan FU ; Yaan ZHENG ; Bin ZHAO ; Dongmin YU ; Fujun QIN ; Degui ZHOU ; Ying LI ; Fujun LIU ; Wei LI ; Wei ZHAO ; Yanmin YANG ; Huiqiong TAN ; Litian YU ; Xin GAO ; Zheng WANG ; Ming JIN ; Hong ZENG ; Yi LI ; Guoxing WANG ; Hong ZHOU ; Xin WANG ; Yan LIU ; Fen XU ; Zhiqiang LI ; Lisheng YANG ; Aichun JIN ; Pengbo WANG ; Sijia WANG ; Ruohua YAN ; Leyu LIN ; Fusheng WANG ; Hui LIU
Chinese Journal of Emergency Medicine 2018;27(1):85-92
Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16%.The most common underlying disease were coronary disease (43.27%),hypertension (17.73%),cardiomyopathy (16.07%) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81% (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3% and 32.27%,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64% and 46.89%,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64% vs.49.93%),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43% vs.37.45%) and emergency department mortality(1.58% vs.4.09%).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6% vs.33.2%),cardiovascular disease mortality (20.2% vs.26.0%),aggravated heart failure mortality (22.4% vs.28.8%) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51% vs.28.17%,1.41% vs.9.58%),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.
9.Overexpressed miR-9 promotes tumor metastasis via targeting E-cadherin in serous ovarian cancer
Zhou BO ; Xu HONGBIN ; Xia MENG ; Sun CHAOYANG ; Li NA ; Guo ENSONG ; Guo LILI ; Shan WANYING ; Lu HAO ; Wu YIFAN ; Li YUAN ; Yang DEGUI ; Weng DANHUI ; Meng LI ; Hu JUNBO ; Ma DING ; Chen GANG ; Li KEZHEN
Frontiers of Medicine 2017;11(2):214-222
MicroRNAs (miRNAs) play critical roles in the development and progression in various cancers.Dysfunctional miR-9 expression remains ambiguous,and no consensus on the metastatic progression of ovarian cancer has been reached.In this study,results from the bioinformatics analysis show that the 3'-UTR of the E-cadherin mRNA was directly regulated by miR-9.Luciferase reporter assay results confirmed that miR-9 could directly target this 3'-UTR.miR-9 and E-cadherin expression in ovarian cancer tissue was quantified by qRTPCR.Migration and invasion were detected by wound healing and Transwell system assay in SKOV3 and A2780.qRT-PCR and Western blot were performed to detect the epithelial-mesenchymal transition-associated mRNA and proteins.Immunofluorescence technique was used to analyze the expression and subcellular localization of Ecadherin,N-cadherin,and vimentin.The results showed that miR-9 was frequently upregulated in metastatic serous ovarian cancer tissue compared with paired primary ones.Upregulation of miR-9 could downregulate the expression of E-cadherin but upregulate the expression of mesenchymal markers (N-cadherin and vimentin).Overexpression of miR-9 could promote the cell migration and invasion in ovarian cancer,and these processes could be effectively inhibited via miR-9 inhibitor.Thus,our study demonstrates that miR-9 may promote ovarian cancer metastasis via targeting E-cadherin and a novel potential therapeutic approach to control metastasis of ovarian cancer.
10.Effects of hydrogen-rich saline on liver of severely scalded rats with delayed resuscitation.
Degui LIU ; Xiaojuan WANG ; Yong YANG ; Jinheng JIANG ; Xianhui LI ; Gang XUE
Chinese Journal of Burns 2014;30(6):506-511
OBJECTIVETo explore the effects of hydrogen-rich saline (HS) on liver of severely scalded rats with delayed resuscitation.
METHODSTwenty-four SD rats were inflicted with 40% TBSA full-thickness scald using a temperature-controlled scalding apparatus. The injured rats were divided into lactated Ringer's solution (RS) and HS groups according to the random number table, with 12 rats in each group. Rats in groups RS and HS were respectively resuscitated with an intraperitoneal injection of 4 mL × kg⁻¹ × %TBSA⁻¹ of RS or HS (self-prepared, with concentration of hydrogen 0.6 mmol/L) 6 hours after injury up to 48 hours after scald. The infusion volume of the second 24 hours after injury was a half of that of the first 24 hours. At post scald hour (PSH) 6 (before resuscitation), 12, 24, and 48, blood was collected from the heart of 3 rats in each group, and then the rats were sacrificed for harvesting liver tissue. The pathological change in liver tissue was observed with HE staining. The number of hepatic neutrophils was counted with a hematocytometer. Serum levels of AST and ALT were determined with full-automatic biochemical analyzer. Contents of TNF-α, IL-1β, IL-6, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in liver tissue were determined with ELISA. Absorbance value of malondialdehyde (MDA) in liver tissue was detected and quantified with spectrophotometer. Data were processed with analysis of variance of repeated measurement and LSD-t test.
RESULTSAt PSH 48, moderate infiltration of inflammatory cells and hepatic hyperemia were observed in rats of group HS as compared with group RS. At PSH 12, 24, and 48, the number of neutrophils in group HS was respectively (25.3 ± 1.8) × 10⁵, (19.6 ± 0.6) × 10⁵, and (14.1 ± 3.2) × 10⁵ cells per mililitre, and they were significantly lower than those in group RS \[(31.9 ± 2.0) × 10⁵, (30.9 ± 2.2) × 10⁵, and (23.8 ± 3.0) × 10⁵ cells per mililitre, with t values respectively 5.6, 7.6, and 8.7, P values below 0.05\]. At PSH 6 and 12, the serum levels of AST and ALT and the levels of TNF-α, IL-1β, and IL-6 in liver tissue were close between the two groups (with t values respectively 0.3-3.9 and 0.9-3.8, P values above 0.05). At PSH 24 and 48, the serum levels of AST and ALT in group HS were respectively (308 ± 24) and (210 ± 15) U/L and (93 ± 7) and (70 ± 5) U/L, which were significantly lower than those in group RS \[(541 ± 39) and (505 ± 18) U/L, with t values respectively 17.5 and 16.7, P values below 0.05; (156 ± 9) and (166 ± 21) U/L, with t values respectively 30.3 and 6.9, P values below 0.05\]. At PSH 24 and 48, the levels of TNF-α, IL-1β, and IL-6 in liver tissue in group HS were respectively (20.7 ± 1.6) and (13.7 ± 1.5) pg/mg, (7.7 ± 1.5) and (6.3 ± 1.2) pg/mg, and (8.7 ± 1.2) and (6.0 ± 2.0) pg/mg, which were significantly lower than those in group RS \[(32.7 ± 5.0) and (25.7 ± 4.0) pg/mg, with t values respectively 5.2 and 5.7, P values below 0.05; (16.3 ± 2.5) and (12.0 ± 2.7) pg/mg, with t values both as 4.7, P values below 0.05; (14.7 ± 2.1) and (13.3 ± 1.5) pg/mg, with t values respectively 10.4 and 4.4, P values below 0.05\]. The level of MDA at PSH 6 and levels of 8-OHdG at PSH 6 and 12 in liver tissue were close between the two groups (with t values respectively 0.1, 0.7, and 4.3, P values above 0.05). In group HS, the levels of MDA in liver tissue at PSH 12, 24, and 48 were respectively (15.3 ± 1.5), (8.7 ± 1.2), and (6.7 ± 1.5) mmol/mg, and the levels of hepatic 8-OHdG at PSH 24 and 48 were respectively (124 ± 12) and (79 ± 10) pg/mg, which were significantly lower than those in group RS \[(27.3 ± 4.7), (20.3 ± 1.5), and (14.0 ± 1.0) mmol/mg, with t values respectively 5.2, 5.7, and 5.1, P values below 0.05; (191 ± 10) and (136 ± 15) pg/mg, with t values respectively 8.0 and 8.1, P values below 0.05\].
CONCLUSIONSResuscitation with HS could protect liver of severely scalded rats with delayed resuscitation possibly by reducing infiltration of neutrophils, thus lowering the content of inflammatory cytokines, and effectively alleviating oxidative stress.
Animals ; Burns ; metabolism ; physiopathology ; Deoxyguanosine ; analogs & derivatives ; blood ; Hydrogen ; pharmacology ; Interleukin-6 ; Liver ; drug effects ; metabolism ; physiopathology ; Male ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Resuscitation ; Sodium Chloride ; pharmacology ; Soft Tissue Injuries ; Time Factors ; Tumor Necrosis Factor-alpha ; blood

Result Analysis
Print
Save
E-mail