1.Subtalar arthroereisis for treatment of pediatric flexible flatfoot:relationship between radiographic indicators and clinical efficacy
Guangtao LIAO ; Ziyu FENG ; Xiaoyong FU ; Qinglan ZHAO ; Chao CHEN ; Jinsong HONG
Chinese Journal of Tissue Engineering Research 2026;30(3):661-670
BACKGROUND:Pediatric flexible flatfoot is a common foot deformity that often leads to foot pain and reduced quality of life.OBJECTIVE:To explore the relationship between radiographic parameters and clinical efficacy of subtalar arthroereisis in the treatment of pediatric flexible flatfoot.METHODS:A retrospective study was conducted on 56 pediatric patients(mean age of 11.8 years)who underwent subtalar arthroereisis at Guangzhou Orthopedic Hospital between January 2022 and May 2023.All patients underwent detailed radiographic examinations and clinical evaluations before and after surgery,including the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score and Visual Analog Scale score.Paired t-tests and independent t-tests were used to compare changes in radiographic parameters and clinical scores before and after surgery.Correlation analyses were conducted to evaluate the relationship between radiographic parameters and clinical outcomes.RESULTS AND CONCLUSION:(1)All radiographic parameters significantly improved during the 8 to 12-month follow-up after surgery(P<0.001).(2)Clinical evaluation results indicated that the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score significantly improved from 66.2±6.0 preoperatively to 91.3±5.8 postoperatively,and the Visual Analog Scale score significantly decreased from 3.1±0.8 preoperatively to 1.3±0.8 postoperatively(P<0.001).(3)Independent t-tests showed a significant difference in postoperative the first metatarsal angle and Visual Analog Scale score grades(P=0.043),with a smaller the first metatarsal angle associated with less postoperative pain;preoperative lateral arch angle showed a significant difference between the"excellent"and"good"groups in postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scores(P=0.033),suggesting that a smaller preoperative posterior arch angle might predict better postoperative foot function recovery.(4)Correlation analysis showed that preoperative posterior arch angle(r=-0.486,P<0.01)and heel pitch angle(r=-0.344,P<0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,while preoperative medial longitudinal arch angle(r=0.293,P<0.05)was significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.Postoperative medial longitudinal arch angle(r=0.331,P<0.05)and lateral arch angle(r=0.387,P<0.01)were significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,whereas postoperative Bohler's angle(r=-0.272,P<0.05),posterior arch angle(r=-0.461,P<0.01),and heel pitch angle(r=-0.318,P<0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.(5)It is concluded that subtalar arthroereisis is significantly effective in correcting pediatric flexible flatfoot,and improvements in radiographic parameters are closely related to clinical efficacy.Preoperative and postoperative radiographic evaluations can serve as important reference indicators for predicting postoperative clinical outcomes,guiding clinicians to optimize treatment plansand rehabilitation programs.
2.Subtalar arthroereisis for treatment of pediatric flexible flatfoot:relationship between radiographic indicators and clinical efficacy
Guangtao LIAO ; Ziyu FENG ; Xiaoyong FU ; Qinglan ZHAO ; Chao CHEN ; Jinsong HONG
Chinese Journal of Tissue Engineering Research 2026;30(3):661-670
BACKGROUND:Pediatric flexible flatfoot is a common foot deformity that often leads to foot pain and reduced quality of life.OBJECTIVE:To explore the relationship between radiographic parameters and clinical efficacy of subtalar arthroereisis in the treatment of pediatric flexible flatfoot.METHODS:A retrospective study was conducted on 56 pediatric patients(mean age of 11.8 years)who underwent subtalar arthroereisis at Guangzhou Orthopedic Hospital between January 2022 and May 2023.All patients underwent detailed radiographic examinations and clinical evaluations before and after surgery,including the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score and Visual Analog Scale score.Paired t-tests and independent t-tests were used to compare changes in radiographic parameters and clinical scores before and after surgery.Correlation analyses were conducted to evaluate the relationship between radiographic parameters and clinical outcomes.RESULTS AND CONCLUSION:(1)All radiographic parameters significantly improved during the 8 to 12-month follow-up after surgery(P<0.001).(2)Clinical evaluation results indicated that the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score significantly improved from 66.2±6.0 preoperatively to 91.3±5.8 postoperatively,and the Visual Analog Scale score significantly decreased from 3.1±0.8 preoperatively to 1.3±0.8 postoperatively(P<0.001).(3)Independent t-tests showed a significant difference in postoperative the first metatarsal angle and Visual Analog Scale score grades(P=0.043),with a smaller the first metatarsal angle associated with less postoperative pain;preoperative lateral arch angle showed a significant difference between the"excellent"and"good"groups in postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scores(P=0.033),suggesting that a smaller preoperative posterior arch angle might predict better postoperative foot function recovery.(4)Correlation analysis showed that preoperative posterior arch angle(r=-0.486,P<0.01)and heel pitch angle(r=-0.344,P<0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,while preoperative medial longitudinal arch angle(r=0.293,P<0.05)was significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.Postoperative medial longitudinal arch angle(r=0.331,P<0.05)and lateral arch angle(r=0.387,P<0.01)were significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,whereas postoperative Bohler's angle(r=-0.272,P<0.05),posterior arch angle(r=-0.461,P<0.01),and heel pitch angle(r=-0.318,P<0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.(5)It is concluded that subtalar arthroereisis is significantly effective in correcting pediatric flexible flatfoot,and improvements in radiographic parameters are closely related to clinical efficacy.Preoperative and postoperative radiographic evaluations can serve as important reference indicators for predicting postoperative clinical outcomes,guiding clinicians to optimize treatment plansand rehabilitation programs.
3.Regulation of natural killer cell subtypes and functions by programmed cell death protein 1 and its receptor at the maternal-fetal interface in mice infected with Toxoplasma gondii during the second trimester
Jiayue SUN ; Qiuhua BAI ; Xiaodan CHEN ; Jiayin LÜ ; Shanshan HE ; Lili TANG ; Dejun LIAO ; Dengyu LIU ; Xiaoyin FU
Chinese Journal of Schistosomiasis Control 2025;37(5):465-474
Objective To investigate the regulatory role of the programmed cell death protein 1 (PD-1) and its ligand programmed cell death protein ligand 1 (PD-L1) signaling on the subtypes and functions of natural killer (NK) cells at the maternal-fetal interface during the second trimester in mice following Toxoplasma gondii infection during the first trimester. Methods Twelve 6- to 8-week-old female mice of the C57BL/6J strain were divided into a control group and an infection group, of 6 mice in each group. On the 6.5th day of pregnancy (Gd6.5), each pregnant mouse in the infection group was intraperitoneally injected with 150 tachyzoites of the Toxoplasma gondii PRU strain, while mice in the control group were injected with an equal volume of physiological saline. On the 12.5th day of pregnancy (Gd12.5), uterus and placenta tissues were sampled from pregnant mice for pathological observations, and the mRNA expression levels of PD-1, PD-L1, and tumor necrosis factor-α (TNF-α) were quantified in uterus and placenta tissues. The PD-1 and DX5 expression was measured on NK cells at the maternal-fetal interface using flow cytometry. In addition, the in vitro JEG-3 trophoblast cells and NK-92MI cells co-culture system was established as the control group, and the addition of T. gondii tachyzoites in the co-culture system served as the infection group. The PD-1, PD-L1, and DX5 mRNA expression was quantified in cells using real-time fluorescence quantitative reverse transcription PCR (RT-qPCR) assay, and the TNF-α concentration was measured in the cell culture supernatant using enzyme-linked immunosorbent assay (ELISA). Results On Gd12.5, clear and intact cellular structures of placental decidual tissues were seen in pregnant mice in the control group, with no remarkable abnormal changes found in the uterine columnar epithelial cells, and inflammatory cell infiltration and blood stasis at varying degrees were found in uterine and placental tissues from pregnant mice in the infection group. The relative PD-1, PD-L1, and TNF-α mRNA expression was (1.004 ± 0.004), (1.001 ± 0.001), and (1.001 ± 0.001) in uterine tissues from pregnant mice in the control group and (2.480 ± 0.720), (3.355 ± 0.920), and (2.391 ± 0.073) in the infection group, respectively. The relative PD-1, PD-L1, and TNF-α mRNA expression was (1.007 ± 0.010), (1.006 ± 0.006), and (1.001 ± 0.001) in the uterine tissues in the control group and (6.948 ± 1.918), (3.225 ± 1.034), and (1.536 ± 0.150) in the infection group, respectively. The relative PD-1, PD-L1, and TNF-α mRNA expression was higher in both the uterine (t = 3.55, 4.43 and 33.02, all P values < 0.05) and placental tissues (t = 5.36, 3.72 and 6.18, all P values < 0.05) in the infection group than in the control group. Flow cytometry showed that the proportions of PD-1+ NK cells, PD-1+ DX5+ NK cells, and DX5+ NK cells were (12.200 ± 1.082)%, (9.373 ± 7.728)%, and (44.000 ± 4.095)% in uterine tissues from pregnant mice in the control group, and (21.733 ± 1.630)%, (18.767 ± 1.242)%, and (73.367 ± 0.611)% in the infection group, respectively. The proportions of PD-1+ NK cells, PD-1+ DX5+ NK cells, and DX5+ NK cells were (1.100 ± 0.510)%, (2.277 ± 1.337)%, and (96.167 ± 2.831)% in placental tissues from mice in the control group, and (26.867 ± 9.722)%, (23.433 ± 6.983)%, and (82.467 ± 2.248)% in the infection group, respectively. The proportions of PD-1+ NK cells (t = 8.45, P < 0.05) and DX5+ NK cells (t = 12.29, P < 0.05) were higher in uterine tissues from pregnant mice in the infection group than in the control group, and no significant difference was seen in the proportion of PD-1+ DX5+ NK cells (Z = -1.09, P > 0.05). The proportions of PD-1+ NK cells (t = 4.58, P < 0.05) and PD-1+ DX5+ NK cells (t = 5.15, P < 0.05) were higher in placental tissues from pregnant mice in the infection group than in the control group, while the proportion of DX5+ NK cells was lower in the infection group than in the control group (t = -6.56, P < 0.05). RT-qPCR assay revealed that the relative PD-1, PD-L1, and DX5 mRNA expression was (1.010 ± 0.005), (1.002 ± 0.003), and (1.001 ± 0.001) in the JEG-3 cells and NK92MI cells co-culture system and (3.638 ± 1.258), (0.397 ± 0.158), and (4.267 ± 1.750) in the control group, and ELISA measured that the TNF-α concentration was higher in the cell culture supernatant in the infection group [(22.056 ± 3.205) pg/mL] than in the control group [(12.441 ± 0.001) pg/mL] (t = 5.20, P < 0.05). The PD-1(t = 3.62, P < 0.05) and DX5 mRNA expression (t = 3.23, P < 0.05) was higher in the infection group than in the control group, and the PD-L1 mRNA expression was lower in the infection group than in the control group (t = -6.63, P < 0.05). Conclusions Following T. gondii infection, both PD-L1 expression and PD-1 expression on DX5+ NK cells at the maternal-fetal interface are upregulated in mice during the second trimester; however, the proportion of DX5+ NK cells decreases. These findings suggest that PD-1/PD-L1 signaling may suppress NK cell functions by modulating DX5+ NK cell subsets.
4.Effects of varying durations of overwork on cardiomyocyte pyroptosis of mice
Xue MA ; Yue LIAO ; San-Chun DENG ; Wei FU ; Shang JIANG ; Yu-Lan LI
Medical Journal of Chinese People's Liberation Army 2025;50(6):756-761
Objective To investigate the effects of varying durations of overwork on cardiomyocyte pyroptosis in mice.Methods A total of 24 SPF KM mice were randomly divided into four groups(n=6)using a random number table:control group,2-week overwork(W2)group,4-week overwork(W4)group,and 6-week overwork(W6)group.Mice in control group were normally raised,while those in W2,W4,and W6 groups were forced to stand in water for 8 h and then restrained for 3 h daily for 2,4,6 weeks,respectively.The general condition and weekly weight changes of the mice were observed.After modeling,blood samples were collected,and hearts were excised.Myocardial histopathological changes were assessed using hematoxylin and eosin(HE)staining.The localization of gasdermin D(GSDMD)protein in myocardial tissue was detected through immunohistochemical staining,and the expression levels of pyroptosis-related proteins[NOD-like protein receptor 3(NLRP3),Caspase-1,GSDMD]in myocardial tissue were analyzed using Western blotting.The contents of interleukin-1β(IL-1β)and interleukin-18(IL-18)in serum and myocardial tissues were measured using ELISA.Results(1)The weight of control group mice increased steadily within 2 weeks.In W2 group,there was no significant weight change within 2 weeks,while in W4 and W6 groups,the body weights were higher than their initial values from the 2nd to 6th week.Compared with control group,the body weights of W2,W4,and W6 groups were lower than those of control group in the 1st and 2nd week,with statistically significant differences(P<0.05).The activity levels of the mice in W2,W4,and W6 groups initially increased and then decreased,with their fur becoming dull and falling out,and their mental state deteriorating.(2)In control group,cardiomyocytes were neatly arranged,and the nuclear morphology was normal.Compared with control group,in W2 group,cardiomyocyte arrangement was less regular,and capillary congestion was increased.In W4 group,the vascular congestion in the myocardium was significantly increased,the interstitial tissue was hyperplastic,and vacuolization appeared around the nuclei.In W6 group,the myocardial interstitium was loose,fat infiltration was increased,vacuolization around the nuclei was increased,and myocardial fibers were swollen,and the arrangement was disordered.(3)GSDMD was mainly located in the cytoplasm of cardiomyocytes.Compared with control group,the expression levels of NLRP3,Caspase-1,and GSDMD proteins in W2,W4,and W6 groups were significantly increased,and the expression levels were in the order of W6 group>W4 group>W2 group,with significant differences(P<0.05).(4)Compared to control group,the levels of IL-1β in serum and myocardial tissues of W2,W4,and W6 groups were significantly increased.In serum,the level of IL-1β in W6 group was higher than those in W2 and W4 groups,and in myocardial tissue,the levels in W4 and W6 groups were higher than those in the W2 group,with significant differences(P<0.05).There were no significant differences in IL-1β levels in serum among W2 and W4 groups,nor were there significant differences in myocardial tissue between W4 and W6 groups(P>0.05).Compared with control group,the levels of IL-18 in serum and myocardial tissue of W4 and W6 groups were significantly increased(P<0.05).In serum,the levels of IL-18 in W4 and W6 groups were higher than that in W2 group,and in myocardial tissue,the level in W6 group was higher than those in W2 and W4 groups,with the differences being statistically significant(P<0.05).Conclusions Overwork can cause structural damage to mouse myocardial tissue,increase the expression of pyroptosis proteins NLRP3,Caspase-1,GSDMD,and aggravate myocardial inflammatory responses in overworked mice.Cardiomyocyte pyroptosis may be one of the factors contributing to sudden cardiac death induced by overwork.
5.The clinical value of serum soluble PD-1/PD-L1 in the prognosis analysis of patients with intracerebral hemorrhage
Wei ZHANG ; Zhaohui LIAO ; Ling WANG ; Zheyuan FAN ; Bao FU
Chinese Journal of Emergency Medicine 2025;34(9):1258-1267
Objective:This study aimed to explore the serum levels of soluble programmed cell death protein 1 (sPD-1) and soluble programmed cell death-ligand 1 (sPD-L1) in patients with spontaneous intracerebral hemorrhage (ICH) and their clinical value in the prognostic analysis.Methods:This prospective cohort study included patients aged ≥18 years admitted to the department of critical care medicine at the Affiliated Hospital of Zunyi Medical University between January 2022 and October 2024 with a first episode of ICH presenting within 24 hours of onset. Patients with hemorrhage caused by other causes (e.g., tumor, medication and trauma) or incomplete data were excluded. Based on 28-day all-cause mortality, patients were divided into survival group and non-survival group. According to the 60-day neurological outcome, patients were divided into good neurological outcome group and poor neurological outcome group. Clinical and imaging data were collected, along with venous blood samples obtained within 24 hours of admission to measure serum levels of sPD-1 and sPD-L1. Predictive indicators were identified using LASSO-Logistic regression analysis was used to identify predictive indicators, and a nomogram was constructed to visualize the prediction model. Model performances were evaluated using receiver operating characteristic curves, decision curve analysis, calibration curves, and the Hosmer-Lemeshow test.Results:A total of 155 patients were included: 101 in the survival group and 54 in the death group; 56 in the favorable neurological outcome group and 99 in the poor neurological outcome group. Serum sPD-1 concentrations were significantly lower in the death group and poor neurological outcome group compared to the survival group and favorable neurological outcome group, respectively. Conversely, serum sPD-L1 concentrations were significantly higher in the death group and poor neurological outcome group compared to the survival group and favorable neurological outcome group (all P < 0.05). Serum sPD-1 and sPD-L1 were identified as predictors of 28-day mortality risk. A nomogram incorporating seven indicators—brainstem hemorrhage, hemorrhage volume, obstructive hydrocephalus, surgical intervention, admission NIHSS score, and admission serum sPD-1 and sPD-L1 levels—demonstrated superior predictive performance [AUC=0.984 (95% CI: 0.968-1.000)] compared to sPD-1 alone (AUC=0.712) or sPD-L1 alone (AUC=0.753). Serum sPD-1 was a predictor of poor 60-day neurological outcome. A nomogram incorporating obstructive hydrocephalus, admission NIHSS score, and admission serum sPD-1 level [AUC=0.818 (95% CI: 0.754-0.882)] outperformed sPD-1 alone (AUC=0.637) or sPD-L1 alone (AUC=0.602). Conclusions:Serum levels of sPD-1 were significantly lower in the non-survivors and the patients with poor neurological outcomes compared to the survivors and the patients with good neurological outcomes. However, serum levels of sPD-L1 were significantly higher in the non-survivors and the patients with poor neurological outcome. Serum sPD-1 was an independent predictor of 28-day mortality risk and 60-day poor neurological outcome; serum sPD-L1 was an independent predictor of 28-day mortality risk. A nomogram prediction model incorporating sPD-1 and sPD-L1 demonstrated good predictive performance for mortality risk and poor neurological outcome.
7.Research and verification of oxygen consumption forecast model for extravehicular activity
Changsheng TIAN ; Wanxin ZHANG ; Zongbao FU ; Likun YAO ; Qianfang LIAO ; Shiyao LUO ; Qi TIAN
Space Medicine & Medical Engineering 2025;36(2):178-182
Aiming at the problem that the amount of Oxygen remaining and available time can not be accurately predicted while an astronaut conducting extravehicular activities(EVAs)in EVA spacesuit.Research the oxygen consumption process of EVA spacesuit.The model and algorithm of oxygen consumption are established by the gas state equation including compressibility and temperature coefficient,combined with human metabolism and micro leakage characteristics of spacesuit.Experimental data show that the orecast model and algorithm hasing high accuracy and practicability.
8.Randomized Double-blind Placebo-controlled Study on Clinical Efficacy and Mechanism of Shexiang Baoxinwan in Treating Stable Angina Pectoris Complicated with Anxiety and Depression in Coronary Artery Disease
Jie WANG ; Linzi LONG ; Zhiru ZHAO ; Feifei LIAO ; Jieming LU ; Tianjiao LIU ; Yuxuan PENG ; Hua QU ; Changgeng FU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):159-169
ObjectiveTo evaluate the efficacy of Shexiang Baoxinwan in treating stable angina pectoris with Qi stagnation and blood stasis syndrome in patients with coronary artery disease (CAD) complicated with anxiety and depression and explore its underlying mechanisms. MethodsThis study employed a randomized, double-blind, and placebo-controlled clinical trial design. Patients admitted to the hospital were randomly assigned to the observation group and the control group, with 52 patients in each group. Patients in the observation and control groups received Shexiang Baoxinwan and placebo, respectively, both in combination with conventional Western medication. The dose was 45.0 mg, three times daily, for a total duration of eight weeks. The primary outcome was the Seattle Angina Questionnaire (SAQ) scores before and after treatment. Secondary outcomes included changes in traditional Chinese medicine (TCM) syndrome score, the patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), inflammatory markers [interleukin-18 (IL-18), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), CD40, etc.], monoamine neurotransmitters [e.g., dopamine (DA)], vascular endothelial function markers [e.g., endothelin-1(ET-1)], adipokines, and ischemia-modified albumin (IMA). Adverse reactions were also recorded. ResultsA total of 92 patients completed the study, with 44 in the observation group and 48 in the control group. Compared with baseline, both groups showed significant decreases in PHQ-9, GAD-7, and TCM syndrome scores following treatment (P<0.05), along with a significant increase in SAQ scores (P<0.05). In the observation group, DA levels were significantly increased (P<0.05), while levels of IL-18, TNF-α, CD40, ET-1, and IMA were decreased (P<0.05). In contrast, the control group exhibited significantly increased CD40 levels (P<0.05). Compared with the control group after treatment, the observation group showed significant improvements in the SAQ dimensions of physical limitation, angina stability, treatment satisfaction, and disease perception, as well as in TCM syndrome score, PHQ-9 score, IL-18, CD40, ET-1, and IMA (P<0.05). No adverse reactions were observed in either group during treatment. ConclusionShexiang Baoxinwan can improve anxiety and depression, alleviate angina symptoms, and reduce TCM symptoms of Qi stagnation and blood stasis in CAD patients. The mechanism may involve anti-inflammation, improvement of vascular endothelial function, reduction of IMA, and increase of monoamine neurotransmitter levels.
9.Randomized Double-blind Placebo-controlled Study on Clinical Efficacy and Mechanism of Shexiang Baoxinwan in Treating Stable Angina Pectoris Complicated with Anxiety and Depression in Coronary Artery Disease
Jie WANG ; Linzi LONG ; Zhiru ZHAO ; Feifei LIAO ; Jieming LU ; Tianjiao LIU ; Yuxuan PENG ; Hua QU ; Changgeng FU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):159-169
ObjectiveTo evaluate the efficacy of Shexiang Baoxinwan in treating stable angina pectoris with Qi stagnation and blood stasis syndrome in patients with coronary artery disease (CAD) complicated with anxiety and depression and explore its underlying mechanisms. MethodsThis study employed a randomized, double-blind, and placebo-controlled clinical trial design. Patients admitted to the hospital were randomly assigned to the observation group and the control group, with 52 patients in each group. Patients in the observation and control groups received Shexiang Baoxinwan and placebo, respectively, both in combination with conventional Western medication. The dose was 45.0 mg, three times daily, for a total duration of eight weeks. The primary outcome was the Seattle Angina Questionnaire (SAQ) scores before and after treatment. Secondary outcomes included changes in traditional Chinese medicine (TCM) syndrome score, the patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), inflammatory markers [interleukin-18 (IL-18), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), CD40, etc.], monoamine neurotransmitters [e.g., dopamine (DA)], vascular endothelial function markers [e.g., endothelin-1(ET-1)], adipokines, and ischemia-modified albumin (IMA). Adverse reactions were also recorded. ResultsA total of 92 patients completed the study, with 44 in the observation group and 48 in the control group. Compared with baseline, both groups showed significant decreases in PHQ-9, GAD-7, and TCM syndrome scores following treatment (P<0.05), along with a significant increase in SAQ scores (P<0.05). In the observation group, DA levels were significantly increased (P<0.05), while levels of IL-18, TNF-α, CD40, ET-1, and IMA were decreased (P<0.05). In contrast, the control group exhibited significantly increased CD40 levels (P<0.05). Compared with the control group after treatment, the observation group showed significant improvements in the SAQ dimensions of physical limitation, angina stability, treatment satisfaction, and disease perception, as well as in TCM syndrome score, PHQ-9 score, IL-18, CD40, ET-1, and IMA (P<0.05). No adverse reactions were observed in either group during treatment. ConclusionShexiang Baoxinwan can improve anxiety and depression, alleviate angina symptoms, and reduce TCM symptoms of Qi stagnation and blood stasis in CAD patients. The mechanism may involve anti-inflammation, improvement of vascular endothelial function, reduction of IMA, and increase of monoamine neurotransmitter levels.
10.Proteomics and Network Pharmacology Reveal Mechanism of Xiaoer Huatan Zhike Granules in Treating Allergic Cough
Youqi DU ; Yini XU ; Jiajia LIAO ; Chaowen LONG ; Shidie TAI ; Youwen DU ; Song LI ; Shiquan GAN ; Xiangchun SHEN ; Ling TAO ; Shuying YANG ; Lingyun FU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):69-79
ObjectiveTo explore the pharmacological mechanism involved in the treatment of allergic cough (AC) by Xiaoer Huatan Zhike granules (XEHT) based on proteomics and network pharmacology. MethodsAfter sensitization by intraperitoneal injection of 1 mL suspension containing 2 mg ovalbumin (OVA) and 100 mg aluminum hydroxide, a guinea pig model of allergic cough was constructed by nebulization with 1% OVA. The modeled guinea pigs were randomized into the model, low-, medium- and high-dose (1, 5, 20 g·kg-1, respectively) XEHT, and sodium montelukast (1 mg·kg-1) groups (n=6), and another 6 guinea pigs were selected as the blank group. The guinea pigs in drug administration groups were administrated with the corresponding drugs by gavage, and those in the blank and model groups received the same volume of normal saline by gavage, 1 time·d-1. After 10 consecutive days of drug administration, the guinea pigs were stimulated by 1% OVA nebulization, and the coughs were observed. The pathological changes in the lung tissue were observed by hematoxylin-eosin staining. The enzyme-linked immunosorbent assay was performed to measure the levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), and malondialdehyde (MDA) in the bronchoalveolar lavage fluid (BALF) and immunoglobulin G (IgG) and immunoglobulin A (IgA) in the serum. Immunohistochemistry (IHC) was employed to observe the expression of IL-6 and TNF-α in the lung tissue. Transmission electron microscopy was employed observe the alveolar type Ⅱ epithelial cell ultrastructure. Real-time PCR was employed to determine the mRNA levels of IL-6, interleukin-1β (IL-1β), and TNF-α in the lung tissue. Label-free proteomics was used to detect the differential proteins among groups. Network pharmacology was used to predict the targets of XEHT in treating AC. The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was performed to search for the same pathways from the results of proteomics and network pharmacology. ResultsCompared with the blank group, the model group showed increased coughs (P<0.01), elevated levels of CRP, TNF-α, IL-6, and MDA and lowered level of SOD in the BALF (P<0.05, P<0.01), elevated levels of IgA and IgG in the serum (P<0.05, P<0.01), congestion of the lung tissue and infiltration of inflammatory cells, increased expression of IL-6 and TNF-α (P<0.01), large areas of low electron density edema in type Ⅱ epithelial cells, obvious swelling and vacuolization of the organelles, karyopyknosis or sparse and dissolved chromatin, and up-regulated mRNA levels of IL-6, IL-1β, and TNF-α (P<0.01). Compared with the model group, the drug administration groups showed reduced coughs (P<0.01), lowered levels of CRP, TNF-α, IL-6, and MDA and elevated level of SOD in the BALF (P<0.05, P<0.01), alleviated lung tissue congestion, inflammatory cell infiltration, and type Ⅱ epithelial cell injury, and decreased expression of IL-6 and TNF-α (P<0.01). In addition, the medium-dose XEHT group and the montelukast sodium group showcased lowered serum levels of IgA and IgG (P<0.05, P<0.01). The medium- and high-dose XEHT groups and the montelukast sodium showed down-regulated mRNA levels of IL-6, IL-1β, and TNF-α and the low-dose XEHT group showed down-regulated mRNA levels of IL-6 and TNF-α (P<0.05, P<0.01). Phospholipase D, mammalian target of rapamycin (mTOR), and epidermal growth factor receptor family of receptor tyrosine kinase (ErbB) signaling pathways were the common pathways predicted by both proteomics and network pharmacology. ConclusionProteomics combined with network pharmacology reveal that XEHT can ameliorate AC by regulating the phospholipase D, mTOR, and ErbB signaling pathways.

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