Acute kidney injury (AKI) is a clinical syndrome characterized by severe impairment of renal function. The occurrence of AKI often leads to the accumulation of metabolites, electrolyte imbalance, changes in drug concentration gradients, and may even induce systemic inflammatory responses and indirectly affect distal organs, which is one of the reasons for the high mortality rate of AKI. In traditional Chinese medicine, cordyceps sinensis is a widely used natural herb, which is believed to improve kidney injury and promote the recovery of renal tubular function. It contains abundant chemical components, has diverse species, and the distribution, content and efficacy of its active substances also vary. This article reviews the research progress of cordyceps sinensis in the treatment of AKI.

OBJECTIVES: To propose a hypothesis that aloe-emodin may inhibit scar tissue fibrosis through thrombospondin-1(THBS1)-PI3K-Akt pathway. METHODS: By cultivating fibroblasts derived from scar tissue after cleft palate surgery in humans, aloe emodin of different concentrations (10, 20, 30, 40 and 50 μmol/L) was added to the cells which activity was detected. At the same time, transcriptome sequencing was performed on scar tissue and cells, and bioinformatics methods were used to explore potential targets and signaling pathways of scar tissue fibrosis. RESULTS: Aloe-emodin had a concentration dependent inhibitory effect on fibroblast proliferation,with the 40 μmol/L concentration group showing the most significant effect. The results of tissue and cell sequencing indicated that differentially expressed genes were significantly enriched in extracellular matrix-receptor interaction pathway, and shared a common differential gene which was THBS1. The ORA analysis results indicated that differentially expressed genes, including THBS1, were significantly enriched in the PI3K-Akt signaling pathway. CONCLUSIONS Aloe emodin may inhibit the PI3K-Akt pathway by downregulating THBS1, thereby reducing the proliferation activity of fibroblasts derived from postoperative palatal scar tissue.
Thrombospondin 1/genetics* ; Humans ; Signal Transduction/drug effects* ; Fibroblasts/cytology* ; Proto-Oncogene Proteins c-akt/metabolism* ; Fibrosis ; Phosphatidylinositol 3-Kinases/metabolism* ; Cicatrix/metabolism* ; Cell Proliferation/drug effects* ; Anthraquinones/pharmacology* ; Cells, Cultured

Acute kidney injury (AKI), a life-threatening clinical syndrome, lacks effective therapeutic interventions beyond supportive care such as hemodialysis and kidney transplantation. Pathologically, excessive reactive oxygen species -mediated oxidative stress is recognized as a pivotal contributor to AKI progression, positioning reactive oxygen species scavenging as a critical therapeutic target. Emerging nanozymes, nanomaterials with enzyme-mimetic activities, have shown promise in addressing AKI by targeting renal oxidative stress. The article mainly reviewed the content of classification of nanozymes, research findings on nanozymes in treating AKI along with discussions on their mechanisms of action, as well as the current challenges and existing issues in nanozymes-based AKI therapy, to provide enhanced research perspectives for advancing nanozyme applications in the prevention and treatment of AKI.

Background and Aims:Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality,which may hinder postoperative recovery.Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep,conventional medications may lead to adverse effects such as delirium and dependence.This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block(SGB)—on postoperative sleep quality in elderly patients.Methods:A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled.Using a random number table,the patients were divided into two groups:30 in the control group(SGB alone)and 30 in the study group(SGB combined with buccal acupuncture).Perioperative mean arterial pressure(MAP),heart rate(HR),postoperative visual analogue scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and the incidence of adverse events were recorded and analyzed.Results:There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group(all P<0.05).VAS scores at 6,24,and 48 h postoperatively,as well as PSQI scores on postoperative days 1,3,and 5,were significantly lower in the study group(all P<0.05).Additionally,the incidence of drowsiness was significantly reduced(P<0.05).No significant differences were found between the two groups in terms of nausea,vomiting,or agitation(all P>0.05).Conclusion:The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality,alleviate pain,and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer.This safe and effective non-pharmacological intervention holds promising clinical application value.

Background and Aims:Elderly patients undergoing laparoscopic radical resection of colon cancer often experience decreased sleep quality,which may hinder postoperative recovery.Although pharmacological interventions are commonly used in clinical practice to improve postoperative sleep,conventional medications may lead to adverse effects such as delirium and dependence.This study aimed to evaluate the effect of a non-pharmacological intervention—buccal acupuncture combined with ultrasound-guided stellate ganglion block(SGB)—on postoperative sleep quality in elderly patients.Methods:A total of 60 elderly patients who underwent laparoscopic radical resection of colon cancer at the Forth Hospital of Changsha from February to August 2024 were enrolled.Using a random number table,the patients were divided into two groups:30 in the control group(SGB alone)and 30 in the study group(SGB combined with buccal acupuncture).Perioperative mean arterial pressure(MAP),heart rate(HR),postoperative visual analogue scale(VAS)scores,Pittsburgh Sleep Quality Index(PSQI)scores,and the incidence of adverse events were recorded and analyzed.Results:There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The study group showed significantly lower intraoperative and postoperative HR and MAP compared to the control group(all P<0.05).VAS scores at 6,24,and 48 h postoperatively,as well as PSQI scores on postoperative days 1,3,and 5,were significantly lower in the study group(all P<0.05).Additionally,the incidence of drowsiness was significantly reduced(P<0.05).No significant differences were found between the two groups in terms of nausea,vomiting,or agitation(all P>0.05).Conclusion:The combination of buccal acupuncture and SGB during the perioperative period can effectively improve postoperative sleep quality,alleviate pain,and reduce adverse reactions in elderly patients undergoing laparoscopic radical resection of colon cancer.This safe and effective non-pharmacological intervention holds promising clinical application value.

Acute kidney injury (AKI), a life-threatening clinical syndrome, lacks effective therapeutic interventions beyond supportive care such as hemodialysis and kidney transplantation. Pathologically, excessive reactive oxygen species -mediated oxidative stress is recognized as a pivotal contributor to AKI progression, positioning reactive oxygen species scavenging as a critical therapeutic target. Emerging nanozymes, nanomaterials with enzyme-mimetic activities, have shown promise in addressing AKI by targeting renal oxidative stress. The article mainly reviewed the content of classification of nanozymes, research findings on nanozymes in treating AKI along with discussions on their mechanisms of action, as well as the current challenges and existing issues in nanozymes-based AKI therapy, to provide enhanced research perspectives for advancing nanozyme applications in the prevention and treatment of AKI.

Acute kidney injury (AKI) is a clinical syndrome characterized by severe impairment of renal function. The occurrence of AKI often leads to the accumulation of metabolites, electrolyte imbalance, changes in drug concentration gradients, and may even induce systemic inflammatory responses and indirectly affect distal organs, which is one of the reasons for the high mortality rate of AKI. In traditional Chinese medicine, cordyceps sinensis is a widely used natural herb, which is believed to improve kidney injury and promote the recovery of renal tubular function. It contains abundant chemical components, has diverse species, and the distribution, content and efficacy of its active substances also vary. This article reviews the research progress of cordyceps sinensis in the treatment of AKI.

Objective:To construct an early prediction model for post cardiopulmonary resuscitation-acute kidney injury (PCPR-AKI) by machine learning and provide a basis for early identification of acute kidney injury (AKI) high-risk patients and accurate treatment.Methods:It was a single-center retrospective study. The clinical data of patients admitted to Tianjin Medical University General Hospital after cardiopulmonary resuscitation following cardiac arrest from January 1, 2016 to October 31, 2023 were collected. The end-point event of the study was defined as AKI occurring within 48 hours after cardiopulmonary resuscitation. The patients were divided into AKI group and non-AKI group according to the AKI diagnostic criteria, and the differences of baseline clinical data between the two groups were compared. The patients who met the inclusion criteria were randomly (using the train_test_split function, set the random seeds to 1, 2, and 3) divided into training and validation sets at a ratio of 7∶3. Random forest (RF), support vector machine, decision tree, extreme gradient boosting and light gradient boosting machine algorithm were used to develop the early prediction model of PCPR-AKI. The receiver-operating characteristic curve and decision curve analysis were used to evaluate the performance and clinical practicality of the predictive models, and the importance of variables in the optimal model was screened and ranked.Results:A total of 547 patients were enrolled, with age of 66 (59, 70) years old and 282 males (51.6%). There were 238 patients (43.5%) having incidence of AKI within 48 hours after cardiopulmonary resuscitation. In the AKI group, 182 patients (76.5%) were in stage 1, 47 patients (19.7%) were in stage 2, and 9 patients (3.8%) were in stage 3. There were statistically significant differences in the age, time to reach resuscitation of spontaneous circulation, time from cardiac arrest to starting cardiopulmonary resuscitation, proportion of initial defibrillation rhythm, proportion of electric defibrillation, proportion of mechanical ventilation, adrenaline dosage, sodium bicarbonate dosage, proportion of coronary heart disease, proportion of hypertension, proportion of diabetes, serum creatinine, blood urea nitrogen, blood lactic acid, blood potassium, brain natriuretic peptide, troponin, D-dimer, neuron specific enolase, and 24 hours urine volume after cardiopulmonary resuscitation between AKI group and non-AKI group (all P<0.05). Among the five machine learning algorithms, RF model achieved the best performance and clinical practicality, with area under the curve of 0.875, sensitivity of 0.863, specificity of 0.956, and accuracy rate of 90.7%. In the variable importance ranking of RF model, the top 10 variables were as follows: time to reach resuscitation of spontaneous circulation, time from cardiac arrest to starting cardiopulmonary resuscitation, initial defibrillable rhythm, serum creatinine, mechanical ventilation, blood lactate acid, adrenaline dosage, brain natriuretic peptide, D-dimer and age. Conclusions:An early predictive model for PCPR-AKI is successfully constructed based on machine learning. RF model has the best predictive performance. According to the importance of the variables, it can provide clinical strategies for early identification and precise intervention for PCPR-AKI.

Background::Schizophrenia (SCZ) is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure. Hemispheric asymmetries are a fundamental organizational principle of the human brain and relate to human psychological and behavioral characteristics. We aimed to explore the state of thalamic lateralization of SCZ.Methods::We used voxel-based morphometry (VBM) analysis, whole-brain analysis of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and resting-state seed-based functional connectivity (FC) analysis to investigate brain structural and functional deficits in SCZ. Also, we applied Pearson's correlation analysis to validate the correlation between Positive and Negative Symptom Scale (PANSS) scores and them.Results::Compared with healthy controls, SCZ showed increased gray matter volume (GMV) of the left thalamus ( t = 2.214, p = 0.029), which positively correlated with general psychosis ( r = 0.423, p = 0.010). SCZ also showed increased ALFF in the putamen, the caudate nucleus, the thalamus, fALFF in the nucleus accumbens (NAc), and the caudate nucleus, and decreased fALFF in the precuneus. The left thalamus showed significantly weaker resting-state FC with the amygdala and insula in SCZ. PANSS negative symptom scores were negatively correlated with the resting-state FC between the thalamus and the insula ( r = -0.414, p = 0.025). Conclusions::Collectively, these results suggest the possibility of aberrant laterality in the left thalamus and its FC with other related brain regions involved in the limbic system.

Background::Schizophrenia (SCZ) is a complex psychiatric disorder associated with widespread alterations in the subcortical brain structure. Hemispheric asymmetries are a fundamental organizational principle of the human brain and relate to human psychological and behavioral characteristics. We aimed to explore the state of thalamic lateralization of SCZ.Methods::We used voxel-based morphometry (VBM) analysis, whole-brain analysis of low-frequency fluctuations (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and resting-state seed-based functional connectivity (FC) analysis to investigate brain structural and functional deficits in SCZ. Also, we applied Pearson's correlation analysis to validate the correlation between Positive and Negative Symptom Scale (PANSS) scores and them.Results::Compared with healthy controls, SCZ showed increased gray matter volume (GMV) of the left thalamus ( t = 2.214, p = 0.029), which positively correlated with general psychosis ( r = 0.423, p = 0.010). SCZ also showed increased ALFF in the putamen, the caudate nucleus, the thalamus, fALFF in the nucleus accumbens (NAc), and the caudate nucleus, and decreased fALFF in the precuneus. The left thalamus showed significantly weaker resting-state FC with the amygdala and insula in SCZ. PANSS negative symptom scores were negatively correlated with the resting-state FC between the thalamus and the insula ( r = -0.414, p = 0.025). Conclusions::Collectively, these results suggest the possibility of aberrant laterality in the left thalamus and its FC with other related brain regions involved in the limbic system.