1.Research progress of non-insulin hypoglycemic drugs in the treatment of type 1 diabetes mellitus
Zejie XU ; Jiaoni ZHENG ; Jing LUO ; Liangyu WANG ; Wei YAN ; Qiang HE ; Xuefeng SHAN
China Pharmacy 2026;37(2):263-267
Traditional treatment for type 1 diabetes mellitus (T1DM) primarily involves insulin replacement, yet some patients encounter issues such as significant blood glucose fluctuations, high risk of hypoglycemia, and weight gain. In recent years, the adjuvant therapeutic role of non-insulin hypoglycemic drugs in T1DM has gradually gained attention. This article reviews the mechanisms of action and clinical research progress of five types of non-insulin hypoglycemic drugs in the treatment of T1DM: amylin analogues (pramlintide), biguanides (metformin), sodium-glucose co-transporter 2 inhibitor, dipeptidyl peptidase-4 inhibitor, and glucagon-like peptide-1 receptor agonist. It is found that these drugs can enhance clinical benefits for T1DM patients by improving insulin sensitivity, delaying gastric emptying, promoting urinary glucose excretion, and regulating incretin levels, thereby reducing glycated hemoglobin levels, decreasing insulin dosage, and managing body weight. Simultaneously, these drugs also present limitations such as low patient compliance due to complex dosing regimens, increased risk of diabetic ketoacidosis, and heterogeneity in glycemic control. Future research could focus on developing individualized treatment strategies, combining pharmacogenomics with novel biomarkers to precisely identify subpopulations of patients who may benefit, and delving into the potential value of these drugs in delaying diabetic vascular complications and improving patients’ quality of life.
2.Mechanism of Huangqin in Improving Postoperative Cognitive Dysfunction Based on Network Pharmacology,Molecular Docking and Experimental Validation
Ronghua LI ; Liangyu CAI ; Yongcheng XU ; Shajin LIU ; Jingge WANG ; Ao XUE ; Minyi XU
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(8):2406-2417
Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.
3.Relationship of peripheral blood PCⅢ and HPX levels with blood lipid and liver fibrosis in patients with nonalcoholic steatohepatitis
Liangyu SHI ; Tingting JI ; Lei LEI ; Lingling WANG ; Simin WEN
International Journal of Laboratory Medicine 2025;46(2):175-179
Objective To investigate the relationship between the levels of type Ⅲ procollagen(PCⅢ)and heme-binding protein(HPX)in peripheral blood,blood lipid and liver fibrosis in patients with nonalcoholic steatohepatitis(NASH).Methods Totally 126 patients with NASH admitted to the hospital from January 2021 to December 2023 were selected as NASH group,and they were divided into 3 subgroups according to the degree of liver fibrosis:no liver fibrosis group(22 cases),mild group(63 cases),moderate and severe group(41 cases).In addition,150 healthy subjects in the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect and compare the levels of PC Ⅲ and HPX in periph-eral blood of all groups,and Pearson correlation analysis was used to explore the correlation between peripher-al blood PC Ⅲ and HPX levels and related indexes of blood lipids in NASH patients.The predictive value of peripheral blood PC Ⅲ and HPX for liver fibrosis in NASH patients was evaluated by receiver operating char-acteristic(ROC)curve.Results The levels of PC Ⅲ and HPX,as well as total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)in NASH group were higher than those in control group,and the levels of high density lipoprotein cholesterol(HDL-C)were lower than those in control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the lev-els of PCⅢ and HPX in peripheral blood of NASH patients were positively correlated with TC,TG and LDL-C(P<0.05),while negatively correlated with HDL-C(P<0.05).The levels of PC Ⅲ and HPX in peripheral blood of the non-fibrosis group were lower than those of the mild and moderate severe groups,and the mild group was lower than that of the moderate and severe group,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of peripheral blood PC Ⅲ and HPX in predicting liver fibrosis in NASH patients were 0.757 and 0.861,respectively,and the cut-off values were 135.51 ng/mL and 804.86 mg/L,respectively.The AUC of the combined prediction for liver fibrosis was 0.905,which was higher than that predicted by the two alone.Conclusion The level of PC Ⅲ and HPX in peripheral blood is closely related to the level of blood lipids and the degree of liver fibrosis in NASH patients,which can be used as potential bi-omarkers to predict liver fibrosis in NASH patients.
4.Protective mechanism of modulating cyclic guanosine monophosphate-adenosine monophosphate synthase/stimulator of interferon gene pathway in oleic acid-induced acute lung injury in mice.
Liangyu MI ; Wenyan DING ; Yingying YANG ; Qianlin WANG ; Xiangyu CHEN ; Ziqi TAN ; Xiaoyu ZHANG ; Min ZHENG ; Longxiang SU ; Yun LONG
Chinese Critical Care Medicine 2025;37(7):651-656
OBJECTIVE:
To investigate the role and mechanism of the cyclic guanosine monophosphate-adenosine monophosphate synthase/stimulator of interferon gene (cGAS/STING) pathway in oleic acid-induced acute lung injury (ALI) in mice.
METHODS:
Male wild-type C57BL/6J mice were randomly divided into five groups (each n = 10): normal control group, ALI model group, and 5, 50, 500 μg/kg inhibitor pretreatment groups. The ALI model was established by tail vein injection of oleic acid (7 mL/kg), while the normal control group received no intervention. The inhibitor pretreatment groups were intraperitoneally injected with the corresponding doses of cGAS inhibitor RU.521 respectively 1 hour before modeling. At 24 hours post-modeling, blood was collected, and mice were sacrificed. Lung tissue pathological changes were observed under light microscopy after hematoxylin-eosin (HE) staining, and pathological scores were assessed. Western blotting was used to detect the protein expressions of cGAS, STING, phosphorylated TANK-binding kinase 1 (p-TBK1), phosphorylated interferon regulatory factor 3 (p-IRF3), and phosphorylated nuclear factor-κB p65 (p-NF-κB p65) in lung tissue. Immunohistochemistry was performed to observe STING and p-NF-κB positive expressions in lung tissue. Serum interferon-β (IFN-β) levels were measured by enzyme-linked immunosorbent assay (ELISA).
RESULTS:
Compared with the normal control group, the ALI model group exhibited significant focal alveolar thickening, intra-alveolar hemorrhage, pulmonary capillary congestion, and neutrophil infiltration in the pulmonary interstitium and alveoli, along with markedly increased pathological scores (10.33±0.58 vs. 1.33±0.58, P < 0.05). Protein expressions of cGAS, STING, p-TBK1, p-IRF3, and p-NF-κB p65 in lung tissue significantly increased [cGAS protein (cGAS/β-actin): 1.24±0.02 vs. 0.56±0.02, STING protein (STING/β-actin): 1.27±0.01 vs. 0.55±0.01, p-TBK1 protin (p-TBK1/β-actin): 1.34±0.03 vs. 0.22±0.01, p-IRF3 protein (p-IRF3/β-actin): 1.23±0.02 vs. 0.36±0.01, p-NF-κB p65 protein (p-NF-κB p65/β-actin): 1.30±0.02 vs. 0.53±0.02, all P < 0.05], positive expressions of STING and p-NF-κB in lung tissue were significantly elevated [STING (A value): 0.51±0.03 vs. 0.30±0.07, p-NF-κB (A value): 0.57±0.05 vs. 0.31±0.03, both P < 0.05], and serum IFN-β levels were also significantly higher (ng/L: 256.02±3.84 vs. 64.15±1.17, P < 0.05). The cGAS inhibitor pretreatment groups showed restored alveolar structural integrity, reduced inflammatory cell infiltration, and decreased hemorrhage area, along with dose-dependent lower pathological scores as well as the protein expressions of cGAS, STING, p-TBK1, p-IRF3 and p-NF-κB p65 in lung tissue, with significant differences between the 500 μg/kg inhibitor group and ALI model group [pathological score: 2.67±0.58 vs. 10.33±0.58, cGAS protein (cGAS/β-actin): 0.56±0.03 vs. 1.24±0.02, STING protein (STING/β-actin): 0.67±0.03 vs. 1.27±0.01, p-TBK1 protein (p-TBK1/β-actin): 0.28±0.01 vs. 1.34±0.03, p-IRF3 protein (p-IRF3/β-actin): 0.32±0.01 vs. 1.23±0.02, p-NF-κB p65 protein (p-NF-κB p65/β-actin): 0.63±0.01 vs. 1.30±0.02, all P < 0.05]. Compared with the ALI model group, positive expressions of STING and p-NF-κB in lung tissue were significantly reduced in the 500 μg/kg inhibitor group [STING (A value): 0.40±0.01 vs. 0.51±0.03, p-NF-κB (A value): 0.43±0.02 vs. 0.57±0.05, both P < 0.05], and serum IFN-β levels were also markedly reduced (ng/L: 150.03±6.19 vs. 256.02±3.84, P < 0.05).
CONCLUSIONS
The cGAS/STING pathway is activated in oleic acid-induced ALI, leading to exacerbated inflammatory responses and increased lung damage. RU.521 can inhibit cGAS, thereby down-regulating the expression of pathway proteins and cytokines, and providing protection to lung tissue.
Animals
;
Acute Lung Injury/chemically induced*
;
Male
;
Nucleotidyltransferases/metabolism*
;
Mice
;
Signal Transduction
;
Mice, Inbred C57BL
;
Membrane Proteins/metabolism*
;
Oleic Acid/adverse effects*
;
Transcription Factor RelA/metabolism*
;
Lung/pathology*
;
Interferon Regulatory Factor-3/metabolism*
;
Disease Models, Animal
5.Safety and efficacy of the reamer-irrigator-aspirator technique in adult lower extremity long bone nonunion
Hui DONG ; Wenxiang LI ; Liangyu ZHU ; Wei YUAN ; Aiguo WANG ; Xinghua LI
Chinese Journal of Orthopaedics 2025;45(20):1327-1334
Objective:To compare the clinical efficacy of the reamer-irrigator-aspirator (RIA) technique and iliac crest bone grafting (ICBG) in the treatment of adult noninfectious long bone nonunion of the lower extremity, and to evaluate the safety and effectiveness of the RIA technique.Methods:A retrospective review was conducted of 42 adult patients with noninfectious long bone nonunion of the lower extremity treated surgically at Zhengzhou Orthopaedic Hospital from January 2021 to June 2024. The cohort included 33 men and 9 women with a mean age of 47.0±14.4 years (range, 18-62 years). Twenty-three patients had nonunion on the left side and 19 on the right. Initial surgical fixation methods included plate fixation (19 cases), intramedullary nail (16 cases), external fixator (5 cases), and combined plate-and-nail fixation (2 cases). Revision procedures included debridement and freshening of the nonunion ends, revision or adjustment of internal fixation, and autologous bone grafting. Nineteen patients underwent graft harvesting with the RIA technique (RIA group), and 23 received autograft harvested from the iliac crest (iliac group). Baseline and perioperative variables compared between the two groups included sex, age, body-mass index, preoperative comorbidities, anatomical site of the nonunion (tibial or femoral), duration from the index fracture operation to the current revision, operative time, intraoperative blood loss, volume of blood transfusion and rate of perioperative complications, nonunion fracture sites, visual analogue scale (VAS) pain score at the fracture site, donor-site morphology and functional appearance scores, and radiographic union score for tibial fractures (RUST).Results:There was no significant difference in age between the RIA and ICBG groups (45.1±14.1 vs. 48.5±14.7 years, t=0.746, P=0.449). However, intraoperative blood loss was higher in the RIA group [300 (150, 720) ml, Z=-3.072, P=0.002] and the transfusion rate was higher (14/19 vs. 8/23, χ 2=6.313, P=0.012). The harvested bone volume was very similar [40(35, 60) cm 2vs. 40(35, 40) cm 2, Z=-1.077, P=0.281]. All patients were followed for a mean of 16.5±2.8 months (range, 7-40 months). VAS scores at the surgical site showed no significant difference between groups at 3 months (3.2±1.0 vs. 3.3±1.4, t= 4.754, P=0.720) and 6 months (1.6±0.8 vs. 1.8±1.2, t=6.841, P=0.542). Donor-site morphology and functional scores were significantly better in the RIA group at 3 months [14.5(13.0, 15.5) vs. 9.0(7.0, 10.0), Z=-3.748, P<0.001] and 6 months [15.5(15.0, 16.0) vs. 11.0(10.0, 13.0), Z=-3.782, P<0.001]. At 12 months postoperatively, RUST scores did not differ significantly between groups (10.6±1.2 vs. 10.4±1.5, t=0.483, P=0.632). The incidence of perioperative complications was comparable [42%(8/19) vs. 30%(7/23), χ 2=0.617, P=0.432]. Conclusions:Both RIA and ICBG achieved favorable clinical outcomes in the treatment of adult noninfectious lower-extremity long bone nonunion. Although RIA was associated with greater intraoperative blood loss, it resulted in less donor-site morbidity and better cosmetic and functional outcomes. Bone healing capacity and overall complication rates did not differ significantly between the two groups. These findings suggest that the RIA technique is safe and effective for use in the Chinese patient population.
6.Application of the reaming-irrigation-aspirator technique in autologous bone grafting for non-union of lower limb fracture
Yanxin SHI ; Aiguo WANG ; Hui DONG ; Liangyu ZHU ; Wenxiang LI ; Xinghua LI
Chinese Journal of Orthopaedic Trauma 2025;27(3):216-221
Objective:To evaluate the application of the reaming-irrigation-aspirator (RIA) technique in autologous bone grafting for non-union of lower limb fracture.Methods:A retrospective analysis was conducted of the data of 16 patients with non-union of lower limb fracture who had undergone autologous bone grafting using the RIA technique at Department of Lower Limb Orthopaedics Ⅰ, Zhengzhou Orthopaedic Hospital from July 2023 to March 2024. There were 12 males and 4 females with an age of (47.2±14.3) years. Sites of non-union: the femur in 14 cases and the tibia in 2 cases. Initial surgical fixation: intramedullary nail fixation in 5 cases, plate fixation in 10 cases, and intramedullary nail plus plate fixation in 1 case. The time for fracture non-union was (21.0±12.0) months. Intraoperatively, autologous bone reaming was conducted using a drill bit of RIA system, and simultaneous flushing using irrigation fluid. The bone debris carried out by the irrigation fluid was collected into a filtration device through negative pressure aspiration. After the filter was opened to squeeze out congestion, bone paste was taken out for standby. Internal fixation methods were adjusted according to the non-union condition of the fractures. Finally, the bone paste was implanted into bone defects. The time for autologous bone harvest, amount of bone harvested, intraoperative blood loss, postoperative pain at a donor site, fracture healing, functional recovery of a lower limb and occurrence of complications were recorded.Results:In 2 of the 16 patients, fracture of the RIA drill bit occurred when bone marrow was harvested from the tibia, and their operation was completed only after the drill bits were replaced. In the 16 patients, time for bone harvest was (31.4±6.1) min, bone harvest volume (42.6±9.5) mL, and intraoperative blood loss (815.6±238.6) mL. The incisions in this cohort healed primarily after operation, and 4-week follow-up revealed that no patients had pain symptoms at a donor site. The 16 patients were followed up for (8.0±2.0) months after operation. All patients achieved bone union after (4.4±0.5) months. Follow-ups showed that no patients had complications like delayed infection, donor site fracture, or loosening or fracture of an internal fixator. According to the rating scale for lower limb function at the last follow-up, the function of affected limb was evaluated as excellent in 7 cases, as good in 8 cases, and as fair in 1 case.Conclusion:Application of RIA technique for autologous bone grafting to treat non-union of lower limb fracture can lead to fine fracture healing and good lower limb function, but no long-term pain symptoms in the donor area for the patients.
7.Comparison of anterior long-segment, posterior long-segment, and combined anterior-posterior fixations for ankylosing spondylitis with cervical fracture
Xiuzhi LI ; Yuwei LI ; Yuan CAO ; Zengzhen CUI ; Yuliang FU ; Liangyu BAI ; Zhuoqi WEI ; Haijiao WANG ; Yang LYU
Chinese Journal of Orthopaedic Trauma 2025;27(10):836-843
Objective:To compare the anterior long-segment fixation, posterior long-segment fixation, and combined anterior-posterior fixation in the treatment of ankylosing spondylitis with cervical fracture (ASCF).Methods:A retrospective study was conducted to analyze the 153 patients with ASCF who had been treated at Department of Orthopaedics, Peking University Third Hospital and Department of Orthopedics, Luoche Central Hospital between January 2014 and December 2023. The cohort included 86 males and 67 females, with an age of (41.6±11.5) years, a disease duration of (10.0±3.9) years, and an interval from injury to surgery of (3.3±1.4) d. By Frankel's classification for preoperative nerve injury, 57 cases were grade B, 51 grade C, and 45 grade D. Based on the surgical approaches, the patients were divided into 3 groups: an anterior group ( n=63) undergoing the anterior cervical long-segment fixation, a posterior group ( n=51) undergoing the posterior cervical long-segment fixation, and a combination group ( n=39) undergoing combined anterior-posterior cervical fixation. Surgical time, intraoperative blood loss, fracture healing, complications, and changes in Frankel grading for spinal cord injury were compared among the 3 groups. Results:There was no statistically significant difference in the preoperative general data among the 3 groups, indicating comparability ( P > 0.05). All patients were followed up for (33.5±12.0) months after surgery. In the anterior group, the surgical time [(103.0±16.8) min] was significantly shorter than that in the posterior group [(148.4±17.7) min] and that in the combination group [(228.5±23.9) min], the intraoperative blood loss [(92.8±27.8) mL] was significantly less than that in the posterior group [(477.5±109.5) mL] and that in the combination group [(769.5±136.9) mL], and the incidence of complications [9.5% (6/63)] was significantly lower than that in the posterior group [41.2% (21/51)] and that in the combination group [53.8% (21/39)] (all P<0.05). There was no statistically significant difference in the fracture healing time among the 3 groups ( P=0.111). At the last follow-up, X-ray and CT scans showed no loosening or breakage of internal fixation in all the 3 groups. The Frankel grading at the last follow-up: 12 cases of grade C, 15 cases of grade D, and 36 cases of grade E in the anterior group; 3 cases of grade B, 12 cases of grade C, 12 cases of grade D, and 24 cases of grade E in the posterior group; 6 cases of grade C, 12 cases of grade D, and 21 cases of grade E in the combination group. At the last follow-up, all patients showed a significant improvement compared to their Frankel grades before surgery ( P<0.001), but there was no statistically significant difference between the 3 groups ( H=2.238, P=0.327). Conclusions:In the treatment of ASCF, anterior long-segment fixation is advantageous over posterior long-segment fixation and combined anteri-or-posterior fixation due to its shorter surgical time, reduced intraoperative blood loss, and a lower complication incidence. All the 3 surgical approaches demonstrate comparable outcomes in terms of fracture healing time, radiographic stability, and final neurological recovery.
8.Safety and efficacy of the reamer-irrigator-aspirator technique in adult lower extremity long bone nonunion
Hui DONG ; Wenxiang LI ; Liangyu ZHU ; Wei YUAN ; Aiguo WANG ; Xinghua LI
Chinese Journal of Orthopaedics 2025;45(20):1327-1334
Objective:To compare the clinical efficacy of the reamer-irrigator-aspirator (RIA) technique and iliac crest bone grafting (ICBG) in the treatment of adult noninfectious long bone nonunion of the lower extremity, and to evaluate the safety and effectiveness of the RIA technique.Methods:A retrospective review was conducted of 42 adult patients with noninfectious long bone nonunion of the lower extremity treated surgically at Zhengzhou Orthopaedic Hospital from January 2021 to June 2024. The cohort included 33 men and 9 women with a mean age of 47.0±14.4 years (range, 18-62 years). Twenty-three patients had nonunion on the left side and 19 on the right. Initial surgical fixation methods included plate fixation (19 cases), intramedullary nail (16 cases), external fixator (5 cases), and combined plate-and-nail fixation (2 cases). Revision procedures included debridement and freshening of the nonunion ends, revision or adjustment of internal fixation, and autologous bone grafting. Nineteen patients underwent graft harvesting with the RIA technique (RIA group), and 23 received autograft harvested from the iliac crest (iliac group). Baseline and perioperative variables compared between the two groups included sex, age, body-mass index, preoperative comorbidities, anatomical site of the nonunion (tibial or femoral), duration from the index fracture operation to the current revision, operative time, intraoperative blood loss, volume of blood transfusion and rate of perioperative complications, nonunion fracture sites, visual analogue scale (VAS) pain score at the fracture site, donor-site morphology and functional appearance scores, and radiographic union score for tibial fractures (RUST).Results:There was no significant difference in age between the RIA and ICBG groups (45.1±14.1 vs. 48.5±14.7 years, t=0.746, P=0.449). However, intraoperative blood loss was higher in the RIA group [300 (150, 720) ml, Z=-3.072, P=0.002] and the transfusion rate was higher (14/19 vs. 8/23, χ 2=6.313, P=0.012). The harvested bone volume was very similar [40(35, 60) cm 2vs. 40(35, 40) cm 2, Z=-1.077, P=0.281]. All patients were followed for a mean of 16.5±2.8 months (range, 7-40 months). VAS scores at the surgical site showed no significant difference between groups at 3 months (3.2±1.0 vs. 3.3±1.4, t= 4.754, P=0.720) and 6 months (1.6±0.8 vs. 1.8±1.2, t=6.841, P=0.542). Donor-site morphology and functional scores were significantly better in the RIA group at 3 months [14.5(13.0, 15.5) vs. 9.0(7.0, 10.0), Z=-3.748, P<0.001] and 6 months [15.5(15.0, 16.0) vs. 11.0(10.0, 13.0), Z=-3.782, P<0.001]. At 12 months postoperatively, RUST scores did not differ significantly between groups (10.6±1.2 vs. 10.4±1.5, t=0.483, P=0.632). The incidence of perioperative complications was comparable [42%(8/19) vs. 30%(7/23), χ 2=0.617, P=0.432]. Conclusions:Both RIA and ICBG achieved favorable clinical outcomes in the treatment of adult noninfectious lower-extremity long bone nonunion. Although RIA was associated with greater intraoperative blood loss, it resulted in less donor-site morbidity and better cosmetic and functional outcomes. Bone healing capacity and overall complication rates did not differ significantly between the two groups. These findings suggest that the RIA technique is safe and effective for use in the Chinese patient population.
9.Mechanism of Huangqin in Improving Postoperative Cognitive Dysfunction Based on Network Pharmacology,Molecular Docking and Experimental Validation
Ronghua LI ; Liangyu CAI ; Yongcheng XU ; Shajin LIU ; Jingge WANG ; Ao XUE ; Minyi XU
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(8):2406-2417
Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.
10.Application of the reaming-irrigation-aspirator technique in autologous bone grafting for non-union of lower limb fracture
Yanxin SHI ; Aiguo WANG ; Hui DONG ; Liangyu ZHU ; Wenxiang LI ; Xinghua LI
Chinese Journal of Orthopaedic Trauma 2025;27(3):216-221
Objective:To evaluate the application of the reaming-irrigation-aspirator (RIA) technique in autologous bone grafting for non-union of lower limb fracture.Methods:A retrospective analysis was conducted of the data of 16 patients with non-union of lower limb fracture who had undergone autologous bone grafting using the RIA technique at Department of Lower Limb Orthopaedics Ⅰ, Zhengzhou Orthopaedic Hospital from July 2023 to March 2024. There were 12 males and 4 females with an age of (47.2±14.3) years. Sites of non-union: the femur in 14 cases and the tibia in 2 cases. Initial surgical fixation: intramedullary nail fixation in 5 cases, plate fixation in 10 cases, and intramedullary nail plus plate fixation in 1 case. The time for fracture non-union was (21.0±12.0) months. Intraoperatively, autologous bone reaming was conducted using a drill bit of RIA system, and simultaneous flushing using irrigation fluid. The bone debris carried out by the irrigation fluid was collected into a filtration device through negative pressure aspiration. After the filter was opened to squeeze out congestion, bone paste was taken out for standby. Internal fixation methods were adjusted according to the non-union condition of the fractures. Finally, the bone paste was implanted into bone defects. The time for autologous bone harvest, amount of bone harvested, intraoperative blood loss, postoperative pain at a donor site, fracture healing, functional recovery of a lower limb and occurrence of complications were recorded.Results:In 2 of the 16 patients, fracture of the RIA drill bit occurred when bone marrow was harvested from the tibia, and their operation was completed only after the drill bits were replaced. In the 16 patients, time for bone harvest was (31.4±6.1) min, bone harvest volume (42.6±9.5) mL, and intraoperative blood loss (815.6±238.6) mL. The incisions in this cohort healed primarily after operation, and 4-week follow-up revealed that no patients had pain symptoms at a donor site. The 16 patients were followed up for (8.0±2.0) months after operation. All patients achieved bone union after (4.4±0.5) months. Follow-ups showed that no patients had complications like delayed infection, donor site fracture, or loosening or fracture of an internal fixator. According to the rating scale for lower limb function at the last follow-up, the function of affected limb was evaluated as excellent in 7 cases, as good in 8 cases, and as fair in 1 case.Conclusion:Application of RIA technique for autologous bone grafting to treat non-union of lower limb fracture can lead to fine fracture healing and good lower limb function, but no long-term pain symptoms in the donor area for the patients.

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