1.Resveratrol activates Wnt/β-catenin signaling pathway to inhibit apopto-sis and alleviate intestinal ischemia-reperfusion injury in mice
Jialu MU ; Yufang LENG ; Xiaojie MA ; Lingguo KONG
Chinese Journal of Pathophysiology 2025;41(6):1212-1217
AIM:To investigate the mechanism by which resveratrol(RSV)alleviates intestinal ischemia-re-perfusion(I/R)injury through modulation of the Wnt/β-catenin signaling pathway.METHODS:Twenty-four male C57BL/6J mice were randomly allocated into four experimental groups:the sham group,I/R group,I/R+RSV(treatment)group,and I/R+RSV+XAV939(inhibitor)group,with 6 mice per group.In the I/R,treatment,and inhibitor groups,the superior mesenteric artery was clamped for 45 minutes and then reperfused for 2 hours to establish the intestinal I/R injury model.The sham group underwent vascular dissection without occlusion.The treatment and inhibitor groups received dai-ly intraperitoneal injections of 15 mg/kg resveratrol for 5 d preoperatively,and the other two groups were intraperitoneally injected with an equal volume of 0.1%dimethyl sulfoxide.The inhibitor group additionally received 10 mg/kg XAV939 30 minutes pre-ischemia.HE staining was used to observe the pathological changes in the intestinal tissues,and the Chiu score standard was used to evaluate the pathological damage.Apoptosis was evaluated through TUNEL staining and the apoptotic index(AI).Diamine oxidase(DAO)level was measured by ELISA.The expression levels of B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein,cleaved caspase-3,Wnt3a and β-catenin proteins were detected by Western blot.RESULTS:Compared with sham group,the mice in I/R group showed significantly increased Chiu score,elevated DAO level and AI(P<0.05),up-regulated cleaved caspase-3 and Bax protein levels,and down-regulated Bcl-2,Wnt3a and β-catenin protein levels(P<0.05).Treatment with RSV reversed these alterations(P<0.05).XAV939 co-administration abolished the protective effects of RSV(P<0.05).CONCLUSION:Resveratrol ameliorates intestinal I/R injury by acti-vating the Wnt/β-catenin signaling pathway and suppressing apoptosis.
2.Quercetin inhibits ferroptosis to alleviate intestinal ischemia-reperfusion injury
Xiaojie MA ; Yufang LENG ; Jialu MU ; Lingguo KONG
Journal of Army Medical University 2025;47(12):1301-1311
Objective To investigate the role of quercetin(QUE)in ferroptosis during intestinal ischemia-reperfusion(IR)injury and elucidate its underlying mechanisms.Methods ① Potential target genes of QUE were predicted using the TCMSP,PharmMapper,and SwissTargetPredictive databases.Target genes associated with intestinal IR injury and ferroptosis were collected from GeneCards,PharmGKB,and OMIM databases.After overlapping genes were identified and analyzed,protein-protein interaction(PPI)networks were constructed using the STRING database and then visualized with Cytoscape 3.10.0.Molecular docking was performed to validate the binding conformations between QUE and key targets.② In vivo experiments were conducted to verify QUE's protective effects against intestinal IR injury.Thirty-six SPF-grade male C57BL/6J mice(6~8 weeks old,body weight:22±2 g)were randomly divided into Sham,Sham+QUE,IR,IR+QUE,IR+QUE+erastin(IR+QUE+Era),and IR+QUE+kevetrin hydrochloride(IR+QUE+KH)groups,with 6 mice in each group.Mouse model of intestinal IR injury was induced by 45 min ischemia of the superior mesenteric artery followed by 60 min reperfusion.HE staining was used to observe histopathological changes in the intestinal tissues.ELISA was employed to the serum or intestinal contents of diamine oxidase(DAO),pro-inflammatory cytokines(TNF-α,IL-6,IL-1β),and ferroptosis markers[glutathione(GSH)and Fe2+].Western blotting was utilized to detect the protein expression of glutathione peroxidase 4(GPX4),acyl-CoA synthetase long-chain family member 4(ACSL4),and tumor protein 53(p53).Results ① Network pharmacology identified 460 QUE targets,1 552 intestinal IR injury targets,and 1 967 ferroptosis-related targets,and 92 overlapping genes were identified as potential therapeutic targets.Molecular docking revealed a strong binding affinity between QUE and p53(binding energy:-6.8 kcal/mol).② In vivo experiments demonstrated that the IR+QUE group exhibited reduced intestinal damage and lower Chiu's score(P<0.05),decreased serum DAO content but elevated intestinal DAO content(P<0.05),decreased levels of TNF-α,IL-6,and IL-1β in the serum and intestinal tissues(P<0.05),reduced Fe2+accumulation,and increased GSH content(P<0.05),and up-regulated GPX4(P<0.05)and down-regulated ACSL4 and p53 expression(P<0.05)at protein level when compared with the IR group.While,the administration of ferroptosis agonist Era,or p53 agonist KH resulted in diminished therapeutic effects of QUE(P<0.05)when compared with the IR+QUE group.Conclusion QUE alleviates intestinal IR injury by inhibiting ferroptosis,which may be associated with its down-regulating p53 expression.
3.Remimazolam attenuates intestinal ischemia-reperfusion injury in mice by regulating ferroptosis through CX43
Lingguo KONG ; Yufang LENG ; Xiaojie MA ; Jialu MU
Journal of Army Medical University 2025;47(15):1771-1781
Objective To investigate whether remimazolam attenuates intestinal ischemia-reperfusion(I/R)injury in mice by regulating ferroptosis through connexin-43(CX43).Methods Molecular docking was applied to predict the binding affinity of remimazolam to CX43.A total of 72 SPF-grade adult male C57BL/6J mice(6~8 weeks old,weighing 20~25 g)were subjected.Thirty of them were randomly divided into sham operation group(Sham group),I/R group 1,and I/R+10,20 and 40 mg/kg remimazolam groups(RM10,RM20 and RM40 groups),with 6 mice in each group.Another 30 mice were randomly assigned into 5 groups(n=6),I/R group 2,erastin group(E group),I/R+40 mg/kg remimazolam group 2(RM40 group 2),I/R+Fer-1 group(Fer-1 group),and erastin+40 mg/kg remimazolam group(ERM group).The left 12 mice were randomly and equally grouped into I/R+RM+oe-NC group(oe-NC group)and I/R+RM+oe-CX43 group(oe-CX43 group).The Fer-1 group was given an intraperitoneal injection of 5 mg/kg Fer-1 in 1 h prior to reperfusion,the E group was given 10 mg/kg erastin intraperitoneally 1 d before modeling,and all the remimazolam groups,the oe-NC group and the oe-CX43 group were injected intravenously with corresponding doses of remimazolam 30 min pre-modeling,while the oe-NC and oe-CX43 groups were injected with empty vector virus and overexpression of CX43 vector virus,respectively,48 h before the administration of remimazolam.A mouse intestinal I/R injury model was constructed by clamping the superior mesenteric artery for 45 min and reperfusion for 30 min.The small intestine tissues were harvested and observed for pathological changes,and the intestinal mucosal damage was assessed with Chiu's score.The contents of Fe2+,total iron,malondialdehyde(MDA),glutathione(GSH),and superoxide dismutase(SOD)were detected by colorimetric assay;the production of reactive oxygen species(ROS)was determined by DHE probe;the expression of ferroptosis-related genes was determined by RT-qPCR;and the expression levels of CX43,GPX4,and SLC7A11 were detected by Western blotting.Results Molecular docking indicated that remimazolam had a binding energy of-6.699 kcal/mol with CX43 protein,suggesting good binding affinity between them.Compared with the Sham group,the I/R group 1 showed increases in Chiu's scores and CX43 expression(P<0.05),along with pathological damage to intestinal tissues,and elevated contents of Fe2+,total iron,ROS and MDA(P<0.05),and down-regulated GPX4 and SLC7A11(P<0.05).Compared with the I/R group 1,Chiu's score was reduced in the RM40 group,and CX43 was significantly down-regulated(P<0.05),contents of Fe2+,total iron,ROS,and MDA were decreased(P<0.05),and expression levels of GPX4 and SLC7A11 were enhanced(P<0.05),and severity of intestinal histological damage was attenuated in both the RM40 and Fer-1 groups.Compared with the E group,the ERM group had the decreases in CX43 expression level(P<0.05),Fe2+,total iron,ROS,and MDA contents(P<0.05),and increases in GPX4 and SLC7A11 expression levels(P<0.05),with the improvement in intestinal tissue.Compared with the oe-NC group,overexpression of CX43 resulted in the increased CX43 expression,elevated contents of Fe2+,total iron,ROS and MDA(P<0.05)and decreased expression of GPX4 and SLC7A11(P<0.05),leading to the exacerbated injury in intestinal tissue.Conclusion Remimazolam attenuates intestinal I/R injury by inhibiting ferroptosis through down-regulating CX43 expression.
4.Role of ferroptosis in reduction of intestinal ischemia-reperfusion injury by sodium butyrate pretreatment in mice
Zicen ZHAO ; Yufang LENG ; Liya CHANG ; Yu WANG ; Dongbin LI ; Yang XING ; Yuxuan WU
Chinese Journal of Anesthesiology 2025;45(2):203-207
Objective:To evaluate the role of ferroptosis in reduction of intestinal ischemia-reperfusion injury (IRI) by sodium butyrate pretreatment in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-23 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal IRI group (IR group), intestinal IRI + sodium butyrate pretreatment group (IN group), intestinal IRI + sodium butyrate pretreatment+ FER-1 group (INF group), and intestinal IRI + sodium butyrate pretreatment + Erastin group (INE group). The intestinal IRI model was established by occluding the superior mesenteric artery for 45 min followed by reperfusion for 30 min in S group. In IN, INF and INE groups, sodium butyrate was administered by gavage at a dose of 500 mg/kg daily at 1 week before developing the model, while the equal volume of normal saline was given by gavage in the other two groups. The ferroptosis inhibitor FER-1 5 mg/kg and ferroptosis agonist Erastin 30 mg/kg were intraperitoneally injected at 1 h prior to ischemia in INF and INE groups. Mice were sacrificed after anesthesia at the end of reperfusion to obtain small intestinal tissues for examination of the pathological changes (using light microscopy) which were scored according to Chiu and for determination of the contents of Fe 2+, malondialdehyde (MDA), glutathione (GSH) and glutathione disulfide(GSSG) (by enzyme-linked immunosorbent assay), expression of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and ferritin heavy chain 1 (FTH1) (by Western blot). The ratio of GSH to GSSG was calculated. Results:Compared to S group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in IR group ( P<0.001). Compared to IR group, Chiu′s scores and contents of MDA and Fe 2+ were significantly decreased, the expression of GSH, GPX4, FTH1 and SLC7A11 was up-regulated, and the GSH/GSSG ratio was increased in IN and INF groups ( P<0.001). Compared to IN group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in INE group ( P<0.001). Conclusions:Ferroptosis is involved in sodium butyrate pretreatment-induced reduction of intestinal I/RI in mice.
5.Construction and validation of a machine learning network calculator for the risk of delayed awakening from anaesthesia in breast cancer patients
Liang GE ; Yufang LENG ; Peng ZHANG ; Lingguo KONG ; Xudong HAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(9):1182-1192
AIM:To construct a network calcula-tor based on machine learning(ML)models to pre-dict the risk of delayed awakening from anaesthesia in breast cancer(BC)patients.METHODS:A total of 435 BC patients surgically treated at our hospital from January 2023 to June 2024 were selected.The Boruta algorithm was used to screen for important characteristic variables for the risk of delayed awak-ening from anaesthesia.All patients were randomly assigned to a training set(n=261)and a test set(n=174)based on a 3:2 ratio and nine ML models were constructed and trained.Nine ML models were evaluated on the basis of receiver operating charac-teristic(ROC)curves for a random sample of 10 sub-jects and the clinical utility of the models was as-sessed using decision curve analysis.Combined with SHapley Additive exPlanations(SHAP)bar graphs,summary graphs and force diagrams additional in-terpretation and visualization of the ML model.Con-struction of a network calculator for predicting the risk of delayed awakening from anesthesia in BC pa-tients using the R package.RESULTS:Of the 435 BC patients,25.1%experienced delayed awakening from anesthesia.Boruta algorithm screened seven feature variables.The ROC curve shows that the XG-Boost model has the highest area under the curve(AUC)for 10 random samples among the 9 ML mod-els,and the decision curve shows that the XGBoost model has a significant clinical net benefit.The SHAP bar graph shows the importance of ASA classi-fication,surgery time,anesthesia time,intraopera-tive blood loss,propofol,preoperative anemia,and intraoperative hypothermia,and the SHAP summa-ry graph reflects the distribution of the ranges of in-fluence of the seven important characteristic vari-ables,which are"separated at the ends."The SHAP force diagram visualization XGBoost model predict-ed the risk of delayed awakening from anesthesia for individual patients with a predictive value of 0.998 for patients with delayed awakening from an-esthesia and 0.008 91 for patients without delayed awakening from anesthesia.A web-based calculator(https://xz-nomogram.shinyapps.io/DE_web/)based on an interpretable XGBoost model effective-ly predicts the risk of delayed awakening from anes-thesia in BC patients.CONCLUSION:ASA classifica-tion,surgery time,propofol,intraoperative blood loss,anaesthesia time,preoperative anaemia and intraoperative hypothermia are important charac-teristic variables for the risk of delayed awakening from anaesthesia in BC patients.The network calcu-lator based on the interpretable XGBoost model can accurately and quickly quantify the risk of de-layed awakening from anaesthesia,which can help clinicians to effectively adjust the treatment strate-gy and better improve the prognosis of patients.
6.Role of ferroptosis in reduction of intestinal ischemia-reperfusion injury by sodium butyrate pretreatment in mice
Zicen ZHAO ; Yufang LENG ; Liya CHANG ; Yu WANG ; Dongbin LI ; Yang XING ; Yuxuan WU
Chinese Journal of Anesthesiology 2025;45(2):203-207
Objective:To evaluate the role of ferroptosis in reduction of intestinal ischemia-reperfusion injury (IRI) by sodium butyrate pretreatment in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-23 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal IRI group (IR group), intestinal IRI + sodium butyrate pretreatment group (IN group), intestinal IRI + sodium butyrate pretreatment+ FER-1 group (INF group), and intestinal IRI + sodium butyrate pretreatment + Erastin group (INE group). The intestinal IRI model was established by occluding the superior mesenteric artery for 45 min followed by reperfusion for 30 min in S group. In IN, INF and INE groups, sodium butyrate was administered by gavage at a dose of 500 mg/kg daily at 1 week before developing the model, while the equal volume of normal saline was given by gavage in the other two groups. The ferroptosis inhibitor FER-1 5 mg/kg and ferroptosis agonist Erastin 30 mg/kg were intraperitoneally injected at 1 h prior to ischemia in INF and INE groups. Mice were sacrificed after anesthesia at the end of reperfusion to obtain small intestinal tissues for examination of the pathological changes (using light microscopy) which were scored according to Chiu and for determination of the contents of Fe 2+, malondialdehyde (MDA), glutathione (GSH) and glutathione disulfide(GSSG) (by enzyme-linked immunosorbent assay), expression of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and ferritin heavy chain 1 (FTH1) (by Western blot). The ratio of GSH to GSSG was calculated. Results:Compared to S group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in IR group ( P<0.001). Compared to IR group, Chiu′s scores and contents of MDA and Fe 2+ were significantly decreased, the expression of GSH, GPX4, FTH1 and SLC7A11 was up-regulated, and the GSH/GSSG ratio was increased in IN and INF groups ( P<0.001). Compared to IN group, Chiu′s scores and contents of MDA and Fe 2+ were significantly increased, the expression of GSH, GPX4, FTH1 and SLC7A11 was down-regulated, and the GSH/GSSG ratio was decreased in INE group ( P<0.001). Conclusions:Ferroptosis is involved in sodium butyrate pretreatment-induced reduction of intestinal I/RI in mice.
7.Resveratrol activates Wnt/β-catenin signaling pathway to inhibit apopto-sis and alleviate intestinal ischemia-reperfusion injury in mice
Jialu MU ; Yufang LENG ; Xiaojie MA ; Lingguo KONG
Chinese Journal of Pathophysiology 2025;41(6):1212-1217
AIM:To investigate the mechanism by which resveratrol(RSV)alleviates intestinal ischemia-re-perfusion(I/R)injury through modulation of the Wnt/β-catenin signaling pathway.METHODS:Twenty-four male C57BL/6J mice were randomly allocated into four experimental groups:the sham group,I/R group,I/R+RSV(treatment)group,and I/R+RSV+XAV939(inhibitor)group,with 6 mice per group.In the I/R,treatment,and inhibitor groups,the superior mesenteric artery was clamped for 45 minutes and then reperfused for 2 hours to establish the intestinal I/R injury model.The sham group underwent vascular dissection without occlusion.The treatment and inhibitor groups received dai-ly intraperitoneal injections of 15 mg/kg resveratrol for 5 d preoperatively,and the other two groups were intraperitoneally injected with an equal volume of 0.1%dimethyl sulfoxide.The inhibitor group additionally received 10 mg/kg XAV939 30 minutes pre-ischemia.HE staining was used to observe the pathological changes in the intestinal tissues,and the Chiu score standard was used to evaluate the pathological damage.Apoptosis was evaluated through TUNEL staining and the apoptotic index(AI).Diamine oxidase(DAO)level was measured by ELISA.The expression levels of B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein,cleaved caspase-3,Wnt3a and β-catenin proteins were detected by Western blot.RESULTS:Compared with sham group,the mice in I/R group showed significantly increased Chiu score,elevated DAO level and AI(P<0.05),up-regulated cleaved caspase-3 and Bax protein levels,and down-regulated Bcl-2,Wnt3a and β-catenin protein levels(P<0.05).Treatment with RSV reversed these alterations(P<0.05).XAV939 co-administration abolished the protective effects of RSV(P<0.05).CONCLUSION:Resveratrol ameliorates intestinal I/R injury by acti-vating the Wnt/β-catenin signaling pathway and suppressing apoptosis.
8.Construction and validation of a machine learning network calculator for the risk of delayed awakening from anaesthesia in breast cancer patients
Liang GE ; Yufang LENG ; Peng ZHANG ; Lingguo KONG ; Xudong HAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(9):1182-1192
AIM:To construct a network calcula-tor based on machine learning(ML)models to pre-dict the risk of delayed awakening from anaesthesia in breast cancer(BC)patients.METHODS:A total of 435 BC patients surgically treated at our hospital from January 2023 to June 2024 were selected.The Boruta algorithm was used to screen for important characteristic variables for the risk of delayed awak-ening from anaesthesia.All patients were randomly assigned to a training set(n=261)and a test set(n=174)based on a 3:2 ratio and nine ML models were constructed and trained.Nine ML models were evaluated on the basis of receiver operating charac-teristic(ROC)curves for a random sample of 10 sub-jects and the clinical utility of the models was as-sessed using decision curve analysis.Combined with SHapley Additive exPlanations(SHAP)bar graphs,summary graphs and force diagrams additional in-terpretation and visualization of the ML model.Con-struction of a network calculator for predicting the risk of delayed awakening from anesthesia in BC pa-tients using the R package.RESULTS:Of the 435 BC patients,25.1%experienced delayed awakening from anesthesia.Boruta algorithm screened seven feature variables.The ROC curve shows that the XG-Boost model has the highest area under the curve(AUC)for 10 random samples among the 9 ML mod-els,and the decision curve shows that the XGBoost model has a significant clinical net benefit.The SHAP bar graph shows the importance of ASA classi-fication,surgery time,anesthesia time,intraopera-tive blood loss,propofol,preoperative anemia,and intraoperative hypothermia,and the SHAP summa-ry graph reflects the distribution of the ranges of in-fluence of the seven important characteristic vari-ables,which are"separated at the ends."The SHAP force diagram visualization XGBoost model predict-ed the risk of delayed awakening from anesthesia for individual patients with a predictive value of 0.998 for patients with delayed awakening from an-esthesia and 0.008 91 for patients without delayed awakening from anesthesia.A web-based calculator(https://xz-nomogram.shinyapps.io/DE_web/)based on an interpretable XGBoost model effective-ly predicts the risk of delayed awakening from anes-thesia in BC patients.CONCLUSION:ASA classifica-tion,surgery time,propofol,intraoperative blood loss,anaesthesia time,preoperative anaemia and intraoperative hypothermia are important charac-teristic variables for the risk of delayed awakening from anaesthesia in BC patients.The network calcu-lator based on the interpretable XGBoost model can accurately and quickly quantify the risk of de-layed awakening from anaesthesia,which can help clinicians to effectively adjust the treatment strate-gy and better improve the prognosis of patients.
9.Molecular Mechanism of Action of Astragaloside Ⅳ in Modulating Pyroptosis to Attenuate Intestinal Ischemia-reperfusion Injury Based on Experimental Validation
Liya CHANG ; Yufang LENG ; Zicen ZHAO ; Yu WANG ; Yang XING ; Dongbin LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):116-123
ObjectiveTo investigate the mechanism of astragaloside-Ⅳ (AS-Ⅳ) in regulating pyroptosis to alleviate intestinal ischemia-reperfusion injury (IRI) by combining network pharmacology and in vivo experiments. MethodFirstly, the corresponding target genes of AS-Ⅳ were obtained from TraditionalChineseMedicineSystemsPharmacology(TCMSP) database and Swiss Target Prediction database, and the target genes related to intestinal IRI and Pyroptosis were obtained from GeneCards database, and the common target genes of the three were obtained by drawing Venn diagrams through unspiralized website. Protein-protein interaction (PPI) network was constructed by STRING database and Cytoscape software to screen common target genes and imported into Cytoscape software to obtain core target genes. Microbiotics platform was used for gene ontology(GO) and Kyoto encyclopedia of genes and genomes(KEGG) enrichment analysis and prediction of the mechanism of action of AS-Ⅳ in regulating Pyroptosis to alleviate intestinal IRI. Then C57/BL6J mice were randomly divided into 5 groups normal group, model group(IR), drug administration group (IR+AS-Ⅳ), nucleotide-binding oligomerization structural domain-like receptor protein 3 (NLRP3) agonist NSS group (IR+AS-Ⅳ+NSS), and NLRP3 inhibitor MCC950 group (IR+AS-Ⅳ+MCC950) by using a randomized numerical table method. The intestinal IRI model was established by clamping the superior mesenteric artery for 45 min and resuming perfusion for 2 h in the model group, the drug administration group, the NLRP3 agonist NSS group, and the NLRP3 inhibitor MCC950 group, and the normal group was only separated from the vessels without clamping. The administration group, the NLRP3 agonist NSS group, and the NLRP3 inhibitor MCC950 group were gavaged with astragaloside dissolved in 0.1% dimethylsulfoxide (50 mg·kg-1) for 3 consecutive days before modeling, with the last gavage 2 h before modeling, and the remaining two groups were gavaged with equal amounts of saline. The NLRP3 agonist NSS group was injected intraperitoneally with 4 mg·kg-1 of NSS 1 h before modeling, and the NLRP3 inhibitor MCC950 group was injected intraperitoneally with 10 mg·kg-1 of MCC950 1 h before modeling.The mice were put to death by reperfusion for 2 h, and intestinal tissues were obtained. The levels of IL-18 and IL-1β were detected by enzyme linked immunosorbent assay(ELISA), and the protein expression of thioredoxin-binding protein (TXNIP), NLRP3, Caspase-1 and pyrocatechin D (GSDMD) were detected by Western blot, and the pathological changes of intestinal tissues were evaluated by Chiu's score. ResultNetwork pharmacological analysis showed that there were 1599 targets of intestinal IRI, 199 targets of AS-Ⅳ action, 197 targets of pyroptosis, and 20 targets common to all three. There were 10 core targets, including NLRP3, TXNIP, silencing information regulator 1 (SIRT1), high mobility group protein 1 (HMGB1), interleukin-18 (IL-18), GSDMD, and metallo matrix protease-9 (MMP-9),et al. The results of in vivo experiments showed that compared with the normal group, Chiu's score was elevated in the model group, the levels of IL-18,IL-1β inflammatory factors in mouse intestinal tissues were elevated (P<0.05), and the protein expression levels of TXNIP, NLRP3, Caspase-1, and GSDMD were elevated (P<0.05). Compared with the model group,Chiu's score was decreased in the administered group and NLRP3 inhibitor MCC950 group,the level of IL-18,IL-1β inflammatory factors in the intestinal tissue of mice was decreased(P<0.05), and the level of TXNIP,NLRP3,Caspase-1,GSDMD protein expression was decreased(P<0.05). Compared with the administered group, Chiu's score was elevated in the NLRP3 agonist NSS group, the levels of IL-18, IL-1β inflammatory factors in mouse intestinal tissues were elevated (P<0.05), and the protein expression levels of NLRP3, Caspase-1, and GSDMD were elevated (P<0.05). Compared with the NLRP3 inhibitor MCC950 group, the NLRP3 agonist NSS group had elevated Chiu's scores, elevated levels of IL-18,IL-1β inflammatory factors in mouse intestinal tissues (P<0.05), and elevated levels of TXNIP,NLRP3, Caspase-1, and GSDMD protein expression (P<0.05). ConclusionNetwork pharmacological predictions were consistent with the results of in vivo experiments, and astragaloside attenuated intestinal ischemia-reperfusion injury by inhibiting cellular pyroptosis through the TXNIP-NLRP3 signaling pathway.
10.Application of cypropofol and propofol combined with low-dose alfentanil in gastroenteroscopy
Yu WANG ; Yufang LENG ; Dongbin LI ; Yang XING ; Liya CHANG ; Zicen ZHAO
Journal of Army Medical University 2024;46(23):2642-2648
Objective To investigate the anesthetic effects and adverse effects of cypropofol and propofol combined with alfentanil,respectively,for gastroenteroscopy.Methods A total of 162 patients who underwent elective gastroenteroscopy at the Gastrointestinal Endoscopy Center of the First Hospital of Lanzhou University from January to February 2024 were enrolled,including 86 males and 76 females,at an age of 18~65 years old,with a BMI value of 18~30 kg/m2,and ASA grade ≤ Ⅱ.They were randomly divided into propofol group(Group P)and cypropofol group(Group C),with 81 cases in each group.All patients were sedated with 0.7 μg/kg alfentanil,and in 30 s later,2 mg/kg propofol and 0.4 mg/kg cypropofol was intravenously dripped into Group P and Group C,respectively.When the modified alertness/sedation score(MOAA/S)≤1,a gastroscope was started to insert.The related indicators,including total procedure time,successful cases of sedation,induction time and awakening time,heart rate,blood pressure,and pulse oximetry saturation were recorded,occurrence of adverse reactions such as hypotension,respiratory depression,injection pain,intraoperative body movement,nausea and vomiting were observed,and the satisfaction of endoscopists and of patients to anesthesia were recorded and compared between the 2 groups.Results There were no statistical differences in the success rate of sedation,induction time and awakening time between the 2 groups.The patients of the Group C had more stable intraoperative vital signs,statistically lower incidences of injection pain,respiratory depression and hypotension(P<0.05),and increased satisfaction for anesthesia(P<0.05)when compared with those in Group P.No obvious difference were observed in the satisfaction of endoscopist to anesthesia between the 2 groups.Conclusion In combination with small-dose alfentanil,0.4 mg/kg cypropofol shows similar sedation effect as 2 mg/kg propofol in gastroenteroscopy,with comparable induction and awakening time.Cypropofol has more advantages in stable intraoperative vital signs,less adverse effects such as low blood pressure,respiratory depression and injection pain,higher the patient satisfaction,which is worthy of clinical promotion.

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