1.Regulatory Pathways of Cell Apoptosis in Diabetic Kidney Disease and Intervention by Traditional Chinese Medicine: A Review
Yunjie YANG ; Mingqian JIANG ; Chen QIU ; Yaqing RUAN ; Senlin CHEN ; Wenxin HUANG ; Hangbin ZHENG ; Yi WEI ; Pengfei LI ; Xueqin LIN ; Jing WU ; Shiwei RUAN ; Jianting WANG ; Yuliang QIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):294-306
Diabetic kidney disease(DKD) is a chronic kidney structural and functional disorder caused by diabetes. With the global prevalence of diabetes continuing to rise, DKD has gradually become a major cause of chronic kidney disease and end-stage renal disease(ESRD), posing a serious threat to patients' quality of life and long-term health outcomes. Studies have shown that apoptosis plays a pivotal role in the development and progression of DKD, with its mechanisms involving abnormal activation of multiple signaling pathways such as Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)/B-cell lymphoma-2(Bcl-2)/cysteinyl aspartate-specific proteinase(Caspase)-3, protein kinase R-like endoplasmic reticulum kinase(PERK)/eukaryotic initiation factor 2α(eIF2α)/activating transcript factor 4(ATF4)/CCAAT enhancer-binding protein homologous protein(CHOP), phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/glycogen synthase kinase-3β(GSK-3β), Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3), adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) and silent information regulator 1(SIRT1)/tumor suppressor protein 53(p53), thereby accelerating renal pathological damage in DKD. Extensive evidence-based medical studies have confirmed that traditional Chinese medicine(TCM), leveraging its unique therapeutic advantages of multi-target, multi-component and multi-pathway approaches, has demonstrated remarkable efficacy and favorable safety profiles in treating DKD. Recent studies have demonstrated that active components of TCM can specifically target and modulate key effectors in apoptotic signaling pathways. Meanwhile, traditional compound formulations exert synergistic effects through multiple approaches such as replenishing deficiency and activating blood circulation, detoxifying and dredging collaterals, tonifying kidney essence, and removing stasis and purging turbidity, thereby comprehensively regulating critical pathological processes including endoplasmic reticulum stress and mitochondrial apoptosis pathways. This combined therapeutic approach of molecular targeting and holistic regulation provides novel strategies for delaying the progression of DKD. Based on this, this paper provides an in-depth analysis of key apoptotic signaling pathways and their regulatory mechanisms, while systematically summarizing recent research advances regarding the therapeutic effects of TCM active components, compound formulations, and proprietary Chinese medicines on DKD through modulation of these pathways, with particular emphasis on their underlying molecular mechanisms. These findings not only elucidate the modern scientific connotation and theoretical basis of TCM in treating DKD but also establish a solid theoretical and practical foundation for promoting the wider clinical application and further research of TCM in the field of DKD treatment.
2.Analyses of the epidemiological characteristics of multiple pathogens in people aged 14 years and above with acute respiratory infection in Huangpu District of Shanghai from 2015 to 2024
Yun ZHANG ; Yinzi CHEN ; Zhenzi ZUO ; Yu WANG ; Fujie SHEN ; Yuliang HUANG ; Qiang GAO ; Chenyan JIANG ; Yijun WANG
Shanghai Journal of Preventive Medicine 2026;38(2):116-121
ObjectiveTo analyze the epidemiological characteristics of 8 major respiratory pathogens in influenza-like illness (ILI) cases with acute respiratory infections at fever clinics in Huangpu District, Shanghai from 2015 to 2024, and to provide a scientific basis for the prevention and treatment of respiratory diseases. MethodsA retrospective study was conducted in Huangpu District. Individuals meeting the case definition of ILI from 2015 to 2024 was registered. Their nasopharyngeal swabs were collected for pathogen detection. A total of 8 respiratory viruses were tested, including Influenza A virus (Flu A), Influenza B virus (Flu B), adenovirus (ADV), enterovirus/human rhinovirus (EV/HRV), human parainfluenza virus (HPIV), human coronavirus (HCoV), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ResultsFrom 2015 to 2019, a total of 344 ILI cases were tested, of which 192 out of 344 cases (55.81%) were tested positive for single respiratory pathogen. From 2023 to 2024, 1 557 ILI cases were tested, with 572 out of 1 557 cases (36.74%) being positive for single pathogen. From 2023 to 2024, the positive rate of single pathogen in ILI cases was significantly lower than that in 2015‒2019 (χ2=42.66, P<0.001). Specifically, the positive rate of Flu A (χ2=74.43, P<0.001) decreased, while that of HPIV (χ2=8.66, P=0.003) increased, both with statistically significant differences. According to the seasonal pattern, the epidemic intensity of Flu A decreased in summer, while that of HPIV increased in summer and autumn. Demographic results showed statistically significant differences in the positive rates of EV/HRV between genders (χ2=22.38, P<0.001), with males exhibiting a higher positive rate than females. No statistically significant differences were identified in the positive rates of single pathogen among different age groups (χ2=4.42, P=0.110). Nevertheless, statistically significant differences were noted when comparing the positive rates of EV/HRV, Flu A, Flu B and HPIV across different age groups (P<0.05). EV/HRV was more commonly detected in the 15‒<25 age group (10.93%), while Flu A and HPIV had the highest positive rates in the ≥60 age group (21.24% and 4.77%). Flu B had the highest positive rate in the 25‒<60 age group (11.26%). 52.63% of cases with co-infections occurred during winter, with the primary pathogens involved being EV/HRV (9 cases) and HCoV (6 cases). The most prevalent combination of co-infection was Flu A with EV/HRV. ConclusionThe prevalence of respiratory pathogens among ILI cases from 2023 to 2024 exhibited notable fluctuations compared to that from 2015 to 2019. Therefore, influenza surveillance should be strengthened, and attention should also be paid to the prevalence of respiratory pathogens such as HPIV. These findings have profound implications for future research, surveillance, vaccine planning, and public health policy making.
3.Predictive value of coronary microcirculation dysfunction after revascularization in patients with acute myocardial infarction for acute heart failure during hospitalization.
Lan WANG ; Yuliang MA ; Weimin WANG ; Tiangang ZHU ; Wenying JIN ; Hong ZHAO ; Chengfu CAO ; Jing WANG ; Bailin JIANG
Journal of Peking University(Health Sciences) 2025;57(2):267-271
OBJECTIVE:
To study incident and clinical characteristics of the coronary microcirculation dysfunction (CMD) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by myocardial contrast echocardiography (MCE) and to explore the predictive value of CMD for in-hospital acute heart failure event.
METHODS:
One hundred and forty five patients with AMI who had received PCI and completed MCE during hospitalization in Peking University People' s Hospital from November 2015 to July 2021 were enrolled in our study. The patients were divided into CMD group and normal group according to the coronary microcirculation status detected by MCE. Clinical data and MCE data of the two groups were collected and analyzed. The acute heart failure event during hospitalization was described. A multivariate Logistic regression model was built to analyze the risk of acute heart failure in patients with CMD. A receiver operating characteristic (ROC) curve was drawn to evaluate the value of CMD in predicting acute heart failure event.
RESULTS:
CMD detected by MCE occurred in 87 patients (60%). Compared with normal group, patients with CMD had higher troponin I (TnI) peak level [52.8 (8.1, 84.0) μg/L vs. 18.9 (5.7, 56.1) μg/L, P=0.005], poorer Killip grade on admission (P=0.030), different culprit vessel (P < 0.001) and more patients had thrombolysis in myocardial infarction (TIMI) flow pre-PCI less than grade 3 in culprit vessel (65.1% vs. 43.1%, P=0.025). Meanwhile, patients with CMD had poorer left ventricular ejection fraction (LVEF) [52% (43%, 58%) vs. 61% (54%, 66%)], poorer global longitudinal strain (GLS) [-11.2% (-8.7%, -14.0%) vs.-13.9% (-10.8%, -17.0%)] and worse wall motion score index (WMSI) (1.58±0.36 vs. 1.25± 0.24) (P all < 0.001). Acute left heart failure happened in 13.8% of the CMD patients, which were significant higher than that in the patients with normal coronary microcirculation perfusion (1.7%, P=0.013). After correcting for the culprit vessel, the TIMI flow pre-PCI in the culprit vessel and the peak TnI value, the risk of acute left heart failure in the patients with CMD was still high (OR=9.120, 95%CI: 1.152-72.192, P=0.036). The area under ROC curve (AUC) was 0.677 (95%CI: 0.551-0.804, P=0.035).
CONCLUSION
The incidence of CMD detected by MCE in patients with AMI post-PCI was 60%. Patients with CMD have a higher risk of acute left heart failure during hospitalization.
Humans
;
Heart Failure/physiopathology*
;
Microcirculation
;
Percutaneous Coronary Intervention/adverse effects*
;
Myocardial Infarction/complications*
;
Male
;
Female
;
Hospitalization
;
Middle Aged
;
Aged
;
Echocardiography
;
Coronary Circulation
;
Predictive Value of Tests
;
Troponin I/blood*
4.Comparison of clinical features and surgical outcomes in patients with cervicothoracic hemivertebra at different ages
Ziqun LIU ; Yawei LI ; Yuliang DAI ; Lei LI ; Hong MA ; Zhiming TU ; Bin JIANG ; Can GUO ; Zheyu WANG ; Bing WANG
Chinese Journal of Surgery 2025;63(5):413-421
Objective:To investigate the clinical characteristics of children with cervicothoracic hemivertebra at different ages and evaluate the surgical outcomes of hemivertebra resection.Methods:This retrospective cohort study analyzed clinical and radiographic data of 35 children (under 18 years old) with cervicothoracic hemivertebra who underwent one-stage posterior hemivertebra resection at the Department of Spine Surgery, Second Xiangya Hospital of Central South University, from June 2005 to June 2022. The cohort included 19 males and 16 females, with a surgical age of (9.7±4.1) years (range: 3 to <18 years). Patients were divided into three groups based on initial surgical age: preschool group (≤5 years, n=10), school-age group (6 to 10 years, n=10), and adolescent group (11 to <18 years, n=15). The intraoperative blood loss, operative time, number of fixed vertebrae, and perioperative and postoperative complications were recorded. Radiographic measurements were taken preoperatively, postoperatively, and at final follow-up, including the Cobb angle of the primary curve, curve length, distal curve Cobb angle, neck tilt, shoulder balance, coronal balance, trunk tilt, clavicle angle, head deviation, and local kyphosis. Statistical analyses included one-way ANOVA, Kruskal-Wallis H test, chi-square test, and Fisher′s exact test. Results:The operative time was (333±74) minutes (range:200 to 450 minutes), the intraoperative blood loss was (419±132) ml (range:200 to 650 ml), and the number of fixed vertebrae was (6.0±2.7) segments (range:2 to 12 segments). Preoperatively, the preschool group had a smaller primary curve Cobb angle compared to the adolescent group (33.6°±8.4° vs. 43.0°±9.4°, F=3.394, P=0.046) and distal curve Cobb angle (6.4°±2.4° vs.11.9°±4.5°, F=6.550, P=0.038). The preschool group had better coronal balance ((8.8±4.3) mm vs. (20.2±11.7)mm, F=9.448, P=0.009) and trunk tilt (4.0°±2.0° vs.7.0°±3.0°, F=4.343, P=0.029) than the school-age group. The preschool group had fewer fused vertebrae than the school-age and adolescent groups (3.8±1.6 vs. 7.0±2.6 vs. 6.8±2.6, F=10.480, P=0.005). The preschool group also had less intraoperative blood loss than the adolescent groups ((320±125) ml vs. (480±113) ml, F=8.666, P=0.013). However, no significant differences were found in postoperative and final follow-up measurements of primary and distal curve Cobb angles, neck tilt, shoulder balance, coronal balance, trunk tilt, clavicle angle, head deviation, local kyphosis, or complication rates (all P>0.05). Conclusions:Children with cervicothoracic hemivertebra across different age groups exhibit similar surgical outcomes and complication rates. But the preschool group had fewer fixed segments and less intraoperative blood loss, suggesting that this age group is an ideal time for surgery.
5.Abnormal O-glycosylation mediated by the deficiency of molecular chaperone Cosmc or T-synthase regulates the expression of miRNAs in colorectal cancer exosomes
Tianbo GAO ; Yang GE ; Guangyu AN ; Jiannan YAO ; Yuliang JIANG ; Heshu LIU ; Rui YAN
Journal of Capital Medical University 2025;46(3):401-409
Objective To explore the effects of aberrant O-glycosylation modifications induced by the knockout of Cosmc or T-synthase genes on the expression profiles of miRNAs in exosomes derived from colorectal cancer cells and to reveal the molecular mechanisms of O-glycosylation in the development of colorectal cancer and identify potential biomarkers for early diagnosis and treatment.Methods This research specifically targets the Cosmc or T-synthase genes in the human colorectal cancer cell line HCT116 to create stable cell lines exhibiting abnormal O-glycosylation with CRISPR/Cas-9 gene editing technology.Exosomes originating from these colorectal cancer cells were isolated and authenticated.A microarray chip equipped with primer sequences for 16 miRNAs closely associated with colorectal cancer was employed to assess the differential expression of miRNAs within these exosomes with fluorescent quantitative polymerase chain reaction(PCR).And then,a cohort of miRNAs that exhibited significant and consistent changes in expression levels across the exosomes from both cell lines was selected.These miRNAs were further validated independently with traditional fluorescent quantitative PCR.Subsequently,data from The Cancer Genome Atlas Program(TCGA)database containing patient information on colorectal cancer was harnessed.Employing R programming language,Gene Set Enrichment Analysis(GSEA)was conducted on the upregulated miRNA to investigate the downstream pathways significantly impacted and the malignant biological behaviors they may influence.Results The absence of either Cosmc or T-synthase genes results in the dysregulation of O-glycosylation in colorectal cancer cells,leading to the exposure of Tn antigens.This,in turn,affects the expression levels of specific miRNAs in exosomes derived from these cells.Specifically,the expression of hsa-miR-125b-1-3p was downregulated,while that of hsa-miR-218-5p was upregulated.Notably,hsa-miR-218-5p were found to be closely associated with the epithelial-mesenchymal transition(EMT)process in tumor cells,which is a key mechanism in cancer progression.Conclusion It elucidates that the aberrant O-glycosylation mediated by the knockout of Cosmc or T-synthase genes significantly influences the expression of certain miRNAs in exosomes from colorectal cancer cells,potentially affect the EMT process in colorectal cancer and thereby promoting distant metastasis.Given the inherent stability and detectability advantages of colorectal cancer-derived exosomes,the altered expression levels of miRNAs within these exosomes may serve as indicators of the stated of abnormal O-glycosylation in colorectal cancer.These findings suggest that exosomal miRNAs have potential as biomarkers for monitoring disease progression and therapeutic efficacy.Consequently,this could pave the way for more personalized diagnostic and treatment strategies tailored to individual colorectal cancer patients,enhancing the precision and effectiveness of clinical management.
6.Abnormal O-glycosylation mediated by the deficiency of molecular chaperone Cosmc or T-synthase regulates the expression of miRNAs in colorectal cancer exosomes
Tianbo GAO ; Yang GE ; Guangyu AN ; Jiannan YAO ; Yuliang JIANG ; Heshu LIU ; Rui YAN
Journal of Capital Medical University 2025;46(3):401-409
Objective To explore the effects of aberrant O-glycosylation modifications induced by the knockout of Cosmc or T-synthase genes on the expression profiles of miRNAs in exosomes derived from colorectal cancer cells and to reveal the molecular mechanisms of O-glycosylation in the development of colorectal cancer and identify potential biomarkers for early diagnosis and treatment.Methods This research specifically targets the Cosmc or T-synthase genes in the human colorectal cancer cell line HCT116 to create stable cell lines exhibiting abnormal O-glycosylation with CRISPR/Cas-9 gene editing technology.Exosomes originating from these colorectal cancer cells were isolated and authenticated.A microarray chip equipped with primer sequences for 16 miRNAs closely associated with colorectal cancer was employed to assess the differential expression of miRNAs within these exosomes with fluorescent quantitative polymerase chain reaction(PCR).And then,a cohort of miRNAs that exhibited significant and consistent changes in expression levels across the exosomes from both cell lines was selected.These miRNAs were further validated independently with traditional fluorescent quantitative PCR.Subsequently,data from The Cancer Genome Atlas Program(TCGA)database containing patient information on colorectal cancer was harnessed.Employing R programming language,Gene Set Enrichment Analysis(GSEA)was conducted on the upregulated miRNA to investigate the downstream pathways significantly impacted and the malignant biological behaviors they may influence.Results The absence of either Cosmc or T-synthase genes results in the dysregulation of O-glycosylation in colorectal cancer cells,leading to the exposure of Tn antigens.This,in turn,affects the expression levels of specific miRNAs in exosomes derived from these cells.Specifically,the expression of hsa-miR-125b-1-3p was downregulated,while that of hsa-miR-218-5p was upregulated.Notably,hsa-miR-218-5p were found to be closely associated with the epithelial-mesenchymal transition(EMT)process in tumor cells,which is a key mechanism in cancer progression.Conclusion It elucidates that the aberrant O-glycosylation mediated by the knockout of Cosmc or T-synthase genes significantly influences the expression of certain miRNAs in exosomes from colorectal cancer cells,potentially affect the EMT process in colorectal cancer and thereby promoting distant metastasis.Given the inherent stability and detectability advantages of colorectal cancer-derived exosomes,the altered expression levels of miRNAs within these exosomes may serve as indicators of the stated of abnormal O-glycosylation in colorectal cancer.These findings suggest that exosomal miRNAs have potential as biomarkers for monitoring disease progression and therapeutic efficacy.Consequently,this could pave the way for more personalized diagnostic and treatment strategies tailored to individual colorectal cancer patients,enhancing the precision and effectiveness of clinical management.
7.Comparison of clinical features and surgical outcomes in patients with cervicothoracic hemivertebra at different ages
Ziqun LIU ; Yawei LI ; Yuliang DAI ; Lei LI ; Hong MA ; Zhiming TU ; Bin JIANG ; Can GUO ; Zheyu WANG ; Bing WANG
Chinese Journal of Surgery 2025;63(5):413-421
Objective:To investigate the clinical characteristics of children with cervicothoracic hemivertebra at different ages and evaluate the surgical outcomes of hemivertebra resection.Methods:This retrospective cohort study analyzed clinical and radiographic data of 35 children (under 18 years old) with cervicothoracic hemivertebra who underwent one-stage posterior hemivertebra resection at the Department of Spine Surgery, Second Xiangya Hospital of Central South University, from June 2005 to June 2022. The cohort included 19 males and 16 females, with a surgical age of (9.7±4.1) years (range: 3 to <18 years). Patients were divided into three groups based on initial surgical age: preschool group (≤5 years, n=10), school-age group (6 to 10 years, n=10), and adolescent group (11 to <18 years, n=15). The intraoperative blood loss, operative time, number of fixed vertebrae, and perioperative and postoperative complications were recorded. Radiographic measurements were taken preoperatively, postoperatively, and at final follow-up, including the Cobb angle of the primary curve, curve length, distal curve Cobb angle, neck tilt, shoulder balance, coronal balance, trunk tilt, clavicle angle, head deviation, and local kyphosis. Statistical analyses included one-way ANOVA, Kruskal-Wallis H test, chi-square test, and Fisher′s exact test. Results:The operative time was (333±74) minutes (range:200 to 450 minutes), the intraoperative blood loss was (419±132) ml (range:200 to 650 ml), and the number of fixed vertebrae was (6.0±2.7) segments (range:2 to 12 segments). Preoperatively, the preschool group had a smaller primary curve Cobb angle compared to the adolescent group (33.6°±8.4° vs. 43.0°±9.4°, F=3.394, P=0.046) and distal curve Cobb angle (6.4°±2.4° vs.11.9°±4.5°, F=6.550, P=0.038). The preschool group had better coronal balance ((8.8±4.3) mm vs. (20.2±11.7)mm, F=9.448, P=0.009) and trunk tilt (4.0°±2.0° vs.7.0°±3.0°, F=4.343, P=0.029) than the school-age group. The preschool group had fewer fused vertebrae than the school-age and adolescent groups (3.8±1.6 vs. 7.0±2.6 vs. 6.8±2.6, F=10.480, P=0.005). The preschool group also had less intraoperative blood loss than the adolescent groups ((320±125) ml vs. (480±113) ml, F=8.666, P=0.013). However, no significant differences were found in postoperative and final follow-up measurements of primary and distal curve Cobb angles, neck tilt, shoulder balance, coronal balance, trunk tilt, clavicle angle, head deviation, local kyphosis, or complication rates (all P>0.05). Conclusions:Children with cervicothoracic hemivertebra across different age groups exhibit similar surgical outcomes and complication rates. But the preschool group had fewer fixed segments and less intraoperative blood loss, suggesting that this age group is an ideal time for surgery.
8.Impaired Global Longitudinal Strain Predicts Poor Prognosis in Patients With Acute ST-segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention
Lan WANG ; Yuliang MA ; Tiangang ZHU ; Wenying JIN ; Bailin JIANG ; Chengfu CAO ; Jing WANG
Chinese Circulation Journal 2024;39(5):451-455
Objectives:To evaluate the impact of global longitudinal strain(GLS)for prognosis in ST-segment elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention(PCI). Methods:We enrolled 156 STEMI patients who underwent PCI and spackle tracking imaging(STI)during hospitalization from September 2020 to August 2023.Patients with Killip Ⅱ-Ⅳ at baseline were excluded,138 patients were finally included.GLS was detected by STI.Patients were divided into more impaired group(GLS>-11.7%,n=57)and less impaired group(GLS≤-11.7%,n=81)according to Youden index.Clinical characteristics and echocardiography data were analyzed.Patients were followed up for a median of 21(13,28)months.Heart failure events were compared between the two groups. Results:The peak troponin I(TnI)was significantly higher in patients with GLS>-11.7%than those with GLS≤-11.7%at admission(85 160[31 297,214 226]pg/ml vs.34 942[13 571,92 713]pg/ml,P<0.001).Culprit vessel was different between the 2 groups(P<0.001).Compared with patients with GLS≤-11.7%,patients with GLS>-11.7%had lower left ventricular ejection fraction(LVEF)([60.1±8.7]%vs.[49.2±8.3]%,P<0.001),higher proportion of regional wall motion abnormality(90.1%vs.100%,P=0.015).Both LVEF and GLS recovered in patients with GLS>-11.7%during follow-up,but remained lower as compared to patients with GLS≤-11.7%(both P<0.001).The median follow-up time was 21(13,28)months.After adjusting age,sex,culprit vessel and peak TnI,the risk of heart failure of patients with GLS>-11.7%was significant higher(HR=9.123,95%CI:1.720-43.394,P=0.009). Conclusions:STEMI patients with more impaired GLS have a higher risk of heart failure post PCI.
9.Clinical effect of double plasma molecular adsorption system in treatment of patients with chronic liver failure in high-altitude areas
Bowen WANG ; Mengjia PENG ; Liheng JIANG ; Fei FANG ; Yuliang WANG ; Yuandi SHEN
Journal of Clinical Hepatology 2024;40(1):110-115
ObjectiveTo investigate the differences in clinical features and mortality rate between native patients with chronic liver failure (CHF) and migrated patients with CHF after treatment with double plasma molecular adsorption system (DPMAS) in high-altitude areas. MethodsA total of 63 patients with CHF who received DPMAS treatment in the intensive care unit of General Hospital of Tibet Military Command from January 2016 to December 2021 were enrolled, and according to their history of residence in high-altitude areas, they were divided into native group with 29 patients and migrated group with 34 patients. The two groups were compared in terms of baseline data and clinical features before and after DPMAS treatment. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the paired t-test was used for comparison before and after treatment within each group; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the Wilcoxon signed rank sum test was used for comparison before and after treatment within each group; the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison of the risk of death. ResultsCompared with the native group, the migrated group had a significantly higher proportion of Chinese Han patients (χ2=41.729, P<0.001), and compared with the migrated group, the native group had a significantly longer duration of the most recent continuous residence in high-altitude areas (Z=3.364, P<0.001). Compared with the native group, the migrated group had significantly higher MELD score and incidence rates of hepatic encephalopathy, hepatorenal syndrome, and gastrointestinal bleeding (Z=2.318, χ2=6.903, 5.154, and 6.262, all P<0.05). Both groups had significant changes in platelet count (PLT), hemoglobin count (HGB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, total bilirubin (TBil), direct bilirubin (DBil), lactate dehydrogenase (LDH), creatinine (Cr), and international normalized ratio (INR) after DPMAS treatment (all P<0.05). Before DPMAS treatment, compared with the native group, the migrated group had significantly higher levels of ALT, AST, TBil, DBil, LDH, Cr, BUN, and INR (all P<0.05) and a significantly lower level of HGB (P<0.05); after DPMAS treatment, compared with the native group, the migrated group had significantly greater reductions in PLT and HGB (both P<0.05) and still significantly higher levels of ALT, AST, TBil, DBil, LDH, BUN, and INR (all P<0.05). The 60-day mortality rate of patients after DPMAS treatment was 52.5% (95% confidence interval [CI]: 41.7 — 63.8) in the native group and 81.3% (95%CI: 77.9 — 85.6) in the migrated group. Compared with the native group (hazard ratio [HR]=0.47, 95%CI: 0.23 — 0.95), the migrated group had a significant increase in the risk of death on day 60 (HR=2.14, 95%CI: 1.06 — 4.32, P=0.039). ConclusionCompared with the native patients with CHF in high-altitude areas, migrated patients have a higher degree of liver impairment, a lower degree of improvement in liver function after DPMAS treatment, and a higher mortality rate. Clinical medical staff need to pay more attention to migrated patients with CHF, so as to improve their survival rates.
10.Improvement effect of Phellodendron amurense polysaccharides on gouty nephropathy in rats and its mechanism
Yongzhe MA ; Yuliang WANG ; Kai ZHANG ; Hong ZHAO ; Yu SHEN ; Hongbin QIU ; Chaoxing WANG ; Shiqing SUN ; Zhenxu JIANG ; Mingming SONG ; Yu ZHANG
China Pharmacy 2024;35(5):555-559
OBJECTIVE To study the effects of Phellodendron amurense polysaccharides (PAP) on improving gouty nephropathy (GN) in rats, and to investigate its mechanism primarily by interfering the p38 mitogen-activated protein kinase (p38 MAPK)/nuclear factor-κB(NF-κB)/tumor necrosis factor-α(TNF-α). METHODS Sixty rats were randomly divided into normal group (water), model group (water), allopurinol group (positive control, 20 mg/kg), PAP high-dose, medium-dose and low-dose groups (100, 50, 25 mg/kg, by raw material) after being stratified by body weight, with 10 rats in each group. Except for the normal group, the other groups were induced to construct GN model by giving 1 500 mg/kg potassium oxazinate and 100 mg/kg adenine intragastrically for 14 days. After modeling, the rats in each group were given relevant medicine/water intragastrically, once a day, for consecutive 28 days. After the last medication, the levels of biochemical parameters related to renal function [uric acid, creatinine (Cr), blood urea nitrogen (BUN), xanthine oxidase (XOD)] were detected in rats, and the histopathological changes in the rat kidney were observed. The protein expressions of monocyte chemoattractant protein-1(MCP-1),TNF-α and interleukin-6(IL-6) as well as the phosphorylation levels of p38 MAPK and NF-κB p65 protein were determined in renal tissue of rats. RESULTS Compared with the normal group, the model group suffered from the dilatation of renal tubules, structural damage to glomeruli, accompanied by inflammatory infiltration and fibrosis; the contents of uric acid, Cr, BUN and XOD, the protein expressions of MCP-1,TNF-α and IL-6 and the phosphorylation levels of p38 MAPK and NF-κB p65 protein were all increased significantly (P<0.05 or P<0.01). Compared with the model group, the pathological symptoms of renal tissue in rats had been improved to varying degrees in different dose groups of PAP; the contents of uric acid, Cr, BUN and XOD, protein expressions of MCP-1, TNF-α and IL-6, the phosphorylation levels of p38 MAPK and NF-κB p65 protein in PAP high-dose and PAP medium-dose groups were all decreased significantly (P<0.05 or P<0.01). CONCLUSIONS PAP exhibits an anti-GN effect, the mechanism of which may be associated with inhibiting the p38 MAPK/NF-κB/TNF-α signaling pathway.

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