AIM To analyze the dynamic change patterns of aflatoxin B1,aflatoxin B2,aflatoxin G1,aflatoxin G2,T-2 toxin and deoxynivalenol contents during the fermentation of Massa Medicata Fermentata.METHODS The analysis was performed on a 40 ℃ thermostatic Waters ACQUITY UPLC HSS T3 column(100 mm×2.1 mm,1.8 μm),with the mobile phase comprising of 0.01％formic acid-[acetonitrile-methanol(1∶1)]flowing at 0.3 mL/min,and electron spray ionization source was adopted in positive ion scanning with multiple reaction monitoring mode.RESULTS Six mycotoxins showed good linear relationships within their own ranges(R2＞0.998 0),whose average recoveries were 76.1％-119.3％with the RSDs of 0.49％-9.27％,and except for deoxynivalenol,their contents demonstrated the trends of growing out of nothing and gradually increasing.CONCLUSION The risk of mycotoxin infection exists in the fermentation of Massa Medicata Fermentata.This simple,efficient,rapid and sensitive method can provide a reference for whole-process monitoring the fermentation process for Massa Medicata Fermentata.

Aim To investigate the effect of Shenqi Dihuang decoction(SQDH)on henoch-schonlein pur-pura nephritis(HSPN)rats by regulating AMPK/Sirt1/Nrf2 mediated ferroptosis and the possible mech-anism.Methods Thirty SD rats were randomly divid-ed into a control group(Control),HSPN group,SQDH low-dose group(SQDH-L,5.4 g·kg-1),SQDH high-dose group(SQDH-H,21.6 g·kg-1),and SQDH high-dose+AMPK inhibitor group(SQDH-H+CC,20 mg·kg-1),with six rats in each group.Except for the control group,all other groups of rats were injected intraperitoneally with ovalbumin and complete Freund's adjuvant to establish HSPN rat models.After the successful construction of the model,each group of rats was orally administered with the cor-responding dosage or physiological saline once a day for five weeks.HE staining was used to observe the his-topathological changes in renal tissues;immunohisto-chemistry(IHC)was employed to detect the deposition of IgA and IgG in renal tissues;serum biochemical pa-rameters of renal function and urinary protein levels were measured;commercial assay kits were utilized to determine oxidative stress markers and Fe2+levels in renal tissues;Western blot analysis was performed to assess ferroptosis-related proteins and the protein ex-pression of the AMPK/Sirt1/Nrf2 signaling pathway in renal tissues.Results Compared with the control group,the HSPN group showed significant pathological damage in kidney tissue,with significantly increased scores,increased deposition of IgA and IgG in kidney tissue,decreased serum total protein(TP)and albu-min(ALB),and average increases in serum creatinine(Cre),urea nitrogen(BUN),and urinary protein levels(P＜0.05).The levels of MDA,ROS,Fe2+,and ACSL4 protein expression in the kidney tissue sig-nificantly increased,while SOD activity,SLC7A11,GPX4,p-AMPK/AMPK,Sirt1,and Nrf2 protein ex-pression significantly decreased(P＜0.05).Com-pared with the HSPN group,the pathological damage to renal tissue was reduced,IgA and IgG deposition in renal tissue decreased,TP and ALB decreased,Cre,BUN,and urinary protein levels were all reduced(P＜0.05),and the levels of MDA,ROS,Fe2+,and ACSL4 protein expression in renal tissue were signifi-cantly reduced in each dose group of SQDH rats.SOD activity,SLC7A11,GPX4,p-AMPK/AMPK,Sirt1,and Nrf2 protein expression significantly increased(P＜0.05).Compared with the SQDH-H group,the AMPK inhibitor CC could inhibit the AMPK/Sirt1/Nrf2 signaling pathway induced ferroptosis and reverse the protective effect of SQDH on renal injury in HSPN rats.Conclusions SQDH can improve renal injury in HSPN rats,and its mechanism may be related to the activation of AMPK/Sirt1/Nrf2 signaling pathway to in-hibit ferroptosis.

Objective:To explore the effect of horizontal Baduanjin guided by interactive standard reaching theory(ISRT)on cardiac function and quality of life in patients with chronic heart failure(CHF).Methods:This random-ized controlled study enrolled 114 patients diagnosed with CHF in Bozhou People's Hospital between September 2024 and February 2025.Patients were randomly divided into control group(n=57,routine nursing care)and interven-tion group(n=57,horizontal Baduanjin under the guidance of interactive standard theory).Both groups were con-tinuously treated for 3 months.Cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proB-NP),self-care ability,quality of life and incidence of major adverse cardiovascular events(MACE)were com-pared between the two groups.Results:Compared to patients in the control group,those in the intervention had significant higher left ventricular ejection fraction(LVEF)[(56.34±0.86)％vs.(46.69±0.91)％],6min walking distance(6MWD)[(477.16±6.62)m vs.(451.39±4.17)m]and the proportion of New York Heart Association(NYHA)class Ⅱ(70.18％vs.35.09％),and significant lower NT-proBNP[(237.76±6.41)pg/ml vs.(377.46±6.85)pg/ml],scores of the European heart failure self-care behavior scale 9(EHFSCB-9)[(12.61±1.81)points vs.(25.51±1.71)points],the physical domain[(3.96±0.91)points vs.(11.05±0.79)points],emotional domain[(4.00±0.85)points vs.(11.95±0.81)points]and other domain[(4.05±0.83)points vs.(13.47±1.15)points]of MLHFQ(P＜0.001 all).Compared to those in the control group,patients in intervention group had significant lower incidence of MACE(7.02％vs.22.81％,P=0.035).Conclusion:Under the guidance of the interactive standard theory,the horizontal Baduanjin exercise may enhance the cardiac function,improve self-care ability and quality of life in patients with chronic heart failure.

Objective:To explore the effect of horizontal Baduanjin guided by interactive standard reaching theory(ISRT)on cardiac function and quality of life in patients with chronic heart failure(CHF).Methods:This random-ized controlled study enrolled 114 patients diagnosed with CHF in Bozhou People's Hospital between September 2024 and February 2025.Patients were randomly divided into control group(n=57,routine nursing care)and interven-tion group(n=57,horizontal Baduanjin under the guidance of interactive standard theory).Both groups were con-tinuously treated for 3 months.Cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proB-NP),self-care ability,quality of life and incidence of major adverse cardiovascular events(MACE)were com-pared between the two groups.Results:Compared to patients in the control group,those in the intervention had significant higher left ventricular ejection fraction(LVEF)[(56.34±0.86)％vs.(46.69±0.91)％],6min walking distance(6MWD)[(477.16±6.62)m vs.(451.39±4.17)m]and the proportion of New York Heart Association(NYHA)class Ⅱ(70.18％vs.35.09％),and significant lower NT-proBNP[(237.76±6.41)pg/ml vs.(377.46±6.85)pg/ml],scores of the European heart failure self-care behavior scale 9(EHFSCB-9)[(12.61±1.81)points vs.(25.51±1.71)points],the physical domain[(3.96±0.91)points vs.(11.05±0.79)points],emotional domain[(4.00±0.85)points vs.(11.95±0.81)points]and other domain[(4.05±0.83)points vs.(13.47±1.15)points]of MLHFQ(P＜0.001 all).Compared to those in the control group,patients in intervention group had significant lower incidence of MACE(7.02％vs.22.81％,P=0.035).Conclusion:Under the guidance of the interactive standard theory,the horizontal Baduanjin exercise may enhance the cardiac function,improve self-care ability and quality of life in patients with chronic heart failure.

OBJECTIVE To evaluate the cost-effectiveness of finerenone combined with standard of care （SoC） in the treatment of heart failure with mildly reduced ejection fraction （HFmrEF） or preserved ejection fraction （HFpEF）. METHODS Based on a phase Ⅲ clinical trial， a Markov model was constructed from the perspective of China’s healthcare system to compare the treatment outcomes of finerenone combined with SoC regimen versus SoC regimen alone in the treatment of different cardiac functional statuses of HFmrEF/HFpEF. Using quality-adjusted life year （QALY） as the health output index， 3 times China’s per capita GDP in 2023 as the willingness-to-pay （WTP） threshold， a simulation was conducted with a 3-month cycle length and a 10- year time horizon， incorporating an annual discount rate of 5%. The dynamic changes across various stages of HFmrEF/HFpEF treated with finerenone combined with SoC versus SoC alone were simulated to evaluate the long-term effectiveness and costs of the two treatment strategies. Additionally， one-way sensitivity analysis and probabilistic sensitivity analysis were performed， to test the robustness of the results. RESULTS The incremental cost-effectiveness ratio （ICER） of the finerenone combined with SoC regimen versus SoC regimen alone was 179 504.75 yuan/QALY， which was below the WTP threshold set in this study， indicating that the finerenone combined with SoC regimen possessed certain economic advantages. The results of one-way sensitivity analysis showed that the utility value of NYHA Ⅱ status， the drug price of finerenone， the discount rate， and the probability of hospital transfer for both groups had a great influence on ICER， but did not affect the robustness of the model. The probabilistic sensitivity analysis also confirmed the robustness of the model. CONCLUSIONS Under the WTP threshold set in this study， finerenone combined with SoC is cost-effective in the treatment of HFmrEF/HFpEF， compared with the SoC regimen.

Aim To investigate the effect of Shenqi Dihuang decoction(SQDH)on henoch-schonlein pur-pura nephritis(HSPN)rats by regulating AMPK/Sirt1/Nrf2 mediated ferroptosis and the possible mech-anism.Methods Thirty SD rats were randomly divid-ed into a control group(Control),HSPN group,SQDH low-dose group(SQDH-L,5.4 g·kg-1),SQDH high-dose group(SQDH-H,21.6 g·kg-1),and SQDH high-dose+AMPK inhibitor group(SQDH-H+CC,20 mg·kg-1),with six rats in each group.Except for the control group,all other groups of rats were injected intraperitoneally with ovalbumin and complete Freund's adjuvant to establish HSPN rat models.After the successful construction of the model,each group of rats was orally administered with the cor-responding dosage or physiological saline once a day for five weeks.HE staining was used to observe the his-topathological changes in renal tissues;immunohisto-chemistry(IHC)was employed to detect the deposition of IgA and IgG in renal tissues;serum biochemical pa-rameters of renal function and urinary protein levels were measured;commercial assay kits were utilized to determine oxidative stress markers and Fe2+levels in renal tissues;Western blot analysis was performed to assess ferroptosis-related proteins and the protein ex-pression of the AMPK/Sirt1/Nrf2 signaling pathway in renal tissues.Results Compared with the control group,the HSPN group showed significant pathological damage in kidney tissue,with significantly increased scores,increased deposition of IgA and IgG in kidney tissue,decreased serum total protein(TP)and albu-min(ALB),and average increases in serum creatinine(Cre),urea nitrogen(BUN),and urinary protein levels(P＜0.05).The levels of MDA,ROS,Fe2+,and ACSL4 protein expression in the kidney tissue sig-nificantly increased,while SOD activity,SLC7A11,GPX4,p-AMPK/AMPK,Sirt1,and Nrf2 protein ex-pression significantly decreased(P＜0.05).Com-pared with the HSPN group,the pathological damage to renal tissue was reduced,IgA and IgG deposition in renal tissue decreased,TP and ALB decreased,Cre,BUN,and urinary protein levels were all reduced(P＜0.05),and the levels of MDA,ROS,Fe2+,and ACSL4 protein expression in renal tissue were signifi-cantly reduced in each dose group of SQDH rats.SOD activity,SLC7A11,GPX4,p-AMPK/AMPK,Sirt1,and Nrf2 protein expression significantly increased(P＜0.05).Compared with the SQDH-H group,the AMPK inhibitor CC could inhibit the AMPK/Sirt1/Nrf2 signaling pathway induced ferroptosis and reverse the protective effect of SQDH on renal injury in HSPN rats.Conclusions SQDH can improve renal injury in HSPN rats,and its mechanism may be related to the activation of AMPK/Sirt1/Nrf2 signaling pathway to in-hibit ferroptosis.

Objective:To evaluate the effect of dietary adjustment guided by body composition analysis on blood glucose,,blood lipids,weight gain and pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods:A total of 122 GDM patients who had regular prenatal check-ups and gave birth at Wenzhou People's Hospital from May 2021 to October 2023 were selected as the research subjects and were randomly divided into Group A and Group B,with 61 cases in each group.Group A was given routine nutritional intervention with GDM,and Group B was adjusted their dietary structure based on body composition analysis.Another 50 normal pregnant women were selected as the control group.Three groups were compared for blood glucose,lipids,and body mass growth and pregnancy outcomes.Results:After intervention,the levels of FPG and 2hPG in the three groups were significantly decreased,while the levels of TC,TG,and LDL-C were significantly increased;The HbA1c levels in Group A and Group B were decreased significantly,while the HDL-C levels in the control group were significantly increased(P<0.05).After intervention,the levels of FPG,2hPG,HbA1c,TC,TG,and LDL-C in Group A were significantly higher than those in Group B and the control group(P<0.05).After intervention,the levels of FPG,TC,and LDL-C in group B were significantly higher than those in the control group(P<0.05).The predelivery body mass and increased body mass during pregnancy in Group A and Group B were significantly higher than those in the control group,while Group B was significantly lower than Group A(P<0.05).There was no significant difference in the compliance rate of body mass increase during pregnancy between the control group and group B(P>0.05),but both groups were significantly higher than group A(P<0.05).There was no significant difference in the cesarean section rate,pregnancy complications,and overall incidence of adverse perinatal outcomes between the control group and group B(P>0.05),but they were significantly lower than group A(P<0.05).Conclusion:Dietary structure adjustment guided body composition analysis can help to control blood glucose levels in GDM patients,maintain reasonable weight gain during pregnancy,reduce cesarean section rates,and reduce the risk of pregnancy complications and adverse perinatal outcomes.

Ursodeoxycholic acid (UDCA) is a naturally occurring, low-toxicity, and hydrophilic bile acid (BA) in the human body that is converted by intestinal flora using primary BA. Solute carrier family 7 member 11 (SLC7A11) functions to uptake extracellular cystine in exchange for glutamate, and is highly expressed in a variety of human cancers. Retroperitoneal liposarcoma (RLPS) refers to liposarcoma originating from the retroperitoneal area. Lipidomics analysis revealed that UDCA was one of the most significantly downregulated metabolites in sera of RLPS patients compared with healthy subjects. The augmentation of UDCA concentration (≥25 μg/mL) demonstrated a suppressive effect on the proliferation of liposarcoma cells. [¹⁵N₂]-cystine and [¹³C₅]-glutamine isotope tracing revealed that UDCA impairs cystine uptake and glutathione (GSH) synthesis. Mechanistically, UDCA binds to the cystine transporter SLC7A11 to inhibit cystine uptake and impair GSH de novo synthesis, leading to reactive oxygen species (ROS) accumulation and mitochondrial oxidative damage. Furthermore, UDCA can promote the anti-cancer effects of ferroptosis inducers (Erastin, RSL3), the murine double minute 2 (MDM2) inhibitors (Nutlin 3a, RG7112), cyclin dependent kinase 4 (CDK4) inhibitor (Abemaciclib), and glutaminase inhibitor (CB839). Together, UDCA functions as a cystine exchange factor that binds to SLC7A11 for antitumor activity, and SLC7A11 is not only a new transporter for BA but also a clinically applicable target for UDCA. More importantly, in combination with other antitumor chemotherapy or physiotherapy treatments, UDCA may provide effective and promising treatment strategies for RLPS or other types of tumors in a ROS-dependent manner.

This study explored the potential therapeutic targets and mechanisms of Danggui Shaoyao San(DSS) in the prevention and treatment of Alzheimer's disease(AD) through transcriptomics and metabolomics, combined with animal experiments. Fifty male C57BL/6J mice, aged seven weeks, were randomly divided into the following five groups: control, model, positive drug, low-dose DSS, and high-dose DSS groups. After the intervention, the Morris water maze was used to assess learning and memory abilities of mice, and Nissl staining and hematoxylin-eosin(HE) staining were performed to observe pathological changes in the hippocampal tissue. Transcriptomics and metabolomics were employed to sequence brain tissue and identify differential metabolites, analyzing key genes and metabolites related to disease progression. Reverse transcription-quantitative polymerase chain reaction(RT-qPCR) was employed to validate the expression of key genes. The Morris water maze results indicated that DSS significantly improved learning and cognitive function in scopolamine(SCOP)-induced model mice, with the high-dose DSS group showing the best results. Pathological staining showed that DSS effectively reduced hippocampal neuronal damage, increased Nissl body numbers, and reduced nuclear pyknosis and neuronal loss. Transcriptomics identified seven key genes, including neurexin 1(Nrxn1) and sodium voltage-gated channel α subunit 1(Scn1a), and metabolomics revealed 113 differential metabolites, all of which were closely associated with synaptic function, oxidative stress, and metabolic regulation. RT-qPCR experiments confirmed that the expression of these seven key genes was consistent with the transcriptomics results. This study suggests that DSS significantly improves learning and memory in SCOP model mice and alleviates hippocampal neuronal pathological damage. The mechanisms likely involve the modulation of synaptic function, reduction of oxidative stress, and metabolic balance, with these seven key genes serving as important targets for DSS in the treatment of AD.
Animals ; Alzheimer Disease/genetics* ; Male ; Drugs, Chinese Herbal/administration & dosage* ; Mice ; Mice, Inbred C57BL ; Metabolomics ; Transcriptome/drug effects* ; Maze Learning/drug effects* ; Hippocampus/metabolism* ; Humans ; Disease Models, Animal ; Memory/drug effects*