1.Mechanism of Paeonol in Alleviating Alcohol-induced Liver Injury in Mice Through Regulating SCFAs-GPR43/MAPK Signaling Pathway Mediated by Intestinal Flora
Shengnan JIANG ; Qifeng WU ; Zining WANG ; Hao PU ; Guiming YAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):129-139
ObjectiveTo investigate the ameliorative effect of paeonol on acute alcohol-induced hepatic inflammation in mice via the regulation of the short-chain fatty acids (SCFAs)-specific receptor GPR43/mitogen-activated protein kinase (MAPK) signaling pathway. MethodsC57BL/6 mice were randomly divided into five groups: blank control group, model group, low-dose paeonol group (120 mg·kg-1), high-dose paeonol group (480 mg·kg-1), and silybin group (36.8 mg·kg-1). A mouse model of alcohol-induced liver disease (ALD) was established by ad libitum administration of a Lieber-DeCarli alcohol liquid diet. Serum lipid levels, liver function, inflammatory cytokines, and oxidative stress markers were measured. Liver hematoxylin-eosin (HE) staining and Oil Red O staining were performed to validate successful modeling. Western blot analysis was used to assess the expression levels of zonula occludens-1 (ZO-1), Claudin-1, and proteins related to the GPR43/MAPK signaling pathway in the colonic tissue. Immunohistochemistry was employed to detect the protein expression of GPR43, ZO-1, and Claudin-1 in the colon. Then 16S rDNA sequencing was performed to analyze differences in intestinal flora between the model group and the high-dose paeonol group. Additionally, fecal microbiota transplantation (FMT) experiments were conducted to validate the regulatory effect of paeonol on ALD via modulation of intestinal flora. ResultsCompared with the blank control group, the model group showed significantly elevated serum lipid levels, oxidative stress, and inflammatory cytokine expression (P<0.01). Liver histology revealed increased inflammatory infiltration and lipid droplet accumulation. Colonic mucosal injury and impaired intestinal barrier function were observed. Levels of MAPK pathway-related proteins in the colonic tissue were upregulated (P<0.01), while GPR43, ZO-1, and Claudin-1 protein expression levels were significantly decreased (P<0.01). The composition and abundance of the intestinal flora were markedly altered, with a reduced Bacteroidetes-to-Firmicutes ratio and decreased relative abundances of Eubacterium, Parabacteroides, Erysipelothrix, and Adlercreutzia, alongside increased abundances of Clostridium butyricum, Enterococcus, and Helicobacter pylori in the model group. Compared with the model group, paeonol significantly reduced serum lipid levels, oxidative stress responses, and the expression of inflammatory cytokines in ALD mice (P<0.05, P<0.01). It also attenuated hepatic lipid accumulation, restored intestinal barrier function, and repaired the structural integrity of liver and colonic tissues. The protein expression levels of ZO-1, Claudin-1, and GPR43 in the colonic tissue were significantly increased (P<0.05, P<0.01), while those of MAPK pathway-related proteins were significantly decreased (P<0.05, P<0.01). The intestinal flora dysbiosis was effectively alleviated, rendering its composition closer to that of normal mice. The efficacy of paeonol in modulating ALD was further confirmed by FMT experiments, supporting its mechanistic involvement in the SCFAs-GPR43/MAPK signaling pathway. ConclusionPaeonol exerts a protective effect against ALD in mice, which may be mediated through regulation of the SCFAs-GPR43/MAPK signaling pathway, thereby achieving anti-inflammatory effects and improving intestinal barrier function.
2.Mechanism of Paeonol in Alleviating Alcohol-induced Liver Injury in Mice Through Regulating SCFAs-GPR43/MAPK Signaling Pathway Mediated by Intestinal Flora
Shengnan JIANG ; Qifeng WU ; Zining WANG ; Hao PU ; Guiming YAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):129-139
ObjectiveTo investigate the ameliorative effect of paeonol on acute alcohol-induced hepatic inflammation in mice via the regulation of the short-chain fatty acids (SCFAs)-specific receptor GPR43/mitogen-activated protein kinase (MAPK) signaling pathway. MethodsC57BL/6 mice were randomly divided into five groups: blank control group, model group, low-dose paeonol group (120 mg·kg-1), high-dose paeonol group (480 mg·kg-1), and silybin group (36.8 mg·kg-1). A mouse model of alcohol-induced liver disease (ALD) was established by ad libitum administration of a Lieber-DeCarli alcohol liquid diet. Serum lipid levels, liver function, inflammatory cytokines, and oxidative stress markers were measured. Liver hematoxylin-eosin (HE) staining and Oil Red O staining were performed to validate successful modeling. Western blot analysis was used to assess the expression levels of zonula occludens-1 (ZO-1), Claudin-1, and proteins related to the GPR43/MAPK signaling pathway in the colonic tissue. Immunohistochemistry was employed to detect the protein expression of GPR43, ZO-1, and Claudin-1 in the colon. Then 16S rDNA sequencing was performed to analyze differences in intestinal flora between the model group and the high-dose paeonol group. Additionally, fecal microbiota transplantation (FMT) experiments were conducted to validate the regulatory effect of paeonol on ALD via modulation of intestinal flora. ResultsCompared with the blank control group, the model group showed significantly elevated serum lipid levels, oxidative stress, and inflammatory cytokine expression (P<0.01). Liver histology revealed increased inflammatory infiltration and lipid droplet accumulation. Colonic mucosal injury and impaired intestinal barrier function were observed. Levels of MAPK pathway-related proteins in the colonic tissue were upregulated (P<0.01), while GPR43, ZO-1, and Claudin-1 protein expression levels were significantly decreased (P<0.01). The composition and abundance of the intestinal flora were markedly altered, with a reduced Bacteroidetes-to-Firmicutes ratio and decreased relative abundances of Eubacterium, Parabacteroides, Erysipelothrix, and Adlercreutzia, alongside increased abundances of Clostridium butyricum, Enterococcus, and Helicobacter pylori in the model group. Compared with the model group, paeonol significantly reduced serum lipid levels, oxidative stress responses, and the expression of inflammatory cytokines in ALD mice (P<0.05, P<0.01). It also attenuated hepatic lipid accumulation, restored intestinal barrier function, and repaired the structural integrity of liver and colonic tissues. The protein expression levels of ZO-1, Claudin-1, and GPR43 in the colonic tissue were significantly increased (P<0.05, P<0.01), while those of MAPK pathway-related proteins were significantly decreased (P<0.05, P<0.01). The intestinal flora dysbiosis was effectively alleviated, rendering its composition closer to that of normal mice. The efficacy of paeonol in modulating ALD was further confirmed by FMT experiments, supporting its mechanistic involvement in the SCFAs-GPR43/MAPK signaling pathway. ConclusionPaeonol exerts a protective effect against ALD in mice, which may be mediated through regulation of the SCFAs-GPR43/MAPK signaling pathway, thereby achieving anti-inflammatory effects and improving intestinal barrier function.
3.Clinical effects comparison of different approaches and anterior attachment release methods in temporomandibular joint disc repositioning and anchoring surgery
WANG Hao ; WANG Wei ; LI Qiang ; YAN Jiaxuan ; NIE Wei ; GUO Yanjun ; YAN Wei ; CHEN Yong
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(2):129-136
Objective:
To explore the therapeutic effects of different surgical methods for temporomandibular joint disc reduction and anchoring surgery, providing reference for optimizing this surgical procedure.
Method:
The study was approved by the hospital ethics committee. 173 patients (195 joints) who underwent temporomandibular joint disc repositioning and anchoring surgery were selected for retrospective analysis. Patients were categorized into groups A (traditional preauricular incision-scalpel/tissue scissors anterior attachment release), 35 patients (40 joints), B (traditional preauricular incision-plasma bipolar radiofrequency electrode anterior attachment release), 42 patients (46 joints), C (revised tragus incision - scalpel/tissue scissors anterior attachment release), 50 patients (58 joints), and D (revised tragus incision-plasma bipolar radiofrequency electrode anterior attachment release), 46 patients (51 joints). After a 6-month postoperative follow-up, the differences in maximum mouth opening (MMO), visual analogue scale (VAS), effective rate of joint disc reduction, incidence of preauricular numbness, obvious scars among patients in each group at 1, 3, and 6 months were compared postoperatively.
Results:
After surgery, the MMO of all four groups of patients initially shrunk and then gradually increased compared to before surgery. At the 1-month follow-up after surgery, the plasma bipolar radiofrequency release (B+D) group had a smaller impact on the patient’s MMO compared to the surgical knife/tissue scissors release (A+C) group (P < 0.05). Postoperative VAS scores for all four groups showed a gradual decrease from pre-operative levels, with the (B+D) group scoring significantly lower in the first month post-surgery compared to the (A+C) group (P < 0.05). Six months post-surgery, the rate of joint disc reduction of the four groups were higher than 95%, with no significant differences observed between the groups (P > 0.05). Patients in the revised tragus incision (C+D) group experienced a lower rate of preauricular numbness compared to those in the traditional preauricular incision (A+B) group (4.59% vs. 12.79%, P < 0.05), The incidence of obvious scars in the (C+D) group was significantly lower than that in the (A+B) group (3.67% vs. 23.26%, P < 0.05).
Conclusion
The revised tragus incision is superior to traditional preauricular incision in terms of protecting the auriculotemporal nerve and the scars were more inconspicuous. Further, the plasma bipolar radiofrequency electrode is superior to the scalpel/tissue scissors in terms of mouth opening recovery and pain control. For temporomandibular joint disc reduction and anchoring surgery, a modified tragus incision combined with plasma bipolar radiofrequency electrode to release the anterior attachment of the joint disc can be recommended as a surgical option.
4.The effect of rutaecarpine on improving fatty liver and osteoporosis in MAFLD mice
Yu-hao ZHANG ; Yi-ning LI ; Xin-hai JIANG ; Wei-zhi WANG ; Shun-wang LI ; Ren SHENG ; Li-juan LEI ; Yu-yan ZHANG ; Jing-rui WANG ; Xin-wei WEI ; Yan-ni XU ; Yan LIN ; Lin TANG ; Shu-yi SI
Acta Pharmaceutica Sinica 2025;60(1):141-149
Metabolic-associated fatty liver disease (MAFLD) and osteoporosis (OP) are two very common metabolic diseases. A growing body of experimental evidence supports a pathophysiological link between MAFLD and OP. MAFLD is often associated with the development of OP. Rutaecarpine (RUT) is one of the main active components of Chinese medicine Euodiae Fructus. Our previous studies have demonstrated that RUT has lipid-lowering, anti-inflammatory and anti-atherosclerotic effects, and can improve the OP of rats. However, whether RUT can improve both fatty liver and OP symptoms of MAFLD mice at the same time remains to be investigated. In this study, we used C57BL/6 mice fed a high-fat diet (HFD) for 4 months to construct a MAFLD model, and gave the mice a low dose (5 mg·kg-1) and a high dose (15 mg·kg-1) of RUT by gavage for 4 weeks. The effects of RUT on liver steatosis and bone metabolism were then evaluated at the end of the experiment [this experiment was approved by the Experimental Animal Ethics Committee of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences (approval number: IMB-20190124D303)]. The results showed that RUT treatment significantly reduced hepatic steatosis and lipid accumulation, and significantly reduced bone loss and promoted bone formation. In summary, this study shows that RUT has an effect of improving fatty liver and OP in MAFLD mice.
5.Neogambogic Acid Suppresses Characteristics of Colorectal Cancer Stem Cells Through Inhibition of Wnt/β-catenin Signaling Pathway
Hao WANG ; Huixian HUANG ; Youran LI ; Yuehua YAN ; Jiaqin YI ; Xiaoyu LIU ; Dongmei LUO ; Yu GU
Cancer Research on Prevention and Treatment 2025;52(7):554-561
Objective To explore the role of neogambogic acid in the characteristics of colorectal cancer stem cells (CRC-CSCs) through the Wnt/β-catenin signaling pathway. Methods The colorectal cells SW480 and HCT166 were divided into control group and neogambogic acid groups (1.5, 3, 6, and 12 μmol/L). The viability of CRC-CSCs was determined by MTT method, and spheroid and clone formation assays were used to assess the capacity of spheroid formation and self-renewal ability of the cells. The effects of neogambogic acid on the apoptosis and cell cycle of CRC-CSCs were evaluated by flow cytometry assays. Real-time quantitative PCR was used to detect the mRNA expression levels of relative markers (CD133, CD44, ALDH1, Oct4, and Nanog) of CRC-CSCs, and the protein expression levels of the self-renewal marker (PCNA), apoptosis markers (cleaved caspase-3 and cleaved caspase-9), and Wnt/β-catenin signaling pathway markers (p-GSK3β, GSK3β, β-catenin, and Wnt) were analyzed using Western blot. Results Compared with the control group, after neogambogic acid treatment, the viability of SW480 and HCT116 cells decreased (P<0.05), the spheroid forming ability and the clone numbers of CRC-CSCs decreased (P<0.001, P<0.01) but the cell apoptosis rate increased (P<0.01), and cell cycle was arrested in G0/G1 phase. Moreover, neogambogic acid downregulated the mRNA and protein expression of relative markers of CRC-CSCs (CD133, CD44, ALDH1, Oct4, and Nanog), PCNA, p-GSK3β, β-catenin, and Wnt (P<0.05) and upregulated the expression of cleaved caspase-3, cleaved caspase-9, and GSK3β (P<0.01). Conclusion Neogambogic can inhibit the stem cell properties of colorectal cells via inhibition of Wnt/β-catenin signaling pathway. As a result, neogambogic acid may be an attractive agent against colorectal cancer.
6.Clinical study on high-dose ilaprazole combined with amoxicillin for newly diagnosed elderly patients with Helicobacter pylori infection
Chen LI ; Yujing WANG ; Jianna MAO ; Hao GUO ; Yuhou SHEN ; Zhichao DONG ; Binbin YAN
China Pharmacy 2025;36(14):1792-1796
OBJECTIVE To evaluate the efficacy and safety of high-dose ilaprazole combined with amoxicillin for newly diagnosed elderly patients with Helicobacter pylori (Hp) infection, and analyze independent risk factors for failure of Hp infection eradication treatment. METHODS Totally 200 cases of newly diagnosed elderly patients with Hp infection in Xinxiang Central Hospital from August 1, 2021 to December 1, 2024 were selected and randomly divided into control group and study group, with 100 cases in each group. The control group was treated with classic quadruple therapy regimen (Amoxicillin capsules+ Clarithromycin tablets+Bismuth potassium citrate tablets+Ilaprazole enteric-coated tablets). The study group was treated with high- dose Ilaprazole enteric-coated tablets+Amoxicillin capsules. All patients were administered medication for 2 weeks. Hp eradication rates in the two groups were compared using intention-to-treat (ITT) and per-protocol (PP) analyses. The incidence of adverse reactions in both groups was also recorded. The multiple-factor Logistic regression analysis was used to identify independent risk factors for failure of Hp infection eradication treatment. RESULTS In ITT and PP analyses, there was no significant difference of Hp eradication rates between the two groups (P>0.05). There was no significant difference in incidence of mild to moderate adverse reactions between the two groups (P>0.05). BMI ≤18.5 kg/m2, BMI >23.9 kg/m2, rural residence, concomitant diabetes and concomitant heart disease were identified as independent risk factors influencing the failure of Hp infection eradication treatment (P<0.05). CONCLUSIONS The efficacy and safety of high-dose ilaprazole combined with amoxicillin are comparable to classic quadruple therapy regimen in treating newly diagnosed elderly patients with Hp infection. Independent risk factors influencing the failure of Hp infection eradication treatment include BMI ≤18.5 kg/m2, BMI >23.9 kg/m2, rural residence, concomitant diabetes and concomitant heart disease.
7.Phenomics of traditional Chinese medicine 2.0: the integration with digital medicine
Min Xu ; Xinyi Shao ; Donggeng Guo ; Xiaojing Yan ; Lei Wang ; Tao Yang ; Hao LIANG ; Qinghua PENG ; Lingyu Linda Ye ; Haibo Cheng ; Dayue Darrel Duan
Digital Chinese Medicine 2025;8(3):282-299
Abstract
Modern western medicine typically focuses on treating specific symptoms or diseases, and traditional Chinese medicine (TCM) emphasizes the interconnections of the body’s various systems under external environment and takes a holistic approach to preventing and treating diseases. Phenomics was initially introduced to the field of TCM in 2008 as a new discipline that studies the laws of integrated and dynamic changes of human clinical phenomes under the scope of the theories and practices of TCM based on phenomics. While TCM Phenomics 1.0 has initially established a clinical phenomic system centered on Zhenghou (a TCM definition of clinical phenome), bottlenecks remain in data standardization, mechanistic interpretation, and precision intervention. Here, we systematically elaborates on the theoretical foundations, technical pathways, and future challenges of integrating digital medicine with TCM phenomics under the framework of “TCM phenomics 2.0”, which is supported by digital medicine technologies such as artificial intelligence, wearable devices, medical digital twins, and multi-omics integration. This framework aims to construct a closed-loop system of “Zhenghou–Phenome–Mechanism–Intervention” and to enable the digitization, standardization, and precision of disease diagnosis and treatment. The integration of digital medicine and TCM phenomics not only promotes the modernization and scientific transformation of TCM theory and practice but also offers new paradigms for precision medicine. In practice, digital tools facilitate multi-source clinical data acquisition and standardization, while AI and big data algorithms help reveal the correlations between clinical Zhenghou phenomes and molecular mechanisms, thereby improving scientific rigor in diagnosis, efficacy evaluation, and personalized intervention. Nevertheless, challenges persist, including data quality and standardization issues, shortage of interdisciplinary talents, and insufficiency of ethical and legal regulations. Future development requires establishing national data-sharing platforms, strengthening international collaboration, fostering interdisciplinary professionals, and improving ethical and legal frameworks. Ultimately, this approach seeks to build a new disease identification and classification system centered on phenomes and to achieve the inheritance, innovation, and modernization of TCM diagnostic and therapeutic patterns.
8.The Invariant Neural Representation of Neurons in Pigeon’s Ventrolateral Mesopallium to Stereoscopic Shadow Shapes
Xiao-Ke NIU ; Meng-Bo ZHANG ; Yan-Yan PENG ; Yong-Hao HAN ; Qing-Yu WANG ; Yi-Xin DENG ; Zhi-Hui LI
Progress in Biochemistry and Biophysics 2025;52(10):2614-2626
ObjectiveIn nature, objects cast shadows due to illumination, forming the basis for stereoscopic perception. Birds need to adapt to changes in lighting (meaning they can recognize stereoscopic shapes even when shadows look different) to accurately perceive different three-dimensional forms. However, how neurons in the key visual brain area in birds handle these lighting changes remains largely unreported. In this study, pigeons (Columba livia) were used as subjects to investigate how neurons in pigeon’s ventrolateral mesopallium (MVL) represent stereoscopic shapes consistently, regardless of changes in lighting. MethodsVisual cognitive training combined with neuronal recording was employed. Pigeons were first trained to discriminate different stereoscopic shapes (concave/convex). We then tested whether and how light luminance angle and surface appearance of the stereoscopic shapes affect their recognition accuracy, and further verify whether the results rely on specify luminance color. Simultaneously, neuronal firing activity of neurons was recorded with multiple electrode array implanted from the MVL during the presentation of difference shapes. The response was finally analyzed how selectively they responded to different stereoscopic shapes and whether their selectivity was affected by the changes of luminance condition (like lighting angle) or surface look. Support vector machine (SVM) models were trained on neuronal population responses recorded under one condition (light luminance angle of 45°) and used to decode responses under other conditions (light luminance angle of 135°, 225°, 315°) to verify the invariance of responses to different luminance conditions. ResultsBehavioral results from 6 pigeons consistently showed that the pigeons could reliably identify the core 3D shape (over 80% accuracy), and this ability wasn’t affected by changes in light angle or surface appearance. Statistical analysis of 88 recorded neurons from 6 pigeons revealed that 83% (73/88) showed strong selectivity for specific 3D shapes (selectivity index>0.3), and responses to convex shapes were consistently stronger than to concave shapes. These shape-selective responses remained stable across changes in light angle and surface appearance. Neural patterns were consistent under both blue and orange lighting. The decoding accuracy achieves above 70%, suggesting stable responses under different conditions (e.g., different lighting angles or surface appearance). ConclusionNeurons in the pigeon MVL maintain a consistent neural encoding pattern for different stereoscopic shapes, unaffected by illumination or surface appearance. This ensures stable object recognition by pigeons in changing visual environments. Our findings provide new physiological evidence for understanding how birds achieve stable perception (“invariant neural representations”) while coping with variations in the visual field.
9.Unregistered treatment situation among pulmonary tuberculosis patients in Quzhou City from 2017 to 2023
YAN Qingxiu ; WANG Wei ; HAO Xiaogang ; GAO Yu ; FANG Chunfu ; ZHANG Xing ; LIU Wenfeng
Journal of Preventive Medicine 2025;37(8):799-803
Objective:
To analyze the unregistered treatment situation and its influencing factors among pulmonary tuberculosis patients in Quzhou City, Zhejiang Province from 2017 to 2023, so as to provide a basis for promoting the management of tuberculosis patients and optimizing disease prevention and control strategies.
Methods:
Data of pulmonary tuberculosis patients including demographic information, etiological results, and mortality status were collected through the China Disease Prevention and Control Information System Infectious Disease Reporting and Surveillance System and the Tuberculosis Management Information System. Pulmonary tuberculosis patients not matched in the Tuberculosis Management Information System were defined as unregistered treatment patients, and the unregistered treatment rate was analyzed. Factors affecting unregistered treatment among pulmonary tuberculosis patients were analyzed using a multivariable logistic regression model.
Results:
A total of 10 779 pulmonary tuberculosis patients were reported in Quzhou City from 2017 to 2023, including 7 700 males (71.44%) and 3 079 females (28.56%). There were 5 484 cases aged <65 years, accounting for 50.88%. Among them, 630 cases were unregistered treatment, with an unregistered treatment rate of 5.84% (95%CI: 5.42%-6.38%). Multivariable logistic regression analysis showed pulmonary tuberculosis patients aged ≥65 years (OR=1.829, 95%CI: 1.512-2.212) had a higher risk of being unregistered treatment than those aged <65 years; patients with non-local household registration (OR=5.710, 95%CI: 4.724-6.901) had a higher risk than local patients; and patients engaged in housework/unemployed (OR=2.001, 95%CI: 1.421-2.818) or other occupations (OR=2.396, 95%CI: 1.789-3.137) had a higher risk than farmers. The mortality of unregistered treatment pulmonary tuberculosis patients was higher than the registered treatment patients (26.67% vs. 5.02%),with a significantly elevated mortality risk (OR=7.147, 95%CI: 5.738-8.902).
Conclusions
The unregistered treatment rate among pulmonary tuberculosis patients was well controlled in Quzhou City from 2017 to 2023, but the elderly, patients with non-local household registration, and those engaged in housework/unemployed had a higher risk of unregistered treatment. It is recommended to improve medical and social security policies, strengthen health education on tuberculosis prevention, enhance treatment adherence, and reduce mortality risk.
10.Mechanism by which esketamine improves postoperative cognitive impairment in rats with hip fracture through AMPK/SIRT1/PGC-1α signaling pathway
Xuan LIU ; Xiaomin ZHANG ; Jinting LIU ; Yan HAO ; Yeming WANG ; Lixing CHEN
China Pharmacy 2025;36(21):2674-2680
OBJECTIVE To investigate the mechanism by which esketamine improves postoperative cognitive impairment in rats with hip fracture based on the AMP-activated protein kinase (AMPK)/silencing information regulatory factor 1 (SIRT1)/ peroxisome proliferator activated-receptor-γ coactivator-1α (PGC-1α) signaling pathway. METHODS Rats with hip fracture surgery were assigned into model group, esketamine group (10 mg/kg), inhibitor group (250 μg/mL AMPK inhibitor Compound C), and esketamine+inhibitor group (10 mg/kg esketamine + 250 μg/mL Compound C), and rats undergoing sham surgery were used as the control group, with 12 rats in each group. New object recognition and Barnes maze experiments were used to E-mail:448231@163.com evaluate cognitive function in rats. The levels of serum tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β),superoxide dismutase (SOD), malondialdehyde (MDA), gamma-aminobutyric acid (GABA), dopamine (DA) and glutamate (Glu), and the apoptosis of hippocampal neurons were detected. The pathological morphology of the hippocampal tissue and the ultrastructure of mitochondria were observed. The mRNA expression of B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax),the mRNA and protein expression of AMPK, SIRT1 and PGC-1α, as well as the expression of phosphorylated (p)-AMPK in hippocampal tissue, were detected. RESULTS Compared with the control group, the hippocampal neurons in the model group of rats were disordered, with more neurons necrotic and swollen mitochondria;the new object recognition index, the SOD, GABA, DA levels, Bcl-2, AMPK, SIRT1 and PGC-1α mRNA expression levels, and p-AMPK, SIRT1, PGC-1α protein expression levels were significantly reduced, while the latency and number of errors for locating unknown holes, the TNF-α, IL-1β, MDA and Glu levels, neuronal cell apoptosis rate, and Bax mRNA expression levels were significantly increased/prolonged (P<0.05). Compared with the model group, the esketamine group showed reduced pathological damage to the hippocampal tissue of rats, and the new object recognition index, the SOD, GABA and DA levels, the Bcl-2, AMPK, SIRT1 and PGC-1α mRNA expression levels, and p-AMPK, SIRT1, PGC-1α protein expression levels were significantly increased,while the latency and error frequency for locating unknown holes, TNF-α, IL-1β, MDA and Glu levels, neuronal cell apoptosis rate, and Bax mRNA expression levels were significantly decreased (P<0.05);the inhibitor group showed the opposite trend of changes in these indicators compared to the esketamine group (P<0.05).AMPK inhibitor could reverse the improvement effect of esketamine on the above indicators after hip fracture surgery in rats (P<0.05). CONCLUSIONS Esketamine may improve postoperative inflammatory response and oxidative stress levels in rats with hip fracture by activating the AMPK/SIRT1/PGC-1α signaling pathway, inhibiting neuronal cell apoptosis, improving mitochondrial structure, and promoting postoperative cognitive function recovery.


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