Objective To analyze the differentially expressed microRNA(miRNA)and their target genes in the serum of pediatric patients with fulminant myocarditis(FM)through bioinformatics methods,and to explore the pathogenesis.Methods GSE221090 dataset from the high-throughput Gene Expression Omnibus(GEO)were selected,and bioinformatics analysis was performed by using the GEO2R online tool to screen for differentially expressed miRNA.The online miRDB database was used to predict the target genes of the differentially expressed miRNA.The DAVID tool was employed for gene ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis of the screened target genes.Additionally,protein-protein interaction networks(PPI)associated with the differentially expressed genes was constructed by using STRING database and Cytoscape software,and core genes were screened.Results A total of 148 differentially expressed miRNA were identified in the serum of pediatric FM group compared to normal children group,including 109 up-regulated and 39 down-regulated miRNA.The top ten up-regulated and down-regulated miRNA based on their scores were selected,and target gene prediction for a forementioned miRNA was conducted by using the online miRDB database,identifying 291 target genes regulated by up-regulted miRNA and 290 target genes regulated by down-regulated miRNA.Subsequent GO and KEGG analyses demonstrated that the target genes of up-regulated miRNA were primarily enriched in signaling pathways including phosphatidylinositol 3-kinase/protein kinase B signaling pathway(PI3K/Akt)and forhead box O,whereas the target genes of down-regulated miRNA predominantly participated in the transforming growth factor-β(TGF-β)signaling pathway and related pathways.The top ten differentially expressed genes with the highest relevance scores using PPI and Cytoscape software were identified,including sirtuin 1(SIRT1),signal transducer and activator of transcription 3,estrogen receptor 1,H3.3 histone B,nuclear receptor corepressor 1,interferon regulatory factor 4,interleukin-1 Beta,dicer 1 ribonuclease Ⅲ,histone deacetylase 1(HDAC1),and DEAD-box helicase.Conclusion miR-22-3p,miR-4284,and others are crucial in the pathogenesis of pediatric FM,possibly related to the expression levels of SIRT1 and HDAC1 regulated,with mechanisms that may exert biological effects via the PI3K/Akt,TGF-β,and other signaling pathways.

Objective To analyze the differentially expressed microRNA(miRNA)and their target genes in the serum of pediatric patients with fulminant myocarditis(FM)through bioinformatics methods,and to explore the pathogenesis.Methods GSE221090 dataset from the high-throughput Gene Expression Omnibus(GEO)were selected,and bioinformatics analysis was performed by using the GEO2R online tool to screen for differentially expressed miRNA.The online miRDB database was used to predict the target genes of the differentially expressed miRNA.The DAVID tool was employed for gene ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis of the screened target genes.Additionally,protein-protein interaction networks(PPI)associated with the differentially expressed genes was constructed by using STRING database and Cytoscape software,and core genes were screened.Results A total of 148 differentially expressed miRNA were identified in the serum of pediatric FM group compared to normal children group,including 109 up-regulated and 39 down-regulated miRNA.The top ten up-regulated and down-regulated miRNA based on their scores were selected,and target gene prediction for a forementioned miRNA was conducted by using the online miRDB database,identifying 291 target genes regulated by up-regulted miRNA and 290 target genes regulated by down-regulated miRNA.Subsequent GO and KEGG analyses demonstrated that the target genes of up-regulated miRNA were primarily enriched in signaling pathways including phosphatidylinositol 3-kinase/protein kinase B signaling pathway(PI3K/Akt)and forhead box O,whereas the target genes of down-regulated miRNA predominantly participated in the transforming growth factor-β(TGF-β)signaling pathway and related pathways.The top ten differentially expressed genes with the highest relevance scores using PPI and Cytoscape software were identified,including sirtuin 1(SIRT1),signal transducer and activator of transcription 3,estrogen receptor 1,H3.3 histone B,nuclear receptor corepressor 1,interferon regulatory factor 4,interleukin-1 Beta,dicer 1 ribonuclease Ⅲ,histone deacetylase 1(HDAC1),and DEAD-box helicase.Conclusion miR-22-3p,miR-4284,and others are crucial in the pathogenesis of pediatric FM,possibly related to the expression levels of SIRT1 and HDAC1 regulated,with mechanisms that may exert biological effects via the PI3K/Akt,TGF-β,and other signaling pathways.

Objective:To investigate the clinical efficacy of Yiqi Yangyin decoction combined with metformin and irbesartan in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. Methods:A case-control study was performed to retrospectively analyze the clinical data of 92 patients with type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. These patients received treatment at the First People's Hospital of Huzhou from February 2021 to April 2023. They were divided into two groups, with 46 patients in each group, based on different treatment methods. The control group received metformin and irbesartan, while the observation group was treated with Yiqi Yangyin decoction in addition to the treatment provided to the control group. Both groups underwent treatment for 1 month. The clinical efficacy of the two groups was evaluated, and the changes in traditional Chinese medicine symptom scores, blood glucose levels, blood pressure, and the occurrence of adverse reactions were compared between the two groups before and after treatment. Results:The total response rate of the observation group was 93.48% (43/46), which was significantly higher than that of the control group [82.61% (38/46), χ2 = 5.63, P < 0.05). After treatment, the traditional Chinese medicine symptom score for the observation group was (9.43 ± 2.11) points, which was significantly lower than that of the control group [(12.11 ± 2.32) points, t = 11.34, P < 0.001]. The fasting blood glucose, 2-hour postprandial blood glucose, and glycosylated hemoglobin levels in the observation group were (7.51 ± 1.34) mmol/L, (9.06 ± 2.11) mmol/L, and (6.23 ± 0.76)%, respectively, all of which were significantly lower than those in the control group [(8.75 ± 2.12) mmol/L, (11.15 ± 2.43) mmol/L, (7.11 ± 1.02)%, t = 4.13, 6.14, 4.01, all P < 0.05]. The systolic blood pressure in the observation group was (125.48 ± 8.14) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than that in the control group [(131.32 ± 9.22) mmHg, t = 6.76, P < 0.001]. The difference in the incidence of adverse reactions between the two groups was not statistically significant ( P > 0.05). Conclusion:Yiqi Yangyin decoction combined with metformin and irbesartan is highly effective in treating type 2 diabetes complicated by hypertension with qi and yin deficiency syndrome. This combined therapy can effectively lower the traditional Chinese medicine symptom score, improve patients' blood glucose and blood pressure levels, and has a low incidence of adverse reactions.