1.Traditional Chinese Medicine Regulates Signaling Pathways Related to Precancerous Lesions of Gastric Cancer: A Review
Maofu ZHANG ; Xinyu LI ; Yanyun SHEN ; Yeyuan LIU ; Jialin ZHONG ; Lulu CHEN ; Haihong ZHAO ; Zhongyang SONG ; Zhiming ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):297-306
Precancerous lesions of gastric cancer (PLGC) are a group of pathological changes caused by abnormalities in the structure, morphology, and differentiation of gastric mucosal epithelial cells. Since the early symptoms are hidden and non-specific, PLGC is not easy to be diagnosed and it has often developed into intermediate or advanced gastric cancer once being diagnosed and missed the best time for treatment. Accordingly, the incidence of this disease is increasing year by year, which lifts a heavy burden on the patients. The pathogenesis of PLGC is complex, involving inflammatory microenvironment, bile reflux, glycolysis, autophagy, and apoptosis. Currently, PLGC is mainly treated with anti-inflammatory and endoscopic therapies, which are difficult to curb the development of PLGC. Therefore, seeking a safe and effective therapy is an important topic of modern research. Traditional Chinese medicine (TCM), characterized by treatment based on syndrome differentiation and a holistic view, exerts effects via multiple pathways, mechanisms, and targets. Recent studies have confirmed that TCM can regulate the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR), Wnt/β-catenin, Sonic Hedgehog, nuclear factor-κB (NF-κB), Janus kinase/signal transducer and activator of transcription (JAK/STAT), hypoxia-inducible factor-1α (HIF-1α), neurogenic locus notch homolog protein (Notch), nuclear factor E2-related factor 2 (Nrf2) and other signaling pathways. By targeting these pathways, TCM can inhibit aerobic glycolysis, reduce oxidative stress, repair the inflammatory microenvironment, regulate cellular autophagy, and promote vascular normalization, thereby delaying or reversing PLGC. However, few researchers have systematically summarized the TCM regulation of PLGC-associated pathways. By reviewing the relevant articles at home and abroad, this paper summarized the roles of the above signaling pathways in the development of PLGC and the research progress in the regulation of signaling pathways by TCM in the treatment of PLGC, with a view to providing a new theoretical basis for the clinical research on PLGC and the drug development for this disease.
2.Community resilience evaluation index system based on Delphi method for emergent major infectious diseases
Wen SUN ; Zhen LI ; Jialin CHEN ; Hao XU ; Li WEI ; Xiaoxiao WU
Journal of Public Health and Preventive Medicine 2025;36(2):6-11
Objective To establish a scientific, comprehensive, and operable community resilience evaluation index system for emergent major infectious diseases. Methods Based on the social ecosystem theory, a preliminary evaluation index system was formed by using content analysis and boundary analysis. The index system was then supplemented and revised through panel discussions. The final index system and index weights were clarified by two rounds of Delphi method. Results The expert positive coefficient, expert authority coefficient, and expert coordination coefficient of the two rounds of expert consultations were examined. According to the screening principle of the “threshold method”, the indicators were screened, and the weights of each indicator were determined in the second round of Delphi expert consultation. The analysis of the reliability of the indicator system showed Cronbach's α= 0.399 , indicating that the indicator system had a relatively high reliability. Factor analysis was carried out on 7 primary indicators, and the measure of sampling adequacy (MSA) values were all greater than 0.5, which passed the validity test. Conclusion A set of evaluation index system that can accurately reflect the resilience level of communities with emergent major infectious diseases has been constructed, including 7 primary indicators, 21 secondary indicators, 54 tertiary indicators, and 108 tertiary indicators, which has realized the quantitative evaluation of the hidden resilience level of communities.
3.Retrospective Study on Tongue Image Characteristics of Patients with Glucolipid Metabolism Disorders with Different Traditional Chinese Medicine Syndromes
Shi LIU ; Yang GAO ; Tao JIANG ; Zhanhong CHEN ; Jialin DENG ; Jiatuo XU
Journal of Traditional Chinese Medicine 2025;66(8):826-833
ObjectiveTo explore the distribution pattern of tongue image characteristics in patients with glucolipid metabolic disorders and its main syndromes. MethodsA total of 841 patients with glucolipid metabolic disorders (disease group), and 380 healthy subjects (control group) were included. The disease group was classified into three syndrome types: 283 cases of liver depression and spleen deficiency syndrome, 311 cases of phlegm-dampness obstruction syndrome, and 247 cases of qi stagnation and blood stasis syndrome. Tongue image data were collected using the TFDA-1 Tongue Diagnosis Instrument, and the TDAS V3.0 software was used to analyze the color, texture, and morphological features of the tongue body (TB) and tongue coating (TC) in patents with different syndromes of disease group (including lightness (L), red-green axis (a), yellow-blue axis (b), luminance (Y), difference between red signal and brightness (Cr), difference between blue signal and brightness (Cb), contrast (CON), angular second moment (ASM), entropy (ENT), mean value (MEAN), tongue coating area/tongue surface area (perAll), and tongue coating area/non-coated area (perPart)). Logistic regression analysis was conducted to identify influencing factors for different syndrome types of glucolipid metabolic disorders. ResultsThe tongue body indicators TB-L, TB-Y, and TB-Cb in the disease group were significantly higher than those in the control group, while TB-a, TB-b, and TB-Cr were significantly lower. The tongue coating indicators TC-L, TC-Y, TC-Cb, perAll, and perPart in the disease group were significantly higher than those in the control group, while TC-a, TC-b, and TC-Cr were significantly lower (P<0.05). Comparing with the different syndromes in disease group, the TB-L and TB-Y of the liver depression and spleen deficiency syndrome, and the phlegm-damp obstruction syndrome were higher than those of the qi stagnation and blood stasis syndrome; the TB-a and TB-Cr of the phlegm-damp obstruction syndrome were lower than those of the qi stagnation and blood stasis syndrome; the perAll of the phlegm-damp obstruction syndrome was higher than that of the qi stagnation and blood stasis syndrome (P<0.05). In the analysis of the morphological characteristics of tongue signs, more spotted tongue in disease group compared with control group, more teeth-marked tongue in liver depression and spleen deficiency syndrome than the other two syndromes, more greasy coating in phlegm-damp obstruction syndrome, and more stasis spots of tongue in qi stagnation and blood stasis syndrome (P<0.05). Logistic regression analysis identified that greasy coating, spotted tongue, stasis spots of tongue, tooth-marked tongue, perAll, and TB-Cb are the influencing factors of liver depression and spleen deficiency syndrome; greasy coating, tooth-marked tongue, TC-Cb, and TC-Cr are the influencing factors of phlegm-damp obstruction syndrome; cracked tongue, stasis spots of tongue, tooth-marked tongue, and TB-Y are the influencing factors of qi stagnation and blood stasis syndrome (P<0.05). ConclusionCompared to healthy individuals, patients with glycolipid metabolic disorder have darker tongue color and thicker, greasy tongue coating. Glycolipid metabolic disorder patients of liver depression and spleen deficiency syndrome exhibit a reddish tongue with finer textures and more tooth marks; patients of phlegm-damp obstruction syndrome have lighter tongue coating with a coarser texture and a higher prevalence of greasy coating; patients of qi stagnation and blood stasis syndrome display lower tongue brightness with a higher prevalence of blood stasis spots.
4.Research on the standardization of living will model texts based on the Delphi method
Hongjun CHEN ; Wenyue DONG ; Jialin FU ; Xuanyun WANG ; Dingyi WANG ; Yue WANG
Chinese Medical Ethics 2025;38(4):512-521
ObjectiveTo develop a standardized living will manual suitable for promotion in China, combining existing literature and the current implementation status of living will both domestically and internationally as well as the characteristics of modern medicine. MethodsA pool of manual entries was constructed through hospital interviews and literature retrieval. A Delphi method expert correspondence was conducted to modify and supplement the manual entry settings. The results of the correspondence were statistically analyzed to verify the reliability and scientific validity of the manual and the correspondence. ResultsThis study constructed a pool of manual entries by conducting interviews in four hospitals in Beijing and retrieving and including 155 pieces of literature,and developed a preliminary version of the manual with a total of 40 entries in four sections, namely medicine, psychology, society, and farewell. The manual items were revised through two rounds of the Delphi method correspondence with a total of 88 experts. The expert response rates in the two rounds of the correspondence questionnaires were 100% and 90%, respectively; the expert authority coefficients were 0.84 and 0.865, respectively; and Kcndall W was 0.141 and 0.077, respectively. In terms of the reliability test, the Cronbach’s α coefficients of the two rounds of correspondence were 0.941 and 0.969, respectively, and the Guttman coefficients were 0.862 and 0.857, respectively. As for the validity test, the Pearson correlation coefficient for 39 entries was R>0.4 in the first round of correspondence, and for 41 entries was R>0.4 in the second round of correspondence; a total of 20 entries in the first round of correspondence had an I-CVI ≥ 0.780, and the scale’s S-CVI was 0.786; a total of 31 entries in the second round of correspondence had an I-CVI ≥ 0.780, and the scale’s S-CVI was 0.846. Meanwhile, this study developed a legal instrument section of the manual including personal information, effective time, modification and revocation, witnesses, and other contents by reviewing relevant laws and regulations both domestically and internationally. ConclusionThe standardized living will manual is comprehensive, reliable, and scientific, which makes it suitable for promotion and further improvement.
5.Advantages and application strategies of machine learning in diagnosis and treatment of lumbar disc herniation
Weijie YU ; Aifeng LIU ; Jixin CHEN ; Tianci GUO ; Yizhen JIA ; Huichuan FENG ; Jialin YANG
Chinese Journal of Tissue Engineering Research 2024;28(9):1426-1435
BACKGROUND:Based on different algorithms of machine learning,how to carry out clinical research on lumbar disc herniation with the help of various algorithmic models has become a trend and hot spot in the development of intelligent medicine at present. OBJECTIVE:To review the characteristics of different algorithmic models of machine learning in the diagnosis and treatment of lumbar disc herniation,and summarize the respective advantages and application strategies of algorithmic models for the same purpose. METHODS:The computer searched PubMed,Web of Science,EMBASE,CNKI,WanFang,VIP and China Biomedical(CBM)databases to extract the relevant articles on machine learning in the diagnosis and treatment of lumbar disc herniation.Finally,96 articles were included for analysis. RESULTS AND CONCLUSION:(1)Different algorithm models of machine learning provide intelligent and accurate application strategies for clinical diagnosis and treatment of lumbar disc herniation.(2)Traditional statistical methods and decision trees in supervised learning are simple and efficient in exploring risk factors and establishing diagnostic and prognostic models.Support vector machine is suitable for small data sets with high-dimensional features.As a nonlinear classifier,it can be applied to the recognition,segmentation and classification of normal or degenerative intervertebral discs,and to establish diagnostic and prognostic models.Ensemble learning can make up for the shortcomings of a single model.It has the ability to deal with high-dimensional data and improve the precision and accuracy of clinical prediction models.Artificial neural network improves the learning ability of the model,and can be applied to intervertebral disc recognition,classification and making clinical prediction models.On the basis of the above uses,deep learning can also optimize images and assist surgical operations.It is the most widely used model with the best performance in the diagnosis and treatment of lumbar disc herniation.The clustering algorithm in unsupervised learning is mainly used for disc segmentation and classification of different herniated segments.However,the clinical application of semi-supervised learning is relatively less.(3)At present,machine learning has certain clinical advantages in the identification and segmentation of lumbar intervertebral discs,classification and grading of the degenerative intervertebral discs,automatic clinical diagnosis and classification,construction of the clinical predictive model and auxiliary operation.(4)In recent years,the research strategy of machine learning has changed to the neural network and deep learning,and the deep learning algorithm with stronger learning ability will be the key to realizing intelligent medical treatment in the future.
6.Medication Patterns of Chinese Medicines for Neurodermatitis Based on Contemporary Medical Cases
Shuguang CHEN ; Xuemin WANG ; Fanghong DUAN ; Lele CHEN ; Jialin TENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):206-213
ObjectiveTo mine the medication patterns of Chinese medicines for neurodermatitis based on contemporary medical cases in published articles. MethodThe medical cases of treating neurodermatitis with Chinese medicines were retrieved from the medical case articles published by contemporary famous and old Chinese medicine doctors in the library of Shandong University of Traditional Chinese Medicine, CNKI, VIP, and Wanfang Data. A case library was established, and SPSS Statistics 26.0 and SPSS Modeler 18.0 were employed to analyze the symptoms and syndromes of neurodermatitis and mine the medication patterns. ResultAccording to the inclusion and exclusion criteria, 130 medical case articles were included in this study. Neurodermatitis was prevalent in young adults between 20 and 39 years old (female patients of 30-49 years old and male patients of 20-39 years old), and male patients were more than female patients. The patients mainly presented the clinical manifestations of itchy rashes, thickened skin, and lichenification. Symptoms included skin injury, emotional abnormalities, and Yin damage caused by prolonged illness. Red tongue, thin white or yellow tongue coating, and wiry pulse were common in the patients. The patients with the syndrome of blood deficiency and wind dryness were often treated with Angelicae Sinensis Radix, Rehmanniae Radix, Glycyrrhizae Radix et Rhizoma, Tribuli Fructus, and Chuanxiong Rhizoma. The commonly used herb pairs included Chuanxiong Rhizoma-Paeoniae Radix Alba, Chuanxiong Rhizoma-Glycyrrhizae Radix et Rhizoma, and Rehmanniae Radix Praeparata-Saposhnikoviae Radix, and the commonly used prescriptions were Siwutang and Dangguiyinzi. The patients with the syndrome of muscle and skin dystrophy were mainly treated with Rehmanniae Radix, Sophorae Flavescentis Radix, Paeoniae Radix Alba, Tribuli Fructus, and Dictamni Cortex. The commonly used herb pairs included Polygoni Multiflori Caulis-Sophorae Flavescentis Radix, Polygoni Multiflori Caulis-Dictamni Cortex, and Salviae Miltiorrhizae Radix et Rhizoma-Paeoniae Radix Alba, and the commonly used prescriptions were Jingjie Siwutang and Baixianpiyin. The patients with the syndrome of liver depression transforming into fire were often treated with Rehmanniae Radix, Gentianae Radix et Rhizoma, Gardeniae Fructus, Bupleuri Radix, and Scutellariae Radix. The commonly used herb pairs included Gentianae Radix et Rhizoma-Polygoni Multiflori Caulis, Polygoni Multiflori Caulis-Gardeniae Fructus, and Gentianae Radix et Rhizoma-Saposhnikoviae Radix, and the commonly used prescriptions were Longdan Xiegantang and Danzhi Xiaoyaosan. ConclusionThis study enriches the knowledge about neurodermatitis, clarifies the treatment principles and methods as well as the medication patterns, and provides a theoretical basis for clinical treatment and medication based on syndrome differentiation.
7.Discussing the new implications of"toxins damaging brain collaterals"from the pathogenesis of acquired cerebral amyloid angiopathy
Fan ZHANG ; Jialin LIU ; Junchen JIANG ; Yuanxin ZHANG ; Junlong CHEN ; Jinmin LIU
Journal of Beijing University of Traditional Chinese Medicine 2024;47(5):598-602
Acquired cerebral amyloid angiopathy,as a cerebrovascular disease discovered in recent years,mainly spreads through iatrogenic factors.This paper focuses on acquired cerebral amyloid angiopathy and delves into the new applications and profound implications of the"toxins damaging brain collaterals"theory proposed by academician WANG Yongyan in stroke research.Starting from the perspective of"toxins damaging brain collaterals",it comprehensively analyzes the causes and pathological mechanisms of acquired cerebral amyloid angiopathy,emphasizing the importance of external toxins,latent toxins,and turbid toxins in understanding the pathogenesis of the disease.It reveals that"toxins damaging brain collaterals"is the core mechanism of acquired cerebral amyloid angiopathy.On this basis,it proposes a new connotation of"toxins damaging brain collaterals":first,"toxin"includes both internal and external toxins;second,the organic integration of"external wind theory"and"toxins damaging brain collaterals"guides the improvement of theoretical research,clinical treatment,and prevention strategies for stroke,and promotes a deeper understanding of the disease.This approach to understanding acquired cerebral amyloid angiopathy from the perspective of"toxins damaging brain collaterals"not only demonstrates the effective integration of traditional Chinese medicine theory and modern biomedical science,but also provides insights and references for the clinical diagnosis and treatment of the disease.
8.Exploring Mechanism of Neferine in Promoting Vascular Regeneration Against Cerebral Ischemia Based on Mitochondrial MCU Channel
Qiman ZHANG ; Yanhua GAO ; Wenjie WU ; Wei YANG ; Chen LIU ; Shuting LI ; Bingjie CAI ; Jialin YANG ; Ying ZHANG ; Jing MA ; Shaojing LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):103-113
ObjectiveTo investigate the mechanism of neferine(Nef) in promoting vascular regeneration against cerebral ischemia through modulation of mitochondrial calcium uniporter(MCU) ion channel. MethodTaking the area of subintestinal vessels in microvascular deficiency zebrafish as an index, the vascular regenerative efficacy of Nef was evaluated, and the median effective concentration(EC50) was calculated. Rats were randomly divided into a sham operation group, a model group, a positive drug group(butylphthalide, 6 mg·kg-1), and Nef low, medium, and high dose groups(0.125, 0.625, 3.125 μg·kg-1). Except for the sham operation group, the middle cerebral artery occlusion(MCAO) model was established in other groups. After modeling, the groups were administered the corresponding dose of drugs by gavage, while the sham operation and model groups received equal volumes of saline, once a day for 7 consecutive days. Neurobehavioral scores were assessed for each group of rats, and the infarct rate of ischemic brain tissue was calculated by 2,3,5-triphenyltetrazolium chloride(TTC) staining. The regional cerebral blood flow(rCBF) of each group was measured using a speckle contrast imaging. Immunofluorescence and Western blot were conducted to detect the expression of vascular endothelial growth factor(VEGF), platelet endothelial cell adhesion molecule-1(CD31), and hypoxia-inducible factor-1α(HIF-1α) proteins in each group. Human umbilical vein endothelial cells(HUVECs) were divided into the normal group, model group, positive drug group(astragaloside Ⅳ, 10 μmol·L-1), and Nef group (32 nmol·L-1). In the verification of mitochondrial protection of Nef and its mechanism in promoting vascular regeneration, the spermine(MCU agonist) and Nef+spermine group were added. HUVECs model of oxygen-glucose deprivation(OGD) was established in all groups except the normal group, the cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assay, and cell migration ability was evaluated through scratch and tube formation assays. Fluorescent probes(Rhod-2 AM, Fluo-3 AM, JC-1, Calcein AM) and a cellular energy metabolism analyzer were used to analyze the mitochondrial protective effects of Nef. Molecular docking was performed to predict the binding ability of Nef with MCU and HIF-1α, and Western blot was used to detect the effects of Nef on the protein expressions of MCU, B-cell lymphoma-2 associated X protein(Bax), Caspase-3 and HIF-1α in the OGD model HUVECs. ResultThe results of vascular regeneration in microvascular deficiency zebrafish showed that compared to the normal group, the area of subintestinal vessels in the model group significantly decreased(P<0.01). Compared to the model group, different concentrations of Nef could significantly increase the area of subintestinal vessels(P<0.01), with the maximum tolerated concentration of 10.24 μmol·L-1 and the EC50 of 0.23 μmol·L-1. Anti-cerebral ischemia results on MCAO rats showed that compared to the sham operation group, the model group had a significant decrease in rCBF and a significant increase in infarct rate, while CD31 expression significantly decreased(P<0.01), and VEGF and HIF-1α protein expressions significantly increased(P<0.05). Compared to the model group, the treated groups showed significant increases in rCBF, significant reductions in infarct volume, and significant increases in CD31, VEGF, and HIF-1α protein expression(P<0.01). Cell experiment results showed that compared to the normal group, the model group had decreased cell viability and migration ability, increased intracellular Ca2+ and mitochondrial Ca2+ levels, reduced mitochondrial permeability transition pore(MPTP) opening, and decreased mitochondrial energy metabolism capability, with increased expressions of MCU, Bax, Caspase-3 and HIF-1α proteins(P<0.05, P<0.01). Compared to the model group, the Nef group showed increased cell viability and migration ability, decreased intracellular Ca2+ and mitochondrial Ca2+ levels, increased MPTP opening, enhanced mitochondrial energy metabolism capability, decreased expressions of MCU, Bax and Caspase-3 proteins, and increased HIF-1α protein expression(P<0.05, P<0.01). ConclusionNef can stabilize mitochondrial membrane potential and inhibit mitochondrial apoptosis. By down-regulating the expression of MCU, it suppresses the activation of intracellular Bax and Caspase-3 while activating the HIF-1α signaling pathway, enhancing the expression of VEGF and CD31, thereby promoting vascular regeneration to treat ischemic brain injury.
9.The mediating role of family support between type D personality and intolerance of uncertainty in first-stroke patients
Xiaoping YANG ; Huijuan WANG ; Xiaohui LIU ; Haihua GAO ; Jialin YUAN ; Miaomiao CHEN ; Lijun WANG
Chinese Journal of Practical Nursing 2024;40(7):548-555
Objective:To analyze the status quo of type D personality, intolerance of uncertainty and family support in first-episode stroke patients, and to explore the mediating role of family support between type D personality and intolerance of uncertainty in first-episode stroke patients, in order to provide reference for formulating relevant clinical intervention measures to promote the physical and mental health of first-episode stroke patients.Methods:This study was a cross-sectional investigation. A total of 300 patients with acute first-episode stroke who met the inclusion and exclusion criteria in the Department of Neurology of the General Hospital of Ningxia Medical University and the First People′s Hospital of Yinchuan from May 2023 to September 2023 were selected as the study objects by convenience sampling method. The general data questionnaire, Type D personality Scale-14, Family Caring Index Scale and the Intolerance of Uncertainty Scale were used to investigate them. Pearson correlation analysis was used to test the correlation between variables, and SPSS plug-in PROCESS 3.5 was used to test the mediation effect.Results:Finally, 300 questionnaires were effectively collected, including 228 males and 72 females. Patients aged ≥ 60 years old were the majority, accounting for 49.3% (148/300). The detection rate of type D personality in the first stroke patients was 37.3% (112/300), and the total score of Type D personality inventory, family support and intolerance of uncertainty of type D personality in the first stroke patients were (22.16 ± 9.95), (6.40 ± 2.23), (27.82 ± 7.93) points. The correlation analysis results showed that the intolerance of uncertainty of type D personality in the first stroke patients was positively correlated with type D personality scores ( r=0.675, P<0.001). There was a negative correlation with family support score ( r=-0.644, P<0.001). The results of mediating effect analysis showed that family support played a partial mediating role in the relationship between type D personality and intolerability of uncertainty in first-stroke patients, and the mediating effect accounted for 34.94% of the total effect. Conclusions:The mediating role of family support between type D personality and intolerability of uncertainty in first-stroke patients is established. In the future, the level of family support of patients can be continuously improved to reduce their intolerability of uncertainty, so as to promote the physical and mental health of patients and improve their quality of life.
10.Pharmacological Effect of Nuanxinkang Powder on Ventricular Remodeling in Post-infarction Mice Through"Metabolic-Inflammatory"Network Regulating Macrophage Polarization
Zhijun LIN ; Zixin CHEN ; Jialin JIANG ; Xin DONG ; Zhuoji GUAN ; Lingjun WANG
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(2):159-167
Objective To explore the mechanism of Nuanxinkang Powder(aka.NXK,composed of Ginseng Radix et Rhizoma Rubra and Ilex Pubescens Radix)on improving ventricular remodeling in post-infarction mice based on the"metabolic-inflammatory"network regulating macrophage polarization.Methods ①Thirty C57BL/6J male mice were randomly divided into three groups:sham-operation group,model group,and NXK group(1.65 g·kg-1),with 10 mice in each group;the mouse model of myocardial infarction was replicated using left anterior descending coronary artery ligation;and the drug was administered by gavage once a day for 4 consecutive weeks.Masson staining was used to detect collagen deposition in myocardial tissue;ultrasound was used to detect cardiac function in mice:left ventricular ejection fraction(LVEF),left ventricular anterior wall thickness at end-systole(LVAWS)and left ventricular anterior wall thickness at end-diastole(LVAWD);flow cytometry was used to detect distribution of cardiac macrophages in mice;qPCR was used to detect mRNA expressions of lactate dehydrogenase A(LDHA),carnitine palmitoyltransferase 1(CPT-1),glucose transport protein 4(GLUT4),isocitrate dehydrogenase(IDH),and succinate dehydrogenase(SDHa)in heart tissue.②NXK was given 1.15 g·kg-1 NXK suspension to rats by gavage twice a day for 5 consecutive days to prepare NXK-containing serum.Lipopolysaccharide(LPS)-induced RAW 264.7 cells were used to construct a pro-inflammatory macrophage model.The cells were grouped into the following groups:blank serum control group(medium containing 5%blank serum+5%fetal bovine serum),NXK drug-containing serum group(medium containing 5%NXK drug-containing serum+5%fetal bovine serum),lipopolysaccharide group(medium containing 5%blank serum+5%fetal bovine serum+200 μg·mL-1 lipopolysaccharide),NXK drug-containing serum+ lipopolysaccharide group(medium containing 5%NXK drug-containing serum+5%fetal bovine serum+200 μ g·mL-1 lipopolysaccharide),all the groups were intervened for 16 hours.Glycolysis stress test was used to detect the level of glycolysis in RAW 264.7 cells;qPCR was used to detect the mRNA expression of mitochondrial pyruvate carrier(MPC1)in RAW 264.7 cells;and MitoSox Red fluorescent staining was used to detect the level of oxidative stress damage in mitochondria of RAW 264.7 cells.Results ①Compared with the sham-operation group,the blue-stained area of cardiac collagen fibres in mice of the model group was significantly increased,accompanied by thinning of the ventricular wall and enlargement of the left ventricular cavity;cardiac function indexes,such as LVEF,LVAWS,LVAWD,etc.,were all significantly reduced(P<0.01,P<0.001);the mRNA expressions of LDHA and CPT-1 were significantly up-regulated in the cardiac tissues of mice(P<0.05),and the mRNA expressions of GLUT4,IDH and SDHa were significantly down-regulated(P<0.05,P<0.01),and CD86 staining positive cell was significantly increased(P<0.001).Compared with the model group,mice in the NXK group showed a significant decrease in cardiac collagen fiber deposition and an increase in the thickness of the ventricular wall;cardiac function indexes such as LVEF,LVAWS and LVAWD were significantly increased(P<0.05,P<0.01,P<0.001);and the mRNA expressions of LDHA and CPT-1 in the cardiac tissues of the mice were significantly down-regulated(P<0.01,P<0.001),mRNA expressions of GLUT4,SDHa and IDH were significantly up-regulated(P<0.01),and the number of CD86 positive cells was significantly reduced(P<0.001).②Compared with the blank serum control group,the cytosolic glycolysis level and ROS level of macrophages in the NXK serum-containing group did not change significantly(P>0.05),whereas the glycolysis level and ROS level of macrophages in the lipopolysaccharide group were significantly increased(P<0.01),and the mRNA expression of MPC1 was significantly down-regulated(P<0.001).Compared with the lipopolysaccharide group,the macrophage glycolysis level and ROS level were significantly reduced in the NXK serum-containing + lipopolysaccharide group(P<0.05,P<0.01),and mRNA expression of MPC1 was significantly up-regulated(P<0.001).Conclusion NXK can reduce myocardial fibrosis and ventricular remodeling after myocardial infarction and improve cardiac function in mice,and its mechanism may be related to the down-regulation of mRNA expression of LDHA in cardiac tissues,the up-regulation of mRNA expression of GLUT4,the improvement of cardiac glucose uptake after myocardial infarction,the inhibition of pro-inflammatory macrophage glycolysis,the increase in the expressions of SDHa and IDH to alleviate the accumulation of succinate and citrate,and the reduction of reactive oxygen species(ROS)generation,thereby reducing pro-inflammatory macrophage hyperpolarisation.


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