1.Huanglian Jiedutang Improves Myelin Damage and Agitated Behavior in Vascular Dementia by Regulating Microglial Polarization via CD22/SHP-1/p-Akt Signaling Pathway
Chen CHEN ; Xiaoxia FENG ; Shiting LIANG ; Xinxian SHI ; Guang YANG ; Jing QIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):25-33
ObjectiveTo investigate the mechanisms by which Huanglian Jiedutang (HLJDT) modulates microglial (MG) phenotypes through the sialic acid-binding Ig-like lectin 2 (SIGLEC2/CD22)/Src-homology-2-domain-containing protein tyrosine phosphatase-1 (SHP-1)/phosphorylated protein kinase B (p-Akt) signaling pathway, thereby promoting myelin repair and alleviating agitation-like behaviors in vascular dementia (VAD). MethodsSixty C57BL/6J mice were randomly assigned to a sham (normal) group, model group, HLJDT low-, medium-, and high-dose groups (2.5, 5, and 10 g·kg-1·d-1), and a risperidone group (2 mg·kg-1·d-1), with 10 mice per group. VAD was induced by bilateral common carotid artery stenosis (BCAS). From day 42, mice received drug interventions for 2 weeks. Agitation-like behaviors were assessed using the resident-intruder test. After behavioral testing, ventrolateral part of the ventromedial hypothalamus (VMHvl) tissues were collected. Western blot was used to measure protein levels of myelin oligodendrocyte glycoprotein (MOG), myelin basic protein (MBP), proteolipid protein (PLP), inducible nitric oxide synthase (iNOS), arginase-1 (Arg1), CD86, CD206, and CD22, SHP-1, and p-Akt. Immunofluorescence was used to evaluate myelin-associated glycoprotein (MAG) intensity and the proportion of iNOS+/ionized calcium-binding adapter molecule 1 (Iba1)+ cells. ELISA was used to detect tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-1β. ResultsCompared with the normal group, the model group exhibited markedly increased biting and aggressive behaviors and shortened attack latency (P<0.01). MOG, MBP, and PLP protein levels and MAG fluorescence intensity were significantly reduced (P<0.05, P<0.01). INOS and CD86 expression and TNF-α, IL-6, and IL-1β levels were significantly elevated (P<0.01). CD22 and SHP-1 expression increased significantly (P<0.01), whereas p-Akt expression decreased (P<0.01). Compared with the model group, the medium- and high-dose HLJDT groups and the risperidone group showed markedly reduced biting and aggression (P<0.05, P<0.01) and prolonged attack latency (P<0.01). MOG, MBP, and PLP levels and MAG fluorescence intensity were significantly increased (P<0.05, P<0.01). INOS, CD86, TNF-α, IL-6, and IL-1β levels decreased significantly (P<0.05, P<0.01). CD22 and SHP-1 expression decreased, while p-Akt expression increased significantly (P<0.05, P<0.01). ConclusionHLJDT may modulate CD22/SHP-1/p-Akt signaling in the VMHvl, promote the shift of MG toward an anti-inflammatory and phagocytic phenotype, enhance myelin repair, and improve agitation-like behaviors in VAD mice.
2.Effect of Quercetin on Improving Myelin Sheath Injury and Neuropsychiatric Symptoms of VaD by Inhibiting Activation of Microglia in mPFC via RIPK1/NLRP3/Caspase-1 Pathway
Shiting LIANG ; Xinxian SHI ; Chen CHEN ; Xiaoxia FENG ; Jing QIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):126-134
ObjectiveTo investigate the ameliorative effects of quercetin on neuropsychiatric symptoms associated with vascular dementia (VaD) and to elucidate the molecular mechanism, specifically whether quercetin inhibits pro-inflammatory activation of microglia by modulation of the receptor-interacting serine/threonine-protein kinase 1 (RIPK1)/NOD-like receptor protein 3 (NLRP3)/Caspase-1 signaling pathway, thereby promoting myelin repair in the medial prefrontal cortex (mPFC). MethodsA C57BL/6J mouse model of VaD with neuropsychiatric symptoms was established by bilateral common carotid artery stenosis (BCAS) combined with chronic restraint stress (CRS). Mice were randomly divided into a sham group, a model group, low-dose, medium-dose, and high-dose quercetin groups (30, 60, 120 mg·kg-1·d-1), and a fluoxetine group (10 mg·kg-1·d-1). After intervention, depressive- and anxiety-like behaviors were assessed by the sucrose preference test (SPT), forced swim test (FST), open field test (OFT), and elevated plus maze (EPM). mPFC tissue was collected. Immunofluorescence (IF) was used to detect myelin basic protein (MBP) expression and microglial morphology. Western blot was used to measure the protein level of MBP, myelin oligodendrocyte glycoprotein (MOG), myelin-associated glycoprotein (MAG), inducible nitric oxide synthase (iNOS), CD86, RIPK1, phosphorylated RIPK1 (Ser166), NLRP3, and Caspase-1. Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β). ResultsCompared with the sham group, the model group exhibited significant depressive- and anxiety-like behaviors (P<0.01), significantly decreased protein expression of MBP, MOG, and MAG in the mPFC (P<0.01), activated microglia (characterized by enlarged cell bodies, reduced protrusions, and upregulated iNOS and CD86 expressions, P<0.01), and significantly elevated p-RIPK1/RIPK1 ratio, NLRP3, Caspase-1 protein expression, and level of TNF-α, IL-6, and IL-1β (P<0.01, P<0.05). Compared with the model group, the quercetin treatment (especially at medium and high doses) significantly ameliorated these behavioral abnormalities (P<0.05, P<0.01), increased the expression of MBP (protein and fluorescence intensity), MOG, and MAG in the mPFC (P<0.05, P<0.01), suppressed excessive microglial activation (characterized decreased cell bodies, increased protrusions, and downregulated iNOS and CD86 expressions, P<0.01), and significantly reduced the p-RIPK1/RIPK1 ratio, NLRP3, Caspase-1 protein expression, and inflammatory cytokine levels (P<0.01). ConclusionQuercetin effectively alleviates neuropsychiatric symptoms in VaD mice. Its mechanism may be associated with the inhibition of microglial inflammatory activation mediated by the RIPK1/NLRP3/Caspase-1 signaling pathway, thereby promoting myelin repair in the mPFC region.
3.Multi-organ inflammatory phenotypes and transcriptomic characterization in an inflammation-driven mouse model of preeclampsia induced by LPS.
Ning WANG ; Jing-Qiu FENG ; Ying XIE ; Meng-Can SUN ; Qi WANG ; Zhe WANG ; Lu GAO
Acta Physiologica Sinica 2025;77(5):775-791
Preeclampsia (PE) is a severe gestational disorder characterized by hypertension and proteinuria, with a subset of cases exhibiting an immune-driven phenotype marked by placental overexpression of proinflammatory cytokines and chronic inflammatory damage, profoundly impacting fetal development. To elucidate the pathophysiology of this PE subtype, we established an inflammation-driven PE mouse model via lipopolysaccharide (LPS) intraperitoneal injection, systematically evaluating histopathological changes in maternal heart, liver, lung, kidney, and placenta, and integrating transcriptomic profiling to uncover molecular mechanisms. LPS administration robustly induced maternal hypertension and proteinuria, hallmarks of PE, without significantly altering organ or fetal weights. Histological analyses revealed pronounced inflammatory damage in the maternal lung, kidney, and placenta, with the lung exhibiting the most severe pathology, characterized by inflammatory cell infiltration, alveolar wall thickening, and interstitial edema-challenging the conventional focus on placental and renal primacy in PE. Placental labyrinth and junctional zones displayed extensive structural disruption and necrosis, indicating functional impairment. Transcriptomic analysis identified 27 inflammation-related genes consistently upregulated across tissues, with protein-protein interaction networks pinpointing Il1β, Il6, Ccl5, Ccl2, Cxcl10, Tlr2, and Icam1 as hub genes. Quantitative PCR validation confirmed Tlr2 as a central regulator, evidenced by significant upregulation of Tlr2 in lung, kidney, and placenta of LPS-induced PE mice, while Cxcl10 exhibited placenta-specific upregulation, suggesting a synergistic inflammatory axis in placental pathology. These findings highlight the lung as a critical, yet underappreciated, target in inflammation-driven PE, reframe the multi-organ inflammatory landscape of the disease, and nominate Tlr2 and Cxcl10 as potential diagnostic biomarkers and therapeutic targets, offering new avenues for precision intervention in PE.
Animals
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Female
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Pregnancy
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Mice
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Pre-Eclampsia/genetics*
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Inflammation
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Lipopolysaccharides/adverse effects*
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Disease Models, Animal
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Transcriptome
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Placenta/pathology*
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Phenotype
4.Identification of GSK3 family and regulatory effects of brassinolide on growth and development of Nardostachys jatamansi.
Yu-Yan LEI ; Zheng MA ; Jing WEI ; Wen-Bing LI ; Ying LI ; Zheng-Ming YANG ; Shao-Shan ZHANG ; Jing-Qiu FENG ; Hua-Chun SHENG ; Yuan LIU
China Journal of Chinese Materia Medica 2025;50(2):395-403
This study identified 8 members including NjBIN2 of the GSK3 family in Nardostachys jatamansi by bioinformatics analysis. Moreover, the phylogenetic tree revealed that the GKS3 family members of N. jatamansi had a close relationship with those of Arabidopsis. RT-qPCR results showed that NjBIN2 presented a tissue-specific expression pattern with the highest expression in roots, suggesting that NjBIN2 played a role in root growth and development. In addition, the application of epibrassinolide or the brassinosteroid(BR) synthesis inhibitor(brassinazole) altered the expression pattern of NjBIN2 and influenced the photomorphogenesis(cotyledon opening) and root development of N. jatamansi, which provided direct evidence about the functions of NjBIN2. In conclusion, this study highlights the roles of BIN2 in regulating the growth and development of N. jatamansi by analyzing the expression pattern and biological function of NjBIN2. It not only enriches the understanding about the regulatory mechanism of the growth and development of N. jatamansi but also provides a theoretical basis and potential gene targets for molecular breeding of N. jatamansi with improved quality in the future.
Brassinosteroids/metabolism*
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Steroids, Heterocyclic/metabolism*
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Gene Expression Regulation, Plant/drug effects*
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Plant Proteins/metabolism*
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Phylogeny
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Nardostachys/metabolism*
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Plant Growth Regulators/pharmacology*
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Plant Roots/drug effects*
5.Effect and mechanism of Xintong Granules in ameliorating myocardial ischemia-reperfusion injury in rats by regulating gut microbiota.
Yun-Jia WANG ; Ji-Dong ZHOU ; Qiu-Yu SU ; Jing-Chun YAO ; Rui-Qiang SU ; Guo-Fei QIN ; Gui-Min ZHANG ; Hong-Bao LIANG ; Shuai FENG ; Jia-Cheng ZHANG
China Journal of Chinese Materia Medica 2025;50(14):4003-4014
This study investigates the mechanism by which Xintong Granules improve myocardial ischemia-reperfusion injury(MIRI) through the regulation of gut microbiota and their metabolites, specifically short-chain fatty acids(SCFAs). Rats were randomly divided based on body weight into the sham operation group, model group, low-dose Xintong Granules group(1.43 g·kg~(-1)·d~(-1)), medium-dose Xintong Granules group(2.86 g·kg~(-1)·d~(-1)), high-dose Xintong Granules group(5.72 g·kg~(-1)·d~(-1)), and metoprolol group(10 mg·kg~(-1)·d~(-1)). After 14 days of pre-administration, the MIRI rat model was established by ligating the left anterior descending coronary artery. The myocardial infarction area was assessed using the 2,3,5-triphenyltetrazolium chloride(TTC) staining method. Apoptosis in tissue cells was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) assay. Pathological changes in myocardial cells and colonic tissue were observed using hematoxylin-eosin(HE) staining. The levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), creatine kinase MB isoenzyme(CK-MB), and cardiac troponin T(cTnT) in rat serum were quantitatively measured using enzyme-linked immunosorbent assay(ELISA) kits. The activities of lactate dehydrogenase(LDH), creatine kinase(CK), and superoxide dismutase(SOD) in myocardial tissue, as well as the level of malondialdehyde(MDA), were determined using colorimetric assays. Gut microbiota composition was analyzed by 16S rDNA sequencing, and fecal SCFAs were quantified using gas chromatography-mass spectrometry(GC-MS). The results show that Xintong Granules significantly reduced the myocardial infarction area, suppressed cardiomyocyte apoptosis, and decreased serum levels of pro-inflammatory cytokines(TNF-α, IL-1β, and IL-6), myocardial injury markers(CK-MB, cTnT, LDH, and CK), and oxidative stress marker MDA. Additionally, Xintong Granules significantly improved intestinal inflammation in MIRI rats, regulated gut microbiota composition and diversity, and increased the levels of SCFAs(acetate, propionate, isobutyrate, etc.). In summary, Xintong Granules effectively alleviate MIRI symptoms. This study preliminarily confirms that Xintong Granules exert their inhibitory effects on MIRI by regulating gut microbiota imbalance and increasing SCFA levels.
Animals
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Gastrointestinal Microbiome/drug effects*
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Rats
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Male
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Myocardial Reperfusion Injury/genetics*
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Drugs, Chinese Herbal/administration & dosage*
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Rats, Sprague-Dawley
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Apoptosis/drug effects*
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Humans
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Tumor Necrosis Factor-alpha/metabolism*
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Interleukin-6/genetics*
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Malondialdehyde/metabolism*
6.Dimeric sesquiterpenoids with anti-inflammatory activities from Inula britannica.
Juan ZHANG ; Jiankun YAN ; Hongjun DONG ; Rui ZHANG ; Jing CHANG ; Yanli FENG ; Xinrong XU ; Wei LI ; Feng QIU ; Chengpeng SUN
Chinese Journal of Natural Medicines (English Ed.) 2025;23(8):961-971
In continuation of research aimed at identifying anti-inflammatory agents from natural sesquiterpenoids, an activity-guided fractionation approach utilizing lipopolysaccharide (LPS)-mediated RAW264.7 cells was employed to investigate chemical constituents from Inula Britannica (I. britannica). Seven novel sesquiterpenoid dimers inulabritanoids A-G (1-7) and two novel sesquiterpenoid monomers inulabritanoids H (8) and I (9) were isolated from I. britannica together with eighteen known compounds (10-27). The structural elucidation was accomplished through comprehensive analysis of 1D and 2D nuclear magnetic resonance (NMR), high-resolution mass spectrometry (HR-MS), and electronic circular dichroism (ECD) spectra, complemented by quantum chemical calculations. Compounds 1, 2, 12, 16, 19, and 26 demonstrated inhibitory effects on NO production, with IC50 values of 3.65, 5.48, 3.29, 6.91, 3.12, and 5.67 μmol·L-1, respectively. Mechanistic studies revealed that compound 1 inhibited IκB kinase β (IKKβ) phosphorylation, thereby blocking nuclear factor κB (NF-κB) nuclear translocation, and activated the kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signal pathway, leading to decreased expression of NADPH oxidase 2 (NOX-2), inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), IL-1β, and IL-1α and increased expression of NAD(P)H: quinone oxidoreductase 1 (NQO-1) and heme oxygenase-1 (HO-1), thus exhibiting anti-inflammatory effects in vitro. These results indicate that dimeric sesquiterpenoids may serve as promising candidates for anti-inflammatory drug development.
Mice
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Animals
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Sesquiterpenes/isolation & purification*
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Anti-Inflammatory Agents/isolation & purification*
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Inula/chemistry*
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RAW 264.7 Cells
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Nitric Oxide
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Molecular Structure
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NF-kappa B/immunology*
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NF-E2-Related Factor 2/immunology*
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Macrophages/immunology*
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Nitric Oxide Synthase Type II/immunology*
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Plant Extracts/pharmacology*
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Lipopolysaccharides
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Tumor Necrosis Factor-alpha/immunology*
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I-kappa B Kinase/genetics*
7.Guided by National Strategic Needs,Striving to Build a First-Class Forensic Medicine Discipline—The Construction Plan for Forensic Medicine at Southern Medical University
Dong-Fang QIAO ; Ping-Ming QIU ; Qi WANG ; Yun-Chun TAI ; Dong-Ri LI ; Jing-Tao XU ; Qi-Zhi LUO ; En-Ping HUANG ; Bo-Feng ZHU
Journal of Forensic Medicine 2025;41(1):15-19
The 2024 National Education Work Conference pointed out that at the current juncture of the critical period for achieving the goals and tasks of the 14th Five-Year Plan,the implementation of the Education Powerhouse Construction Plan Outline should be taken as the main line of work,and building first-class disciplines is an crucial task for a higher education powerhouse.In 2022,forensic medicine was officially listed as a first-level discipline under the medical category,presenting an un-precedented historical opportunity for the development of forensic medicine.The forensic medicine dis-cipline of Southern Medical University comprehensively improves the quality of talent cultivation and facilitates the construction of first-class disciplines as its main direction.It aims to initiate and imple-ment a high-level faculty team building plan featuring"combining recruitment and cultivation,inter-disciplinary integration";make vigorous efforts to establish a first-level doctoral program,refine advan-tageous second-level disciplines and research directions;and establish an innovative research platform from a high starting point with deep integration.The discipline adheres to moral cultivation and the Five Domains of Education simultaneous development,to build a high-quality talent joint training model.Guided by the construction of the national legal system and industry needs,the discipline will enhance social service capabilities.The forensic medicine construction in our university will continue to contribute to the rule of law in China and educational power.
8.Effect of Huanglian Jiedutang in Improving Brain Iron Metabolism Disorders, Myelin Damage, and Aggressive Behavior in VaD Mice via Regulation of FBXL5/IRP2
Xiaoxia FENG ; Chen CHEN ; Jing QIU ; Guang YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):1-9
ObjectiveThis study aims to investigate the effect of Huanglian Jiedutang on brain iron metabolism disorders, myelin damage, and aggressive behavior in vascular dementia (VaD) mice by regulating the F-box leucine-rich repeat protein 5 (FBXL5)/iron regulatory protein 2 (IRP2) pathway. MethodSixty C57BL/6J mice were randomly divided into six groups: sham operation group, model group, risperidone group (2 mg·kg-1·d-1), and low-dose, medium-dose, and high-dose groups of Huanglian Jiedutang (0.25, 0.5, 1 g·kg-1·d-1), with 10 mice in each group. The VaD model was established by bilateral carotid artery stenosis (BCAS). Drug intervention was administered for two weeks starting from the seventh week. Behavioral assessments, including the touch escape and resident-intruder tests, were conducted in the ninth week. After the behavioral tests, ventromedial hypothalamus ventrolateral (VMHvl) tissue samples were collected. Western blot was used to detect the expression of myelin-associated glycoprotein (MAG), myelin oligodendrocyte glycoprotein (MOG), myelin basic protein (MBP), 4-hydroxynonenal (4-HNE), glutathione peroxidase 4 (GPX4), transferrin receptor 1 (TFR1), ferritin light chain (Ft-L), ferroportin 1 (FPN1), FBXL5, and IRP2. Immunofluorescence was used to measure MBP fluorescence intensity. Transmission electron microscopy was employed to observe ultrastructural changes in the myelin sheath. Perl's staining was used to detect tissue iron deposition. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were measured by enzyme linked immunosorbent assay (ELISA). ResultCompared to the sham operation group, the model group exhibited a significant increase in biting, aggression, and irritability scores, along with a reduced latency of the attack (P<0.01). The expression levels of MAG, MOG, and MBP, as well as the fluorescent density of MBP, were significantly decreased (P<0.01). Disordered myelin ultrastructure, increased Ft-L and TFR1 expression, decreased FPN1 expression, and elevated iron deposition were observed (P<0.01). Antioxidants GPX4 and SOD were reduced, while 4-HNE and lipid peroxidation product MDA were increased (P<0.01). FBXL5 protein expression decreased, and IRP2 protein expression increased (P<0.01). Compared with the model group, in the middle-dose and high-dose groups of Huanglian Jiedutang and the risperidone group, the number of bites, aggressive behaviors, and irritability scores were reduced (P<0.05, P<0.01), while the latency of the attack increased (P<0.01). In the middle-dose and high-dose groups of Huanglian Jiedutang, the expression levels of MAG, MOG, and MBP, as well as MBP immunofluorescence increased (P<0.01). The ultrastructure was orderly arranged. Ft-L and TFR1 expression decreased; FPN1 expression increased, and iron deposition was reduced (P<0.01). GPX4 and SOD expression levels increased, and 4-HNE and MDA expression levels decreased (P<0.01). FBXL5 protein expression increased, and IRP2 protein expression decreased (P<0.01). ConclusionHuanglian Jiedutang may alleviate brain iron metabolism disorders, myelin damage, and aggressive behavior in VaD mice by regulating FBXL5/IRP2 expression in the VMHvl region.
9.A randomized positive parallel-controlled clinical study of Dibai Yijing Formula for the treatment of male infertility with essence deficiency in the kidney and damp-heat type in the essence chamber
Shuang WU ; Chao-Qian CHEN ; Yun-Zhi LI ; Qiu-Jian FENG ; Hui LÜ ; Xiao-Jing AN ; Jun GUO
National Journal of Andrology 2024;30(11):1019-1024
Objective:This study aims to evaluate the clinical efficacy and safety of Dibai Yijing Formula(DYF)in the treat-ment of male infertility with essence deficiency in the kidney and damp-heat in the essence chamber(Abbreviation:kidney deficiency and damp-heat type).Methods:This study employed a randomized,controlled clinical trial design,recruiting 72 male patients with infertility due to kidney deficiency and damp-heat type.Patients were randomly assigned to an treatment group(36 patients)and a control group(36 patients)using a random number table.The control group received oral Clomiphene Citrate Capsules(50 mg,twice daily),while the treatment group received oral DYF(one dose daily,200 ml each time,30 minutes after breakfast and dinner).Both groups underwent a 12-week treatment period.After treatment,sperm concentration(SC),percentage of progressively motile sperms(PR),total sperm motility[PR+percentage of non-progressively motile sperms(NP)],and semen volume(SV)were compared between the two groups before and after treatment.Additionally,the total score of Traditional Chinese Medicine(TCM)syndrome score and sperm DNA fragmentation index(DFI)and pregnancy outcomes of the patients'spouses were compared between the two groups.Results:Three patients dropped out from the treatment group and four from the control group.There were no statistically sig-nificant differences in semen parameters between the two groups(P>0.05).After treatment,the patients in the treatment group showed significant difference in the percentage of SC([19.42±5.30]x 106/ml vs[10.75±2.41]x 106/ml),PR([27.72±6.62]%vs[20.04±4.10]%),PR+NP([49.86±10.68]%vs(33.74±5.58)%],DFI([12.33±3.43]%vs[15.06±3.98]%)and TCM symtom score([7.45±1.82]vs[13.85±1.91]),and the difference was statistically significant(P<0.05).The patients in the control group showed significant difference in the percentage of SC([19.56±5.24]× 106/ml vs[11.31±2.08]× 106/ml)and TCM symptom score([12.81±1.86]vs[14.06±1.64]).But no significant changes were observed in the PR([21.75±5.93]%vs[20.05±4.67]%),PR+NP([34.23±7.15]%vs[32.35±4.09]%),SV([3.19±1.08]ml vs[3.12±1.13]ml),and DFI([15.11±4.76]%vs[15.51±4.35]%)were not statistically significant(P>0.05).Improve-ments in PR,PR+NP,TCM symptom score and DFI in the treatment group were better than those in the control group after treatment(P<0.05);the differences in SC and SV and spousal pregnancy in the treatment group were not statistically significant compared with those in the control group(P>0.05).No serious adverse events occurred in both groups during the treatment period.Conclusion:The treatment of male infertility with DYF is effective and safe.
10.Clinical and imaging analysis of COVID-19-related osmotic demyelination syndrome
Yuyue QIU ; Chenhui MAO ; Jialu BAO ; Li SHANG ; Tianyi WANG ; Bo LI ; Yixuan HUANG ; Yuhan JIANG ; Shanshan CHU ; Wei JIN ; Liling DONG ; Feng FENG ; Jing GAO
Chinese Journal of Neurology 2024;57(7):763-769
Objective:To analyze the clinical and imaging features of patients with COVID-19-related osmotic demyelination syndrome (ODS).Methods:COVID-19-related ODS cases diagnosed in the Department of Neurology, Peking Union Medical College Hospital from January 2020 to September 2023 were retrospectively reviewed. And their past medical history, possible triggers, clinical manifestations, imaging manifestations, treatment and prognosis were summarized.Results:A total of 5 patients with COVID-19-related ODS were included. Electrolyte disturbances acted as an inducement of ODS in all patients (5/5),4 of whom with hyponatremia. Four of 5 patients first presented with disturbance of consciousness, followed by predominant dystonia. Imaging of all patients (5/5) showed isolated extrapontine myelinolysis (EPM). With the prolongation of the course of disease, such signal intensity could return to normal, and lesions showed atrophic changes in some patients. The patients′ clinical symptoms were partly relieved within a few days to a few months after treatment.Conclusions:COVID-19-related ODS is mostly associated with hyponatremia, and EPM is more common. COVID-19 should be considered as a risk factor for ODS.

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