Objective To investigate the effect of artesunate(ART)on hypoxia/reoxygenation(H/R)-induced injury of human renal proximal tubular HK-2 cells by regulating the high mobility group protein B1(HMGB1)-receptor of advanced glycation endproduct(RAGE)signaling pathway.Methods HK-2 cells cultured in vitro were stochastically separated into control group,model group,L-ART group(4 μg/ml ART),H-ART group(16 μg/ml ART),H-ART+pcDNA NC group(16 μg/ml ART+transfected pcDNA NC plasmid),and H-ART+pcDNA-HMGB1 group(16 μg/ml ART+transfected pcDNA-HMGB1 plasmid).HK-2 cells in the control group were cultured normally,while the cells in the other groups were induced with hypoxia/reoxygenation(H/R).MTT and plate clone formation experiments were applied to detect the proliferation of cells in each group;ELISA kits were used to measure the expression of interleukin(IL)-1β,IL-6 and tumor necrosis factor-α(TNF-α)in various groups;flow cytometry was applied to detect the apoptosis in various groups;Western blot was applied to detect the expression of proliferation related proteins(PCNA),apoptosis related proteins(Bcl-2,Bax),and HMGB1-RAGE signaling pathway related proteins(HMGB1,RAGE)in each group.Results Compared with the control group,the survival rate,clone number,PCNA and Bcl-2 proteins expression of HK-2 cells decreased in the model group,but the apoptosis rate,IL-1β,IL-6,TNF-α,Bax,HMGB1 and RAGE proteins expression increased(P<0.05).Compared with the model group,the survival rate,clone number,PCNA and Bcl-2 proteins expression of HK-2 cells increased in L-ART and H-ART groups,but the apoptosis rate,IL-1β,IL-6,TNF-α,Bax,HMGB1 and RAGE proteins expression decreased(P<0.05).Compared with the H-ART and H-ART+pcDNA NC groups,the survival rate,clone number,PCNA and Bcl-2 proteins expression of HK-2 cells decreased in the H-ART+pcDNA-HMBB1 group,but the apoptosis rate,IL-1β,IL-6,TNF-α,Bax,HMGB1 and RAGE proteins expression increased(P<0.05).Conclusion ART may suppress inflammatory response and cell apoptosis,promote cell proliferation,and alleviate H/R-induced injury of renal proximal tubular HK-2 cells by inhibiting the HMGB1-RAGE signaling pathway.

Objective To investigate the effect of artesunate(ART)on hypoxia/reoxygenation(H/R)-induced injury of human renal proximal tubular HK-2 cells by regulating the high mobility group protein B1(HMGB1)-receptor of advanced glycation endproduct(RAGE)signaling pathway.Methods HK-2 cells cultured in vitro were stochastically separated into control group,model group,L-ART group(4 μg/ml ART),H-ART group(16 μg/ml ART),H-ART+pcDNA NC group(16 μg/ml ART+transfected pcDNA NC plasmid),and H-ART+pcDNA-HMGB1 group(16 μg/ml ART+transfected pcDNA-HMGB1 plasmid).HK-2 cells in the control group were cultured normally,while the cells in the other groups were induced with hypoxia/reoxygenation(H/R).MTT and plate clone formation experiments were applied to detect the proliferation of cells in each group;ELISA kits were used to measure the expression of interleukin(IL)-1β,IL-6 and tumor necrosis factor-α(TNF-α)in various groups;flow cytometry was applied to detect the apoptosis in various groups;Western blot was applied to detect the expression of proliferation related proteins(PCNA),apoptosis related proteins(Bcl-2,Bax),and HMGB1-RAGE signaling pathway related proteins(HMGB1,RAGE)in each group.Results Compared with the control group,the survival rate,clone number,PCNA and Bcl-2 proteins expression of HK-2 cells decreased in the model group,but the apoptosis rate,IL-1β,IL-6,TNF-α,Bax,HMGB1 and RAGE proteins expression increased(P<0.05).Compared with the model group,the survival rate,clone number,PCNA and Bcl-2 proteins expression of HK-2 cells increased in L-ART and H-ART groups,but the apoptosis rate,IL-1β,IL-6,TNF-α,Bax,HMGB1 and RAGE proteins expression decreased(P<0.05).Compared with the H-ART and H-ART+pcDNA NC groups,the survival rate,clone number,PCNA and Bcl-2 proteins expression of HK-2 cells decreased in the H-ART+pcDNA-HMBB1 group,but the apoptosis rate,IL-1β,IL-6,TNF-α,Bax,HMGB1 and RAGE proteins expression increased(P<0.05).Conclusion ART may suppress inflammatory response and cell apoptosis,promote cell proliferation,and alleviate H/R-induced injury of renal proximal tubular HK-2 cells by inhibiting the HMGB1-RAGE signaling pathway.

Objective:To systematically evaluate the efficacy and safety of controlled low central venous pressure (CLCVP) applied in patients undergoing hepatectomy.Methods:PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases were searched from inception to October 1, 2022 for randomized controlled trials (RCTs) involving CLCVP in hepatectomy.All RCTs enrolled included CLCVP group and conventional operation group.The major evaluation indicators were intraoperative blood loss, operation duration and intraoperative blood transfusion.The secondary evaluation indicators were intraoperative monitoring indicators, postoperative liver and renal function, and complications at 1 day after operation.Meta-analysis was performed using the RevMan 5.3 software.Results:A total of 25 RCTs involving 1 816 patients were finally included.Compared with conventional operation group, the intraoperative blood loss was significantly reduced, the operation time was shorten, the rate of intraoperative blood transfusion was decreased, the amount of blood transfused was decreased ( P<0.01), and no significant change was found in intraoperative hemodynamic parameters and parameters of liver and renal function at 1 day after operation, and incidence of gas embolism, pleural effusion and bile leakage in CLCVP group ( P>0.05). Conclusions:CLCVP is safe and effective during hepatectomy.

Objective To observe the effect of nutritional status change on hemodialysis patients of chronic renal failure and deficiency of spleen and kidney treated bytraditional Chinese medicine(TCM) of warming kidney and invigorating spleen. Methods In our center, 146 patients who were diagnosed chronic renal failure belonging to deficiency of spleen and kidney in TCM were received hemodialysis between Jun2012 and May2013. All patients were randomly divided into a treatment group (n=72) and a control group (n=74). 74 patients in the control groupreceived conventional hemodialysis and medicine treatment, and 72 patients in treatment group received conventional hemodialysis、medicine treatment and TCM treatment of warming kidney and invigorating spleen. The comprehensive nutritional assessment of all patients were treated by modified SGAN method (MQSGAN), anthropometric, biochemical and laboratory examination before and 6 monthsafter the treatment. Results The treatment group patients of modified SGAN(9.58±3.15), BMI (body mass index 19.34±0.52) Kg/m2, MAC(upper arm circumference 27.51±1.95)cm, TSF(tricepsskinfold thickness 12.92± 2.42) mm and MAMC(upper arm muscle circumference 23.64±1.96)cm were significantly improved compared with the control g roup(respectively data 13.23±3.14, 17.29±0.76) Kg/m2, (24.01±2.55, 10.58±2.71) mm, (20.71±2.04)cm, P<0.05,and treatment group patients with ALB(serum albumin 38.19±1.95)g/L, PA(prealbumin 2.23±0.16)g/L, TF(transferrin 0.21±0.04)g/L, CH(cholesterol 4.02±0.26)mmol/L, BUN(blood urea nitrogen 19.58±2.17)mmol/L and SCr (creatinine 869.54±79.15)mmol/L were significant improved also compared with the control group(respectively data 33.73±1.31)g/L, (1.67±0.25)g/L, (0.17±0.02)g/L, (3.22± 0.46)mmol/L, (16.27±1.12)mmol/L, (792.73±71.65)mmol/L, P<0.05. Conclusion Traditional Chinese medicine of warming kidney and invigorating spleen can improve the nutritional status and quality of life on patients with chronic renal failure belonging to deficiency of spleen and kidney type during hemodialysis.

A platinum-based doublet with a third-generation agent represents the standard first-line treatment for advanced non-small cell lung cancer patients with good performance status (PS). Traditional chemotherapy provides response rates of 20 %-40 % and a median survival of 8-10 months. In an attempt to improve its outcome, alternative schedules have been proposed, namely sequential, alternating, and maintenance therapy. Sequential chemotherapy with a platinum-based doublet followed by a single agent is feasible in patients with good PS; The use of sequential single agents is an option for elderly and frail patients unsuitable for a platinum-based combination. Based on trials published so far, it is unlikely that an alternating chemotherapy strategy will be proved superior to standard chemotherapy in patients with good PS.Consolidation chemotherapy may provide additional benefit for patients achieving disease control after standard first-line chemotherapy.