Astragali Radix (AR), a traditional Chinese medicine (TCM), has demonstrated therapeutic efficacy against various diseases, including cardiovascular conditions, over centuries of use. While doxorubicin serves as an effective chemotherapeutic agent against multiple cancers, its clinical application remains constrained by significant cardiotoxicity. Research has indicated that AR exhibits protective properties against doxorubicin-induced cardiomyopathy (DIC); however, the specific bioactive components and underlying mechanisms responsible for this therapeutic effect remain incompletely understood. This investigation seeks to identify the protective bioactive components in AR against DIC and elucidate their mechanisms of action. Through network medicine analysis, astragaloside IV (AsIV) and formononetin (FMT) were identified as potential cardioprotective agents from 129 AR components. In vitro experiments using H9c2 rat cardiomyocytes revealed that the AsIV-FMT combination (AFC) effectively reduced doxorubicin-induced cell death in a dose-dependent manner, with optimal efficacy at a 1∶2 ratio. In vivo, AFC enhanced survival rates and improved cardiac function in both acute and chronic DIC mouse models. Additionally, AFC demonstrated cardiac protection while maintaining doxorubicin's anti-cancer efficacy in a breast cancer mouse model. Lipidomic and metabolomics analyses revealed that AFC normalized doxorubicin-induced lipid profile alterations, particularly by reducing fatty acid accumulation. Gene knockdown studies and inhibitor experiments in H9c2 cells demonstrated that AsIV and FMT upregulated peroxisome proliferator activated receptor γ coactivator 1α (PGC-1α) and PPARα, respectively, two key proteins involved in fatty acid metabolism. This research establishes AFC as a promising therapeutic approach for DIC, highlighting the significance of multi-target therapies derived from natural herbals in contemporary medicine.
Animals ; Doxorubicin/adverse effects* ; Saponins/administration & dosage* ; Isoflavones/pharmacology* ; Rats ; Cardiomyopathies/prevention & control* ; Mice ; Fatty Acids/metabolism* ; Myocytes, Cardiac/metabolism* ; Triterpenes/administration & dosage* ; Male ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Cardiotonic Agents/administration & dosage* ; Mice, Inbred C57BL ; Cell Line ; Astragalus Plant/chemistry* ; Astragalus propinquus

Objective:To understand the epidemiology, clinical characteristics and associated risk factors of severe adenovirus(ADV)pneumonia in children, providing the basis for targeted prevention and treatment.Methods:Clinical features of children with ADV pneumonia at Children′s Hospital of Soochow University from January 2011 to December 2020 were retrospectively analyzed.According to the severity of the disease, cases were divided into severe ADV pneumonia group and common ADV pneumonia group.The epidemiological and clinical characteristics of two groups were compared, and risk factors for the occurrence of severe ADV pneumonia were analyzed.Results:A total of 1 158 patients with ADV pneumonia were enrolled, including severe ADV pneumonia 104 cases(8.98%) and ordinary ADV pneumonia 1 054 cases(91.02%).The median age of severe ADV pneumonia group was 1.17 (0.83, 2.73) years, which was significantly younger than that of common ADV pneumonia group 3.16 (1.50, 4.50) years( P<0.05), and 77.89% (81/104) of them were younger than 3 years old.The occurrence of severe ADV pneumonia was predominant in winter and spring, accounting for 71.15% (74/104).Cough was present in 89.42% (93/104) and fever in 99.01% (103/104) of the severe ADV pneumonia group.Compared with the common ADV pneumonia group, the severe ADV pneumonia group had a significantly longer febrile time[10(6, 14)d vs. 5(4, 7)d, P<0.05], significantly higher incidence of shortness of breath, wheezing, convulsions/coma[100% vs. 2.09%, 45.19% vs. 13.57%, 10.57% vs. 1.99%, P<0.05], and significantly higher incidences of emphysema, pleural effusion, bronchial signs, pulmonary solids, and atelectasis [21.15% vs. 2.09%, 5.77% vs. 0.19%, 4.81% vs. 0, 3.85% vs. 0.09%, P<0.05].Multivariable Logistic regression showed that age younger than 1.71 years old, wheezing, and the presence of underlying diseases (moderate to severe anaemia, congenital heart disease, neurological disease) were risk factors for the development of severe ADV pneumonia ( P<0.05).Receiver operating characteristic curve analysis showed that the sensitivity and specificity of age<1.71 years old(20 months old) for predicting the occurrence of severe ADV pneumonia were 65.4% and 71.5%, respectively. Conclusion:The age of most severe ADV pneumonia is less 3 years in Suzhou.It usually occurres in winter and spring, with fever, cough, shortness of breath, and wheezing as the main symptoms.Pulmonary manifestations such as pleural effusion, emphysema, pulmonary consolidation, and atelectasis may occur.The underlying disease, wheezing, and age of onset less than 1.71 years (20 months) old are independent risk factors for severe ADV pneumonia.

Objective:To compare the therapeutic effects of debris spondylectomy,piecemeal spondylectomy,total en bloc spomdylectomy in treating lumbar metastatic tumors. Methods:The clinical data of 20 patients with lumbar metastatic tu-mors treated from January 2008 to October 2013 were retrospectively reviewed. There were 8 males and 12 females ,aged from 35 to 65 years old with an average of (49.50±9.97) years. All patients had single solitary metastases. Four cases were in L 1,5 cases in L2,4 cases in L3,4 cases in L4,and 3 cases in L5. According to the type of Tomita,typeⅡhad in 4 cases,typeⅢin 6 cases,typeⅣin 6 cases,type V in 4 cases. Tokuhashi score was 12.50±1.97. All patients complained with back or leg pain , VAS score was 8.13±0.85. Among patients,7 cases were treated with debris spondylectomy (group A),7 cases with piecemeal spondylectomy (group B),6 cases with total en bloc spondylectomy (group C). Statistical analysis was used to compare the three groups with respect to surgical trauma (including operative time,transoperative bleeding,and intraoperative blood trans-fusion),clinical symptoms (by VAS score at 1 week after operation),surgical procedures conditions (by AP and lateral X rays),and long term results (by recurrence and death information). Results:All patients were followed up from 6 to 36 months with an average of (16.50±7.88) months. Operative time for debris spondylectomy was (6.14±0.68) h,intraoperative bleeding was(3 457.14±399.40) ml,and intraoperative blood transfusion was(2 771.43±423.14)ml. Operative time for piece-meal spondylectomy was(4.93±0.61) h,intraoperative bleeding was(1 942.86±378.51) ml,and intraoperative blood transfu-sion was (1 500.00±336.65)ml. Operative time for total en bloc spondylectomy was(4.17±0.67) h,intraoperative bleeding was (1 341.67±361.13) ml,and intraoperative blood transfusion was (916.67±321.66) ml. There was significant differences in op-erative time,intraoperative blood loss,and intraoperative blood transfusion between three groups (P<0.05). In terms of these factors,total en bloc spondylectomy had the best outcome followed by piecemeal spondylectomy. All pains had released ,VAS score decreased obviously at 1 week after operation(P<0.05),and there was no significant differences between three groups(P>0.05). Surgical effects were well with these methods according to the evaluation of AP and lateral X rays . At final follow up, group A had 4 recurrences(2 with breast cancer,1 with prostate cancer,and 1 with thyroid cancer) and 3 deaths (2 with lung cancer and 1 with thyroid cancer);group B had 2 recurrences (1 with breast cancer and 1 with prostate cancer) and 3 deaths (1 with lung cancer,1 with breast cancer and 1 with kidney cancer);group C had no recurrences and 2 deaths for lung cancer. There was significant differences in recurrence and death between three groups(P<0.05). In terms of these factors,total en bloc spondylectomy had the best outcome in three methods. Conclusion:Three kinds of operation method can relieve pain ,improve nerve function,increase the spinal stability,control the local lesions,improve the patient's quality of life in treating lumbar metastatic tumors,but total en bloc spendylectomy,respect to operative time,transoperative bleeding,intraoperative blood transfusion,tumor recurrence and death is clearly superior to other two methods.