1.Transition of body mass index and metabolic syndrome in patients with major depressive disorder
Han QI ; Chengcheng DONG ; Rui LIU ; Xuequan ZHU ; Xuzhou LIN ; Yanshu QIN ; Zibo YU ; Haining WANG ; Lei LI ; Yuan FENG ; Ling ZHANG ; Fang YAN
Journal of Capital Medical University 2025;46(2):202-209
Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.
2.Expert consensus on pre-hospital emergency management of heatstroke(2024 edition)
Tao WANG ; Yue ZHAO ; Meng WANG ; Hai-Yan ZHU ; Chen LI ; Yu-Jian CHEN ; Qin-Rui XING ; Qing SONG
Medical Journal of Chinese People's Liberation Army 2025;50(3):245-253
Heatstroke,especially in high-temperature and high-humidity environments,is a life-threatening acute heat-injury disease that seriously endangers human health.Timely and effective on-site treatment is crucial for patients'survival and prognosis.Early recognition,rapid assessment,and on-site cooling are the core of pre-hospital treatment of heatstroke.Currently,there is a lack of standardized application procedures for pre-hospital emergency care of heatstroke.Therefore,the"Expert Consensus on Pre-hospital Emergency Management of Heatstroke(2024 edition)"was initiated by the Expert Group on Heatstroke Prevention of the People's Liberation Army and developed in collaboration with experts from local pre-hospital emergency care,emergency departments,and intensive care units.This consensus focuses on heatstroke prevention,on-site and ambulance-based treatment,and early emergency room interventions,and puts forward 10 evidence-based recommendations,aiming to provide a reference for scientific and standardized pre-hospital emergency care of heatstroke.
3.Modification with bone forming peptide 1 and polydopamine coating to improve bioactivity of polyetheretherketone surface
Jingjie QIN ; Zige GUO ; Rui LI ; Shiqing MA ; Ruijie LU ; Mengjun LI
Chinese Journal of Tissue Engineering Research 2025;29(16):3318-3325
BACKGROUND:Polyether ether ketone has the advantages of elastic modulus close to human cortical bone,good ray transmission,chemical stability,and biocompatibility.Polyether ether ketone is expected to be applied in the field of oral implants.However,polyether ether ketone is bioinert and is difficult to integrate with surrounding bone tissue.Therefore,how to improve the surface bioactivity of polyether ether ketone remains a major issue.OBJECTIVE:To analyze the osteogenic and vasogenic effects of polyether ether ketone surface bone forming peptide 1 and polydopamine composite coating.METHODS:Polyether ether ketone titanium sheets were immersed in dopamine solution for 24 hours to prepare polyether ether ketone-polydopamine materials.Polyether ether ketone-polydopamine material was immersed in the bone forming peptide 1 solution for 24 hours to prepare polyether ether ketone-polydopamine-bone forming peptide 1 material.The micromorphology,hydrophilicity,and elemental composition of the material were characterized.Bone marrow mesenchymal stem cells were injected on the surface of polyether ether ketone,polyether ether ketone-polydopamine,and polyether ether ketone-polydopamine-bone forming peptide-1 materials.Cell viability and adhesion status were evaluated by live/dead cell staining and cytoskeleton staining.Cellular osteogenic differentiation ability was detected by alizarin red and osteocalcin immunofluorescence staining.Human umbilical vein endothelial cells were inoculated on the surface of three groups of materials.Cell viability and angiogenesis level were assessed by live/dead cell staining and immunofluorescence staining of cytoskeleton/vascular endothelial growth factor.RESULTS AND CONCLUSION:(1)Under scanning electron microscope,the surface of polyether ether ketone material was smooth;the surface of polyether ether ketone-polydopamine material had uneven deposits,and the surface of polyether ether ketone-polydopamine-bone forming peptide 1 material had small particles protruding.The results of contact angle test showed that the hydrophilicity of polyether ether ketone-polydopamine-bone forming peptide-1 material was better than the other two materials.X-ray photoelectron spectroscopy results showed that bone forming peptide 1 had been successfully modified on the surface of polyether ether ketone material.(2)Live/dead cell staining and cytoskeleton staining exhibited that compared with the other two materials,polyether ether ketone-polydopamine-bone-forming peptide 1 material could improve the viability and adhesion of bone marrow mesenchymal stem cells.Alizarin red and osteocalcin immunofluorescence staining showed that compared with the other two materials,polyether ether ketone-polydopamine-bone forming peptide-1 materials could promote the osteogenic differentiation of bone marrow mesenchymal stem cells.(3)Live/dead cell staining and immunofluorescence staining showed that compared with the other two materials,polyether ether ketone-polydopamine-bone forming peptide 1 material could improve the viability and adhesion of human umbilical vein endothelial cells and the expression of vascular endothelial growth factor protein.(4)The results show that the modification of bone forming peptide 1 and polydopamine composite coating on polyether ether ketone surface can improve the osteogenesis and angiogenesis.
4.Simultaneous Determination of 21 Kinds of Aconitum Alkaloids in Biological Specimens and Herbal Wines Using Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry
Ju YANG ; Guo-Jun LI ; Xian-Mou FAN ; Rui-Bin ZHAO ; Shao-Ming SU ; Xu-Xian FU ; En-Jin ZHU ; Qi-Lin HUANG ; Yao QIN ; Li-Na LI
Chinese Journal of Analytical Chemistry 2025;53(8):1391-1401,后插1-后插6,封3
A method for simultaneous determination of 21 kinds of Aconitum alkaloids(ATS)in biological specimens and infused liquor using ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)was developed.The biological samples were pretreated with methanol-acetonitrile(1∶2,V/V)for protein precipitation,while infused liquors were diluted 100-fold with acetonitrile,followed by centrifugation,and filtration by a 0.22-μm membrane.Chromatographic separation was carried out on an EC-C18 column using gradient elution with the mixture of 10 mmol/L ammonium acetate and 0.2%formic acid as mobile phase A and acetonitrile as mobile phase B.With this method,all the analytes were separated within 9.5 min.The samples were detected in positive ESI mode with dynamic multiple reaction monitoring(MRM)and quantified via external standard calibration.The results showed that the concentrations of the analytes in the range of 2-1000 ng/mL had excellent linearity(R2>0.9992)with the peak area.The developed method was successfully used for detection of 21 kinds of aconitum alkaloids,with limits of detection of 0.5-2 ng/mL,quantification limits of 2-6 ng/mL,intra/inter-day precision≤6.0%,spiked recoveries of 89.4%-100.9%,extraction recoveries of 74.2%-104.4%,and matrix effects ranging from-11.1%to 9.2%in blood/urine.The method was applied to detection of 12 samples from 4 fatal aconite poisoning cases,and all 21 kinds of ATS with total alkaloid concentrations of 0.04-4.18 μg/mL in blood and 154.96-422.83 μg/mL in medicinal liquors were detected.Tissue distribution revealed that the order of concentrations from highest to lowest is as follows:urine(157.22 μg/mL)>gastric contents(51.37 μg/mL)>kidney(21.6 μg/g)>whole blood(4.18 μg/mL)>liver(0.03 μg/g).This method showed many advantages such as simple pretreatment,low detection limits,accurate quantification,broad analyte coverage,and superior anti-interference capability in complex matrices,proving ideal for forensic and toxicological analysis of aconitum alkaloids.
5.Staging system for renal tuberculosis and prognostic analysis of treatment at different stages
Chenhao GUO ; Xiao LU ; Yuyang ZHANG ; Rui ZHANG ; Wei QIN ; Linping QI ; Xiumei LI ; Panfeng SHANG
Chinese Journal of Urology 2025;46(8):581-586
Objective:To investigate the staging criteria of renal tuberculosis,and to analyze the diagnostic and therapeutic characteristics as well as prognostic outcomes at different stages.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with renal tuberculosis who were admitted to the Second Hospital of Lanzhou University between January 2019 and December 2023.The study cohort included 62 males and 72 females,with a mean age of(46.63 ± 13.52)years and a mean body mass index(BMI)of(22.85 ± 3.73)kg/m 2. A total of 107 patients resided in rural areas. Sixty patients had a history of pulmonary tuberculosis. Tuberculous lesions were located in the left kidney in 72 cases and in the right kidney in 62 cases. The main presenting complaints included irritative lower urinary tract symptoms in 85 patients and systemic symptoms in 92 patients. Ureteral involvement was observed in 97 patients,bladder involvement in 32 patients,and genital involvement in 9 patients. Based on computed tomography(CT)findings,the number,extent,and degree of renal destruction caused by tuberculous lesions were comprehensively evaluated in axial,coronal,and sagittal planes. The primary staging criteria included lesion diameter(2 cm)and the proportion of renal volume involved by the lesion(one-third,one-half,and two-thirds). Renal tuberculosis was classified into three stages and six subtypes:Stage Ⅰa,a solitary lesion with a diameter ≤ 2 cm;Stage Ⅰb,a solitary lesion >2 cm or multiple lesions confined within one-third of the renal volume;Stage Ⅱa,lesions involving more than one-third but confined within one-half of the renal volume;Stage Ⅱb,lesions involving more than one-half but confined within two-thirds of the renal volume;Stage Ⅲa,lesions involving more than two-thirds of the renal volume with a glomerular filtration rate(GFR)of the affected kidney <10 ml/min;and Stage Ⅲb,complete renal calcification,presenting as an “autonephrectomy”. Among the 134 patients included in this study,7 were classified as Stage Ⅰa,17 as Stage Ⅰb,20 as Stage Ⅱa,19 as Stage Ⅱb,62 as Stage Ⅲa,and 9 as Stage Ⅲb. The severity of hydronephrosis was graded as follows:mild,renal pelvic separation <2 cm;moderate,2-3 cm;and severe,>3 cm. Prior to treatment,the mean renal pelvic separation was(1.76 ± 0.92)cm in Stage Ⅰa,(1.69 ± 0.81)cm in Stage Ⅰb,and(1.10 ± 0.82)cm in Stage Ⅱa,corresponding to mild to moderate hydronephrosis. All 7 patients in Stage Ⅰa underwent ureteroscopic examination and double-J stent placement,combined with a 6-month short-course anti-tuberculosis regimen consisting of isoniazid,rifampicin,pyrazinamide,and ethambutol for 2 months(intensive phase),followed by isoniazid and rifampicin for 4 months(continuation phase). Among the 17 patients in Stage Ⅰb,13 presented with hydronephrosis and underwent ureteroscopic examination and double-J stent placement in combination with 6 months of anti-tuberculosis therapy,while 4 patients with isolated renal tuberculosis received anti-tuberculosis therapy alone for 6 months.Of the 20 patients in Stage Ⅱa,4 with hydronephrosis underwent ureteroscopic examination and double-J stent placement plus 6 months of anti-tuberculosis therapy,whereas 16 underwent nephroureterectomy. All 19 patients in Stage Ⅱb underwent nephroureterectomy. Among the 62 patients in Stage Ⅲa,60 underwent nephroureterectomy,while 2 refused surgery and were treated with the 6-month short-course anti-tuberculosis regimen. Of the 9 patients in Stage Ⅲb,8 underwent nephroureterectomy;in 1 patient,surgery was not performed due to severe adhesions in the operative field,and the patient received the 6-month short-course anti-tuberculosis regimen instead. Follow-up assessments included clinical symptoms,erythrocyte sedimentation rate(ESR),serum creatinine,degree of renal pelvic separation,and imaging findings from urinary tract CT. Efficacy was evaluated according to the following criteria:Cure was defined as clinical stability with all of the following conditions:① improvement of systemic symptoms,including absence of flank pain,fever,and lower urinary tract irritative symptoms,with normalization of erythrocyte sedimentation rate(ESR);② negative urine culture for Mycobacterium tuberculosis;and ③ complete calcification of renal lesions and/or no evidence of tuberculous lesions at other sites. Stable disease was defined as no change in the size or extent of renal tuberculosis lesions. Progressive disease was defined as enlargement or increase in the number of tuberculous lesions or involvement of additional sites. Results:Among the 7 patients in Stage Ⅰa,follow-up imaging after treatment showed a mean renal pelvic separation of(0.44 ± 0.56)cm,which was significantly reduced compared with baseline( t = 3.909, P = 0.008). Five patients achieved cure,1 remained stable,and 1 showed disease progression and subsequently underwent nephroureterectomy,resulting in postoperative cure. In Stage Ⅰb,among 13 patients with hydronephrosis,post-treatment imaging showed a mean renal pelvic separation of(0.8 ± 0.75)cm,a statistically significant improvement from baseline( t = 5.633, P < 0.01). Six patients were cured,4 remained stable,and 3 experienced disease progression and underwent nephroureterectomy. Of the 4 patients with isolated renal tuberculosis,2 were controlled,and 2 progressed and underwent nephroureterectomy. In Stage Ⅱa,among 4 patients with tuberculous hydronephrosis,post-treatment renal pelvic separation was(1.20±0.98)cm,with no significant difference from baseline( t = -1.675, P = 0.193);these patients underwent nephroureterectomy 1-2 years later. The remaining 16 patients without hydronephrosis underwent nephroureterectomy and were cured. All 19 patients in Stage Ⅱb underwent nephroureterectomy;17 were cured,and 2 developed ipsilateral perirenal fluid collections 3 months postoperatively,which resolved spontaneously with the standard 6-month anti-tuberculosis regimen. Among 62 patients in Stage Ⅲa,60 underwent nephroureterectomy. Of these,54 were cured;1 developed a urinary tract infection within 2 weeks postoperatively;3 showed contralateral renal disease progression at 3 months;and 1 developed ipsilateral perirenal fluid at 3 months,which resolved spontaneously with standard anti-tuberculosis therapy. One patient developed solitary kidney failure 7 months postoperatively and underwent ureteral stent placement,with disease remaining stable thereafter. Two patients refused surgery and received only anti-tuberculosis therapy;during follow-up,1 patient experienced disease progression and died of disseminated tuberculosis after 1 year,while the other developed contralateral renal involvement at 3 months and received standard 6-month therapy,with disease remaining stable. Among 9 patients in Stage Ⅲb,8 underwent nephroureterectomy and were cured. One patient,with severe adhesions precluding surgery,received anti-tuberculosis therapy alone,and disease remained stable over a 2-year follow-up. Conclusions:The CT-based staging system for renal tuberculosis proposed in this study(three stages and six subtypes)effectively reflects the severity of renal lesions and clearly delineates the clinical characteristics and prognostic outcomes at each stage. Stage Ⅰ patients treated with anti-tuberculosis drugs combined with double-J stent placement demonstrated favorable outcomes and high renal preservation rates. In contrast,Stages Ⅱ and Ⅲ patients showed poor responses to anti-tuberculosis therapy combined with drainage,with a higher risk of disease progression and relatively worse prognosis,highlighting the recommendation for early nephroureterectomy of the affected kidney.
6.Multicenter study on the prediction of microvascular invasion in hepatocellular carcinoma using multiphase ultrasound imaging radiomics models
Yanhong HAO ; Juan CHEN ; Qin LU ; Ruining WANG ; Yuan SU ; Shanshan SHI ; Rui SHI ; Lingjie WANG ; Jianhong WANG ; Li YANG ; Liping LIU
Chinese Journal of Ultrasonography 2025;34(11):983-991
Objective:To construct and evaluate the predictive performance of a multiphase ultrasound radiomics model for microvascular invasion(MVI)in hepatocellular carcinoma(HCC).Methods:A total of 126 patients with pathologically confirmed HCC were retrospectively enrolled from 4 medical centers between May 2018 and July 2025,including the First Hospital of Shanxi Medical University,Shanxi Province Third People's Hospital,Changzhi People's Hospital,and the Organ Transplant Center of the Affiliated Hospital of Qingdao University. A total of 630 ultrasound images of the lesions in different phases were collected,from which 1 561 radiomic features were extracted. The patients from medical institutions in Shanxi Province were chosen as the training set( n=91),and the patients from the Organ Transplant Center of the Affiliated Hospital of Qingdao University were chosen as the validation set( n=35). In the training set,37.4%(34/91)patients presented MVI(+),whereas in the validation set,54.3%(19/35)patients presented MVI(+). Radiomics features were extracted from ultrasound images,and features related to the MVI(+)were selected through dimensionality reduction analysis. Five multiple machine learning algorithms were used to construct predictive models,which were then evaluated using an external validation set. The Radscore was calculated,and a nomogram was constructed combining Radscore with ultrasound and clinical characteristics to predict MVI. Results:The model combining radiomics features from the portal venous phase and the delay phase showed the best predictive performance in both the training and validation sets,with area under curve(AUC)values of 0.835 and 0.727,respectively. The prediction model developed using radiomics Radscore and clinical indicators could be represented and presented as a nomogram.Conclusions:The radiomics model based on multi-phase ultrasound offers a novel approach for non-invasive preoperative prediction of MVI in liver cancer. Furthermore,its integration with clinical features aids in optimizing clinical treatment strategies.
7.Relationship between SIRT2 and occurrence and disease severity of cognitive impairment in patients with acute cerebral infarction
Houjie NI ; Rui ZHU ; Shuanglai QIN ; Xinhua LI
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(4):436-439
Objective To analyze the relationship of silent information regulator 2(SIRT2)with the occurrence and severity of cognitive impairment in patients with acute cerebral infarction(ACI).Methods Clinical data of 150 ACI patients(study group)complicated with cognitive im-pairment admitted in our hospital from May 2022 to May 2024 were collected and analyzed retro-spectively.According to the severity of cognitive impairment,they were divided into mild(45 cases),moderate(66 cases)and severe subgroups(39 cases).Another 125 ACI patients without cognitive dysfunction admitted in our hospital during the same period were recruited and served as the control group.Spearman correlation analysis was adopted to analyze the correlation between serum SIRT2 level and cognitive impairment and disease severity.ROC curve analysis was applied to assess the value of serum SIRT2 level for cognitive impairment and its severity,and its area under the curve(AUC)was calculated.Results The serum SIRT2 level was significantly higher in the study group than the control group(20.38±5.19 mg/L vs 14.66±4.49 mg/L,P<0.05),so was in the severe subgroup than the moderate and mild subgroups,and in the moderate subgroup than the mild subgroup(P<0.05).Spearman analysis showed that serum SIRT2 level was posi-tively correlated with the occurrence and severity of cognitive impairment(r=0.510,r=0.527,P<0.01).ROC curve analysis indicated that the AUC value of serum SIRT2 level in evaluating the occurrence of cognitive impairment was 0.796(95%CI:0.743-0.842),with a cutoff value,sensitivity and specificity of 19.0 mg/L,63.33%and 84.00%,respectively,and the AUC value was 0.747(95%CI:0.655-0.824)in assessing the severity of cognitive impairment,with a cutoff value,sensitivity and specificity of 17.2 mg/L,75.76%and 71.11%,respectively(P<0.05).Conclusion Serum SIRT2 level is closely associated with the occurrence and severity of cognitive impairment in ACI patients.
8.Protective effect of knock-down the expression of Blimp1 gene on early liver injury in CCl4-induced mouse model of liver fibrosis
Qiushi QIN ; Rui LI ; Yanxi ZHOU ; Yue ZHANG ; Ming HAN ; Liuluan ZHU
Journal of Peking University(Health Sciences) 2025;57(4):727-734
Objective:To explore the protective effect of knock-down the expression of B lymphocyte induced maturation protein 1(Blimp1)gene on early liver injury in carbon tetrachloride(CCl4)-induced mouse model of liver fibrosis.Methods:C57BL/6 mice were intraderitoneal injected with 5%CCl4 olive oil solution to create mouse model of hepatic fibrosis.The expression of Blimp1 gene in the mice was re-duced by intraderitoneal injection of short hairpin RNA(shRNA)adeno-associated virus(AAV).The mice were randomly divided into 3 groups:blank test group(n=10),CCl4+AAV-shRNA-NC group(n=10)and CCl4+AAV-shRNA-Blimp1 group(n=10).After 27 days of preparation of the CCl4 mouse model,animal materials were carried out.Western blot and real-time PCR were used to detect the levels of Blimp1,α-smooth muscle actin(α-SMA),collagen type Ⅰ alpha 1(COL1A1),collagen typeⅢ alpha 1(COL3A1),and their mRNA expression levels of liver tissue in each group.The serum of each group was separated to measure aspartate transaminase(AST)and alanine transaminase(ALT)by automatic biochemical analyzer.The pathological changes of liver tissue and the degree of liver fibrosis in the mice were detected by pathological staining including hematoxylin-eosin staining,Masson,and Sirius red.Results:The expression levels of Blimp1 protein in the liver of CCl4+AAV-shRNA-NC group(2.036±0.244,t=3.690,P=0.002)were significantly increased than that of the blank test group.In the CCl4+AAV-shRNA-Blimp1 group,the expression of Blimp1 protein decreased to the basal level(0.783±0.249,t=6.223,P=0.003).Compared with the serum levels of ALT[(1 957.8±633.6)U/L]and AST[(1 808.8±260.1)U/L]in the CCl4+AAV-shRNA-NC group,the serum levels of ALT[(894.0±360.1)U/L,t=3.998,P=0.003]and AST[(820.0±100.6)U/L,t=6.141,P=0.004]in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased.The pathological re-sults of the CCl4+AAV-shRNA-Blimp1 group showed that compared with the CCl4+AAV-shRNA-NC group,the infiltration of inflammatory cells in the liver tissue was reduced and the degree of fibrosis was alleviated.The level of α-SMA(0.676±0.064,t=7.930,P=0.001),COL1A1(1.426±0.143,t=6.364,P=0.003)and COL3A1(1.124±0.198,t=3.440,P=0.026)of liver in the CCl4+AAV-shRNA-Blimp1 group were significantly decreased than that of CCl4+AAV-shRNA-NC group,and the mRNA expression levels were altered as well as their protein levels.Conclusion:Blimp1 plays an important role in CCl4-induced liver fibrosis in mice,and knock-down the expression of Blimp1 gene is beneficial to protect early liver injury in mice.
9.Clinical efficacy of intravitreal anti-vascular endothelial growth factor agents plus panretinal photocoagulation for the treatment of young and middle-aged patients with proliferative diabetic retinopathy
Rui SHI ; Jing QIN ; Xiaoyu GONG ; Zhuoming LI ; Dandan LIU
Recent Advances in Ophthalmology 2025;45(3):216-220
Objective To assess the clinical efficacy of intravitreal anti-vascular endothelial growth factor(VEGF)agents plus panretinal photocoagulation(PRP)for treating young and middle-aged patients with proliferative diabetic reti-nopathy(PDR).Methods A retrospective case study was conducted on young and middle-aged PDR patients presenting to the Ophthalmology Department of Shaanxi Provincial People's Hospital between January 1,2021 and October 1,2024.The patients were divided into three groups according to Chinese Clinical Guidelines for Diabetic Retinopathy(2022):se-vere non-proliferative diabetic retinopathy(NPDR),early proliferative diabetic retinopathy(E-PDR)and fibrous prolifera-tive diabetic retinopathy(F-PDR).A total of 53 patients(94 eyes)were included in this study,and the mean age was(41.66±10.24)year old.There were 17 cases(31 eyes)in the NPDR group,18 cases(33 eyes)in the E-PDR group,and 18 cases(30 eyes)in the F-PDR group.All the patients were treated with the intravitreal injection of anti-VEGF agents(0.5 mg ranibizumab)about 3.5 mm from the sclerocorneal limbus at the inferior temporal sector,once a month,for three consecutive months.Routine PRP treatment was given 1 week after the first injection.Best-corrected visual acuity[BCVA(logMAR)],intraocular pressure,slit-lamp,slit-lamp fundus,optos fundus photography and OCT examinations were per-formed.The central macular thickness(CMT),average macular thickness(AMT),and the incidence of diabetic vitreous hemorrhage and emerging epiretinal membrane were recorded 1 month and 3 months after the first injection.Results Pa-tients in the F-PDR group were younger than those in NPDR and E-PDR groups(all P<0.05).The BCVA values of eyes in all the three groups increased to varying degrees after 3 months of treatment,compared with those before treatment(all P<0.05).The eyes in the F-PDR group had poorer vision than those in NPDR and E-PDR groups after 3 months of treat-ment(all P<0.05).CMT and AMT decreased in all groups after 3 months of treatment,compared with those before treat-ment(all P<0.05).No significant difference was found in CMT and AMT among the three groups at the same period(all P>0.05).Eyes in the F-PDR group had higher risk of diabetic vitreous hemorrhage and emerging epiretinal membrane than those in NPDR and E-PDR groups 3 months after treatment(all P<0.05).Conclusion Intravitreal anti-VEGF therapy combined with PRP can effectively slow the progression of PDR and improve vision acuity in young and middle-aged pa-tients.PDR patients with fibrovascular proliferation are at higher risk of diabetic vitreous hemorrhage and emerging epireti-nal membrane during the treatment with intravitreal anti-VEGF therapy plus PRP.These patients need a close follow-up,and vitrectomy should be performed in a timely manner to relieve vitreous traction when necessary.
10.Liang-Ge-San Decoction Ameliorates Acute Respiratory Distress Syndrome via Suppressing p38MAPK-NF-κ B Signaling Pathway.
Quan LI ; Juan CHEN ; Meng-Meng WANG ; Li-Ping CAO ; Wei ZHANG ; Zhi-Zhou YANG ; Yi REN ; Jing FENG ; Xiao-Qin HAN ; Shi-Nan NIE ; Zhao-Rui SUN
Chinese journal of integrative medicine 2025;31(7):613-623
OBJECTIVE:
To explore the potential effects and mechanisms of Liang-Ge-San (LGS) for the treatment of acute respiratory distress syndrome (ARDS) through network pharmacology analysis and to verify LGS activity through biological experiments.
METHODS:
The key ingredients of LGS and related targets were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. ARDS-related targets were selected from GeneCards and DisGeNET databases. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed using the Metascape Database. Molecular docking analysis was used to confirm the binding affinity of the core compounds with key therapeutic targets. Finally, the effects of LGS on key signaling pathways and biological processes were determined by in vitro and in vivo experiments.
RESULTS:
A total of LGS-related targets and 496 ARDS-related targets were obtained from the databases. Network pharmacological analysis suggested that LGS could treat ARDS based on the following information: LGS ingredients luteolin, wogonin, and baicalein may be potential candidate agents. Mitogen-activated protein kinase 14 (MAPK14), recombinant V-Rel reticuloendotheliosis viral oncogene homolog A (RELA), and tumor necrosis factor alpha (TNF-α) may be potential therapeutic targets. Reactive oxygen species metabolic process and the apoptotic signaling pathway were the main biological processes. The p38MAPK/NF-κ B signaling pathway might be the key signaling pathway activated by LGS against ARDS. Moreover, molecular docking demonstrated that luteolin, wogonin, and baicalein had a good binding affinity with MAPK14, RELA, and TNF α. In vitro experiments, LGS inhibited the expression and entry of p38 and p65 into the nucleation in human bronchial epithelial cells (HBE) cells induced by LPS, inhibited the inflammatory response and oxidative stress response, and inhibited HBE cell apoptosis (P<0.05 or P<0.01). In vivo experiments, LGS improved lung injury caused by ligation and puncture, reduced inflammatory responses, and inhibited the activation of p38MAPK and p65 (P<0.05 or P<0.01).
CONCLUSION
LGS could reduce reactive oxygen species and inflammatory cytokine production by inhibiting p38MAPK/NF-κ B signaling pathway, thus reducing apoptosis and attenuating ARDS.
Drugs, Chinese Herbal/pharmacology*
;
Respiratory Distress Syndrome/enzymology*
;
p38 Mitogen-Activated Protein Kinases/metabolism*
;
NF-kappa B/metabolism*
;
Animals
;
Signal Transduction/drug effects*
;
Molecular Docking Simulation
;
Humans
;
Male
;
Network Pharmacology
;
Apoptosis/drug effects*
;
Mice

Result Analysis
Print
Save
E-mail