1.Mechanism of Yueju Wan in Treatment of Functional Dyspepsia Based on Regulation of 5-HT Signaling Pathway
Haoran SHEN ; Yaru GU ; Muqing ZHANG ; Zhikuo DONG ; Xingxing GAO ; Dantong LI ; Ying GU ; Yixin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):20-28
ObjectiveTo investigate the effects of Yueju Wan on the 5-hydroxytryptamine (5-HT) signaling pathway in rats with functional dyspepsia (FD) and to explore its therapeutic mechanism in the treatment of FD. MethodsSixty Sprague-Dawley (SD) rats were randomly divided into a normal group, model group, mosapride group (1.575 mg·kg-1), and Yueju Wan low-, medium-, and high-dose groups (0.735, 1.47, and 2.94 g·kg-1, respectively). The FD rat model was established using GUO's tail-clamping stimulation combined with irregular feeding. After 14 days of modeling, rats were administered the corresponding drugs by gavage for 28 days. After treatment, gastric emptying rate and small intestinal propulsion rate were measured. Serum levels of 5-HT, tryptophan hydroxylase (TPH), and substance P (SP) were detected by enzyme-linked immunosorbent assay (ELISA), and acetylcholine (ACh) levels were determined by chemical methods. Histopathological changes in the gastric antrum were observed using hematoxylin-eosin (HE) staining. Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to assess the mRNA and protein expression levels of 5-hydroxytryptamine 4 receptor (5-HT4R), SP, and acetylcholinesterase (AChE) in colon tissue, as well as 5-hydroxytryptamine 3 receptor (5-HT3R), SP, and AChE in hypothalamic tissue. Immunohistochemistry (IHC) was used to examine the expression of 5-HT and 5-HT4R in the colon and 5-HT and 5-HT3R in the hypothalamus. ResultsCompared with the normal group, the gastric emptying rate and small intestinal propulsion rate in the model group were significantly decreased (P<0.01). Serum levels of 5-HT, SP, ACh, and TPH were significantly reduced (P<0.01). Histopathological examination revealed irregular arrangement of glands in the gastric antrum, slight mucosal atrophy, and mild inflammatory cell infiltration. The mRNA and protein expression levels of 5-HT4R, SP, and AChE in colon tissue, as well as 5-HT3R, SP, and AChE in hypothalamic tissue, were significantly decreased (P<0.01), and 5-HT protein expression in both the colon and hypothalamus was also significantly reduced (P<0.01). Compared with the model group, all Yueju Wan groups showed significantly increased gastric emptying rate and small intestinal propulsion rate (P<0.01). The glands in the gastric antrum were more regularly arranged, with no inflammatory cell infiltration observed. Serum levels of 5-HT, SP, ACh, and TPH were significantly increased (P<0.01). The mRNA and protein expression levels of 5-HT4R, SP, and AChE in colon tissue and 5-HT3R, SP, and AChE in hypothalamic tissue were significantly upregulated (P<0.05, P<0.01), and 5-HT protein expression in both the colon and hypothalamus was significantly increased (P<0.01). ConclusionYueju Wan has preventive and therapeutic effects on FD, and its mechanism may be related to regulation of the 5-HT signaling pathway, promotion of brain-gut peptide secretion, and enhancement of gastric motility.
2.Analyses of the epidemiological characteristics of multiple pathogens in people aged 14 years and above with acute respiratory infection in Huangpu District of Shanghai from 2015 to 2024
Yun ZHANG ; Yinzi CHEN ; Zhenzi ZUO ; Yu WANG ; Fujie SHEN ; Yuliang HUANG ; Qiang GAO ; Chenyan JIANG ; Yijun WANG
Shanghai Journal of Preventive Medicine 2026;38(2):116-121
ObjectiveTo analyze the epidemiological characteristics of 8 major respiratory pathogens in influenza-like illness (ILI) cases with acute respiratory infections at fever clinics in Huangpu District, Shanghai from 2015 to 2024, and to provide a scientific basis for the prevention and treatment of respiratory diseases. MethodsA retrospective study was conducted in Huangpu District. Individuals meeting the case definition of ILI from 2015 to 2024 was registered. Their nasopharyngeal swabs were collected for pathogen detection. A total of 8 respiratory viruses were tested, including Influenza A virus (Flu A), Influenza B virus (Flu B), adenovirus (ADV), enterovirus/human rhinovirus (EV/HRV), human parainfluenza virus (HPIV), human coronavirus (HCoV), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ResultsFrom 2015 to 2019, a total of 344 ILI cases were tested, of which 192 out of 344 cases (55.81%) were tested positive for single respiratory pathogen. From 2023 to 2024, 1 557 ILI cases were tested, with 572 out of 1 557 cases (36.74%) being positive for single pathogen. From 2023 to 2024, the positive rate of single pathogen in ILI cases was significantly lower than that in 2015‒2019 (χ2=42.66, P<0.001). Specifically, the positive rate of Flu A (χ2=74.43, P<0.001) decreased, while that of HPIV (χ2=8.66, P=0.003) increased, both with statistically significant differences. According to the seasonal pattern, the epidemic intensity of Flu A decreased in summer, while that of HPIV increased in summer and autumn. Demographic results showed statistically significant differences in the positive rates of EV/HRV between genders (χ2=22.38, P<0.001), with males exhibiting a higher positive rate than females. No statistically significant differences were identified in the positive rates of single pathogen among different age groups (χ2=4.42, P=0.110). Nevertheless, statistically significant differences were noted when comparing the positive rates of EV/HRV, Flu A, Flu B and HPIV across different age groups (P<0.05). EV/HRV was more commonly detected in the 15‒<25 age group (10.93%), while Flu A and HPIV had the highest positive rates in the ≥60 age group (21.24% and 4.77%). Flu B had the highest positive rate in the 25‒<60 age group (11.26%). 52.63% of cases with co-infections occurred during winter, with the primary pathogens involved being EV/HRV (9 cases) and HCoV (6 cases). The most prevalent combination of co-infection was Flu A with EV/HRV. ConclusionThe prevalence of respiratory pathogens among ILI cases from 2023 to 2024 exhibited notable fluctuations compared to that from 2015 to 2019. Therefore, influenza surveillance should be strengthened, and attention should also be paid to the prevalence of respiratory pathogens such as HPIV. These findings have profound implications for future research, surveillance, vaccine planning, and public health policy making.
3.Prognostic factors and surgical approach selection for descending duodenal gastrointestinal stromal tumors
Xiaohan LIN ; Chao LI ; Xiaodong GAO ; Kuntang SHEN
Chinese Journal of Clinical Medicine 2026;33(2):250-259
Objective To explore the prognostic factors for patients with descending duodenum gastrointestinal stromal tumors (GIST), analyze the impact of different surgical approaches on prognosis, and develop a predictive model for surgical approach selection. Methods This single-center retrospective cohort study included patients with primary descending duodenum GIST treated in Zhongshan Hospital, Fudan University from January 2010 to January 2015, with follow-up until August 2025. The primary outcomes were incidence of postoperative complications, disease-free survival (DFS) rate, and overall survival (OS) rate. Cox regression and logistic regression were used to identify factors influencing prognosis and surgical approach selection, respectively. A nomogram model for selecting the surgical approach was constructed. Results A total of 78 patients with descending duodenum GIST were included, with age of (56.14±11.76) years. The 1-, 5-, and 10-year OS rates were 100%, 98.7%, and 85.7%, respectively, and the corresponding DFS rates were 100%, 90.9%, and 82.3%. Intraoperative blood loss, postoperative gastroparesis, mucosal ulceration, maximum tumor diameter, and Ki-67-positive cell ratio were independent risk factors for DFS, while maximum tumor diameter and mitotic figure were independent risk factors for OS (P<0.05). The 10-year DFS rate was higher in the local resection group than in the pancreaticoduodenectomy group (89.45% vs 74.24%; HR=0.300, P=0.013), but there was no statistical difference in OS between the two groups. The incidence of postoperative complications in the pancreaticoduodenectomy group was higher than that in the local resection group (P<0.001). Maximum tumor diameter and distance from tumor to the duodenal papilla were independent factors influencing surgical approach selection. The nomogram model based on these two indices demonstrated good discrimination and accuracy upon internal validation. Conclusions The long-term prognosis of patients with descending duodenal GIST is favorable, and surgical treatment achieves satisfactory outcomes. The nomogram model developed in this study can effectively guide individualized surgical approach selection and provide a reference for clinical decision-making.
4.Efficacy and safety of sequential or combined therapy with tenofovir alafenamide fumarate in entecavir-treated patients with low-level viremia
Yijing ZHANG ; Lingying HUANG ; Bowu CHEN ; Wanchun ZHU ; Man LI ; Jie SHEN ; Yueqiu GAO
Journal of Clinical Hepatology 2026;42(1):66-73
ObjectiveTo investigate the efficacy of sequential tenofovir alafenamide fumarate (TAF) therapy versus the regimen of entecavir (ETV) combined with TAF in chronic hepatitis B (CHB) patients experiencing low-level viremia (LLV) after ETV therapy, as well as their impact on virologic response, liver and renal function, and blood lipid levels. MethodsA total of 217 CHB patients with LLV after ETV treatment who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 2020 to December 2023 were enrolled, and according to the treatment regimen, they were divided into TAF group (180 patients receiving sequential TAF therapy) and combined group (37 patients receiving ETV+TAF therapy). The propensity score matching (PSM) method was used to match the patients at a ratio of 1∶1, and finally 37 patients were included in each group to balance the baseline confounding factors. The two groups were compared in terms of hepatitis B virus DNA (HBV DNA) clearance rate, hepatitis B envelope antigen (HBeAg) clearance rate, liver and renal function parameters (liver stiffness measurement [LSM], platelet count [PLT], aspartate aminotransferase [AST], alanine aminotransferase [ALT], and creatinine [Cr]), blood lipid levels (total cholesterol [TC], triglyceride [TG], high-density lipoprotein cholesterol [HDL-C], and low-density lipoprotein cholesterol [LDL-C]), and the incidence rate of adverse reactions. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the paired t-test was used for comparison within each group; the chi-square test was used for comparison of categorical data between groups. ResultsAfter 48 weeks of treatment, compared with the TAF group, the combined group had significantly higher HBV DNA clearance rate (86.49% vs 59.46%, χ²=6.852, P=0.009) and HBeAg clearance rate (59.46% vs 35.14%, χ²=4.391, P=0.036). After treatment, compared with the TAF group, the combined group had significantly lower levels of LSM (7.01±1.50 kPa vs 7.90±1.68 kPa, t=2.404, P=0.019), AST (18.02±2.28 U/L vs 21.12±2.85 U/L, t=5.166, P<0.001), and ALT (19.85±3.86 U/L vs 22.00±3.90 U/L, t=2.383, P=0.020) and significantly higher levels of PLT [(218.35±42.60)×109/L vs (192.82±44.13)×109/L, t=2.532, P=0.014] and Cr (70.92±6.54 μmoL/L vs 67.60±6.13 μmoL/L, t=2.253, P=0.027). After treatment, there was a slight increase in the level of TC in both the TAF group (5.60±0.89 mmol/L vs 5.18±0.85 mmol/L, t=2.076, P=0.041) and the combined group (5.45±0.80 mmol/L vs 5.02±0.83 mmol/L, t=2.269, P=0.026). There was no significant difference in the incidence rate of adverse reactions between the TAF group and the combined group (21.62% vs 18.92%, χ²=0.084, P=0.772). ConclusionFor ETV-treated CHB patients experiencing LLV, compared with sequential TAF therapy, the ETV+TAF combined therapy can effectively increase virologic response rate, alleviate liver fibrosis, and improve liver function, whereas sequential TAF therapy has less impact on renal function. Sequential or combined therapy with TAF may induce a slight increase in the level of TC, which should be taken seriously in clinical practice.
5.Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma Regulates Ferroptosis via Nrf2/SLC7A11/GPX4 Signaling Pathway to Alleviate Myocardial Remodeling in Rat Model of Myocardial Infarction
Xuesong CHEN ; Rongnan QIU ; Shenghao WANG ; Yan FENG ; Jutong XIE ; Yuwen YAN ; Tianlin YANG ; Changxu XIE ; Lei GAO ; Jianping SHEN ; Yuehong SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):54-62
ObjectiveTo investigate the effect of Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma on ferroptosis in the rat model of myocardial infarction and further elucidate its role in myocardial remodeling. MethodsThe rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. The 50 successfully modeled rats were randomly divided into model group, ferroptosis inhibitor group (2 mg·kg-1), enalapril group (2.1 mg·kg-1), and low- and high-dose (4 g·kg-1 and 8 g·kg-1, respectively) Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma, with 10 rats in each group. The rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. After 4 weeks of treatment, echocardiography was used to assess the cardiac structure and function. Hematoxylin-eosin (HE) staining and Masson staining were employed to observe pathological morphology and fibrosis of the myocardial tissue. Serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), transforming growth factor-β (TGF-β), and myosin heavy chain-β (MHC-β) were measured by enzyme-linked immunosorbent assay (ELISA). Prussian blue staining was performed to detect myocardial iron deposition. The myocardial mitochondrial structure was observed by transmission electron microscopy. Levels of malondialdehyde (MDA) and glutathione (GSH) in the myocardial tissue were determined by lipid peroxidation assay kits. Immunofluorescence assay was conducted to observe the fluorescence intensity of nuclear factor E2-related factor 2 (Nrf2) in the myocardial tissue. Western blot analysis was performed to evaluate the expression levels of proteins in the Nrf2/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway. ResultsCompared with the sham group, the model group showed increased left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01), disarrangement of myocardial cells, inflammatory cell infiltration, severe myocardial fibrosis, increased myocardial iron deposition, and irregular mitochondrial morphology with vacuolation. Furthermore, the modeling led to increased MDA (P<0.01), decreased GSH (P<0.01), diminished Nrf2 fluorescence intensity in the myocardial tissue, and downregulated expression levels of Nrf2, SLC7A11, and GPX4 (P<0.01). Compared with the model group, Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma reduced the LVEDD, LVESD, and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.05, P<0.01), increased the LVEF and LVFS (P<0.05, P<0.01), alleviated pathological changes such as myocardial cell disarrangement, inflammatory cell infiltration, myocardial fibrosis, and iron deposition, lowered the level of MDA (P<0.05, P<0.01), raised the level of GSH (P<0.05, P<0.01), improved the mitochondrial morphology and reduced vacuolation in the myocardial tissue, enhanced Nrf2 fluorescence intensity, and upregulated the expression levels of Nrf2, SLC7A11, and GPX4 (P<0.05, P<0.01) in the rat model of myocardial infarction. ConclusionGardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma alleviates pathological damage and myocardial remodeling in the rat model of myocardial infarction by inhibiting ferroptosis, the mechanism of which is related to the activation of Nrf2/SLC7A11/GPX4 signaling pathway.
6.Analyses of T lymphocyte subset levels and viral loads in human immunodeficiency virus antibody-confirmed positive cases in Suzhou from 2021 to 2024
Runfang TIAN ; Qiang SHEN ; Xuerong YA ; Yue DAI ; Qian GAO
Shanghai Journal of Preventive Medicine 2026;38(3):210-215
ObjectiveTo investigate the T lymphocyte subset levels and viral loads in newly human immunodeficiency virus (HIV) antibody-confirmed positive cases in Suzhou (2021‒2024), and to analyze potential influencing factors by integrating their demographic characteristics, immune status, and viral replication patterns, thereby providing evidence for HIV/acquired immune deficiency syndrome (AIDS) prevention and control. MethodsPeripheral whole blood samples were collected from newly confirmed HIV-positive cases in Suzhou from 2021 to 2024. T lymphocyte subset analysis and viral load testing were performed, and influencing factors were identified in combination with demographic characteristics. Logistic regression models were employed to identify factors associated with CD4+T lymphocyte counts ≤350 cells·μL-1, and Spearman’s rank correlation test was used to analyze the correlation between logarithmic value of viral load and CD4+/CD8+ ratio. ResultsAmong the 3 022 confirmed HIV-positive samples, the median CD4+T lymphocyte count was 298.00 cells·μL-1, with 882 cases (29.19%) showing CD4+ T lymphocyte counts <200 cells·μL-1. The median CD8+T lymphocyte count was 1 011.00 cells·μL-1. The median CD4+/CD8+ ratio was 0.28, with 32.46% of cases exhibiting CD4+/CD8+ ratios <0.20, and there were statistically significant differences in CD4+/CD8+ ratio among different genders, age groups, marital status, and sample sources (all P<0.05). Multivariate logistic regression analyses indicated that individuals aged ≥20 years, those who were divorced or widowed, and cases identified through medical institutions had a significantly higher proportion of CD4+T lymphocyte counts ≤350 cells·µL⁻¹ compared to those aged <20 years, unmarried individuals, and cases sourced from voluntary counseling and testing (VCT) clinics, respectively. The mean logarithmic value of viral load was (4.29±1.15) copies·mL-1. The logarithmic value of viral load demonstrated a significantly negative correlation with both CD4+/CD8+ ratio (r=-0.43, P<0.001) and CD4+T lymphocyte count (r=-0.37, P<0.001). ConclusionA substantial proportion of newly diagnosed HIV/AIDS cases in Suzhou are late presenters with high viral load levels. Targeted interventions should prioritize high-risk populations through enhanced active surveillance and the implementation of combined T lymphocyte subsets analysis and viral load testing, which can enable earlier case-finding and timely antiretroviral therapy initiation.
7.Pathogen detection and genetic characteristic analyses of hand-foot-and-mouth disease in Dehong Prefecture of Yunnan Province in 2023
Zhuoya GAO ; Jiangli ZHU ; Dingfu LUO ; Bingjun TIAN ; Kang YANG ; Zengjiao DUAN ; Runbo ZHANG ; Yinghao CHEN ; Zhuo SHEN
Shanghai Journal of Preventive Medicine 2026;38(6):446-452
ObjectiveTo genotype the specimens from hand-foot-and-mouth disease (HFMD) cases in Dehong Prefecture, Yunnan Province in 2023 by gene sequencing, and to analyze the genetic characteristics of Coxsackievirus A4 (CVA4), CVA6, CVA10, CVA16 and enterovirus A71 (EV-A71), so as to clarify the serotypes of enteroviruses causing endemic HFMD and the genotype composition of CVA4, CVA6, CVA10, CVA16 and EV-A71 prevalent in HFMD, and to provide baseline genotype data for monitoring the dynamic changes of the five virus genotypes. MethodsStool specimens from HFMD cases in Dehong Prefecture in 2023 that tested positive for EV-A71, CVA16 and other enteroviruses by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) were first subjected to gene sequencing and typing of the VP4/VP2 junction region to determine the viral types. Subsequently, the complete VP1 gene of each virus was amplified in two segments using group-specific VP1 gene primers corresponding to enterovirus groups (i.e., enterovirus group A, B, and C) and sequenced (group A virus: primers 486/488 and 487/489, group B virus: primers 490/492 and 491/493, group C virus: primers 494/496 and 495/497). The representative reference sequences of VP1 genes for CVA4, CVA6, CVA10, CVA16 and EV-A71 were downloaded from the literature, and the VP1 gene phylogenetic tree was constructed using MEGA 6.0 software for genetic characterization. ResultsA total of 256 stool specimens were collected from HFMD cases in Dehong Prefecture in 2023, of which 94 tested positive for nucleic acid by RT-qPCR, yielding a positive rate of 36.72%. Of the 94 positive specimens, 83 were identified as group A viruses, and were classified into 5 serotypes (17 strains of CVA4, 3 of CVA6, 6 of CVA10, 49 of CVA16, and 8 of EV-A71). Nine strains were group B viruses, comprising 2 serotypes: 2 strains of echovirus type 3 (E3) and 7 strains of Coxsackievirus B type 5 (CVB5). The remaining 2 strains were group C viruses, both identified as poliovirus type 3 (PV3). Genetic analyses of the VP1 region showed that all 17 CVA4 strains were identified as subgenotype C2, all 3 CVA6 strains as subgenotype D3a, all 6 CVA10 strains as genotype C. Among the 49 CVA16 strains, 46 were identified as subgenotype B1a and 3 as subgenotype B1b, and all 8 EV-A71 strains were identified as subgenotype C4a. ConclusionIn 2023, group A viruses dominated the pathogenic spectrum of HFMD in Dehong Prefecture. Among them, CVA16 had the highest positivity rate. Genetic characteristic analyses showed that CVA4, CVA6, CVA10 and EV-A71 were each composed of a single genotype (subgenotype), while CVA16 was composed of two subgenotypes (B1a and B1b), with B1a being the predominant one. It is recommended that molecular epidemiological surveillance of HFMD pathogens, particularly group A viruses, be continuously strengthened in Dehong Prefecture.
8.Traditional Chinese Medicine Regulates NF-κB Signaling Pathway in Treating Diabetic Retinopathy: A Review
Yue ZHU ; Ze WANG ; Yueyao TANG ; Ruoshan GAO ; Xianyan SHEN ; Ruiping XIE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):315-324
Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus, and its characteristic pathological changes include microaneurysm formation, hemorrhagic focus formation, exudate deposition, and neovascular proliferation. Long-term hyperglycemic state can induce inflammatory response, oxidative stress, and overexpression of vascular endothelial growth factor (VEGF), which destroys the blood-retinal barrier and promotes the progression of DR. Although the current clinical treatment methods (such as laser photocoagulation and anti-VEGF drugs) have certain effects, they still have limitations, and there is an urgent need to explore safer and multi-target intervention strategies. Recent studies have discovered that the nuclear factor (NF)-κB signaling pathway plays a key role in the pathological process of DR. This pathway affects the occurrence and development of DR by regulating the release of inflammatory factors, oxidative stress response, and angiogenesis. With the advantages of multi-component, multi-target and overall regulation, traditional Chinese medicine (TCM) has shown unique potential in the prevention and treatment of DR. Especially, its precise regulation of the NF-κB pathway has become a research hotspot. This article systematically reviews the mechanisms of action of NF-κB-related signaling pathways in DR, with focuses on the research progress in TCM single herbs and active ingredients, Chinese patent medicines, and TCM compound preparations in ameliorating DR by regulating the NF-κB pathway. This review aims to provide a theoretical basis and a transformation direction for the development of drugs for the prevention and treatment of DR.
9.Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma Regulates Ferroptosis via Nrf2/SLC7A11/GPX4 Signaling Pathway to Alleviate Myocardial Remodeling in Rat Model of Myocardial Infarction
Xuesong CHEN ; Rongnan QIU ; Shenghao WANG ; Yan FENG ; Jutong XIE ; Yuwen YAN ; Tianlin YANG ; Changxu XIE ; Lei GAO ; Jianping SHEN ; Yuehong SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):54-62
ObjectiveTo investigate the effect of Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma on ferroptosis in the rat model of myocardial infarction and further elucidate its role in myocardial remodeling. MethodsThe rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. The 50 successfully modeled rats were randomly divided into model group, ferroptosis inhibitor group (2 mg·kg-1), enalapril group (2.1 mg·kg-1), and low- and high-dose (4 g·kg-1 and 8 g·kg-1, respectively) Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma, with 10 rats in each group. The rat model of myocardial infarction was established by ligation of the left anterior descending coronary artery. After 4 weeks of treatment, echocardiography was used to assess the cardiac structure and function. Hematoxylin-eosin (HE) staining and Masson staining were employed to observe pathological morphology and fibrosis of the myocardial tissue. Serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), transforming growth factor-β (TGF-β), and myosin heavy chain-β (MHC-β) were measured by enzyme-linked immunosorbent assay (ELISA). Prussian blue staining was performed to detect myocardial iron deposition. The myocardial mitochondrial structure was observed by transmission electron microscopy. Levels of malondialdehyde (MDA) and glutathione (GSH) in the myocardial tissue were determined by lipid peroxidation assay kits. Immunofluorescence assay was conducted to observe the fluorescence intensity of nuclear factor E2-related factor 2 (Nrf2) in the myocardial tissue. Western blot analysis was performed to evaluate the expression levels of proteins in the Nrf2/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway. ResultsCompared with the sham group, the model group showed increased left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01), disarrangement of myocardial cells, inflammatory cell infiltration, severe myocardial fibrosis, increased myocardial iron deposition, and irregular mitochondrial morphology with vacuolation. Furthermore, the modeling led to increased MDA (P<0.01), decreased GSH (P<0.01), diminished Nrf2 fluorescence intensity in the myocardial tissue, and downregulated expression levels of Nrf2, SLC7A11, and GPX4 (P<0.01). Compared with the model group, Gardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma reduced the LVEDD, LVESD, and serum levels of NT-proBNP, TGF-β, and MHC-β (P<0.05, P<0.01), increased the LVEF and LVFS (P<0.05, P<0.01), alleviated pathological changes such as myocardial cell disarrangement, inflammatory cell infiltration, myocardial fibrosis, and iron deposition, lowered the level of MDA (P<0.05, P<0.01), raised the level of GSH (P<0.05, P<0.01), improved the mitochondrial morphology and reduced vacuolation in the myocardial tissue, enhanced Nrf2 fluorescence intensity, and upregulated the expression levels of Nrf2, SLC7A11, and GPX4 (P<0.05, P<0.01) in the rat model of myocardial infarction. ConclusionGardeniae Fructus-Salviae Miltiorrhizae Radix et Rhizoma alleviates pathological damage and myocardial remodeling in the rat model of myocardial infarction by inhibiting ferroptosis, the mechanism of which is related to the activation of Nrf2/SLC7A11/GPX4 signaling pathway.
10.Analysis of subjective visual vertical test results in patients with benign paroxysmal positional vertigo at different head deflection angles
Maolin QIN ; Xiaobao MA ; Dekun GAO ; Jiali SHEN ; Qin ZHANG ; Yulian JIN ; Jie WANG ; Jun YANG ; Jianyong CHEN
Chinese Journal of Clinical Medicine 2025;32(2):183-187
Objective To analyze the clinical significance of subjective visual vertical (SVV) tests at different head deflection angles in assessing utricle function in patients with benign paroxysmal positional vertigo (BPPV). Methods A total of 61 BPPV patients who were treated at the Hearing Impairment and Vertigo Diagnosis and Treatment Center of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from August 2022 to May 2023 were retrospectively included, and 29 healthy adults were selected as controls. SVV tests were performed on all research subjects at different head deflection angles: upright head (0°), left head 45° (L45°), right head 45° (R45°). The test results between the two groups were compared. Results SVV absolute value at R45° in BPPV group was lower than that in the control group (P=0.003); there was no significant difference in SVV values at 0° and L45° between the two groups. There was no statistical difference in SVV values at different head deflection angles between the control group and the left BPPV group. SVV absolute value at R45° in right BPPV group was lower than that in the control group (P<0.001); there was no statistical difference in SVV values at 0° and L45° between the two groups. Conclusions SVV test can provide subjective information about the utricle, and SVV tests at different head deflection angles can fine-tune evaluate the function of the utricle in BPPV patients.

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