1.Primary Cilium-mediated Mechano-metabolic Coupling: Cross-system Homeostatic Regulation of The Nervous, Bone, Vascular, and Renal Systems
Liang-Chen DUAN ; Hao-Liang HU ; Shu-Zhi WANG ; Jia-Long YAN ; Lin-Xi CHEN
Progress in Biochemistry and Biophysics 2026;53(3):577-592
Primary cilia—those solitary, microtubule-based projections extending from the surface of most eukaryotic cells—are increasingly recognized not merely as cellular appendages, but as sophisticated signaling hubs. By compartmentalizing specific receptors (e.g., GPCRs) and effectors within a microdomain guarded by the transition zone, these organelles function effectively as high-gain sensors capable of integrating mechanical stimuli with metabolic cues. In this review, we examine the pivotal role of primary cilia across the nervous, bone-vascular, and renal landscapes, arguing for a unified “mechano-metabolic coupling” framework. Here, conserved ciliary modules are not static; rather, they are differentially deployed to uphold systemic homeostasis. Within the central nervous system, we position primary cilia as upstream integrators. We highlight how hypothalamic neuronal cilia concentrate metabolic receptors, such as the melanocortin 4 receptor (MC4R), to interpret energy status. Moreover, the recent identification of serotonergic “axon-cilium synapses” points to a direct mode of neurotransmission, wherein 5-HT6 receptors drive nuclear signaling and chromatin accessibility to rapidly modulate gene expression. Through these mechanisms, central cilia modulate sympathetic tone and neuroendocrine output, effectively establishing the mechanical and metabolic “boundary conditions” under which peripheral organs operate. Dysfunction in these central hubs is linked to obesity and neurodevelopmental disorders, including Bardet-Biedl syndrome. In peripheral tissues, cilia serve as versatile mechanotransducers that convert physical forces into biochemical responses. Regarding the bone-vascular system, we discuss the translation of mechanical loads and fluid shear stress into structural remodeling. In osteoblasts, specifically, ciliary integrity is intrinsically linked to cholesterol and glucose metabolism, fine-tuning the balance between Hedgehog and Wnt/β-catenin signaling to govern osteogenesis and bone repair. A similar dynamic exists in the vasculature, where endothelial cilia sense shear stress to modulate KLF4 expression and endothelial-to-mesenchymal transition—processes critical for valvulogenesis and vascular remodeling. Meanwhile, in the kidney, tubular cilia act as terminal effectors within a “shear-cilia-metabolism” axis. Here, fluid shear stress engages ciliary signaling to trigger AMPK-mediated lipophagy and mitochondrial biogenesis, thereby securing the ATP supply required for solute transport. Notably, dysregulation of this axis leads to metabolic reprogramming and aberrant proliferation, acting as a hallmark driver of cystogenesis in polycystic kidney disease (PKD). Crucially, this review attempts to dissect the often-conflated logic of cross-system integration by distinguishing 3 non-equivalent pathways: direct communication via ciliary extracellular vesicles, though this remains largely hypothetical in long-range signaling; “physiology-mediated cascades”, where ciliary dysfunction in a single organ—such as the kidney—precipitates systemic pathology through hemodynamic and metabolic shifts (e.g., altered blood pressure, fluid volume, or uremic toxins); and “parallel molecular defects”, where shared genetic mutations in ubiquitous components like the IFT machinery cause simultaneous, independent failures across multiple organ systems. Building on these distinctions, we propose a nested-loop model that links central set-points with peripheral feedback via physiological variables. Furthermore, we construct a “causality-to-translation” roadmap that pinpoints structural repair (e.g., targeting IFT assembly) and metabolic rescue (e.g., AMPK activation or autophagy induction) as promising therapeutic avenues. Ultimately, this framework provides a theoretical basis for deciphering the shared pathological mechanisms of multisystem ciliopathies, offering a strategic guide for the development of targeted interventions that go beyond symptomatic treatment.
2.Advancements in Gas-releasing Micro/Nanoplatforms for Overcoming MDR Bacterial Infections in Diabetic Wounds
Ruo-Can LIU ; Yu-Qian WANG ; Shuai ZHANG ; Shao-Zhi ZUO ; Yun-Di WU ; Xi-Long WU
Progress in Biochemistry and Biophysics 2026;53(5):1356-1375
Chronic diabetic wounds, severely complicated by multidrug-resistant (MDR) bacterial infections, represent a profound and escalating global health crisis. The intrinsically hostile microenvironment of diabetic wounds, characterized by localized hypoxia, persistent oxidative stress, and poor vascularization, creates an ideal niche for opportunistic pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. These bacteria readily construct dense extracellular polymeric substance (EPS) biofilms, which not only physically shield the microbes from host immune responses but also actively trap the wound in a state of chronic, unresolved inflammation. Consequently, conventional systemic and topical antibiotic therapies are becoming increasingly futile, as poor perfusion at the wound site restricts drug bioavailability, while the rapid genetic evolution of bacteria and the impenetrable nature of biofilms lead to catastrophic treatment failures, often culminating in severe tissue necrosis and lower-extremity amputations. To circumvent the limitations of traditional antimicrobials, therapeutic gas delivery has emerged as a highly promising, paradigm-shifting strategy. Gaseous signaling molecules, particularly nitric oxide (NO), carbon monoxide (CO), hydrogen sulfide (H2S), and hydrogen (H2), possess unique physicochemical properties that allow them to seamlessly penetrate dense biofilm matrices and cellular membranes. Once inside, these gases operate via multi-targeted mechanisms that are incredibly difficult for bacteria to develop resistance against; for instance, NO induces severe lipid peroxidation and DNA cleavage in bacteria, CO downregulates pro-inflammatory cytokines, H2S significantly accelerates endothelial cell migration for neovascularization, and H2 acts as a powerful selective antioxidant to neutralize tissue-damaging reactive oxygen species (ROS). Together, these therapeutic gases not only exert broad-spectrum bactericidal effects but also actively reprogram the wound bed by promoting the critical M1-to-M2 macrophage polarization and stimulating angiogenesis. Despite their immense biological potential, the direct clinical translation of gas therapies is severely hindered by inherent physicochemical drawbacks, including extreme volatility, short physiological half-lives, poor aqueous solubility, and the high risk of off-target systemic toxicity, if applied indiscriminately. To conquer these immense pharmacokinetic barriers, cutting-edge advancements in materials science have driven the development of gas-releasing micro- and nanoplatforms. Utilizing sophisticated carriers such as metal-organic frameworks (MOFs), mesoporous silica, polymeric nanoparticles, liposomes, and injectable hydrogels, researchers can now encapsulate gas-donor molecules to achieve sustained, localized delivery. More importantly, these advanced nanoplatforms are ingeniously engineered to be stimuli-responsive. By exploiting the pathological hallmarks of the diabetic wound environment, such as elevated glucose concentrations, acidic pH, and overexpressed ROS, or by utilizing external triggers like near-infrared (NIR) light irradiation and ultrasound, these intelligent platforms ensure on-demand, precise spatio-temporal gas release. This often allows for powerful synergistic combinations, such as photothermal or photodynamic therapy coupled with gas release, thereby obliterating biofilms while sparing healthy tissue. While the therapeutic outcomes of these smart delivery systems in eradicating MDR infections and accelerating tissue repair are unprecedented, several critical challenges remain before widespread clinical adoption, as long-term biosafety profiles of the carrier nanomaterials, complexities in large-scale good manufacturing practice (GMP) production, and stringent regulatory hurdles must be rigorously addressed. Looking forward, the next frontier lies in the realm of precision medicine and theranostics, where future research must focus on the seamless integration of these gas-releasing platforms with flexible, wearable biosensors capable of continuously monitoring wound biomarkers (e.g., pH, temperature, uric acid) in real-time. Coupled with artificial intelligence algorithms to govern automated, closed-loop adaptive dosing, these next-generation smart dressings hold the ultimate potential to comprehensively transform the clinical management of complex, infected diabetic wounds.
3.Advancements in Gas-releasing Micro/Nanoplatforms for Overcoming MDR Bacterial Infections in Diabetic Wounds
Ruo-Can LIU ; Yu-Qian WANG ; Shuai ZHANG ; Shao-Zhi ZUO ; Yun-Di WU ; Xi-Long WU
Progress in Biochemistry and Biophysics 2026;53(5):1356-1375
Chronic diabetic wounds, severely complicated by multidrug-resistant (MDR) bacterial infections, represent a profound and escalating global health crisis. The intrinsically hostile microenvironment of diabetic wounds, characterized by localized hypoxia, persistent oxidative stress, and poor vascularization, creates an ideal niche for opportunistic pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. These bacteria readily construct dense extracellular polymeric substance (EPS) biofilms, which not only physically shield the microbes from host immune responses but also actively trap the wound in a state of chronic, unresolved inflammation. Consequently, conventional systemic and topical antibiotic therapies are becoming increasingly futile, as poor perfusion at the wound site restricts drug bioavailability, while the rapid genetic evolution of bacteria and the impenetrable nature of biofilms lead to catastrophic treatment failures, often culminating in severe tissue necrosis and lower-extremity amputations. To circumvent the limitations of traditional antimicrobials, therapeutic gas delivery has emerged as a highly promising, paradigm-shifting strategy. Gaseous signaling molecules, particularly nitric oxide (NO), carbon monoxide (CO), hydrogen sulfide (H2S), and hydrogen (H2), possess unique physicochemical properties that allow them to seamlessly penetrate dense biofilm matrices and cellular membranes. Once inside, these gases operate via multi-targeted mechanisms that are incredibly difficult for bacteria to develop resistance against; for instance, NO induces severe lipid peroxidation and DNA cleavage in bacteria, CO downregulates pro-inflammatory cytokines, H2S significantly accelerates endothelial cell migration for neovascularization, and H2 acts as a powerful selective antioxidant to neutralize tissue-damaging reactive oxygen species (ROS). Together, these therapeutic gases not only exert broad-spectrum bactericidal effects but also actively reprogram the wound bed by promoting the critical M1-to-M2 macrophage polarization and stimulating angiogenesis. Despite their immense biological potential, the direct clinical translation of gas therapies is severely hindered by inherent physicochemical drawbacks, including extreme volatility, short physiological half-lives, poor aqueous solubility, and the high risk of off-target systemic toxicity, if applied indiscriminately. To conquer these immense pharmacokinetic barriers, cutting-edge advancements in materials science have driven the development of gas-releasing micro- and nanoplatforms. Utilizing sophisticated carriers such as metal-organic frameworks (MOFs), mesoporous silica, polymeric nanoparticles, liposomes, and injectable hydrogels, researchers can now encapsulate gas-donor molecules to achieve sustained, localized delivery. More importantly, these advanced nanoplatforms are ingeniously engineered to be stimuli-responsive. By exploiting the pathological hallmarks of the diabetic wound environment, such as elevated glucose concentrations, acidic pH, and overexpressed ROS, or by utilizing external triggers like near-infrared (NIR) light irradiation and ultrasound, these intelligent platforms ensure on-demand, precise spatio-temporal gas release. This often allows for powerful synergistic combinations, such as photothermal or photodynamic therapy coupled with gas release, thereby obliterating biofilms while sparing healthy tissue. While the therapeutic outcomes of these smart delivery systems in eradicating MDR infections and accelerating tissue repair are unprecedented, several critical challenges remain before widespread clinical adoption, as long-term biosafety profiles of the carrier nanomaterials, complexities in large-scale good manufacturing practice (GMP) production, and stringent regulatory hurdles must be rigorously addressed. Looking forward, the next frontier lies in the realm of precision medicine and theranostics, where future research must focus on the seamless integration of these gas-releasing platforms with flexible, wearable biosensors capable of continuously monitoring wound biomarkers (e.g., pH, temperature, uric acid) in real-time. Coupled with artificial intelligence algorithms to govern automated, closed-loop adaptive dosing, these next-generation smart dressings hold the ultimate potential to comprehensively transform the clinical management of complex, infected diabetic wounds.
4.Research on In-Situ Extractive Ionization for Original Ecological Samples and Its Miniature Device
Xiao-Feng DONG ; Feng LIU ; You-Han XUE ; Xi-De YE ; Shuang-Long WANG
Chinese Journal of Analytical Chemistry 2025;53(5):749-757
Current ambient mass spectrometry ionization often requires external auxiliary equipment such as high-voltage power supply,gas cylinder,and syringe pump.Moreover,the process of sample preparation is cumbersome,and the experimental operations are complex,which makes it difficult to adapt to real-time on-site detection.In this work,a novel method was proposed,in which direct sampling of raw samples,online extraction of interest analytes,and ionization of target molecules were integrated into a single unit.With the developed method,the in-situ extraction and nano-electrospray ionization for both liquid and solid raw samples were achieved.Also,a handheld ion source and its pose adjustment device were developed,and the position and angle parameters were subsequently optimized.The performance of the ionization device was tested using standard solutions of caffeine and reserpine.The limits of detection(LODs)were 0.08 μg/L and 0.14 μg/L,with relative standard deviations(RSDs)≤3.7% and≤5.6%,respectively,indicating that the device possessed high sensitivity and stability.Using this device,three different concentrations of reserpine standard solutions were continuously tested for five days.The intra-day RSDs were consistently≤4.7% and the inter-day RSDs were all≤10.3%,showing the good working stability of the device.Without any pretreatment,a rapid qualitative detection of medicinal components including astragaloside II and cycloastragenol in five traditional Chinese medicines was carried out,with RSDs≤8.0% and≤7.1%,respectively.Additionally,rapid qualitative detection of gallic acid,a medicinal component,in white peony roots,and hypaphorine as well as quercetin in cowherb seeds were carried out,with RSDs≤7.0%,≤6.4% and≤6.1%,respectively.These results demonstrated that the ionization technology and device exhibited good stability during qualitative detection of raw samples.
5.Association between dietary behavior and type 2 diabetes in the older adults aged 65 years and over in 18 longevity areas of China
Xuehua HU ; Yue CHEN ; Zenghang ZHANG ; Chen CHEN ; Yingli QU ; Xi MENG ; Jun WANG ; Zinan XU ; Zheng LI ; Sixin LIU ; Wenhui SHI ; Zhanhong XUE ; Fanye LONG ; Xiaoming SHI ; Yuebin LYU
Chinese Journal of Preventive Medicine 2025;59(5):588-596
Objective:To explore the impact of plant and animal dietary behaviors on type 2 diabetes mellitus (T2DM) in older adults aged ≥65 in 18 longevity areas of China.Methods:The subjects were 5 223 older adults over 65 years old from the Healthy Ageing and Biomarkers Cohort Study (HABCS) in 18 longevity areas in China. Through a questionnaire survey and physical examination, information about their demographic characteristics, lifestyles, daily activities, self-health status, current diseases, and fasting venous blood were collected. Food Frequency and Questionnaire (FFQ) was used to collect data on food intake frequency. Based on the prior method, the plant-based diet index (PDI) and animal-based diet index (ADI) of 5 223 older adults were calculated. Subjects were divided into three groups (low-level group: PDI<39 or ADI<31, middle-level group: 39≤PDI≤42 or 31≤ADI≤34, high-level group: PDI>42 or ADI>34) by tertiles of PDI and ADI. Multivariate logistic regression was used to analyze the association between PDI and ADI and the risk of T2DM.Results:The average age of 5 223 subjects was (84.8±11.5) years, with the median ( Q1, Q3) of PDI about 41(38, 43) and the median ( Q1, Q3) of ADI about 33 (30, 35). The prevalence rate of T2DM was 16.41% (857/5 223). After adjusting for covariates, multivariate logistic regression showed that PDI was negatively associated with T2DM. Compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 0.83 (0.69-0.99). ADI was positively associated with T2DM, and compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 1.28 (1.06-1.55). For every one-point increase in PDI and ADI, the risk of T2DM decreased by 2% and increased by 3%, respectively, with the OR (95% CI) of 0.98 (0.96-1.00) and 1.03 (1.01-1.06), respectively. Conclusion:In Chinese older adults ≥65 years in 18 longevity areas, higher adherence to the plant-based behavior may be negatively associated with the risk of T2DM, while higher adherence to the animal-based behavior may be positively associated with the risk of T2DM.
6.Congrong San alleviates hippocampal neuronal injury and ferroptosis in AD rats by inhibiting GRP78-PERK-ATF4 signaling pathway
Yuan-qin CAI ; Xian-bing CHEN ; Qing-hua LONG ; Xi WANG ; Zhen-ning WANG ; Chu-hua ZENG
Chinese Pharmacological Bulletin 2025;41(5):874-880
Aim To investigate the effects of Congrong San(CRS)on learning and memory ability,hippocam-pal neuronal injury,and ferroptosis in rats with Alzhei-mer's disease(AD)and to explore the related mecha-nisms.Methods AD rat models were established and divided into Sham,Model,CRS low-dose,CRS medium-dose,CRS high-dose,and memantine groups.After treatment,Morris water maze,HE and Nissl staining,transmission electron microscopy,immunofluorescence staining,Western blot,and kit assays were performed to assess learning and memory ability,hippocampal neuro-nal injury,ferroptosis-related indicatorsand glucose reg-ulated protein 78 ku(GRP78)-(proteinkinaseR-li-keERkinase)PERK-(activating transcription factor 4)ATF4 pathway protein expression.Results Com-pared with the model group,rats in the CRS medium-and high-dose groups and the memantine group showed significant improvement in learning and memory abili-ty,reduced hippocampal neuronal injury,increased number of Nissl bodies,and ameliorated endoplasmic reticulum swelling and mitochondrial damage.In addi-tion,the expressions of GRP78,p-PERK/PERK,and ATF4 were downregulated,while GPX4 expression was upregulated in the CRS medium-and high-dose groups and the memantine group.Moreover,MDA content de-creased,and SOD and GSH-PX levels increased in these groups.Conclusions CRS can improve the learning and memory ability in AD rats,reduce hipp-ocampal neuronal injury and ferroptosis,and its mecha-nism may be related to the inhibition of the GRP78-PERK-ATF4 pathway,enhancement of GPX4 expres-sion,and reduction of oxidative stress levels,providing a new approach for the clinical treatment of AD.
7.Mid-term follow-up and clinical experience of a novel expandable PEEK implant in osteoporotic thoraco-lumbar fractures
Long CHEN ; Xiaozhen WANG ; Jintao XI ; Qilin LU
The Journal of Practical Medicine 2025;41(8):1181-1191
Objective To assess the mid-term clinical prognosis and radiological outcomes of a novel expandable PEEK(polyetheretherketone)vertebral replacement device used for anterior and middle column recon-struction in the thoracolumbar spine of osteoporotic patients.Methods A retrospective analysis was performed on 52 patients with single-segment osteoporotic thoracolumbar fractures who underwent vertebral body replacement surgery between January 2020 and December 2023.The surgical procedures included either a thoracoscopic or minimally invasive anterior approach,combined with posterior short-segment cement-augmented screw fixation.According to the type of replacement material used,patients were categorized into two groups:the novel PEEK group and the titanium Mesh cage group.Data on surgical time,intraoperative blood loss,and postoperative complications were collected.The Visual Analogue Score(VAS),Oswestry Disability Index(ODI),local kyphotic angle(LKA),fusion segment height(D-line),anterior vertebral body height(AVBH),and posterior vertebral body height(PVBH)were assessed at three stages:preoperatively,immediately postoperatively,and during the final follow-up.Results All patients were successfully discharged.In the PEEK group,the average operative time was(235.28±58.69)minutes,and intraoperative blood loss was(680.00±163.30)mL.The mean follow-up duration was(14.12±2.44)months.The VAS score decreased significantly from(7.44±0.87)preoperatively to(2.24±0.93)at the final follow-up,and the ODI score also decreased significantly from(42.64±4.86)preoperatively to(11.84±3.73)at the final follow-up,indicating substantial improvement in symptoms and function(P<0.05).At the final follow-up,LKA,D-line,and AVBH exhibited partial loss compared to immediate postoperative values(P>0.05),but they remained significantly improved compared to preoperative values(P<0.05).The postoperative complication rate was 12.00%(3/25),and the fusion rate at the final follow-up was 100.00%.Similarly,the Mesh group effectively improved patient symptoms,function,and vertebral height(P<0.05).However,at the final follow-up,the PEEK group demonstrated significantly better LKA,D-line,and AVBH values compared to the Mesh group(P<0.05).Conclusion The short-segment cement-augmented internal fixation in combination with the novel expandable PEEK replacement device represents a viable solution for anterior column reconstruction in osteoporotic thoracolumbar fractures,as evidenced by its mid-term outcomes of effective pain relief,significant functional improvement,sustained maintenance of vertebral height,and successful deformity correction.
8.Ablation of macrophage transcriptional factor FoxO1 protects against ischemia-reperfusion injury-induced acute kidney injury.
Yao HE ; Xue YANG ; Chenyu ZHANG ; Min DENG ; Bin TU ; Qian LIU ; Jiaying CAI ; Ying ZHANG ; Li SU ; Zhiwen YANG ; Hongfeng XU ; Zhongyuan ZHENG ; Qun MA ; Xi WANG ; Xuejun LI ; Linlin LI ; Long ZHANG ; Yongzhuo HUANG ; Lu TIE
Acta Pharmaceutica Sinica B 2025;15(6):3107-3124
Acute kidney injury (AKI) has high morbidity and mortality, but effective clinical drugs and management are lacking. Previous studies have suggested that macrophages play a crucial role in the inflammatory response to AKI and may serve as potential therapeutic targets. Emerging evidence has highlighted the importance of forkhead box protein O1 (FoxO1) in mediating macrophage activation and polarization in various diseases, but the specific mechanisms by which FoxO1 regulates macrophages during AKI remain unclear. The present study aimed to investigate the role of FoxO1 in macrophages in the pathogenesis of AKI. We observed a significant upregulation of FoxO1 in kidney macrophages following ischemia-reperfusion (I/R) injury. Additionally, our findings demonstrated that the administration of FoxO1 inhibitor AS1842856-encapsulated liposome (AS-Lipo), mainly acting on macrophages, effectively mitigated renal injury induced by I/R injury in mice. By generating myeloid-specific FoxO1-knockout mice, we further observed that the deficiency of FoxO1 in myeloid cells protected against I/R injury-induced AKI. Furthermore, our study provided evidence of FoxO1's pivotal role in macrophage chemotaxis, inflammation, and migration. Moreover, the impact of FoxO1 on the regulation of macrophage migration was mediated through RhoA guanine nucleotide exchange factor 1 (ARHGEF1), indicating that ARHGEF1 may serve as a potential intermediary between FoxO1 and the activity of the RhoA pathway. Consequently, our findings propose that FoxO1 plays a crucial role as a mediator and biomarker in the context of AKI. Targeting macrophage FoxO1 pharmacologically could potentially offer a promising therapeutic approach for AKI.
9.Clinical Study on Modified Chaihu Longgu Muli Decoction Regulating Inflammatory Factors to Improve Chronic Kidney Disease with Depression
Kai-zhen WANG ; Hai-chen LI ; Fan LI ; Mei LONG ; Liang CHEN ; Yue-xi JIANG ; Min TANG ; Yue QIU
Progress in Modern Biomedicine 2025;25(20):3228-3237
Objective:To screen inflammatory markers that can be used for the diagnosis and intervention evaluation of patients with chronic kidney disease(CKD)with depression,and to systematically study the therapeutic effect and safety of modified Chaihu Longgu Muli decoction in patients with CKD with depression.Methods:This study was a prospective study,a total of 120 patients with CKD who were diagnosed and treated in the Department of Nephrology,Chongqing Traditional Chinese Medicine Hospital from April 2023 to October 2024 were included.They were divided into CKD with depression(CKD-D)group and CKD without depression(CKD-N)group according to the diagnostic criteria by random number table method.The results of routine laboratory tests were collected,and the severity of depressive disorder was evaluated by Hamilton Depression Rating Scale-17(HAMD-17).The levels of interleukin-18(IL-18),interferon-γ(IFN-γ),β-thromboglobulin(β-TG),platlet factor-4(PF-4),eosinophil chemotactic factor(Eotaxin),soluble tumor necrosis factor receptor-2(sTNFR-2)and CD40 ligand(CD40L)in serum were quantitatively evaluated by liquid chip technology.Pearson correlation analysis was used to analyze the correlation between HAMD-17 scores and inflammatory markers with statistical differences in CKD patients with depression at different stages.The patients in CKD-D group were randomly divided into control group and treatment group.The control group was given basic treatment of CKD,while the treatment group was treated with modified Chaihu Longgu Muli decoction on the basis of the control group.After 8 weeks of continuous intervention,the clinical effective rate,the changes of effective inflammatory markers and the occurrence of adverse reactions were compared between the two groups.Results:In the CKD-D group and the CKD-N group,the difference of HAMD-17 score,serum phosphorus(P),serum creatinine(Scr),estimated glomerular filtration rate(eGFR),albumin(ALB),serum iron(Fe3+),C-reactive protein(CRP),IL-18,IFN-γ,sTNFR-2 indicators were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that in addition to HAMD-17 score(OR=1.259,P=0.006),SCr(OR=1.748,P=0.003),eGFR(OR=1.354,P=0.005),serum IL-18(OR=0.924,P=0.011)and IFN-γ(OR=0.859,P=0.031)levels were also independent influencing factors for CKD patients with depression.Pearson correlation analysis showed that there was a significant positive correlation between HAMD-17 score and IL-18,IFN-γ,sTNFR-2 and CD40L.The total clinical effective rate of the treatment group was higher than that of the control group,and the serum levels of IL-18 and IFN-γ in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05),and no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:IL-18 and IFN-γ can be used as effective serum markers for the diagnosis and treatment of depressive disorders in CKD patients.At the same time,the changes of serum levels of IL-18 and IFN-γ can be used to evaluate the severity of symptoms in CKD patients with depression at different stages to a certain extent.Modified Chaihu Longgu Muli decoction may improve CKD combined with depressive symptoms and improve the quality of life of patients by down-regulating the level of inflammatory factors.
10.Relationship of 25- (OH) D and MCP-1 levels with bone mineral density and bone metabolism indexes in preschool children after fractures
Jiangtao LONG ; Jie LI ; Deming BAI ; Qianqian WANG ; Yuankai YANG ; Hongwei XI
Chinese Journal of Endocrine Surgery 2025;19(2):252-256
Objective:To investigate the relationship of the levels of 25-hydroxyvitamin (OH) D, monocyte chemoattractant protein-1 (MCP-1) and bone mineral density (BMD) and bone metabolism in preschool children after fractures.Methods:General data of 200 preschool children with fractures admitted to the Department of Orthopedics of Shanxi Children’s Hospital from Apr. 2021 to Jun. 2024 were retrospectively analyzed. The 25- (OH) D level of the children after fracture was determined by electrochemical luminescence method. According to the 25- (OH) D level, the children were divided into VitD deficiency group, VitD insufficient group and VitD sufficient group. The MCP-1 level, BMD and bone metabolism indexes of children among groups were compared and analyzed. SPSS 26.0 statistical software was used to analyze the data in the paper. According to the data type, t test or χ2 test were used to compare among the groups, and the correlation of 25- (OH) D and MCP-1 levels with BMD and bone metabolism indexes was analyzed by Spearman and Pearson methods. Results:The difference of 25- (OH) D levels in different age childeren was statistically significant ( t = 145.26, P<0.05) , and the analysis showed that 26 cases were VitD deficient, 64 cases were VitD insufficient, and 110 cases were VitD sufficient; The mean BMD in VitD patients with different levels was significantly different ( F=783.25, P<0.05) ; With the increase of MCP-1, PTH and TPINP levels decreased ( F=78.98, 703.57, 243.27, P<0.05) , while the levels of PICP and BGP increased ( F=122.97, 340.32, P<0.05) ; 25- (OH) D was positively correlated with BMD, PICP and BGP ( r=0.93, 0.76, 0.87, P<0.05) , and negatively correlated with PTH and TPINP ( r=-0.94, -0.81, P<0.05) . MCP-1 was negatively correlated with BMD, PICP and BGP ( r=-0.54, -0.51, -0.56, P<0.05) , and positively correlated with PTH and TPINP ( r=0.57, 0.55, P<0.05) . Conclusions:The 25- (OH) D level is significantly correlated with BMD and bone metabolism indexes in preschool children after fracture, and the lack and insufficiency of VitD significantly affect BMD and bone metabolism status. At the same time, MCP-1 may also play an important role in metabolic changes after fracture. Therefore, in clinical treatment, it is necessary to strengthen the monitoring and management of 25- (OH) D and MCP-1 levels after fracture in children, which is of great significance to promote bone healing and improve bone density.

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