Oxidative stress due to aberrant metabolism is considered as a crucial contributor to diabetes and its complications. Hyperglycemia and hyperlipemia boost excessive reactive oxygen species generation by elevated mitochondrial respiration, increased nicotinamide adenine dinucleotide phosphate oxidase activity, and enhanced pro-oxidative processes, including protein kinase C pathways, hexosamine, polyol, and advanced glycation endproducts, which exacerbate oxidative stress. Oxidative stress plays a significant role in the onset of diabetes and its associated complications by impairing insulin production, increasing insulin resistance, maintaining hyperglycemic memory, and inducing systemic inflammation. A more profound comprehension of the molecular processes that link oxidative stress to diabetes is crucial to new preventive and therapeutic strategies. Therefore, this review discusses the mechanisms underlying how oxidative stress contributes to diabetes mellitus and its complications. We also summarize the current approaches for prevention and treatment by targeting the oxidative stress pathways in diabetes.
Oxidative Stress/physiology* ; Humans ; Diabetes Mellitus/physiopathology* ; Diabetes Complications/metabolism* ; Reactive Oxygen Species/metabolism* ; Glycation End Products, Advanced/metabolism* ; Animals

Objective:To evaluate the efficacy and safety of telitacicept in the treatment of systemic lupus erythematosus (SLE) .Methods:The clinical data of 25 SLE patients who received standard therapy combined with telitacicept at the Department of Dermatology, Xiangya Second Hospital, Central South University, from 2021 to 2024 were retrospectively collected. Baseline demographic and clinical characteristics were analyzed. Changes in skin lesions, joint pain symptoms, complete blood count, and biochemical parameters at 4, 12, and 24 weeks of treatment were compared with baseline (week 0). The Wilcoxon signed-rank test was used to compare complement C3 and C4 levels before and after treatment, and univariate logistic regression analysis was performed to explore factors influencing the efficacy of telitacicept.Results:Among the 25 SLE patients, 3 were male (12.0%) and 22 were female (88.0%). Based on the SLE Disease Activity Index (SLEDAI) -2000 scores, 8 patients were mild, 13 were moderate, and 4 were severe. Of the 11 SLE patients with rashes before treatment, 6 achieved complete remission at 12 weeks. Among the 7 patients with joint pain before treatment, 4 experienced symptom resolution at 24 weeks. The proportion of patients with leukopenia at baseline and at 4, 12, and 24 weeks was 10/25 (40.0%), 0/24 (0), 1/22 (4.5%), and 2/19 (10.5%), respectively. The proportion of patients with thrombocytopenia was 6/25 (24.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively, and the proportion of patients with anemia was 7/25 (28.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively. At baseline, 11 out of 25 patients (44.0%) had proteinuria. At 12 weeks, the urinary protein quantification level (0.4 [0, 0.6] g/L) was significantly lower than at baseline (0.9 [0.8, 1.2] g/L). The SLE responder index-4 (SRI4) response rates at 4, 12, and 24 weeks were 14/18, 15/17, and 12/14, respectively. Complement C3 and C4 levels were significantly higher at 4, 12, and 24 weeks compared to baseline (all P < 0.001). Univariate logistic regression analysis showed that age, disease duration, glucocorticoid dosage, baseline complement C4 levels, antinuclear antibody titer, and SLEDAI-2K score did not significantly affect the efficacy of telitacicept (SRI4 response rate at 12 weeks) (all P > 0.05). No serious adverse reactions related to telitacicept were observed in patients. Conclusions:Telitacicept improved skin lesions, complement C3 and C4 levels, and anti-double-stranded DNA antibody levels in SLE patients. No association was found between the efficacy of telitacicept and baseline SLEDAI-2K scores, antinuclear antibody titers, or complement C4 levels, suggesting that telitacicept is an effective and safe treatment for SLE patients.

Objective:To evaluate the efficacy and safety of telitacicept in the treatment of systemic lupus erythematosus (SLE) .Methods:The clinical data of 25 SLE patients who received standard therapy combined with telitacicept at the Department of Dermatology, Xiangya Second Hospital, Central South University, from 2021 to 2024 were retrospectively collected. Baseline demographic and clinical characteristics were analyzed. Changes in skin lesions, joint pain symptoms, complete blood count, and biochemical parameters at 4, 12, and 24 weeks of treatment were compared with baseline (week 0). The Wilcoxon signed-rank test was used to compare complement C3 and C4 levels before and after treatment, and univariate logistic regression analysis was performed to explore factors influencing the efficacy of telitacicept.Results:Among the 25 SLE patients, 3 were male (12.0%) and 22 were female (88.0%). Based on the SLE Disease Activity Index (SLEDAI) -2000 scores, 8 patients were mild, 13 were moderate, and 4 were severe. Of the 11 SLE patients with rashes before treatment, 6 achieved complete remission at 12 weeks. Among the 7 patients with joint pain before treatment, 4 experienced symptom resolution at 24 weeks. The proportion of patients with leukopenia at baseline and at 4, 12, and 24 weeks was 10/25 (40.0%), 0/24 (0), 1/22 (4.5%), and 2/19 (10.5%), respectively. The proportion of patients with thrombocytopenia was 6/25 (24.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively, and the proportion of patients with anemia was 7/25 (28.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively. At baseline, 11 out of 25 patients (44.0%) had proteinuria. At 12 weeks, the urinary protein quantification level (0.4 [0, 0.6] g/L) was significantly lower than at baseline (0.9 [0.8, 1.2] g/L). The SLE responder index-4 (SRI4) response rates at 4, 12, and 24 weeks were 14/18, 15/17, and 12/14, respectively. Complement C3 and C4 levels were significantly higher at 4, 12, and 24 weeks compared to baseline (all P < 0.001). Univariate logistic regression analysis showed that age, disease duration, glucocorticoid dosage, baseline complement C4 levels, antinuclear antibody titer, and SLEDAI-2K score did not significantly affect the efficacy of telitacicept (SRI4 response rate at 12 weeks) (all P > 0.05). No serious adverse reactions related to telitacicept were observed in patients. Conclusions:Telitacicept improved skin lesions, complement C3 and C4 levels, and anti-double-stranded DNA antibody levels in SLE patients. No association was found between the efficacy of telitacicept and baseline SLEDAI-2K scores, antinuclear antibody titers, or complement C4 levels, suggesting that telitacicept is an effective and safe treatment for SLE patients.

Objective To investigate the clinical effect of laparoscopic treatment of one side high and one side low cryptorchidism.Methods From January 2020 to December 2022,19 cases of bilateral cryptorchidism were treated by laparoscopic surgery,with low cryptorchidism on one side(palpable in the groin)and high cryptorchidism on the other side(in the abdominal cavity).The age range was 1 year and 1 month to 11 years and 5 months,with a median of 2 years and 4 months.The low cryptorchidism was operated with orchiopexy,and the high cryptorchidism was operated with laparoscopic two-staged Fowler-Stephens(FS)stage Ⅰ surgery and then laparoscopic FS stage Ⅱ surgery after 6 months.Results All the 19 cases were successfully operated.One case was lost to follow-up after surgery,and 18 cases were followed up for 3-23 months(last ultrasound time),with a median of 4 months.A total of 17 cases had normal testicular growth and development,and 1 case with combined Noonan syndrome had bilateral testicular atrophy(diameter＜1 cm)and normal blood supply at 15 months after surgery.Conclusions One side high and one side low cryptorchidism can be treated simultaneously with the low side testicular fixation surgery and the high side laparoscopic FS stage Ⅰ surgery.Six months later,the high side laparoscopic FS stage Ⅱ surgery can be performed.

The clinical practice guidelines of traditional Chinese medicine （TCM） have problems such as limited clinical application and unclear implementation effects， which may be related to the lack of clinical practice evidence. To provide reliable and precise evidence for clinical practice， this article proposes a model of combining TCM guidelines with real-world study， which includes 4 steps. Firstly， during the implementation process of the guidelines， a high-quality research database is established. Secondly， the recommendations in the guidelines are evaluated based on the established database in multiple dimensions， including applicability， effectiveness， safety， and cost-effectiveness， and thus their effectiveness in practical applications can be determined. Thirdly， based on the established database， core prescriptions are identified， and the targeted populations and medication plans are determined. That is， the best treatment regimen is established based on the analysis of abundant clinical data regarding the effects of different medication frequencies， dosages， and duration on efficacy. Fourthly， the guidelines are updated according to the real-world evidence. The research based on this model can provide real-world evidence for ancient and empirical prescriptions， improving their application in clinical practice. Moreover， this model can reduce research costs and improve research efficiency. When applying this model， researchers need to pay attention to the quality of real-world evidence， ensuring that it can truly reflect the situation in clinical practice. In addition， importance should be attached to the clinical application of guideline recommendations， ensuring that doctors can conduct standardized diagnosis and treatment according to the guidelines. Finally， full-process participation of multidisciplinary experts is encouraged to ensure the comprehensiveness and scientificity of the study. In conclusion， the application of this model will contribute to the development of TCM guidelines responsive to the needs of clinical practice and achieve the goal of promoting the homogenization of TCM clinical diagnosis and treatment.

Objective To investigate the clinical effect of laparoscopic treatment of one side high and one side low cryptorchidism.Methods From January 2020 to December 2022,19 cases of bilateral cryptorchidism were treated by laparoscopic surgery,with low cryptorchidism on one side(palpable in the groin)and high cryptorchidism on the other side(in the abdominal cavity).The age range was 1 year and 1 month to 11 years and 5 months,with a median of 2 years and 4 months.The low cryptorchidism was operated with orchiopexy,and the high cryptorchidism was operated with laparoscopic two-staged Fowler-Stephens(FS)stage Ⅰ surgery and then laparoscopic FS stage Ⅱ surgery after 6 months.Results All the 19 cases were successfully operated.One case was lost to follow-up after surgery,and 18 cases were followed up for 3-23 months(last ultrasound time),with a median of 4 months.A total of 17 cases had normal testicular growth and development,and 1 case with combined Noonan syndrome had bilateral testicular atrophy(diameter＜1 cm)and normal blood supply at 15 months after surgery.Conclusions One side high and one side low cryptorchidism can be treated simultaneously with the low side testicular fixation surgery and the high side laparoscopic FS stage Ⅰ surgery.Six months later,the high side laparoscopic FS stage Ⅱ surgery can be performed.

Objective To explore the association between rs3179060C/A polymorphism in the ex-on 1 of TNF-a gene and hyperandrogenism and polycystic ovary syndrome (PCOS). Methods One hundred thirty PCOS women and one hundred seventy five normal women as controls were enrolled in this study. The genotypes were screened by polymerase chain reaction-On/off switch and the product was isolated by e-lectrophoresis on a 2. 5% agarose gel containing ethidium bromide and visualized using an ultraviolet transil-luminator. The relationship of TNF-a alleles to serum testosterone level was analyzed in PCOS patients. Results Three genotypes were identified, corresponding to CC, CA, AA, and two alleles were screened, corresponding to C and A. The frequencies of the CC, CA, AA genotypes were 58. 4% ,23.1% ,18.5% vs. 72. 0% , 17.7% , 10. 3% in PCOS group and control group, showing statistically significant difference between two groups( P < 0.05 ). The allelic frequency was 70.0% for the C allele and 30.0% for the A in P-COS group, and 80. 9% for the C allele and 19. 1% for the A in control group, respectively, showing statistically significant between two groups ( P <0.05). The relationship was not observed between rs3179060C/ A polymorphism and serum testosterone level in PCOS patients in Han Chinese racial origin ( P >0.05). Conclusions The TNF-a gene rs3179060C/A polymorphism may be a risk factor for the pathogenesis of P-COS in Chinese women, but it was not effect on hyperandrogenism in PCOS women.

OBJECTIVETo study the chemical constituents of the roots of Osbeckia opipara.

METHODRepeated column chromatography over silica gel, RP-18 and Sephadex LH-20, and preparative thin layer chromatography(PTLC) were used to isolate the compounds, whose structures were determined by spectroscopic methods by direct comparing spectral data with those reported references.

RESULTFrom the MeOH extract of the roots O. opipara, twelve compounds were isolated and identified as follows: lasiodiplodin (1) , de-O-methyllasiodiplodin (2), 2, 3- dihydro-2-hydroxy-2, 4-dimethyl-5-trans-propenylfuran-3-one (3), integracin (4), 5alpha, 8alpha-epidioxy-(22E, 24R)-ergosta-6, 22-dien-3beta-ol (5), 3, 3', 4'-tri-O-methylellagic acid (6), 5-hydroxymethyl furaldehyde (7), vomifolio (8) , betulintic acid (9), 2alpha-hydroxyursolic acid (10), (24R)-stigmast-4-ene-3-one (11), and eugenitin (12).

CONCLUSIONCompounds 1-12 were isolated from O. opipara for the first time.

Cholestenones ; chemistry ; isolation & purification ; Fermentation ; Fruiting Bodies, Fungal ; chemistry ; Melastomataceae ; chemistry ; Molecular Structure ; Plant Extracts ; chemistry ; Plant Roots ; chemistry ; Spectrum Analysis ; Triterpenes ; chemistry ; isolation & purification