Diabetic kidney disease （DKD） is one of the most common and harmful microvascular complications of diabetes， and there is currently a lack of effective treatment methods to delay its progression. Traditional Chinese medicine has a long history of treating DKD and offers unique advantages. As a traditional Chinese medicine， Rehmannia glutinosa has shown potential in the treatment of DKD in clinical and modern pharmacological research. After integrating relevant research on the pharmacological mechanism of R. glutinosa in treating DKD， it has been found that the main active components of R. glutinosa， such as catalpol， rehmannioside D， aucubin， verbascoside， salidroside， echinacoside and R. glutinosa polysaccharides， along with its extracts and compounds （such as Liuwei dihuang pills， Shenqi dihuang decoction， and Shenqi pills）， can exert multiple effects by intervening in various signaling pathways， including advanced glycation end product （AGE）/receptor for AGE， nuclear factor kappa-B （NF- κB）， and transforming growth factor-β1 （TGF-β1）/Smads. These effects include ameliorating metabolic disorders and oxidative stress in DKD， inhibiting the processes of renal inflammation and fibrosis， regulating cell death modalities including apoptosis and ferroptosis， as well as autophagy， and reshaping the gut microbiota. Consequently， it can improve physical and chemical indices and renal tissue pathological damage， thus delaying the progression of DKD.

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R² = 0.033; P = 0.018), followed by acute kidney injury (AKI; R² = 0.032; P = 0.011) and plasma MIP-1β level (R² = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
Acute Kidney Injury/complications* ; Bacteria/classification* ; Chemokine CCL4/blood* ; Community-Acquired Infections/microbiology* ; Humans ; Lung ; Microbiota/genetics* ; Pneumonia, Bacterial/diagnosis* ; Prognosis ; RNA, Ribosomal, 16S/genetics*

Aim To study the effect of astragaloside (AS-Ⅳ) in CLP-induced septic mice.Methods C57BL/6 mice were randomly divided into the sham group, CLP group and CLP+ AS-Ⅳ group.Two days before operation, AS-Ⅳ (10 mg·kg-1) solution was intragastrically administered into CLP +AS-Ⅳ group, and the other groups were treated with normal saline.A sepsis model was established by cecal ligation and puncture (CLP).Blood, peritoneal fluid and tissue organs were collected at 6 h and 24 h.Neutrophils of blood were purified by Percoll density gradient.Transwell was used to detect the chemotaxis function of neutrophils.The killing activity of neutrophils was detected by coculture with E.coli.Results The survival rate of AS-Ⅳ-pretreated septic mice significantly increased.The number of neutrophils in peritoneal fluid was enhanced markedly.The number of bacteria in the peritoneal fluid, blood and tissue organs such as liver, lung and kidney significantly decreased after AS-Ⅳ pretreatment.The chemotaxis and killing activity of neutrophils increased significantly in AS-Ⅳ-treated mice (P<0.05).Conclusion Astragaloside displays an immunoprotective effect in CLP-induced septic mice, which is related to the upregulation of CXCR2 expression on neutrophils and the increase of neutrophil antibacterial activity.