1.Epidemiological characteristics and influencing factors of latent tuberculosis infection among detainees in eastern China
Xinru FEI ; Peng LU ; Jingxian NING ; Yuchen PAN ; Limei ZHU ; Qiao LIU ; Hongxi ZHOU
Shanghai Journal of Preventive Medicine 2026;38(4):280-283
ObjectiveTo analyze the epidemiological characteristics of latent tuberculosis infection (LTBI) among newly detained populations in eastern China, to identify high-risk groups, and to provide a scientific basis for formulating tuberculosis prevention and control strategies in the prison system. MethodsA cross-sectional study was conducted among the newly admitted detainees in two prisons in eastern China in 2022. Data on demographic characteristics, behavioral risk factors and previous disease history of the research subjects were collected through a structured questionnaire survey. The LTBI status of the detainees was determined using the QuantiFERON-TB Gold In-Tube (QFT-GIT) method. Lasso regression was used to screen variables, followed by multivariate logistic regression analysis to investigate the influencing factors of LTBI. ResultsA total of 305 detainees were included in the study. The median age of detainees was 35 (31, 43) years. The study population was predominantly male (67.21%), of Han ethnicity (95.41%), had a junior or senior high school education (59.34%), and was unemployed (31.80%). A history of smoking was reported by 52.79% of participants, while 57.70% reported no alcohol consumption. The majority had no history of hypertension (85.90%), diabetes mellitus (93.77%), human immunodeficiency virus (HIV) infection (97.38%), familial genetic diseases (95.08%), surgery or trauma (73.77%), drug use (92.79%), or hepatitis (93.77%). The LTBI rate was 14.75%. After comparing the demographic characteristics of LTBI and non-infected groups, it was found that smoking history (χ2=7.40, P=0.025), drug use history (χ2=5.49, P=0.019), and HIV infection (χ2=8.12, P=0.004) were statistically correlated with LTBI infection. The results of multivariate logistic regression analyses showed that smoking [adjusted odds ratio (aOR)=4.08, 95%CI: 1.60‒10.42, P=0.003], HIV infection (aOR=11.57, 95%CI: 2.50‒53.51, P=0.002) and drug use (aOR=3.04, 95%CI: 1.02‒9.09, P=0.046) were risk factors for LTBI. ConclusionThe LTBI rate among newly detainees in two prisons in eastern China is slightly lower than that among long-term detainees. Early screening and intervention should be implemented for newly detainees, with particular attention focused on high-risk groups such as those with a history of smoking, HIV infection, or drug use.
2.Association of Arterial Elasticity with Left Ventricular Structure and Function
Zhiran LIU ; Bin CHEN ; Xinru XU
Journal of Medical Research 2025;54(9):79-85
Objective To investigate the association between brachial-ankle pulse wave velocity(baPWV)and left ventricular structure and function.Methods A total of 4864 participants who completed baPWV and transthoracic echocardiography from January 2010 to December 2021 were included.The participants were divided into three groups based on baPWV:Group T1:baPWV<14m/s;Group T2:14m/s≤baPWV<18m/s;Group T3:baPWV ≥18m/s.Multivariable Logistic regression and linear regression was used to examine the correlation between baPWV and interventricular septal thickness(IVS),left ventricular posterior wall thickness(LVPW),left ventricular end diastolic diameter(LVEDd),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),and the presence of mitral e'/a'<1.Results Increased baPWV was significantly associated with thickening of IVS(β=0.095,95%CI:0.007-0.182),thickening of LVPW(β=0.145,95%CI:0.056-0.233),and mitral e'/a'<1(OR=2.200,95%CI:1.608-3.010)(P<0.05).It was negatively correlated with LVEDd(β=-0.048,95%CI:-0.075--0.021)and showed no significant associa-tion with LVMI and LVEF(P>0.05).Stratified analysis indicated that systolic blood pressure and baPWV had an interaction effect on LVEDd and mitral e'/a'<1(P<0.05).Conclusion BaPWV is associated with left ventricular remodeling and diastolic function.The correlation between baPWV and LVPW and LVEDd is stronger in groups with normal systolic blood pressure.In contrast,the correlation with mitral e'/a'<1 is more prominent in groups with elevated systolic blood pressure.
3.Comparative analysis of sporadic and von Hippel-Lindau syndrome-associated intracranial hemangioblastomas:clinical features and survival ending
Lixin XU ; Xuanshi LIU ; Xinru XIAO ; Hongqi ZHANG
Chinese Journal of Cerebrovascular Diseases 2025;22(7):439-452
Objective To investigate the differences in clinical characteristics,surgical outcomes,and prognosis between sporadic intracranial hemangioblastoma(IC-HB)and von Hippel-Lindau(VHL)syndrome-associated IC-HB.Methods A retrospective consecutive series of patients who underwent microsurgical resection at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,between April 2014 and January 2024,with postoperative pathological confirmation of IC-HB,was included.Clinical and imaging data were collected,including demographics(sex,age),preoperative clinical manifestations(asymptomatic,headache,dizziness,vertigo or imbalance,blurred vision or papilledema,nausea or vomiting,other symptoms),number of symptoms,lesion type(solid or solid-cystic),lesion size(volume,longest diameter,anteroposterior diameter,superoinferior diameter,transverse diameter),lesion location(cerebellar region:hemisphere,vermis;brainstem region:medulla oblongata,fourth ventricle;skull base region:cerebellopontine angle,jugular foramen,petroclival region),Karnofsky performance status(KPS)score(preoperative,postoperative;KPS score>70 and 70),surgical information,and follow-up data.Based on past medical history,family history,and VHL gene test results,patients were classified into sporadic IC-HB and VHL syndrome-associated IC-HB groups.Differences in clinical characteristics,surgical outcomes,and follow-up status were compared between the groups.Improved outcomes were defined as increases in KPS scores over 0 at 6-month follow-ups in comparison with preoperative KPS,while non-improved outcomes were defined by unchanged or decreased(>0 point)KPS scores.Survival outcomes,including postoperative recurrence(newly occurring abnormally enhancing nodules at the surgical site or periphery with continuous development during follow-ups.Recurrence could be verified through the combination of imaging enhancement features,clinical manifestations and post-operative pathological examinations),postoperative KPS improvement,and death of any cause during follow-up.The outcomes of postoperative KPS improvement versus non-improvement(unchanged or worsened)were analyzed through univariate analysis with the Firth penalized maximum likelihood Logistic regression model.Variables meeting the criteria(P<0.05 in univariate analysis,clinical importance,statistical model feasibility)were included in a multivariate Logistic regression model to identify independent factors influencing functional outcomes.Survival outcomes were analyzed using Cox proportional hazards regression models.Kaplan-Meier survival analysis was used to assess recurrence-free survival rates between groups with the Log-rank test.Furthermore,univariate and multivariate Logistic regression analyses were performed separately for the sporadic IC-HB and VHL syndrome-associated IC-HB subgroups to explore independent factors for postoperative KPS improvement.Results A total of 82 IC-HB patients(41 male,41 female),aged 11-73 years(mean[42±15]years),were included.Among which,68 had sporadic IC-HB and 14 had VHL syndrome-associated IC-HB.39 patients had improved postoperative KPS and 43 patients showed no improvements in KPS scores.(1)For clinical characteristics,the age of onset was younger in the VHL syndrome-associated IC-HB group([35±14]years vs.[44±15]years,P=0.044).Lesions in VHL syndrome-associated IC-HB patients were more likely to involve the brainstem and adjacent critical structures(8/14 of which involved medulla oblongata),while sporadic IC-HB was more common in the cerebellar hemispheres(70.6%[48/68]).The distribution of lesion location across cerebellar,skull base,and brainstem regions differed significantly between groups(P=0.015),while other characteristics showed no significant differences(all P>0.05).(2)For treatment and follow-ups,all patients underwent gross total microsurgical resection.Preoperative angiography via femoral artery was performed in 22 patients,with partial preoperative embolization in 4 patients.Postoperatively,KPS improved in 39 patients,remained unchanged in 33 patients,and worsened in 10 patients.The change in KPS scores pre-to post-operatively did not differ significantly between groups(P=0.707).The recurrence rate was higher in the VHL syndrome-associated IC-HB group(4/14 vs.5.9%[4/68],P=0.026),but there was no significant difference in mortality(P=0.999).(3)For analysis of factors influencing postoperative KPS improvement,univariate Logistic regression showed preoperative asymptomatic(OR,0.05,95%CI0.00-0.39,P=0.002),preoperative dizziness(OR,2.62,95%CI 1.09-6.47,P=0.031),vertigo/imbalance(OR,3.60,95%CI 1.04-15.45,P=0.043),nausea/vomiting(OR,4.49,95%CI 1.65-13.53,P=0.003),preoperative symptoms(OR,2.27,95%CI 1.46-3.86,P<0.01)and preoperative KPS ≤70(OR,7.65,95%CI 1.60-74.47,P=0.009)were strongly associated with KPS improvement.Multivariate Logistic regression only identified the number of preoperative symptoms as an independent predictor of postoperative KPS improvement(OR,2.44,95%CI 1.04-6.32,P=0.049).(4)For survival outcome analysis,no significant differences in the risk of postoperative recurrence,KPS improvement,or death were observed between the VHL syndrome-associated and sporadic IC-HB patients(recurrence:HR,4.88,95%CI 0.97-24.69,P=0.055;KPS improvement:HR,0.60,95%CI 0.25-1.43,P=0.246;mortality:P=0.999).Kaplan-Meier curves showed no statistically significant difference in recurrence-free survival rate between groups(P=0.053).(5)In the subgroup analysis,in sporadic IC-HB patients,multivariate Logistic regression identified the number of preoperative symptoms as an independent predictor of postoperative KPS improvement(OR,1.97,95%CI 1.14-3.68,P=0.021).Due to the small sample size,reliable parameter estimation was not possible for the VHL syndrome-associated IC-HB subgroup due to the small sample size.Conclusions VHL syndrome-associated IC-HB patients have a higher risk of recurrence in comparison with sporadic IC-HB patients.The number of preoperative symptoms can guide survival ending assessment.
4.Clinical Comprehensive Evaluation of MRSA Treatment Drugs in Artificial Joint Infection
Xinru LIU ; Menglu LI ; Jinhong GONG ; Yuji WANG ; Dan SU ; Xindie ZHOU ; JingJing SHANG
Herald of Medicine 2025;44(3):422-428
Objective To evaluate the comprehensive value of methicillin-resistant Staphylococcus aureus(MRSA)treatment drugs in artificial joint infections from multiple perspectives and to solve the problem of MRSA infections in artificial joints.Methods Through literature research,relevant literature was retrieved and clinical studies meeting the requirements were selected and summarized.The Analytic Hierarchy Process(AHP)was applied to collect comprehensive clinical evaluation evidence and to conduct evaluations across different dimensions according to evaluation guidelines;the Delphi method combined with AHP was used for expert anonymous questionnaire evaluation,and the data was compared and analyzed.Results A clini-cal comprehensive evaluation index model for the treatment of artificial joint infections was successfully established,and the yaahp analysis software was used to score the comprehensive clinical evaluation evidence in various directions.Treatment drugs,vancomy-cin,daptomycin,and linezolid,at various levels were calculated through the software,and it was concluded that linezolid has the highest clinical comprehensive evaluation score.Conclusion Among the treatment drugs for MRSA infections in artificial joints,linezolid has a higher clinical comprehensive value and can provide a reference for the clinical treatment of MRSA infec-tions in artificial joints.
5.A comparison and prediction study of wide-field swept-source optical coher-ence tomography angiography in identifying non-perfusion areas in diabetic retinopathy
Chuyun GUO ; Yue HAN ; Li CHEN ; Yi LIU ; Hongzhuang CHENG ; Xinru NING ; Yadan SHEN ; Ruolan LING ; Jie ZHONG ; Jie LI
Recent Advances in Ophthalmology 2025;45(3):211-215
Objective To compare the differences between swept-source optical coherence tomography angiography(SS-OCTA)and ultra-wide-field fluorescein angiography(UWFA)in detecting non-perfusion areas(NPs)in patients with diabetic retinopathy(DR),to evaluate the accuracy of SS-OCTA in predicting NPs outside its visible range,and to explore the distribution patterns of NPs.Methods A retrospective analysis was made on 69 DR patients(88 eyes)who under-went both UWFA and SS-OCTA examinations at the Ophthalmology Department of Sichuan Provincial People's Hospital from December 2022 to September 2024.Manual NP labeling was conducted to compare the detection rate of NPs between the two imaging techniques.The distribution patterns of NPs and the accuracy of SS-OCTA for predicting NPs outside its visible range were also analyzed.Results In a scanning area of 20 mm x 24 mm,the overall NP detection rate by SS-OCTA was 47.40%,with UWFA taken as the standard.The NP detection rate by SS-OCTA was 51.56%in the superotemporal quad-rant,58.35%in the inferotemporal quadrant,45.50%in the superonasal quadrant,and 43.17%in the inferonasal quad-rant.Most NPs occurred in the inferonasal quadrant,accounting for 41.71%of the total NP.The accuracy of SS-OCTA in predicting NPs was 75.00%in the superonasal quadrant and 78.41%in the inferonasal quadrant.The ischemic indices(ISI)of the two imaging techniques were highly positively correlated(r2=0.74).Conclusion Although SS-OCTA can-not yet fully replace UWFA for NP detection in DR patients due to a small visible range,it is still an effective tool to assess retinal ischemia.SS-OCTA has the ability to predict NPs outside its visible range in its scanning range.The inferonasal quadrant is the region where NPs occur most frequently in DR patients,so it is suggested that special attention should be paid to this region in early diagnosis and follow-up periods.
6.Association of Arterial Elasticity with Left Ventricular Structure and Function
Zhiran LIU ; Bin CHEN ; Xinru XU
Journal of Medical Research 2025;54(9):79-85
Objective To investigate the association between brachial-ankle pulse wave velocity(baPWV)and left ventricular structure and function.Methods A total of 4864 participants who completed baPWV and transthoracic echocardiography from January 2010 to December 2021 were included.The participants were divided into three groups based on baPWV:Group T1:baPWV<14m/s;Group T2:14m/s≤baPWV<18m/s;Group T3:baPWV ≥18m/s.Multivariable Logistic regression and linear regression was used to examine the correlation between baPWV and interventricular septal thickness(IVS),left ventricular posterior wall thickness(LVPW),left ventricular end diastolic diameter(LVEDd),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),and the presence of mitral e'/a'<1.Results Increased baPWV was significantly associated with thickening of IVS(β=0.095,95%CI:0.007-0.182),thickening of LVPW(β=0.145,95%CI:0.056-0.233),and mitral e'/a'<1(OR=2.200,95%CI:1.608-3.010)(P<0.05).It was negatively correlated with LVEDd(β=-0.048,95%CI:-0.075--0.021)and showed no significant associa-tion with LVMI and LVEF(P>0.05).Stratified analysis indicated that systolic blood pressure and baPWV had an interaction effect on LVEDd and mitral e'/a'<1(P<0.05).Conclusion BaPWV is associated with left ventricular remodeling and diastolic function.The correlation between baPWV and LVPW and LVEDd is stronger in groups with normal systolic blood pressure.In contrast,the correlation with mitral e'/a'<1 is more prominent in groups with elevated systolic blood pressure.
7.Clinical Comprehensive Evaluation of MRSA Treatment Drugs in Artificial Joint Infection
Xinru LIU ; Menglu LI ; Jinhong GONG ; Yuji WANG ; Dan SU ; Xindie ZHOU ; JingJing SHANG
Herald of Medicine 2025;44(3):422-428
Objective To evaluate the comprehensive value of methicillin-resistant Staphylococcus aureus(MRSA)treatment drugs in artificial joint infections from multiple perspectives and to solve the problem of MRSA infections in artificial joints.Methods Through literature research,relevant literature was retrieved and clinical studies meeting the requirements were selected and summarized.The Analytic Hierarchy Process(AHP)was applied to collect comprehensive clinical evaluation evidence and to conduct evaluations across different dimensions according to evaluation guidelines;the Delphi method combined with AHP was used for expert anonymous questionnaire evaluation,and the data was compared and analyzed.Results A clini-cal comprehensive evaluation index model for the treatment of artificial joint infections was successfully established,and the yaahp analysis software was used to score the comprehensive clinical evaluation evidence in various directions.Treatment drugs,vancomy-cin,daptomycin,and linezolid,at various levels were calculated through the software,and it was concluded that linezolid has the highest clinical comprehensive evaluation score.Conclusion Among the treatment drugs for MRSA infections in artificial joints,linezolid has a higher clinical comprehensive value and can provide a reference for the clinical treatment of MRSA infec-tions in artificial joints.
8.Comparative analysis of sporadic and von Hippel-Lindau syndrome-associated intracranial hemangioblastomas:clinical features and survival ending
Lixin XU ; Xuanshi LIU ; Xinru XIAO ; Hongqi ZHANG
Chinese Journal of Cerebrovascular Diseases 2025;22(7):439-452
Objective To investigate the differences in clinical characteristics,surgical outcomes,and prognosis between sporadic intracranial hemangioblastoma(IC-HB)and von Hippel-Lindau(VHL)syndrome-associated IC-HB.Methods A retrospective consecutive series of patients who underwent microsurgical resection at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,between April 2014 and January 2024,with postoperative pathological confirmation of IC-HB,was included.Clinical and imaging data were collected,including demographics(sex,age),preoperative clinical manifestations(asymptomatic,headache,dizziness,vertigo or imbalance,blurred vision or papilledema,nausea or vomiting,other symptoms),number of symptoms,lesion type(solid or solid-cystic),lesion size(volume,longest diameter,anteroposterior diameter,superoinferior diameter,transverse diameter),lesion location(cerebellar region:hemisphere,vermis;brainstem region:medulla oblongata,fourth ventricle;skull base region:cerebellopontine angle,jugular foramen,petroclival region),Karnofsky performance status(KPS)score(preoperative,postoperative;KPS score>70 and 70),surgical information,and follow-up data.Based on past medical history,family history,and VHL gene test results,patients were classified into sporadic IC-HB and VHL syndrome-associated IC-HB groups.Differences in clinical characteristics,surgical outcomes,and follow-up status were compared between the groups.Improved outcomes were defined as increases in KPS scores over 0 at 6-month follow-ups in comparison with preoperative KPS,while non-improved outcomes were defined by unchanged or decreased(>0 point)KPS scores.Survival outcomes,including postoperative recurrence(newly occurring abnormally enhancing nodules at the surgical site or periphery with continuous development during follow-ups.Recurrence could be verified through the combination of imaging enhancement features,clinical manifestations and post-operative pathological examinations),postoperative KPS improvement,and death of any cause during follow-up.The outcomes of postoperative KPS improvement versus non-improvement(unchanged or worsened)were analyzed through univariate analysis with the Firth penalized maximum likelihood Logistic regression model.Variables meeting the criteria(P<0.05 in univariate analysis,clinical importance,statistical model feasibility)were included in a multivariate Logistic regression model to identify independent factors influencing functional outcomes.Survival outcomes were analyzed using Cox proportional hazards regression models.Kaplan-Meier survival analysis was used to assess recurrence-free survival rates between groups with the Log-rank test.Furthermore,univariate and multivariate Logistic regression analyses were performed separately for the sporadic IC-HB and VHL syndrome-associated IC-HB subgroups to explore independent factors for postoperative KPS improvement.Results A total of 82 IC-HB patients(41 male,41 female),aged 11-73 years(mean[42±15]years),were included.Among which,68 had sporadic IC-HB and 14 had VHL syndrome-associated IC-HB.39 patients had improved postoperative KPS and 43 patients showed no improvements in KPS scores.(1)For clinical characteristics,the age of onset was younger in the VHL syndrome-associated IC-HB group([35±14]years vs.[44±15]years,P=0.044).Lesions in VHL syndrome-associated IC-HB patients were more likely to involve the brainstem and adjacent critical structures(8/14 of which involved medulla oblongata),while sporadic IC-HB was more common in the cerebellar hemispheres(70.6%[48/68]).The distribution of lesion location across cerebellar,skull base,and brainstem regions differed significantly between groups(P=0.015),while other characteristics showed no significant differences(all P>0.05).(2)For treatment and follow-ups,all patients underwent gross total microsurgical resection.Preoperative angiography via femoral artery was performed in 22 patients,with partial preoperative embolization in 4 patients.Postoperatively,KPS improved in 39 patients,remained unchanged in 33 patients,and worsened in 10 patients.The change in KPS scores pre-to post-operatively did not differ significantly between groups(P=0.707).The recurrence rate was higher in the VHL syndrome-associated IC-HB group(4/14 vs.5.9%[4/68],P=0.026),but there was no significant difference in mortality(P=0.999).(3)For analysis of factors influencing postoperative KPS improvement,univariate Logistic regression showed preoperative asymptomatic(OR,0.05,95%CI0.00-0.39,P=0.002),preoperative dizziness(OR,2.62,95%CI 1.09-6.47,P=0.031),vertigo/imbalance(OR,3.60,95%CI 1.04-15.45,P=0.043),nausea/vomiting(OR,4.49,95%CI 1.65-13.53,P=0.003),preoperative symptoms(OR,2.27,95%CI 1.46-3.86,P<0.01)and preoperative KPS ≤70(OR,7.65,95%CI 1.60-74.47,P=0.009)were strongly associated with KPS improvement.Multivariate Logistic regression only identified the number of preoperative symptoms as an independent predictor of postoperative KPS improvement(OR,2.44,95%CI 1.04-6.32,P=0.049).(4)For survival outcome analysis,no significant differences in the risk of postoperative recurrence,KPS improvement,or death were observed between the VHL syndrome-associated and sporadic IC-HB patients(recurrence:HR,4.88,95%CI 0.97-24.69,P=0.055;KPS improvement:HR,0.60,95%CI 0.25-1.43,P=0.246;mortality:P=0.999).Kaplan-Meier curves showed no statistically significant difference in recurrence-free survival rate between groups(P=0.053).(5)In the subgroup analysis,in sporadic IC-HB patients,multivariate Logistic regression identified the number of preoperative symptoms as an independent predictor of postoperative KPS improvement(OR,1.97,95%CI 1.14-3.68,P=0.021).Due to the small sample size,reliable parameter estimation was not possible for the VHL syndrome-associated IC-HB subgroup due to the small sample size.Conclusions VHL syndrome-associated IC-HB patients have a higher risk of recurrence in comparison with sporadic IC-HB patients.The number of preoperative symptoms can guide survival ending assessment.
9.Randomized Controlled Study of Baoshen Prescription in Treating Stage Ⅳ Diabetic Nephropathy in Patients with Syndromes of Qi-Yin Deficiency and Kidney Collateral Stasis and Obstruction
Yiting QIU ; Shuangshuang HONG ; Zhiqiu LIU ; Xinru SUN ; Yuefen WANG ; Mengchao LIU ; Wenjing ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):124-131
ObjectiveTo evaluate the clinical efficacy and safety of Baoshen prescription in the treatment of stage Ⅳ diabetic nephropathy (DN) in the patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction, and to explore the mechanism of this prescription delaying the disease progression. MethodsA randomized, controlled, double-blind, multicenter clinical trial was conducted, in which 94 stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction were randomly assigned into Baoshen prescription and control groups (47 cases). The treatment lasted for 12 weeks. The primary efficacy indicators were mainly renal function indexes, including urine albumin-to-creatinine ratio (UACR), 24-hour urine total protein (24 h-UTP), serum creatinine (SCr), and estimated glomerular filtration rate (eGFR). The secondary efficacy indicators were metabolic memory of hyperglycemia, podocyte epithelial-to-mesenchymal transdifferentiation-related indexes, and TCM syndrome score. ResultsAfter 12 weeks of treatment, the Baoshen prescription group showed lowered levels of advanced glycation end products (lgAGEs), connective tissue growth factor (CTGF), type Ⅳ collagen (Col-Ⅳ), receptor of AGEs (RAGE), urinary fibroblast-specific protein-1 (FSP-1), UACR, 24 h-UTP, and glycated hemoglobin (HbAlc) (P<0.05), and an upward trend of miR-21 mRNA. The control group showed elevated levels of SCr and UREA and lowered levels of urinary FSP-1, eGFR, and HbAlc (P<0.05). After treatment, the Baoshen prescription group had lower levels of lgAGEs, CTGF, urinary FSP-1, SCr, UACR, and 24 h-UTP and higher levels of Col-Ⅳ and eGFR than the control group (P<0.05). In addition, the Baoshen prescription group showed statistically significant differences in SCr, eGFR, UACR, and 24 h-UTP before and after treatment (P<0.05). ConclusionBaoshen prescription can effectively improve the renal function, reduce the urinary protein level, and alleviate clinical symptoms in stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction. The mechanism may be related to the metabolic memory of hyperglycemia and epithelial-to-mesenchymal transdifferentiation of podocytes.
10.Mechanism of Congrong Zonggan Capsules in Improving Neuroinflammation and Cognitive Impairment in 5×FAD Mice Based on NF-κB/NLRP3 Signaling Pathway
Yanru ZHOU ; Xinru GU ; Yuru LIU ; Shun ZHANG ; Yaozhong LYU ; Zhenzhong WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):130-138
ObjectiveTo investigate the effects of Congrong Zonggan capsules (CRZG) on cognitive impairment in the Alzheimer's disease (AD) model of mice and its related mechanisms. MethodsSPF grade 4-week-old 5×FAD mice were divided into a model group, low-dose CRZG (0.819 g·kg-1) and high-dose CRZG (1.638 g·kg-1) groups, and Donepezilepezil hydrochloride group (2 mg·kg-1), with eight mice in each group. Eight C57 mice with the same background were set as the normal group. After one week of adaptive feeding, mice were orally administered continuously for six months. On the 5th month of drug administration, Y maze, new object recognition, and Morris water maze tests were conducted separately. After administration, mouse brain tissue was taken, and the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in brain tissue were detected by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence (IF) was used to detect the expression of small glial cell markers Iba1, astrocyte markers GFAP, and amyloid protein 1-42 (Aβ1-42) in the hippocampus of the brain tissue. The hematoxylin-eosin (HE) staining was used to detect pathological changes in the hippocampus of brain tissue. Western blot was used to detect the expression of nuclear factor-κB (NF-κB) p65, NOD-like receptor protein 3 (NLRP3), cleaved Caspase-1, apoptosis-associated speck-like protein containing a CARD (ASC), and other proteins in the brain tissue. ResultsCompared with those in the normal group, the mice in the model group had obvious cognitive impairment. The spontaneous alternation rate of the Y maze was decreased, and the discrimination index of novel object recognition was decreased significantly (P<0.01). The escape latency in the water maze was shortened significantly (P<0.01). The contents of IL-6 and TNF-α in brain tissue were increased. The fluorescence levels of Iba1 and Aβ1-42 in the hippocampus were significantly increased (P<0.01). There was a significant increase in neuronal lesions, neuronal atrophy, loose arrangement of tissue structure, and abnormal erythrocyte aggregation in the hippocampus. The protein expressions of p-NF-κB p65/NF-κB p65, cleaved Caspase-1, ASC, IL-6, and IL-1β were significantly increased (P<0.05, P<0.01). Compared with the model group, the spontaneous alternation rate and discrimination index of the high-dose CRZG group were increased significantly (P<0.01), and the escape latency was shortened significantly (P<0.05, P<0.01). The content of IL-6 decreased in the brain, and that of TNF-α dropped significantly (P<0.01). The expression of Iba1 protein and Aβ1-42 in the hippocampus decreased significantly (P<0.05, P<0.01). The hippocampal neurons were densely arranged, and the pyramidal nuclei were clear and centered. The abnormal aggregation of red blood cells was alleviated. The value of p-NF-κB/NF-κB proteins and the expression of ASC, cleaved Caspase-1, IL-6, and IL-1β were significantly decreased (P<0.05, P<0.01). ConclusionCRZG can effectively improve cognitive impairment in 5×FAD mice with Alzheimer's disease, and its mechanism may be related to the regulation of the NF-κB/NLRP3 pathway to reduce the abnormal activation of microglia and inhibit neuroinflammation.

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