1.Evaluation and management of nutritional consequences in patients with alcoholic cirrhosis
Lijie WANG ; Yanrong YANG ; Yu CHEN ; Jinling DONG
Journal of Clinical Hepatology 2025;41(4):761-767
Patients with alcoholic cirrhosis often experience varying degrees of malnutrition, and the patients with malnutrition are more susceptible to complications such as infections and ascites, which may lead to a poor prognosis. Therefore, it is particularly important to conduct nutritional risk screening for patients in clinical practice, and appropriate nutritional assessment tools should be used to evaluate the nutritional status of patients and develop individualized nutritional supplementation regimens, thereby promoting disease recovery and improving prognosis and quality of life. This article elaborates on the specific methods for nutritional screening, assessment, and management in patients with alcoholic cirrhosis and points out that systematic nutritional screening and assessment can help to identify the patients with malnutrition in the early stage and provide timely intervention. Individualized nutritional supplementation regimens should be adjusted based on the conditions of patients, so as to meet their nutritional needs, promote the recovery of liver function, improve overall health status, and enhance long-term quality of life.
2.The mechanism of Laggerae Herba in improving chronic heart failure by inhibiting ferroptosis through the Nrf2/SLC7A11/GPX4 signaling pathway
Jinling XIAO ; Kai HUANG ; Xiaoqi WEI ; Xinyi FAN ; Wangjing CHAI ; Jing HAN ; Kuo GAO ; Xue YU ; Fanghe LI ; Shuzhen GUO
Journal of Beijing University of Traditional Chinese Medicine 2025;48(3):343-353
Objective:
To investigate the role and mechanism of the heat-clearing and detoxifying drug Laggerae Herba in regulating the nuclear factor-erythroid 2-related factor-2(Nrf2)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway to inhibit ferroptosis and improve chronic heart failure induced by transverse aortic arch constriction in mice.
Methods:
Twenty-four male ICR mice were divided into the sham (n=6) and transverse aortic arch constriction groups (n=18) according to the random number table method. The transverse aortic arch constriction group underwent transverse aortic constriction surgery to establish models. After modeling, the transverse aortic arch constriction group was further divided into the model, captopril, and Laggerae Herba groups according to the random number table method, with six mice per group. The captopril (15 mg/kg) and Laggerae Herba groups (1.95 g/kg) received the corresponding drugs by gavage, whereas the sham operation and model groups were administered the same volume of ultrapure water by gavage once a day for four consecutive weeks. After treatment, the cardiac function indexes of mice in each group were detected using ultrasound. The heart mass and tibia length were measured to calculate the ratio of heart weight to tibia length. Hematoxylin and eosin staining were used to observe the pathological changes in myocardial tissue. Masson staining was used to observe the degree of myocardial fibrosis. Wheat germ agglutinin staining was used to observe the degree of myocardial cell hypertrophy. Prussian blue staining was used to observe the iron deposition in myocardial tissue. An enzyme-linked immunosorbent assay was used to detect the amino-terminal pro-brain natriuretic peptide (NT-proBNP) and glutathione (GSH) contents in mice serum. Colorimetry was used to detect the malondialdehyde (MDA) content in mice serum. Western blotting was used to detect the Nrf2, GPX4, SLC7A11, and ferritin heavy chain 1 (FTH1) protein expressions in mice cardiac tissue.
Results:
Compared with the sham group, in the model group, the ejection fraction (EF) and fractional shortening (FS) of mice decreased, the left ventricular end-systolic volume (LVESV) and left ventricular end-systolic diameter (LVESD) increased, the left ventricular anterior wall end-systolic thickness (LVAWs) and left ventricular posterior wall end-systolic thickness (LVPWs) decreased, the ratio of heart weight to tibia length increased, the myocardial tissue morphology changed, myocardial fibrosis increased, the cross-sectional area of myocardial cells increased, iron deposition appeared in myocardial tissue, the serum NT-proBNP and MDA levels increased, the GSH level decreased, and Nrf2, GPX4, SLC7A11, and FTH1 protein expressions in cardiac tissue decreased (P<0.05). Compared with the model group, in the captopril and Laggerae Herba groups, the EF, FS, and LVAWs increased, the LVESV and LVESD decreased, the ratio of heart weight to tibia length decreased, the myocardial cells were arranged neatly, the degree of myocardial fibrosis decreased, the cross-sectional area of myocardial cells decreased, the serum NT-proBNP level decreased, and the GSH level increased. Compared with the model group, the LVPWs increased, the iron deposition in myocardial tissue decreased, the serum MDA level decreased, and Nrf2, GPX4, SLC7A11, and FTH1 protein expressions in cardiac tissue increased (P<0.05) in the Laggerae Herba group.
Conclusion
Laggerae Herba improves the cardiac function of mice with chronic heart failure caused by transverse aortic arch constriction, reduces the pathological remodeling of the heart, and reduces fibrosis. Its mechanism may be related to Nrf2/SLC7A11/GPX4 pathway-mediated ferroptosis.
3.Research progress on Astragali Radix for promoting healing of chronic refractory wound
Yangyang YU ; Yuan GAO ; Jinling HE ; Hao WU ; Keyu CHEN ; Yuxing ZHAO
China Pharmacy 2025;36(19):2473-2478
Chronic refractory wound (CRW) presents significant clinical treatment challenges due to pathological characteristics such as persistent inflammation, bacterial infection, oxidative stress and inadequate angiogenesis. Astragali Radix, a traditional Chinese medicinal herb, exerts multi-target pharmacological effects on CRW through its active components, including Astragalus polysaccharides, flavonoids, and astragaloside Ⅳ, etc. Fundamental studies indicate that these components promote CRW healing by modulating inflammatory responses, inhibiting pathogen growth, improving antioxidant capacity and stimulating neovascularization. Network pharmacology and bioinformatics studies have revealed that active components of Astragali Radix target and modulate key signaling nodes such as nuclear factor-κB, phosphatidylinositol 3-kinase/Akt, AMP-activated protein kinase, and vascular endothelial growth factor receptor, as well as inflammation-angiogenesis-related pathways, thereby synergistically exerting anti-inflammatory and pro-angiogenic effect. Clinical applications have demonstrated that oral formulations (e.g., Huangqi guizhi decoction, Danggui huangqi decoction, etc.) reduce healing time of CRW and lower inflammatory marker levels, while topical preparations (e.g., Zizhu ointment, Huangqi shengji ointment, electrostatically spun Astragalus polysaccharide composite nanofibre dressings, etc.) significantly improve healing rates of CRW and minimize complications.
4.Establishment and evaluation of an animal model of heart failure with preserved ejection fraction integrating disease and syndrome based on the "deficiency-blood stasis-toxin" pathogenesis
Xiaoqi WEI ; Xinyi FAN ; Feng JIANG ; Wangjing CHAI ; Jinling XIAO ; Fanghe LI ; Kuo GAO ; Xue YU ; Wei WANG ; Shuzhen GUO
Journal of Beijing University of Traditional Chinese Medicine 2025;48(4):501-515
Objective:
This study aimed to construct an animal model of heart failure with preserved ejection fraction (HFpEF) that integrates disease and syndrome based on the "deficiency-blood stasis-toxin" pathogenesis and to evaluate it comprehensively.
Methods:
The HFpEF mouse model was constructed using a combination of Nω-nitro-L-arginine methyl ester (L-NAME) and a high-fat diet. According to the random number table method, SPF-grade male C57BL/6J mice were randomly assigned to the control, L-NAME, high-fat diet, and model groups, 10 in each group. Comprehensive observations and data collection on macroscopic signs (e.g., fur condition, mental state, stool and urine, oral and nasal condition, paw and body condition, etc.) and cardiac function were performed after 10 and 16 weeks of model induction. Additionally, the syndrome evolution was elucidated based on diagnostic criteria for clinical syndromes of heart failure. Furthermore, pathological and molecular biological examinations of myocardial tissue were performed to assess the stability and reliability of the model.
Results:
Mice in the model group showed typical characteristics of syndrome of qi deficiency and blood stasis, as well as syndrome of internal heat accumulation, including lethargy, slow response, dull paw color and oral/nasal color, exercise intolerance, abnormal platelet activation, dry feces, and dark yellow urine. The time window for these syndromes was between 10 and 16 weeks post-modeling. Cardiac function assessments revealed severe diastolic dysfunction, concentric myocardial hypertrophy, and myocardial fibrosis in the model group. Pathological examinations showed a significantly increased collagen deposition in the myocardial interstitium, enlarged cross-sectional area of cardiomyocytes, and sparse coronary microvasculature in the model group. Molecular biological analyses indicated marked activation of the inducible nitric oxide synthase/nuclear factor kappa-light-chain-enhancer of activated B cells/NOD-like receptor family pyrin domain containing 3 inflammatory pathway and significantly elevated inflammation levels in the myocardial tissue of the model group. Although mice in the L-NAME and high-fat diet groups also showed certain manifestations of qi deficiency syndrome, the substantial cardiac damage was relatively limited compared to the control group.
Conclusion
This study has constructed an animal model of HFpEF that integrates disease and syndrome based on the "deficiency-blood stasis-toxin" pathogenesis. The macroscopic and microscopic characteristics of this model are consistent with the manifestations of syndrome of qi deficiency and blood stasis, toxin syndrome, and syndrome of internal heat accumulation. Moreover, it can stably simulate the HFpEF state and reflect phenotypic changes in human disease. This model provides a suitable experimental platform to explore the pathogenesis of HFpEF, evaluate the effectiveness of traditional Chinese medicine (TCM) treatment regimens, and promote in-depth research on TCM syndromes of heart failure.
5.Effect and mechanism of Qipi Qiangxin Capsule on myocardial endothelial mesenchymal in heart failure mice
Fenglei WANG ; Yangyang ZHAO ; Jinling YU ; Xiaoyan WU
International Journal of Laboratory Medicine 2024;45(22):2789-2794
Objective To investigate the effect and possible mechanism of Qili Qiangxin Capsule on the en-dothelial mesenchymal transition of myocardial cells in mice with heart failure after myocardial infarction.Methods A total of 21 male C57BL/6 mice aged 6-8 weeks were divided into a normal control group,a drug control group(normal mice were treated with high-dose Qili Qiangxin Capsule),and a heart failure model group.The heart failure model group was divided into a positive drug control group[microRNA21(miR-21)inhibitor intervention],high,medium,and low dose Qili Qiangxin Capsule intervention groups,a total of seven groups.The heart failure model group underwent ligation of the left anterior descending coronary artery,while the normal control group and the drug control group underwent the same surgical procedure as the model group,but left anterior descending coronary artery ligation was not performed.A small animal ultrasound ima-ging system was used to detect hemodynamic parameters in mice.HE staining was used to observe pathologi-cal changes in mouse myocardium.Sirius red staining was used to detect myocardial tissue fibrosis in mice.Wheat-germ agglutinin staining was used to evaluate the degree of myocardial cell enlargement.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression of N-terminal pro brain natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnⅠ)in mouse serum heart failure markers,as well as the expression levels of activator protein-1(AP-1)and transforming growth factor-β1(TGF-β1)in mouse myocardial tissue.Real time fluorescence quantitative PCR(qRT-PCR)was used to detect the expression level of miR-21 in pe-ripheral blood of mice.Western blot was used to detect CD31 and VE-cadherin in mouse myocardial tissue,and immunohistochemistry was used to detect the expression levels of a-smooth muscle actin(a-SMA),iron death inhibitory protein 1(FSP1),bone morphogenetic protein 7(BMP7),TGF-β1,Smad2/3,and p-Smad2/3 pro-teins.Results Qili Qiangxin Capsule significantly improved heart function and myocardial tissue pathological damage in heart failure mice,reduced myocardial tissue fibrosis levels,alleviated compensatory hypertrophy of non infarcted myocardial cells,inhibited endothelial mesenchymal transition in myocardial tissue,decreased the expression of miR-21,TGFβ1,a-SMA,FSP1 and Smad2/3,and increased the expression of BMP7,VE-cadher-in,and CD31.Conclusion Qili Qiangxin Capsule may improve myocardial injury in mice with heart failure caused by myocardial infarction by regulating the expression of miR-21 and affecting the downstream TGF-β1/Smad2/3 signaling pathway.
6.Changes in the subfoveal choroidal thickness of children and adolescents with different refractive states
Jinling ZHANG ; Yujie LIAO ; Xiaoyan YU ; Qi YANG ; Jiaqing KANG ; Jiawen LU ; Chen CHEN ; Haohao ZHU
Recent Advances in Ophthalmology 2024;44(11):883-886
Objective To observe the changes in the subfoveal choroidal thickness(SFCT)of children and adoles-cents with different refractive states using optical coherence tomography angiography.Methods A total of 171 children and adolescents were followed.They were divided into the lower primary school group(6-8 years old),upper primary school group(9-11 years old),and junior high school group(12-14 years old)according to their age at the time of en-rollment.Dioptric examinations(including best corrected visual acuity,diopter,intraocular pressure,corneal curvature,axial length and SFCT)were performed,data collection was conducted twice in half a year(initial examination and review after half a year),and the eyeball parameters and changes in eyeball parameters after half a year among all groups were compared.Results The axial length and SFCT of subjects had significant differences among all groups(both P<0.05).In children and adolescents,the axial length gradually lengthened and SFCT gradually thickened with age,while intraocular pressure and corneal curvature were not associated with age(both P>0.05).In the initial examination and review after half a year,there was no significant difference in intraocular pressure,corneal curvature and SFCT of subjects with differ-ent refractive states in all groups(all P>0.05),while the axial length of myopic subjects was greater than that of non-my-opic subjects in all groups(all P<0.05).In the review after half a year,the SFCT of non-myopic subjects in the lower pri-mary school group and upper primary school group was significantly thickened(P<0.001,P=0.003),while there was no significant difference in SFCT of myopic subjects in all groups compared with the value half a year ago(all P>0.05).The axial length of all subjects showed a positive correlation with the SFCT in the initial examination and review after half a year(r=0.354,0.228,P<0.05).Conclusion Myopia affects the increase in SFCT in children and adolescents.
7.Intervention effect of kushenol F on ulcerative colitis mice
Xudong HE ; Haoyu NI ; Jinbiao HE ; Min LI ; Yunkai HU ; Dihong GONG ; Jinling YAO ; Jie YU ; Xingxin YANG
China Pharmacy 2024;35(4):419-424
OBJECTIVE To investigate the intervention effect of kushenol F (KSC-F) on ulcerative colitis (UC) mice. METHODS Totally 30 male C57BL/6J mice were randomly divided into the normal group, model group, positive drug group (sulfasalazine, 703 mg/kg), KSC-F 50 mg/kg group (KSC-F50 group), and KSC-F 100 mg/kg group (KSC-F100 group), with 6 mice in each group. Except for the normal group, the mice in the remaining groups were given 3% dextran sulfate sodium solution continuously for 7 days to induce UC model. Concurrently, administration groups received corresponding drug solution intragastrically, once a day, for 10 consecutive days. During the experiment, the changes in body weight and bowel movements of the mice were observed. Disease activity index scoring was performed after the last administration. The histopathological morphology of colonic tissue was examined. The levels of inflammatory factors in the serum and colon tissue were measured. Additionally, the mRNA expression of inflammatory factors, and the protein expressions of inflammation-related proteins [interleukin-1β (IL-1β), forkhead box O1(FOXO1), phosphoinositide 3-kinase(PI3K), phosphorylated PI3K(p-PI3K), p38 mitogen-activated protein kinase(p38 MAPK), phosphorylated p38 MAPK(p-p38 MPAK) and phosphorylated protein kinase B(p- Akt)] were determined in colonic tissue. RESULTS KSC-F could alleviate weight loss and colonic tissue damage in UC mice. KSC- F reduced the levels of IL-1β, IL-6, IL-8 and tumor necrosis factor-α (TNF-α) in serum, as well as IL-1β, IL-6, IL-17 and TNF- α in colonic tissue to varying degrees and increased the levels of IL-10 in both serum and colonic tissue (P<0.05 or P<0.01). Moreover, KSC-F decreased the expression levels of IL-1β, IL-17 and TNF-α mRNA, as well as p-PI3K, p-p38 MAPK, and p- Akt proteins in colonic tissue to varying degrees, and increased the expression levels of IL-10 mRNA and FOXO1 protein in colonic tissue (P<0.05 or P<0.01). CONCLUSIONS KSC-F effectively alleviates UC symptoms in mice by inhibiting PI3K, Akt and p38 MAPK activation, mitigating the release of pro-inflammatory factors such as IL-1β, IL-6, TNF- α,promoting the anti-inflammatory factor IL-10 secretion, and reducing inflammation-induced colonic tissue damage.
8.Application of proanthocyanidin in the treatment and repair of deep caries
GAO Ying ; WANG Jue ; TAO Lu ; YAO Jingjing ; YU Jinling ; HUANG Handan ; YANG Liuqing ; LIU Zhihui
Journal of Prevention and Treatment for Stomatological Diseases 2023;31(7):518-523
Proanthocyanidin (PA), as a kind of natural plant polyphenol, have a variety of biological functions, such as promoting remineralization, inducing collagen cross-linking, inhibiting protease activity and inhibiting bacteria. Therefore, PA could be broadly used in the clinical application of treatment and repair of deep caries in the future; for example, PA could promote dentin remineralization, improve resin-dentin bonding durability and improve the dentin acid erosion effect. This application potential of PA arises from several features, firstly, PA can not only promote dentin remineralization on its own or with other remineralizers but also exhibits antibacterial effects, which can inhibit acid production while reducing the formation of cariogenic pathogens and their biofilms. Based on the above features, PA can reduce the incidence of caries disease; thus, PA improves deep caries and long-term effects after treatment. In addition, PA added to adhesives or etch agents can improve the etching and bonding effect of dentin by inducing collagen cross-linking and inhibiting protease activity, thus achieving the ultimate goal of improving the bonding performance of deep caries. This paper summarizes recent progress of research on PA for the treatment and repair of deep caries, including the promotion of dentin remineralization and antibacterial activity as well as the improvement in dentin bonding and acid etching effect, to provide a more comprehensive reference for treating and restoring deep caries in clinical practice.
9.Advances in the classification and treatment of isolated superior mesenteric artery dissection.
Chao Chen WANG ; Yu Dong SUN ; Xiao Long WEI ; Zai Ping JING ; Zhi Qing ZHAO
Chinese Journal of Surgery 2023;61(1):81-85
Isolated superior mesenteric artery dissection (ISMAD) has attracted more and more clinicians' attention in recent years. Patients onset of ISMAD often present with abdominal pain. The misdiagnosis or miss diagnosis is common because of the non-specific symptoms and signs, which even can endanger lives in serious cases. Imaging classification is of great significance for diagnosis and treatment of ISMAD. The Sakamoto classification and the Yun classification are two classical classified methods. However, with the further study of ISMAD, various new classifications emerge. Conservative treatment was once considered as the preferred. As the rapid development of endovascular therapy and the great progress of new devices, stenting therapy can significantly improve symptoms and achieve satisfactory long-term effects, and be even expected to become the preferred method for clinical therapy of ISMAD. However, the long-term effects of endovascular therapy still need a large number of follow-up data, and complications after stent implantation can't be ignored.
Humans
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Mesenteric Artery, Superior
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Treatment Outcome
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Tomography, X-Ray Computed
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Aortic Dissection/therapy*
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Stents
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Endovascular Procedures
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Retrospective Studies
10.Effects of life satisfaction and shift work and their interaction on cumulative fatigue in petrochemical employees
Baoyu WAN ; Yu SU ; Qianqian GAO ; Jin WANG ; Xin DU ; Liming WANG ; Qiaoyun ZHANG ; Geyu LIANG
Journal of Environmental and Occupational Medicine 2023;40(9):1039-1045
Background Cumulative fatigue without intervention will seriously threaten the physical and mental health of workers. Shift work and life satisfaction are strongly associated with fatigue accumulation. Objective To explore the effects of life satisfaction, shift work, and their interaction on cumulative fatigue in petrochemical employees, and to provide a scientific basis for preventing cumulative fatigue. Methods All staff of a petrochemical enterprise were selected by cluster sampling for a cross-sectional study from July to October 2021 in Jiangsu Province. A questionnaire designed by the project team was used to collect information on shift work; and life satisfaction and cumulative fatigue were investigated by the World Health Organization Five-item Well-Being Index and the Self-diagnosis Checklist for Assessment of Worker’s Fatigue Accumulation respectively. A logistic regression model was used to analyze the influences of life satisfaction and shift work on cumulative fatigue. Multiplicative and additive models were applied to analyze the interaction effect of life satisfaction and shift work. Results A total of 4066 questionnaires were returned, of which 3763 were valid, with an effective recovery rate of 92.5%. The percentage of cumulative fatigue in the petrochemical employees was 63.2% (2377/3763), and the percentages of low life satisfaction and shift work in the petrochemical employees were 53.6% (2016/3763) and 54.2% (2041/3763), respectively. The results of univariate analysis showed no significant difference in cumulative fatigue among different marital status groups (P=0.176), and there were statistically significant differences in cumulative fatigue among the petrochemical employees in different groups of age, gender, educational level, average monthly income, job title, length of service, working hours, night shift, smoking, drinking, physical exercise, life satisfaction, and shift work (P<0.001). After adjustment for covariates such as age, gender, educational level, average monthly income, job title, length of service, working hours, night shift, smoking, drinking, and physical activity, the unconditional logistic regression model showed that the risk of reporting cumulative fatigue in high life satisfaction participants was 0.129 (95%CI: 0.109, 0.154) times of that in participants of low life satisfaction; the risk of reporting cumulative fatigue in shift work participants was 3.792 (95%CI: 2.713, 5.300) times of that in no shift work participants; and the risk of reporting cumulative fatigue in participants with both high life satisfaction and shift work was 0.105 (95%CI: 0.081, 0.135) times of that in participants with low life satisfaction and shift work. The relative excess risk due to interaction, the attributable proportion due to interaction, and the synergy index of coexisting life satisfaction and shift work were −5.504 (95%CI: −7.247, −3.760), −4.728 (95%CI: −7.575, −1.880), and 0.029 (95%CI: 0.002, 0.351) respectively, which suggested that life satisfaction and shift work have an additive interaction effect on cumulative fatigue. A significant multiplicative interaction was also found between life satisfaction and shift work (OR=0.688, 95%CI: 0.476, 0.936). Conclusion Life satisfaction and shift work are the influencing factors of cumulative fatigue among petrochemical employees, and they interact with each other on the risk of cumulative fatigue. High life satisfaction can reduce the risk of accumulated fatigue associated with shift work.


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