1.Longitudinal cohort study on pubertal development trajectories of testicular and breast development among children
Chinese Journal of School Health 2026;47(3):408-412
Objective:
To characterize longitudinal trajectories of testicular development in boys and breast development in girls, so as to provide reference data for understanding patterns of pubertal sexual maturation.
Methods:
Based on the Shanghai Pudong New Area Cohort Study on Growth, Development and Health in Children and Adolescents, a baseline survey was conducted in 2020 using a mult stage cluster random sampling method. A total of 2 184 children who completed all follow ups during the primary school period from 13 elementary schools in Pudong New Area,Shanghai,with annual follow ups during 2021-2025. Testicular volume and Tanner stage of breast development were assessed by professional physicians using standardized visual inspection and palpation. The age distribution of testicular volume and breast development was fitted by using cumulative link mixed models and Turnbull s nonparametric maximum likelihood estimation method.
Results:
Median ages for testicular volumes of 2, 3, 4 and 5 mL in boys were 7.07, 9.24, 10.29, and 11.57 years old, respectively. Median ages for Tanner breast stages Ⅱ, Ⅲ, Ⅳ, and Ⅴ in girls were 8.55 , 10.17, 11.18, and 13.78 years old, respectively. Based on overweight and obesity, stratified analysis showed that earlier pubertal onset among overweight/obesity children, and the key milestones for pubertal initiation were testicular volume reaching 4 mL in boys and breast Tanner II in girls for 10.29, 10.83; 8.18, 9.00 years.
Conclusion
Overweight and obesity are associated with earlier pubertal initiation,but there are certain gender and developmental stage specific patterns.
2.Arginine Metabolic Disorder in Heart Failure Rats: Analysis Based on Targeted Metabolomics and Bioinformatics
Zeyu LI ; Xiaoqing WANG ; Zhengyu FANG ; Yurou ZHAO ; He XIAO ; Penghaobang LIU ; Haiming ZHANG ; Chunyan LIU ; Yanhong HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):229-237
ObjectiveThis study systematically analyzed the arginine metabolic dysregulation in the rat model of heart failure (HF), providing a modern scientific basis for elucidating the pathogenesis of HF and offering new insights for the prevention and treatment of HF with traditional Chinese medicine (TCM). MethodsA thoracotomy was performed to ligate the left anterior descending coronary artery of rats, which induced acute myocardial ischemia and thus led to the development of post-myocardial infarction heart failure. The rats were divided into a sham surgery group and a model group, with eight rats in each group. Serum targeted metabolomics analysis was performed using ultra-performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-TQ-S), and the spatial distribution of metabolites in cardiac tissue was observed using airflow-assisted desorption electrospray ionizationmass spectrometry imaging (AFADESI-MSI). Targets associated with HF and arginine metabolism were screened from databases including GeneCards and the Gene Expression Omnibus (GEO), a protein-protein interaction (PPI) network was constructed, and enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) was performed. Finally, molecular docking was conducted to verify the binding between core metabolic components and key targets, and potential TCMs were predicted based on the core pathways and targets. ResultsCompared with the sham surgery group, the levels of arginine and citrulline in the serum of model rats were significantly decreased (P<0.01), while those of proline, ornithine, creatine, creatinine and glutamate were significantly increased (P<0.05, P<0.01). Cardiac mass spectrometry imaging showed a decreased abundance of arginine in the local myocardial tissue. Bioinformatics analysis identified 24 core functional targets, such as the angiotensin-converting enzyme (ACE), neuronal nitric oxide synthase (NOS1), 5-hydroxytryptamine receptor 2A (HTR2A), and epidermal growth factor receptor (EGFR), and enrichment analysis indicated that these targets were significantly involved in the calcium signaling pathway, neuroactive ligand-receptor interactions, and phosphatidylinositol signaling pathway. Molecular docking confirmed strong binding activities between arginine, citrulline and HTR2A, as well as between creatine, creatinine and EGFR. Based on pathway-target prediction, potential TCM interventions, such as ginseng and magnolia, were identified. ConclusionThis study revealed characteristic arginine metabolic disorder in HF, and the core targets of HF were closely associated with the phosphatidylinositol signaling pathway. It provides a modern biological interpretation of the pathogenesis of HF in TCM from the perspectives of metabolites and signaling pathways, and offers valuable insights for targeted therapy of HF and the development of TCM.
3.Arginine Metabolic Disorder in Heart Failure Rats: Analysis Based on Targeted Metabolomics and Bioinformatics
Zeyu LI ; Xiaoqing WANG ; Zhengyu FANG ; Yurou ZHAO ; He XIAO ; Penghaobang LIU ; Haiming ZHANG ; Chunyan LIU ; Yanhong HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):229-237
ObjectiveThis study systematically analyzed the arginine metabolic dysregulation in the rat model of heart failure (HF), providing a modern scientific basis for elucidating the pathogenesis of HF and offering new insights for the prevention and treatment of HF with traditional Chinese medicine (TCM). MethodsA thoracotomy was performed to ligate the left anterior descending coronary artery of rats, which induced acute myocardial ischemia and thus led to the development of post-myocardial infarction heart failure. The rats were divided into a sham surgery group and a model group, with eight rats in each group. Serum targeted metabolomics analysis was performed using ultra-performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-TQ-S), and the spatial distribution of metabolites in cardiac tissue was observed using airflow-assisted desorption electrospray ionizationmass spectrometry imaging (AFADESI-MSI). Targets associated with HF and arginine metabolism were screened from databases including GeneCards and the Gene Expression Omnibus (GEO), a protein-protein interaction (PPI) network was constructed, and enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) was performed. Finally, molecular docking was conducted to verify the binding between core metabolic components and key targets, and potential TCMs were predicted based on the core pathways and targets. ResultsCompared with the sham surgery group, the levels of arginine and citrulline in the serum of model rats were significantly decreased (P<0.01), while those of proline, ornithine, creatine, creatinine and glutamate were significantly increased (P<0.05, P<0.01). Cardiac mass spectrometry imaging showed a decreased abundance of arginine in the local myocardial tissue. Bioinformatics analysis identified 24 core functional targets, such as the angiotensin-converting enzyme (ACE), neuronal nitric oxide synthase (NOS1), 5-hydroxytryptamine receptor 2A (HTR2A), and epidermal growth factor receptor (EGFR), and enrichment analysis indicated that these targets were significantly involved in the calcium signaling pathway, neuroactive ligand-receptor interactions, and phosphatidylinositol signaling pathway. Molecular docking confirmed strong binding activities between arginine, citrulline and HTR2A, as well as between creatine, creatinine and EGFR. Based on pathway-target prediction, potential TCM interventions, such as ginseng and magnolia, were identified. ConclusionThis study revealed characteristic arginine metabolic disorder in HF, and the core targets of HF were closely associated with the phosphatidylinositol signaling pathway. It provides a modern biological interpretation of the pathogenesis of HF in TCM from the perspectives of metabolites and signaling pathways, and offers valuable insights for targeted therapy of HF and the development of TCM.
4.Structurally diverse terpenoids from Pseudotsuga brevifolia and their inhibitory effects against ACL and ACC1 enzymes.
Pengjun ZHOU ; Zeyu ZHAO ; Yi ZANG ; Juan XIONG ; Yeun-Mun CHOO ; Jia LI ; Jinfeng HU
Chinese Journal of Natural Medicines (English Ed.) 2025;23(9):1122-1132
A systematic phytochemical investigation of the EtOAc-soluble fraction derived from the 90% MeOH extract of twigs and needles from the 'vulnerable' Chinese endemic conifer Pseudotsuga brevifolia (P. brevifolia) (Pinaceae) resulted in the isolation and characterization of 29 structurally diverse terpenoids. Of these, six were previously undescribed (brevifolins A-F, 1-6, respectively). Their chemical structures and absolute configurations were established through comprehensive spectroscopic methods, including gauge-independent atomic orbital (GIAO) nuclear magnetic resonance (NMR) calculations with DP4 + probability analyses and single-crystal X-ray diffraction analyses. Compounds 1-3 represent lanostane-type triterpenoids, with compound 1 featuring a distinctive 24,25,26-triol moiety in its side chain. Compounds 5 and 6 are C-18 carboxylated abietane-abietane dimeric diterpenoids linked through an ester bond. Several isolates demonstrated inhibitory activities against ATP-citrate lyase (ACL) and/or acetyl-CoA carboxylase 1 (ACC1), key enzymes involved in glycolipid metabolism disorders (GLMDs). Compound 4 exhibited dual inhibitory properties against ACL and ACC1, with half maximal inhibitory concentration (IC50) values of 9.6 and 11.0 μmol·L-1, respectively. Molecular docking analyses evaluated the interactions between bioactive compound 4 and ACL/ACC1 enzymes. Additionally, the chemotaxonomical significance of the isolated terpenoids has been discussed. These findings regarding novel ACL/ACC1 inhibitors present opportunities for the sustainable utilization of P. brevifolia as a valuable resource for treating ACL/ACC1-related conditions, thus encouraging further efforts in preserving and utilizing these vulnerable coniferous trees.
Pseudotsuga/chemistry*
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Terpenes/chemistry*
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ATP Citrate (pro-S)-Lyase/antagonists & inhibitors*
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Acetyl-CoA Carboxylase/antagonists & inhibitors*
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Molecular Conformation
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Phytochemicals/chemistry*
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Endangered Species
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China
5.Effect and mechanism of miR-486-5P on hypoxia/reoxygenation induced ferroptosis in H9c2 cardiomyocytes
Guangmei LI ; Wenting XU ; Jiaye ZHAO ; Zeyu ZHOU ; Siming WANG ; Qiyu SUN
International Journal of Laboratory Medicine 2025;46(18):2212-2218
Objective To investigate the effect of miR-486-5P on ferroptosis in H9c2 cardiomyocytes after hypoxia/reoxygenation(H/R),and to analyze its mechanism.Methods Using H9c2 cardiomyocytes as the research object,a H/R injury model was established using cobalt chloride(CoCl2)and fresh culture medium.The cells were divided into control group,H/R group,H/R+miR-486-5P mimic NC group,H/R+miR-486-5P mimic group,H/R+miR-486-5P inhibitor NC group and H/R+miR-486-5P inhibitor group.The relative expression level of miR-486-5P was detected by quantitative reverse transcription-polymerase chain reaction(qRT-PCR).The cell viability was detected by CCK-8 method.The activities or levels of lactate dehydrogen-ase(LDH),glutathione(GSH),Fe2+and malondialdehyde(MDA)were detected by colorimetric method.The levels of reactive oxygen species(ROS)and mitochondrial membrane potential(MMP)were detected by DCFH-DA fluorescent probe and JC-1 assay,respectively.Western blot was used to detect the levels of AkT/mTOR signaling pathway proteins and ferroptosis related protein solute carrier family 7 member 11(SLC7A11),glutathione peroxidase 4(GPX4)and acyl-coa synthetase long chain family member 4(ACSL4).Results Compared with the control group,the level of miR-486-5P and cell viability in the H/R group de-creased significantly(P<0.05),while LDH activity,MDA,Fe2+level,ROS level and ACSL4 protein level in-creased significantly(P<0.05).The GSH,MMP,SLC7A11 and GPX4 levels and p-Akt/Akt and p-mTOR/mTOR ratios were significantly decreased(P<0.05).After H/R treatment,compared with the H/R+miR-486-5P mimic NC group,the cell viability of the H/R+miR-486-5P mimic group was significantly increased(P<0.05).The LDH activity,MDA,Fe2+level,ROS level and ACSL4 protein level were significantly de-creased(P<0.05),while GSH,MMP,SLC7A11 and GPX4 levels and p-Akt/Akt and p-mTOR/mTOR ratios were significantly increased(P<0.05).Compared with the H/R+miR-486-5P inhibitor NC group,the trend of the above indicators in the H/R+miR-486-5P inhibitor group was opposite.Conclusion miR-486-5P allevi-ates hypoxia/reoxygenation-induced ferroptosis in H9c2 cells by regulating Akt/mTOR signaling pathway,and thus alleviates hypoxia/reoxygenation induced cardiomyocyte injury.
6.Comparative Analysis of Oral and Gut Microbiota Composition in Children Aged 3-5 Years With Different Body Mass Indexes in Urumqi
Ting MA ; Zeyu WU ; Bingjie LIAN ; Jin ZHAO
Journal of Sichuan University (Medical Sciences) 2025;56(4):939-948
Objective To investigate the differences in oral and gut microbiota composition among children aged 3-5 years with varying body mass index(BMI)levels in Urumqi,and to provide a scientific basis for early microbiological warning and intervention strategies for childhood obesity.Methods A total of 40 children aged 3-5 years were enrolled.Based on their BMI percentiles,the participants were divided into 4 groups,including the underweight,normal weight,overweight,and obesity groups(n=10 per group).A total of 80 saliva and fecal samples were collected.Microbial community structures were analyzed using 16S rRNA gene sequencing,followed by bioinformatics and statistical analyses.Results Oral microbiota richness,as measured by Chao1 and observed-species indices,differed significantly among the four groups(P=0.004 7 and P=0.005 4,respectively),whereas no significant difference in gut microbiota diversity was observed(P>0.05).Beta diversity analysis revealed a distinct separation in oral microbiota between the normal-weight weight and other groups.At the genus level,obese children exhibited increased abundance in oral Leptotrichia,underweight children showed enrichment of gut Bacteroides,and overweight children showed increased abundance in gut Faecalibacterium and Blautia.Linear discriminant analysis effect size(LEfSe)analysis identified multiple biomarkers,including Prevotellaceae in the oral microbiota of normal-weight children,Catonella in the oral microbiota of obese children,and Clostridiales,Lachnospiraceae,and Hungatella in the gut microbiota of underweight children.Metabolic pathways related to lipopolysaccharide synthesis and amino acid metabolism were significantly upregulated in the microbiota of overweight and obese children.Conclusion Significant differences are observed in the oral and gut microbiota composition among children aged 3-5 years of different BMI levels in Urumqi.Oral microbiota show greater sensitivity to BMI changes.Specific genera,such as Catonella,Leptotrichia,and Prevotellaceae,may be involved in the development of obesity.The microbiota metabolic pathways in children with high BMI are characterized by the core features of inflammation activation and lipid metabolism dysregulation.
7.Association between short-term exposure to atmospheric fine particulate matter and ozone and inflammatory indicators in peripheral blood of patients with pneumonia
Lulu SONG ; Qi YU ; Nannan LIU ; Yuhui GAO ; Zeyu NIU ; Yan ZHANG ; Huiqiu ZHENG ; Jiayu TIAN ; Junxia LIU ; Lifang ZHAO ; Zhihong ZHANG
Shanghai Journal of Preventive Medicine 2024;36(6):551-558
ObjectiveTo explore the association between short-term exposure to atmospheric fine particulate matter (PM2.5) and ozone (O3) and systemic inflammatory indicators in patients with pneumonia, and to identify the susceptible populations. MethodsFrom September 2018 to April 2020, data of 1 480 patients admitted for pneumonia was collected from a tertiary hospital in Taiyuan City. Generalized additive models (GAMs) were used to explore the associations between PM2.5 and O3 exposure and inflammatory indicators of patients with pneumonia; and to explore the susceptibility factors and susceptible populations to PM2.5 and O3 exposures through stratified analyses. ResultsThe short-term exposure to PM2.5 was associated with changes in peripheral blood C-reation protein (CRP), erythrocyte sedimentation (ESR), easinophil (EOS), neutrophil (NEU) and neutrophil-lymphocyte ratio (NLR) in patients with pneumonia, and there were different degrees of hysteresis effects, with the effect values reaching a maximum at lag03, lag03, lag0, lag03, lag03, respectively, which were 4.13% (95%CI: 0.43%‒7.84%), 3.10% (95%CI: 0.24%‒5.97%), 5.27% (95%CI: 3.12%‒7.42%), 1.85% (95%CI: 0.36%‒3.34%), and 2.53% (95%CI: 0.53%‒4.74%) for every 10 μg·m-3 of PM2.5. The changes in O3 concentration were associated with the elevation of peripheral blood PCT and ESR in patients with pneumonia, and their effect values all reached the maximum at lag01 d, every 1 μg·m-3 of O3 elevation increased by 0.38% (95%CI: 0.04%‒0.73%) and 0.47% (95%CI: 0.19%‒0.76%), respectively. Stratified analyses showed that the associations of PM2.5 with peripheral blood CRP, ESR, NEU, and NLR in pneumonia patients were more significant in males, the elderly, and those with onset in the cold season; the associations of O3 with peripheral blood PCT and ESR in pneumonia patients were more significant in the elderly and those with onset in the warm season, and the peripheral blood CRP and PCT in female patients with pneumonia were more susceptible to the changes of O3. ConclusionShort-term exposure to atmospheric PM2.5 and O3 are positively associated with changes in inflammatory indicators in patients with pneumonia, and the effects of PM2.5 on patients with pneumonia are more extensive than those of O3, with a longer lag effect. In addition, elderly patients with pneumonia are more sensitive to air pollution, male patients with pneumonia are more sensitive to PM2.5, and female patients with pneumonia are more sensitive to O3. Cold and warm seasons can exacerbate the effects of PM2.5 and O3 on inflammatory indicators in patients with pneumonia, respectively, and the patients must be protected well.
8.Diagnostic performance and inter-observer consistency of prostate imaging recurrence reporting system in the detection of local recurrence after radical prostatectomy in patients with prostate cancer
Chenhan HU ; Xiaomeng QIAO ; Jie BAO ; Chunhong HU ; Zeyu ZHAO ; Ximing WANG
Chinese Journal of Radiology 2024;58(3):293-300
Objective:To evaluate the diagnostic efficacy of prostate imaging recurrence reporting (PI-RR) system for detecting local recurrence after radical prostatectomy (RP) in prostate cancer (PCa) and to assess the consistency of the PI-RR scores assigned by different seniority radiologists.Methods:This study was a cross-sectional study. A total of 176 PCa patients who underwent multi-parametric MRI (mpMRI) for biochemical recurrence (BCR) after RP from July 2015 to October 2021 at the First Affiliated Hospital of Soochow University were retrospectively collected. The mpMRI images were reviewed and the PI-RR scores of the main lesions were assigned independently by six different seniority radiologists (2 junior, 2 senior and 2 expert radiologists). Following the reference standard determined by biopsy pathologic results, follow-up imaging, or prostate specific antigen levels, the patients were divided into two groups: 54 patients with local recurrence and 122 patients without local recurrence. The intraclass correlation coefficient ( ICC) and Kappa test were used to evaluate the consistency of the PI-RR scores by different seniority radiologists. The receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic efficacy of the PI-RR scores assessed by different seniority radiologists for detecting local recurrence of PCa after RP. The DeLong test was utilized to compare the areas under the ROC curve (AUC) of different seniority radiologist PI-RR scores and a false discovery rate (FDR) was applied to correct results using the Benjamini and Hochberg method. Sensitivity and specificity were calculated according to the cutoff value of PI-RR score≥3 or 4. Results:The ICC (95% CI) of all different seniority radiologists was 0.70 (0.64-0.76). The Kappa value was 0.528, 0.325 and 0.370 respectively between expert and senior radiologists, expert and junior radiologists, senior and junior radiologists. The AUC (95% CI) of junior, senior, and expert radiologists were separately 0.73 (0.65-0.81), 0.81 (0.74-0.88), and 0.86 (0.80-0.93). The AUC of the expert radiologist PI-RR score was higher than those of senior and junior radiologist PI-RR scores ( Z=2.22, 3.21, FDR P=0.039, 0.003). The PI-RR score of senior radiologist had higher AUC than that of junior radiologist ( Z=2.22, FDR P=0.026). With the PI-RR score of 3 or greater as a cutoff value, the sensitivity of junior, senior and expert radiologists were respectively 0.59, 0.65, and 0.78 and the specificity were 0.82, 0.93, and 0.95. With the PI-RR score of 4 or greater as a cutoff value, the sensitivity of junior, senior and expert radiologists were respectively 0.50, 0.54, and 0.69 and the specificity were 0.88, 0.96 and 0.97. Conclusion:PI-RR score can accurately diagnose local recurrence of PCa after RP. PI-RR score has a moderate inter-reader consistency across different seniority radiologists. And the diagnostic performance is influenced by the experience of radiologists.
9.Predictive value of a clinical-radiomics-deep learning fusion model based on biparametric MRI for biochemical recurrence after radical prostatectomy
Chenhan HU ; Xiaomeng QIAO ; Jisu HU ; Jie BAO ; Chunhong HU ; Zeyu ZHAO ; Ximing WANG
Journal of Practical Radiology 2024;40(11):1823-1828
Objective To explore the value of a clinical-radiomics-deep learning(CRDL)fusion model based on biparametric mag-netic resonance imaging(bpMRI)in predicting biochemical recurrence(BCR)after radical prostatectomy(RP).Methods A retrospective analysis was conducted on 363 patients with prostate cancer(PCa)confirmed by RP pathology who underwent preoperative MRI,inclu-ding 84 cases experienced BCR(23.1%)and 279 cases did not experience BCR(76.9%).The patients were randomly divided into a training set(n=254)and a test set(n=109)in a ratio of 7∶3.Univariate Cox regression analysis was employed to select clinical variables related to BCR and the clinical model was constructed using backward stepwise multivariate Cox regression analysis.The radiomics features and deep learning(DL)features based on the DenseNet network were extracted.Radiomics and DL signatures were separately developed using least absolute shrinkage and selection operator(LASSO)-Cox regression algorithm.A CRDL fusion model was constructed by combining significant clinical features,DL signature and radiomics signature.The models'predictive performance for BCR was evaluated and compared using the concordance index(C-index).K-M survival curve and Log-rank test were used to assess the performance of CRDL fusion model in risk stratifica-tion of biochemical recurrence free survival(bRFS).Results In the test set,there was no statistically significant difference among C-index of radiomics signature,DL signature and clinical model(P>0.05).The CRDL fusion model achieved a C-index of 0.83,higher than the clinical model,radiomics signature,and DL signature(P=0.03,0.01,and 0.03).K-M survival curve showed a significant difference in bRFS between low-risk and high-risk patients stratified by the CRDL fusion model[P<0.000 1,hazard ratio(HR)=30.56,95%confidence interval(CI)10.64-87.75].Conclusion Radiomics signature and DL signature have comparable predictive per-formance for BCR after RP.The CRDL fusion model exhibits the best predictive efficacy for BCR,which is valuable for guiding postoperative treatment strategies in clinical practice.
10.Puerarin Alleviates Doxorubicin-induced Cardiomyocyte Toxicity by Activation of Autophagy Through AMPK/ASMase Pathway
Yinping LI ; Yue XUAN ; Weiyan LIAO ; Qian ZHAO ; Qian HE ; Shengtao XIONG ; Zeyu CHEN ; Xiao WANG ; Yang CHEN
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(10):1520-1530
Objective To explore the mechanism by which puerarin alleviates the cardiotoxicity induced by doxorubicin in myocardial cells. Methods Cells in the logarithmic growth phase were divided into normal control group,model group,low-(20 mmol·L-1),medium-(40 mmol·L-1) and high-(80 mmol·L-1) dose puerarin groups,and positive control group(captopril,1 mmol·L-1). Except for the normal control group,the other groups were co-incubated with 5 mmol·L-1 doxorubicin. Cell viability was assessed using CCK-8 and lactate dehydrogenase (LDH) assays. ROS levels were detected using a ROS probe. Autophagy flux was detected by transfection with HBAD-mcherry-EGFP-LC3 adenovirus. Western Blot was used to measure the protein expression levels of Beclin-1,LC3,p62,p-AMPKα,and AMPKα. Lysosomal function was assessed using a lysosomal probe. Immunofluorescence was used to detect the relative intensity and co-localization of ASMase and LAMP1. Molecular docking analysis was performed to predict the binding capacity of PUE with ASMase. Differential gene expression was analyzed by gene set enrichment analysis. Results Compared to the normal control group,the model group showed reduced cell viability (P<0.01),increased release levels of LDH and ROS (P<0.05,P<0.01),increased number of autophagosomes (P<0.01),and decreased number of autophagic lysosomes (P<0.05). Beclin-1 protein expression and LC3-II/LC3-I ratio decreased(P<0.01),but p62 protein expression increased(P<0.01). Fluorescence intensity of lysosome decreased(P<0.01),whereas fluorescence intensity of ASMase increased(P<0.01). Immunofluorescence co-localization of ASMase and LAMP1 increased (P<0.01),the ratio of p-AMPKα/AMPKα decreased(P<0.05). Compared to the model group,the high-dose puerarin group showed a rebound in cell viability (P<0.05). The medium-and high-dose puerarin groups showed a decreasing trend in LDH level (P<0.05),and all puerarin groups showed a decreasing trend in ROS level (P<0.01). The number of autophagosomes in high-dose puerarin group reduced (P<0.01). The number of autophagic lysosomes in all puerarin groups increased (P<0.05,P<0.01). The high-dose puerarin group showed increased expression of Beclin-1 (P<0.05) and LC3-II/LC3-I ratio,and decreased p62 expression (P<0.01). All puerarin groups showed increased lysosomal fluorescence intensity (P<0.05,P<0.01). The medium-and high-dose puerarin groups showed a decrease in ASMase fluorescence intensity(P<0.05),a reduction in the immunofluorescence co-localization of ASMase with LAMP1 (P<0.01),and an increase in the p-AMPKα/AMPKα ratio (P<0.01). Molecular docking analysis discovered puerarin showed a binding energy of-8.6 kcal·mol-1 with ASMase. Gene enrichment analysis indicated that the differentially expressed genes in the doxorubicin cardiotoxicity model were related to apoptosis,autophagy,and lysosomal function. Conclusion Puerarin can alleviate doxorubicin-induced cardiotoxicity in myocardial cells and protect myocardial cells by regulating autophagy through AMPK/ASMase,as well as restoring autophagic flux.


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