1.Evaluation of the anticoagulant effect of nafamostat mesylate in continuous veno-venous hemofiltration with different dilution methods for uremic patients
Li SHEN ; Yao ZHANG ; Jun WANG ; Hong ZHU ; Yong QIN ; Yuewu TANG ; Ni DU
China Pharmacy 2026;37(3):350-355
OBJECTIVE To evaluate the anticoagulant efficacy and safety of nafamostat mesylate (NM) in the treatment of uremic patients at high risk of bleeding undergoing continuous veno-venous hemofiltration (CVVH) with different methods (pre- dilution and post-dilution). METHODS A total of 130 uremic patients at high risk of bleeding who underwent CVVH treatment in the nephrology department of Chongqing University Three Gorges Hospital from July 2023 to September 2024 were selected. They were divided into pre-dilution group and post-dilution group according to the random number table method, with 65 cases in each group. Both groups of patients received CVVH treatment under NM anticoagulation. The pre-dilution group adopted the pre-dilution replacement method, while the post-dilution group adopted the post-dilution replacement method. The coagulation, pressure, and usage duration of the filter and dialysis circuit venous reservoirs were compared between the two groups. The changes in prothrombin time (PT), prothrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (APTT), and fibrinogen (FIB) in the peripheral venous blood before the heparin pump and after the filter at 1, 4 and 7 h of CVVH treatment, as well as 20 min after the end of treatment, were compared between the two groups. The single-compartment urea clearance rate (spKt/V), β2-microglobulin (β2-MG) clearance rate and the incidence of adverse reactions were duni2007@foxmail.com compared between the two groups. RESULTS Both the pre-dilution and post-dilution groups had 60 patients who completed the study. The incidence of grade Ⅱ-Ⅲ coagulation of the filter and venous reservoirs, as well as the number of patients with transmembrane and venous pressure alarm intervention in the post- dilution group were significantly higher or more than those in the pre-dilution group (P<0.05), while usage time of the filter and the pipeline in the post-dilution group was significantly shorter than that in the pre-dilution group (P<0.05). The APTT values before the heparin pump as well as PT and APTT values after the filter at 1 h, 4 h, and 7 h of CVVH treatment in the post-dilution group were significantly higher than those in the pre-dilution group (P<0.001). There were no significant differences in PT, PT- INR, APTT and FIB between the two groups of patients 20 min after the end of treatment (P>0.05). The spKt/v and β2-MG clearance rates in the post-dilution group were significantly higher than those in the pre-dilution group (P<0.001). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSIONS When NM is used as an anticoagulant in the CVVH treatment of uremic patients at high risk of bleeding, compared with the pre-dilution treatment method, the post-dilution treatment method has a higher incidence of filter and dialysis tubing venous reservoir, a shorter usage time of the filter and pipeline, and a greater impact on extracorporeal coagulation, but has a higher solute clearance rate. Clinically, different dilution methods can be selected according to the different treatment needs of patients.
2.The Structure and Function of The YopJ Family Effectors in The Bacterial Type III Secretion System
Ao-Ning LI ; Wen-Bo LI ; Yu-Ying LU ; Min-Hui ZHU ; Yu-Long QIN ; Yong ZHAO ; Zhao-Huan ZHANG
Progress in Biochemistry and Biophysics 2026;53(3):516-533
The Type III Secretion System (T3SS) serves as a pivotal virulence apparatus for numerous Gram-negative bacterial pathogens, enabling them to infect both animal and plant hosts. Functioning as a molecular syringe, the T3SS directly translocates bacterial effector proteins from the bacterial cytoplasm into the interior of eukaryotic host cells. These effectors are central weapons that precisely manipulate a wide spectrum of host cellular physiological processes, ranging from cytoskeletal dynamics to immune signaling, to establish a favorable niche for bacterial survival and proliferation. Among the diverse arsenal of T3SS effectors, the YopJ family constitutes a critical group of virulence factors. Members of this family are characterized by a conserved catalytic triad structure—a hallmark of the CE clan of cysteine proteases that has been evolutionarily repurposed to confer acetyltransferase activity. A defining and intriguing feature of these enzymes is their stringent dependence on a host-derived eukaryotic cofactor, inositol hexakisphosphate (IP6), for allosteric activation. This requirement acts as a sophisticated molecular safeguard, ensuring enzymatic activity only within the appropriate host environment, thereby preventing detrimental effects on the bacterium itself. While seminal studies on individual members such as Yersinia’s YopJ and Salmonella’s AvrA have provided deep mechanistic insights, a systematic and integrative understanding of the structure-function relationships across the entire family remains fragmented. Key questions persist regarding how a conserved catalytic core has diverged to recognize distinct host substrates in different kingdoms of life. To address this gap, this article provides a systematic review of the YopJ family, focusing on three interconnected aspects: their structural features, their catalytic mechanism, and their divergent immunosuppressive strategies in animal versus plant hosts. By conducting a comparative analysis of the sequences and resolved three-dimensional structures of three representative members (e.g., HopZ1a, PopP2, AvrA), we elucidate regions of significant variation embedded within the conserved core catalytic architecture. These variable regions, often involving surface loops and substrate-binding interfaces, are crucial determinants of target specificity and functional specialization. The functional divergence of this effector family is most apparent when comparing their modes of action in different hosts. In animal hosts, YopJ-family effectors primarily sabotage innate immune signaling pathways. They achieve this by acetylating key serine and threonine residues within the activation loops of critical kinases in the MAPK and NF‑κB pathways. This post-translational modification blocks the phosphorylation and subsequent activation of these kinases, leading to potent suppression of inflammatory cytokine production. Conversely, in plant hosts, the strategy broadens to dismantle the two-tiered plant immune system. YopJ homologs target a more diverse set of substrates, including immune-associated receptor-like cytoplasmic kinases (RLCKs), microtubule networks via tubulin acetylation (which disrupts cellular trafficking and signaling), and transcription factors central to defense gene regulation. This multi-target approach effectively suppresses both Pattern-Triggered Immunity (PTI) and Effector-Triggered Immunity (ETI). In conclusion, this synthesis aims to deepen the mechanistic understanding of YopJ family-mediated pathogenesis by integrating structural biology with cellular function across host kingdoms. Elucidating the precise molecular basis for substrate selection—how conserved platforms achieve target diversity—is a major frontier. Furthermore, this knowledge provides a vital theoretical foundation for developing novel anti-virulence strategies. Targeting the conserved IP6-binding pocket or the catalytic acetyltransferase activity itself represents a promising avenue for designing broad-spectrum inhibitors that could disarm this critical family of bacterial effectors, potentially offering new therapeutic approaches against a range of pathogenic bacteria.
3.Signal mining for bleeding risk associated with the concomitant use of direct oral anticoagulants and triazole antifungals
Ziyang WU ; Ying ZHU ; Menghua ZHANG ; Na HE ; Qiong QIN ; Cheng XIE
China Pharmacy 2026;37(9):1185-1189
OBJECTIVE To assess the bleeding risk signals associated with the concomitant use of direct oral anticoagulants (DOACs) and triazole antifungals, and to provide pharmacovigilance evidence for the safety evaluation and monitoring of combined clinical use. METHODS Adverse event reports involving the concomitant use of DOACs and triazole antifungals were extracted from the US FDA Adverse Event Reporting System (FAERS) from the first quarter of 2004 to the third quarter of 2025. Nine bleeding-related preferred terms (PTs) were selected. The Ω shrinkage measure, additive model, multiplicative model, and combined risk ratio method were employed to detect drug-drug interaction signals. The strength of positive signals was further analyzed based on the Ω shrinkage measure. RESULTS A total of 790 adverse event reports involving the concomitant use of DOACs and triazole antifungals were included, among which 229 reports involved nine bleeding-related PTs. A total of 13 signals were consistently identified as posit ive by all four methods. These signals involved six drug combinations: apixaban-fluconazole, apixaban-posaconazole, rivaroxaban-itraconazole, dabigatran etexilate-fluconazole, apixaban-voriconazole, and dabigatran etexilate-itraconazole. The Ω shrinkage measure showed that the apixaban-posaconazole combination exhibited stronger signals for bleeding ( Ω =2.73, Ω 025 =2.05) and hemoptysis ( Ω =2.17, Ω 025 =0.83); the apixaban-fluconazole combination exhibited stronger signals for hematoma ( Ω =2.30, Ω 025 =1.47) and hematuria ( Ω =1.71, Ω 025 =0.74); the rivaroxaban-itraconazole combination exhibited stronger signals for epistaxis ( Ω =2.01, Ω 025 =0.90) and hematoma ( Ω =1.93, Ω 025 =0.42); no positive Ω signals were observed for intracranial hemorrhage or upper gastrointestinal hemorrhage. CONCLUSION S This study suggests that the concomitant use of DOACs and triazole antifungals may increase the risk of bleeding-related events, with differences in signal strength and signal distribution across various drug combinations. In clinical practice, particular attention should be paid to the concomitant use of apixaban or rivaroxaban with strong cytochrome P450 3A4 or P-glycoprotein inhibitors such as posaconazole and itraconazole. For other DOAC-triazole antifungal combinations, close monitoring for bleeding-related manifestations and timely adjustment of anticoagulation or antifungal regimens are also warranted.
4.Construction and analysis of machine learning models for preoperative prediction of glioma grading and isocitrate dehydrogenase mutation status
Yuting WANG ; Junle ZHU ; Shuang QIN ; Saifei SUN ; Xin ZHANG ; Qi LÜ
Chinese Journal of Clinical Medicine 2026;33(1):3-15
Objective To construct machine learning models based on preoperative inflammatory and radiological features for the prediction of glioma grading and isocitrate dehydrogenase (IDH) mutation status, and to analyze application values of these models and identify the optimal predictive models. Methods A retrospective analysis was conducted on the data of pathologically confirmed glioma patients admitted to Tongji Hospital Affiliated to Tongji University from March 2019 to March 2023. LASSO regression was used to screen feature variables, and predictive models were constructed based on logistic regression (LR), random forest (RF), support vector machine (SVM), gradient boosting decision tree (XGBoost) and K-nearest neighbor (KNN) algorithms. The model performance was comprehensively evaluated using metrics including discrimination ability, area under the precision-recall curve (AUC), accuracy, F1 score and Brier score. The DeLong test was adopted to compare the AUC values among different models; Friedman rank-sum test was used to determine the overall performance differences of the models, with the Nemenyi test applied for multiple comparison correction. Results In the task of glioma grading prediction, the LR model achieved the highest comprehensive score (0.726), and no significant difference was observed between the LR model and the other four models; age was positively correlated with glioma grading (P=0.003). In the task of IDH mutation status prediction, the XGBoost model obtained the highest comprehensive score (0.832), which was superior to the LR (0.762, P=0.035) and KNN models (0.754, P=0.025), while no statistical differences were found between the XGBoost model and the RF or SVM models. Conclusions The LR model for glioma grading prediction and XGBoost model for IDH mutation prediction constructed based on a task-oriented strategy achieve a favorable interpretability while ensuring optimized performance, thereby providing reliable decision support for the individualized diagnosis and treatment of glioma.
5.Pathological changes and macrophage polarization in the liver and spleen of mice infected with Angiostrongylus cantonensis
Xiaoyu QIN ; Yuchun CAI ; Yang HONG ; Fanna WEI ; Yahong HU ; Yumeng CAI ; Yuan HU ; Ting ZHANG ; Xiaojin MO ; Bin XU ; Yan LU ; Jiahui SUN ; Yan ZHOU ; Zelin ZHU ; Muxin CHEN
Chinese Journal of Schistosomiasis Control 2026;38(2):169-183
Objective To investigate the temporal changes in pathological damage and macrophage polarization in liver and spleen tissues of mice infected with Angiostrongylus cantonensis, and to preliminarily unravel the peripheral immune responses during the early stage of A. cantonensis infection. Methods Forty female BALB/c mice at ages of 6 to 8 weeks were randomly divided into four groups, including the control group and 7-, 14-, and 21-day infection groups, with 10 mice in each group. Each mouse in the infection groups was inoculated with 30 third-stage (L3) larvae of A. cantonensis by oral gavage, and five mice were randomly selected from each infection group on days 7, 14, and 21 post-infection, while mice in the control group were given the same volume of physiological saline and five mice were randomly selected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled. The histopathological changes of mouse liver and spleen tissues were observed using hematoxylin and eosin (HE) staining, and the percentage of positive staining area and the co-localization positive rates of the macrophage surface antigens F4/80, CD86, and CD206 were quantified in mouse liver and spleen tissues using immunohistochemical and immunofluorescence staining. In addition, five mice were collected from each infection group on days 7, 14, and 21 post-infection, and five mice were collected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled for detection of macrophage markers CD86 and CD206 and macrophage phenotyping using flow cytometry, and the expression of M1 macrophage markers, including inducible nitric oxide synthase (Nos2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and M2 markers, including arginase 1 (Arg1), mannose receptor C-type 1 (Mrc1) and chitinase-like protein 3 (Chil3) was quantified in mouse liver and spleen tissues using real-time quantitative PCR (RT-qPCR) assay. Results Proliferative lesions of the hepatocyte were observed in mouse liver tissues and the follicular structures of the mouse spleen white pulp were disrupted 21 days post-infection with A. cantonensis. Immunohistochemical staining showed that there were significant differences in the percentages of F4/80, CD86 and CD206 positive staining areas in the liver and spleen tissues among the four groups of mice (F = 242.40, 197.14, 183.19, 157.65, 242.35 and 146.24; all P values < 0.001), and the percentages of positive staining in the liver and spleen tissues of mice in the 14-day infection group [(4.45 ± 0.51)%, (3.74 ± 0.67)%, (8.32 ± 0.72)%, (16.56 ± 1.14)%, (11.62 ± 0.52)%, and (8.29 ± 0.72)%, respectively] and the 21-day infection group [(3.70 ± 0.11)%, (3.22 ± 0.43)%, (11.53 ± 1.03)%, (12.59 ± 1.05)%, (9.02 ± 0.83)%, and (11.67 ± 1.10)%, respectively] were higher than in the control group [(0.35 ± 0.16)%, (0.40 ± 0.02)%, (0.93 ± 0.05)%, (2.78 ± 0.26)%, (2.33 ± 0.20)%, and (1.85 ± 0.20)%, respectively] (all P values < 0.05). Immunofluorescence staining showed significant differences in the positive rates of F4/80 co-localization with CD86 and CD206 in mouse liver and spleen tissues among the four groups (F = 24.42, 25.28, 54.51 and 130.55; all P values < 0.001). Flow cytometry detected significant differences in the proportions of CD86+ and CD206+ macrophages in mouse liver and spleen tissues among the four groups (F = 67.98, 18.41, 29.77, 172.80; all P values < 0.001), and the proportions of CD206+ macrophages in the liver and spleen of the 21-day infection group were significantly higher than those in the control group [(9.25 ± 2.55)% vs (3.83 ± 0.72)%, and (4.22 ± 0.56)% vs (0.47 ± 0.18)%, respectively] (both P values < 0.05). In addition, RT-qPCR assay quantified significant differences in the relative mRNA expression of M1 macrophage markers (IL-1β, TNF-α and Nos2) and M2 macrophage markers (Arg1, Chil3 and Mrc1) in mouse liver and spleen tissues among the four groups (F = 41.30, 31.82, 199.33, 19.96, 62.01, 119.76, 23.67, 95.90, 72.27, 82.59, 123.41 and 29.75; all P values < 0.05). Conclusions A. cantonensis infection may cause progressive pathological damage in mouse liver and spleen tissues, accompanied by dynamic temporal changes in macrophage polarization. M1 macrophage polarization predominates at the early stage of A. cantonensis infection and shifts towards M2 polarization at the later stages, suggesting that M2 polarization may participate in immune regulation at late stages of A. cantonensis infection by suppressing excessive inflammatory responses and promoting tissue repair.
6.Galectin-9 mediates type Ⅰ collagen production by cancer-associated fibroblasts to promote the invasion and migration of pancreatic cancer cells
ZHAO Chuangchuang1 ; QIN Qin1 ; ZHU Haitao1 ; ZHANG Zhengyang1 ; LIU Yanfang2 ; LIAO Xiang1 ; Hsiang-i Tsai1
Chinese Journal of Cancer Biotherapy 2026;33(6):630-640
[摘 要] 目的:探究半乳糖凝集素-9(Gal-9)对胰腺癌细胞的侵袭与迁移功能的促进作用及其机制。方法:基于公开单细胞转录组数据分析胰腺癌中免疫检查点分子的表达谱,结合Western blotting和ELISA验证Gal-9在胰腺癌细胞及临床相关模型中的表达与分泌特征。建立C57BL/6小鼠胰腺原位移植瘤模型,通过免疫组化、免疫荧光染色和流式细胞术分析Gal-9对肿瘤细胞增殖及其对瘤内CD8+ T细胞浸润与功能状态的影响。Gal-9重组蛋白及肿瘤细胞条件培养基(CM)处理肿瘤相关成纤维细胞(CAF),Western blotting、RT-qPCR和免疫荧光检测CAF中Ⅰ型胶原表达变化。免疫共沉淀、免疫荧光染色和Western blotting分析Gal-9与CD44的相互作用及JAK2/STAT3通路相关蛋白的表达。构建过表达Gal-9胰腺癌细胞与CAF共移植的裸鼠皮下荷瘤模型,结合天狼星红和马松染色评估小鼠肿瘤组织中胶原沉积情况。脱细胞外基质法提取CAF中沉积的细胞外基质(ECM)蛋白;通过细胞划痕、Transwell迁移及侵袭实验,检测CAF来源Ⅰ型胶原对胰腺癌细胞侵袭、迁移功能的影响,并通过siRNA干扰Gal-9表达进行功能反向验证。结果:与经典免疫检查点分子PD-L1和CTLA-4相比,Gal-9在胰腺癌中显著高表达(P < 0.000 1)。体内实验表明,Gal-9促进肿瘤生长(P < 0.001),上调Ki-67表达,同时减少肿瘤内CD8⁺ T细胞浸润并诱导肿瘤组织中TIM-3⁺细胞比例升高,Granzyme B、IFN-γ及TNF-α表达下降(P < 0.05)。体外实验显示,外源性Gal-9及肿瘤细胞来源的CM均可上调CAF中Ⅰ型胶原表达(P < 0.001)。机制研究表明,在CAF中抗Gal-9抗体免疫沉淀复合物中检测到CD44,且JAK2/STAT3蛋白表达水平增加。CAF来源的Ⅰ型胶原处理胰腺癌细胞后,肿瘤细胞的迁移和侵袭数量增加。相反,肿瘤细胞中敲低Gal-9表达后,CAF来源Ⅰ型胶原水平下降,同时肿瘤细胞侵袭和迁移数量下降。结论:胰腺癌来源的Gal-9具有双重作用:一方面,通过促进肿瘤细胞增殖和诱导CD8+ T细胞耗竭促进肿瘤进展;另一方面,通过结合CAF上的CD44受体,激活JAK2/STAT3信号通路,刺激CAF合成并分泌Ⅰ型胶原,进而增强胰腺癌细胞的侵袭迁移能力。
7.Value of serum Golgi protein 73, hypoxia-inducible factor-1α, and matrix metalloproteinase-9 in predicting the efficacy of transcatheter arterial chemoembolization in treatment of hepatitis B virus-related hepatocellular carcinoma
Ababaikeli BAOYIXIAMU ; Jie ZHANG ; Qin XU ; Xiaobo LU ; Diwen ZHU
Journal of Clinical Hepatology 2026;42(6):1342-1348
ObjectiveTo investigate the association of the serum levels of Golgi protein 73 (GP73), hypoxia-inducible factor-1α (HIF-1α), and matrix metalloproteinase-9 (MMP-9) before and after transcatheter arterial chemoembolization (TACE) with the treatment outcome of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). MethodsA total of 135 patients with HBV-related HCC who received TACE for the first time in The First Affiliated Hospital of Xinjiang Medical University from January 2023 to October 2025 were enrolled as subjects, and the serum levels of GP73, HIF-1α, and MMP-9 were measured before TACE and at 1 month after TACE. According to the treatment outcome after TACE, the patients were divided into remission group and non-remission group. The two groups were compared in terms of general information and the serum levels of GP73, HIF-1α, and MMP-9 before and after treatment. The Logistic regression analysis was used to investigate the influencing factors for the efficacy of TACE, and the receiver operating characteristic (ROC) curve was used to assess the value of the serum levels of GP73, HIF-1α, and MMP-9 before treatment used alone or in combination in predicting the efficacy of TACE. The independent-samples t test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. ResultsAmong the 135 patients after treatment, 78 (57.78%) were enrolled in the remission group and 57 (42.22%) were enrolled in the non-remission group. Before treatment, the remission group had significantly lower serum levels of GP73, HIF-1α, and MMP-9 than the non-remission group (all P<0.05); after treatment, both groups had reductions in the serum levels of GP73, HIF-1α, and MMP-9, and the remission group had significantly lower levels than the non-remission group (all P<0.05). The binary Logistic regression analysis showed that increases in the serum levels of GP73, HIF-1α, and MMP-9 before treatment were independent influencing factors for the efficacy of TACE (all P<0.05). The ROC curve analysis showed that the serum levels of GP73, HIF-1α, and MMP-9 before treatment used alone had an area under the ROC curve (AUC) of 0.799, 0.835, and 0.777, respectively, in predicting the efficacy of TACE, among which HIF-1α showed the highest predictive value, and the combination of these three indicators had an AUC of 0.950, a Youden index of 0.787, an optimal cut-off value of 0.39, a sensitivity of 87.72%, and a specificity of 91.03%. ConclusionTACE can reduce the serum levels of GP73, HIF-1α, and MMP-9 in patients with HBV-related HCC, and patients with a good outcome tend to have greater reductions. The high serum levels of GP73, HIF-1α, and MMP-9 before treatment are independent risk factors for poor short-term efficacy of TACE, and the combination of these three indicators has a relatively high value in predicting the efficacy of TACE.
8.Variation Tendency and Prediction of Colorectal Cancer Burden Among Chinese Population from 1990 to 2021
Tongzhou WANG ; Juanfang ZHU ; Jin ZHOU ; Pan ZHANG ; Qin TANG
Cancer Research on Prevention and Treatment 2025;52(4):319-323
Objective To examine the current status and trends of colorectal cancer (CRC) burden among Chinese residents from 1990 to 2021. Methods Data on CRC burden in China, Asia, and the global population from 1990 to 2021 were retrieved from the Global Burden of Disease database for descriptive analysis. An age-period-cohort model was employed to estimate the effects of age, period, and cohort on CRC mortality and to forecast changes in disease burden. Results In 2021, China’s age-standardized mortality rate, prevalence rate, and DALY rate for CRC were higher than global and Asian averages. The estimated annual percentage changes (EAPC) from 1990 to 2021 were −0.49% (95%CI: −0.55% to −0.43%) for mortality, 3.17% (95%CI: 3.03%−3.31%) for prevalence, and −0.62% (95%CI: −0.71% to −0.54%) for DALYs. Areas with high and medium-high sociodemographic indexes (SDIs) showed significant decreases in standardized mortality and DALY rates, but these rates remained higher compared with other regions. CRC mortality increased with age in the Chinese population, more prominently in males than in females. Using the 2002–2006 period as a reference (RR=1), the period effect on CRC mortality risk for women was higher than that for men until 2004, after which it declined considerably. With the 1957 birth cohort as a reference (RR=1), CRC mortality risk generally decreased across subsequent birth cohorts. Predictions indicate that by 2035, the standardized prevalence rate will be 267.21 per 100 000, and the standardized mortality rate will be 12.29 per 100 000. Conclusion From 1990 to 2021, China’s age-standardized CRC mortality and DALY rates have decreased, while the standardized prevalence rate has increased. These findings suggest the government to establish a comprehensive multi-level CRC prevention network.
9.Burden and risk factors of stroke worldwide and in China: An analysis from the Global Burden of Disease Study 2021.
Zhengbao ZHU ; Mengyao SHI ; Quan YU ; Jiawen FEI ; Beiping SONG ; Xiaoli QIN ; Lulu SUN ; Yonghong ZHANG
Chinese Medical Journal 2025;138(20):2588-2595
BACKGROUND:
Stroke is the leading cause of death and long-term disability worldwide, including China. This study aimed to provide timely updates on stroke burden and stroke-related risk factors to help improve population-based prevention and control strategies.
METHODS:
Based on the Global Burden of Disease study 2021, incidence rate, prevalence rate, mortality rate, and disability-adjusted life-year (DALY) rate were used to estimate stroke burden trend from 1990 to 2021.
RESULTS:
In 2021, China had 4.1 million incident stroke cases, 26.3 million prevalent stroke cases, 2.6 million stroke related deaths, and 53.2 million stroke related DALYs, compared to 11.9 million incident stroke cases, 93.8 million prevalent stroke cases, 7.3 million stroke related deaths, and 160.5 million stroke-related DALYs worldwide. In 2021, the top six risk factors contributing to stroke burden were high blood pressure, air pollution, tobacco consumption, dietary risk factors, high low-density lipoprotein cholesterol, and high fasting plasma glucose, both in China and worldwide. From 1990 to 2021, China had significant increases of incidence rate, prevalence rate, mortality rate, and DALY rate for stroke, with estimates of 100.6 (95% uncertainty intervals [UI]: 87.2, 114.1)%, 102.9 (95% UI: 95.5, 110.9)%, 40.0 (95% UI: 14.9, 72.3)% and 15.7 (95% UI: -4.6, 41.2)%, respectively, while global incidence rate, prevalence rate, mortality rate and DALY rate for total stroke showed relatively moderate increases or even decreases, with estimates of 15.0 (95% UI: 12.1,18.0)%, 25.8 (95% UI: 23.7, 28.0)%, -2.6 (95% UI: -10.6, 5.5)%, and -10.7 (95% UI: -17.7, -3.6)%, respectively.
CONCLUSION
Stroke remains a huge disease burden worldwide and in China, and compared to the worldwide China has a significantly higher burden of stroke.
Humans
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Stroke/etiology*
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China/epidemiology*
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Risk Factors
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Global Burden of Disease
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Disability-Adjusted Life Years
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Prevalence
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Incidence
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Female
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Quality-Adjusted Life Years
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10.Mechanism of vanillic acid against cardiac fibrosis induced by isoproterenol in mice based on Drp1/HK1/NLRP3 and mitochondrial apoptosis signaling pathways.
Hai-Bo HE ; Mian WU ; Jie XU ; Qian-Qian XU ; Fang-Zhu WAN ; Hua-Qiao ZHONG ; Ji-Hong ZHANG ; Gang ZHOU ; Hui-Lin QIN ; Hao-Ran LI ; Hai-Ming TANG
China Journal of Chinese Materia Medica 2025;50(8):2193-2208
This study investigated the effects and underlying mechanisms of vanillic acid(VA) against cardiac fibrosis(CF) induced by isoproterenol(ISO) in mice. Male C57BL/6J mice were randomly divided into control group, VA group(100 mg·kg~(-1), ig), ISO group(10 mg·kg~(-1), sc), ISO + VA group(10 mg·kg~(-1), sc + 100 mg·kg~(-1), ig), ISO + dynamin-related protein 1(Drp1) inhibitor(Mdivi-1) group(10 mg·kg~(-1), sc + 50 mg·kg~(-1), ip), and ISO + VA + Mdivi-1 group(10 mg·kg~(-1), sc + 100 mg·kg~(-1), ig + 50 mg·kg~(-1), ip). The treatment groups received the corresponding medications once daily for 14 consecutive days. On the day after the last administration, cardiac functions were evaluated, and serum and cardiac tissue samples were collected. These samples were analyzed for serum aspartate aminotransferase(AST), lactate dehydrogenase(LDH), creatine kinase-MB(CK-MB), cardiac troponin I(cTnI), reactive oxygen species(ROS), interleukin(IL)-1β, IL-4, IL-6, IL-10, IL-18, and tumor necrosis factor-α(TNF-α) levels, as well as cardiac tissue catalase(CAT), glutathione(GSH), malondialdehyde(MDA), myeloperoxidase(MPO), superoxide dismutase(SOD), total antioxidant capacity(T-AOC) activities, and cytochrome C levels in mitochondria and cytoplasm. Hematoxylin-eosin, Masson, uranium acetate and lead citrate staining were used to observe morphological and mitochondrial ultrastructural changes in the cardiac tissues, and myocardial injury area and collagen volume fraction were calculated. Flow cytometry was applied to detect the relative content and M1/M2 polarization of cardiac macrophages. The mRNA expression levels of macrophage polarization markers [CD86, CD206, arginase 1(Arg-1), inducible nitric oxide synthase(iNOS)], CF markers [type Ⅰ collagen(Coll Ⅰ), Coll Ⅲ, α-smooth muscle actin(α-SMA)], and cytokines(IL-1β, IL-4, IL-6, IL-10, IL-18, TNF-α) in cardiac tissues were determined by quantitative real-time PCR. Western blot was used to detect the protein expression levels of Coll Ⅰ, Coll Ⅲ, α-SMA, Drp1, p-Drp1, voltage-dependent anion channel(VDAC), hexokinase 1(HK1), NOD-like receptor protein 3(NLRP3), apoptosis-associated speck-like protein(ASC), caspase-1, cleaved-caspase-1, gasdermin D(GSDMD), cleaved N-terminal gasdermin D(GSDMD-N), IL-1β, IL-18, B-cell lymphoma-2(Bcl-2), B-cell lymphoma-xl(Bcl-xl), Bcl-2-associated death promoter(Bad), Bcl-2-associated X protein(Bax), apoptotic protease activating factor-1(Apaf-1), pro-caspase-3, cleaved-caspase-3, pro-caspase-9, cleaved-caspase-9, poly(ADP-ribose) polymerase-1(PARP-1), and cleaved-PARP-1 in cardiac tissues. The results showed that VA significantly improved cardiac function in mice with CF, reduced myocardial injury area and cardiac index, and decreased serum levels of AST, CK-MB, cTnI, LDH, ROS, IL-1β, IL-6, IL-18, and TNF-α. VA also lowered MDA and MPO levels, mRNA expressions of IL-1β, IL-6, IL-18, and TNF-α, and mRNA and protein expressions of Coll Ⅰ, Coll Ⅲ, and α-SMA in cardiac tissues, and increased serum levels of IL-4 and IL-10, cardiac tissue levels of CAT, GSH, SOD, and T-AOC, and mRNA expressions of IL-4 and IL-10. Additionally, VA ameliorated cardiac pathological damage, inhibited myocardial cell apoptosis, inflammatory infiltration, and collagen fiber deposition, reduced collagen volume fraction, and alleviated mitochondrial damage. VA decreased the ratio of F4/80~+CD86~+ M1 cells and the mRNA expressions of CD86 and iNOS in cardiac tissue, and increased the ratio of F4/80~+CD206~+ M2 cells and the mRNA expressions of CD206 and Arg-1. VA also reduced protein expressions of p-Drp1, VDAC, NLRP3, ASC, caspase-1, cleaved-caspase-1, GSDMD, GSDMD-N, IL-1β, IL-18, Bad, Bax, Apaf-1, cleaved-caspase-3, cleaved-caspase-9, cleaved-PARP-1, and cytoplasmic cytochrome C, and increased the expressions of HK1, Bcl-2, Bcl-xl, pro-caspase-3, pro-caspase-9 proteins, as well as the Bcl-2/Bax and Bcl-xl/Bad ratios and mitochondrial cytochrome C content. These results indicate that VA has a significant ameliorative effect on ISO-induced CF in mice, alleviates ISO-induced oxidative damage and inflammatory response, and its mechanism may be closely related to the inhibition of Drp1/HK1/NLRP3 and mitochondrial apoptosis signaling pathways, suppression of myocardial cell inflammatory infiltration and collagen fiber deposition, reduction of collagen volume fraction and CollⅠ, Coll Ⅲ, and α-SMA expressions, thus mitigating CF.
Animals
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Isoproterenol/adverse effects*
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Male
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Mice
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Signal Transduction/drug effects*
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Vanillic Acid/administration & dosage*
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Dynamins/genetics*
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Mice, Inbred C57BL
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Fibrosis/genetics*
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Apoptosis/drug effects*
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Mitochondria/metabolism*
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NLR Family, Pyrin Domain-Containing 3 Protein/genetics*
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Myocardium/metabolism*
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Humans

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