1.Three new chalcone C-glycosides from Carthami Flos.
Jia-Xu BAO ; Yong-Xiang WANG ; Xian ZHANG ; Ya-Zhu YANG ; Yue LIN ; Jiao-Jiao YIN ; Yun-Fang ZHAO ; Hui-Xia HUO ; Peng-Fei TU ; Jun LI
China Journal of Chinese Materia Medica 2025;50(13):3715-3745
The chemical components of Carthami Flos were investigated by using macroporous resin, silica gel column chromatography, reversed-phase octadecylsilane(ODS) column chromatography, Sephadex LH-20, and semi-preparative high-performance liquid chromatography(HPLC). The planar structures of the compounds were established based on their physicochemical properties and ultraviolet-visible(UV-Vis), infrared(IR), high-resolution electrospray ionization mass spectrometry(HR-ESI-MS), and nuclear magnetic resonance(NMR) spectroscopic technology. The absolute configurations were determined by comparing the calculated and experimental electronic circular dichroism(ECD). Six flavonoid C-glycosides were isolated from the 30% ethanol elution fraction of macroporous resin obtained from the 95% ethanol extract of Carthami Flos, and identified as saffloquinoside F(1), 5-hydroxysaffloneoside(2), iso-5-hydroxysaffloneoside(3), isosafflomin C(4), safflomin C(5), and vicenin 2(6). Among these, the compounds 1 to 3 were new chalcone C-glycosides. The compounds 1, 2, 4, and 5 could significantly increase the viability of H9c2 cardiomyocytes damaged by oxygen-glucose deprivation/reoxygenation(OGD/R) at a concentration of 50 μmol·L~(-1), showing their good cardioprotective activity.
Glycosides/pharmacology*
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Flowers/chemistry*
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Drugs, Chinese Herbal/pharmacology*
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Carthamus tinctorius/chemistry*
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Chalcones/pharmacology*
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Animals
2.Research on Regulatory Mechanism of Verbenalin on HCoV-229E-infected Macrophage Injury Based on Mitophagy
Qiyue SUN ; Lei BAO ; Zihan GENG ; Ronghua ZHAO ; Shuran LI ; Xihe CUI ; Jingsheng ZHANG ; Xian LIU ; Rui XIE ; Xiaolan CUI ; Shanshan GUO ; Jing SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):29-37
ObjectiveTo investigate the protective effect and mechanism of verbenalin on mouse mononuclear macrophage leukemia cells (RAW264.7) damaged by human coronavirus (HCoV)-229E infection, thereby providing experimental evidence for its development and application. MethodsRAW264.7 macrophages were infected with different concentrations of HCoV-229E to establish a coronavirus-induced macrophage injury model using the cell counting kit-8 (CCK-8) assay for assessing cell proliferation and viability. Cells were randomly divided into four groups: normal control, verbenalin group (125 μmol·L-1), model group (HCoV-229E), and HCoV-229E + verbenalin group (HCoV-229E + 125 μmol·L-1 verbenalin). Cell viability was measured using the CCK-8 assay, and the maximum non-toxic concentration (CC0), half-maximal cytotoxic concentration (CC50), half-maximal effective concentration (EC50), and selectivity index (SI) of verbenalin were calculated. Calcein/PI double staining was used to assess cell viability and cytotoxicity, and JC-1 staining was applied to evaluate changes in mitochondrial membrane potential (MMP). mito-Keima adenovirus labeling was used to assess mitophagy levels in each group. ResultsA macrophage infection model was successfully established by infecting RAW264.7 cells with the original concentration of HCoV-229E for 36 h. The CC0 of verbenalin was 125 μmol·L-1. The CC50 was 448.25 μmol·L-1. The EC50 against HCoV-229E-infected cells was 46.28 μmol·L-1, and the SI was 9.68. Compared with the normal group, the model group showed significantly reduced cell survival rate (P<0.01), increased cell death rate (P<0.01), decreased MMP (P<0.01), and suppressed mitophagy (P<0.01). In contrast, verbenalin treatment significantly improved cell survival rate (P<0.01), reduced cell death rate (P<0.01), alleviated MMP loss (P<0.01), and enhanced mitophagy levels (P<0.01) compared with the model group. ConclusionVerbenalin can enhance the survival rate of macrophages following HCoV-229E infection. The underlying mechanism may be associated with the activation of mitophagy, maintenance of MMP stability, and alleviation of mitochondrial damage.
3.Research on Regulatory Mechanism of Verbenalin on HCoV-229E-infected Macrophage Injury Based on Mitophagy
Qiyue SUN ; Lei BAO ; Zihan GENG ; Ronghua ZHAO ; Shuran LI ; Xihe CUI ; Jingsheng ZHANG ; Xian LIU ; Rui XIE ; Xiaolan CUI ; Shanshan GUO ; Jing SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):29-37
ObjectiveTo investigate the protective effect and mechanism of verbenalin on mouse mononuclear macrophage leukemia cells (RAW264.7) damaged by human coronavirus (HCoV)-229E infection, thereby providing experimental evidence for its development and application. MethodsRAW264.7 macrophages were infected with different concentrations of HCoV-229E to establish a coronavirus-induced macrophage injury model using the cell counting kit-8 (CCK-8) assay for assessing cell proliferation and viability. Cells were randomly divided into four groups: normal control, verbenalin group (125 μmol·L-1), model group (HCoV-229E), and HCoV-229E + verbenalin group (HCoV-229E + 125 μmol·L-1 verbenalin). Cell viability was measured using the CCK-8 assay, and the maximum non-toxic concentration (CC0), half-maximal cytotoxic concentration (CC50), half-maximal effective concentration (EC50), and selectivity index (SI) of verbenalin were calculated. Calcein/PI double staining was used to assess cell viability and cytotoxicity, and JC-1 staining was applied to evaluate changes in mitochondrial membrane potential (MMP). mito-Keima adenovirus labeling was used to assess mitophagy levels in each group. ResultsA macrophage infection model was successfully established by infecting RAW264.7 cells with the original concentration of HCoV-229E for 36 h. The CC0 of verbenalin was 125 μmol·L-1. The CC50 was 448.25 μmol·L-1. The EC50 against HCoV-229E-infected cells was 46.28 μmol·L-1, and the SI was 9.68. Compared with the normal group, the model group showed significantly reduced cell survival rate (P<0.01), increased cell death rate (P<0.01), decreased MMP (P<0.01), and suppressed mitophagy (P<0.01). In contrast, verbenalin treatment significantly improved cell survival rate (P<0.01), reduced cell death rate (P<0.01), alleviated MMP loss (P<0.01), and enhanced mitophagy levels (P<0.01) compared with the model group. ConclusionVerbenalin can enhance the survival rate of macrophages following HCoV-229E infection. The underlying mechanism may be associated with the activation of mitophagy, maintenance of MMP stability, and alleviation of mitochondrial damage.
4.Proteomics-based Investigation of Therapeutic Effect and Mechanism of Verbenalin on Lung Injury in Mice Infected with Human Coronavirus-229E
Qiyue SUN ; Shanshan GUO ; Shuangrong GAO ; Lei BAO ; Zihan GENG ; Shuran LI ; Ronghua ZHAO ; Jingsheng ZHANG ; Xian LIU ; Rui XIE ; Xiaolan CUI ; Jing SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):69-78
ObjectiveTo evaluate the pharmacological effects of verbenalin on both in vitro and in vivo infection models of human coronavirus 229E (HCoV-229E) and to preliminarily explore the antiviral mechanism of verbenalin through proteomic analysis. MethodsIn vitro, the cell counting kit-8 (CCK-8) for cell proliferation and viability assessment was used to establish a model of HCoV-229E-induced injury in human lung adenocarcinoma cells(A549). A549 cells were divided into five groups: normal group, model group, and three verbenalin treatment groups (125, 62.5, and 31.25 μmol·L-1). The cell protective activity of verbenalin was evaluated through cell viability assay and immunofluorescence staining. In vivo, 30 BALB/c mice were randomly divided into normal group, model group, chloroquine group, and high-dose, low-dose verbenalin groups (40 and 20 mg·kg-1), with six mice per group. An HCoV-229E-induced mouse lung injury model was established to evaluate the therapeutic effects of verbenalin. Lung injury was assessed by detecting the lung index and lung inhibition rate. The severity of pulmonary inflammation cytokines was measured by enzyme-linked immunosorbent assay (ELISA), while the lung morphology and structure were analyzed by micro-computed tomography (Micro-CT). Hematoxylin and eosin (HE) staining was used to assess histopathological changes in lung tissue. Additionally, four-dimensional data-independent acquisition (4D-DIA) proteomics was employed to preliminarily explore the potential mechanisms of verbenalin in treating HCoV-229E-induced lung injury in mice, through differential protein expression screening, functional annotation, enrichment analysis, and protein-protein interaction network analysis. ResultsThe A549 cells were infected with HCoV-229E at the original viral titer for 36 hours to establish an in vitro infection model. The maximum non-toxic concentration of verbenalin was 125 μmol·L-1, and the half-maximal cytotoxic concentration (CC50) was 288.8 μmol·L-1. Compared with the normal group, the model group showed a significant decrease in cell viability (P<0.01), a significant increase in the proportion of dead cells (P<0.01), mitochondrial damage, and a significant reduction in mitochondrial membrane potential (P<0.01). After treatment with different concentrations of verbenalin (125, 62.5, and 31.25 μmol·L-1), cell viability was significantly increased (P<0.01), and the proportion of dead cells was reduced (P<0.01), with mitochondrial membrane potential restored (P<0.01). In vivo experiments further confirmed the therapeutic effect of verbenalin on HCoV-229E-infected mice. Compared to the normal group, the model group showed a significant increase in the lung index (P<0.01), severe lung tissue injury, lung volume enlargement, and a significant increase in the expression of inflammatory cytokines, including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) (P<0.01). In contrast, in the verbenalin treatment groups, these pathological changes were significantly improved, with a reduction in the lung index (P<0.01), alleviation of lung tissue injury, reduced lung volume enlargement, and a significant decrease in inflammatory cytokine expression (P<0.01). Proteomics analysis revealed that, compared to the normal group, the model group showed enrichment in several antiviral immune-related signaling pathways, including the nuclear factor-κB (NF-κB) signaling pathway (P<0.05). Compared to the model group, the verbenalin treatment group showed enrichment in several signaling pathways related to inflammatory response and autophagy (P<0.05), suggesting that verbenalin may exert its antiviral and anti-inflammatory effects by regulating these pathways. ConclusionVerbenalin demonstrates significant therapeutic effects in both in vitro and in vivo HCoV-229E infection models, with its mechanism likely related to the NOD-like receptor protein 3 (NLRP3) inflammasome pathway and mitochondrial autophagy.
5.Pathogenicity and Transcriptomic Profiling Revealed Activation of Apoptosis and Pyroptosis in Brain of Mice Infected with the Beta Variant of SARS-CoV-2.
Han LI ; Bao Ying HUANG ; Gao Qian ZHANG ; Fei YE ; Li ZHAO ; Wei Bang HUO ; Zhong Xian ZHANG ; Wen WANG ; Wen Ling WANG ; Xiao Ling SHEN ; Chang Cheng WU ; Wen Jie TAN
Biomedical and Environmental Sciences 2025;38(9):1082-1094
OBJECTIVE:
Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection frequently develop central nervous system damage, yet the mechanisms driving this pathology remain unclear. This study investigated the primary pathways and key factors underlying brain tissue damage induced by the SARS-CoV-2 beta variant (lineage B.1.351).
METHODS:
K18-hACE2 and C57BL/6 mice were intranasally infected with the SARS-CoV-2 beta variant. Viral replication, pathological phenotypes, and brain transcriptomes were analyzed. Gene Ontology (GO) analysis was performed to identify altered pathways. Expression changes of host genes were verified using reverse transcription-quantitative polymerase chain reaction and Western blot.
RESULTS:
Pathological alterations were observed in the lungs of both mouse strains. However, only K18-hACE2 mice exhibited elevated viral RNA loads and infectious titers in the brain at 3 days post-infection, accompanied by neuropathological injury and weight loss. GO analysis of infected K18-hACE2 brain tissue revealed significant dysregulation of genes associated with innate immunity and antiviral defense responses, including type I interferons, pro-inflammatory cytokines, Toll-like receptor signaling components, and interferon-stimulated genes. Neuroinflammation was evident, alongside activation of apoptotic and pyroptotic pathways. Furthermore, altered neural cell marker expression suggested viral-induced neuroglial activation, resulting in caspase 4 and lipocalin 2 release and disruption of neuronal molecular networks.
CONCLUSION
These findings elucidate mechanisms of neuropathogenicity associated with the SARS-CoV-2 beta variant and highlight therapeutic targets to mitigate COVID-19-related neurological dysfunction.
Animals
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COVID-19/genetics*
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Mice
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Brain/metabolism*
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Apoptosis
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Mice, Inbred C57BL
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SARS-CoV-2/physiology*
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Pyroptosis
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Gene Expression Profiling
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Transcriptome
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Male
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Female
6.Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”
Congling CHEN ; Han WU ; Jie ZHOU ; Ruobin ZHANG ; Jinping ZHANG ; Xue BAO ; Xian YANG
China Pharmacy 2024;35(1):63-68
OBJECTIVE To evaluate the cost-effectiveness of ivabradine in the treatment of chronic heart failure (CHF) in the context of “Quadruple Therapy” from the perspective of the health system. METHODS Based on real-world cohort data, the Markov model was constructed according to the natural progression of CHF, with a cycle time of 3 months, a study timeframe of 20 years, and a discount rate of 5%. Using quality-adjusted life year (QALY) and incremental cost-effectiveness ratios (ICER) as the output indexes, the cost-utility analysis was used to evaluate the cost-effectiveness of ivabradine in combination with the “Quadruple Therapy” regimen, compared with the “Quadruple Therapy” regimen for the treatment of CHF, and the robustness of the results of the base analysis was verified by univariate sensitivity analysis and probabilistic sensitivity analysis. RESULTS The results of the base analysis showed that the ICER of ivabradine combined with the “Quadruple Therapy” regimen was 165 065.54 yuan/QALY, compared with the “Quadruple Therapy” regimen, which was lower than the willingness-to-pay (WTP) threshold (257 094 yuan/QALY) based on 3 times of China’s gross domestic product (GDP) per capita in 2022. The results of the univariate sensitivity analysis showed that the discount rate had the greatest impact on the robustness of the model. The probabilistic sensitivity analysis showed that the probability that the ivabradine combined with the “Quadruple Therapy” regimen was cost-effective under the WTP threshold in this study was 59.50%. CONCLUSIONS When using 3 times China’s 2022 GDP per capita (257 094 yuan/ QALY) as the WTP threshold, the combination of ivabradine and the “Quadruple Therapy” regimen for treating CHF is cost- effective.
7.Exercise Improves Nonalcoholic Fatty Liver Disease in T2DM Mice by Inhibiting Ferroptosis Through p38 MAPK Signaling Pathway
Bao-Wen ZHANG ; Ying LI ; Yuan GAO ; Ke-Yan SHENG ; Zhi WANG ; Xian-Juan KOU
Progress in Biochemistry and Biophysics 2024;51(11):2983-2997
ObjectiveTo explore the mechanism of treadmill exercise against type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD) based on the regulator effects of exercise on ferroptosis. MethodsEight 8-week-old male m/m mice were used as control group (Con, n=8), and db/db mice of the matched age were randomly divided into T2DM model group (db/db, n=8), exercise group (db+Exe, n=8), p38 mitogen-activated protein kinase (MAPK) inhibitor group (db+SB203580, n=8) and exercise combined with p38 MAPK inhibitor group (db+Exe+SB203580, n=8). After one-week adaptive feeding, the mice in the db+Exe group and db+Exe+SB203580 group underwent moderate intensity treadmill exercise for 40 min/d, 5 d/week lasting 8 weeks. The db+SB203580 group and db+Exe+SB203580 group were treated with SB203580 (a specific inhibitor of p38 MAPK) with a dose of 5 mg/kg, 5 d/week for 8 weeks. And the exercise intervention was performed 2 h later after the intraperitoneal injection of SB203580. The body weight and fasting blood glucose of mice were measured regularly every week during the experiment. After 24 h of the last intervention, the mice were weighted, the liver tissues were taken, weighted and the liver index was calculated. The pathological changes of liver were determined by Oil Red O and hematoxylin-eosin (HE) staining. The levels of blood lipids, liver function, Fe2+ and oxidative stress markers of liver were measured by enzyme linked immunosorbent assay (ELISA). The related mRNA expression levels of lipogenesis and inflammation were evaluated by quantitative reverse transcriptase-mediated PCR (qRT-PCR). The related protein expression levels of lipogenesis and ferroptosis in liver were determined by immunohistochemical (IHC) staining and Western blot. ResultsThe body weight, fasting blood glucose, liver index, blood lipid and transaminase levels in the db/db group were significantly increased compared with the Con group. HE and Oil Red O staining showed severe lipid accumulation and ballooning change in the liver of db/db mice. Biochemical tests showed that Fe2+ and MDA level of liver constitution homogenate increased, while GSH level decreased significantly. The results of qRT-PCR showed that the mRNA levels of MCP-1, IL-6, SREBF1 and ACC1 in liver tissue of db/db mice were all significantly increased. Western blot results showed that the expression levels of SREBF1, ACC1 increased, ferroptosis relative proteins were significantly decreased. The 8 weeks of exercise significantly reduced the rise in body weight, blood glucose, liver index and blood lipid levels in db/db mice. Exercise intervention also alleviated hepatic steatosis and reduced the expression levels of Fe2+, MDA, MCP-1, IL-6, ACC1 and SREBF1, upregulated the expression levels of GSH, NRF2, HO-1, SLC7A11 and GPX4 in liver tissue of db/db mice. The intervention of exercise combined with SB203580 significantly down-regulated the mRNA expression levels of ACC1, MCP-1, IL-6, reduced the levels of Fe2+ and MDA, and up-regulated the level of GSH in db/db mice. Compared with the db+Exe group, the expression of Fe2+, MDA, MCP-1, and SREBF1 in the liver of the db+Exe+SB203580 group mice significantly increased, while the expression level of GSH and expression levels of ferroptosis relative proteins also significantly decreased. In addition, compared with db+SB203580 group, the iron accumulation and lipid peroxidation in the liver of db+Exe+SB203580 group were significantly improved. ConclusionThe8-week treadmill exercise can effectively alleviate liver injury and steatosis, and its mechanism may be related to the inhibition of hepatocyte ferroptosis through p38 MAPK signal.
8.Host Targets Interacting with Influenza Virus NP and Mechanism of Gardenia Jasminoides Iridoid Glycoside Against Influenza Virus
Xiaowei YANG ; Lei BAO ; Yu ZHANG ; Xian LIU ; Zihan GENG ; Shuran LI ; Jingsheng ZHANG ; Xiaolan CUI ; Shanshan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(13):60-66
ObjectiveTo explore host factors interacting with influenza virus nucleoprotein (NP) and study their effects on influenza virus replication, as well as the mechanism of gardenia jasminoides iridoid glycoside (IGE) in inhibiting influenza virus. MethodA yeast two-hybrid system was utilized to screen host factors that interacted with influenza virus NP. Heterogeneous nuclear ribonucleoprotein D0 (HNRNPD), glucosamine-6-phosphate deaminase 1 (GNPDA1), poly(rC)-binding protein 1 (PCBP1), and protein inhibitor of activated signal transducer and activator of transcription (STAT) protein 1 (PIAS1) were validated by immunoprecipitation assay. The effects of PIAS1 and HNRNPD on influenza virus replication were compared by a dual luciferase assay, and the effects of IGE on influenza virus replication were examined in the presence of transfected ribonucleoprotein (RNP) and knockdown of PIAS1. ICR mice were randomly divided into a normal group, model group, oseltamivir phosphate group, and high, medium, and low dose IGE groups, with 10 mice in each group. In addition to the normal group, each group was infected with the influenza A virus FM1 strain by nasal drip to establish a viral pneumonia model. The high, medium, and low dose IGE groups were given drugs of 50, 25, and 12.5 mg∙kg-1 by gavage, and the oseltamivir phosphate group was given the drug of 27.5 mg∙kg-1 by gavage. Equal amounts of distilled water were instilled in the normal and model groups for four consecutive days. Later, protein expression of PIAS1, NP, phosphorylated (p)-STAT3, STAT3, p-STAT1, and STAT1 were detected in the lung tissue by Western blot. ResultIn yeast two-hybrid assays, 16 potential host targets interacting with influenza virus NP were identified. Immunoprecipitation experiments revealed that HNRNPD and PIAS1 could interact with influenza virus NP. The dual luciferase reporter assays found that both PIAS1 knockdown and overexpression significantly affected IAV RNP activity (P<0.05, P<0.01), and the effect of HNRNPD on IAV RNP was not significant. Both high and low dose IGE groups reduced influenza virus replication (P<0.05) and reversed the increase in influenza virus replication caused by the knockdown of PIAS1(P<0.05, P<0.01). The expressions of PIAS1, NP, p-STAT3, p-STAT1, and STAT1 in the lung tissue of infected mice were reduced to different degrees in each IGE group (P<0.05, P<0.01). ConclusionPIAS1 interacts with influenza virus NP and is able to inhibit influenza virus replication. IGE may exert antiviral effects by inhibiting the activity of IAV RNP through the PIAS1/STAT1 pathway.
9.Treadmill Exercise Improves Cognitive Dysfunction in Diabetic Mice by Regulating PANoptosis Through the p38 MAPK Signaling Pathway
Ke-Yan SHENG ; Yu-Yan CHEN ; Yuan GAO ; Bao-Wen ZHANG ; Meng ZHANG ; Zhi WANG ; Xian-Juan KOU
Chinese Journal of Biochemistry and Molecular Biology 2024;40(7):987-998
Cognitive dysfunction is one of the serious complications of type 2 diabetes.Exercise interven-tion has a certain effect on improving diabetes cognition,but the exact process remains ambiguous.This research aims to explore the impact and molecular processes of treadmill exercises in enhancing cognitive impairments in type 2 diabetic mice.Ten m/m 8-week-old male mice were used as the control group.Forty db/db mice,each 8 weeks old and male,were categorized into four distinct groups with each group containing 10 mice,including the db/db group(model group),db+Exe group(exercise group),db+Exe+SB203580 group(exercise combined with the p38 MAPK inhibitor group),db+SB203580 group(p38 MAPK inhibitor group).db+Exe group and db+Exe+SB203580 group were subjected to treadmill running intervention(40 min/time,5 times/week,a total of 8 weeks).db+Exe+SB203580 and db+SB203580 group were intraperitoneally injected with SB203580(5 mg/kg,5 times/week,8 weeks)2 hours before treadmill exercise.The results of body weights and fasting blood glucose measurement showed that 8-week treadmill exercise could significantly reduce the body mass and fasting blood glucose levels(P<0.01);the results of water maze showed that treadmill exercise improved cognitive dysfunction in diabetic mice(P<0.05).Immunofluorescence staining revealed that treadmill exercise diminished the fluorescence intensity of NLRP3 in hippocampus,and there was a significant difference in CA1 and CA3 regions(P<0.05).Treadmill exercise reduced the fluorescence intensity of PI in the hippocampus,and there was a significant difference in the DG region(P<0.01).The results of qRT-PCR revealed that treadmill exercise decreased IL-1β and IL-18 mRNA levels in hippocampus,with a notable difference in IL-1β mRNA levels(P<0.05).Western blotting analysis revealed that treadmill exercise reduced the concentrations of Caspase3,Caspase9 and Bax in hippocampus(P<0.01),reduced the concentrations of TXNIP,NLRP3,GSDMD-N,IL-1β,IL-18,Cleaved Caspase1 and Caspasel(P<0.05),decreased the levels of p-RIPK1,RIPK1,p-RIPK3 and RIPK3(P<0.05).After adding p38 inhibitors,treadmill ex-ercise combined with p38 inhibitor intervention further inhibited the expression of Caspase3,TXNIP,GS-DMD-N and IL-18(P<0.05),and the expression levels of Caspase9,Bax,NLRP3,IL-1β,Cleaved Caspase 1 and Caspase 1 also showed a downward trend.The expression of RIPK1 and p-RIPK3 in-creased significantly(P<0.05),and the protein expression levels of p-p38,p-RIPK1 and RIPK3 showed an upward trend.In conclusion,treadmill running intervention can effectively improve the cogni-tive dysfunction in type 2 diabetic mice,and its mechanism is partly through the p38 MAPK signaling pathway to regulate PANoptosis.
10.The clinical effect of flow-diverting stent for treatment of unruptured internal carotid artery small- and medium-sized wide-neck aneurysms
Juan BAO ; Yi CAO ; Xian ZHANG ; Rui JING ; Yongtao YANG ; Feixiong CHEN ; Jiayi HU ; Yunfei LI
Chinese Journal of Surgery 2024;62(12):1104-1112
Objective:To study the feasibility of domestic flow diverter(TFD) for the treatment of unruptured internal carotid artery small- and medium-sized wide-neck aneurysms.Methods:This is a retrospective case series study.The study retrospectively evaluated consecutive 54 patients with unruptured intracranial small- and medium-sized wide-neck aneurysms treated with TFD in the Department of Cerebrovascular Disease,the Second Affiliated Hospital of Kunming Medical University between October 2019 and January 2024. There were 11 males and 43 females, and the age of patients was (54.9±9.6) years (range:36 to 74 years). There were 63 aneurysms in 54 patients,6 of which were tandem multiple small aneurysms. One case had saccular aneurysms of bilateral internal carotid artery. The maximum diameter of aneurysm was (4.1±0.8) mm (range: 1.5 to 10.0 mm).The ratio of the maximum diameter of the aneurysm to the neck width diameter was 1.3±0.4 (range:0.4 to 2.4). The surgical and follow-up data were collected. The aneurysm embolization rate at the immediate operation and follow-up,and the complications were analyzed. The degree of aneurysm embolization was evaluated using the O′Kelly-Marotta (OKM) grading system,with OKM grade D as complete occlusion and grade C and above (C1,C2,C3 and D) as successful occlusion. Clinical outcomes of all patients were evaluated by modified Rankin scale(mRS).Results:For 63 aneurysms, 48 aneurysms were treated with TFD alone,and 15 aneurysms were treated with a combination of TFD and coiling. The immediate postoperative successful occlusion rate was 14.3% (9/63) and the complete occlusion rate was 3.2% (2/63). Follow-up results were obtained for all of the patients. The follow-up time ( M(IQR)) was 124 (182) days (range: 85 to 754 days). The time to aneurysm successful occlusion was 140.5 (151.5) days (range: 85 to 308 days). At final follow-up,the successful aneurysm occlusion rate was 68.3% (43/63) and the complete occlusion rate was 58.7% (37/63). The complete occlusion rate of the TFD group was 50.0% (24/48) and the TFD+coiling group was 13/15. All patients had no aneurysm rupture,ischemic complications and no recurrence of the aneurysm needed to retreatment during the intraoperative and follow-up period. A total of 3 mild haemorrhagic complications which were related to dual-antiplatelet agents. Twelve patients had asymptomatic mild-moderate stent stenosis. TFD covered 66 branch vessels totally. Only 6 branches were affected by the time of the last follow-up and none of the patients had relevant ischaemic symptoms. All of 54 patients were evaluated as mRS score<2 points at the last follow-up. Conclusion:Using TFD to treat internal carotid artery unruptured small and medium-sized wide-neck aneurysms can simplify the surgical procedure with low complication rate, which is a clinically optional treatment approach.

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