OBJECTIVE To explore the effects of levosimendan on cardiac function， hemodynamics and prognosis of patients with septic shock complicated with myocardial depression， and evaluate the safety of levosimendan. METHODS Patients with septic shock complicated with myocardial depression who were admitted to the Department of Critical Care Medicine of Chongqing University Three Gorges Hospital from April 2021 to August 2023， underwent adequate fluid resuscitation， had a mean arterial pressure （MAP） ≥65 mmHg， and received pulse indicator continuous cardiac output （PiCCO） monitoring were enrolled. The patients were randomly divided into dobutamine group and levosimendan group according to a random number table， with 20 patients in each group. Both groups received intravenous infusion of Norepinephrine bitartrate injection at a dose of 0.1-2.0 μg/（kg·min）. On this basis， the dobutamine group additionally received intravenous infusion of Dobutamine hydrochloride injection at a dose of 5- 10 μg/（kg·min） for 3 to 7 days， while the levosimendan group additionally received intravenous infusion of Levosimendan injection at a dose of 0.1-0.2 μg/（kg·min） for 24 hours. Heart rate （HR） and hemodynamic parameters [systolic blood pressure， diastolic blood pressure， MAP， central venous pressure （CVP）]， PiCCO monitoring parameters [cardiac function index （CFI）， cardiac index （CI）， stroke volume index （SVI）， extravascular lung water index， global end-diastolic volume index， pulmonary vascular permeability index （PVPI）， global ejection fraction （GEF）， systemic vascular resistance index， left ventricular contractility index]， and prognosis indicators [death within 3 days after administration， mechanical ventilation time，intensive care unit （ICU） stay time， 28-day mortality rate] were compared between the two groups before treatment and at 24 and 72 hours after treatment. Adverse reactions were E-mail：recorded for both groups. RESULTS Compared with before treatment in the same group， CFI， CI and GEF at 24 hours after treatment， CI and GEF at 72 hours after treatment in the dobutamine group， as well as SVI at 24 hours after treatment and SVI and GEF at 72 hours after treatment in the levosimendan group were significantly increased； PVPI at 72 hours after treatment in the dobutamine group was significantly decreased （P＜0.05）. Compared with the dobutamine group during the same period， patients in the levosimendan group had significantly lower HR and significantly higher CVP at 24 hours after treatment （P＜0.05）. Within 3 days after administration， there were no deaths in either group； there were no statistically significant differences in mechanical ventilation time， ICU stay time， 28-day mortality rate， or the incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS For patients with septic shock complicated with myocardial depression who have undergone adequate fluid resuscitation and have a MAP of ≥65 mmHg， levosimendan is comparable to dobutamine in improving cardiac function and hemodynamic parameters， without affecting patients’ prognosis or increasing the risk of adverse reactions such as hypotension.

[Abstract] Objective To establish an inflammation model by stimulating BV2 microglia by lipopolysaccharide, and to explore the regulation effect of ginsenoside Rg1 on inflammation by activating peroxisome proliferator activated receptor γ(PPARγ) receptor protein. Methods BV2 microglia were randomly divided into control group, model group, ginsenoside Rg1 group, rosiglitazone group and GW9662 group. The control group did not do any treatment, the model group was treated with 1 mg/ L lipopolysaccharide, and the other groups were treated with lipopolysaccharide added with 0. 4 mmol/ L ginsenoside Rg1, 10 μmol/ L rosiglitazone or 10 μmol/ L respectively. GW9662. The proliferation of BV2 microglia in each group was detected by CCK-8 method; PPAR-γ, phospho-NF-κB p65 (p-NF-κB p65), induced expression of inducible nitric oxide synthase(iNOS) and human arginase 1(ARG-1) proteins. ELISA was used to detect the inflammatory factors interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8) and the content of tumor necrosis factor-α (TNF-α). Results Compared with the control group, the cell proliferation rate in the model group was significantly increased, and the contents of IL-1β, IL-6, IL-8 and TNF-α increased significantly. The result of immunofluorescence and Western blotting showed that iNOS and p-NF-κB p65 increased significantly, and the positive expressions of PPARγ and ARG-1 decreased significantly(both P<0. 01). The expression level of TNF-α decreased, the positive expressions of iNOS and p-NF-κB p65 decreased significantly, and the positive expressions of PPARγ and ARG-1 increased significantly(all P<0. 01). Conclusion Ginsenoside Rg1 inhibits the inflammatory response of BV2 microglia after lipopolysaccharide stimulation, and its mechanism may be related to the regulation of PPARγ/ NF-κB pathway to promote the M2-type polarization of microglia.

AIM:To systematically compare and evaluate the clinical efficacy of intraocular lens(IOL)incarceration and non-incarceration in pediatric cataract.

METHODS: Literatures were searched from domestic and foreign databases such as PubMed, Embase, Cochrane Library, Wanfang, and CNKI, and the paper editions of relevant journals were consulted as well. The retrieval period of literature was from January 2000 to January 2021. The screened literatures were evaluated and extracted by two experienced researchers. After performing the evaluation guidelines of Cochrane collaboration and the Newcastle-Ottawa Scale(NOS), the Rev Man 5.4 software was applicated to complete the Meta-analysis.

RESULTS:Seven references(328 eyes)were involved in this analysis. The results of the Meta-analysis showed that the two groups had statistically significant differences in best corrected visual acuity(BCVA)>0.5 eyes(RR=2.00, 95%CI: 1.18-3.37, P=0.01), IOL shift(RR=0.28, 95%CI: 0.17-0.46, P<0.00001)and mild or above opacification of the visual axis(RR=0.35, 95%CI: 0.19-0.65, P=0.0007)after surgery. However, there was no significant difference in the occurrence of posterior synechia(RR=0.67, 95%CI: 0.10-4.33, P=0.67)and very mild opacification of the visual axis(RR=1.05, 95%CI: 0.64-1.73, P=0.84).

CONCLUSION:IOL incarceration in the treatment of pediatric cataract can significantly improve postoperative BCVA, reduce occurrence of IOL shift and prevent mild or above opacification of the visual axis, which has more advantages in overall clinical efficacy. But more high quality prospective studies should be still required for further analysis.

As is known, the nuclear accident resulting from the explosion of a nuclear weapon or the release of nuclear material could cause acute radiation syndrome within a short time. The study had found that the dose of > 0.7 Gy radiation on human body can result in persistent myelosuppression, a kind of acute radiation syndrome, leading to pancytopenia, bleeding, infection and other injuries. Several evidences also have shown that hematopoietic stem cell is conducive to repair hematopoietic injury in bone marrow, improve hematopoietic microenvironment and promote hematopoietic reconstruction. Therefore, hematopoietic stem cell transplantation is widely considered as the main treatment of the bone marrow acute radiation syndrome. However, before a surgery of hematopoietic stem cell transplantation, it still needs more research on donor selection, formulation of preconditioning and prevention of complications such as graft-versus-host disease. This paper mainly summarizes the application and research progress of hematopoietic stem cell transplantation in treating radiation injury.

[摘 要] 目的：探讨miR-496是否通过靶向mTOR影响宫颈癌HeLa细胞的周期、增殖、迁移、侵袭以及裸鼠移植瘤的生长。方法：选取2020年12月至2021年12月期间于河北医科大学第四医院接受手术的74例宫颈癌患者的肿瘤标本和癌旁组织标本，qPCR、WB法和免疫荧光法检测宫颈癌组织中miR-496和mTOR在mRNA和蛋白水平的表达。利用TargetScan数据库预测miR-496的靶基因并用双荧光素酶报告基因实验进行验证。将HeLa细胞按转染物不同分为对照组、miR-496 mimic组和miR-496 mimic+pMIR-mTOR组，CCK-8法、流式细胞术和Transwell实验分别检测miR-496和mTOR对HeLa细胞增殖、周期、迁移和侵袭的影响。将对照组、miR-496 mimic组HeLa细胞接种至BALB/c裸鼠皮下构建宫颈癌裸鼠移植瘤模型，21 d后处死小鼠，剥离小鼠肿瘤组织并称取瘤质量，免疫荧光法和WB法检测miR-496过表达对移植瘤组织中mTOR和Ki67表达的影响。结果：在宫颈癌组织中，miR-496呈低表达，而mTOR mRNA和蛋白呈高表达。miR-496能够靶向结合mTOR mRNA的3’-UTR。与对照组和miR-496 mimic+pMIR-mTOR组相比，miR-496 mimic组HeLa细胞的miR-496水平和S期细胞比例均显著升高，而增殖水平、迁移和侵袭细胞数均显著降低（均P<0.01）。成功构建宫颈癌裸鼠移植瘤模型，接种21 d后，miR-496 mimic组移植瘤质量、移植瘤组织中mTOR和Ki67的表达水平均显著低于对照组（均P<0.01）。结论：miR-496在宫颈癌组织中呈低表达，miR-496过表达可通过靶向调控mTOR抑制HeLa细胞的恶性生物学行为和裸鼠移植瘤的生长。

In this study, the model of Propionibacterium acnes/lipopolysaccharide (P. acnes/LPS)-induced acute liver injury in mice was employed to investigate the protective effects of Fuzheng Yanggan Fomula (FYF) on acute liver injury. The effects of FYF on the contents of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and interleukin-1β (IL-1β) in the serum, and the levels of malondialdehyde (MDA), oxygen radical absorbance capacity (ORAC), and glutathione (GSH) were examined in the livers of mice treated with P. acnes/LPS; The protein expression levels of Nod-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC), cysteinyl aspartate specific proteinase-1 (caspase-1), and IL-1β in liver tissues were detected by Western blot; Furthermore, hematoxylinendash-eosin (HE) staining, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, and immunohistochemical assay were used to observe pathological changes, apoptosis index, and inflammation infiltration of the liver tissue sections. All animal welfare and experimental procedures were followed by the Animal Ethics Committee of Jinan University. We conclude that FYF could alleviate P. acnes/LPS induced pathological damage and inflammatory infiltration in the liver of mice. Meanwhile, FYF decreases the contents of ALT, AST, IL-1β, and MDA, increases the contents of ORAC and GSH, and downregulates the expression of caspase-1 and IL-1β proteins. Collectively, these findings suggested that FYF could alleviate P. acnes/LPS induced acute liver injury in mice by inhibiting the activation of NLRP3 inflammasome, which provides a theoretical basis and a new drug target for the prevention and treatment of liver injury.

The study was aimed to investigate the protective effect and pharmacodynamic difference of the ethanol extracts of Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus on the drug-induced liver injury induced by acetaminophen.The cell activations of LO2 cells treated by Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extracts were tested by CCK-8 essay.The effects of ethanol extracts on cell survival rate,the activities of ALT and AST in culture medium were detected based on the injury model of LO2 cells induced by APAP.Further,in purpose to observe the protective effect of Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extracts on a mouse model of liver injury induced by intraperitoneal injectionof acetaminophen was established.Mice were randomly divided into control group,model group,positive drug group and Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extracts administration groups.The activities of ALT and AST in the serum and the levels of MDA,SOD,GSH and GSH-PX in the liver homogenate of the mice were detected by commercial kits.The HEstaining was used to observe the histopathological changes of liver tissue in each group and the TUNEL staining was used to observe the hepatocyte apoptosis.The results showed that the ethanol extracts at less than 1 g·L~(-1)did not affect the activity of LO2 cell.Compared with the model group,the cell survival rates of the Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extract administration groups was significantly increased;the ALT and AST in the culture medium were distinct decreased(P<0.05 or P<0.01).The survival rate of Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extract from different batches were similar,while that of the Schisandrea Sphenatherae Fructus ethanol extract from different batches were quite different(P<0.05or P<0.01).Further,animal experiments showed that Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extract administration groups could markedly inhibit the increase of ALT and AST levels in serum(P<0.01),decrease MDA content significantly(P<0.01),and increase GSH,GSH-PX and SOD activity significantly(P<0.01).Among them,compared with other groups,Schisandrae Sphenantherae Fructus ethanol extract-2 group showed the best effect(P<0.05 or P<0.01)while Schisandrae Sphenantherae Fructus ethanol extract-1 showed a poor effect(P<0.05 or P<0.01).In conclusion,both Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extracts have protective effect on APAP-induced drug-induced liver injury and there was a certain difference in the efficacy between Schisandrae Sphenantherae Fructus and Schisandrae Chinensis Fructus ethanol extracts from different habitats.
Acetaminophen ; Animals ; Chemical and Drug Induced Liver Injury ; Drugs, Chinese Herbal ; Fruit ; Liver ; Mice

The model of drug-induced liver injury (DILI) induced by acetaminophen (APAP) in mice was established to investigate the anti-oxidation and anti-ferroptosis mechanisms of Fuzheng Yanggan Mixture on DILI. C57BL/6 mice were randomly divided into five groups: control group, model group, positive group, and low and high-dose Fuzheng Yanggan Mixture groups (0.12, 0.24 g·kg⁻¹). Mice were intragastrically administration with Fuzheng Yanggan Mixture (0.12, 0.24 g·kg⁻¹) once per day for 21 consecutive days, and at the same time, mice were weighted every day. The mice were injected intraperitoneally with 600 mg·kg⁻¹ of APAP to establish a mouse model of acute DILI after 16 h from the last administration of Fuzheng Yanggan Mixture. After 6 h from APAP challenge, the experimental animals were weighted and sacrificed to collect blood and liver tissue samples. And then, the effect of Fuzheng Yanggan Mixture on liver weight and the liver weight ratio of mice were examined; the content of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the serum and the level of malondialdehyde (MDA), glutathione (GSH) and nicotinamide adenine dinucleotide phosphate (NADPH) in the liver tissue were measured. Prostaglandinendoperoxide synthase 2(ptgs2) mRNA level in liver tissues was detected by Q-PCR, and protein expression levels of SLC7A11 and GPX4 in liver tissues were detected by Western blot. Moreover, HE staining, immunohistochemical assay and TUNEL staining were used to observe pathological changes of the liver tissue sections. It is found that Fuzheng Yanggan Mixture could relieve APAP-induced liver enlargement and inhibit hepatic weight ratio increase. Compared with model group, the mice in Fuzheng Yanggan Mixture groups showed decreases in the content of ALT, AST and MDA, and increases in the content of GSH and NADPH. What is more, Fuzheng Yanggan Mixture could down-regulate ptgs2 mRNA level and up-regulate SLC7A11 and GPX4 protein levels. All of the results lead to a conclusion that Fuzheng Yanggan Mixture plays a protective effect on DILI in mice, which may be associated with the inhibition of ferroptosis.
Acetaminophen ; Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Chemical and Drug Induced Liver Injury ; Glutathione ; Liver ; Mice ; Mice, Inbred C57BL ; Oxidative Stress

Objective To investigate the effect of a Chinese medicine formula GAPT, a combination containing Chinese herbs ginseng,Acorus tatarinowii, Polygala and tuber curcuma, on the behavior and cholinergic system in mice with scopolamine-induced memory impairment, and to explore the neuroprotective mechanism of GAPT. Methods ICR mice were randomly divided into normal control group(solution of 0.5% carboxy methyl cellulose, CMC), model group (0.5% CMC),positive control group(donepezil, 0.92 mg/(kg·d)), GAPT high, medium and low dose groups(20 mg/(kg·d),10 mg/(kg·d),5 mg/(kg·d)),18 mice in each group, were given intragastric gavage once a day for 30 days. After the last administration,the control group and model group received intraperitoneal injection of normal saline,and the other groups intraperitoneal injection of scopolamine(3 mg/(kg·d)), dissolved in 0.9% normal saline. Morris water maze test was performed to assess the learning and memmory ability. Then the mice were killed and the Ach content and AchE and ChAT activity in the cortex and hippocampus were detected. Results GAPT increased the swimming dis-tance,swimming time and the residence time in target quadrant of the model mice,increased the content of Ach and the ac-tivity of ChAT,and decreased the activity of AchE in the brain of the model group. Conclusions GAPT can improve the learning and memory ability of mice induced by scopolamine,and its mechanism may be related to cholinergic system.

In the processes of planting, harvest, transport and storage, improper treatment of Chinese materia medica (CMM) and foodstuffs and agricultural products will result in fungal growth and mycotoxins contamination, which will not only directly affect the quality, safety and efficacy of these complex matrices, but also seriously threaten the consumers' health and lives. Therefore, the establishment of high-throughout analytical methods with high sensitivity for the determination of mycotoxins in CMM and foodstuffs and agricultural products at trace levels will provide reliable references for reducing the risk of mycotoxin exposure in humans. Due to the matrix complexity of CMM and foodstuffs and agricultural products, highly-effective pretreatment technologies are necessary for the establishment of such analytical techniques. In this review, the current extraction and purification methods commonly used for the detection of mycotoxins were summarized, the importance of pretreatment techniques for the precise quantification of mycotoxins in complex matrices such as Chinese herbal medicines was highlighted, as well as the development tendency about the pretreatment techniques for mycotoxins in complex matrices in the future was proposed.