1.Intervention of Traditional Chinese Medicine in Diabetic Nephropathy by Regulating Nrf2 Signaling Pathway: A Review
Qinyuan ZHANG ; Yanxu CHEN ; Dakai QIN ; Jin PENG ; Zhisheng JIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):277-285
Diabetic nephropathy (DN) is a serious chronic microvascular complication of diabetes mellitus (DM) and a major cause of end-stage renal disease (ESRD). It is characterized by gradual and progressive decline of renal function, which eventually leads to glomerular sclerosis, interstitial fibrosis and other serious lesions. Although modern medical treatment can partially relieve the symptoms, there are limitations such as single therapeutic effect, low long-term therapeutic effect, and severe side effects. Traditional Chinese medicine (TCM), with a wide effect range, lasting efficacy, and high safety, often exerts unique therapeutic effect in the clinical treatment of DN. Nuclear factor E2-related factor 2 (Nrf2), an anti-oxidative stress transcription factor, has received much attention. It can regulate multiple upstream and downstream factors such as heme oxygenase-1 (HO-1), NAD(P)H: quinone oxidoreductase 1 (NQO1), nuclear factor-κB (NF-κB), NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome, glutathione peroxidase 4(GPX4), and p62, playing a role in cell protection by intervening in different mechanisms. A large number of studies have found that TCM active ingredients and compound prescriptions can inhibit oxidative stress, inflammation, pyroptosis, apoptosis, and ferroptosis or promote autophagy by regulating the signaling pathway composed of Nrf2 and the above-mentioned related factors, thus protecting the kidney function, reducing proteinuria, alleviating kidney fibrosis, and significantly ameliorating DN. This review briefly summarized the structure and function of Nrf2, clarified the regulation mechanism of Nrf2 in DN, focused on the main studies on the intervention of DN by the effective components and compound formulas of TCM through the targeted activation of the Nrf2 signaling pathway in the past five years, and discussed the huge potential of Nrf2 signaling pathway as a target for the treatment of DN. The aim is to provide reference for the development and promotion of new drugs in clinical practice and promote the innovation and development of the treatment methods for DN in the future.
2.Effect of Ferroptosis on Diabetes Mellitus and Its Complications and Intervention of Chinese Medicine: A Review
Qinyuan ZHANG ; Zhisheng JIN ; Xiaoxue JIANG ; Yanxu CHEN ; Boling ZHANG ; Yaoqin FU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):280-288
Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by absolute or relative insufficiency of insulin secretion. As the disease progresses, patients begin to suffer from diabetic nephropathy, diabetic cardiomyopathy, non-alcoholic fatty liver disease or other complications, which increase the burden on the patients. Moreover, the number of patients is increasing, which brings a heavy burden to the society. Ferroptosis is a new type of programmed cell death which has attracted wide attention in recent years. It refers to the cell death caused by the excessive accumulation of lipid peroxide under the overload of iron ions. Studies have discovered that ferroptosis exists in diabetes mellitus and its complications. Inhibiting ferroptosis can greatly slow down the occurrence and progression of diabetes mellitus and its complications. Chinese medicine, the unique medical treasure in China, acts in a multi-pathway, multi-target manner and is praised for the cheap price, low toxicity, and mild side effects. It has been widely used in the treatment of diabetes mellitus and its complications and has demonstrated definite therapeutic effects, bringing the good news for the majority of patients. The regulation of ferroptosis by Chinese medicine may be a new direction for the treatment of diabetes mellitus and its complications in the future. This paper briefly describes the mechanism of ferroptosis, explores the relationship of ferroptosis with diabetes mellitus and its complications, summarizes the research status of Chinese medicine interventions, and puts forward suggestions, aiming to provide a reference for further research on the treatment of diabetes mellitus and its complications with Chinese medicine.
3.Role of Iron-lipid Disorder in Nonalcoholic Fatty Liver Disease and Research Progress of Traditional Chinese Medicine Intervention: A Review
Yanxu CHEN ; Lei ZHANG ; Zhisheng JIN ; Qinyuan ZHANG ; Xiaoxue JIANG ; Changqing XU ; Pengcheng DOU ; Cong SUN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):281-290
Nonalcoholic fatty liver disease (NAFLD) is one of the most common complications of type 2 diabetes mellitus (T2DM). Cell death caused by iron-lipid disorder is a new mode of regulating programmed cell death, which is characterized by lipid peroxidation induced by the accumulation of lipid reactive oxygen species and excessive accumulation of iron ions induced by iron metabolism disorders. Among them, iron homeostasis disorder and metabolic pathway disorder are the main causes of iron-lipid disorder, which play an important role in a variety of pathological processes related to cell death. Because the liver is an important organ for iron storage and lipid metabolism, iron-lipid disorder is an ideal target for liver disease, and inhibition of iron-lipid disorder may become a new strategy for the treatment of NAFLD. However, the pathogenic relationship and mechanism between NAFLD and iron-lipid disorder have not been fully elucidated. Based on the complex molecular regulation mechanism of iron-lipid disorder, by expounding the role of iron-lipid disorder in NAFLD and its related mechanism, this paper summarizes the research status of traditional Chinese medicine on the target treatment of NAFLD in recent years, so as to provide a new perspective and point out a new direction for the treatment of NAFLD in the future.
4.Research on the enrollment status of students in Master's Degree Program in Pediatrics in China and the countermeasures
Mingyue WEN ; Xin JIN ; Jinzhong JIA ; Zhisheng LIANG ; Yuexin LI ; Rui ZHU ; Mengquan LIU ; Qi YAN ; Mengting ZHANG ; Zhiqiang WANG
Chinese Journal of Medical Education Research 2024;23(9):1197-1202
Objective:To investigate the enrollment scale and distribution of Master's Degree in Pediatrics programs in China, and to provide a reference for promoting pediatric education and disciplinary development.Methods:Data on colleges and universities authorized to award Master's Degree in Pediatrics in 2023 were collected, sorted, and analyzed for the number, structure, distribution, and enrollment scale and direction of these institutions using descriptive statistics.Results:Among the 117 clinical medicine academic master's degree programs in China, 72 enroll pediatric academic master's degree candidates, with an enrollment of 260 students. Among the 120 master's degree programs in clinical medicine, 104 enroll professional master's degree candidates, enrolling 1 195 students. Enrollment is mainly concentrated in East China, "non-double first-class" colleges and universities, medical colleges and universities with subject level B, and enrollment is carried out in the direction of secondary disciplines.Conclusions:The number of colleges and universities authorized to award Master's Degree in Pediatrics was small, and the distribution of these colleges and universities was unbalanced. The enrollment scale was small and the orientation of Professional Master's Degree was not reasonable. Some colleges and universities were authorized to award Master's Degree in Pediatrics, but did not enroll any students. It is suggested to increase the number of colleges and universities authorized to award Master's Degree in Pediatrics and strengthen the staffing of pediatric departments. The aim is to expand the enrollment scale of candidates for Master's Degree in Pediatrics, improving the differential training of candidates for Academic Master's Degree and Professional Master's Degree, and attach importance to the construction of pediatrics.
5.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Wong Wing-kin GARY ; Yanxia HE ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2023;38(1):20-30
China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
6.Mechanism of miRNA-related Signaling Pathway Against Diabetic Nephropathy and Intervention of Traditional Chinese Medicine: A Review
Xiaoxue JIANG ; Zhisheng JIN ; Caiyun JIN ; Yanxu CHEN ; Boling ZHANG ; Yaoqin FU
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(4):228-235
Diabetic nephropathy (DN), as one of the common chronic microvascular complications of diabetes, has become the main cause of renal failure in end-stage renal disease in China, increasing the risks of renal dialysis and kidney transplantation in diabetes patients. It is the leading cause of death in people with diabetes. The latest research on DN has focused on the gene level. microRNAs (miRNAs) are a family of endogenous accessible short-chain non-coding RNA molecules. By acting on a particular target, they activate or inhibit its mediated signaling pathways and related molecules, playing an important role in the occurrence and development of DN. They have become microeconomic factors for the prevention and treatment of DN. Traditional Chinese medicine (TCM) has a long history in the diagnosis and treatment of DN and has unique advantages such as significant curative effect and few side effects. A large number of studies have proved that TCM can target miRNA to affect multiple signaling pathways, participate in the regulation of inflammatory response, pyroptosis, mesenchymal transdifferentiation, and other pathological changes, and delay the further development of DN. Therefore, this study discusses the biogenesis mechanism of miRNA and its action mechanism in disease-related signaling pathways based on TCM diagnosis and treatment approaches from the perspective of miRNA, and summarizes the effect of TCM targeting miRNA on the disease-related signaling pathways and on DN. Thus, this study is expected to provide a theoretical reference for exploring the progress of TCM intervention in DN from the perspective of genes.
7.Mechanism of Hedysari Radix Polysaccharide on Diabetic Nephropathy in db/db Mice Based on JAK2/STAT3 Signaling Pathway
Yanxu CHEN ; Zhisheng JIN ; Xiaoxue JIANG ; Boling ZHANG ; Yaoqin FU ; Caiyun JIN ; Qinyuan ZHANG ; Changqing XU
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(13):65-71
ObjectiveTo observe the effect of Hedysari Radix polysaccharide (HRP) on the Janus kinase 2 (JAK2)/signal transducer and activator of transcription protein 3 (STAT3) signaling pathway in diabetic nephropathy db/db mice. MethodFifty db/db mice were randomly divided into model group, irbesartan group (irbesartan suspension, 22.75 mg·kg-1), and high-, medium-, and low-dose HRP groups (HRP suspension, 200, 100, 50 mg·kg-1) according to the body weight, with 10 mice in each group. Another 10 C57BL/6 mice were assigned to the normal group. The mice were treated with corresponding drugs by gavage, while those in the normal group and the model group received distilled water at 5 mL·kg-1. The mice in the six groups were administered once a day by gavage for 12 consecutive weeks. The uric acid (UA), triglycerides (TG), and total cholesterol (TC) were detected. Periodic acid-Schiff (PAS) staining and Masson staining were used to observe the pathological changes in kidney tissues. Western blot and Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) were used to detect the protein and mRNA expression levels of JAK2, STAT3, suppressor of cytokine signaling 3 (SOCS3), and tumor necrosis factor-α (TNF-α) in the kidney. ResultAfter 12 weeks of treatment, compared with the normal group, the model group showed significant pathological ultrastructural changes in kidney tissues and increased UA, TG, and TC levels (P<0.01). Compared with the model group, the high- and medium-dose HRP groups and the irbesartan group showed improvement in pathological ultrastructure of kidney tissues and reduced UA, TG, and TC levels (P<0.05, P<0.01). Compared with the normal group, the model group showed a decrease in SOCS3 protein and mRNA expression levels and an increase in JAK2, STAT3, and TNF-α protein and mRNA expression levels (P<0.01). Compared with the model group, the high- and medium-dose HRP groups and the irbesartan group showed an increase in SOCS3 protein and mRNA expression levels and a decrease in JAK2, STAT3, and TNF-α protein and mRNA expression levels (P<0.05, P<0.01). ConclusionHRP can alleviate renal damage in diabetic nephropathy to a certain extent, and its mechanism may be related to the inhibition of the activation of the JAK2/STAT3 signaling pathway.
8.Expert consensus on the diagnosis, treatment and prevention of monkeypox in children
Rongmeng JIANG ; Yuejie ZHENG ; Lei ZHOU ; Luzhao FENG ; Lin MA ; Baoping XU ; Hongmei XU ; Wei LIU ; Zhengde XIE ; Jikui DENG ; Lijuan XIONG ; Wanjun LUO ; Zhisheng LIU ; Sainan SHU ; Jianshe WANG ; Yi JIANG ; Yunxiao SHANG ; Miao LIU ; Liwei GAO ; Zhuang WEI ; Guanghua LIU ; Gang LIU ; Wei XIANG ; Yuxia CUI ; Gen LU ; Min LU ; Xiaoxia LU ; Runming JIN ; Yan BAI ; Leping YE ; Dongchi ZHAO ; Adong SHEN ; Xiang MA ; Qinghua LU ; Fengxia XUE ; Jianbo SHAO ; Tianyou WANG ; Zhengyan ZHAO ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(13):964-973
Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.
9.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fourth Edition)
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Kwok-keung Daniel NG ; Wing-kin Gary WONG ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(14):1053-1065
Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.
10.Mechanism of Hedysarum Polysaccharide in Diabetic Nephropathy in db/db Mice Based on Wnt/β-catenin Signal Pathway
Yanxu CHEN ; Caiyun JIN ; Zhisheng JIN ; Xiaoxue JIANG ; Boling ZHANG ; Yaoqin FU ; Liu HE
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(21):74-80
ObjectiveTo observe the effect of Hedysarum polysaccharides (HPS) on the Wnt/β-catenin signal pathway in db/db mice with diabetic nephropathy. MethodFifty db/db mice were randomly divided into model group, irbesartan group, and high, middle, and low-dose HPS experimental groups according to their body mass, with 10 mice in each group, and another 10 C57BL/6 mice were selected as a normal group. The normal group and the model group were given 5 mL·kg-1·d-1 distilled water, the irbesartan group was given 22.75 mg·kg-1·d-1 irbesartan suspension, and the high, middle, and low-dose HPS experimental groups were given 200, 100, and 50 mg·kg-1·d-1 HPS suspensions, respectively. The mice in the 6 groups were given intragastric administration once a day for 12 weeks. The general state, blood glucose (GLU), 24 h urine protein (UTP), blood creatinine (SCr), and urea nitrogen (BUN) of mice in each group were determined. The pathological changes in the kidney tissue were observed by hematoxylin-eosin staining (HE). The protein and mRNA expression levels of Wnt1, β-catenin, glycogen synthesis kinase-3β (GSK-3β), and phosphorylated GSK-3β (p-GSK-3β) in the kidney were detected by Western blot and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). ResultAfter treatment for 12 weeks, as compared with the normal group, the general state of mice in the model group was worse and the pathological ultrastructural lesions of kidney tissues were obvious. The levels of GLU, 24 h UTP, SCr, and BUN in the model group increased (P<0.01). As compared with the model group, the general state and renal pathological ultrastructure of mice in the high and middle-dose HPS groups were improved to some extent, and the levels of SCr, BUN, and 24 h UTP in the high and middle-dose HPS groups decreased (P<0.05,P<0.01). As compared with the normal group, the expression levels of Wnt1, β-catenin, GSK-3β, and p-GSK-3β protein and mRNA in the model group were higher (P<0.01), while the expression levels of Wnt1, β-catenin, GSK-3β, and p-GSK-3β protein and mRNA in the high and middle-dose HPS groups were lower than those in the model group (P<0.05,P<0.01). ConclusionHPS can alleviate the renal injury of diabetic nephropathy to some extent, and its mechanism may be related to the inhibition of the activation of the Wnt/β-catenin signal pathway.

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