Objective To investigate the clinical comprehensive value of finerenone in the treatment of diabetic nephropathy(DN),and to provide evidence-based medicine evidence for clinical drug decision.Methods PubMed,Web of Science,Embase,Cochrane Library,WanFang Data,CNKI and health technology assessment(HTA)official website were systematically searched to collect the systematic review/Meta-analysis and pharmacoeconomic evaluation on finerenone in treatment of DN from the inception to November 31,2023.The method of rapid HTA was used to evaluate the effectiveness,safety and economic evaluation.The innovation,suitability and accessibility of finerenone were analyzed by relevant data from drug instructions,professional websites such as the National Medical Products Administration(NMPA)and Center for Drug Evaluation,NMPA.Results In terms of effectiveness,finerenone significantly reduced the risk of the renal composite events and composite cardiovascular outcomes in DN compared with placebo and traditional mineralocorticoid receptor antagonist(MRA).In terms of safety,the incidence of adverse reactions and acute kidney injury of finerenone was similar to that of placebo and traditional MRA,but the incidence of hyperkalemia was higher than that of placebo.In terms of economy,two foreign HTA reports showed that finerenone was more economical than standard treatment.In terms of innovation,finerenone was the world's first approved non-steroidal,selective MRA innovative drug for the treatment of type 2 DN,making its efficacy and adverse reactions more advantageous.In terms of suitability,finerenone should only be taken once a day,which had good suitability in pharmaceutical properties and clinical use.In terms of accessibility,the domestic price of finerenone was lower than the international price,and it was included in the medical insurance,and the market coverage was high,it had a good affordability and availability.Conclusion Finerenone has good effectiveness and safety in the treatment of DN,but attention should be paid to the risk of hyperkalemia,and its economy requires further economic research in China.As the world's first approved non-steroidal,selective MRA innovative drug,finerenone has better innovation,suitability and accessibility.

Moyamoya disease (MMD) is a cerebrovascular disorder characterized by a steno-occlusive internal carotid artery and compensatory vascular network formation. Although the precise pathogenic mechanism remains elusive, genetic association studies have identified RNF213 as the principal susceptibility gene for MMD, with the single nucleotide polymorphism p.R4810K recognized as the founder variant predominantly in the Asian populations. Distinct genotype-phenotype correlations are observable in RNF213-related MMD. The clinical manifestations linked to p.R4810K bear commonalities within Asian cohort, including familial predisposition, earlier age of onset, ischemic episodes, and involvement of the posterior cerebral artery (PCA). However, despite these shared phenotypic characteristics, there is significant heterogeneity in RNF213-related MMD presentations. This diversity manifests as variations across ethnic groups, inconsistent clinical symptoms and prognosis, and occurrence of other vasculopathies involving RNF213. This heterogeneity, in conjunction with the observed low disease penetrance of RNF213 mutations, suggests that the presence of these mutations may not be sufficient to cause MMD, underscoring the potential influence of other genetic or environmental factors. Although the current research might not have fully identified these additional contributors, experimental evidence points toward the involvement of RNF213 in angiogenesis, lipid metabolism, and the immune response. Future research is required to unveil the molecular mechanisms and identify the factors that synergize with RNF213 in the pathogenesis of MMD.

OBJECTIVETo investigate the inhibition effect of Salvia chinensis extraction (SJC) on growth of H22 bearing tumor, and to analyze the mechanism about the anti-tumor effect.

METHODWith hepatoma H22 bearing mice, ICR mice were inoculated with H22 cells by subcutaneous injection. On day 2 after inoculation, the ICR mice were randomize into 5 groups, they were the control group, the high, middle, low dosages of SJC, and the positive-control group. Administrated 10 days, the inhibition rate of tumor in the treatment groups were analyzed at 11th day. Meanwhile, Immunostaining with antibodies against CD105 and VEGF were used to investigate the tumor-related angiogenesis. In addition, the effect of SJC on angiogenesis of tumor were investigated on chick embry chorioallantoic membrane (CAM) inoculated H22 cells.

RESULTIn contrast to model group, the inhibition rate of the high, middle, and low dosages of SJC were 26.44% (P < 0.05), 42.28% (P < 0.01) and 32.59% (P < 0.05), respectively, and SJC could significantly reduced the express of VEGF and microvessel density (MVD) (P < 0.01). Injection with 6.25 g x L(-1) doses of SJC could significantly inhibited the angiogenesis of tumor, the inhibition rate of tumor-related angiogenesis was 50.67% (P < 0.01).

CONCLUSIONSJC showed anticancer effect, and maybe it is related to down-regulation VEGF and reducing MVD, then inhibiting the tumor-related angiogenesis.

Animals ; Carcinoma, Hepatocellular ; drug therapy ; metabolism ; pathology ; Cell Line, Tumor ; Male ; Mice ; Mice, Inbred ICR ; Neovascularization, Pathologic ; drug therapy ; metabolism ; pathology ; Plant Extracts ; therapeutic use ; Salvia ; chemistry