1.Effective Ingredients of Chinese Medicine in Prevention and Treatment of Osteoarthritis by Regulating Oxidative Stress: A Review
Shuang ZHANG ; Yingyan BI ; Xiaoting LIU ; Yusuo GONG ; Xuerui LIU ; Baohua YUAN ; Chenglong LU ; Xufan CHEN ; Ying WANG ; Jiaru GUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):282-289
Osteoarthritis (OA) is a common degenerative joint disease with a rising incidence rate year by year. Treatment often relies on analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), which can lead to gastrointestinal damage with long-term use and the recurrence of symptoms. Chinese medicine has a long history of preventing and treating OA, with widespread application and fewer side effects. It offers unique advantages such as a broad treatment scope, multiple targets, and pathways. The effective components of Chinese medicine can reduce the content of reactive oxygen species (ROS), relieve oxidative stress (OS) damage, and increase the antioxidant capacity of the body by interfering with the expression of biomarkers of OS response such as malondialdehyde (MDA) and superoxide dismutase (SOD). Through the modulation of signaling pathways such as nuclear factor E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), nuclear factor kappa B (NF-κB), c-Jun N-terminal kinase (JNK), NOD-like receptor protein 3 (NLRP3), and osteoprotegerin (OPG), they downregulated the expression of inflammatory factors such as interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), thereby effectively relieving local joint inflammation, protecting chondrocytes and bone tissue, inhibiting chondrocyte apoptosis, and further alleviating the progression of OA. Currently, there are still certain limitations in the medical research status and development trends of OA, necessitating the continued advancement of traditional Chinese medicine. This paper reviewed the literature on the regulation of OS response by effective components of Chinese medicine for the prevention and treatment of OA, providing new directions and ideas for future research.
2.Progress in regulation of JAK/STAT signaling pathway by traditional Chinese medicine in treatment of osteoarthritis
Xiaoting LIU ; Jiaru GUANG ; Yusuo GONG ; Baohua YUAN ; Chenglong LU ; Xufan CHEN ; Bifeng ZHANG
Chinese Journal of Pathophysiology 2024;40(2):375-384
Osteoarthritis(OA)mainly lies in the lesions of articular cartilage and surrounding tissues,pro-ducing osteophytes and bone sclerosis,resulting in damage to the articular cartilage.The main pathological mechanism of OA rests with a large number of inflammatory cytokines and inflammatory mediators produced by joint synovial lesions as well as pathological vascular growth at the junction of the synovium and cartilage,which may be one of the key reasons for promoting synovitis and cartilage damage.The OA mainly occurs in the knees,hips,hands and the spine.It is mainly manifested by chronic joint pain,swelling and stiffness,and limitation of motion seriously affects the functional activities of patients.The treatment of OA mainly relies on oral administration or intraarticular injection of drugs to relieve symp-toms.When OA develops to the middle and late stages,the action and life of patients will be seriously affected.There-fore,surgical replacement of joints is considered to ensure the basic life demands of patients.Studies show that traditional Chinese medicine(TCM)treatment has attracted widespread attention and application due to its unique advantages in pre-vention and treatment of OA.Janus kinase(JAK)/signaling transduction and transcriptional activator(STAT)signaling pathway may be one of the important signaling pathways that regulate the chondrocyte proliferation,differentiation and apoptosis.Moreover,it is closely associated with intra-articular inflammatory response.The JAK/STAT signaling pathway regulates the expression of inflammatory factors and related proteins through TCM so as to reduce the inflammatory re-sponse and decrease the chondrocyte damage.It has an important reference value for OA treatment.In this paper,the roles and mechanisms of the TCM monomers and active ingredients and the Chinese herbal compounds in OA by regulating JAK/STAT signaling pathway and affecting related cytokine and protein expression levels have been reviewed,providing a new method and direction for TCM treatment of OA.
3.Small case study of retinopathy associated with novel coronavirus infection
Fuyu YANG ; Shengnan LIU ; Song CHEN ; Yuanyuan LIU ; Jiaru GUO ; Wei ZHOU
International Eye Science 2024;24(6):994-999
AIM: To observe the clinical and multimodal imaging features of retinopathy associated with novel coronavirus disease 2019(COVID-19)infection, investigate the related risk factors, and analyze the treatment and prognosis.METHODS: A total of 7 patients(7 eyes)with clinically confirmed COVID-19-associated retinopathy in Tianjin Medical University General Hospital from December 13, 2022 to January 13, 2023 were included in the study. All patients underwent color fundus photography, IR, spectral-domain optical coherence tomography(SD-OCT), fundus autofluorescein(FAF)and other ophthalmic examination and serological examination.RESULTS: Among the included patients, 2 cases(2 eyes)of central retinal vein occlusion(CRVO)appeared differently from previous CRVO. The hemorrhagic features of CRVO were round or fusiform shape hemorrhagic spots with white centers. One of them, the von Willebrand factor antigen(vWF: Ag)level was increased to 161.8%. The other case was positive in serologic test for lupus anticoagulant. In 2 cases(2 eyes)of multiple evanescent white dot syndrome(MEWDS), FAF showed that dots of high spontaneous fluorescence were scattered in the posterior pole. The prognosis of 2 MEWDS were good after the treatment of glucocorticoids. The 3 cases(3 eyes)of acute macular neuroretinopathy(AMN)showed reddened brown lesions in the macular area, hyporeflective lesions with clear boundaries on IR, and high signal intensity in the ONL and ELM, EZ/IZ signal fracture on SD-OCT.CONCLUSION: COVID-19 may cause inflammatory storm, involving all layers of retinal tissues and blood vessels, leading to the occurrence of various retinal lesions. Hormone therapy may be effective and the prognosis is good in most cases. Roth spot can be seen in fundus hemorrhage of CRVO, lupus anticoagulant and increased vWF: Ag may be risk factors for CRVO after COVID-19.
4.Experience of surgical repair combined with automated peritoneal dialysis in the treatment of a patient with peritoneal dialysis-related thoracoabdominal fistula
Jiaru CHEN ; Dongmei ZOU ; Xiaoming ZHANG ; Jianwen YU ; Jianying LI
Chinese Journal of Nephrology 2024;40(10):823-826
The paper summarizes the treatment experience of surgical repair combined with automated peritoneal dialysis in a maintenance peritoneal dialysis patient complicated with thoracoabdominal fistula. Through the close participation of medical and patients, the diagnosis method and peritoneal dialysis scheme were optimized continuously. The thoracoabdominal fistula repair operation was successfully implemented by a multidisciplinary team, and the patient's condition was improved and was discharged. This case suggests that standardized diagnosis process and optimized diagnosis method can be applied to improve the sensitivity and specificity of diagnosis, and strive for early diagnosis and intervention; multi-disciplinary teams can be actively formed and the patients can be encouraged to participate in decision-making, to improve treatment confidence; the advantages of automated peritoneal dialysis can be made full use to reduce complications and improve the life quality of the patient.
5.Adverse drug event signal mining of semaglutide based on FDA Adverse Event Reporting System database
Weitao LU ; Jiaru HE ; Wenying CHEN
China Pharmacy 2022;33(15):1865-1869
OBJECTIVE To exc avate the adverse drug event (ADE)signals of semaglutide and provide reference for its clinical rational use. METHODS The proportional unbalance method was used to mine the signals of all semaglutide ADE reports from FDA Adverse Event Reporting System (FAERS)up to September 2021. The basic situations of the reported cases were analyzed. The corresponding system organ classification (SOC)was mapped and compared with the adverse drug reactions recorded in the drug instructions. Preferred terms (PT)of patients with different indications were analyzed. RESULTS A total of 6 661 semaglutide ADE reports were extracted and 194 valid signals were mined. Among 6 661 cases of ADE ,the proportion of men (43.40%)was lower than women (52.65%);the age was mainly distributed in >40-65 years old (29.00%)and >65 years old (22.61%);the reporting country was mainly the United States (83.88%);the report year was mainly concentrated in 2021 (40.88%),with an increasing trend year by year ;the main outcome was hospitalization or prolonged hospitalization in serious ADE reports (17.78%). Semaglutide ADE signal was mapped to the main SOC ,mainly including gastrointestinal diseases ,various injuries,poisoning and operation complications ,metabolic and nutritional diseases ,various examinations. The screening criteria were based on the report odds ratio >10 or ADE reported cases >50,and 48 new potential adverse drug reactions were added to the drug description. Among the indications with the top two reported cases (type 2 diabetes and obesity ,overweight,weight control),the frequency of gastrointestinal system related ADE reports represented by nausea ,vomiting and diarrhea was higher , which was similar to the drug instructions. CONCLUSIONS This study supplemented 48 new potential adverse drug reactions based on the drug instructions of semaglutide. At present ,it can be considered that semaglutide is safe.
6.The effect of calpeptin on injury and atrophy of diaphragm under mechanical ventilation in rats
Lei SHI ; Hong GUO ; Jiaru HUANG ; Shaolin MA ; Xiaoping CHEN ; Xiaoping ZHU
Chinese Critical Care Medicine 2014;26(8):549-553
Objective To investigate the effect of calpeptin on diaphragmatic injury and atrophy under controlled mechanical ventilation in rats.Methods A total of 24 SPF Sprague-Dawley (SD) rats were randomly divided into anesthetized control group (CON group),24-hour controlled mechanical ventilation group (CMV group),and 24-hour CMV + treatment with calpeptin group (CMVC group),with 8 rats in each group.Animals in the CON group received an intraperitoneal injection of pentobarbital sodium without CMV and continuous infusion of pentobarbital sodium.A small-animal ventilator was used for 24 hours in rats of CMV group.Rats of CMVC were treated with a specific calpain inhibitor calpeptin (4 mg/kg).The drug was injected subcutaneously 2 hours before and 8,15 and 23 hours after mechanical ventilation.Changes in diaphragm ultrastructure,light microscopic picture,and myosin heavy chain (MHC) expression were observed.Results ① Alignment of myofilaments and normal Z-band,and the shape of mitochondria were maintained in CON group as revealed by electron microscope.The signs of misalignment of myofibrils,disruption of Z-band and vacuolar mitochondria were found in CMV group,and they were obviously improved in CMVC group.The density of muscle injury (× 10-2/μm2) in CMV group was significantly higher than that in control group (36.8 ± 13.7 vs.6.4 ± 6.3,t=6.373,P=0.001),and that in CMVC group was significantly lowered (17.6 ± 9.1 vs.36.8 ± 13.7,t=3.694,P=0.002).② In CON group,the diaphragm fibers appeared regular in cross section without pathologic change under light microscopy.Fuzzy muscle striations,irregular muscle fibers,centralized nuclei and swelling of capillary endothelial cells were observed in CMV group,while pathological changes in the CMVC group were milder significantly.③ In CMV group,the density of MHCslow and MHCfast was lower compared with that of CON group,and the gray value was lowered by 61.1% (t=8.138,P=0.001) and 77.1% (t=8.844,P=0.001),respectively,especially in MHCfast.However,the gray values of MHCslow and MHCfast were increased by 1.51 folds (t=4.601,P=0.010),and 1.33 folds (t=2.859,P=0.011),respectively,after treatment with calpeptin,and the elevation was more significantly in MHCslow.Conclusions Diaphragmatic injury and atrophy were found after CMV for 24 hour.Calpeptin could reverse the detrimental effects of CMV,and it suggested that calpain plays an important role in modulating the ventilator-induced dysfunction of the diaphragm.
7.Relationship between hypoxia-inducible factor-lα and construction of collateral circulation in patients with coronary artery disease
Jiaru LONG ; Songming CHEN ; Dongming WANG
Clinical Medicine of China 2008;24(9):866-868
Objective To investigate the relationship between hypoxia-inducible factor-1α(HIF-1α) and construction of collateral circulation in patients with coronary artery disease. Methods Collateral vessels were determined in 96 patients with≥70% narrowing of at least one coronary artery without prior revascularization,42 patients with coronary artery collaterals and 54 patients with no coronary artery collaterals.Another 50 cases with normal coronary arteries were selected as control.The levels of HIF-lα expression in monocytes and lymphocytes were tested by immunohistochemistry (IHC) and Western blot.Results Compared to the controls,the patients had higher expression of HIF-1α(P<0.01).Higher HIF-1α expression was found in patients with collaterals than in those without collaterals (P<0.01).Positive correlation was observed between the expression of HIF-1α protein and collateral score (r1=0.78,r2=0.84,P<0.01).Conclusion HIF-1α expression in circulating monocytes and lymphocytes are associated with collateral circulation.Detection HIF-1α might be helpful in the prognosis of patients with coronary artery disease.

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