1.The role of glucose metabolism reprogramming and its targeted therapeutic agents in inflammation-related diseases
Yi WEI ; Xiao-man JIANG ; Shi-lin XIA ; Jing XU ; Ya LI ; Ran DENG ; Yan WANG ; Hong WU
Acta Pharmaceutica Sinica 2024;59(3):511-519
Cells undergo glucose metabolism reprogramming under the influence of the inflammatory microenvironment, changing their primary mode of energy supply from oxidative phosphorylation to aerobic glycolysis. This process is involved in all stages of inflammation-related diseases development. Glucose metabolism reprogramming not only changes the metabolic pattern of individual cells, but also disrupts the metabolic homeostasis of the body microenvironment, which further promotes aerobic glycolysis and provides favourable conditions for the malignant progression of inflammation-related diseases. The metabolic enzymes, transporter proteins, and metabolites of aerobic glycolysis are all key signalling molecules, and drugs can inhibit aerobic glycolysis by targeting these specific key molecules to exert therapeutic effects. This paper reviews the impact of glucose metabolism reprogramming on the development of inflammation-related diseases such as inflammation-related tumours, rheumatoid arthritis and Alzheimer's disease, and the therapeutic effects of drugs targeting glucose metabolism reprogramming on these diseases.
2.Research progress on the regulation of ferroptosis by lipid droplet metabolism
Quan-ao JIANG ; Ran DENG ; Shi-lin XIA ; Xiao-man JIANG ; Jing XU ; Hong WU
Acta Pharmaceutica Sinica 2024;59(7):1897-1904
As a novel iron-dependent form of cell death, ferroptosis is characterized by the excessive accumulation of phospholipids containing polyunsaturated fatty acids (PUFA) on the cell membrane and peroxidation. Lipid droplets are always in the dynamic transition of generation and decomposition, play a central role in regulating lipid metabolism, and are always in the dynamic transition of generation and decomposition. Lipid droplet metabolism is closely related to the occurrence of ferroptosis and plays an important role in the disease caused by ferroptosis. This review firstly focuses on the lipid droplet metabolism process and its effects on the storage and release of PUFA, and further elucidates the regulatory mechanism and key regulatory proteins of lipid drop metabolism on ferroptosis, in order to reveal the intrinsic relationship between lipid droplets and ferroptosis, and provide a new strategy for disease prevention and treatment.
3.Effects of sodium acetate on lowering uric acid and renal protection in mice with hyperuricemic nephropathy
Xue-Man LIN ; Shi-Qi ZHONG ; Yong-Mei LI ; Xiao-Yi QIN ; He-Yang JIANG ; Jia-Xin ZHOU ; Jian-Xin PANG ; Ting WU
The Chinese Journal of Clinical Pharmacology 2024;40(15):2222-2226
Objective To investigate the renal protective effect and mechanism of sodium acetate(Ace)on hyperuricemic nephropathy(HN)in mice.Methods Uric acid nephropathy mice model was prepared by intraperitoneal injection of potassium oxonate combined with adenine gavage.Mice were divided into blank control group(0.9%NaCl+0.5%carboxymethyl cellulose sodium),Ace group(200 mmol·L-1 Ace+0.5%carboxymethyl cellulose sodium),model group(0.9%NaCl+350 mg·kg-1 potassium oxonate+70 mg·kg-1 adenine),and experimental group(based on model group with additional 200 mmol·L-1 Ace).Serum and urine uric acid(UA)and serum creatinine(SCr)levels were observed in each group.Real-time fluorescence quantitative reverse transcription-polymerase chain reaction(qRT-PCR)was used to detect the expression levels of kidney injury molecule-1(Kim-1)and anti-aging gene Klotho,renal fibrosis markers Collagen Ⅰ and Fibronectin,intestinal inflammation-related factors interleukin-1 β(IL-1 β),and mRNA expression levels of tight junction proteins Zo-1.Results The serum UA levels of blank control group,Ace group,model group,and experimental group mice were(259.52±24.40),(227.71±35.91),(604.06±73.55),and(496.24±30.16)μmol·L-1,respectively;SCr levels were(16.85±0.40),(16.18±0.94),(22.38±1.56),and(19.78±1.43)μmol·L-1;Kim-1 mRNA relative expression levels were 1.04±0.25,1.17±0.28,13.00±2.87,and 4.24±3.92;Klotho mRNA relative expression levels were 1.04±0.15,1.02±0.18,0.43±0.12,and 0.69±0.12;Collagen Ⅰ mRNA relative expression levels were 1.05±0.15,1.02±0.18,3.19±1.09,and 1.61±0.55;Fibronectin mRNA relative expression levels were 1.07±0.18,1.02±0.25,7.86±2.40,and 3.34±2.10;intestinal IL-1β mRNA relative expression levels were 1.00±0.01,1.01±0.03,2.55±0.63,and 1.21±0.28;intestinal Zo-1 mRNA relative expression levels were 1.00±0.07,1.07±0.09,0.54±0.20,and 0.92±0.17.The above indicators in blank control group compared with model group,and experimental group compared with model group,all showed statistically significant differences(P<0.05,P<0.01,P<0.001).Conclusion Sodium acetate can effectively reduce UA levels in HN mice,significantly improve renal injury and fibrosis,and its mechanism may be related to the improvement of intestinal inflammatory response and up-regulation of intestinal Zo-1/Occuludin pathway to reduce intestinal mucosal permeability.
4.The current status and influencing factors of separate serving chopsticks and ladles provided by catering enterprises in Shanghai
Wei JIN ; Zong-Min JIANG ; Xiao-Min WEI ; Ting-Fang MAN ; Si-Kun CHEN
Fudan University Journal of Medical Sciences 2024;51(4):522-527,542
Objective To understand the present situation of the standardization of separate serving chopsticks and ladles provided by catering service providers in Shanghai,and to analyze the influencing factors.Methods A total of 971 catering service providers from extra large,medium and small restaurant in 16 administrative districts of Shanghai were investigated with a self-designed questionnaire using stratified two-stage sampling method between Sep and Nov 2023,mainly concentrate on thesituation and reasons of providing separate serving chopsticks and ladles and their compliance with standards.Logistic regression was used to explore the influencing factors.Results Among the 971 units surveyed,there were 911 catering service(93.8%)providers that provided separate serving chopsticks and ladles.The main reason for providing separate serving chopsticks and ladles is for improving high quality of catering service.Binary Logistic analysis showed that catering service providers with large scale restaurant(large:OR=2.08,95%CI:2.03-2.12;medium:OR=1.99,95%CI:1.96-2.02),good quantitative level of food safety(OR=1.84,95%CI:1.83-1.85),named Shanghai Green Restaurant(OR=1.11,95%CI:1.09-1.12),known as time-honored brand(OR=1.20,95%CI:1.17-1.22),regularly acceptance of law enforcement inspections(OR=6.99,95%CI:6.91-7.07),knowledge of relevant regulation(OR=5.77,95%CI:5.70-5.85)and more channels for understanding standards(OR=1.23,95%CI:1.21-1.25)were more likely to provide separate serving chopsticks and ladles.The situation that strictly follow the fully standard requirements of separate serving chopsticks and ladles to provide 8 types of catering conducts was unsatisfactory(14.1%).Logistic analysis showed that catering service providers with large scale restaurant(extra large:OR=6.42,95%CI:2.52-16.33;large:OR=4.29,95%CI:2.24-8.21;medium:OR=3.21,95%CI:1.76-5.87)and the provision of separate serving chopsticks and ladles for more than 3 years(OR=3.1,95%CI:1.09-9.02)had a higher percentage of providing separate serving chopsticks and ladles in accordance with specification.Conclusion The overall provision of separate serving chopsticks and ladles by catering service providers in Shanghai is satisfactory.The scale of restaurant,quantitative level of food safety and named Shanghai Green Restaurant are possible main factors for providing separate serving chopsticks and ladles of catering service providers.However,the implementation is not good according to the standardization.The different scale of restaurant and the time of the provision of separate chopsticks and ladles are possible factors for providing separate serving chopsticks and ladles in accordance with specification.
5.Discussion on the construction of the first sexual-health internet hospital in China
Yi-Cun MAN ; Xiao-Hui GU ; Ling LIN ; Jian-Jiang TONG ; Qiang FENG
National Journal of Andrology 2024;30(5):463-468
We retrieved the data on sexual-health internet hospitals from the Baidu Search Engine and Apple and Android APP Stores between August 2018 and September 2022.With the specialized Sexual-Health Internet Hospital affiliated to SPPH as an exam-ple,we analyzed its framework and system.It fully displays the closed-loop of medical service system of"doctor-patient-medicine-insurance-delivery",provides the protection of patients'privacy,offers comprehensive services,and manifests the values of socializa-tion,instrumentalization and commercialization.The booming of the internet medical industry in China is driven by national policies,and the rapid-rising of specialized internet hospitals largely stems from the clearer requirements of the state for regulation compliance and operation supervision.Against the background of the global spread of COVID-19,which has been demonstrated with a significant correlation to sexual health,only further rational and standardized management can ensure safe and efficient development of sexual-health internet hospitals to satisfy various health needs.
6.Effect of microRNA-214-3p expression in cancer-associated fibroblasts on cisplatin sensitivity of ovarian cancer cells
Yeping DING ; Weixue JI ; Lan XIAO ; Feiyun JIANG ; Lifang SUN ; Man XU ; Rui XU
Journal of Clinical Medicine in Practice 2024;28(10):5-12
Objective To investigate the effect of microRNA-214-3p (miR-214-3p) expression in cancer-associated fibroblasts (CAFs) on the cisplatin sensitivity of ovarian cancer cells and its mechanism. Methods Sixty-four ovarian cancer patients were selected as study subjects and divided into platinum-partially sensitive group and platinum-sensitive group based on progression-free survival after chemotherapy. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression of miR-214-3p in ovarian cancer tissues from the two groups, and the 2-year survival rates of patients with different clinical characteristics were compared. CAFs and normal ovarian fibroblasts (NFs) were primarily cultured, and qRT-PCR and immunofluorescence experiments were used to detect the expression of miR-214-3p and p62 protein in CAFs and NFs. The expression levels of
7.Cost-effectiveness analysis of Chaiyin Granules in treatment of influenza.
Li-Man DING ; Dao-Wen YANG ; Hong-Chun ZHANG ; Xiao MA ; Zhen-Gang YAN ; Sheng-Tang ZHANG ; Wu-Zhi MA ; Wei-Ge LI ; Dong-Xing WU ; Qing-Rong JIANG
China Journal of Chinese Materia Medica 2023;48(16):4529-4535
This study aimed to evaluate the cost-effectiveness of Chaiyin Granules compared with Oseltamivir Phosphate Capsules in the treatment of influenza(exogenous wind-heat syndrome). Based on a randomized, double-blind, positive drug parallel control clinical trial, this study evaluated the pharmacoeconomics of Chaiyin Granules with cost-effectiveness analysis method. A total of 116 patients with influenza from eight hospitals(grade Ⅱ level A above) in 6 cities were selected in this study, including 78 cases in the experimental group with Chaiyin Granules and Oseltamivir Phosphate Capsules placebo, and 38 cases in the control group with Oseltamivir Phosphate Capsules and Chaiyin Granules placebo. The total cost of this study included direct medical cost, direct non-medical cost, and indirect cost. The remission time of clinical symptoms, cure time/cure rate, antipyretic onset time/complete antipyretic time, viral nucleic acid negative rate, and traditional Chinese medicine(TCM) syndrome curative effect were selected as the effect indicators for cost-effectiveness analysis. Four-quadrant diagram was used to estimate the incremental cost-effectiveness ratio. The results showed that Chaiyin Granules were not inferior to Oseltamivir Phosphate Capsules in the remission time of clinical symptoms of influenza(3.1 d vs 2.9 d, P=0.360, non-inferiority margin was 0.5 d). Compared with Oseltamivir Phosphate Capsules, Chaiyin Granules would delay the remission time of clinic symptoms of influenza for 1 d, but could save 213.9 yuan. 1 d delay in cure time could save 149.3 yuan; 1% reduction in the cure rate could save 8.2 yuan; 1 d delay in antipyretic onset time could save 295.4 yuan; 1 d delay in complete antipyretic time could save 114.3 yuan; 1% reduction in the 5-day cure rate of TCM syndrome could save 19.2 yuan. Different from other indicators, there was no statistically significant difference between two groups in the effect of negative conversion rate of viral nucleic acid, but the cost was lower and the effect was superior, and the pharmacoeconomics was not different from that of Oseltamivir Phosphate Capsules in the field of influenza treatment.
Humans
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Antipyretics/therapeutic use*
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Antiviral Agents/therapeutic use*
;
Cost-Effectiveness Analysis
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Influenza, Human/drug therapy*
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Nucleic Acids/therapeutic use*
;
Oseltamivir/therapeutic use*
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Phosphates/therapeutic use*
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Treatment Outcome
;
Double-Blind Method
8.A pre-conception cohort study of fertility and its related factors among couples with the intention of conception.
He Qing SONG ; Feng Yun YANG ; Yong Mei WU ; Shou Le WU ; Jiang Man LE ; Hai Qi WANG ; Li Feng ZHANG ; Dong Xiao YIN ; Hong JIANG
Chinese Journal of Preventive Medicine 2023;57(2):179-186
Objective: To describe fertility and explore factors associated with it among pre-conception couples of childbearing age. Methods: Based on the pre-conceptional offspring trajectory study of the School of Public Health of Fudan University, couples of childbearing age who participated in the pre-conception physical examination in Shanghai Jiading District from 2016 to 2021 were recruited and followed up. Couples' time to pregnancy (TTP) was analyzed and Cox proportional hazards regression model was used to explore the factors associated with TTP. Kaplan-Meier was used to calculate each menstrual cycle's cumulative pregnancy rate. Results: A total of 1 095 preconception couples were included in the analysis, the M(Q1,Q3)of TTP was 4.33 (2.41, 9.78) menstrual cycles. Age of women (FR=0.90, 95%CI: 0.85-0.95, P<0.001), women who were overweight or obese before pregnancy (FR=0.36, 95%CI: 0.24-0.55, P<0.001), women who were exposed to second-hand smoking (FR=0.63, 95%CI: 0.44-0.92, P=0.016), women whose home or office had been renovated in the past 2 years and had a particular smell (FR=0.46, 95%CI: 0.26-0.81, P=0.008) were risk factors for impaired fertility. Regular menstrual cycles (FR=1.64, 95%CI: 1.16-2.31, P=0.005), females who often drank tea/coffee (FR=1.55, 95%CI: 1.11-2.17, P=0.011) and males who took folic acid before conception (FR=2.35, 95%CI: 1.38-4.23, P=0.002) were associated with better fertility. The cumulative pregnancy rate of 3, 6, and 12 menstrual cycles was 37.6%, 64.4%, and 78.4%, respectively. Conclusion: Older couples, overweight or obesity before pregnancy, irregular menstruation, exposure to secondhand smoke and decoration pollutants in females are associated with impaired fertility. Frequent tea/coffee drinking before pregnancy in females and taking folic acid before pregnancy in males are associated with shortened conception time.
Pregnancy
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Male
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Humans
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Female
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Cohort Studies
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Overweight/complications*
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Coffee
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Intention
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China/epidemiology*
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Fertility
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Obesity/complications*
;
Tea
9.Research progress on ferroptosis regulated by glycolysis-fatty acid metabolism in metabolic diseases
Xiao-man JIANG ; Ran DENG ; Yi WEI ; Shi-lin XIA ; Jing XU ; Ya LI ; Hong WU
Acta Pharmaceutica Sinica 2023;58(5):1204-1210
In metabolic diseases, the accumulation of reactive oxygen species and oxidative stress are closely associated with ferroptosis. As a key regulatory factor, the imbalance between glycolysis and fatty acid metabolism can participate in ferroptosis directly or indirectly, thereby regulating the occurrence and development of various metabolic diseases. The essence of ferroptosis is a new regulatory cell death mode, which is caused by the excessive accumulation of iron-dependent lipid peroxide. It is closely related to glycolysis and fatty acid metabolism, which plays an important role in metabolic diseases. This regulatory cell death mode is significantly distinguished from other programmed cell death modes and has unique changes in cell morphology, symbolic characteristics and mechanisms. This paper first illustrates the main mechanism of glycolysis and fatty acid metabolism imbalance in the occurrence of ferroptosis, then reviews the research progress of ferroptosis in tumor, diabetes, rheumatoid arthritis and other metabolic diseases, and finally reveals the internal connection between glycolysis-fatty acid metabolism imbalance and ferroptosis, as well as its impacts on metabolic diseases, which provide new strategies for the prevention and treatment of metabolic diseases.
10.Expert consensus on late stage of critical care management.
Bo TANG ; Wen Jin CHEN ; Li Dan JIANG ; Shi Hong ZHU ; Bin SONG ; Yan Gong CHAO ; Tian Jiao SONG ; Wei HE ; Yang LIU ; Hong Min ZHANG ; Wen Zhao CHAI ; Man hong YIN ; Ran ZHU ; Li Xia LIU ; Jun WU ; Xin DING ; Xiu Ling SHANG ; Jun DUAN ; Qiang Hong XU ; Heng ZHANG ; Xiao Meng WANG ; Qi Bing HUANG ; Rui Chen GONG ; Zun Zhu LI ; Mei Shan LU ; Xiao Ting WANG
Chinese Journal of Internal Medicine 2023;62(5):480-493
We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.
Humans
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Consensus
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Critical Care/methods*
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Intensive Care Units
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Pain/drug therapy*
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Analgesics/therapeutic use*
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Delirium/therapy*
;
Critical Illness


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