This study aimed to investigate the underlying mechanism of Zhenwu Decoction in the treatment of heart failure by regulating electrical remodeling through the transient outward potassium current(I_(to))/voltage-gated potassium(Kv) channels. Five normal SD rats were intragastrically administered with Zhenwu Decoction granules to prepare drug-containing serum, and another seven normal SD rats received an equal amount of distilled water to prepare blank serum. H9c2 cardiomyocytes underwent conventional passage and were treated with angiotensin Ⅱ(AngⅡ) for 24 h. Subsequently, 2%, 4%, and 8% drug-containing serum, simvastatin(SIM), and BaCl_2 were used to interfere in H9c2 cardiomyocytes for 24 h. The cells were divided into a control group [N, 10% blank serum + 90% high-glucose DMEM(DMEM-H)], a model group(M, AngⅡ + 10% blank serum + 90% DMEM-H), a low-dose Zhenwu Decoction-containing serum group(Z1, AngⅡ + 2% drug-containing serum of Zhenwu Decoction + 8% blank serum + 90% DMEM-H), a medium-dose Zhenwu Decoction-containing serum group(Z2, AngⅡ + 4% drug-containing serum of Zhenwu Decoc-tion + 6% blank serum + 90% DMEM-H), a high-dose Zhenwu Decoction-containing serum group(Z3, AngⅡ + 8% drug-containing serum of Zhenwu Decoction + 2% blank serum + 90% DMEM-H), an inducer group(YD, AngⅡ + SIM + 10% blank serum + 90% DMEM-H), and an inhibitor group(YZ, AngⅡ + BaCl_2 + 10% blank serum + 90% DMEM-H). The content of ANP in cell extracts of each group was detected by ELISA. The relative mRNA expression levels of ANP, Kv1.4, Kv4.2, Kv4.3, DPP6, and KChIP2 were detected by real-time quantitative PCR. The protein expression of Kv1.4, Kv4.2, Kv4.3, DPP6, and KChIP2 was detected by Western blot. I_(to) was detected by the whole cell patch-clamp technique. The results showed that Zhenwu Decoction at low, medium, and high doses could effectively reduce the surface area of cardiomyocytes. Compared with the M group, the Z1, Z2, Z3, and YD groups showed decreased ANP content and mRNA level, increased protein and mRNA expression of Kv4.2, Kv4.3, DPP6, and KChIP2, and decreased protein and mRNA expression of Kv1.4, and the aforementioned changes were the most notable in the Z3 group. Compared with the N group, the Z1, Z2, and Z3 groups showed significantly increased peak current and current density of I_(to). The results indicate that Zhenwu Decoction can regulate myocardial remodeling and electrical remodeling by improving the expression trend of Kv1.4, Kv4.2, Kv4.3, KChIP2, and DPP6 proteins and inducing I_(to) to regulate Kv channels, which may be one of the mechanisms of Zhenwu Decoction in treating heart failure and related arrhythmias.
Rats ; Animals ; Myocytes, Cardiac ; Atrial Remodeling ; Rats, Sprague-Dawley ; Heart Failure/metabolism* ; RNA, Messenger/metabolism* ; Potassium

OBJECTIVES: To investigate the distribution of body mass index (BMI) and risk factors for obesity in children with Diamond-Blackfan Anemia (DBA). METHODS: The children with DBA who attended National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, from January 2003 to December 2020 were enrolled as subjects. The related clinical data and treatment regimens were recorded. The height and weight data measured within 1 week before or after follow-up time points were collected to calculate BMI. The risk factors for obesity were determined by multivariate regression analysis in children with DBA. RESULTS: A total of 129 children with DBA were enrolled, among whom there were 80 boys (62.0%) and 49 girls (38.0%), with a median age of 49 months (range 3-189 months). The prevalence rate of obesity was 14.7% (19/129). The multivariate logistic regression analysis showed that the absence of ribosomal protein gene mutation was closely associated with obesity in children with DBA (adjusted OR=3.63, 95%CI: 1.16-11.38, adjusted P=0.027). In children with glucocorticoid-dependent DBA, obesity was not associated with age of initiation of glucocorticoid therapy, duration of glucocorticoid therapy, and maintenance dose of glucocorticoids (P>0.05). CONCLUSIONS There is a high prevalence rate of obesity in children with DBA, and the absence of ribosomal protein gene mutation is closely associated with obesity in children with DBA.
Child ; Male ; Female ; Humans ; Anemia, Diamond-Blackfan/genetics* ; Pediatric Obesity/complications* ; Glucocorticoids/therapeutic use* ; Prevalence ; Risk Factors ; Ribosomal Proteins/genetics* ; Mutation

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

OBJECTIVE: To evaluate whether the efficacy of Getong Tongluo Capsule (, GTC, consisted of total flavone of Radix Puerariae) on improving patients' quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba (EGB) for patients with convalescent-phase ischemic stroke and primary hypertension. METHODS: This randomized, positive-drug- and placebo-controlled, double-blind trial was conducted from September 2015 to October 2017. Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions, twice a day for 12 weeks: (1) GTC 250 mg plus EGB-matching placebo 40 mg (237 cases, GTC group), (2) EGB 40 mg plus GTC-matching placebo 250 mg (120 cases, EGB group) or (3) GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg (120 cases, placebo group). Moreover, all patients were orally administered aspirin enteric-coated tablets 100 mg, once a day for 12 weeks. The primary outcome was the Barthel Index (BI). The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale (NIHSS) scores. The incidence and severity of adverse events (AEs) were calculated and assessed. RESULTS: The BI relative independence rates, the clinical recovery rates of NIHSS, and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment (P<0.05), and no statistical significance was found between the GTC and EGB groups (P>0.05). The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12, 18 and 24 weeks after treatment (P<0.01). There were no statistically significant differences in the incidences of AEs, adverse drug reactions, or serious AEs among the 3 groups (P>0.05). CONCLUSION GTC exhibited significant efficacy in improving patients' quality of life as well as neurological function and controlling hypertension. (Registration No. ChiCTR1800016667).

OBJECTIVETo explore effects of exendin-4 on the metabolism of extracellular matrix (ECM) in human mesangial cells (HMC) cultured in the presence of high glucose and explore the possible mechanism.

METHODSHuman mesangial cells (HMC) were treated with exendin-4 under high glucose conditions. The cell proliferation was observed using CCK8 assay, and the expressions of collagen type I, fibronectin, transforming growth factor-β1 (TGFβ1) expression and extracellular signal- regulated kinase (ERK) signaling pathway activity were assessed using Western blotting.

RESULTSExendin-4 inhibited cell proliferation and the expressions of collagen type I, fibronectin and TGFβ1 and reversed ERK phosphorylation in high glucose-induced HMC.

CONCLUSIONExendin-4 can regulate ECM metabolism in HMC cultured in high glucose by inhibiting TGFβ1/ERK pathway, suggesting the beneficial effects of exendin-4 in preventing and treating diabetic nephropathy.

Cell Proliferation ; Cells, Cultured ; Collagen Type I ; metabolism ; Culture Media ; chemistry ; Diabetic Nephropathies ; Extracellular Matrix ; metabolism ; Fibronectins ; metabolism ; Glucose ; chemistry ; Humans ; MAP Kinase Signaling System ; Mesangial Cells ; drug effects ; Peptides ; pharmacology ; Phosphorylation ; Signal Transduction ; Transforming Growth Factor beta1 ; metabolism ; Venoms ; pharmacology

This study was purposed to investigate the role of cytokines in pathogenesis of lymphoma-associated anemia. The levels of IFN-γ, IL-1β, IL-6, TNF-α and EPO in serum from 45 lymphoma patients and 12 normal controls were detected by using ELISA, the EPOR level on bone marrow cells were detected by flow cytometry, the CFU-E of bone marrow cultured in vitro was counted under inverted microscope. The results showed that 25 (55.6%) out of 45 newly diagnosed lymphoma patients had anemia before diagnosis, 13 (28.9%) had anemia during therapy, 7 (15.5%)never had anemia. The IFN-γ and TNF-α levels in serum of patients with moderate and severe anemia were significantly higher than those in patients with mild anemia and without anemia as well as normal controls. The EPO, IL-6 and IFN-γ levels correlated negatively with Hb concentration in patients, the EPOR level in patients without anemia significantly higher than that in patients with anemia and normal controls. The bone marrow CFU-E amount in patients showed positive correlation with Hb and EPOR levels. It is concluded that the increased IFN-γ, TNF-α and IL-6 may contribute to the anemia in lymphoma, and yet the EPO and EPOR levels are elevated to balance negative regulatory effects on hematopoiesis and maintain normal hematopoiesis.
Adult ; Aged ; Anemia ; blood ; etiology ; pathology ; Case-Control Studies ; Cytokines ; blood ; Erythropoietin ; blood ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-1 ; blood ; Interleukin-6 ; blood ; Lymphoma ; blood ; complications ; pathology ; Male ; Middle Aged ; Receptors, Erythropoietin ; blood ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo explore the therapeutic effect of debridement and vacuum sealing drainage (VSD) of cavitas medullaris for the treatment of chronic osteomyelitis of tibia.

METHODSFrom March 2006 to May 2009, 19 patients with chronic osteomyelitis of tibia were treated by debridment and VSD, then the second operation were performed to close the wound. Among them, 12 patients were male and 7 patients were female, the average age was 39 years (ranged from 25 to 68 years). The course of disease were from 10 months to 5 years. The main clinical symptoms were red swelling, tenderness and fluid of local soft tissue. There were prolonged unhealed sinus and pus; the X-ray showed osteosclerosis, increased bone mineral, and sequestrum and dead space was formed. The result of bacterial culture showed 3 cases were aeruginosus bacillus, 13 cases staphylococcus aureus, 1 case bacillus aerogenes and 2 cases beta streptococcus. Among them, 3 cases were methicillin resistant staphylococcus (MRS).

RESULTSAfter debridement and VSD of cavitas medullaris 18-22 days later, the granulation tissue grow well and the wounds of the 19 patients all healed primarily with direct suturing of 17 cases, loco-regional flap of 2 cases. The standard of wound healing was the dryness, cleanness and no drainage. The X-ray revealed the bone tissue grew well and no relapse and fracture occurred during followed-up 6-12 months.

CONCLUSIONThe debridement and VSD of cavitas medullaris is a very effective and safe treatment for chronic osteomyelitis of tibia.

Adult ; Aged ; Chronic Disease ; Debridement ; methods ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Tibia ; surgery ; Wound Healing

OBJECTIVETo investigate the distribution of pathogenic C.albican genotype and Candida species in association with the severity of vulvovaginal candidiasis (VVC).

METHODSPolymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) of the internal transcribed spacer analysis was employed to identify the Candida species isolated from the vaginal secretions of 198 patients with acute VVC. SSCP and GeneScan analyses of microsatellite locus I polymorphism were used to determine the genotypes of the clinical isolates of C. albican associated with VVC. All the patients were scored for clinical signs and symptoms to evaluate the severity of VVC.

RESULTSA total of 198 Candida strains were isolated from VVC patients, including 140 (70.7%) C. albicans strains and 58 (29.3%) non-albicans strains. In the 95 patients with severe VVC and 103 with mild-moderate VVC, C.albican was detected in 62.1% and 76.6% of the patients, respectively (P=0.011). Thirty-eight microsatellite locus I genotypes were detected in 140 unrelated C. albican strains, among which the dominant genotypes 30-45 (44 strians, 31.43%) and 32-46 (23 strains, 16.43%) were the most common, followed by genotypes 30-46 (4 strains, 2.86%) and 32-47 (9 strains, 6.42%). The overall frequencies of the 4 genotypes were significantly higher in severe VVC than in mild-moderate VVC cases (77.9% vs 42.0%, P<0.001).

CONCLUSIONC. albicans remains the most common pathogenic Candia species in patients with VVC, but the non-alibcans species seem more likely to cause severe VVC. The dominant genotypes of C. albicans with a tropism for the vagina are correlated to the severity of VVC.

Adolescent ; Adult ; Candida ; classification ; isolation & purification ; Candida albicans ; genetics ; isolation & purification ; Candidiasis, Vulvovaginal ; microbiology ; Female ; Genotype ; Humans ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Single-Stranded Conformational ; Severity of Illness Index ; Young Adult

OBJECTIVETo observe changes of learning and memory ability (LMA) in burn rats with depression, and study the relationship between LMA and expression of hippocampal NMDA.

METHODSAccording to simple random method, 46 Wistar rats were divided into burn group (B, with 30% TBSA deep partial-thickness burn, n = 10), depression group (D, with moderate stress stimulation in chronic and unpredictable, n = 12), B + D group (with the same stress stimulation inflicted to B group after burn, n = 12), healthy control group ( HC, without treatment, n = 12). Changes in escape latency was examined in water maze test. Expression of hippocampal NMDA in CA1, CA2 regions and dentate gyrus were observed with immunohistochemistry.

RESULTSCompared with that of HC group (22 +/- 20 s), water maze escape latency in B, D, B + D groups on 2 day after training prolonged (38 +/- 31, 41 +/- 36, 42 +/- 33 s, respectively, P < 0.05 or P < 0.01). Water maze escape latency in B + D group on 4th day after training was longer than that of other groups (P < 0.01). There was no obvious difference in positive expression of NMDA in CA1, CA2 regions among groups (P > 0.05). The positive count of NMDA in dentate gyrus in D group (198 +/- 14) and B + D group (191 +/- 6) were lower than that of HC group (224 +/- 23, P < 0.05 or P < 0.01), but there was no obvious difference between HC group and B group (219 +/- 25, P > 0.05).

CONCLUSIONSBurn complicated with depression can reduce LMA, which may be due to a decrease in NMDA in dentate gyrus.

Animals ; Burns ; complications ; metabolism ; psychology ; Depression ; complications ; Hippocampus ; metabolism ; Maze Learning ; physiology ; Memory ; N-Methylaspartate ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo investigate the self-esteem level and social adaptation ability of hospitalized burn patients in our burn ward.

METHODSOne hundred and twenty hospitalized burn patients in our burn ward were enrolled in the study and evaluated according to their sex, severity of burn injury and education level. Their self-esteem level and social adaptation ability were scored with the Felling of Inadequacy Scale and Abbreviated Burn Specific Health Scale.

RESULTSThe general score of self-esteem of the patients with mild burns( 183+/-23) was obviously lower than that with moderate and severe burns (167+/-21 and 154 +/-24) , ( P <0.01). The self-esteem level of burn patients was different in different sex and education level. Among the self-esteem scores, male burn patients presented evidently higher scores of self evaluation, social ability, appearance, as well as the general score than those in the female ( P < 0.05). Moreover, the self evaluation score and study ability was higher in those with higher education level than those with lower education. Furthermore, the score of social adaptation ability was higher in the patients with mild burns than that in patients with moderate and severe burns ( P < 0. 01). The social adaptation ability and psychological function were much higher in male patients than those in female patients, but the former were weaker than the latter in regard to the body function. The psychological function, social relationship and general condition of the patients with lower education were better than those with higher education ( P <0. 05 ).

CONCLUSIONThere existed difference in the self-esteem and social adaptation ability in different burn patients during different periods.

Adolescent ; Adult ; Burns ; psychology ; Female ; Humans ; Inpatients ; psychology ; Male ; Middle Aged ; Self Concept ; Social Adjustment