A case report: Castleman disease treated by the trinity of internal and external treatment of "Fuzheng, phlegm-resolving, and detoxification method".

RATIONALE: Castleman disease (CD) was first included in the CSCO lymphoma diagnosis and treatment guidelines in 2021. Its diagnosis relies on lymph node pathological examination. Observation, surgical resection of the lesion, radiotherapy, chemotherapy, and medical therapy (e.g., rituximab, siltuximab, steroids) can be used. Due to the traumatic, incurable, and recurrent nature of surgical treatment, drug therapy has many side effects and is expensive. Exploring effective traditional Chinese medicine (TCM) comprehensive treatment methods for this disease is important and necessary. PATIENT CONCERNS: The main symptom was recurrent lymphadenopathy, which had been surgically removed 5 times in the past. This time, lymph node enlargement occurred again, and the local hospital recommended surgical resection again. The patient could not tolerate another surgical treatment. Other targeted treatments are not available due to financial constraints. DIAGNOSES: The case was diagnosed as CD by pathological examination, which is an important basis for the diagnosis of this disease. INTERVENTIONS: The patient was treated with surgery in the early stage several times, later came to our hospital for the trinity of TCM integrated treatment program, which combines oral TCM with external application of TCM and intravenous drip of TCM as a syndrome of positive deficiency and phlegm-toxin internalization, and the therapeutic principle. OUTCOMES: After nearly 3 years of comprehensive treatment with TCM, the enlarged lymph nodes could not be touched, and there was no fatigue, fever, or weight loss. During this period, the patient did not undergo surgery, chemotherapy and other western medicine treatment, and lived a normal life. It not only met the patient's expectation but also confirmed that the TCM treatment was indeed effective. LESSONS: This case report confirms that TCM is safe and effective in the treatment of CD, which is worthy of promotion. In clinical practice, the individualized treatment for the patient, the duration of treatment, and the different disease states also affect the treatment outcome.

Lead dissociation and redistribution properties of actual contaminated farmland soil after long-term EKAPR treatment.

Electrokinetic-assisted phytoremediation (EKAPR) is a potential technology much affected by the metal species and accessibility to plant roots. In this study, Pb-contaminated red soil was remediated with Sedum plumbizincicola to investigate the changes in soil pH, available nutrients, dissociation and redistribution of Pb under a long-term periodic reversal direct-current electric field. This approach could effectively activate soil P, K, organic matter (OM) and Pb, without significant soil acidification; the effect was positively correlated with applied voltage. Soil Pb can be continuously dissociated, migrated, and tended to accumulate in the middle region. The maximum Pb removal rate in the anodic section of the EKAPR system was 21.4%, and the aggregation rate in middle regions was 14.4%, higher than the available Pb content of the original soil. The Pb desorption in aqueous solution increased significantly with increasing voltage, irrespective of the solution pH. At a voltage of 20 V, the Pb cumulative desorption content reached 91.1 mg kg-1 (pH = 7), which was 2.7 times than that without electric field (33.2 mg kg-1). Compared to original soil (2.80 mg kg-1) and the control (14.54 mg kg-1), the available Pb in the anode section of EKAPR system (20.66 mg kg-1) increased by 637.9% and 42.1%, respectively. These results indicated that except for the indirect influence of soil pH changes, electrodynamics can directly promote the bioavailability and dissociation of Pb at the soil-water interface. This finding provides a new perspective for further studies on the mechanism of Pb speciation evolution and accumulation changes using EKAPR.

Taohong siwu decoction attenuates myocardial fibrosis by inhibiting fibrosis proliferation and collagen deposition via TGFBR1 signaling pathway.

ETHNOPHARMACOLOGICAL RELEVANCE: Myocardial fibrosis after myocardial infarction (MI) leads to cardiac remodeling and loss of function. Taohong siwu decoction (THSWD), a well-known traditional Chinese medicinal prescription, has been clinically used to treat various cardiovascular and cerebrovascular diseases, but its potential functions in myocardial fibrosis after MI remain uncharacterized. AIM OF THE STUDY: The purpose of current study was to explore the potential mechanism action and anti-myocardial fibrosis effects of treatment with THSWD in vivo and in vitro. MATERIALS AND METHODS: Mouse underwent ligation of coronary artery to induce MI and divided equally into the sham group, model group and THSWD treatment groups. After 4 weeks, the effects of THSWD treatment on cardiac function were estimated by echocardiography. HE staining was used to detect the pathologic changes and Masson trichrome staining was used to estimate tissue fibrosis. To further explore the regulatory molecular mechanisms of THSWD, transcriptome analysis was performed. Furthermore, in vitro, we investigated the effect of THSWD on cell proliferation and collagen deposition in primary cardiac fibrosis cells and its possible mechanism of action. Overexpression of TGFBR1 was achieved by infection with an adenovirus vector encoding TGFBR1. RESULTS: Treatment with THSWD significantly decreased myocardial fibrosis and recovered cardiac function in the post-MI mouse. The transcriptomics data imply that the TGF-ß pathway might be a target in the anti-fibrosis effect of THSWD. THSWD inhibits TGF-ß1-induced proliferation of primary cardiac fibroblasts. THSWD decreased collagen expression and TGFBR1 and Smad2/3 phosphorylation. Moreover, the inhibitory effect of THSWD on CFs proliferation and collagen deposition, as well as TGFBR1 signaling pathway-associated proteins expression was partially abrogated by overexpression of TGFBR1. CONCLUSION: Collectively, the results implicate that THSWD attenuates myocardial fibrosis by inhibiting fibrosis proliferation and collagen deposition via inhibiting TGFBR1, and might be a potential therapeutic agent for treatment of myocardial fibrosis post-MI.

Gonadotropin-Inhibitory Hormone, the Piscine Ortholog of LPXRFa, Participates in 17ß-Estradiol Feedback in Female Goldfish Reproduction.

Gonadotropin-inhibitory hormone (GnIH) plays a critical role in regulating gonadotropin-releasing hormone, gonadotropin hormone, and steroidogenesis in teleosts. In the present study, we sought to determine whether 17ß-estradiol (E2) acts directly on GnIH neurons to regulate reproduction in goldfish, a seasonal breeder, and we investigated the role of estrogen receptors (ERs) in mediating this process. We found that GnIH neurons coexpress three types of ERs. Ovariectomy and letrozole implantation into female goldfish at the vitellogenic stage elicited a substantial decrease in the expression of GnIH messenger RNA (mRNA), and E2 supplementation abolished this effect. In primary cultured hypothalamus cells, E2 increased GnIH mRNA levels; surprisingly, selective ERα and ERß agonists showed opposite effects in regulating GnIH mRNA levels. Using genome walking, we isolated a 2329-bp section of the GnIH promoter sequence, and 7 half-estrogen response elements (EREs) were found in the promoter region. Luciferase assays and electrophoretic mobility shift assay results show that the half-ERE element at -2203 is the key site for competitive binding between ERα and ERß. Ovariectomy and letrozole implantation into female goldfish in the maturating stage did not change the GnIH mRNA expression levels. Taken together, these findings suggest that E2 binds to multiple types of ERs, which competitively bind to the same half-ERE binding site of the GnIH promoter to achieve both positive and negative feedback in response to estrogen to regulate goldfish reproduction at different stages of ovarian development.

A novel neuropeptide in suppressing luteinizing hormone release in goldfish, Carassius auratus.

The fish reproductive axis is regulated by many neuroendocrine factors. However, factors involved in the suppression of this axis are largely uncharacterized. In this study, we describe a novel neuropeptide derived from the spexin precursor acting as a negative factor to suppress the reproductive axis in teleost. The cDNA sequences of the spexin precursors have been cloned from both zebrafish and goldfish. A 14-aa mature peptide with the C-terminal amidated (spexin-14a: NWTPQAMLYLKGTQ-NH2) is conceivably generated by processing of the spexin precursors in both species. Spexin is mainly expressed in the brain and ovary of zebrafish and spexin-14a-ir cells are located in several brain regions of goldfish. Functionally, goldfish spexin-14a could significantly suppress luteinizing hormone (LH) release in cultured goldfish pituitary cells. Moreover, intraperitoneal injection of spexin-14a could effectively suppress serum LH level. The mRNA expression of spexin is lower in the breeding season and hypothalamic expression of spexin is regulated by gonadal hormones. These results constitute the first report on the novel role of spexin in the negative regulation of the reproductive axis in teleost.

Evidences for the regulation of GnRH and GTH expression by GnIH in the goldfish, Carassius auratus.

Gonadotrophin-inhibitory hormone (GnIH) plays an important role in regulating of reproduction in teleosts. To clarify the mode of action of GnIH on the synthesis of gonadotropin releasing hormone (GnRH) and gonadotrophin (GtH), three GnIHR cDNAs were cloned from the goldfish brain. In situ hybridization results showed that GnIHRs were localized to the hypothalamus and pituitary. In the hypothalamus, GnIHRs were found in the NPP, NPO and NLT, whereas sGnRH neurons were reported to be located, and potentially regulated by GnIH. In the pituitary, only two GnIHRs were observed and they were localized to the PI instead of the adenohypophysis where GtH-expressing cells are localized, suggesting indirect regulation of GtH by GnIH. In vivo, intraperitoneal (i.p.) injections of synthetic goldfish GnIH-II peptide and GnIH-III peptide significantly decreased sGnRH and FSHß mRNA levels. Only GnIH-II decreased LHß mRNA levels significantly. In vitro, both GnIH-II and GnIH-III showed no effect on GtH synthesis, but an inhibition of GnRH-stimulated LHß and FSHß synthesis was observed when GnIH-III was applied to primary pituitary cells in culture. Thus, GnIH could contribute to the regulation of gonadotropin in the brain and pituitary in teleosts.

Structural and functional characterization of neuropeptide Y in a primitive teleost, the Japanese eel (Anguilla japonica).

In the present study, the first full-length cDNA encoding Neuropeptide Y (NPY) was cloned from the brain of Japanese eel (Anguilla japonica). The open reading frame of Japanese eel NPY gene is 294 bp in length, encoding a precursor protein of 97 amino acids, which contains a 36-amino-acid mature peptide. Sequence analysis showed that the Japanese eel NPY peptide is similar to that of other species. Real-time PCR revealed that NPY in Japanese eel is mainly expressed in the brain, especially in the hypothalamus and the optic tectum thalamus. The effect of a negative energy balance on NPY gene expression was examined subsequently. The mRNA level of NPY in the hypothalamus and the optic tectum thalamus showed a pronounced increase after 4 days of food deprivation. The biological activities of Japanese eel NPY were further investigated in vivo and in vitro. Intraperitoneal injection of the NPY peptide into Japanese eel could potently elevate the expression of the mammalian gonadotropin-releasing hormone (mGnRH) in hypothalamus and the follicle-stimulating hormone beta (FSHß), the luteinizing hormone beta (LHß) and growth hormone (GH) in pituitary. In static incubation studies, the stimulatory effects of NPY on mGnRH expression in hypothalamic fragments and on FSHß, LHß and GH expression in pituitary cells were also observed. However, in vivo and in vitro studies showed that NPY exhibits an inhibitory action on the expression of thyroid-stimulating hormone beta (TSHß) in pituitary. The results indicate that NPY is involved in the regulation of multiple physiological processes in Japanese eel.