Maturity model for assessing the medical humanities: a Delphi study.

BACKGROUND: Becoming a first-level discipline in China means access to more educational resources. The development of medical humanities in China has been going on for more than 40 years, and some medical schools have set up master's and doctoral programs in medical humanities. The demand for medical humanities-related knowledge in China is also growing after COVID-19. However, medical humanities is only a second-level discipline and receives limited resources to meet the needs of society. This study aims to establish a system of indicators that can assess whether the medical humanities has a first-level discipline and provide a basis for its upgrading to a first-level. METHODS: A Delphi technique was used, with the panel of expert expressing their views in a series of two questionnaires. A coefficient of variation of less than 0.2 indicates expert agreement. RESULT: A total of 25 experts participated in this Delphi study. Consensus was reached on 11 first-grade indices and 48 s-grade indices. The authoritative coefficient(Cr) of the experts was 0.804, which indicates that the experts have a high level of reliability. CONCLUSION: This study provides a reliable foundation for the evaluation of medical humanities maturity.

Ginsenoside Rh4 inhibits breast cancer growth through targeting histone deacetylase 2 to regulate immune microenvironment and apoptosis.

High expression of histone deacetylase 2 (HDAC2) is recognized as a marker of invasive breast cancer (BC). HDAC2 is not only responsible for enhancing tumor cell growth, development, and anti-apoptosis, but also plays a significant role in regulating PD-L1 on the surface of tumor cells. Continuous expression of PD-L1 allows tumor cells to escape immune surveillance. There is not much research on how HDAC2 affects the immune system in breast cancer. Ginsenoside Rh4 (Rh4) is a major rare saponin in heat-treated ginseng, which is widely applied in treating and preventing various diseases because of its potent medicinal value and stable safety. However, it is unclear how Rh4 affects the tumor immune microenvironment in breast cancer. Therefore, this paper aims to investigate the effect of Rh4 on HDAC2 in breast cancer, specifically the effect of HDAC2 on apoptosis and the immune microenvironment to inhibit breast cancer growth. According to our study, ginsenoside Rh4 has been shown to significantly suppress breast cancer cell proliferation without any adverse effects. The molecular docking results of Rh4 and HDAC2 indicate a binding energy of -6.06 kcal/mol, suggesting the potential of Rh4 as a targeting modulator of HDAC2. Mechanistically, Rh4 induces apoptosis of breast cancer cells by the HDAC2-mediated caspase pathway and inhibits the HDAC2-mediated JAK/STAT pathway to regulate the immune microenvironment, which inhibits breast cancer growth. Specifically, Rh4 was shown for the first time to blockade immune checkpoints (PD-1/PD-L1) and increase levels of T-lymphocytes in the tumor. In a word, our study establishes a theoretical framework for applying Rh4 as an immune checkpoint inhibitor as part of breast cancer treatment.

Educational efficacy of medical humanities in empathy of medical students and healthcare professionals: a systematic review and meta-analysis.

BACKGROUND: Medical humanities education is an important part of medical education. The purpose of this study was to determine the effectiveness of medical humanities in improving empathy among medical students and healthcare professionals. METHODS: PubMed, Embase, EBSCO-ERIC, Web of Science were searched systematically for studies in the English language. The last retrieval date is May 1, 2023. Best Evidence Medical Education (BEME) Global Rating Scale and Kirkpatrick-based results were used to evaluate the quality of literature. In this study, a meta-analysis of continuous data was conducted. RESULTS: The pooled results by single-arm test meta-analysis showed a benefit with medical humanities programs in empathy (SMD 1.33; 95% CI 0.69-1.96). For single-arm trials of medical humanities program interventions of less than 4 months, 4 months to 12 months, and more than one year, the standardized mean differences(SMD) between post-test and pre-test were 1.74 (P < 0.05), 1.26 (P < 0.05), and 0.13 (P = 0.46), respectively. The results showed a significant difference in the effect of medical humanities programs on male and female empathy (SMD - 1.10; 95% CI -2.08 - -0.13). The SMDs for the study of course, the course combined reflective writing, and the course combined reflective writing and practice as intervention modalities for medical humanities programs were 1.15 (P < 0.05), 1.64 (P < 0.05), and 1.50 (P < 0.05), respectively. CONCLUSION: Medical humanities programs as a whole can improve the empathy of medical students and health professionals. However, different intervention durations and different intervention methods produce different intervention effects.

Metabolomic and transcriptomic analysis of cold plasma promoting biosynthesis of active substances in broccoli sprouts.

INTRODUCTION: Broccoli sprouts have great health and commercial value because they are rich in sulforaphane, a special bioactive compound that helps to prevent chronic diseases, such as cancer and cardiovascular disease. OBJECTIVE: The aim of this study was to increase the levels of active substances in broccoli sprouts and understand their metabolic mechanisms. METHODOLOGY: Metabolomics based on liquid chromatography-tandem mass spectrometry and transcriptome analysis were combined to analyse the enrichment of metabolites in broccoli sprouts treated with cold plasma. RESULTS: After 2 min of cold plasma treatment, the contents of sulforaphane, glucosinolates, total phenols, and flavonoids, as well as myrosinase activity, were greatly improved. Transcriptomics revealed 7460 differentially expressed genes in the untreated and treated sprouts. Metabolomics detected 6739 differential metabolites, including most amino acids, their derivatives, and organic acids. Enrichment analyses of metabolomics and transcriptomics identified the 20 most significantly differentially expressed metabolic pathways. CONCLUSIONS: Overall, cold plasma treatment can induce changes in the expression and regulation of certain metabolites and genes encoding active substances in broccoli sprouts.

Injectable Hydrogel Based on Defect-Rich Multi-Nanozymes for Diabetic Wound Healing via an Oxygen Self-Supplying Cascade Reaction.

Diabetic wound healing remains challenging owing to the risk for bacterial infection, hypoxia, excessive glucose levels, and oxidative stress. Glucose-activated cascade reactions can consume glucose and eradicate bacteria, avoiding the direct use of hydrogen peroxide (H2 O2 ) and wound pH restriction on peroxidase-like activity. However, the anoxic microenvironment in diabetic wounds impedes the cascade reaction due to the oxygen (O2 ) dependence of glucose oxidation. Herein, defect-rich molybdenum disulfide nanosheets loaded with bovine serum albumin-modified gold nanoparticle (MoS2 @Au@BSA NSs) heterostructures are designed and anchored onto injectable hydrogels to promote diabetic wound healing through an O2 self-supplying cascade reaction. BSA decoration decreases the particle size of Au, increasing the activity of multiple enzymes. Glucose oxidase-like Au catalyzes the oxidation of glucose into gluconic acid and H2 O2 , which is transformed into a hydroxyl radical (•OH) catalyzed by peroxidase-like MoS2 @Au@BSA to eradicate bacteria. When the wound pH reaches an alkalescent condition, MoS2 @Au@BSA mimicks superoxide dismutase to transform superoxide anions into O2 and H2 O2 , and decomposes endogenous and exogenous H2 O2 into O2 via catalase-like mechanisms, reducing oxidative stress, alleviating hypoxia, and facilitating glucose oxidation. The MoS2 @Au@BSA nanozyme-anchored injectable hydrogel, composed of oxidized dextran and glycol chitosan crosslinked through a Schiff base, significantly accelerates diabetic wound healing.

Ginsenoside Rh4 Suppressed Metastasis of Lung Adenocarcinoma via Inhibiting JAK2/STAT3 Signaling.

Lung adenocarcinoma (LAC) is a common lung cancer with a high malignancy that urgently needs to be treated with effective drugs. Ginsenoside Rh4 exhibits outstanding antitumor activities. However, few studies reported its effects on growth, metastasis and molecular mechanisms in LAC. Here, Rh4 is certified to show a strong anti-LAC efficiency in vitro and in vivo. Results of flow cytometry and Western blot are obtained to exhibited that Rh4 markedly restrained cellular proliferation and colony formation by arresting the cell cycle in the G1 phase. Results from a wound healing assay and transwell assays demonstrated that Rh4 is active in the antimigration and anti-invasion of LAC. The analysis of Western blot, immunofluorescence and RT-qPCR confirmed that Rh4 reverses the epithelial-mesenchymal transition (EMT) through upregulating the gene expression of E-cadherin and downregulating that of snail, N-cadherin and vimentin. In vivo results from immunohistochemistry show consistent trends with cellular studies. Furthermore, Rh4 suppresses the Janus kinases2/signal transducer and activator of the transcription3 (JAK2/STAT3) signaling pathway stimulated by TGF-ß1. Silencing the STAT3 signal or co-treating with AG490 both enhanced the EMT attenuation caused by Rh4, which revealed that Rh4 suppressed EMT via inhibiting the JAK2/STAT3 signaling pathway. These findings explore the capacity and mechanism of Rh4 on the antimetastasis of LAC, providing evidence for Rh4 to LAC therapy.

Study of Nightingale's nursing professionalism: a survey of nurses and nursing students in China.

BACKGROUND: Nursing professionalism is highly significant to the development of nursing. Florence Nightingale was the founder and leader of modern nursing, and Nightingale's nursing professionalism has a significant impact on nursing in China and all over the world. In the new era, a new understanding of Nightingale's nursing professionalism should be developed, and its positive role in nursing reshaped. METHODS: A total of 1,557 nurses and nursing students from 27 provincial administrative regions of China were surveyed using a customized questionnaire. Their recognitions of Nightingale's nursing professionalism were evaluated based on scores, and statistical differences between and within the groups were analyzed using an Analysis of Variance (ANOVA). The elements of Nightingale's nursing professionalism were extracted by the exploratory factor method and a principal component analysis. RESULTS: The Cronbach's α of the questionnaire was 0.965, and the two groups did not differ significantly (p > 0.05). Based on the standard that the cumulative contribution rate of common factor should be > 85%, three common factors of Nightingale's nursing professionalism, including professional emotion, professional ability and professional ethics, were extracted based on the Scree plot. CONCLUSIONS: This study aimed to explore the connotation of Nightingale's nursing professionalism. Our survey indicates that Nightingale's nursing professionalism is highly recognized by nurses and nursing students in China. Its connotation includes professional emotion, ability and ethics. Nursing education and nursing management should fully utilize the leading role of Nightingale and guide the professional behaviors of nurses to be consistent with Nightingale's nursing professionalism, thus, improving the degree of nurse professionalism.

The effects on pain, physical function, and quality of life of quadriceps strengthening exercises combined with Baduanjin qigong in older adults with knee osteoarthritis: a quasi-experimental study.

BACKGROUND: Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). However, the best choice for an optimal exercise program able to promote long-term compliance in KOA patients is not clear. This study aims to compare the effect of combined exercise (CE: quadriceps strengthening exercises (QSE) and Baduanjin qigong training (BDJ)) versus QSE alone and BDJ alone on older adults with KOA. METHODS: A three-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from three community centers were assigned respectively to QSE group, BDJ group and CE group. We assessed pain intensity, physical function, self-efficacy, and health-related quality-of-life (HRQoL) using standardized instruments at baseline, 3 months and 6 months follow-up. RESULTS: One hundred and twenty-eight participants with KOA aged over 60 completed the study. Over the 6 months, there were significant group interaction effects on pain intensity (F = 28.888, P < 0.001), physical function (F = 26.646, P < 0.001), and self-efficacy (F = 22.359, P < 0.001), and, based on a short form-12 item health survey questionnaire (SF-12), physical component summary (F = 7.470, P < 0.001), and mental component summary (F = 10.207, P < 0.001). Overall, the CE group exhibited significantly greater improvement in all outcomes when compared to the QSE group and the BDJ group. CONCLUSIONS: CE treatment is more effective than QSE and BDJ in pain relief, increasing physical function, improving self-efficacy, and raising quality-of-life in community-dwelling KOA older adults. Moreover, it promotes long-term compliance in KOA community patients. TRIAL REGISTRATION: Chinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020.

A bibliometric analysis of publication of funded studies in nursing research from Web of Science, 2008-2018.

AIM: To analyse the current status and publication trends of funded studies in nursing-related research from 2008 to 2018, available in the Web of Science. DESIGN: A longitudinal bibliometric analysis of publications of funded studies in nursing-related research, obtained from the Web of Science, was conducted. METHODS: On 10 May 2019, we accessed 77,772 funded studies (2008-2018) from the Web of Science. Bibliometric methods and indicators were used to classify the publications and summarize the overall number, countries/regions, institutions, journals, and other parameters of the publications. RESULTS: The global output of nursing-related funded research publications increased significantly over time. The three leading countries with the highest number of funded publications were the United States, Australia, and the United Kingdom, with the United States accounting for 15 of the top 20 institutions associated with funded publications, which mostly included institutions of higher education. The most common disciplines of these publications were oncology, psychiatry, and paediatrics. The top three journals that published the largest number of nursing-related funded publications were the Journal of Clinical Nursing, the Journal of Advanced Nursing, and the International Journal of Nursing Studies. Keywords with the highest frequency of occurrence included "nurses," "qualitative research," "older people," "quality of life," "depression," "cancer," and "children." CONCLUSIONS: Nursing-related research has been drawing increasing attention over the years. Analysing the output of funded publications and monitoring the new dynamics of the international development of academic research in the field of nursing are crucial for determining future directions of nursing-related research development. IMPACT: The results of this study will provide a reference for scholars to evaluate the current utilization efficiency of global nursing-related research funding and demonstrate the development and trends in nursing-related research.

Transformation of ginsenoside via deep eutectic solvents based on choline chloride as an enzymatic reaction medium.

Ginsenoside compound K (CK) with a wide range of pharmacological activities has been widely used in the healthcare product industry. However, the application of CK is limited by low productivity and difficult separation. The purpose of this study is to convert ginsenoside Rb1 into CK by improving conversion efficiency in novel "green" reaction medium-deep eutectic solvent (DES). Talaromyces purpureogenus was selected from ginseng rhizosphere soil to produce ß-glucosidase with high activity and purity to transform ginsenosides, and Mn2+ was found to be an enzyme promoter. Among the DES based on choline chloride as hydrogen-bond receptor, choline chloride:ethylene glycol (ChCl:EG = 2:1) was the most promising solvent in maintaining enzyme activity and stability. In the presence of 30% v/v ChCl:EG = 2:1, the half-life of ß-glucosidase was increased by 96%, the solubility of F2 was increased by 120%, and CK yield was increased by 54% compared with those in the buffer. Fourier transform infrared, circular dichroism, and fluorescence spectroscopy confirmed that DES did not destroy the structure and conformation of ß-glucosidase. In addition, 80.6% CK conversion was obtained at 60 °C, pH 4.5, 48 h and 8 mM Rb1, which provided a feasible method for efficiently producing CK.

Trends in high-impact papers in nursing research published from 2008 to 2018: A web of science-based bibliometric analysis.

OBJECTIVE: To assess the overall trends in the development and citation impact of high-impact papers in nursing research worldwide to gain insight into the focus areas of nursing research. BACKGROUND: Bibliometric method is proved to be effective in analysing the papers' characteristics, and it gained considerable interest from the scientific community in recent years. An analysis of the characteristics and intrinsic patterns of high-impact papers in nursing research will provide an objective reflection of the research hot spots. Nursing managers can pointedly increase funding amount and strengthen research cooperation in order to put the scientific results into management practice. METHODS: Bibliometric methods and visualization software were used to comprehensively analyse high-impact papers in nursing research in terms of development trends, countries/regions, distribution of subject areas, research institutes, collaborative networks and subject terms. RESULTS: There were 6,886 papers between 2008 and 2018. The number of papers increased from 528 in 2008 to 723 in 2015, and then remained above 600 in 2016 and 2017. These papers were mainly distributed in nursing, oncology, paediatrics, gynaecology, teaching and education, and cardiac and cardiovascular systems and were cited by 128,845 papers that came from 89 Web of Science subject areas. Papers in nursing research accounted for the largest share of these citations. The top five countries in the world in terms of the number of high-impact papers were the United States, Australia, the United Kingdom, Canada and Sweden. The research institutions with the highest number of high-impact papers worldwide were the University of California System, the University of Pennsylvania, the University of North Carolina, the University of London and the University of Technology Sydney. In this data set, it was shown that research collaborative circles have been formed in the United States, Australia, Canada and Europe; the subject-term analysis indicated that 'women' and 'students' have always been high-interest populations for high-impact papers and that cancer is still one of the greatest threats to human health. Furthermore, the subject terms of high-impact papers in nursing research have gradually evolved from 'disease' and 'therapy' to 'symptoms'. CONCLUSION: In recent years, the number of high-impact papers published each year in nursing research has grown over time. Nursing has been shown to be a highly specialized subject, and the majority of its high-impact papers have been published by research institutions. Although cross-regional collaborations are beginning to emerge, there is much room for improvement in this regard. Finally, women, students, cancer and symptomatic care are the current focus areas in nursing research. IMPLICATIONS FOR NURSING MANAGEMENT: This study informs nursing managers within the nursing research field about subject areas, collaborative networks and hot topics. It is beneficial to pay attention to studies, manage scientific outputs, allocate resources, seek cooperation and improve the work efficiency of scientific research management.

The anti-tumor effect of ginsenoside Rh4 in MCF-7 breast cancer cells in vitro and in vivo.

Breast cancer is a tremendous threat to humans in many countries, and thus we need to find safe and effective drugs for treatment. Ginsenoside Rh4 has been reported to be present in processed ginseng. However, few studies have focused on its anti-tumor activity. In this study, we investigated the inhibitory effects of ginsenoside Rh4 on MCF-7 breast cancer cells and the pathways that promote apoptosis in vitro. To study the effect of ginsenoside Rh4 in vivo, xenograft models were randomly divided into 3 groups (the control group, 10 mg/kg/d Rh4, 20 mg/kg/d Rh4, n = 10 per group), the ginsenoside Rh4 injection method was i.p. The results showed that ginsenoside Rh4 effectively inhibited proliferation, arrested the cell cycle in S phase and induced apoptosis in MCF-7 cells by flow cytometry. Morphological changes caused by ginsenoside Rh4-induced apoptosis were also observed by Hoechst 33342 staining. Western-blot analyses indicated that the apoptosis-inducing effects of ginsenoside Rh4 were associated with the external pathway by decreasing Bcl-2, increasing Bax, and activating caspase-8, -3 and PARP. Moreover, ginsenoside Rh4 significantly inhibited the growth of MCF-7 tumor cells in vivo. These results suggested that ginsenoside Rh4 could be a potentially effective anti-tumor drug for breast cancer.

[An intervention study of college student' dietary behavior based on the health action process approach].

OBJECTIVE: To carry out a stage-matched intervention study on dietary behavior based on the Health Action Process Approach( HAPA), in order to verify the effectiveness of the intervention on improving the dietary behavior of college students. METHODS: The study recruited 184 medical university 's students who were admitted between 2013 and 2015 from Shanxi, including 37 males and 147 females to participate the intervention of dietary behavioral based on HAPA from October 2015 to May 2016 by method of random sampling. They were divided into control group( 98) and intervention group( 86). No intervention was conducted on participants in the control group, differentintervention measures were applied to non-intenders, intenders and actors according to their characteristics in intervention group. Epi Data 3. 1 and SPSS 20. 0 were employed to analyze data. RESULTS: After the stage-matched intervention, the proportion of actors in the intervention group increased from 52. 33% to 66. 28%. In the intervention group the scores of participants after intervention were significantly higher than those before intervention, and were also significantly higher after intervention than those from control group in dietary behaviors( P < 0. 001), dietary concepts( P < 0. 001), taste tendency( P < 0. 001, P = 0. 002), eating regular( P < 0. 001) and dietary habits( P = 0. 006, P < 0. 001). In the intervention group, the total scores in dietary behavior at nonintenders( t =-5. 22, P < 0. 001), intenders( t =-13. 69, P < 0. 001) and actors( t =-8. 82, P < 0. 001) after intervention were significantly higher than those before intervention. CONCLUSION: Stage-matched intervention based on the HAPA has a positive effect on improving the dietary behavior of college students.

Thin polymer-layer decorated, structure adjustable crystals of nanoparticles.

Flattened polymer chain decorated crystals of nanoparticles (NPs) are observed for polymer-NP mixtures confined between two parallel substrates. In order to minimize the entropy loss, polymer chains instead of NPs aggregate at the substrate surfaces when the number of NPs is high enough to have the conformation of chains significantly disturbed. Increasing NP concentration to be much higher than that of polymer chains leads to an ordered arrangement of NPs in the central region, which are sandwiched between two thin layers of polymer chains. A scaling model regarding polymer chains consisting of packed correlation blobs is provided to clarify the physics mechanism behind the formation of thin polymer layer and the crystallization of NPs. The order structure of the crystallized NPs is shown to be switchable through an adjustment of the bulk concentrations of polymer chains and NPs.

Visualization analysis of author collaborations in schizophrenia research.

BACKGROUND: Schizophrenia is a serious mental illness that levies a heavy medical toll and cost burden throughout the world. Scientific collaborations are necessary for progress in psychiatric research. However, there have been few publications on scientific collaborations in schizophrenia. The aim of this study was to investigate the extent of author collaborations in schizophrenia research. METHODS: This study used 58,107 records on schizophrenia from 2003 to 2012 which were downloaded from Science Citation Index Expanded (SCI Expanded) via Web of Science. CiteSpace III, an information visualization and analysis software, was used to make a visual analysis. RESULTS: Collaborative author networks within the field of schizophrenia were determined using published documents. We found that external author collaboration networks were more scattered while potential author collaboration networks were more compact. Results from hierarchical clustering analysis showed that the main collaborative field was genetic research in schizophrenia. CONCLUSION: Based on the results, authors belonging to different institutions and in different countries should be encouraged to collaborate in schizophrenia research. This will help researchers focus their studies on key issues, and allow each other to offer reasonable suggestions for making polices and providing scientific evidence to effectively diagnose, prevent, and cure schizophrenia.

Analysis on evolution and research focus in psychiatry field.

BACKGROUND: With the dramatic rise in mental disorders and mental illnesses, psychiatry has become one of the fastest growing clinical medical disciplines. This has led to a rise in the number of scientific research papers being published in this field. METHODS: We selected research papers in ten psychiatric journals that were published during 1983 to 2012. These ten journals were those with the top Impact Factor (IF) as indicated by the Science Citation Index Expanded (SCI-Expanded). We utilized information visualization software (CiteSpace) to conduct co-citation and Hierarchal clustering analysis to map knowledge domains to determine the evolution and the foci of research in this field. RESULTS: In the evolution of the field of psychiatry, there were four stages identified. The result of hierarchal clustering analysis revealed that the research foci in the psychiatric field were primarily studies of child and adolescent psychiatry, diagnostic and classification criteria, brain imaging and molecular genetics. CONCLUSION: The results provide information about the evolution and the foci of the research in the field of psychiatry. This information can help researchers determine the direction of the research in the field of psychiatry; Moreover, this research provides reasonable suggestions to guide research in psychiatry field and provide scientific evidence to aid in the effective prevention and treatment of mental disorders.

[The correlation between carotid stenosis detected by neck vascular ultrasound and branch retinal vein occlusion].

OBJECTIVE: To discuss the clinical significance of the neck vascular ultrasound examination in patients with branch retinal vein occlusion (BRVO). METHODS: Case-control study. Thirty patients of BRVO and 30 healthy subjects with no ophthalmic and systemic symptoms were recruited from January 2010 to January 2012 in the Department of Ophthalmology of the First People's Hospital of Dali Prefecture. The neck vascular ultrasound examination was performed in two groups. The incidence of carotid atheromatous plaque, the rate of carotid stenosis and the carotid artery resistance index (RI) were compared using chi square test. Logistic regression analysis of the rate of carotid stenosis and carotid artery RI were performed. RESULTS: In BRVO group, 23 cases had carotid atheromatous plaque with the incidence of 76.7% Nineteen cases had carotid stenosis with the incidence of 63.3%. The average carotid artery RI was 0.66. In control group, carotid artery atheromatous plaque was found on 6 subjects with incidence of 20.0%. Carotid artery stenosis was detected in 3 subjects with incidence of 10.0%. The average carotid artery RI was 0.61. The incidence of carotid artery atheromatous plaque and carotid stenosis and carotid artery RI in BRVO group were significantly higher than the control group. The difference was statistically significant (P < 0.05). Logistic regression analysis showed that carotid artery stenosis (partial regression coefficien t = 2.263, OR = 9.611, P = 0.004) and carotid artery RI (partial regression coefficien t = 23.713, OR = 669.273, P = 0.006) had influence in BRVO patients as risk factors. CONCLUSION: Early detection of carotid scleratheroma and carotid artery stenosis by the carotid artery ultrasound examination played an important role in prevention or treatment of BRVO.

Ginsenoside Rg5 inhibits lipid accumulation and hepatocyte apoptosis via the Notch1 signaling pathway in NASH mice.

BACKGROUND: Non-alcoholic steatohepatitis (NASH) is a prevalent chronic liver disease that lacks an FDA-approved treatment medicine. Despite the known antitumor and hypoglycemic properties of Ginsenoside Rg5, its effects and underlying mechanisms in the context of NASH remain largely unexplored. PURPOSE: This study aims to investigate the effect of Rg5 on NASH mice induced by a high-fat diet and CCl4. STUDY DESIGN: In vivo experiments, a mouse NASH model was established by a HFHC diet plus intraperitoneal injection of low-dose CCl4. In vitro experiments, a cellular steatosis model was established using free fatty acids (FFA) induced HepG2 cells. In addition, a fibrogenesis model was established using HSC-LX2 cells. METHODS: The effects of Ginsenoside Rg5 on lipid accumulation and oxidative damage were analyzed by ELISA kit, H&E staining, Oil Red O staining, flow cytometry and Western blot. The effects of Ginsenoside Rg5 on liver fibrosis were analyzed by Masson staining, Sirus Red staining, immunohistochemistry and Western blot. The effect of Ginsenoside Rg5 on Notch1 signaling pathway in liver was studied by protein Oil Red staining, protein immunoblotting and immunofluorescence. RESULTS: In terms of lipid accumulation, Rg5 has the ability to regulate key proteins related to lipogenesis, thereby inhibiting hepatic lipid accumulation and oxidative stress. Additionally, Rg5 can reduce the occurrence of hepatocyte apoptosis by regulating the p53 protein. Moreover, after Rg5 intervention, the presence of fibrotic proteins (α-SMA, Collagen 1, TGF-ß) in the liver is significantly suppressed, thus inhibiting liver fibrosis. Lastly, Rg5 leads to a decrease in the expression levels of Notch1 and its ligand Jagged-1 in the liver. CONCLUSION: In summary, the regulatory effects of Rg5 on the Notch1 signaling pathway play a crucial role in modulating hepatic lipid metabolism and preventing hepatocyte apoptosis, thereby impeding the progression of NASH. These findings highlight the potential of Rg5 as a promising natural product for interventions targeting NASH.

Ginsenoside Rh4 alleviates gastrointestinal mucositis and enhances chemotherapy efficacy through modulating gut microbiota.

BACKGROUND: Gastrointestinal mucositis stands as one of the most severe side effects of irinotecan (CPT-11). however, only palliative treatment is available at present. Therefore, there is an urgent need for adjunctive medications to alleviate the side effects of CPT-11. PURPOSE: In this study, our objective was to explore whether ginsenoside Rh4 could serve as a modulator of the gut microbiota and an adjunctive agent for chemotherapy, thereby alleviating the side effects of CPT-11 and augmenting its anti-tumor efficacy. STUDY DESIGN: A CPT-11-induced gastrointestinal mucositis model was used to investigate whether ginsenoside Rh4 alleviated CPT-11-induced gastrointestinal mucositis and enhanced the anti-tumor activity of CPT-11. METHODS: In this study, we utilized CT26 cells to establish a xenograft tumor model, employing transcriptomics, genomics, and metabolomics techniques to investigate the impact of ginsenoside Rh4 on CPT-11-induced gastrointestinal mucositis and the effect on the anti-tumor activity of CPT-11. Furthermore, we explored the pivotal role of gut microbiota and their metabolites through fecal microbiota transplantation (FMT) experiments and supplementation of the key differential metabolite, hyodeoxycholic acid (HDCA). RESULTS: The results showed that ginsenoside Rh4 repaired the impairment of intestinal barrier function and restored intestinal mucosal homeostasis in a gut microbiota-dependent manner. Ginsenoside Rh4 treatment modulated gut microbiota diversity and upregulated the abundance of beneficial bacteria, especially Lactobacillus_reuteri and Akkermansia_muciniphila, which further regulated bile acid biosynthesis, significantly promoted the production of the beneficial secondary bile acid hyodeoxycholic acid (HDCA), thereby alleviating CPT-11-induced gut microbiota dysbiosis. Subsequently, ginsenoside Rh4 further alleviated gastrointestinal mucositis through the TGR5-TLR4-NF-κB signaling pathway. On the other hand, ginsenoside Rh4 combination therapy could further reduce the weight and volume of colon tumors, promote tumor cell apoptosis, and enhance the anti-tumor activity of CPT-11 by inhibiting the PI3K-Akt signaling pathway, thus exerting a synergistic anti-tumor effect. CONCLUSION: In summary, our findings confirm that ginsenoside Rh4 can alleviate CPT-11-induced gastrointestinal mucositis and enhance the anti-tumor activity of CPT-11 by modulating gut microbiota and its related metabolites. Our study validates the potential of ginsenoside Rh4 as a modulator of the gut microbiota and an adjunctive agent for chemotherapy, offering new therapeutic strategies for addressing chemotherapy side effects and improving chemotherapy efficacy.

Ginsenoside Rh4 inhibits colorectal cancer via the modulation of gut microbiota-mediated bile acid metabolism.

INTRODUCTION: Dysbiosis of the gut microbiota is emerging as a pivotal factor in the pathogenesis of colorectal cancer (CRC). Ginsenoside Rh4 (Rh4) is an active compound isolated from ginseng with beneficial effects in modulating intestinal inflammation and gut microbiota dysbiosis, but how Rh4 regulates the gut microbiota to alleviate CRC remains underexplored. OBJECTIVES: We investigated the impact of Rh4 on CRC and the mechanism of its action in inhibiting CRC via modulation of gut microbiota. METHODS: We used the AOM/DSS model and employed transcriptomics, genomics and metabolomics techniques to explore the inhibitory impact of Rh4 on CRC. Furthermore, we employed experiments involving antibiotic treatment and fecal microbiota transplantation (FMT) to investigate the role of the gut microbiota. Finally, we elucidated the pivotal role of key functional bacteria and metabolites regulated by Rh4 in CRC. RESULTS: Our research findings indicated that Rh4 repaired intestinal barrier damage caused by CRC, alleviated intestinal inflammation, and inhibited the development of CRC. Additionally, Rh4 inhibited CRC in a gut microbiota-dependent manner. Rh4 increased the diversity of gut microbiota, enriched the probiotic Akkermansia muciniphila (A. muciniphila), and alleviated gut microbiota dysbiosis caused by CRC. Subsequently, Rh4 regulated A. muciniphila-mediated bile acid metabolism. A. muciniphila promoted the production of UDCA by enhancing the activity of 7α-hydroxysteroid dehydrogenase (7α-HSDH). UDCA further activated FXR, modulated the TLR4-NF-κB signaling pathway, thus inhibiting the development of CRC. CONCLUSION: Our results confirm that Rh4 inhibits CRC in a gut microbiota-dependent manner by modulating gut microbiota-mediated bile acid metabolism and promoting the production of UDCA, which further activates the FXR receptor and regulates the TLR4-NF-κB signaling pathway. Our results confirm that Rh4 has the potential to be used as a modulator of gut microbiota for preventing and treatment of CRC.