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Polyphenols are a group of naturally occurring compounds that possess a range of biological properties capable of potentially mitigating or preventing the progression of age-related cognitive decline and Alzheimer's disease (AD). AD is a chronic neurodegenerative disease known as one of the fast-growing diseases, especially in the elderly population. Moreover, as the primary etiology of dementia, it poses challenges for both familial and societal structures, while also imposing a significant economic strain. There is currently no pharmacological intervention that has demonstrated efficacy in treating AD. While polyphenols have exhibited potential in inhibiting the pathological hallmarks of AD, their limited bioavailability poses a significant challenge in their therapeutic application. Furthermore, in order to address the therapeutic constraints, several polymer nanoparticles are being explored as improved therapeutic delivery systems to optimize the pharmacokinetic characteristics of polyphenols. Polymer nanoparticles have demonstrated advantageous characteristics in facilitating the delivery of polyphenols across the blood-brain barrier, resulting in their efficient distribution within the brain. This review focuses on amyloid-related diseases and the role of polyphenols in them, in addition to discussing the anti-amyloid effects and applications of polyphenol-based polymer nanoparticles.
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Malignant melanoma (MM) is a highly aggressive tumour that can easily metastasize through the lymphatic system at the early stages. Lymph node (LN) involvement and lymphatic vessel (LV) density (LVD) represent a harbinger of an adverse prognosis, indicating a strong link between the state of the lymphatic system and the advancement of MM. Permeable capillary lymphatic vessels are the optimal conduits for melanoma cell (MMC) invasion, and lymphatic endothelial cells (LECs) can also release a variety of chemokines that actively attract MMCs expressing chemokine ligands through a gradient orientation. Moreover, due to the lower oxidative stress environment in the lymph compared with the blood circulation, MMCs are more likely to survive and colonize. The number of LVs surrounding MM is associated with tumour-infiltrating lymphocytes (TILs), which is crucial for the effectiveness of immunotherapy. On the other hand, MMCs can release various endothelial growth factors such as VEGF-C/D-VEGFR3 to mediate LN education and promote lymphangiogenesis. Tumour-derived extracellular vesicles are also used to promote lymphangiogenesis and create a microenvironment that is more conducive to tumour progression. MM is surrounded by a large number of lymphocytes. However, both LECs and MMCs are highly plastic, playing multiple roles in evading immune surveillance. They achieve this by expressing inhibitory ligands or reducing antigen recognition. In recent years, tertiary lymphoid structures have been shown to be associated with response to anti-immune checkpoint therapy, which is often a positive prognostic feature in MM. The present review discusses the interaction between lymphangiogenesis and MM metastasis, and it was concluded that the relationship between LVD and TILs and patient prognosis is analogous to a dynamically tilted scale.
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Deep learning is a machine learning method in the field of artificial intelligence,which simu-lates the workings of the neural network of the human brain to solve complex problems,and has been used in many important researches and applications in the field of medicine,such as diagnostic imaging,biomedical data pro-cessing,drug research and development,personalized medicine,etc.,which improves the accuracy and efficiency of diagnosis and treatment.In the field of assisted reproduction,deep learning could efficiently identify well-grown embryos,suitable oocytes,or sperms during the intervention process,assisting medical staff to make more accu-rate choices to improve pregnancy rates and reduce the risk of multiple pregnancies.This paper summarizes the latest advances in the application of deep learning in the field of assisted reproduction technology in the past 5 years,and provides an outlook for future research.
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OBJECTIVE To investigate the effect of pachymic acid (PA) on renal function and fibrosis in chronic renal failure (CRF) rats and its potential mechanism based on the Ras homolog gene family member A (RhoA)/Rho-associated coiled-coil forming protein kinase (ROCK) signaling pathway. METHODS Using male SD rats as subjects, the CRF model was established by 5/6 nephrectomy; the successfully modeled rats were divided into model group, PA low-dose, medium-dose and high-dose groups (5, 10, 20 mg/kg PA), high-dose PA+ROCK pathway activator lysophosphatidic acid (LPA) group (20 mg/kg PA+1 mg/kg LPA), with 15 rats in each group. Another 15 rats were selected as the sham operation group with only the kidney exposed but not excised. The rats in each drug group were gavaged and/or injected with the corresponding liquid via the caudal vein, once a day, for 12 consecutive weeks. During the experiment, the general condition of rats was observed in each group. After the last administration, the serum renal function indexes (blood urea nitrogen, serum creatinine, uric acid) of rats in each group were detected, the renal histopathological changes were observed; the renal tubule injury score and the area of renal fibrosis were quantified. The levels of oxidative stress indexes [malondialdehyde (MDA), superoxide dismutase (SOD)] and inflammatory factors (tumor necrosis factor-α, interleukin-1β, interleukin-6), the positive expression rates of connective tissue growth factor (CTGF) and collagen Ⅰ were detected as well as the expression levels of pathway-related proteins (RhoA, ROCK1) and fibrosis- related proteins (transforming growth factor-β1, bare corneum homologs 2, α-smooth muscle actin) were determined. RESULTS Compared with the sham operation group, the rats in model group had reduced diet, smaller body size, listless spirit and sluggish response, reduced and atrophied glomeruli, dilated renal tubules with chaotic structure, and a large number of inflammatory cells infiltrated interstitium; the serum levels of renal function indexes, renal tubule injury score, renal fibrosis area proportion, the levels of MDA and inflammatory factors, the positive expression rates of CTGF and collagen Ⅰ, and the expression levels of pathway-related proteins and fibrosis-related proteins in renal tissues were significantly increased, while SOD level was significantly decreased (P<0.05). Compared with the model group, the general condition and pathological injuries of kidney tissue of rats in PA groups were improved to varying degrees,and the above quantitative indexes were significantly improved in a dose-dependent manner (P<0.05). LPA could significantly reverse the improvement effect of PA on the above indicators (P<0.05). CONCLUSIONS PA can improve renal function and alleviate renal fibrosis in CRF rats, which may be related to inhibiting the activation of RhoA/ROCK signaling pathway.
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OBJECTIVE To investigate the effect and mechanism of Astragalus polysaccharide (APS) on peritoneal fibrosis and angiogenesis in rats with peritoneal dialysis (PD). METHODS Rats were randomly divided into normal control group (Control group), model group (PD group), 70 mg/kg APS group (APS-L group), 140 mg/kg APS group (APS-H group), and 140 mg/kg APS+40 mg/kg hypoxia-inducible factor-1α (HIF-1α) agonist DMOG group (APS-H+DMOG group), with 12 rats in each group. PD rat models were constructed in the last four groups of rats. Administration groups were given APS intragastrically and DMOG intraperitoneally. Control group and PD group were given constant volume of normal saline intragastrically, once a day, for 4 consecutive weeks. After the last medication, the peritoneal ultrafiltration (UF), mass transfer of glucose (MTG), the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) were detected in rats; peritoneal histomorphology and peritoneal fibrosis (peritoneal thickness and proportion of collagen fiber deposition) were observed; the microvascular density and the expression levels of α-smooth muscle actin (α-SMA), laminin (LN), HIF-1α and vascular endothelial growth factor (VEGF) proteins were detected in peritoneal tissue of rats. RESULTS Compared with Control group, the mesothelium of rats in the PD group was loosely arranged and shed, inflammatory cells infiltrated, the peritoneal thickness and proportion of collagen fiber deposition were increased significantly (P<0.05). The levels of MTG, Scr and BUN in serum, microvascular density and the expressions of α-SMA, LN, HIF-1α and VEGF proteins were significantly increased, while the level of UF was significantly decreased (P< 0.05); compared with PD group, the levels of above indexes were significantly reversed in APS-L and APS-H groups (P<0.05), and the improvement of APS-H group was better than APS-L group (P<0.05). Compared with APS-H group, the levels of above indexes in APS-H+DMOG group were all reversed (P<0.05). CONCLUSIONS APS inhibits peritoneal fibrosis and angioge-nesis in PD rats by inhibiting HIF-1α/VEGF signaling pathway.
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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.
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OBJECTIVE@#To study effects of Shenmai Injection on hypertensive heart failure and its mechanism for inhibiting myocardial fibrosis.@*METHODS@#Salt-sensitive (Dahl/SS) rats were fed with normal diet (0.3% NaCl) and the high-salt diet (8% NaCl) to observe the changes in blood pressure and heart function, as the control group and the model group. Salt-insensitive rats (SS-13BN) were fed with the high-salt diet (8% NaCl) as the negative control group. After modeling, the model rats were randomly divided into heart failure (HF) group, Shenmai Injection (SMI) group and pirfenidone (PFD) group by a random number table, with 6 rats in each group. They were given sterilized water, SMI and pirfenidone, respectively. Blood pressure, cardiac function, fibrosis and related molecular expression were detected by sphygmomanometer, echocardiogram, enzyme linked immunosorbent assay (ELISA), hematoxylin-eosin staining, Masson staining, immunofluorescence and qPCR analysis.@*RESULTS@#After high-salt feeding, compared with the control and negative control group, in the model group the blood pressure increased significantly, the left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly reduced, and the serum NT-proBNP concentration increased significantly (all P<0.05); furthermore, the arrangement of myocardial cells was disordered, the edema was severe, and the degree of myocardial fibrosis was also significantly increased (P<0.05); the protein and mRNA expressions of collagen type I (Col I) were up-regulated (P<0.05), and the mRNA expressions of transforming growth factor β 1 (TGF- β 1), Smad2 and Smad3 were significantly up-regulated (P<0.05). Compared with HF group, after intervention of Shenmai Injection, LVEF and LVFS increased, myocardial morphology was improved, collagen volume fraction decreased significantly (P<0.05), and the mRNA expressions of Col I, TGF- β 1, Smad2 and Smad3, as well as Col I protein expression, were all significantly down-regulated (all P<0.05).@*CONCLUSION@#Myocardial fibrosis is the main pathological manifestation of hypertensive heart failure, and Shenmai Injection could inhibit myocardial fibrosis and effectively improve heart failure by regulating TGF-β 1/Smad signaling pathway.
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Rats , Animals , Stroke Volume , Sodium Chloride , Rats, Inbred Dahl , Ventricular Function, Left , Heart Failure , Transforming Growth Factor beta1/metabolism , Hypertension , Fibrosis , RNA, MessengerABSTRACT
Objective: To evaluate the diagnostic value of serum human-βeta-defensin-1 level (HBD-1) for short-term (28-day) prognosis in patients with acute-on-chronic liver failure (ACLF). Methods: Fifty cases diagnosed with ACLF were selected. 20 cases with decompensated cirrhosis and 20 cases with compensated cirrhosis who were admitted at the same time were included. Age, gender, serum HBD-1 level, C-reactive protein (CRP), procalcitonin (PCT), neutrophil count/lymphocyte ratio (NLR), blood routine, coagulation function, liver function, kidney function, and other indicators from the three groups of patients were collected. Patients with ACLF were screened for indicators related to the short-term (28-day) prognosis. Patients were divided into an improvement group and a worsening group according to the 28-day disease outcome. The serum HBD-1 level and other above-mentioned indicators were compared between the two patient groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of serum HBD-1 levels for short-term prognosis in patients with ACLF. PCT, NLR, and prothrombin activity (PTA) application as a mono indicator and HBD-1 in combination with NLR, PCT, and PTA were compared to evaluate diagnostic efficacy for short-term prognosis in patients with ACLF. The intergroup mean of measurement data was determined using a t-test or analysis of variance. χ (2) test was used for comparison of count data. Spearman's rank correlation analysis was used for correlation analysis. Results: There was no statistically significant difference in age and gender among the three groups: ACLF, decompensated cirrhosis, and compensated cirrhosis (P > 0.05). The expression levels of serum HBD-1 in the ACLF group, decompensated cirrhosis group, and compensated cirrhosis group were (319.1 ± 44.4) ng/ml, (264.5 ± 46.5) ng/ml and (240.1 ± 35.4) ng/ml, respectively, while the ACLF group expression levels were significantly increased, with statistical significance (P < 0.01).The serum HBD-1 level was significantly higher in the ACLF worsening group (346.2 ± 43.6) ng/ml than that in the improvement group (308.5 ± 40.6) ng/ml, and the difference was statistically significant (P < 0.05). Correlation analysis showed that HBD-1, NLR, PCT, prothrombin time (PT), and international standardized ratio (INR) were negatively correlated with the 28-day disease outcome (improvement) of patients (P < 0.05). PTA was positively correlated with 28-day disease outcome (improvement) (P < 0.05). The area under the receiver operating characteristic curve (AUC) for evaluating HBD-1's diagnostic efficacy for short-term prognosis in patients with ACLF was 0.774, with a sensitivity of 0.750, a specificity of 0.786, and a cut-off point of 337.96 ng/ml. PCT, NLR, and PTA had greater diagnostic efficacy. HBD-1 combined with PTA had the highest diagnostic efficacy, with an AUC of 0.802, a sensitivity of 0.778, and a specificity of 0.786. The diagnostic efficacy of HBD-1+PCT, HBD-1+NLR and HBD-1, PCT, and NCR was superior to PTA mono. Conclusion: The serum HBD-1 level gradually increases with the aggravation of liver function injury and is negatively correlated with the short-term prognosis in patients with ACLF. Serum HBD-1 level has high sensitivity and specificity in predicting short-term prognosis in patients with ACLF, and its diagnostic efficacy is superior to that of PCT, NLR, and PTA. The combined application of HBD-1 and PTA has higher diagnostic efficacy; however, when the serum HBD-1 level is greater than 337.96ng/ml, it indicates poor prognosis in patients.
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Humans , Acute-On-Chronic Liver Failure/diagnosis , Prognosis , Liver Cirrhosis , C-Reactive Protein/analysis , ROC Curve , Defensins , Retrospective StudiesABSTRACT
This study aims to objectively and quantitatively analyze the research status and hot spots of Chuanxiong Rhizoma and provide guidance for further research and clinical application of this herbal medicine. Firstly, the research articles involving Chuanxiong Rhizoma from 2010 to 2023 were retrieved from seven databases including Web of Science, PubMed, Medline, CNKI, VIP, Wanfang, and SinoMed. Then, NoteExpress and manual reading were employed to complete the de-duplication and screening of the articles, and the annual number of publications and journals was analyzed. Finally, CiteSpace was used for systematic analysis of the research institutions, authors, and keywords, and the corresponding knowledge maps were established. After screening, 1 137 articles in Chinese and 433 articles in English were included, and the annual number of publications showed an increasing trend. Chinese Journal of Experimental Traditional Medical Formulae and Journal of Ethnopharmacology were the top Chinese and English journal in the number of publications. Chengdu University of Traditional Chinese Medicine and Nanjing University of Chinese Medicine published the most articles in Chinese and English, respectively. PENG Cheng and FENG Yi were the authors published more articles in Chinese and English. Ferulic acid, signaling pathway, mechanism, headache, ligustrazine, and apoptosis were frequent keywords. A total of 20 clusters and 30 bursts were generated. The comprehensive analysis showed that the research trends and hot spots in this field mainly focused on pharmacological components and isolation, pharmacological effects and mechanism, clinical application and efficacy, compatibility and efficacy of drug pairs, quality evaluation and control, and cultivation and germplasm improvement.
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Medicine, Chinese Traditional , Drugs, Chinese Herbal/therapeutic use , Rhizome , Publications , MedicineABSTRACT
Chronic heart failure is the end stage of heart diseases caused by multiple causes. Myocardial cell injury is the key cause of cardiac function deterioration. Ferroptosis, an iron-dependent programmed death mode, is characterized by iron overload and excessive accumulation of lipid peroxides. Studies have demonstrated that inhibiting ferroptosis has a protective effect on myocardial cells. The theory of "harmful hyperactivity and responding inhibition" is an important rule developed by physicians to explain the generation and restriction of the five elements and the pathological imbalance of the human body, and can guide medication. Correlating with the nature, humans need to rely on the law of responding inhibition to maintain the harmony of five Zang-organs and the steady state of Fu-organs. The pathogenesis of ferroptosis in chronic heart failure highly coincides with the process of failing to "inhibition and hyperactivity becoming harmful". The initial factor of ferroptosis is the deficiency of heart Qi, which results in the inability to maintain the balance of cardiomyocyte redox system. The involvement of the five Zang-organs leads to the loss of distribution of body fluid and blood. As a result, the phlegm turbidity, blood stasis, and water retention in the meridians occur, which are manifested as the accumulation of iron and lipid peroxides, which is the aggravating factor of ferroptosis. The two factors interact with each other, leading to the spiral development and thus aggravating heart failure. According to the traditional Chinese medicine(TCM) pathogenesis of ferroptosis, the authors try to treat the chronic heart failure by stages in accordance with the general principle of restraining excess and alleviating hyperactivity. The early-stage treatment should "nourish heart Qi, regulate the five Zang-organs, so as to restrain excess". The middle-stage treatment should "active blood, resolve phlegm, dispel pathogen, and eliminate turbidity", so as to alleviate hyperactivity. The late-stage treatment should "warm Yang, replenish Qi, active blood, and excrete water". Following the characteristics of pathogenesis, the TCM intervention can reduce iron accumulation and promote the clearance of lipid peroxide, thus inhibiting ferroptosis and improving cardiac function.
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Humans , Ferroptosis , Lipid Peroxides , Medicine, Chinese Traditional , Heart Failure/drug therapy , Chronic Disease , Iron , WaterABSTRACT
This study aims to investigate the pathogenesis of chronic heart failure based on ferroptosis-mediated oxidative stress and predict the targets of Shenfu Injection in treating chronic heart failure. A rat model of chronic heart failure was established by the isoproterenol induction method. According to the random number table method, the modeled rats were assigned into three groups: a model group, a Shenfu Injection group, and a ferrostatin-1(ferroptosis inhibitor) group. In addition, a normal group was designed. After 15 days of intervention, the cardiac mass index and left ventricular mass index were determined. Echocardiography was employed to eva-luate the cardiac function. Hematoxylin-eosin staining and Masson staining were employed to reveal the pathological changes and fibrosis of the heart, and Prussian blue staining to detect the aggregation of iron ions in the myocardial tissue. Transmission electron microscopy was employed to observe the mitochondrion ultrastructure in the myocardial tissue. Colorimetry was adopted to measure the levels of iron metabolism, lipid peroxidation, and antioxidant indicators. Flow cytometry was employed to measure the content of lipid-reactive oxygen species(ROS) and the fluorescence intensity of ROS. Western blot and RT-qPCR were employed to determine the protein and mRNA levels, respectively, of ferroptosis-related factors in the myocardial tissue. The results showed that the rats in the model group had reduced cardiac function, elevated levels of total iron and Fe~(2+), lowered level of glutathione(GSH), increased malondialdehyde(MDA), decreased superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px), and rising levels of ROS and lipid-ROS. In addition, the model group showed fibrous tissue hyperplasia with inflammatory cell infiltration and myocardial fibrosis, iron ion aggregation, and characteristic mitochondrial changes specific for iron death. Moreover, the model group showcased upregulated protein and mRNA levels of p53 and COX2 and downregulated protein and mRNA levels of GPX4, FTH1, SLC7A11, and Nrf2 in the myocardial tissue. The intervention with Shenfu Injection significantly improved the cardiac function, recovered the iron metabolism, lipid peroxidation, and antioxidant indicators, decreased iron deposition, improved mitochondrial structure and function, and alleviated inflammatory cell infiltration and fibrosis. Furthermore, Shenfu Injection downregulated the mRNA and protein levels of p53 and COX2 and upregulated the mRNA and protein levels of GPX4, FTH1, SLC7A11, and Nrf2 in the myocardial tissue. Shenfu Injection can improve the cardiac function by regulating iron metabolism, inhibiting ferroptosis, and reducing oxidative stress injury.
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Animals , Rats , Antioxidants , Reactive Oxygen Species , Cyclooxygenase 2 , Ferroptosis , NF-E2-Related Factor 2 , Tumor Suppressor Protein p53 , Heart Failure/genetics , Oxidative Stress , Chronic Disease , Glutathione , Fibrosis , Iron , RNA, Messenger , LipidsABSTRACT
This study aimed to investigate the mechanism and target sites of Shenfu Injection in the intervention of chronic heart fai-lure based on the PI3K/Akt/mTOR autophagy signaling pathway. The chronic heart failure model was induced in rats by subcutaneous injection of isoproterenol. The model rats were randomly divided into model group, Shenfu Injection group, and 3-methyladenine autophagy inhibitor(3-MA) group. A normal group was also set up. After 15 days of administration, cardiac function indexes of the rats were detected by echocardiography. The serum N-terminal pro-B-type natriuretic peptide(NT-proBNP) levels were measured using the ELISA. HE and Masson staining was performed to observe the morphological changes in myocardial tissues, and electron microscopy was used to observe the autophagosomes in myocardial tissues. Western blot was conducted to measure the changes in autophagy-related proteins(LC3 Ⅱ/Ⅰ and p62), PI3K, Akt, mTOR, and phosphorylation levels. The results showed that compared with normal group, model group in rats led to reduced cardiac function, significant activation of cardiac autophagy, increased fibrotic lesions in myocardial tissues, structural disorder of the myocardium, increased autophagosomes, and cytoplasmic vacuolization. Compared with model group, Shenfu Injection group in rats led to cardiac function significantly improved, myocardial fibrosis decreased, and the number of autophagosomes and cytoplasmic vacuolization decreased. The phosphorylation levels of PI3K, Akt, and mTOR were significantly increased(P<0.01). In the 3-MA group, autophagy was inhibited through the activation of the PI3K/Akt/mTOR signaling pathway, resulting in improved cardiac function, reduced myocardial fibrosis, and no significant cytoplasmic vacuolization. The findings suggest that Shenfu Injection can activate the PI3K/Akt/mTOR signaling pathway and inhibit autophagy, thereby improving cardiac function.
Subject(s)
Rats , Animals , Proto-Oncogene Proteins c-akt/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Rats, Sprague-Dawley , TOR Serine-Threonine Kinases/metabolism , Heart Failure/drug therapy , Autophagy , FibrosisABSTRACT
This study investigated the mechanisms and targets of Shenfu Injection in the intervention in chronic heart failure(CHF) through the NOD-like receptor thermal protein domain associated protein 3(NLRP3)/caspase-1 signaling pathway. A CHF model was induced in rats by subcutaneous injection of isoproterenol. Model rats were randomly divided into a model group, a Shenfu Injection group, and a MCC950(NLRP3 inhibitor) group, and a blank group was also set up as a control. After 15 days of treatment, echocardiography was performed to measure cardiac function parameters [left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS)]. Enzyme-linked immunosorbent assay(ELISA) was used to measure serum levels of N-terminal pro-brain natriuretic peptide(NT-proBNP), interleukin(IL)-1β, and IL-18. Hematoxylin-eosin(HE) and Masson staining were used to observe morphological changes in myocardial tissues, and Western blot was used to measure the expression levels of NLRP3/caspase-1 pathway-related proteins [NLRP3, caspase-1, apoptosis-associated speck-like protein containing a CARD(ASC), gasdermin D(GSDMD), IL-1β, and IL-18]. The study found that isoproterenol-induced CHF in rats resulted in decreased cardiac function, worsened myocardial fibrosis, increased expression levels of NLRP3, ASC, caspase-1, GSDMD-N, IL-1β, and IL-18 in myocardial tissues, elevated serum inflammatory factors, and induced myocardial cell pyroptosis. Following Shenfu Injection intervention, the Shenfu Injection group showed significantly improved LVEF and LVFS, a significant decrease in NT-proBNP, a marked downregulation of NLRP3, ASC, caspase-1, GSDMD-N, IL-1β, and IL-18 protein expression levels, reduced serum inflammatory factors IL-1β and IL-18 expression in CHF rats, and a decrease in the rate of TUNEL-positive cells. Shenfu Injection can significantly improve cardiac function in CHF, inhibit myocardial fibrosis, and alleviate the progression of myocardial cell pyroptosis through the inhibition of the NLRP3/caspase-1 pathway.
Subject(s)
Rats , Animals , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Pyroptosis , Interleukin-18/metabolism , Caspase 1/metabolism , Stroke Volume , Isoproterenol , Ventricular Function, Left , Heart Failure/drug therapy , Fibrosis , Drugs, Chinese HerbalABSTRACT
Self-assembling carrier-free nanodrugs are attractive agents because they accumulate at tumor by an enhanced permeability and retention (EPR) effect without introduction of inactive substances, and some nanodrugs can alter the immune environment. We synthesized a peptidyl arginine deiminase 4 (PAD4) molecular inhibitor, ZD-E-1M. It could self-assembled into nanodrug ZD-E-1. Using confocal laser scanning microscopy, we observed its cellular colocalization, PAD4 activity and neutrophil extracellular traps (NETs) formation. The populations of immune cells and expression of immune-related proteins were determined by single-cell mass cytometry. ZD-E-1 formed nanoflowers in an acidic environment, whereas it formed nanospheres at pH 7.4. Accumulation of ZD-E-1 at tumor was pH-responsive because of its pH-dependent differences in the size and shape. It could enter the nucleus and bind to PAD4 to prolong the intracellular retention time. In mice, ZD-E-1 inhibited tumor growth and metastasis by inhibiting PAD4 activity and NETs formation. Besides, ZD-E-1 could regulate the ratio of immune cells in LLC tumor-bearing mice. Immunosuppressive proteins like LAG3 were suppressed, while IFN-γ and TNF-α as stimulators of tumor immune response were upregulated. Overall, ZD-E-1 is a self-assembling carrier-free nanodrug that responds to pH, inhibits PAD4 activity, blocks neutrophil extracellular traps formation, and improves the tumor immune microenvironment.
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ObjectiveTo study the pathological process and changes of metabolites in myocardial tissue of heart failure induced by transverse aortic constriction (TAC) in rats. MethodRats were treated with TAC operation and divided into TAC-30 d group and TAC-60 d group, and sham operation group at the same period was set up as control. Echocardiography and pathological staining of myocardial tissue were performed on rats in each group. Enzyme-linked immunosorbent assay was used to determine the expression of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and adenosine triphosphate (ATP) in serum. Liquid chromatography-mass spectrometry was used to observe the changes of metabolites and related pathways in myocardial tissue, the mobile phase consisted of 25 mmol·L-1 ammonium acetate and 25 mmol·L-1 ammonia hydroxide in water (A) and acetonitrile (B) for gradient elution (0-0.5 min, 95%B; 0.5-7 min, 95%-65%B; 7-8 min, 65%-40%B; 8-9 min, 40%B; 9-9.1 min, 40%-95%B; 9.1-12 min, 95%B), electrospray ionization was used under positive and negative ion detection modes, acquisition range was m/z 70-1 050. ResultCompared with the sham-30 d group, the left ventricular internal diameter at end-systole (LVIDs) in TAC-30 d group was significantly decreased (P<0.01), and left ventricular ejection fraction (LVEF), fraction shortening (FS), left ventricular end-diastolic posterior wall thickness (LVPWd), left vebtricular end-systolic posterior wall thickness (LVPWs) were significantly increased (P<0.01), there were cardiomyocyte arrangement disorder, edema, collagen fibre hyperplasia, the content of NT-probNP was significantly increased, while the content of ATP was significantly decreased (P<0.01), and 15 metabolites with abnormal expression were involved in pyrimidine metabolic pathway, pantothenic acid and coenzyme A biosynthesis pathway. Compared with the sham-60 d group, LVEF and FS in the TAC-60 d group were significantly decreased (P<0.01), and left ventricular internal diameter at end-diastole (LVIDd), LVIDs and LVPWd were increased (P<0.05, P<0.01), the edema of myocardial cells increased obviously, myocardium fibers degenerated, coagulation necrosis appeared, and a large amount of collagen fibers were deposited, the expression of NT-proBNP increased and the expression of ATP decreased (P<0.01), there were 21 metabolites with abnormal expression, involving pyrimidine metabolic pathway, and starch and sucrose metabolic pathway. ConclusionAt 30 d after TAC, there are myocardial hypertrophy, lipid metabolism disorder, pyrimidine metabolism disorder and energy imbalance. At 60 d after TAC, there are heart failure, aggravation of lipid metabolism disorder, excessive activation of glucose metabolism, and continuous disorder of pyrimidine metabolism.
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Hyperthyroidism is a systemic disease characterized by clinical signs and symptoms of hypermetabolism and sympathetic nervous excitement. Based on the clinical diagnostic criteria of traditional Chinese and western medicine for hyperthyroidism,the present study summarized and evaluated animal models of hyperthyroidism. In model evaluation,the models with high coincidence degree in western medicine included the exogenous drug delivery model, the model immune to adenovirus expressing thyrotropin receptor (TSHR),the model immune to nucleic acid, and the model of yin deficiency and effulgent fire syndrome in the disease-syndrome combination. The models with high coincidence degrees in traditional Chinese medicine included the exogenous drug delivery model, the model immune to adenovirus expressing TSHR,and the model of liver-yang ascendant hyperactivity syndrome and the model of yin deficiency and effulgent fire syndrome in the disease-syndrome combination. In light of the coincidence degree, and advantages and disadvantages of traditional Chinese and western medicine,the ideal hyperthyroidism animal models are the exogenous drug delivery model, and the model immune to adenovirus expressing TSHR. In addition to the evaluation of the coincidence degree of animal models of hyperthyroidism in traditional Chinese and western medicine,this study also analyzed the advantages,disadvantages, and problems of the animal models of hyperthyroidism. Most of the animal models of hyperthyroidism were not consistent with the complexity of hyperthyroidism in clinical practice, and standardized and unified syndrome differentiation standards and four-examination information collection standards have not yet been formed. Besides, there have been few studies on the hyperthyroidism model in disease-syndrome combination in traditional Chinese medicine. To make the animal models of hyperthyroidism suitable for clinical practice,the present study proposed the improvement directions of animal models of hyperthyroidism and the necessity of promoting the evaluation system to provide a theoretical basis for the evaluation of the curative effect of Chinese medicine on hyperthyroidism, and exploration of its pharmacological action, as well as the follow-up research on the pathogenesis,prevention, and treatment of hyperthyroidism,which is expected to establish a perfect disease-syndrome model of hyperthyroidism in line with clinical characteristics of traditional Chinese and western medicine.
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Inflammation is the key pathogenic feature of heart failure (HF), and its overexpression can cause myocardial hypertrophy, apoptosis and fibrosis, aggravating the process of HF. Macrophages are important immune cells in human body with high heterogeneity, which involve in inflammation response and maintain heart homeostasis. Macrophage polarization is a dynamic process. Under the stimulation of different microenvironment, it can polarize two subsets, including classically activated M1 type and alternatively activated M2 type, which are antagonistic to each other. When macrophages polarize into the pro-inflammatory phenotype (M1), the inflammatory response is initiated, the anti-inflammatory phenotype (M2) plays a role in inhibiting inflammation and repairing tissue. At the same time, in different stages of development of HF, M1 and M2 macrophages can be transformed into each other, which is similar to the connotation of Yin-yang restriction, balance and transformation of traditional Chinese medicine (TCM) theory. Based on this, this paper intends to clarify the relationship between M1 and M2 macrophages by Yin-yang theory, proposing that the clinical prevention and treatment of HF should pay attention to regulating micro and macro inflammatory responses, regulating macrophage polarization, and achieving the balance between anti-inflammatory and pro-inflammation, which is consistent with the balance of Yin-yang in TCM theory. It can provide a new target and direction for TCM treatment of HF.
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Chronic heart failure is a serious heart disease with dyspnea and limited activity tolerance as the main clinical manifestations. Autophagy is a self-protection mechanism in eukaryotic cells and plays an important role in the development of heart failure. Appropriately increasing the level of autophagy during the compensated stage of heart failure and timely removal of necrotic myocardial organelles and other harmful garbage can inhibit myocardial hypertrophy to a certain extent,alleviate myocardial remodeling,and delay heart failure. The theory of healthy Qi and pathogenic Qi is an important basic theory for explaining the occurrence of diseases,and struggle between healthy Qi and pathogenic Qi exists in the entire onset of chronic heart failure,which may lead to pathogenic Qi invasion and healthy Qi deficiency. The regulatory effect of autophagy on cardiomyocytes is similar to the theory of healthy Qi and pathogenic Qi in traditional Chinese medicine (TCM). Autophagy is the body's self-regulatory mechanism for healthy Qi and pathogenic Qi in a dose-effect manner,Specifically,autophagy can only protect the body's cells to a certain extent,and healthy Qi can only take effect within a certain range and degree. To protect the body from external pathogenic factors,excessive or insufficient autophagy may destroy the stability of the body's environment. In this regard,we use the theory of healthy Qi and pathogenic Qi as a starting point to clarify the function of autophagy in the development of chronic heart failure from a macro and micro perspective,and propose adjusting the balance of healthy Qi and pathogenic Qi in the body to regulate the autophagy of cardiomyocytes. The principle of prevention and treatment is expected to lay the foundation for modern research on the function of autophagy in the development of chronic heart failure in TCM,find novel therapy for chronic heart failure at different stages,and provide new insights into the diagnosis and treatment of chronic heart failure.
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Objective@#To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose. @*Materials and Methods@#This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared.The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland–Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared. @*Results@#No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0–232.28) and C (median, 60.25; IQR, 0–195.20) (p = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0–120.73) was significantly underestimated compared with that for protocol A (p < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, p < 0.001) from that associated with the standard 120 kVp mode. @*Conclusion@#The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.
ABSTRACT
Objective Based on the anthropomorphic phantom experiment and Monte Carlo simulation, the patients’ skin dose, professionals’ dose, and spatial distribution of DSA (Digital Subtraction Angiography) radiation field in an intervention procedure, was performed, in order to provide the basis for the inference of patients’ skin injury and professionals’ radiation protection in intervention procedure. Methods In the simulation experiment, a PBU-60 anthropomorphic phantom was used as the patient and the skin dose of patient’s abdomen was measured by TLD (Thermoluminescence Dosimeters). X-ray and gamma radiation dosimeter (AT1121) was applied to measure the spatial distribution of DSA radiation field, which was verified using Monte Carlo software MCNP meanwhile. Furthermore, the radiation dosimetry of operative staffs at different stations and under different protection conditions was studied experimentally. Results The experimental measurements showed that the maximum skin dose of patients every 5-minute fluoroscopy was 18.62 mGy under the irradiation of PA in an abdominal interventional procedure. The results of Monte Carlo simulation and measurement experiments showed that the spatial distribution of DSA radiation fieldis similar to the butterfly distribution, which is related to distance and angle. The experimental results showed that the dose rate decreases exponentially with the increase of lead equivalent. Conclusion It is very significant to carry out skin dose measurementof patients during interventional surgery and follow-up patients with high dose after surgery. In interventional surgery, doctors should try to avoid the station of high dose rate. However, it is necessary to strengthen the radiation protection of the operator and the first assistant. Under the dual protections of bedside lead protective equipment and personal protective equipment, the exposure dose of intervention personnel can be significantly reduced.