Assessing myocardial indices and inflammatory factors to determine anxiety and depression severity in patients with chronic heart failure.

BACKGROUND: Patients with chronic heart failure (CHF) have a progressive disease that is associated with poor quality of life and high mortality. Many patients experience anxiety and depression (A&D) symptoms, which can further accelerate disease progression. We hypothesized that indicators of myocardial function and inflammatory stress may reflect the severity of A&D symptoms in patients with CHF. Changes in these biomarkers could potentially predict whether A&D symptoms will deteriorate further in these individuals. AIM: To measure changes in cardiac and inflammatory markers in patients with CHF to determine A&D severity and predict outcomes. METHODS: We retrospectively analyzed 233 patients with CHF treated at the Jingzhou Hospital, Yangtze University between 2018-2022 and grouped them according to Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. We compared clinical data in the no-A&D, mild-A&D, moderate-A&D, and severe-A&D groups, the SAS and SDS scores with the New York Heart Association (NYHA) functional classification, and cardiac markers and inflammatory factors between the no/mild-A&D and moderate/severe-A&D groups. Regression analysis was performed on the markers with P < 0.05 to determine their ability to predict A&D severity in patients and the area under the receiver operating characteristic curve (AUROC) was used to evaluate their accuracy. RESULTS: In the inter-group comparison, the following variables had an effect on A&D severity in patients with CHF: NYHA class, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, N-terminal pro-brain natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (P < 0.05). Other variables did not differ significantly between the A&D groups (P > 0.05). In addition, we found that higher NYHA classes were associated with higher the SAS and SDS scores (P < 0.05). Regression analysis showed that LVEF, NT-proBNP, and IL-6 were independent risk factors for A&D severity (P < 0.05). Among them, NT-proBNP had the best predictive ability as a single indicator (AUROC = 0.781). Furthermore, the combination of these three indicators exhibited a good predictive effect toward discriminating the extent of A&D severity among patients (AUROC = 0.875). CONCLUSION: Cardiac and inflammatory biomarkers, such as LVEF, NT-proBNP, and IL-6, are correlated with A&D severity in patients with CHF and have predictive value.

Efficacy of traditional Chinese medicine injections for treating idiopathic pulmonary fibrosis: A systematic review and network meta-analysis.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF), acutely or slowly progressing into irreversible pulmonary disease, causes severe damage to patients' lung functions, as well as death. In China, Chinese medicine injections (CMIs) have been generally combined with Western medicine (WM) to treat IPF, which are safe and effective. This study aimed to systematically compare the efficacy of 14 CMIs combined with WM in the treatment of IPF based on a systematic review and network meta-analysis (NMA). MATERIAL AND METHODS: PubMed, Web of Science, Embase, Cochrane Library, MEDLINE, and Chinese databases, including the China National Knowledge Infrastructure, Wanfang Database, Scientific Journal Database, and China Biology Medicine Database were searched from inception to October 31, 2021. The inclusion criterion was randomized controlled trials (RCTs) on CMIs with WM for treating IPF. Reviewers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. RevMan 5.4 software and Stata software (version 16.0) were used for the data analysis. NMA were carried out for calculating the odd ratios (ORs) with 95% confidence intervals (CI), the surface under cumulative ranking curve (SUCRA) and the probabilities of being the best. RESULTS: A total of 63 eligible RCTs involving 14 CMIs were included in this NMA. More CMIs can significantly improve the clinical effectiveness rate (CER); Shuxuening injection (SXN)+WM (OR 8.91, 95% CI 3.81-20.83), Shuxuetong injection (SXT)+WM (OR 7.36, 95% CI 3.30-16.00), Shenxiong injection (SX)+WM (OR 5.42, 95% CI 2.90-10.13), Danhong injection (DH)+WM (OR 4.06, 95% CI 2.62-6.29), and Huangqi injection (HQ)+WM (OR 3.47, 95% CI 1.55-7.77) were the top five treatment strategies. Furthermore, DH +WM ranked relatively high in the SUCRA value of the nine outcome indicators, oxygen partial pressure (PaO2) (OR -13.39; 95% CI -14.90,-11.89; SUCRA 83.7%), carbon dioxide partial pressure (PaCO2) (OR -4.77; 95% CI -5.55,-3.99; SUCRA 83.3), orced vital capacity (FVC) (OR -1.42; 95% CI -2.47,-0.36; SUCRA 73.5%), total lung capacity (TLC) (OR 0.93; 95% CI 0.51,1.36; SUCRA 89.0%), forced expiratory volume 1/ forced vital capacity (FEV1/FVC%) (OR -10.30; 95% CI -12.98,-7.62; SUCRA 72.7%), type III collagen (IIIC) (OR 13.08; 95% CI 5.11,21.05; SUCRA 54.9%), and transforming growth factor (TGF) (OR -4.22; 95% CI -6.06,-2.37; SUCRA 85.7%) respectively, which seems to indicate that DH+WM had the highest likelihood of being the best treatment. CONCLUSIONS: This review specified several CMIs combined with WM in the treatment of IPF in China. In contrast to glucocorticoids or antioxidants, CMIs combined with WM delayed the decline in lung function, maintained oxygenation and quality of life in patients with IPF. The combined use of DH, SXN, SX, and safflower yellow sodium chloride injection (HHS) with WM exerted a more positive effect in treating IPF than WM alone. However, there were limitations to the conclusions of this study due to quality control differences in the included trials.

Explore the effects of pulmonary fibrosis on sperm quality and the role of the PI3K/Akt pathway based on rat model.

Researches were reported that respiratory diseases can lead to male infertility; however, it is unclear whether there is a relationship between pulmonary fibrosis (PF) and male infertility. This study examined the influence of PF on sperm quality and its mechanisms. The key signalling pathway of male infertility caused by PF was predicted based on bioinformatics research. After modelling, we evaluated semen quality. Real-time quantitative polymerase chain reaction and Western blotting were used to measure the protein and mRNA expression levels of phosphatidylinositol 3-kinase (PI3K), phosphorylation-protein kinase B (p-Akt) and B-cell lymphoma 2 (Bcl2) in rat testicular cells. Compared with group A (48.77 ± 4.67; 59.77 ± 4.79), the sperm concentration and total sperm viability of group B (8.44 ± 1.71; 15.39 ± 3.48) showed a downward trend (p < 0.05). Western blotting showed that the protein expressions of PI3K, p-Akt and Bcl2 in the testes of group B (0.30 ± 0.06; 0.27 ± 0.05; 0.15 ± 0.03) was significantly lower than those of group A (0.71 ± 0.07; 0.72 ± 0.06; 0.50 ± 0.06) (p < 0.05). The hypoxic environment induced by PF can inhibit the expression of PI3K, p-Akt and Bcl2 protein and eventually cause dysfunctional spermatogenesis.

Study on the Mechanism of Jiawei Shengjiang Powder in Improving Male Asthma-Induced Asthenospermia Based on Network Pharmacology and Bioinformatics.

BACKGROUND: Jiawei Shengjiang Powder (JWSJP) is a classical Chinese medicinal formula, which has been widely applied in the treatment of asthma and complications for many years due to its curative effect. AIM: To verify the effect of JWSJP in improving abnormal sperm motility caused by asthma and to explore its potential mechanism. MATERIALS AND METHODS: The active compounds of JWSJP were obtained from high performance liquid chromatography tandem mass spectrometry and the Traditional Chinese Medicine System Pharmacology. The key active components and targets of JWSJP were predicted based on network pharmacological analysis and bioinformatics research. Rats were randomly divided into normal, model and treatment groups. The rat model of allergic asthma was induced by intraperitoneal injection of ovalbumin solution. The experiment judged improvement of semen quality by evaluating sperm motility, and detected the expression of related proteins in testicular tissue of Sprague-Dawley rats by RT-qPCR and Western blot methods. Hematoxylin and eosin (HE) staining was used to observe the changes in testicular tissue structure in rats. RESULTS: Through the analysis of network pharmacology and bioinformatics, it was found that beta-sitosterol, quercetin, gallic acid, pelargonidin and kaempferol were the key active components of Jiawei Shengjiang Powder. Tumor necrosis factor (TNF), interleukin-6 (IL-6) and insulin (INS) genes are crucial targets of JWSJP in the treatment of spermatogenic dysfunction caused by acute asthma. After 8 weeks of intervention, compared with the model group, the treatment group had significantly improved sperm motility (P < 0.05). There were significant differences in TNF, IL6, and INS proteins in the treatment group, and the HE staining of testicular tissue structure in the treatment group was significantly improved. CONCLUSION: JWSJP can improve the abnormal sperm motility induced by asthma, and its mechanism may be related to the expression of related proteins and mRNA of TNF, IL6, and INS.

Alkyl caffeates improve the antioxidant activity, antitumor property and oxidation stability of edible oil.

Caffeic acid (CA) is distributed widely in nature and possesses strong antioxidant activity. However, CA has lower solubility in non-polar media, which limits its application in fat-soluble food. To increase the lipophilicity of natural antioxidant CA, a series of alkyl caffeates were synthesized and their antioxidant and antitumor activities were investigated. The antioxidant parameters, including the induction period, acid value and unsaturated fatty acid content, of the alkyl caffeates in edible oil were firstly investigated. The results indicated that alkyl caffeates had a lower DPPH IC50 (14-23 µM) compared to CA, dibutyl hydroxy toluene (BHT) and Vitamin C (24-51 µM), and significantly inhibited four human cancer cells (SW620, SW480, SGC7901 and HepG2) with inhibition ratio of 71.4-78.0% by a MTT assay. With regard to the induction period and acid value assays, methyl and butyl caffeates had higher abilities than BHT to restrain the oxidation process and improve the stability of edible oil. The addition of ethyl caffeate to oil allowed maintenance of a higher unsaturated fatty acid methyl ester content (68.53%) at high temperatures. Overall, the alkyl caffeats with short chain length (n<5) assessed better oxidative stability than those with long chain length. To date, this is the first report to the correlations among the antioxidant activity, anticancer activity and oxidative stability of alkyl caffeates.

A novel continuous flow biosynthesis of caffeic acid phenethyl ester from alkyl caffeate and phenethanol in a packed bed microreactor.

Caffeic acid phenethyl ester (CAPE) is a rare natural ingredient with several biological activity, but the industrial production of CAPE using lipase-catalyzed esterification of caffeic acid (CA) and 2-phenylethanol (PE) in ionic liquids is hindered by low substrate concentrations and a long reaction time. To establish a high-efficiency bioprocess for obtaining CAPE, a novel continuous flow biosynthesis of CAPE from alkyl caffeate and PE in [Bmim][Tf2N] using a packed bed microreactor was successfully carried out. Among the tested alkyl caffeates and lipases, methyl caffeate and Novozym 435, respectively, were selected as the suitable substrate and biocatalyst. Under the optimum conditions selected using response surface methodology, a 93.21% CAPE yield was achieved in 2.5h using a packed bed microreactor, compared to 24h using a batch reactor. The reuse of Novozym 435 for 20 cycles and continuous reaction for 9 days did not result in any decrease in activity.

Rapid synthesis of propyl caffeate in ionic liquid using a packed bed enzyme microreactor under continuous-flow conditions.

Propyl caffeate has the highest antioxidant activity among caffeic acid alkyl esters, but its industrial production via enzymatic transesterification in batch reactors is hindered by a long reaction time (24h). To develop a rapid process for the production of propyl caffeate in high yield, a continuous-flow microreactor composed of a two-piece PDMS in a sandwich-like microchannel structure was designed for the transesterification of methyl caffeate and 1-propanol catalyzed by Novozym 435 in [B mim][CF3SO3]. The maximum yield (99.5%) in the microreactor was achieved in a short period of time (2.5h) with a flow rate of 2 µL/min, which kinetic constant Km was 16 times lower than that of a batch reactor. The results indicated that the use of a continuous-flow packed bed enzyme microreactor is an efficient method of producing propyl caffeate with an overall yield of 84.0%.

A novel chemoenzymatic synthesis of propyl caffeate using lipase-catalyzed transesterification in ionic liquid.

Propyl caffeate has the highest antioxidant capacity in the caffeate alkyl esters family, but industrial production of propyl caffeate is hindered by low yields using either the chemical or enzymatic catalysis method. To set up a high-yield process for obtaining propyl caffeate, a novel chemoenzymatic synthesis method using lipase-catalyzed transesterification of an intermediate methyl caffeate or ethyl caffeate and 1-propanol in ionic liquid was established. The maximum propyl caffeate yield of 98.5% was obtained using lipase-catalyzed transesterification under the following optimal conditions: Novozym 435 as a biocatalyst, [Bmim][CF3SO3] as a medium, a molar ratio of methyl caffeate to 1-propanol of 1:5, a mass ratio of methyl caffeate to lipase of 1:20, and a reaction temperature of 60°C. The two-step conversion of caffeic acid to propyl caffeate via methyl caffeate is an efficient way to prepare propyl caffeate with an overall yield of 82.7%.

[Effect of three-stage sequential method on interleukin-5 mRNA expression in the lung tissue of asthmatic model rat treated with steroid].

OBJECTIVE: To observe the effect of three-stage sequential method (TSSM) on interleukin-5 (IL-5) mRNA expression in the lung tissue of asthmatic rat model treated with steroid. METHODS: SD rats were randomly divided into 8 groups, the normal control group (GA), the model group (GB), the model with steroid intervention group (GC) and the 5 treated groups (GD - GH). Excepting those in the GA, all rats were established into the asthma model and rats in GC-GH were intervened by dexamethasone, with the dosage reduced by 0.1 mg/kg per week starting from the 3rd week and withdrawn completely till the 7th week. At the same time, rats in GD - GH were treated with TSSM, and the 1st, 2nd and 3rd recipe of TSSM, as well as pulmicort respules (as positive control) respectively. IL-5 mRNA expression in the lung tissue of rats was detected at different time points by in situ hybridization. RESULTS: Comparisons of GD with other groups in IL-5 mRNA expression showed: it was remarkably lowered than that in GB and GC at all time points (P < 0.01); compared to GH, the difference was insignificant at the end of the 2nd week, but significant at the end of the 7th and 9th week (P < 0.01); as for the difference between GD with GE, GF and GG, it showed very significant difference (P < 0.01) at all the time points besides that at the end of the 2nd week, it showed insignificance to GE (P > 0.05) and significance to GF (P < 0.05). The dynamic changes of IL-5 mRNA expression in GD during the steroid withdrawal period showed the lowering was more significantly at the end of the 7th and 9th week than that at the end of the 2nd week (P < 0.05, P < 0.01), but its levels were equal at the former two time points; its lowest level appeared at the end of the 9th week, which approaching the level in GA (P > 0.05). CONCLUSION: Three-stage sequential method could remarkably inhibit IL-5 mRNA expression in the lung tissue of asthmatic rats undergoing steroid treatment.

[Effect of three-step sequential method on Th1/Th2 in patients with corticosteroid-dependent asthma].

OBJECTIVE: To investigate the therapeutic mechanism of three-step sequential method (TSSM) on patients with corticosteroid-dependent asthma (SDA). METHODS: Forty patients with SDA were randomly assigned according to the randomizing number table to two groups equally, the treated group treated with three-step sequential recipes plus inhalation of Pulmicort Turbuhaler 200 microg, twice a day, and the control group treated with Pulmicort Turbuhaler alone. The therapeutic course for both groups was 12 - 14 weeks. Changes of the symptom score of asthma, the corticosteroid dosage used and the lung function were observed and the positive expression rate of IFN-gamma and IL-4 in peripheral CD4+ T cells were determined by flow cytometry before and after treatment. RESULTS: There was significant difference in the asthma symptom score, the oral corticosteroid dosage and the lung function between the treated group and the control group after treatment (P < 0.01). The expression rate of Th2 reduced, the ratio of Th1/Th2 increased significantly after treatment in both groups (P < 0.01, P < 0.05), but the changes were more remarkable in the treated group than those in the control group, showing significant difference between them (P < 0.01), while the expression rate of Th1 had no obvious change after treatment with no significant difference shown between the two groups (P > 0.05). CONCLUSION: TSSM can regulate imbalance of Th1/Th2, inhibit generation of inflammatory cytokines, decrease airway hyper-response, and therefore improve the pulmonary function, alleviate the asthmatic symptoms and reduce the patients' dependence on corticosteroid.