OBJECTIVE：To evaluate inhibition effect and mech- anism of compound ethanol extracts from Wuweizi （Fructus Schisandrae Chinensis）, Chuanxiong （Rhi- zoma Chuanxiong） and Muli （Cocha Ostreae） （FRC） on glomerula...OBJECTIVE：To evaluate inhibition effect and mech- anism of compound ethanol extracts from Wuweizi （Fructus Schisandrae Chinensis）, Chuanxiong （Rhi- zoma Chuanxiong） and Muli （Cocha Ostreae） （FRC） on glomerular and tubular interstitial fibrosis in streptozocin （STZ）-induced diabetic nephropathy （ND） model mice. METHODS： Twenty-seven male C57BL/6 mice were divided randomly into 3 groups： nondibetic （ND）, STZ-induced diabetic （D）, and STZ-induced diabetic that were treated with .5 g. kg1. daylof FRC by oral gavage （DFRc）, with 9 in each group. The protein ex- pressions of E-cadherin, a-smooth muscle actin （a-SMA）, Plasminogen Activator Inhibitor-1 （PAl-l） in renal tissues were investigated by Western blot- ting. The expressions of fibronectin （FN） and o-SMA were detected by immunohistochemical method. The morphological changes of renal tissues were observed under a microscope. RESULTS： Renal tissues in the DFRC group showed a lessened degree of fibrosis. Meanwhile, the expres- sions of FN, o-SMA and PAl-lwere significantly lower in the DrRc group than those in the D group （all P〈0.05）.CONCLUSION： FRC can ameliorate the DN in the C57BL/6 mice, and its mechanism may relate to in- hibition on the epithelial to mesenchymal transdif- ferentiation, endothelial-myofibroblast transition and PAl-1 expression.展开更多
OBJECTIVE:To determine the effect of Wenyang Huazhuo Fang(WHF),a Traditional Chinese Medicine decoction,on renal function in a rat model of doxorubicin-induced nephropathy,and to elucidate the underlying mechanism.MET...OBJECTIVE:To determine the effect of Wenyang Huazhuo Fang(WHF),a Traditional Chinese Medicine decoction,on renal function in a rat model of doxorubicin-induced nephropathy,and to elucidate the underlying mechanism.METHODS:Sprague-Dawley rats were randomly divided into six groups:control,doxorubicin-nephropathy,and prednisone-treated(6.45 mg·kg^-1·d^-1)doxorubicin nephropathy groups,as well as high-(7.26 g·kg^-1·d^-1),medium-(2.42 g·kg-1·d-),and low-dose(0.81 g·kg^-1·d^-1)WHF-treated doxorubicin-nephropathy groups.The nephropathy rat model was established by two tail vein injections of doxorubicin,followed by prednisone or WHF treatment for 8 weeks.Body weights were monitored and urinary protein was measured every 2 weeks.After the end of the treatment period,the rats were euthanized.Serum biochemical indicators were determined and renal morphological alterations were assessed using histological staining.The expression of transient receptor potential cation channel subfamily C member 6(TRPC6),stromal interaction molecule 1(STIM1),and calcium release-activated calcium channel protein 1(Orai1)was detected using western blotting,and their mRNA levels were examined using quantitative real-time reverse transcription-polymerase chain reaction.RESULTS:WHF treatment was found to significantly ameliorate weight loss,proteinuria,hypoalbuminemia,and dyslipidemia in doxorubicin-nephropathy rats.The protein and mRNA levels of TRPC6,STIM1,and Orai1 were partially,but significantly suppressed by prednisone or WHF treatment.CONCLUSION:Treatment with WHF significantly ameliorates renal injury in a rat model of doxorubicin-induced nephropathy,which could be at least partially related to repression of the TRPC6 pathway.展开更多
OBJECTIVE:To examine the nephroprotective mechanism of modified Huangqi Chifeng decoction(加味黄芪赤风汤,MHCD)in immunoglobulin A nephropathy(IgAN)rats.METHODS:To establish the IgAN rat model,the bovine serum albumin,...OBJECTIVE:To examine the nephroprotective mechanism of modified Huangqi Chifeng decoction(加味黄芪赤风汤,MHCD)in immunoglobulin A nephropathy(IgAN)rats.METHODS:To establish the IgAN rat model,the bovine serum albumin,lipopolysaccharide,and carbon tetrachloride 4 method was employed.The rats were then randomly assigned to the control,model,telmisartan,and high-,medium-,and low-dose MHCD groups,and were administered the respective treatments via intragastric administration for 8 weeks.The levels of 24-h urinary protein,serum creatinine(CRE),and blood urea nitrogen(BUN)were measured in each group.Pathological alterations were detected.IgA deposition was visualized through the use of immunofluorescence staining.The ultrastructure of the kidney was observed using a transmission electron microscope.The expression levels of interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),and transforming growth factor-β1(TGF-β1)were examined by immunohistochemistry and quantitative polymerase chain reaction.Levels of toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),and nuclear factor-kappa B(NF-κB)P65,were examined by immunohistochemistry,Western blotting,and quantitative polymerase chain reaction.RESULTS:The 24-h urine protein level in each group increased significantly at week 6,and worsen from then on.But this process can be reversed by treatments of telmisartan,and high-,medium-,and low-dose of MHCD,and these treatments did not affect renal function.Telmisartan,and high-,and medium-dose of MHCD reduced IgA deposition.Renal histopathology demonstrated the protective effect of high-,medium-,and low-dose of MHCD against kidney injury.The expression levels of MCP-1,IL-6,and TGF-β1 in kidney tissues were downregulated by low,medium and high doses of MHCD treatment.Additionally,treatment of low,medium and high doses of MHCD decreased the protein and mRNA levels of TLR4,MyD88,and NF-κB.CONCLUSIONS:MHCD exerted nephroprotective effects on IgAN rats,and MHCD regulated the expressions of key targets in TLR4/MyD88/NF-κB signaling pathway,thereby alleviating renal inflammation by inhibiting MCP-1,IL-6 expressions,and ameliorating renal fibrosis by inhibiting TGF-β1 expression.展开更多
Objective: We prospectively investigated 121 renal allograft biopsy specimens performed in our center. Methods: BKVAN was diagnosed by light microscopic examination and a positive immunohistochemistry staining of anti...Objective: We prospectively investigated 121 renal allograft biopsy specimens performed in our center. Methods: BKVAN was diagnosed by light microscopic examination and a positive immunohistochemistry staining of anti-SV40 large T antibody in a biopsy specimen. Results: Of the 121 patients, nine were diagnosed with BKVAN (7.4%). Nine patients whith BKVN classically presents as allograft dysfunction with an asymptomatic rise in serum creatinine, about 3 to 39 months posttransplant. Urinary decoy cells are positive in two patients (22.2%). The histologic changes of BKVN are not pathognomonic, and can be mistaken for allograft rejection, ie, tubulointerstitial nephritis with varying degrees of inflammatory infiltrates, tubulitis and tubular atrophy, and fibrosis. Typical findings on histology are focal interstitial mononuclear inflammatory cell infiltrates, presence of plasma cells, necrotic tubular epithelium, and presence of homogenous intranuclear inclusion bodies. Immunohistochemistry with SV40 staining were positive in allograft. Graft loss occurred in one patient and the other 8 showed progressive allograft dysfunction. Conclusion: The definitive diagnosis of BKV disease requires renal biopsy. Immunohistochemistry with SV40 staining has been used as an indirect method to document the presence of BKVAN.展开更多
Objective:To observe the effect of Yishen Sanjie Huayu compound prescription on ERK/NF-κB signaling pathway in IgA nephropathy(IgAN)rats,and explore its effect on preventing and treating IgA nephropathy intrarenal ar...Objective:To observe the effect of Yishen Sanjie Huayu compound prescription on ERK/NF-κB signaling pathway in IgA nephropathy(IgAN)rats,and explore its effect on preventing and treating IgA nephropathy intrarenal arteriole disease.Methods:Fifty-five male SD rats were randomly divided into blank group,model group,ShenfukangⅡcapsule group and Losartan potassium tablet group.Bovine serum albumin(BSA)was used for intragastric administration and carbon tetrachloride(CCl4).IgAN rat model was established by subcutaneous injection and lipopolysaccharide(LPS)tail vein injection.ShenfukangⅡcapsule group and Losartan potassium tablet group were given each drug suspension 2ml/head/d one week after modeling Gavage was started.The blank group and the model group were given an equal volume of normal saline.The 24h urine protein(UTP)of the rats was measured at 4,8,and 12 weeks after the administration,and the blood creatinine(SCr)was measured after 12 weeks.,urea nitrogen(BUN),aldosterone(ADS),angiotensinⅡ(AngⅡ),immunohistochemical Envi-sion System two-step method to detect vascular endothelial growth factor(VEGF)and human matrix in the whole rat kidney and small artery area The expression of metalloproteinase-9(MMP-9),proliferating cell nuclear antigen(PCNA),extracellular regulatory protein kinase(ERK)1/2,nuclear transcription factor-κB(NF-κB),and the small arteries of rat kidney tissue The intima,media,vessel wall/vascular outer diameter value.Results:Compared with the model group,the expressions of VEGF,MMP-9,PCNA,ERK1/2 and NF-κB in kidney tissues of the ShenfukangⅡcapsule group and the Losartan potassium tablet group decreased(P<0.05),24hUTP and SCr,BUN level decreased(P<0.05),kidney tissue damage was alleviated;intima and vessel wall/vascular outer diameter values were significantly reduced(P<0.01),there was no significant difference in ADS between the groups.The AngⅡof the Tanpotassium tablets group was lower than that of the model group(P<0.05).Conclusion:Yishen Sanjie Huayu compound can inhibit the ERK/NF-κB signaling pathway in rats with IgA nephropathy,reduce the levels of VEGF,MMP-9,PCNA,ERK1/2,NF-κB,and inhibit intrarenal arteriole vascular endothelial cells Proliferate and reduce kidney damage.展开更多
The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was foun...The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was found that the color of the thumb, index and middle toe of the left foot became black. He went to a third-class hospital in Beijing and was diagnosed as “diabetes foot”. He was treated with “balloon dilation of lower limb blood vessels of diabetes foot”. Half a year ago, the third toe on the right side was broken and treated in the hospital again. “Popliteal artery stent implantation” was given for the diagnosis of “double kidney insufficiency, diabetes foot, left heart failure, combined heart valve disease”, “Hemofiltration therapy” and anti-inflammatory, amino acid supplementation, kidney function protection, anticoagulation, anemia correction and other treatments. Later, he went to our hospital and was diagnosed by the TCM diagnosis: category of consumptive disease, toe or finger gangrene (syndrome/pattern of qi and yin deficiency). Western medicine diagnosed: stage V of diabetes nephropathy, type II diabetes foot gangrene, combined with heart valve disease, hypoalbuminemia, double kidney cyst, moderate anemia, pleural effusion, hyperkalemia, pulmonary infection, and total heart failure. The patient was treated by the Qi-acupuncture therapy of TCM in combination with Chinese and Western medicine Medical treatment made the patient significantly better and discharged.展开更多
Objective: To investigate the effects of atorvastatin on renal function, renal fibrosis, oxidative stress and inflammatory factors in patients with diabetic nephropathy. Methods: A total of 120 patients with diabetic ...Objective: To investigate the effects of atorvastatin on renal function, renal fibrosis, oxidative stress and inflammatory factors in patients with diabetic nephropathy. Methods: A total of 120 patients with diabetic nephropathy admitted to People's Hospital of De Yang, Sichuan, China were randomly divided into control group and observation group, with 60 cases in each group. Patients in the control group were given routine treatment, while patients in the observation group were given atorvastatin on the basis of routine treatment. Before and after treatment, the levels of blood urea nitrogen (BUN), creatinine (Scr), cystatin C (CysC), matrix metalloproteinase inhibitor-1 (TIMP-1), transforming growth factor-β1 (TGF-β1), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), matrix metalloprotein-9 (MMP-9) and tumor necrosis factor-α (TNF-α) were detected and compared between the two groups.Results: After treatment, the levels of BUN, Scr, CysC, TIMP-1, TGF-β1, MDA, MMP-9 and TNF-α of the patients in the control group were significantly decreased (P<0.05), while the levels of SOD and GSH-Px were significantly increased (P<0.05). After treatment, the levels of BUN, Scr, CysC, TIMP-1, TGF-β1, MDA, MMP-9, and TNF-α in the serum of the patients in the observation group were significantly decreased (P<0.05), while the levels of SOD and GSH-Px were significantly increased (P<0.05). The above indexes of the patients in the observation group were better than those of the control group (P<0.05). Conclusions: Atorvastatin can effectively alleviate renal function damage, renal fibrosis and inflammatory stress in patients with diabetic nephropathy, enhance the antioxidant capacity of the body, and have a certain protective effect on the kidney.展开更多
Diabetic kidney disease(DKD)has a high incidence and mortality rate and lacks effective preventive and therapeutic methods.Apoptosis is one of the main reasons for the occurrence and development of DKD.Mesenchymal ste...Diabetic kidney disease(DKD)has a high incidence and mortality rate and lacks effective preventive and therapeutic methods.Apoptosis is one of the main reasons for the occurrence and development of DKD.Mesenchymal stem cells(MSCs)have shown great promise in tissue regeneration for DKD treatment and have protective effects against DKD,including decreased blood glucose and urinary protein levels and improved renal function.MSCs can directly differ-entiate into kidney cells or act via paracrine mechanisms to reduce apoptosis in DKD by modulating signaling pathways.MSC-derived extracellular vesicles(MSC-EVs)mitigate apoptosis and DKD-related symptoms by transferring miRNAs to target cells or organs.However,studies on the regulatory mechanisms of MSCs and MSC-EVs in apoptosis in DKD are insufficient.This review compre-hensively examines the mechanisms of apoptosis in DKD and research progress regarding the roles of MSCs and MSC-EVs in the disease process.展开更多
Background:Chiglitazar is a novel pan-agonist that can activate all three subtypes of peroxisome proliferator-activated receptor.It was approved for the treatment of type 2 diabetes mellitus as monotherapy on October ...Background:Chiglitazar is a novel pan-agonist that can activate all three subtypes of peroxisome proliferator-activated receptor.It was approved for the treatment of type 2 diabetes mellitus as monotherapy on October 19,2021,and as combination therapy with metformin when using metformin alone failed in blood glucose control on July 16,2024,by the National Medical Products Administration(NMPA)in China.However,pharmacokinetic(PK)study of this product in patients with renal impairment have not yet been conducted.The purpose of this study is to evaluate the effects of renal impairment on the PK and safety after a single oral dose of Chiglitazar.Methods:This multicenter,open-label,parallel-controlled,single-dose Phase I clinical trial(NCT 05515458)enrolled 24 participants(12/group)with severe renal impairment(SRI)or normal renal function(NRF).All participants received a single oral dose of 48 mg chiglitazar after breakfast and the PK and safety was evaluated.Results:The median Tmax was similar in both SRI and NRF groups(5.01 vs.5.02 hours).The geometric mean ratios(GMR)for Cmax,AUC0-t,and AUC0-∞were 0.807(90%confidence interval[CI]:0.697–0.935),0.853(90%CI:0.713–1.02),and 0.855(90%CI:0.716–1.02),respectively,indicating that SRI did not significantly affect the exposure of chiglitazar.The Cmax was weakly positively correlated with eGFR(r=0.4798,P=0.0177)and creatinine clearance rate(r=0.4667,P=0.0215).Urinary excretion of chiglitazar was negligible in the SRI group,with average values of Ae0-t=2,900 ng,Fe0-t=0.0060%,and CLR=0.323 mL/h within 0–72 hours post-dose.The treatment-emergent adverse event(TEAE)incidence in the SRI group(16.7%,2/12)was comparable to that in the NRF group(25%,3/12).All TEAEs were of mild severity and were adjudicated by the investigators to be unrelated to chiglitazar.No serious AE were reported.Chiglitazar exhibits a favorable safety profile.Conclusion:Severe renal impairment does not significantly affect the PK and safety of chiglitazar,and no dose adjustment for mild,moderate,and severe renal impairments is required.展开更多
OBJECTIVE:To investigate the effects of Tongluo Digui decoction on renal injury and streptozotocin-induced podocyte autophagy in diabetic rats.METHODS:Male Sprague-Dawley rats were randomly divided into six groups:nor...OBJECTIVE:To investigate the effects of Tongluo Digui decoction on renal injury and streptozotocin-induced podocyte autophagy in diabetic rats.METHODS:Male Sprague-Dawley rats were randomly divided into six groups:normal,model,Tongluo Digui decoction(high,medium,and low dose)and valsartan.Streptozotocin was injected intraperitoneally to replicate the diabetic animal model.After 8 weeks,proteinuria was evaluated to establish the diabetic nephropathy model.Treatments were administered daily via the intragastric route.At 16 weeks after gavage,we determined 24 h urine protein concentration,and blood glucose,serum creatinine,and urea nitrogen concentrations.Then,rats were sacrificed,and kidneys were harvested and stained with periodic acid-Schiff to evaluate the pathological changes in glomeruli,including glomerular podocytes by transmission electron microscopy.Western blot analysis was used to determine the expression of nephrin,podocin,p62,beclin-1,LC3Ⅱ/Ⅰ,and p-m TOR/m TOR protein in kidney tissues.RESULTS:Compared with the model group,Tongluo Digui decoction was associated with decreases in 24 h urine protein concentration,and blood glucose,hemoglobin A1 c,serum creatinine,urea nitrogen concentrations,total serum protein and albumin.Concurrently,mesangial mesenteric broadening and fusion of foot processes were reduced,the glomerular basement membrane was not significantly thickened,and the number of podocytes and the number of autophagosomes in the podocytes was increased.Further,expression of nephrin,podocin,LC3Ⅱ,and beclin-1 protein in kidney tissue was up-regulated,while expression of p62 protein was down-regulated and m TOR phosphorylation was inhibited.CONCLUSION:Tongluo Digui decoction may inhibit the progression of diabetic nephropathy by inhibiting m TOR phosphorylation,thereby increasing autophagy to protect podocytes and reducing proteinuria.展开更多
Hemolymphangioma is a malformation of both lymphatic vessels and blood vessels.Splenic hemolymphangioma is extremely rare.Herein,we present a case of 62-yearold woman with ambiguous upper quadrant abdominal pain for t...Hemolymphangioma is a malformation of both lymphatic vessels and blood vessels.Splenic hemolymphangioma is extremely rare.Herein,we present a case of 62-yearold woman with ambiguous upper quadrant abdominal pain for two months who was found to have an occupying lesion in the spleen on computed tomography.She was eventually diagnosed with hemolymphangioma of the spleen.The patient underwent total splenectomy.Neither symptoms nor recurrence was found during the one-year follow-up period.展开更多
BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical ...BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application.展开更多
Primary liver cancer seriously threatens human health,affects the quality of life,and has a high mortality rate.Traditional Chinese medicine(TCM)has long been used in the prevention,treatment,and adjuvant treatment of...Primary liver cancer seriously threatens human health,affects the quality of life,and has a high mortality rate.Traditional Chinese medicine(TCM)has long been used in the prevention,treatment,and adjuvant treatment of primary liver cancer.Clinical trials were conducted in recent years to evaluate the efficacy and safety of TCM.The mechanism of action of TCM in primary liver cancer treatment also received extensive attention.This study summarizes the common monomial Chinese herbal medicines and their components,formulae,and the proprietary Chinese medicines used to treat primary liver cancer.Common medicines include Chansu(Bufonis venenum),Kushen(Sophorae flavescentis radix),Renshen(Ginseng radix et rhizoma),and Jianghuang(Curcumae longae rhizoma).This study also reviewed the literature on liver cancer treatment using TCM.The results confirmed the safety and efficacy of TCM in liver cancer treatment.The possible mechanisms involved are also listed,including influencing the cell cycle,inducing cancer cell apoptosis and autophagy,inhibiting cancer cell angiogenesis and metastasis,regenerating the microenvironment and DNA methylation,and regulating the innate immune response.For primary liver cancer patients who often have a long disease course,Chinese herbal medicine often plays a role in protecting and conditioning the body.Research aimed at finding more traditional Chinese herbal medicines and their mechanisms of action should be promoted.This study aimed to provide a scientific reference for further research and the rational clinical application of TCM for primary liver cancer treatment.展开更多
BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects o...BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.展开更多
OBJECTIVE:To explore the mechanism of hirudin in the treatment of diabetic kidney disease(DKD).METHOD:Cytoscape software was used to analyze the network between hirudin targets and active components in the treatment o...OBJECTIVE:To explore the mechanism of hirudin in the treatment of diabetic kidney disease(DKD).METHOD:Cytoscape software was used to analyze the network between hirudin targets and active components in the treatment of DKD.The biological function and mechanism of effective targets of hirudin for DKD treatment were analyzed by the Database for Annotation,Visualization and Integrated Discovery(DAVID)database.Molecular docking technology was used to simulate the docking of key targets,and the DKD rat model was used to verify the first 4 key targets with high"Hydrogen number"among the top 10 targets verified by molecular docking.RESULTS:Total of 12334 DKD targets were screened in Gene Cards,OMIM and other databases,Hirudin and DKD had 247 common target genes,and the protein interaction network got 2115 edges.The DAVID database was used for the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis,confirming that hirudin in treatment of DKD involves multiple signaling pathways such as the forkhead box O signaling pathway,the phosphatidylinositol 3-kinase-protein kinase B signaling pathway,the vascular endothelial-derived growth factor signaling pathway and other signaling pathways.The top ten key targets of hirudin in treatment of DKD were verified by molecular docking.Animal experiments showed that hirudin could decrease the expression of caspase-3 in renal tissue of DKD rats,and increase the expression of RAC-alpha serine/threonineprotein kinase,Catalase,and Heat shock protein HSP 90-alpha in renal tissue of DKD rats.CONCLUSION:This study preliminarily reveals that hirudin treats DKD through multiple targets and pathways,and molecular docking and animal experiments indicates the feasibility of this study.Hirudin may be directly or indirectly involved in the regulation of cell metabolism,oxidative stress and other mechanisms in the treatment of DKD,which will lay the foundation for future molecular biological experiments of hirudin in the treatment of DKD.展开更多
OBJECTIVE:To evaluate the efficacy of Shenfu decoction(SFD)prepared with a traditional Chinese formula,on sepsis in rats with the condition induced by cecal ligation and puncture(CLP),and to study the possible mechani...OBJECTIVE:To evaluate the efficacy of Shenfu decoction(SFD)prepared with a traditional Chinese formula,on sepsis in rats with the condition induced by cecal ligation and puncture(CLP),and to study the possible mechanism underlying its action.METHODS:Forty clean-grade male Sprague-Dawley rats were divided randomly into three groups:normal control group(NCG,n=10),model control group(MCG,n=15)and Shenfu decoction group(SFDG,n=15).Sham-operated rats in NCG were served as operation control,while rats in both MCG and SFDG were exposed to CLP,a procedure to develop experimental sepsis.Rats in SFDG were administered with SFD by gavage(3 mg/g of body weight,twice a day)2 h prior to CLP and directly after successful CLP,while rats in NCG and MCG were gavaged with equivalent volume of sterilized water.Rats in all groups were starved with free access to drink.After 24 h of administration,the mortality of rats in each group was assessed.The indicators of inflammatory response[the peritoneal inflammation by Simon's method Classification as well as serum concentrations of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)by enzyme linked immunosorbent assay(ELISA)]in survival rats were evaluated.The indicators of gut barrier[The intestinal mucosal injury index,serum concentrations of D-lactic acid and secretory IgA(sIgA)in intestinal mucosa by ELISA,as well as gut microbiota by16S rRNA gene sequencing]in survival rats were evaluated.RESULTS:The mortality(20%)of rats in SFDG was lower than that(33.3%)of the MCG(P<0.01).The mortality(20%)of rats in SFDG was lower than that(33.3%)of the MCG(χ2=6.533,P=0.011).Compared with the MCG,the peritoneal inflammation as well as serum concentrations of TNF-αand IL-6 decreased significantly in SFDG(all P<0.01).Compared with the MCG,the IMII,serum concentrations of D-lactic acid,sIgA in intestinal mucosa were alleviated by SFD treatment(all P<0.01).Increase in levels of Proteobacteria and reduction levels of Bacteroidetes induced by sepsis were observed,and these two disturbed gut microbiota phyla could be regulated after SFD treatment.Increase in levels of Proteobacteria and reduction levels of Bacteroidetes induced by sepsis were observed,and these two disturbed gut microbiota phyla could be regulated after SFD treatment.CONCLUSION:SFD may play a protective role in sepsis by alleviating sepsis-induced inflammatory response and gut barrier damage in rats.展开更多
Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic...Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction were conducted by 2 reviewers independently. NMA was performed by Stata 14.0, R 4.0.4 software, and the latest risk of bias assessment tool 2(RoB 2).Results: A total of 53 RCTs were finally included, involving 4445 participants and 16 CHIs. RoB 2 showed that 2 of these studies had a high risk of bias. Tianqi injection(TQ) + WM was the most effective in reducing serum creatinine(Scr) level. Xingding injection(XD) + WM was the most effective in reducing blood urea nitrogen(BUN) and cystatin C(Cys C) levels. Guhong injection(GH) + WM had the highest endogenous creatinine clearance rate(Ccr). Shuxuetong injection(SXT) + WM was the most effective in improving the clinical effective rate. Danhong injection(DH) + WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ), while Danshen injection(DS) + WM led to the lowest blood uric acid(UA)level. Shenfu injection(SF) + WM was the most effective in increasing hemoglobin(Hb) level.Conclusion: CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators, SK + WM may be the optimal treatment option for improving renal function in patients with CRF.展开更多
Superhydrophobic surface(SHS) has been well developed, as SHS renders the property of minimizing the water/solid contact interface. Water droplets deposited onto SHS with contact angles exceeding 150°, allow them...Superhydrophobic surface(SHS) has been well developed, as SHS renders the property of minimizing the water/solid contact interface. Water droplets deposited onto SHS with contact angles exceeding 150°, allow them to retain spherical shapes, and the low adhesion of SHS facilitates easy droplet collection when tilting the substrate. These characteristics make SHS suitable for a wide range of applications. One particularly promising application is the fabrication of microsphere and supraparticle materials. SHS offers a distinct advantage as a universal platform capable of providing customized services for a variety of microspheres and supraparticles. In this review, an overview of the strategies for fabricating microspheres and supraparticles with the aid of SHS, including cross-linking process, polymer melting,and droplet template evaporation methods, is first presented. Then, the applications of microspheres and supraparticles formed onto SHS are discussed in detail, for example, fabricating photonic devices with controllable structures and tunable structural colors, acting as catalysts with emerging or synergetic properties, being integrated into the biomedical field to construct the devices with different medicinal purposes, being utilized for inducing protein crystallization and detecting trace amounts of analytes. Finally,the perspective on future developments involved with this research field is given, along with some obstacles and opportunities.展开更多
OBJECTIVE:To assess the quality of Clinical practice guidelines(CPGs)in the context of diabetic kidney disease(DKD)and determine whether any factors affect the quality.METHODS:We searched eight databases along with fi...OBJECTIVE:To assess the quality of Clinical practice guidelines(CPGs)in the context of diabetic kidney disease(DKD)and determine whether any factors affect the quality.METHODS:We searched eight databases along with five international and national organizations to develop or archive guidelines from their inception to July 2023,with an additional search of medlive.cn.And the authoritative organizations related to nephrology.CPGs and consensus statements created using direct differential diagnosis or therapy for DKD were included without language restrictions.Their quality was evaluated by four reviewers using the Appraisal of Guidelines for Research and EvaluationⅡ(AGREEⅡ)instrument.Along with the item and domain scores,the guideline was also allocated an overall quality score,which ranged from 1(lowest possible quality)to 7(highest possible quality).Moreover,an overall recommendation for use was also assigned(“recommended”,“recommended with modifications”or“not recommended”).RESULTS:A total of 16 CPGs were included,of which 14 were from Asia and the remaining two from Europe.These two CPGs were updated in the third version.Six CPGs were recommended for use because their primary domains scored in the medium or high category.Furthermore,five CPGs were recommended with modifications as the stakeholder involvement,applicability,and editorial independence domains were evaluated as low categories.In all domains,the lowest average score was for rigour of development(33%),followed by application(36%),and stakeholder involvement(51%).The highest average score was for scope and purpose(79%),followed by clarity of presentation(75%).None of the CPGs considered the patient's viewpoint,and six of 16 CPGs did not use any grading system to translate the evidence into recommendations.Additionally,only three of 16 CPGs shared search strategy,and eight of 16 CPGs did not declare a funding source.CONCLUSIONS:According to the AGREE II evaluation,more than one in four CPGs for DKD had poor methodological quality.Enhanced efforts are needed to advance the rigour of development,application,and editorial independence of DKD guideline panels for most guidelines.Stakeholders,CPG developers,and CPG users should consider methodological quality while choosing CPGs,and interpret and implement their issued suggestions.展开更多
BACKGROUND In this study,we retrospectively analysed macrophage infiltration and podocyte injury in three patients with diffuse proliferative lupus nephritis(LN)who un-derwent repeated renal biopsy.CASE SUMMARY Clinic...BACKGROUND In this study,we retrospectively analysed macrophage infiltration and podocyte injury in three patients with diffuse proliferative lupus nephritis(LN)who un-derwent repeated renal biopsy.CASE SUMMARY Clinical data of three diffuse proliferative LN patients with different pathological characteristics(case 1 was LN IV-G(A),case 2 was LN IV-G(A)+V,and case 3 was LN IV-G(A)+thrombotic microangiopathy)were reviewed.All patients underwent repeated renal biopsies 6 mo later,and renal biopsy specimens were studied.Macrophage infiltration was assessed by CD68 expression detected by immunohistochemical staining,and an immunofluorescence assay was used to detect podocin expression to assess podocyte damage.After treatment,Case 1 changed to LN III-(A),Case 2 remained as type V LN lesions,and Case 3,which changed to LN IV-S(A),had the worst prognosis.We observed reduced macro-phage infiltration after therapy.However,two of the patients with active lesions after treatment still showed macrophage infiltration in the renal interstitium.Before treatment,the three patients showed discontinuous expression of podocin.Notably,the integrity of podocin was restored after treatment in Case 1.CONCLUSION It may be possible to reverse podocyte damage and decrease the infiltrating ma-crophages in LN patients through effective treatment.展开更多
文摘OBJECTIVE：To evaluate inhibition effect and mech- anism of compound ethanol extracts from Wuweizi （Fructus Schisandrae Chinensis）, Chuanxiong （Rhi- zoma Chuanxiong） and Muli （Cocha Ostreae） （FRC） on glomerular and tubular interstitial fibrosis in streptozocin （STZ）-induced diabetic nephropathy （ND） model mice. METHODS： Twenty-seven male C57BL/6 mice were divided randomly into 3 groups： nondibetic （ND）, STZ-induced diabetic （D）, and STZ-induced diabetic that were treated with .5 g. kg1. daylof FRC by oral gavage （DFRc）, with 9 in each group. The protein ex- pressions of E-cadherin, a-smooth muscle actin （a-SMA）, Plasminogen Activator Inhibitor-1 （PAl-l） in renal tissues were investigated by Western blot- ting. The expressions of fibronectin （FN） and o-SMA were detected by immunohistochemical method. The morphological changes of renal tissues were observed under a microscope. RESULTS： Renal tissues in the DFRC group showed a lessened degree of fibrosis. Meanwhile, the expres- sions of FN, o-SMA and PAl-lwere significantly lower in the DrRc group than those in the D group （all P〈0.05）.CONCLUSION： FRC can ameliorate the DN in the C57BL/6 mice, and its mechanism may relate to in- hibition on the epithelial to mesenchymal transdif- ferentiation, endothelial-myofibroblast transition and PAl-1 expression.
基金the Key Research and Development Projects of Shaanxi Province(Study on the Effect of Wenyanghuazhuo Method on Autophagy-related Proteins in Adriamycin Nephropathy Rat Model,No.2020SF-340)a Grant from the Sci-tech Project of Shaanxi Province(Study on the Expression Regulation of STIM1/Orail and TRPC-related Channel Proteins in Renal Tissues of Adriamycin Nephropathy Rats by Aconiti Lateralis Radix and Wenyanghuazhuofang,No.2016SF-068)。
文摘OBJECTIVE:To determine the effect of Wenyang Huazhuo Fang(WHF),a Traditional Chinese Medicine decoction,on renal function in a rat model of doxorubicin-induced nephropathy,and to elucidate the underlying mechanism.METHODS:Sprague-Dawley rats were randomly divided into six groups:control,doxorubicin-nephropathy,and prednisone-treated(6.45 mg·kg^-1·d^-1)doxorubicin nephropathy groups,as well as high-(7.26 g·kg^-1·d^-1),medium-(2.42 g·kg-1·d-),and low-dose(0.81 g·kg^-1·d^-1)WHF-treated doxorubicin-nephropathy groups.The nephropathy rat model was established by two tail vein injections of doxorubicin,followed by prednisone or WHF treatment for 8 weeks.Body weights were monitored and urinary protein was measured every 2 weeks.After the end of the treatment period,the rats were euthanized.Serum biochemical indicators were determined and renal morphological alterations were assessed using histological staining.The expression of transient receptor potential cation channel subfamily C member 6(TRPC6),stromal interaction molecule 1(STIM1),and calcium release-activated calcium channel protein 1(Orai1)was detected using western blotting,and their mRNA levels were examined using quantitative real-time reverse transcription-polymerase chain reaction.RESULTS:WHF treatment was found to significantly ameliorate weight loss,proteinuria,hypoalbuminemia,and dyslipidemia in doxorubicin-nephropathy rats.The protein and mRNA levels of TRPC6,STIM1,and Orai1 were partially,but significantly suppressed by prednisone or WHF treatment.CONCLUSION:Treatment with WHF significantly ameliorates renal injury in a rat model of doxorubicin-induced nephropathy,which could be at least partially related to repression of the TRPC6 pathway.
基金Joint Innovation Fundation of JIICM:Health Management of Chronic Kidney Disease Based on Integrated Traditional Chinese And Western Medicine(No.2021IR009)Natural Science Foundation-funded Project:the Mechanism of Modified Huangqi Chifeng Decoction Protect Damaged Podocyte via Cross-Talking of PI3K/AKT/mTOR and AMPK/mTOR/ULK1 Signaling Pathway Regulate Autophapy(No.81873300)+1 种基金the Central Publicinterest Scientific Institution Basal Research Fund of the China Academy of Chinese Medical Sciences:Comprehensive Evaluation of Clinical efficacy of Modified Huangqi Chifeng Decoction on IgA Nephropathy(No.ZZ11-023)the Beijing Municipal of Science and Technology Major Project:Evaluation of Clinical Efficacy of Modified Huangqi Chifeng Decoction in Treating Proteinuria in IgA Nephropathy Based on"Deficiency-Wind-Blood-Stasis-Toxicity"Mechanism in Chinese Medicine(No.Z191100006619063)。
文摘OBJECTIVE:To examine the nephroprotective mechanism of modified Huangqi Chifeng decoction(加味黄芪赤风汤,MHCD)in immunoglobulin A nephropathy(IgAN)rats.METHODS:To establish the IgAN rat model,the bovine serum albumin,lipopolysaccharide,and carbon tetrachloride 4 method was employed.The rats were then randomly assigned to the control,model,telmisartan,and high-,medium-,and low-dose MHCD groups,and were administered the respective treatments via intragastric administration for 8 weeks.The levels of 24-h urinary protein,serum creatinine(CRE),and blood urea nitrogen(BUN)were measured in each group.Pathological alterations were detected.IgA deposition was visualized through the use of immunofluorescence staining.The ultrastructure of the kidney was observed using a transmission electron microscope.The expression levels of interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),and transforming growth factor-β1(TGF-β1)were examined by immunohistochemistry and quantitative polymerase chain reaction.Levels of toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),and nuclear factor-kappa B(NF-κB)P65,were examined by immunohistochemistry,Western blotting,and quantitative polymerase chain reaction.RESULTS:The 24-h urine protein level in each group increased significantly at week 6,and worsen from then on.But this process can be reversed by treatments of telmisartan,and high-,medium-,and low-dose of MHCD,and these treatments did not affect renal function.Telmisartan,and high-,and medium-dose of MHCD reduced IgA deposition.Renal histopathology demonstrated the protective effect of high-,medium-,and low-dose of MHCD against kidney injury.The expression levels of MCP-1,IL-6,and TGF-β1 in kidney tissues were downregulated by low,medium and high doses of MHCD treatment.Additionally,treatment of low,medium and high doses of MHCD decreased the protein and mRNA levels of TLR4,MyD88,and NF-κB.CONCLUSIONS:MHCD exerted nephroprotective effects on IgAN rats,and MHCD regulated the expressions of key targets in TLR4/MyD88/NF-κB signaling pathway,thereby alleviating renal inflammation by inhibiting MCP-1,IL-6 expressions,and ameliorating renal fibrosis by inhibiting TGF-β1 expression.
文摘Objective: We prospectively investigated 121 renal allograft biopsy specimens performed in our center. Methods: BKVAN was diagnosed by light microscopic examination and a positive immunohistochemistry staining of anti-SV40 large T antibody in a biopsy specimen. Results: Of the 121 patients, nine were diagnosed with BKVAN (7.4%). Nine patients whith BKVN classically presents as allograft dysfunction with an asymptomatic rise in serum creatinine, about 3 to 39 months posttransplant. Urinary decoy cells are positive in two patients (22.2%). The histologic changes of BKVN are not pathognomonic, and can be mistaken for allograft rejection, ie, tubulointerstitial nephritis with varying degrees of inflammatory infiltrates, tubulitis and tubular atrophy, and fibrosis. Typical findings on histology are focal interstitial mononuclear inflammatory cell infiltrates, presence of plasma cells, necrotic tubular epithelium, and presence of homogenous intranuclear inclusion bodies. Immunohistochemistry with SV40 staining were positive in allograft. Graft loss occurred in one patient and the other 8 showed progressive allograft dysfunction. Conclusion: The definitive diagnosis of BKV disease requires renal biopsy. Immunohistochemistry with SV40 staining has been used as an indirect method to document the presence of BKVAN.
基金National Science Fund subsidized project(No.81774123)Key R&D Projects in Shaanxi Province(No.2018ZDXM-SF-011)。
文摘Objective:To observe the effect of Yishen Sanjie Huayu compound prescription on ERK/NF-κB signaling pathway in IgA nephropathy(IgAN)rats,and explore its effect on preventing and treating IgA nephropathy intrarenal arteriole disease.Methods:Fifty-five male SD rats were randomly divided into blank group,model group,ShenfukangⅡcapsule group and Losartan potassium tablet group.Bovine serum albumin(BSA)was used for intragastric administration and carbon tetrachloride(CCl4).IgAN rat model was established by subcutaneous injection and lipopolysaccharide(LPS)tail vein injection.ShenfukangⅡcapsule group and Losartan potassium tablet group were given each drug suspension 2ml/head/d one week after modeling Gavage was started.The blank group and the model group were given an equal volume of normal saline.The 24h urine protein(UTP)of the rats was measured at 4,8,and 12 weeks after the administration,and the blood creatinine(SCr)was measured after 12 weeks.,urea nitrogen(BUN),aldosterone(ADS),angiotensinⅡ(AngⅡ),immunohistochemical Envi-sion System two-step method to detect vascular endothelial growth factor(VEGF)and human matrix in the whole rat kidney and small artery area The expression of metalloproteinase-9(MMP-9),proliferating cell nuclear antigen(PCNA),extracellular regulatory protein kinase(ERK)1/2,nuclear transcription factor-κB(NF-κB),and the small arteries of rat kidney tissue The intima,media,vessel wall/vascular outer diameter value.Results:Compared with the model group,the expressions of VEGF,MMP-9,PCNA,ERK1/2 and NF-κB in kidney tissues of the ShenfukangⅡcapsule group and the Losartan potassium tablet group decreased(P<0.05),24hUTP and SCr,BUN level decreased(P<0.05),kidney tissue damage was alleviated;intima and vessel wall/vascular outer diameter values were significantly reduced(P<0.01),there was no significant difference in ADS between the groups.The AngⅡof the Tanpotassium tablets group was lower than that of the model group(P<0.05).Conclusion:Yishen Sanjie Huayu compound can inhibit the ERK/NF-κB signaling pathway in rats with IgA nephropathy,reduce the levels of VEGF,MMP-9,PCNA,ERK1/2,NF-κB,and inhibit intrarenal arteriole vascular endothelial cells Proliferate and reduce kidney damage.
文摘The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was found that the color of the thumb, index and middle toe of the left foot became black. He went to a third-class hospital in Beijing and was diagnosed as “diabetes foot”. He was treated with “balloon dilation of lower limb blood vessels of diabetes foot”. Half a year ago, the third toe on the right side was broken and treated in the hospital again. “Popliteal artery stent implantation” was given for the diagnosis of “double kidney insufficiency, diabetes foot, left heart failure, combined heart valve disease”, “Hemofiltration therapy” and anti-inflammatory, amino acid supplementation, kidney function protection, anticoagulation, anemia correction and other treatments. Later, he went to our hospital and was diagnosed by the TCM diagnosis: category of consumptive disease, toe or finger gangrene (syndrome/pattern of qi and yin deficiency). Western medicine diagnosed: stage V of diabetes nephropathy, type II diabetes foot gangrene, combined with heart valve disease, hypoalbuminemia, double kidney cyst, moderate anemia, pleural effusion, hyperkalemia, pulmonary infection, and total heart failure. The patient was treated by the Qi-acupuncture therapy of TCM in combination with Chinese and Western medicine Medical treatment made the patient significantly better and discharged.
文摘Objective: To investigate the effects of atorvastatin on renal function, renal fibrosis, oxidative stress and inflammatory factors in patients with diabetic nephropathy. Methods: A total of 120 patients with diabetic nephropathy admitted to People's Hospital of De Yang, Sichuan, China were randomly divided into control group and observation group, with 60 cases in each group. Patients in the control group were given routine treatment, while patients in the observation group were given atorvastatin on the basis of routine treatment. Before and after treatment, the levels of blood urea nitrogen (BUN), creatinine (Scr), cystatin C (CysC), matrix metalloproteinase inhibitor-1 (TIMP-1), transforming growth factor-β1 (TGF-β1), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), matrix metalloprotein-9 (MMP-9) and tumor necrosis factor-α (TNF-α) were detected and compared between the two groups.Results: After treatment, the levels of BUN, Scr, CysC, TIMP-1, TGF-β1, MDA, MMP-9 and TNF-α of the patients in the control group were significantly decreased (P<0.05), while the levels of SOD and GSH-Px were significantly increased (P<0.05). After treatment, the levels of BUN, Scr, CysC, TIMP-1, TGF-β1, MDA, MMP-9, and TNF-α in the serum of the patients in the observation group were significantly decreased (P<0.05), while the levels of SOD and GSH-Px were significantly increased (P<0.05). The above indexes of the patients in the observation group were better than those of the control group (P<0.05). Conclusions: Atorvastatin can effectively alleviate renal function damage, renal fibrosis and inflammatory stress in patients with diabetic nephropathy, enhance the antioxidant capacity of the body, and have a certain protective effect on the kidney.
基金Supported by Science and Technology Research Program of Jilin Provincial Department of Education,No.JJKH20231218KJProject of the Jilin Provincial Administration of Traditional Chinese Medicine,No.2024111.
文摘Diabetic kidney disease(DKD)has a high incidence and mortality rate and lacks effective preventive and therapeutic methods.Apoptosis is one of the main reasons for the occurrence and development of DKD.Mesenchymal stem cells(MSCs)have shown great promise in tissue regeneration for DKD treatment and have protective effects against DKD,including decreased blood glucose and urinary protein levels and improved renal function.MSCs can directly differ-entiate into kidney cells or act via paracrine mechanisms to reduce apoptosis in DKD by modulating signaling pathways.MSC-derived extracellular vesicles(MSC-EVs)mitigate apoptosis and DKD-related symptoms by transferring miRNAs to target cells or organs.However,studies on the regulatory mechanisms of MSCs and MSC-EVs in apoptosis in DKD are insufficient.This review compre-hensively examines the mechanisms of apoptosis in DKD and research progress regarding the roles of MSCs and MSC-EVs in the disease process.
文摘Background:Chiglitazar is a novel pan-agonist that can activate all three subtypes of peroxisome proliferator-activated receptor.It was approved for the treatment of type 2 diabetes mellitus as monotherapy on October 19,2021,and as combination therapy with metformin when using metformin alone failed in blood glucose control on July 16,2024,by the National Medical Products Administration(NMPA)in China.However,pharmacokinetic(PK)study of this product in patients with renal impairment have not yet been conducted.The purpose of this study is to evaluate the effects of renal impairment on the PK and safety after a single oral dose of Chiglitazar.Methods:This multicenter,open-label,parallel-controlled,single-dose Phase I clinical trial(NCT 05515458)enrolled 24 participants(12/group)with severe renal impairment(SRI)or normal renal function(NRF).All participants received a single oral dose of 48 mg chiglitazar after breakfast and the PK and safety was evaluated.Results:The median Tmax was similar in both SRI and NRF groups(5.01 vs.5.02 hours).The geometric mean ratios(GMR)for Cmax,AUC0-t,and AUC0-∞were 0.807(90%confidence interval[CI]:0.697–0.935),0.853(90%CI:0.713–1.02),and 0.855(90%CI:0.716–1.02),respectively,indicating that SRI did not significantly affect the exposure of chiglitazar.The Cmax was weakly positively correlated with eGFR(r=0.4798,P=0.0177)and creatinine clearance rate(r=0.4667,P=0.0215).Urinary excretion of chiglitazar was negligible in the SRI group,with average values of Ae0-t=2,900 ng,Fe0-t=0.0060%,and CLR=0.323 mL/h within 0–72 hours post-dose.The treatment-emergent adverse event(TEAE)incidence in the SRI group(16.7%,2/12)was comparable to that in the NRF group(25%,3/12).All TEAEs were of mild severity and were adjudicated by the investigators to be unrelated to chiglitazar.No serious AE were reported.Chiglitazar exhibits a favorable safety profile.Conclusion:Severe renal impairment does not significantly affect the PK and safety of chiglitazar,and no dose adjustment for mild,moderate,and severe renal impairments is required.
基金Supported by the funds of Key Scientific Research Project of Colleges and Universities in Henan Province in 2017(Explore the Mechanism of Huoxue Tongluo Decoction in Preventing and Treating Diabetic Nephropathy from the Regulation of Podocyte Autophagy by Mtor Signal Pathway,No.17A360003)the Research Project of National TCM Clinical Research Base(Project Number:2019jdzx068+9 种基金Project Name:Study on the Effect of Tongluo Digui Decoction on Circadian Rhythm of Diabetic Nephropathy Based on Lncrna-mrna Chip Technology)the Special Research Project of TCM In Henan Province(Project Number:2019zybj17Project Name:Study on the Mechanism of Tongluo Digui Decoction in the Treatment of Diabetic Kidney Disease by Regulating the Pyroptosis of Podocyte through Autophagy-related Molecular Pathways)Henan Province Key R&D and Promotion Special(Science and Technology)Project(Project Number:202102310505Project Name:Study on the Mechanism Of Tongluo Digui Decoction in the Treatment of Diabetic Nephropathy Based on Autophagy Regulating Renal Tubular Epithelial Cell Pyroptosis)Henan Province Key R&D and Promotion Special(Science and Technology)Project(Project Number:202102310171Project Name:to Explore the Mechanism of Tongluo Digui Decoction on Improving Non-dipper Blood Pressure In Diabetic Nephropathy Based on Circadian Rhythm)a Sub-station Project of the Inheritance Studio of Famous Old Chinese Medicine Experts Across the CountryTCM Top Talent Training Project of Henan ProvinceNational TCM Innovational Core Talent Training Project。
文摘OBJECTIVE:To investigate the effects of Tongluo Digui decoction on renal injury and streptozotocin-induced podocyte autophagy in diabetic rats.METHODS:Male Sprague-Dawley rats were randomly divided into six groups:normal,model,Tongluo Digui decoction(high,medium,and low dose)and valsartan.Streptozotocin was injected intraperitoneally to replicate the diabetic animal model.After 8 weeks,proteinuria was evaluated to establish the diabetic nephropathy model.Treatments were administered daily via the intragastric route.At 16 weeks after gavage,we determined 24 h urine protein concentration,and blood glucose,serum creatinine,and urea nitrogen concentrations.Then,rats were sacrificed,and kidneys were harvested and stained with periodic acid-Schiff to evaluate the pathological changes in glomeruli,including glomerular podocytes by transmission electron microscopy.Western blot analysis was used to determine the expression of nephrin,podocin,p62,beclin-1,LC3Ⅱ/Ⅰ,and p-m TOR/m TOR protein in kidney tissues.RESULTS:Compared with the model group,Tongluo Digui decoction was associated with decreases in 24 h urine protein concentration,and blood glucose,hemoglobin A1 c,serum creatinine,urea nitrogen concentrations,total serum protein and albumin.Concurrently,mesangial mesenteric broadening and fusion of foot processes were reduced,the glomerular basement membrane was not significantly thickened,and the number of podocytes and the number of autophagosomes in the podocytes was increased.Further,expression of nephrin,podocin,LC3Ⅱ,and beclin-1 protein in kidney tissue was up-regulated,while expression of p62 protein was down-regulated and m TOR phosphorylation was inhibited.CONCLUSION:Tongluo Digui decoction may inhibit the progression of diabetic nephropathy by inhibiting m TOR phosphorylation,thereby increasing autophagy to protect podocytes and reducing proteinuria.
文摘Hemolymphangioma is a malformation of both lymphatic vessels and blood vessels.Splenic hemolymphangioma is extremely rare.Herein,we present a case of 62-yearold woman with ambiguous upper quadrant abdominal pain for two months who was found to have an occupying lesion in the spleen on computed tomography.She was eventually diagnosed with hemolymphangioma of the spleen.The patient underwent total splenectomy.Neither symptoms nor recurrence was found during the one-year follow-up period.
基金Supported by Xiamen Medical and Health Guidance Project Section,No.3502Z20224ZD1169Xiamen sixth batch of TCM Reserve Talent Training Project,No.136,2022.
文摘BACKGROUND Painless gastroscopy is a widely used diagnostic and therapeutic technology in clinical practice.Propofol combined with opioids is a common drug for painless endoscopic sedation and anaesthesia.In clinical work,adverse drug reactions of anaesthesia schemes are often one of the important areas of concern for doctors and patients.With the increase in propofol dosage,the risk of serious adverse drug reactions,such as respiratory depression and hypotension,increases significantly;the use of opioids often causes gastrointestinal reactions in patients after examination,such as nausea,vomiting,delayed recovery of gastrointestinal function and other complications,which seriously affect their quality of life.AIM To observe the effect of wrist-ankle acupuncture therapy on the anaesthesia regimen and anaesthesia-related complications during and after painless gastroscopy examination.METHODS Two hundred patients were selected and randomly divided into a treatment group(n=100)and a control group(n=100).Both groups were routinely anaesthetized with the nalbuphine and propofol regimen,gastroscopy began after the patient lost consciousness,and given supportive treatment and vital sign monitoring.If the patient interrupted the surgery due to intraoperative torsion,intravenous propofol was used to relieve his or her discomfort.The treatment group received wrist-ankle acupuncture on this basis.RESULTS The general data before treatment,American Society of Anesthesiologist(ASA)grade and operation time between the two groups was no significant difference.The Wakeup time,and the Selfambulation time in the treatment group was significantly faster than that in the control group(P<0.05).The total dose of propofol in the treatment group was 109±8.17 mg,significantly lower than that in the control group(P<0.05).The incidence of respiratory depression and hypotension was not significantly different,but the incidence of hiccups was significantly lower than that in the control group(P<0.05).After the examination,the incidence of nausea,vomiting,abdominal distension,and abdominal pain was 11%,8%,6%,and 5%,respectively,which was significantly lower than that in the control group(P<0.05).In addition,both the operators and the patients were more satisfied with this examination,with no significant difference between the groups(P>0.05).CONCLUSION Wrist-ankle acupuncture treatment can optimize the painless gastroscopy and anaesthesia scheme,reduces propofol total dose;shortens patient Wakeup time and Self-ambulation time,improves patient compliance and tolerance,is beneficial to clinical application.
基金the Project Innovation and Entrepreneurship Training Program for Students of Southwest Medical University(No.202110632066)the Joint Project of Luzhou Traditional Chinese Medicine Hospital and Southwest Medical University(No.2018-LH004)。
文摘Primary liver cancer seriously threatens human health,affects the quality of life,and has a high mortality rate.Traditional Chinese medicine(TCM)has long been used in the prevention,treatment,and adjuvant treatment of primary liver cancer.Clinical trials were conducted in recent years to evaluate the efficacy and safety of TCM.The mechanism of action of TCM in primary liver cancer treatment also received extensive attention.This study summarizes the common monomial Chinese herbal medicines and their components,formulae,and the proprietary Chinese medicines used to treat primary liver cancer.Common medicines include Chansu(Bufonis venenum),Kushen(Sophorae flavescentis radix),Renshen(Ginseng radix et rhizoma),and Jianghuang(Curcumae longae rhizoma).This study also reviewed the literature on liver cancer treatment using TCM.The results confirmed the safety and efficacy of TCM in liver cancer treatment.The possible mechanisms involved are also listed,including influencing the cell cycle,inducing cancer cell apoptosis and autophagy,inhibiting cancer cell angiogenesis and metastasis,regenerating the microenvironment and DNA methylation,and regulating the innate immune response.For primary liver cancer patients who often have a long disease course,Chinese herbal medicine often plays a role in protecting and conditioning the body.Research aimed at finding more traditional Chinese herbal medicines and their mechanisms of action should be promoted.This study aimed to provide a scientific reference for further research and the rational clinical application of TCM for primary liver cancer treatment.
基金Supported by Xiamen Municipal Science and Technology Bureau Municipal Medical and Health Guidance Project,No.3502Z20224ZD1169Joint project of Natural Science Foundation of Xiamen Municipal Bureau of Science and Technology,No.3502Z20227368The Sixth Batch of Chinese Medicine Reserve Talent Training Project in Xiamen(Xiamen Municipal Health Commission Traditional Chinese Medicine),No.[2022]No.136.
文摘BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.
基金Supported by the Natural Science Foundation of Henan Province(No.202300410256)the Research Project of the National TCM Clinical Research Base(No.2019JDZX2119)the Key R&D and Extension Project in Henan Province(No.202102310505,No.202102310171)
文摘OBJECTIVE:To explore the mechanism of hirudin in the treatment of diabetic kidney disease(DKD).METHOD:Cytoscape software was used to analyze the network between hirudin targets and active components in the treatment of DKD.The biological function and mechanism of effective targets of hirudin for DKD treatment were analyzed by the Database for Annotation,Visualization and Integrated Discovery(DAVID)database.Molecular docking technology was used to simulate the docking of key targets,and the DKD rat model was used to verify the first 4 key targets with high"Hydrogen number"among the top 10 targets verified by molecular docking.RESULTS:Total of 12334 DKD targets were screened in Gene Cards,OMIM and other databases,Hirudin and DKD had 247 common target genes,and the protein interaction network got 2115 edges.The DAVID database was used for the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis,confirming that hirudin in treatment of DKD involves multiple signaling pathways such as the forkhead box O signaling pathway,the phosphatidylinositol 3-kinase-protein kinase B signaling pathway,the vascular endothelial-derived growth factor signaling pathway and other signaling pathways.The top ten key targets of hirudin in treatment of DKD were verified by molecular docking.Animal experiments showed that hirudin could decrease the expression of caspase-3 in renal tissue of DKD rats,and increase the expression of RAC-alpha serine/threonineprotein kinase,Catalase,and Heat shock protein HSP 90-alpha in renal tissue of DKD rats.CONCLUSION:This study preliminarily reveals that hirudin treats DKD through multiple targets and pathways,and molecular docking and animal experiments indicates the feasibility of this study.Hirudin may be directly or indirectly involved in the regulation of cell metabolism,oxidative stress and other mechanisms in the treatment of DKD,which will lay the foundation for future molecular biological experiments of hirudin in the treatment of DKD.
基金the Basic Scientific Research Expenses of the Central University(No.2018-JYBZZ-JS075,2017-JYB-JS-101)Base Clinical Research Construction Project of National Traditional Chinese Medicine(No.JDZX2015301)。
文摘OBJECTIVE:To evaluate the efficacy of Shenfu decoction(SFD)prepared with a traditional Chinese formula,on sepsis in rats with the condition induced by cecal ligation and puncture(CLP),and to study the possible mechanism underlying its action.METHODS:Forty clean-grade male Sprague-Dawley rats were divided randomly into three groups:normal control group(NCG,n=10),model control group(MCG,n=15)and Shenfu decoction group(SFDG,n=15).Sham-operated rats in NCG were served as operation control,while rats in both MCG and SFDG were exposed to CLP,a procedure to develop experimental sepsis.Rats in SFDG were administered with SFD by gavage(3 mg/g of body weight,twice a day)2 h prior to CLP and directly after successful CLP,while rats in NCG and MCG were gavaged with equivalent volume of sterilized water.Rats in all groups were starved with free access to drink.After 24 h of administration,the mortality of rats in each group was assessed.The indicators of inflammatory response[the peritoneal inflammation by Simon's method Classification as well as serum concentrations of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)by enzyme linked immunosorbent assay(ELISA)]in survival rats were evaluated.The indicators of gut barrier[The intestinal mucosal injury index,serum concentrations of D-lactic acid and secretory IgA(sIgA)in intestinal mucosa by ELISA,as well as gut microbiota by16S rRNA gene sequencing]in survival rats were evaluated.RESULTS:The mortality(20%)of rats in SFDG was lower than that(33.3%)of the MCG(P<0.01).The mortality(20%)of rats in SFDG was lower than that(33.3%)of the MCG(χ2=6.533,P=0.011).Compared with the MCG,the peritoneal inflammation as well as serum concentrations of TNF-αand IL-6 decreased significantly in SFDG(all P<0.01).Compared with the MCG,the IMII,serum concentrations of D-lactic acid,sIgA in intestinal mucosa were alleviated by SFD treatment(all P<0.01).Increase in levels of Proteobacteria and reduction levels of Bacteroidetes induced by sepsis were observed,and these two disturbed gut microbiota phyla could be regulated after SFD treatment.Increase in levels of Proteobacteria and reduction levels of Bacteroidetes induced by sepsis were observed,and these two disturbed gut microbiota phyla could be regulated after SFD treatment.CONCLUSION:SFD may play a protective role in sepsis by alleviating sepsis-induced inflammatory response and gut barrier damage in rats.
基金supported by the Chinese Medicine Development Fund,Hong Kong,China(20B2/027A)China Center for Evidence Based Traditional Chinese Medicine,CCEBTM(2020YJSZX-5)National Natural Science Foundation of China(81704198).
文摘Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction were conducted by 2 reviewers independently. NMA was performed by Stata 14.0, R 4.0.4 software, and the latest risk of bias assessment tool 2(RoB 2).Results: A total of 53 RCTs were finally included, involving 4445 participants and 16 CHIs. RoB 2 showed that 2 of these studies had a high risk of bias. Tianqi injection(TQ) + WM was the most effective in reducing serum creatinine(Scr) level. Xingding injection(XD) + WM was the most effective in reducing blood urea nitrogen(BUN) and cystatin C(Cys C) levels. Guhong injection(GH) + WM had the highest endogenous creatinine clearance rate(Ccr). Shuxuetong injection(SXT) + WM was the most effective in improving the clinical effective rate. Danhong injection(DH) + WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ), while Danshen injection(DS) + WM led to the lowest blood uric acid(UA)level. Shenfu injection(SF) + WM was the most effective in increasing hemoglobin(Hb) level.Conclusion: CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators, SK + WM may be the optimal treatment option for improving renal function in patients with CRF.
基金the financial support from Shenzhen Science and Technology Program (JCYJ20210324142210027, X.D.)the National Natural Science Foundation of China (52103136, 22275028, U22A20153, 22102017, 22302033, and 52106194)+5 种基金the Sichuan Outstanding Young Scholars Foundation (2021JDJQ0013)Natural Science Foundation of Sichuan Province (2022NSFSC1271)Sichuan Science and Technology Program (2023JDRC0082)“Oncology Medical Engineering Innovation Foundation” project of University of Electronic Science and Technology of China and Sichuan Cancer Hospital (ZYGX2021YGCX009)“Medical and Industrial Cross Foundation” of University of Electronic Science and Technology of China and Sichuan Provincial People’s Hospital (ZYGX2021YGLH207)Shandong Key R&D grant (2022CXGC010509)。
文摘Superhydrophobic surface(SHS) has been well developed, as SHS renders the property of minimizing the water/solid contact interface. Water droplets deposited onto SHS with contact angles exceeding 150°, allow them to retain spherical shapes, and the low adhesion of SHS facilitates easy droplet collection when tilting the substrate. These characteristics make SHS suitable for a wide range of applications. One particularly promising application is the fabrication of microsphere and supraparticle materials. SHS offers a distinct advantage as a universal platform capable of providing customized services for a variety of microspheres and supraparticles. In this review, an overview of the strategies for fabricating microspheres and supraparticles with the aid of SHS, including cross-linking process, polymer melting,and droplet template evaporation methods, is first presented. Then, the applications of microspheres and supraparticles formed onto SHS are discussed in detail, for example, fabricating photonic devices with controllable structures and tunable structural colors, acting as catalysts with emerging or synergetic properties, being integrated into the biomedical field to construct the devices with different medicinal purposes, being utilized for inducing protein crystallization and detecting trace amounts of analytes. Finally,the perspective on future developments involved with this research field is given, along with some obstacles and opportunities.
文摘OBJECTIVE:To assess the quality of Clinical practice guidelines(CPGs)in the context of diabetic kidney disease(DKD)and determine whether any factors affect the quality.METHODS:We searched eight databases along with five international and national organizations to develop or archive guidelines from their inception to July 2023,with an additional search of medlive.cn.And the authoritative organizations related to nephrology.CPGs and consensus statements created using direct differential diagnosis or therapy for DKD were included without language restrictions.Their quality was evaluated by four reviewers using the Appraisal of Guidelines for Research and EvaluationⅡ(AGREEⅡ)instrument.Along with the item and domain scores,the guideline was also allocated an overall quality score,which ranged from 1(lowest possible quality)to 7(highest possible quality).Moreover,an overall recommendation for use was also assigned(“recommended”,“recommended with modifications”or“not recommended”).RESULTS:A total of 16 CPGs were included,of which 14 were from Asia and the remaining two from Europe.These two CPGs were updated in the third version.Six CPGs were recommended for use because their primary domains scored in the medium or high category.Furthermore,five CPGs were recommended with modifications as the stakeholder involvement,applicability,and editorial independence domains were evaluated as low categories.In all domains,the lowest average score was for rigour of development(33%),followed by application(36%),and stakeholder involvement(51%).The highest average score was for scope and purpose(79%),followed by clarity of presentation(75%).None of the CPGs considered the patient's viewpoint,and six of 16 CPGs did not use any grading system to translate the evidence into recommendations.Additionally,only three of 16 CPGs shared search strategy,and eight of 16 CPGs did not declare a funding source.CONCLUSIONS:According to the AGREE II evaluation,more than one in four CPGs for DKD had poor methodological quality.Enhanced efforts are needed to advance the rigour of development,application,and editorial independence of DKD guideline panels for most guidelines.Stakeholders,CPG developers,and CPG users should consider methodological quality while choosing CPGs,and interpret and implement their issued suggestions.
基金Supported by National Natural Science Foundation of China,No.81960136the Science and Technology Department of Yunnan Province,No.202101AT070243.
文摘BACKGROUND In this study,we retrospectively analysed macrophage infiltration and podocyte injury in three patients with diffuse proliferative lupus nephritis(LN)who un-derwent repeated renal biopsy.CASE SUMMARY Clinical data of three diffuse proliferative LN patients with different pathological characteristics(case 1 was LN IV-G(A),case 2 was LN IV-G(A)+V,and case 3 was LN IV-G(A)+thrombotic microangiopathy)were reviewed.All patients underwent repeated renal biopsies 6 mo later,and renal biopsy specimens were studied.Macrophage infiltration was assessed by CD68 expression detected by immunohistochemical staining,and an immunofluorescence assay was used to detect podocin expression to assess podocyte damage.After treatment,Case 1 changed to LN III-(A),Case 2 remained as type V LN lesions,and Case 3,which changed to LN IV-S(A),had the worst prognosis.We observed reduced macro-phage infiltration after therapy.However,two of the patients with active lesions after treatment still showed macrophage infiltration in the renal interstitium.Before treatment,the three patients showed discontinuous expression of podocin.Notably,the integrity of podocin was restored after treatment in Case 1.CONCLUSION It may be possible to reverse podocyte damage and decrease the infiltrating ma-crophages in LN patients through effective treatment.
