Baicalin protects against renal interstitial fibrosis in mice by inhibiting the TGF-β/Smad signalling pathway

ContextBaicalin, a flavonoid extracted from radix scutellariae, possesses various pharmacological effects, including protective effects on renal interstitial fibrosis (RIF), but its possible role and mechanisms have not been fully elucidated.ObjectiveThis study explores the protective effects and mechanisms of baicalin on RIF.Materials and methodsC57BL/6 male mice were divided into six groups: sham, model, low baicalin, middle baicalin, high baicalin and positive drug groups. The unilateral ureteral obstruction (UUO) model of RIF was constructed and treated with baicalin doses (10, 20 and 40 mg/kg) and a positive control drug (valsartan, 8 mg/kg). H&E staining was used to observe the pathological changes in renal tissues, Masson staining was performed to evaluate collagen deposition in renal tissues, and immunohistochemical examination was adopted to determine α-SMA and extracellular matrix (ECM) expression. Primary mouse fibroblasts were isolated, extracted and treated with baicalin and/or TGF-β. qRT-PCR and enzyme-linked immunosorbent assay (ELISA) were applied to detect the inflammatory responses. Moreover, ECM and TGF-β/Smad expression levels were evaluated by western blot assay.ResultsBaicalin ameliorated RIF in UUO mice by inhibiting fibrosis and inflammatory responses. The TGF-β/Smad pathway was significantly suppressed in the UUO mouse model. Additionally, baicalin significantly inhibited ECM expression and inflammatory factors in fibroblasts treated with TGF-β. TGF-β/Smad pathway activation was significantly decreased in fibroblasts.Discussion and conclusionsThese findings support the use of baicalin as a potential therapeutic option for the treatment of RIF by possibly inhibiting the TGF-β/Smad signalling pathway.     

脑卒中患者吞咽障碍恢复不良影响因素的Meta分析

目的 系统分析脑卒中患者吞咽障碍恢复不良的影响因素。方法 系统检索中国知 网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Embase 数据库,收集 建库至 2022 年 12 月发表的脑卒中患者吞咽障碍恢复不良影响因素相关研究,使用 RevMan 5.4.1 软件 对纳入文献进行Meta分析。结果 共纳入 22 篇文献,4 248 例患者。Meta分析结果显示,年龄≥ 70 岁 （OR=1.53,95%CI：1.29～1.80）、美国国立卫生研究院卒中量表（NIHSS）评分≥ 8 分（OR=2.36,95%CI： 1.53～3.63）、改 良 Rankin 量 表（mRS）评 分 ＞ 0 分（OR=1.71,95%CI：1.40～2.09）、双 侧 卒 中（OR=4.85, 95%CI：2.62～8.97）、低密度脂蛋白（LDL）水平≥3 mg/L（OR=3.70,95%CI：2.46～5.56）、认知障碍（OR=6.23, 95%CI：0.98～39.58）、误吸（OR=4.47,95%CI：3.28～6.11）、气管插管（OR=2.70,95%CI：1.58～4.63）是脑 卒中患者吞咽功能恢复不良的危险因素（P＜ 0.05）;体重指数＞ 18.5 kg/m2 （OR=0.76,95%CI：0.67～0.86）、 Barthel 指数（BI）＞ 60 分（OR=0.37,95%CI：0.22～0.62）、功能独立性测评（FIM）评分＞ 20 分（OR=0.96, 95%CI：0.94～0.99）是脑卒中患者吞咽功能恢复不良的保护因素（P＜0.05）。结论 高龄、高NIHSS评分、 双侧卒中、低体重指数、高 mRS 评分、低 BI、低 FIM 评分、高 LDL 水平、合并认知障碍、误吸、气管插管是 脑卒中患者吞咽障碍恢复不良的危险因素,临床可结合影响因素完善吞咽障碍患者的管理措施。     

浅低温对心肌缺血-再灌注损伤合并脓毒症大鼠模型的心肌保护作用

目的:探究浅低温对心肌缺血-再灌注损伤合并脓毒症大鼠模型的心肌保护作用.方法:共15只SD大鼠随机分为心肌缺血-再灌注损伤合并脓毒症浅低温(MHT)组、心肌缺血-再灌注损伤合并脓毒症常温(NT)组和假手术常温组作为对照组.大鼠心肌缺血后再灌注同时给予内毒素,然后MHT组将大鼠置于冰床降温,15 min内达(33.0±0...     

雾化吸入剂治疗儿童哮喘的临床价值

目的探讨药物雾化吸入在治疗儿童哮喘病中的临床应用价值。方法以β受体激动剂沙丁胺醇和吸入型糖皮质激素普米克雾化吸入治疗作为观察组,口服氨茶碱和全身用糖皮质激素治疗作为对照组,观察组120例,对照组120例。结果治疗3d后,观察组120例中完全缓解106例(88.33%),部分缓解10例(8.33%),而对照组120例中完全缓解78例(65.00%),部分缓解28例(23.33%),观察组完全缓解显著高于对照组,有显著性差异(P<0.01)。结论雾化吸入β受体激动剂和糖皮质激素,既能解除呼吸道梗阻,又能降低气道高反应性,是哮喘治疗中最有效的方法。     

经皮肾微造瘘大功率钬激光碎石术与气压弹道碎石术治疗复杂性肾结石的比较

目的比较经皮肾微穿刺造瘘大功率钬激光碎石术与气压弹道碎石术治疗复杂性肾结石的有效性和安全性。方法回顾性分析我院自2005年1月～2007年10月使用大功率(45～60W)钬激光碎石术与气压弹道碎石术治疗复杂性肾结石患者82例92侧的临床资料,比较两种碎石方法的手术时间、结石取净率、术中出血量、并发症发生率等指标。结果钬激光组48侧患肾,气压弹道组44侧患肾,钬激光组平均碎石取石时间67min(43～124min),低于气压弹道组99min(66～142min)。钬激光组I期治疗结石排净率为75%,Ⅱ期治疗后结石总排净率为87.5%;气压弹道组I期治疗结石排净率为63.6%,Ⅱ期治疗后结石总排净率为75%。钬激光组术中出血量63ml(20～210ml),低于气压弹道组术中出血量125ml(40～310ml)。手术并发症发生率钬激光组为8.3%,低于气压弹道组18.1%。结论经皮肾微穿刺造瘘大功率钬激光碎石术治疗复杂性肾结石较气压弹道碎石术碎石时间短、效率高、手术并发症低,是治疗复杂性肾结石的有效方法。     

Individual and joint effects of borderline ankle-brachial index and high plasma total homocysteine on all-cause death in hypertensive adults

BACKGROUNDThe cardiovascular hazards of total homocysteine (tHcy) are long known. In addition, despite the acknowledgment on the importance of low ankle-brachial index (ABI) (< 0.9), borderline ABI (0.91-0.99) was once commonly overlooked. This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODSThis study included 10,538 participants from China H-type Hypertension Registry Study. ABI was described into two groups: normal ABI (1.00-1.40) and borderline ABI. tHcy level was also divided into two groups: < 15.02 and ≥ 15.02 μmo/L. Four groups were analyzed, using COX proportional hazard regression model, separately and pairwise to observe the independent and joint effect on all-cause death.RESULTSA total of 126 (1.2%) deaths were observed in the 1.7 years follow-up time. Borderline ABI has a higher predicted risk of death than normal ABI (HR = 1.87, 95%CI: 1.17-3.00) after adjusting for potential covariates. Compare with tHcy level < 15.02 μmo/L (low tHcy), those with tHcy ≥ 15.02 μmo/L (high tHcy) had higher risk to event outcome (HR = 1.99, 95% CI: 1.30-3.05). According to the cumulative hazard curve, group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups. Among those with borderline ABI, participants with high tHcy had higher death risk than those with low tHcy, nevertheless, no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONSBorderline ABI and tHcy level both have independent predictive value on all-cause death. The combined group of borderline ABI and high tHcy has highest risk factor of outcomes, which suggested the mutual additive value of borderline ABI and tHcy. More attention should be given to the importance of borderline ABI in hypertensive population, especially with elevated tHcy level.

Homocysteine (Hcy) is a sulfur-containing, non-proteinogenic amino acid synthesized through the transmethylation of amino acid methionine from one-carbon metabolism. Elevated plasma total homocysteine (tHcy) level is associated with endothelial dysfunction, increased blood coagulation, and metabolic disturbance, promoting cardiovascular diseases, stroke, and coronary artery disease.^[1,2] Notably, patients with high Hcy levels and concomitant hypertension were suggested to be at particularly higher risk.^[3] Moreover, increasing studies have explored a positive association between advanced Hcy level with all-cause mortality. According to a recent dose-response meta-analysis, for each 5-μmol/L increment of tHcy levels, the risk for all-cause mortality increased by 33.6%.^[4]The ankle-brachial index (ABI) is an effective, well-established measure that is commonly used in the diagnosis of peripheral artery disease (PAD),^[5] meanwhile was well studied as an important indicator of atherosclerosis and CVD events.^[6] Although ankle-brachial index (ABI) ≤ 0.90 has been recognized as the threshold value for abnormal/low ABI, which was proven to increase the risk of all-cause mortality,^[7] a study from the American Heart Association has suggested ABI between 0.91 and 1.00 should be considered as “borderline area” in terms of cardiovascular risks,^[8] considering of prior probability and sensitivity of ABI calculation. Emerging studies have aimed to explore the predictive value of borderline ABI,^[9-11] however, controversy remains because of limited and inconsistent data. The current study aimed to explore the individual and joint effect of borderline ABI and tHcy on all-cause mortality among hypertensive adults. Although ABI level ≤ 0.90 has been and is going to remain significant in clinical practice, we believe broader concern should be placed on borderline ABI, especially for its value in risk differentiation and identification. To the best of our knowledge, there are no similar previous studies.     

脑梗死患者血清Hcy、hs-CRP及NEFA水平与患者预后的相关性分析

目的 探讨脑梗死患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及游离脂肪酸(NEFA)水平与患者预后的相关性.方法 收集2018年6月至2019年6月医院收治的108例脑梗死患者(研究组)和同期体检70名健康志愿者(对照组)为研究对象.依据脑梗死病情程度不同分为大梗死组、中梗死组、小梗死组,依据患者神经...     

The Butterfly Fragment in Wedge‐Shaped Femoral Shaft Fracture: Comparison of Two Different Surgical Methods

ObjectiveOur study compared the results of wedge‐shaped femoral shaft fracture following intramedullary (IM) nailing with or without fixation of the third fragment.MethodsWe retrospectively reviewed patients presenting with femoral shaft fracture with AO/OTA type 32‐B from 2011 to 2016. Patients were divided into two groups: closed reduction without touching the third fragment and open reduction with fixation of the third fragment. The fragment ratio, fragment length, nail size, dynamization or not, mRUST scores, union rate, and union time were compared between the two groups. Risk factors of non‐union were also investigated, including sex, age, fracture pattern, fracture location, dynamization, nail size, fragment ratio, fragment size, and postoperative fragment displacement.ResultsA total of 80 patients met inclusion criteria, 20 patients with wedge‐shaped shaft femoral fracture were managed with IM nailing and open reduction with fixation of the third fragment. Sixty patients were treated with IM nail without touching the third fragment. The union rate for the fixation and non‐fixation groups were 60.0% and 81.7%, respectively. The mean union time for the fixation group was 19 months vs 14 months for the non‐fixation group. Multi‐regression analysis showed larger nail size (odds ratio: 2.26) and fixation of the third fragment (odds ratio: 0.18) influenced fracture healing.ConclusionsFixation of the third fragment in wedge‐shaped shaft femoral fracture results in a longer union time and lower union rate. In the management of femoral fracture with a third fragment, a larger nail size is recommended and fixation should be performed in a closed manner. Fixation of the fragment may achieve better fracture reduction. However, disruption of the vasculature and surrounding structures may further result in nonunion of the fracture site.     

乳铁蛋白对大鼠成骨细胞增殖与分化的影响

目的观察乳铁蛋白(Lf)对大鼠成骨细胞增殖分化的影响,初步探讨Lf对成骨细胞的作用机制。方法用不同浓度的Lf干预成骨细胞,在不同时间分别测定细胞数目的增殖、细胞内碱性磷酸酶活性,并用半定量RT-PCR法检测成骨细胞内RANKL/OPG mRNA基因的表达。结果Lf呈时间和浓度依赖性地促进大鼠成骨细胞增殖及碱性磷酸酶活性,每组实验在不同时间的差异均有显著的统计学意义(P<0.05),其中400μg/ml组在72h时细胞增殖数目达到最大。在碱性磷酸酶活性方面,400μg/ml组在72h时则有所下降。不同浓度Lf、不同作用时间均能促使成骨细胞中OPG mRNA表达增加,同时抑制RANKL mRNA表达。结论Lf能促进成骨细胞的增殖分化,并且能够调节成骨细胞RANKL/ OPG mRNA表达,从而抑制破骨细胞介导的骨吸收。     

VEGF在不同类型子宫内膜异位症中的表达

目的 探讨血管内皮生长因子在子宫腺肌症和卵巢子宫内膜异位囊肿发病机制中的作用.方法 采用免疫组化的实验方法 检测29例卵巢子宫内膜异位囊肿和36例子宫腺肌症患者在位内膜和异位内膜及33例正常子宫内膜组织中血管内皮生长因子的表达情况.结果 ①血管内皮生长因子在子宫腺肌症组中在位内膜和异位内膜的阳性表达显著高于正常子宫内膜组(χ2分别为29.30、13.16,均P＜0.01),在卵巢子宫内膜异位囊肿组中在位内膜和异位内膜阳性表达显著高于正常子宫内膜组(χ2=12.52,P＜0.01;χ2=5.15,P＜0.05);②血管内皮生长因子在子宫腺肌症和卵巢子宫内膜异位囊肿的在位内膜中阳性表达均显著高于同组的异位内膜表达(χ2分别为4.43、χ2=3.86,均P＜0.05),在子宫腺肌症在位内膜和异位内膜中的阳性表达高于卵巢子宫内膜异位囊肿中的在位内膜和异位内膜表达(χ2分别为3.97、3.85,均P＜0.05);③血管内皮生长因子在子宫腺肌症和卵巢子宫内膜异位囊肿在位内膜分泌期阳性表达较增殖期显著升高(χ2分别为3.90、3.87,均P＜0.05).结论 ①血管内皮生长因子在子宫腺肌症和巢子宫内膜异位囊肿中的异常表达对子宫腺肌症和卵巢子宫内膜异位囊肿发生、发展起着重要作用;②根据血管内皮生长因子在子宫腺肌症和卵巢子宫内膜异位囊肿中的表达差异,推测这两种疾病可能是同一病因在不同部位、不同环境的不同结果 .