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In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis-a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes.
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Humans , Mice , Animals , Non-alcoholic Fatty Liver Disease/metabolism , NF-kappa B/metabolism , Organelle Biogenesis , Retrospective Studies , Mice, Inbred C57BL , Obesity/metabolism , Liver , Inflammation/metabolism , Body Weight , Lipid Metabolism , Lipids , Diet, High-Fat/adverse effectsABSTRACT
Objective:To analyze the incidence and risk factors of non-acute symptomatic portal vein thrombosis (PVT) after endoscopic gastric variceal injection (GVI) in the treatment of liver cirrhosis with gastric variceal bleeding (GVB).Methods:66 patients with GVB who were treated with GVI for the first time from July 2017 to October 2019 in Minhang Hospital Affiliated to Fudan University were retrospectively analyzed. The data of gender, age, preoperative Child-Pugh grade, preoperative platelet count, preoperative plasma D-dimer concentration, preoperative splenic length, preoperative portal vein velocity, preoperative splenic vein velocity, preoperative portal vein diameter, preoperative splenic vein diameter, treatment times, total number of injection points, total dose of sclerosing agent and tissue adhesive agent were collected. The patients were divided into PVT group and non-PVT group according to the occurrence of non-acute symptomatic PVT within one year after GVI. Univariate analysis was performed first, and then the factors with P<0.2 were included in the binary logistic regression model to screen the risk factors of PVT after GVI. Results:There were 25 cases (37.88%) in PVT group and 41 cases (62.12%) in non-PVT group. There were significant differences in D-dimer concentration, spleen length, Child-Pugh grade and total dose of sclerosing agent between the two groups ( P<0.05). The D-dimer concentration ( OR=2.319, 95% CI:1.359-3.956), spleen length ( OR=1.044, 95% CI:1.007-1.081) and total dose of sclerosing agent ( OR=1.075, 95% CI:1.004-1.152) were independent risk factors for PVT ( P<0.05). Conclusions:Preoperative D-dimer concentration, spleen length and total dose of sclerosing agent can predict the risk of PVT after GVI. In order to reduce the risk of PVT after GVI, the dose of sclerosing agent should be reduced as much as possible.
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Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan on acute myocardial infarction complicated by heart failure.Methods Patients who suffered from anterior wall acute myocardial infarction (AMI) with heart failure (KillipⅡ ～ Ⅲ) within 12 to 24 hours after the onset of chest pain were randomized into two groups: the control group (n=30, receiving dobutamine and/or cedilanid) and the experimental group (n=30, receiving rh-BNP combined with levosimendan).The hemodynamics, parameters of laboratory tests and adverse events were observed before and after treatment.Results The experimental group showed that the respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), arterial blood gas oxygen saturation (SaO2), cardiac index (CI), extravascular lung water index (EVLWI) were significantly different between 2 h and sequential time points after treatment and pre-treatment (allP＜0.05).The control group showed that RR, HR, SaO2, CI, EVLWI were significantly different between 6 h and sequential time points after treatment and pre-treatment (P＜0.05 for all).There were significant differences in RR, HR, SBP, SaO2, CI, EVLWI at 2 h and 6 h after treatment between the two groups (P＜0.05 for all).Parameters of RR, HR, CI, EVLWI at 72 h after treatment had differences between the experimental group and controls.Patients in the experimental group presented larger urine volume, lower level of plasma NT-pro BNP, higher left ventricular ejection fraction (LVEF) and shorter length of stay in CCU as compared with patients in the control group (P＜0.05 for all).In adverse events monitoring in hepatic parameters, electrolyte level and coagulation function before and after treatment, there was no significant difference between the two groups.Conclusions Compared with the conventional treatment, the combination therapy with rh-BNP and levosimendon can improve the hemodynamics, increase the urine volume, decrease the level of plasma NT-proBNP and elevate LVEF significantly, so as to improve the clinical symptoms and shorten the hospital stay in patients with acute myocardial infarction complicated by heart failure.
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AIM:To explore the changes of plasma levels of soluble vascular endothelial growth factor receptor 2 ( sVEGFR2) and superoxide dismutase ( SOD) in hypertensive patients and hypertensive diabetic patients.METHODS:In this cross-sectional study, 88 cases were enrolled, which were divided into hypertensive group (n=31), hypertensive diabetic group ( n=31 ) and control group ( n=26 ) .Blood pressure was obtained from each participant with mercury sphygmomanometer.The levels of sVEGFR2 and SOD were measured by ELISA.Meanwhile, the levels of plasma glucose, glycosylated hemoglobin A1c ( GHbA1c) and lipid profile were detected.RESULTS:The levels of total cholesterol ( TC) and body mass index (BMI) were significantly higher in hypertensive group than those in control group (P<0.05).The levels of TC, low-density lipoprotein cholesterol ( LDL-C) , triglyceride ( TG) , BMI, waist circumference were significantly higher in hypertensive diabetic group than those in control group (P<0.05).The plasma levels of sVEGFR2 and SOD in both hypertensive diabetic group and hypertensive group were significantly decreased compared with control group ( P<0.05), while the mean plasma levels of sVEGFR2 and SOD in hypertensive diabetic group were significantly decreased compared to the hypertensive group ( P<0.05 ) .A significantly positive correlation between sVEGFR2 and SOD in the whole study population (P<0.05) was observed.CONCLUSION: The plasma level of sVEGFR2 is decreased in both hypertensive and hypertensive diabetic patients, and more significantly decreased in hypertensive diabetic patients.De-creased SOD level may be associated with to the reduction of sVEGFR2.
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AIM: To explore the effect of hydrogen sulfide on the senescence of human umbilical vein endothe -lial cells (HUVECs) induced by high glucose.METHODS: Senescence model was established by treating HUVECs with33 mmol/L glucose for 48 h.The parameters were detected to demonstrate the effect of hydrogen sulfide on senescence andthe mechanism involved was also investigated .RESULTS: In the cells treated with high glucose, the proliferation was attenuatedwith a higher number of senescence -associated β-galactosidase (SA-β-Gal) positive cells, and plasminogen activatorinhibitor 1 (PAI-1) protein expression, malondialdehyde (MDA) production and NF-κB p65 activity were increasedsignificantly, but the expression of superoxide dismutase 1 (SOD1) was decreased.However, the cell number and SOD1expression were increased, and the number of SA-β-Gal positive cells, PAI-1 protein expression, MDA production and theactivity of NF-κB p65 were decreased after sodium hydrosulfide (100 and 200 μmol/L) treatment.CONCLUSION: Exogenoushydrogen sulfide prevents HUVECs against high glucose -induced senescence by suppressing oxidative stress and NF -κB p65 activity.
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OBJECTlVE To investigate the myocardiaI toxicity of doxorubicin on the myocardium of rabbits and mechanism. METHODS Doxorubicin 2 mg·kg-1 was injected once a week for eight weeks. After discontinuation of doxorubicin,observation was performed for another 8 weeks. Every weekend, uItrasound examination,cardiac catheterization,angiotensinⅡ(AngⅡ)Western bIotting and pathoIogi-caI examination were performed to anaIyze eject fraction( EF),maximaI rate of rise of Ieft ventricuIar pressure(+dp/ dtmax ),AngⅡexpression IeveI,apoptosis index(AI)and the structure of the myocardium. RESULTS At the 7th injection,EF decreased( P ﹤0.05),but reached the bottom vaIue at the 8th injection. At the 3rd injection,Ieft ventricuIar +dp/ dtmax decreased( P ﹤0.05)and reached the bottom vaIue one week after withdrawaI. After that,it increased and reached a high vaIue six weeks after withd-rowaI. But it was stiII Iower than before administration. At the 2nd injection,AngⅡ expression increased (P﹤0.05). At 1 week after withdrawaI,it reached the top vaIue,but than decreased and reached a Iow vaIue six weeks after withdrowaI,but was stiII higher than before administration. At the 1st injection,AI increased( P ﹤ 0.05). At 1 week after withdrawaI,it reached the top vaIue,but then decreased and reached a Iow vaIue 5 weeks after withdrawaI. But it was stiII higher than before administration. CONCLUSlON Doxorubicin cardiac toxicity can induce an eIevated IeveI of myocardiaI AngⅡ,possibIy associated with increased aIdosterone and myocardiaI tension. Increased Ang Ⅱ may induce further myocardiaI structuraI damage and ventricuIar remodeIing through the ROS and caIcium imbaIance.
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Objective To analyze the consistency of transcutaneous perianal ultrasonography (TPUS) and pelvic magnetic resonance imaging (MRI) in diagnosing perianal lesions of Crohn's disease (CD), and to evaluate the value of transcutaneous perianal ultrasonography in detecting perianal lesions of CD. Methods A cohort of 102 patients diagnosed as Corhn's disease were enrolled from August 2008 to August 2010. Perianal abscess and fistula of these CD patients was diagnosed by ultrasonography and MRI system. Statistics was performed with SPSS 11.5 software for X2 test. The consistency was analyzed with Kappa test. Results The mean onset time of perianal lesions in CD was -0.443 year (95％CI:-1.659～0.773 year) before typical symptoms showed up. There was no significant difference in detecting perianal lesions of CD between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging (P ＝ 0.706, Kappa ＝ 0.541). If pelvic magnetic resonance imaging was considered as the golden standard in detecting perianal lesions of CD,the sensitivity (Sen), specificity (Spe), Youden's index, positive predictive value (PPV) and negative predictive value (NPV) of TPUS were 72.73％, 82.61％, 0.55, 66.67％ and 86.36％ respectively.Furthermore, there was no significant difference between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess ( P ＝ 0.706, Kappa ＝ 0.496) and fistula (P＝0.655, Kappa＝0.546) of CD. Conclusions Perianal lesions occur in the entire course of CD. There was favorable consistency between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess and fistula of CD. Transcutaneous perianal ultrasonography can be used as an additional method in detecting and evaluting perianal lesions of CD.
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BACKGROUND:Modern pharmacological studies have confirmed that Buyang Huanwu Decoction could expand blood vessels,improve microcirculation,decrease oxidative stress,Inflammation and platelet activation,so protect and improve the function of endothelial cells.But its certain mechanism is still unclear,especially for its impact on the restenosis of the coronary artery after percutaneous transluminal coronary angioplasty(PTCA).OBJECTIVE:To investigate the protective effects of Jiawei Buyang Huanwu Decoction on vascular stenosis and oxidative stress after balloon injury of rabbit iliac artery.METHODS:New Zealand rabbits,were randomized and divided into three groups,control group,model group and drug group respectively.Rabbits of control group were fed with common forage,but model group and drug group fed with high fat diet.Two weeks later,the iliac arteries were injured by balloon for model group and drug group.Meanwhile drug group were fed with Jiawei Buyang Huanwu Decoction after the operation,2 mL/kg per day.Control group underwent sham operation control.At the end of4 weeks,serum samples were stored to assay the levels of cholesterol,activity of superoxide dismutase(SOD)and levels of malondialdehyde(MDA).Injured iliac artery was fixed by neural formalin to observe the endothelial hyperplasia by light microscope,and the results were analyzed by picture analysis system.Differences of measurement were compared with one-way analysis of variance as well as repetitive measurements analysis of variance.RESULTS AND CONCLUSION:Iliac artery intima was thin,with Intact structure,without arteriosclerosis In the control group.The vascular lumina were narrower,intima was thicker and there were more enormous arteriosclerosis plaques in model group rabbits.The plaque thickness was reduced and stenosis was mild in drug group.TotaI cholesterol,triglyceridemia,low-density lipoprotein of cholesterol(LDL-C)and MDA levels were significantly lower in the drug group compared with the model group.whereas high-density lipoprotein of cholesterol(HDL-C)and serum SOD levels were significantly greater than the model group(P<0.05).The results showed that Jiawei Buyang Huanwu Decoction has significant preventive effect on intimal hyperplasia and the development of artherosclerosis in rabbits with iliac artery injury,and the mechanism of which may be related to modifying lipid metabolism and cleaning oxygen free radical anti-oxidative stress.
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Objective To compare the diagnostic performance of prospective electrocardiogram (ECG)-gating 320-detectorcomputed tomography coronary angiography (CTCA) versus retrospective ECG-gating CTCA. Methods 500consecutive patients suspected coronary artery disease with heart rate of less than 65 bpm were performed coronary computed tomography angiography (CCTA) with prospective (group P)and retrospective (group R) ECG gating in turn. The image quality was divided into four levels. Success rates, effective radiation dose,image quality and diagnosis were evaluated. Results Success rates of examination in group P and R are100%.Mean patient radiation dose was significantly different in group P (3.28±1mSv) and R(14.36 ±2.3 mSv).131 and 142 of 3750 segments (250 patients x 15 segments per patient) were too small(1.5mm)tobe characterized in group P and R. 96. 51% (3619/3750) and 96.12% (3608/3750) characterized segments were not significantly different in group P and R. 95.09% segments received a score of 4 and 1.09% segments received a score of 3 in group P, while 95.23% and 0.74% in group R.The cause of 2 and 3 points in the two groups was motion artifact. Stair-step artifacts and images scored as 1were not found.Compared with CAG,the sensitivity,specificity,false positive andfalse negative value in group P(86. 49% ,98. 70% ,88. 89% ,98.38%) and R(83. 87% ,98.74% ,89. 65%,97.93%) were not significantly different. Conclusion Although the patient radiation exposure was significantly lower, the diagnostic performance of prospective ECG-gating 320-detector CTCA was comparable with that of retrospective ECG-gating 320-detector CTCA on patients with stable heart rates less than 65 bpm.
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Objective To explore the function of infliximab in inducing remission in Crohn's disease and the effect of the inducing remission were followed up. Methods Ten patients with Crohn's disease received a infliximab, 5-aminosalicylic acid (5-ASA) and Azathioprine (AZA) therapy for inducing and maintenance remission. Crohn' s disease activity index (CDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), apartate aminotransferase, (AST), total bilirubin (TBil), conjugated bilirubin, (CB), creatinine (Scr) were evaluated at week 0, 10, 22 and 50. Simple endoscopic score for Crohn's disease (SES-CD) were evaluated at week 0, 10 and 50. Adverse reactions were also evaluated. Results At week 10, all patients achieved remission. The indicators of CDAI, CRP, ESR and SES-CD were significantly declined than those at week 0 (P＜0.01). The follow-up was terminated in one patient due to the relapse at week 30. At week 50, the indicators of CDAI, CRP, ESR and SES-CD in six patients a little bit increased compared with those at week 10, but no statistic significant (P=0. 2001、0. 0600、0. 1328、0. 4230 respectively), but significantly declined compared with those at week 0 (P =0.0005、0.0087、0.0054、0. 0163 respectively). No severe adverse reaction was observed in all patients.Conclusions Infliximab showed an exact efficacy in inducing remission in Crohn's disease. And 5-ASA and AZA were effective for maintenance remission in part of the patients after infliximab induced remission.
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Objective To investigate the expression of CD27-CD70 co-stimulatory pathway in peripheral circulation and intestinal mucosa of patients with inflammatory bowel disease, and to find the difference between the expression of CD27-CD70 in patients with inflammatory bowel disease and in healthy controls. Methods A total of 62 patients with Crohn's disease, 64 patients with ulcerative colitis and 56 healthy controls were enrolled. Enzyme-linked immunosorbent assay was applied to evaluate plasma CD27-CD70 protein expression in patients with inflammatory bowel disease and healthy controls. SYBR-green real time PCR was applied to access CD27-CD70 mRNA expression in peripheral blood mononuclear cells in patients with inflammatory bowel disease and healthy controls.And CD27-CD70 protein expression in intestinal mucosa was determined by immunohitochemistry.Results Plasma levels of CD27 (P=0. 025) and CD70 (P=0. 000) were significantly higher in patients with Crohn's disease than in healthy controls. However, CD27 (r= 0. 055, P= 0. 673) and CD70 (r= 0. 024, P = 0. 852) were not significantly associated with endoscopic disease activity in patients with Crohn's disease. Similarly, CD27 (P=0. 001) and CD70 (P=0. 000) were significantly higher in patients with ulcerative colitis than in healthy controls. And CD27 (r=0. 077, P=0. 547)and CDT0 (r=0.021, P=0. 869) were not significantly associated with endoscopic disease activity in patients with ulcerative colitis. Moreover, CD27 and CD70 mRNA expression in peripheral blood mononuclear cells were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000), and immunostaining indicated that CD27 and CD70 expression in intestinal mucosa were significantly higher in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P=0. 000). Conclusions CD27-CD70 pathway activated in plasma, peripheral blood mononuclear cells and intestinal mucosa of patients with inflammatory bowel disease. However,plasma levels of CD27 and CD70 can not reflect endoscopic disease activity.
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AIM: To investigate the effects of external counterpulsation (ECP) on nitric oxide (NO) and nitric oxide synthase (NOS) and the expression of NOS gene in myocardial infarction canines. METHODS: Nineteen healthy dogs were randomly divided into three groups ie. controls, ischemia group, ischemia and ECP group. Serum NO concentrations and myocardium NO levels and NOS specific activity were determined by modified nitrate reductase method. The protein synthesis of sub-type NOS including inducible NOS (iNOS) and endothelial NOS (eNOS) of myocardial tissue were also determined by immunohistochemical method. The constitutive NOS (cNOS) mRNA was measured via in situ hybridization. RESULTS: 120 and 180 minutes after the ligating of LAD, serum NO concentration in ECP groups were higher than those in ischemic groups (P
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AIM: To investigate clinical effect of tongxinluo capsule in treating stable angina pectoris patients, and its influence on endothelial function, superoxide dismutase (SOD) and malondialdehyde (MDA). METHODS: One hundred and twenty-four stable angina pectoris patients were divided into three groups, isosorbide treatment group (41 cases), tongxinluo capsule treatment group (40 cases), tongxinluo and isosorbide treatment group (combined treatment group, 43 cases). The serum concentrations of nitric oxide (NO), endothelin-1 (ET-1), SOD and MDA were determined before and after treatment. The data in traetment groups were compared with that in normal control. RESULTS: The symptoms of 3 groups were significantly improved, and the total effective rate of tongxinluo capsule group and combined treatment groups were better than that in isororbide treatment group (85.00% and 88.37% vs 73.17%, P