Targeting PI3K/AKT signaling for treatment of idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrotic interstitial pneumonia with unknown causes. The incidence rate increases year by year and the prognosis is poor without cure. Recently, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB/AKT) signaling pathway can be considered as a master regulator for IPF. The contribution of the PI3K/AKT in fibrotic processes is increasingly prominent, with PI3K/AKT inhibitors currently under clinical evaluation in IPF. Therefore, PI3K/AKT represents a critical signaling node during fibrogenesis with potential implications for the development of novel anti-fibrotic strategies. This review epitomizes the progress that is being made in understanding the complex interpretation of the cause of IPF, and demonstrates that PI3K/AKT can directly participate to the greatest extent in the formation of IPF or cooperate with other pathways to promote the development of fibrosis. We further summarize promising PI3K/AKT inhibitors with IPF treatment benefits, including inhibitors in clinical trials and pre-clinical studies and natural products, and discuss how these inhibitors mitigate fibrotic progression to explore possible potential agents, which will help to develop effective treatment strategies for IPF in the near future.

Characteristics and practice management of intensive nursing care for 1 849 COVID-19 patients / 中华医院管理杂志

Objective:To explore and analyze the characteristics and causes of intensive nursing needs of COVID-19 patients.Methods:This was a cross-sectional study. Critical patients′ treatment and care information were extracted through the HIS system of a designated hospital from critical patients with COVID-19. We used statistical descriptions to analyze patient general information, nursing degree, and therapeutic intensive care needs. The chi-square test or Fisher′s exact test was used to analyze the differences between characteristics of patients and nursing degree.Results:A total of 1 849 cases of critical patients were collected, including special grade nursing care 697(37.70%), grade I nursing care(62.30%). There were 893(48.30%)patients aged≥65 years, and 853(46.13%)patients with one or more complications. All patients required the nursing routine of infection department, and the therapeutic intensive care followed was vein blood collection(99.62%), oxygen inhalation(98.92%), oral medication(98.65%), finger pulse oxygen monitoring(77.07%)and pharyngeal swab collection(71.93%). The nursing degree of the patients with different gender, age, admission mode, body position and complications were statistically significant( P<0.05). Conclusions:The intensive care nursing needs of COVID-19 patients are complex, which are special in treatment, life and psychology, and the tasks of nursing are heavy, difficult and professional. Special attention should be paid to elderly patients and patients with complications. Our hospital has established a provisional nursing department during the COVID-19 outbreak, coordinated nursing manpower and quality of nursing management, and set up a nursing expert consultation team to further enhance the quality of nursing care for critical COVID-19 patients.

Natural products remodel cancer-associated fibroblasts in desmoplastic tumors

Desmoplastic tumors have an abundance of stromal cells and the extracellular matrix which usually result in therapeutic resistance. Current treatment prescriptions for desmoplastic tumors are usually not sufficient to eliminate the malignancy. Recently, through modulating cancer-associated fibroblasts (CAFs) which are the most abundant cell type among all stromal cells, natural products have improved chemotherapies and the delivery of nanomedicines to the tumor cells, showing promising ability to improve treatment effects on desmoplastic tumors. In this review, we discussed the latest advances in inhibiting desmoplastic tumors by modeling CAFs using natural products, highlighting the potential therapeutic abilities of natural products in targeting CAFs for cancer treatment.

Analysis of hot research areas for foreign nursing leadership based on bibliometric and biclustering / 中华护理杂志

Objective To understand the status quo of foreign nursing leadership in recent 20 years,and compare and analyze the hotspots and trends of foreign nursing leadership.Methods The bibliometric analysis and cluster analysis were used for analyzing the literature of nursing leadership in PubMed from 1997 to 2006 and from 2007 to 2016,via Bicomb and gCLUTO softwares.Results A total of 482 articles were included.Bibliometric analysis showed that foreign nursing leadership literature number was increasing,which was mainly concentrated in the United States and England.The biclustering analysis showed that the research from 1997 to 2006 focused on patient safety and nursing leadership styles,education and training of nursing leadership,clinical nursing leadership models and nursing quality management;from 2007 to 2016,the research mainly focused on patient safety and nurses' psychological research,clinical nursing leadership theory,clinical nursing practice and competency training,and nnrses' role of leadership research.Conclusion The foreign nursing leadership theory has been developed well for its variety of topics and methods,and the object has been shifted from nursing administrators to clinical nurses.Future research should focus more on application of leadership in clinical nursing,and specialized leadership model and training system may be developed.

Antidepressant effect and mechanism of Gross saponins of Tribulus terrestris / 中国药理学通报

Aim Tostudytheantidepressanteffectand mechanism of Gross saponins of Tribulus terrestris. Methods Themodelofdepressionwasestablishedby unpredictable chronic mild stress(UCMS),then open filed test (OFT)and tail suspension test (TST)were used to evaluate the behavioral changes.LC-MS/MS method was employed to measure blood neurotransmit-ters.mRNA expressions of IDO,IL-10 and IL-1βwere detected by quantitative PCR method.Hippocampus protein expression was detected by Western blot.Re-sults Comparedwithcontrolgroup,modelgroup's total distance,number of standing and tail suspension fixed time increased significantly (P <0. 05 ),Neuro-transmitter level of 5-HT in the blood was significantly decreased(P<0. 05 ).mRNA expression of IDO and IL-1βwas increased in hippocampus.Protein expres-sion of IDO was significantly increased in hippocampus (P <0. 05 ).Compared with model group,the treat-ment group was significantly decreased in total distance,number of standing and tail suspension fixedtime(P<0. 05).Neurotransmitter level of 5-HT in the blood and mRNA expression of IL-10 in hippocampus were significantly increased after treatment (P <0. 05 ).mRNA and protein expression of IDO were ob-viously down-regulated in hippocampus (P <0. 05 ). Conclusions GrosssaponinsofTribulusterrestriscan obviously improve rat behavior and show antidepressanteffect,which can increase neurotransmitter level of 5-HT in the blood,down-regulate mRNA expression of IDO and IL-1β,and obviously increase protein expres-sion levels of IDO in hippocampus(P<0. 05 ).

Remodeling the blood-brain barrier microenvironment by natural products for brain tumor therapy

Brain tumor incidence shows an upward trend in recent years; brain tumors account for 5% of adult tumors, while in children, this figure has increased to 70%. Moreover, 20%-30% of malignant tumors will eventually metastasize into the brain. Both benign and malignant tumors can cause an increase in intracranial pressure and brain tissue compression, leading to central nervous system (CNS) damage which endangers the patients' lives. Despite the many approaches to treating brain tumors and the progress that has been made, only modest gains in survival time of brain tumor patients have been achieved. At present, chemotherapy is the treatment of choice for many cancers, but the special structure of the blood-brain barrier (BBB) limits most chemotherapeutic agents from passing through the BBB and penetrating into tumors in the brain. The BBB microenvironment contains numerous cell types, including endothelial cells, astrocytes, peripheral cells and microglia, and extracellular matrix (ECM). Many chemical components of natural products are reported to regulate the BBB microenvironment near brain tumors and assist in their treatment. This review focuses on the composition and function of the BBB microenvironment under both physiological and pathological conditions, and the current research progress in regulating the BBB microenvironment by natural products to promote the treatment of brain tumors.

Modification and stability of ginsenoside Rg1PEG / 中国中药杂志

<p><b>OBJECTIVE</b>To study the stability of ginsenoside Rg1 before and after being modified by PEG (PEG-Rg1) in isolated rat stomachs.</p><p><b>METHOD</b>SD rats, after 18 h of fasting, were randomly divided into the Rg1 group and the PEG-Rg1 group. Rg1 stomach perfusion fluid and PEG-Rg1 infusion fluid were accurately extracted and injected into their stomachs in vitro, with oscillation at 37 degrees C. Samples were taken in different time points and contents of ginsenoside Rg1 were determined by UPLC to observe and compare the stability of ginsenoside Rg1 and PEG-Rg1 in rat stomachs in vitro.</p><p><b>RESULT</b>Rg1 in rat stomachs showed poor stability, Rg1 was measured to be 26.8% in 2 h, with degradation of 73.2%. Its stability in PEG-Rg1 was improved in rat stomachs, Rg1 was measured to be 81.8% in 2 h, with degradation of only 18.2%.</p><p><b>CONCLUSION</b>PEG-modified ginsenoside Rg1 can enhance the stability of ginsenoside Rg1 in stomach and improve degradation and poor stability of ginsenoside Rg1 in stomach.</p>

Tissue distribution of ginsenoside Rg1 before and after modification by PEG / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate targeted distribution of ginsenoside Rg1 in mice tissues before and after modification by the PEG.</p><p><b>METHOD</b>SD mice were randomly divided into two groups and given Rg1 and PEG-Rg1 by intravenous injection respectively. Their samples of blood and organ tissues were taken at different time points. The content of Rg1 in samples were determined by UPLC and used as indicator to observe the targeted distribution of Rg1 in mice tissues.</p><p><b>RESULT</b>The AUC of ginsenoside Rg1 in tissues of the Rg1 group were in the order of liver, kidney, lung, heart and spleen, with the liver targeting coefficient was of 2.01. While the AUC of ginsenoside Rg1 in tissues of the PEG-modified group were in the order of the kidney, liver, lung, heart, spleen, with the liver targeting coefficient was of 9.21.</p><p><b>CONCLUSION</b>PEG modified Rg1 can increase Rg1's targeting selectivity to the liver, kidney and lung in mice.</p>

Preparation,optimization and characterization of NC-1900 loaded MePEG-PLA nanoparticles / 复旦学报（医学版）

Purpose To optimize the preparation of NC-1900 loaded MePEG-PLA nanoparticles (NPs). Methods MePEG-PLA copolymers of different molecular weight synthesized by solvent poly-merization method were used to prepare NC-1900 loaded MePEG-PLA NPs by double emulsion/solvent evaporation method.Orthogonal experimental design and multiple regressions were used to optimize the preparation method with nanoparticle size and NC-1900 encapsulation efficiency (EE) as res-ponse variables.NPs were characterized by particle size and Zeta potential detector and transmission electron microscope.The leakage of NC-1900 from NPs was evaluated by high-performance liquid chromatography (HPLC) detection. Results MePEG3000-PLA44800 NPs prepared according to the optimized conditions had a mean diameter of (77 ± 11) nm and EE of (21.4 ± 0.1) %.Only 5% and 15% of NC-1900 were leaked in pH 7.4 PBS and blank plasma at the end of 48 h,respectively. Conc-lusions The optimized MePEG3000-PLA44800 NPs is a favorable carrier for NC-1900.