Eucommia lignans alleviate the progression of diabetic nephropathy through mediating the AR/Nrf2/HO-1/AMPK axis in vivo and in vitro / 中国天然药物

Lignans derived from Eucommia ulmoides Oliver (Eucommia lignans) inhibit the progression of inflammatory diseases, while their effect on the progression of diabetic nephropathy (DN) remained unclear. This work was designed to assess the function of Eucommia lignans in DN. The major constituents of Eucommia lignans were analyzed by UPLC-Q-TOF-MS/MS. The binding between Eucommia lignans and aldose reductase (AR) was predicted by molecular docking. Eucommia lignans (200, 100, and 50 mg·kg-1) were used in model animals to evaluate their renal function changes. Rat glomerular mesangial cells (HBZY-1) were transfected with sh-AR, sh-AMPK, and oe-AR in the presence of high glucose (HG) or HG combined with Eucommia lignans to evaluate whether Eucommia lignans affected HG-induced cell injury and mitochondrial dysfunction through the AR/Nrf2/HO-1/AMPK axis. Eucommia lignans significantly attenuated the progression of DN in vivo. Eucommia lignans notably reversed HG-induced upregulation of inflammatory cytokines and mitochondrial injury, while downregulating the levels of Cyto c, caspase 9, AR, and NOX4 in HBZY-1 cells. In contrast, HG-induced downregulation of Nrf2, HO-1 and p-AMPKα levels were abolished by Eucommia lignans. Meanwhile, knockdown of AR exerted similar therapeutic effect of Eucommia lignans on DN progression, and AR overexpression reversed the effect of Eucommia lignans. Eucommia lignans alleviated renal injury through the AR/Nrf2/HO-1/AMPK axis. Thus, these findings might provide evidence for the use of Eucommia lignans in treating DN.

Prognostic significance of systemic immune inflammation index in patients with pancreatic cancer based on propensity score matching analysis / 中华胰腺病杂志

Objective:To investigate the predictive value of systemic immune inflammation index (SII) for the overall survival of patients with pancreatic cancer by propensity score matching analysis.Methods:The clinical data of 457 patients with pancreatic cancer admitted to the Affiliated Hospital of Qingdao University from August 2000 to December 2019 were retrospectively analyzed. The age, gender, presence of jaundice, pancreatitis and diabetes, serum CA19-9, total bilirubin level, neutrophil count, platelet count, lymphocyte count in blood, presence of radical surgery, tumor TNM stage, tumor location and the like were recorded. The cut-off value of SII was determined by Youden index. The patients were divided into high and low SII groups accroding to the cut-off value. The propensity score matching was applied to reduce the selection bias of patients. Patients were 1∶2 matched and the caliper value was 0.1. The difference on overall survival between the two groups was compared. The prognostic factors were analyzed by univariate and multivariate Cox regression analysis. Kaplan-Meier was used to draw the overall survival curve to calculate the cumulative survival rate, and the differences between the curves were analyzed by Log-Rank test.Results:The cut-off value of SII was 765. There were statistically significant differences between the high SII group ( n=125) and the low SII group ( n=332) on the presence or absence of pancreatitis, the level of total bilirubin in blood, radical surgery, and TNM stage before the propensity score matching (all P value <0.05). After propensity score matching, there was no statistically significant difference between the high SII group ( n=113) and the low SII group ( n=182) on all the clinical parameters mentioned above except for CA19-9, indicating that the two groups were comparable. Univariate analysis showed that the level of CA19-9, SII, radical surgery and different TNM stage were all related to the overall survival of pancreatic cancer patients. Multivariate analysis showed that high CA19-9 level, high SII, no radical surgery, and worse TNM stage were independent risk factors for short overall survival, and high SII ( HR=1.882, 95% CI 1.446-2.450, P<0.001) was significantly associated with poor prognosis. The overall survival of patients with high SII was obviously shorter than the low SII group ( P<0.001), and the average survival time of patients with high and low SII were 8.86 and 11.38 months, respectively. Conclusions:SII is of great value in evaluating the overall survival of pancreatic cancer patients. Higher SII is associated with shorter overall survival.

The diagnostic and prognostic value of osteopontin in patients with pancreatic cancer: A meta-analysis / 中华肝胆外科杂志

Objective To study the expression of osteopontin (OPN) in pancreatic cancer and to determine its prognostic significance.Methods Studies which evaluated the relationship between the expression of OPN and pancreatic cancer published up to May 2018 were found by searching the electronic databases which included the PubMed,Embase,Cochrane Library,CNKI,Wanfang and VIP.The RevMan 5.3 was used to analyze the data in this meta-analysis by determining the odds ratios (ORs) and their 95％ confidence intervals (CIs).Results Using our predetermined selection criteria,this meta-analysis included 13 studies,with 1073 cases of pancreatic cancer tissues in the case group and 346 cases of normal tissues in the control group.The results indicated OPN was over expressed in pancreatic cancers (OR =8.13,95％ CI:6.00 ～ 11.02;P ＜ 0.05).The differences in the expressions of OPN between the well differentiation group and the moderate-poor differentiation group (OR =0.37,95％ CI:O.25 ～ 0.57;P ＜ 0.05),between the clinical stage Ⅰ-Ⅱ group and the clinical stage Ⅲ-Ⅳ group (OR =0.23,95 ％ CI:0.14 ～ 0.38;P ＜0.05),and between the lymph node metastasis group and the no lymph node metastasis group (OR =3.77,95％ CI:1.99 ～ 7.13;P ＜ 0.05) were significant.The expressions of OPN did not correlate with gender,age and location of pancreatic cancer.Conclusions Current evidence indicated that OPN was significantly correlated with pancreatic cancer and its clinicopathological features.OPN could be used as an effective diagnostic and survival evaluation marker.

Sesquiterpene glycosides from the roots of Codonopsis pilosula

Three new sesquiterpene glycosides, named codonopsesquilosides A-C (1-3), were isolated from an aqueous extract of the dried roots of Codonopsis pilosula. Their structures including absolute configurations were determined by spectroscopic and chemical methods. These glycosides are categorized as C15 carotenoid (1), gymnomitrane (2), and eudesmane (3) types of sesquiterpenoids, respectively. Compound 1 is the first diglycoside of C15 carotenoids to be reported. Compound 2 represents the second reported example of gymnomitrane-type sesquiterpenoids from higher plants. The absolute configurations were supported by comparison of the experimental circular dichroism (CD) spectra with the calculated electronic CD (ECD) spectra of 1-3, their aglycones, and model compounds based on quantum-mechanical time-dependent density functional theory. The influences of the glycosyls on the calculated ECD spectra of the glycosidic sesquiterpenoids, as well as some nomenclature and descriptive problems with gymnomitrane-type sesquiterpenoids are discussed.

Spontaneous bacterial peritonitis caused by Aeromonas caviae in a patient with cirrhosis / 中南大学学报(医学版)

Spontaneous bacterial peritonitis (SBP) is a common complication of cirrhosis. Based on our current understanding of SBP, the most common etiologies for SBP in cirrhosis are Enterobacter and Streptococcal species. Th e Aeromonas species are ubiquitous in fresh or sea water. Aeromonas caviae is never identified as etiology in cases of SBP. A patient, who had a history of liver cirrhosis related to chronic hepatitis B virus infection for 1 year, presented with diarrhea. He had diarrhea 1 week later returned from coastal city. He was hospitalized and treated with norfloxacin after 7 days of severe symptoms, including fever, abdominal distention, and diarrhea. Analysis of the ascitic specimen revealed a white-cell count of 4.42 × 109 cells/L with 88% neutrophils. Analysis of stool specimen showed a white-cell count of 60 cells per high-power field. Th e patient started the injection of cefriaxone at a dose of 4 g/d. However, the situation was not improved. Th ree days later, stool and ascitic fluid culture showed positive for Aeromonas caviae. Antibiotic susceptibility testing revealed that imipenem, meropenem, amikacin, and cefoperazone-sulbactam were highly sensitive to the Aeromonas caviae. However, the bacilli resisted to ceftriaxone, ceftazidime, ampicillin-sulbactam, levofloxacin, and sulfamethoxazole. Ceftriaxone was then switched to imipenem. The patient was fully recovered 14 days later. Aeromonas caviae is a rare pathogen of SBP in cirrhosis. It resists to third-generation of cephalosporin and fluroquinolone, which are of frequently used dependent on clinical experience. It needs a special attention.

Acetylenes and fatty acids from Codonopsis pilosula

Four new acetylenes (1-4) and one new unsaturated ω-hydroxy fatty acid (5), together with 5 known analogues, were isolated from an aqueous extract of Codonopsis pilosula roots. Their structures were determined by spectroscopic and chemical methods. The new acetylenes are categorized as an unusual cyclotetradecatrienynone (1), tetradecenynetriol (2), and rare octenynoic acids (3 and 4), respectively, and 3 and 4 are possibly derived from oxidative metabolic degradation of 1 and/or 2. The absolute configuration of 1 was assigned by comparison of the experimental circular dichroism (CD) spectrum with the calculated electronic circular dichroism (ECD) spectra of stereoisomers based on the quantum-mechanical time-dependent density functional theory, while the configuration of 2 was assigned by using modified Mosher׳s method based on the MPA determination rule of Δδ RS values for diols.

Serum proteomic analysis of pancreatic cancer associated diabetes / 中华胰腺病杂志

Objective To detect serum biomarkers for pancreatic cancer associated diabetes and establish a model for diagnosis.Methods SELDI-TOF-MS was used to detect the differentially expressed serum proteins from 17 pancreatic cancer associated diabetes patients,17 new-onset type Ⅱ diabetes patients and 17 healthy controls,then a model of biomarkers was constructed and validated by Biomarker Patterns Software 5.0.Results Twelve discriminating m/z peaks were identified in the protein fingerprints in 10 pancreatic cancer associated diabetes patients,10 new-onset type Ⅱ diabetes patients and 10 healthy controls.Among them,the three biomarkers of mass/charge ratio 6116,6695 and 8936 were used to construct the model,which could diagnose 90％ pancreatic cancer associated diabetes form control groups.Blind test of other7 samples of three groups showed that 100％ pancreatic cancer associated diabetes,71％ new-onset diabetes and 86％ healthy controls were correctly classified.After searching protein database,there were metallothionein,pancreatic progenitor cell differentiation and proliferation factor-like protein,and fibroblastic growth factor 1,which were close to the weights of the above mentioned 3 differentially expressed proteins.Conclusions SELDI can identify 3 biomarkers for pancreatic cancer associated diabetes and a reliable model for diagnosis of pancreatic cancer associated diabetes is established.

The clinical benefit response in treatment of unresectable pancreatic carcinoma by endoscopic ultrasongraphy-guided interstitial implantation of iodine-125 seeds combined with gemcitabine chemotherapy / 中华胰腺病杂志

Objective To investigate the clinical benefit response (CBR) in treating the unresectable pancreatic carcinoma by applying the EUS guided iodine-125 seed implantation combined with chemotherapy of gemeitabine and comparing chemotherapy of gemcitabine alone. Methods Forty-one patients with unresectable pancreatic carcinoma were randomly divided into two groups, one group (Group A) included 21 cases which underwent EUS-guided iodine-125 seed implantation combined with gemcitabine chemotherapy, the rest 20 cases (Group B) were treated with gemcitabine chemotherapy alone. EUS-guided iodine-125 seed implantation were carried according to the treatment plan system (TPS), following chemotherapy after 1 week. Gemcitabine was administered at the dose of 1 000 mg/m2, through intravenous administration once a week for 3 consecutive weeks every 4 weeks. CBR was assessed. Results CBR of Group A was 57.1% and median time to CBR was 1 week and median duration of CBR was 21 weeks, while CBR of Group B was 25%, and median time to CBR was 4 weeks and median duration of CBR was 15 weeks (P<0.01). Conclusions EUS-guided iodine-125 seed implantation combined with chemotherapy of gemcitabine was superior to gemcitabine chemotherapy alone in the term of CBR in patients with unresectable pancreatic carcinoma.

Inverse "Y" incision technique of enlargement annulus for double valve replacement in small aortic root: seven cases report / 中华胸心血管外科杂志

Objective To report the surgical procedure and its results of enlargement annulus for double valve replacement in small aortic root. Methods There were 7 patients with small aortic root undergoing double valve replacement. Mean age of 42 years (from 34 to 52 years). The diameters of aortic annulus ranged from 17 to 20?mm. The aortotomy was extended through the commissure that separates the left and noncoronary cusps of the aortic valve. The aortic annulus was divided, and the incision was extended into anterior leaflet of the mitral valve as inverse "Y". The anterior leaflet of the mitral valve was excised 3～5?mm to its root. A prosthetic patch was attached to the aortic-mitral valve so the aortic annulus was enlarged. The prosthetic valve was implanted. Moreover, it was attached to the prosthetic patch, at the root of the anterior leaflet of the mitral valve. Results The diameters of aortic annulus after operation were enlarged to 4～7?mm. The prosthetic valve (21～23?mm) was implanted in aortic valve position and the prosthetic valve (25～27?mm) in mitral valve position. There were no operative and postoperative deaths. One patient was re-operated for bleeding. All patients were followed up from 1 to 26 months and their cardiac function was significantly improved. Conclusion This surgical procedure is safe and effective for replacement, for double valve replacement in small aortic root.