The role of podocyte autophagy and endoplasmic reticulum stress in diabetic kidney disease / 中华危重病急救医学

Diabetic kidney disease (DKD) is one of the serious complications of diabetes mellitus, and it has become the leading cause of chronic renal failure in China. Podocytes are highly differentiated epithelial cells and are the important part of the glomerular filtration barrier. Apoptosis and shedding of podocytes, foot process fusion and decreased expression of slit membrane proteins can lead to proteinuria, which in turn affects the progression of DKD. Autophagy is an important process for eukaryotic cells to degrade cytoplasmic proteins and organelles,the increase of autophagy level helps to reduce podocytes damage. Endoplasmic reticulum stress (ERS) is the accumulation of misfolded proteins in cells. It allows the cells into stress state, and may be able to regulate cell damage in both directions. Autophagy and ERS are regulated by multiple signaling pathways and are considered to be closely related to the occurrence and development of DKD. This article explained some pathways and the role of podocyte autophagy and ERS in DKD, and the interaction between podocyte autophagy and ERS, which providing some potential targets for the treatment of DKD by interfering with podocyte autophagy and ERS.

Safety and efficacy of transcatheter tricuspid valve replacement with LuX-Valve in patients with severe tricuspid regurgitation / 中华心血管病杂志

Objectives: To evaluate the safety and efficacy of LuX-Valve on the treatment of severe tricuspid regurgitation (TR). Methods: This is a prospective observational study. From September 2018 to March 2019, 12 patients with severe TR, who were not suitable for surgery, received LuX-Valve implantation in Changhai Hospital. LuX-Valve was implanted under general anesthesia and the guidance of transesophageal echocardiography and X-ray fluoroscopy. Access to the tricuspid valve was achieved via a minimally invasive thoracotomy and transatrial approach. Main endpoints were surgery success and device success. Surgery success was defined as successful implanting the device and withdrawing the delivery system, positioning the valve correctly and stably without severe or life-threatening adverse events. Device success was defined as satisfied valve function (TR severity reduction ≥ 2 grades, tricuspid gradient ≤ 6 mmHg (1 mmHg=0.133 kPa)), absence of malposition, valve failure and reintervention, major adverse events including device related mortality, embolization, conduction system disturbances and new onset shunt across ventricular septum at day 30 post implantation. Results: A total of 12 patients with severe to torrential TR were included in this study. The age was (68.5±6.9) years and 7 were female. All patients had typical right heart failure symptoms. Procedural success was achieved in all cases, there was no intraprocedural mortality or transfer to open surgery. TR significantly improved after LuX-Valve implantation (none/trivial in 8 patients, mild in 3 patients and moderate in 1 patient). The average device time was (9.2±4.2) minutes. Intensive care unit duration was 3.0 (2.0, 4.8) days. One patient died at postoperative day 18 due to non-surgery and device reasons. Transthoracic echocardiography at 30 days after operation showed that TR was significantly reduced (none/trivial in 8 patients, mild in 2 patients and moderate in 1 patient) and device success was achieved in 11 cases. All survived patients experienced a significant improvement in life quality with significantly improvement in New York Heart Association (NYHA) classification (Ⅰ and Ⅱ: 6/11 post operation vs. 0/11 before operation, P=0.012) and there were no device related complications in this patient cohort. Conclusions: LuX-Valve implantation is feasible, safe and effective for the treatment of patients with severe TR.

Effect of electroacupuncture on c-IAP1 mRNA and c-lAP2 mRNA in synovial tissues of rats with adjuvant arthritis / 针灸推拿医学（英文版）

Objective:To observe the therapeutic effect of electroacupuncture (EA) at Zusanli (ST 36),Guanyuan (CV 4) and Ashi points on adjuvant arthritis rats,and explore the mechanism of EA treatment of rheumatoid arthritis (RA).Methods:Sixty male rats were randomly divided into a normal group,a model group,a methotrexate group and an EA group,with 15 rats in each group.Rats in the normal group and the model group were routinely raised and did not receive treatment;rats in the methotrexate group received methotrexate at a dose of 0.35 mg/(kg·bw),twice a week for 3 weeks;rats in the EA group received acupuncture at Zusanli (ST 36),Guanyuan (CV 4) and Ashi points,and the bilateral Zusanli (ST 36) and Ashi points were connected to EA apparatus,once a day for 3 weeks.The general status,the swelling degree of the toe,the arthritis index (AI) score,the pathological morphology of the ankle joint,and the mRNA expressions of cellular inhibitor of apoptosis protein (c-IAP) 1 and c-IAP2 in joint synovial tissue cells of the rats in each group were observed.Results:The swelling degree of the toe,AI score and mRNA expressions of c-IAP1 and c-IAP2 in the model group were significantly higher than those in the normal group (all P＜0.05).Compared with the model group,the swelling degree of the toe,AI score and mRNA expressions of c-IAP1 and c-IAP2 in the methotrexate group and the EA group improved (P＜0.01 or P＜0.05);the expressions of c-IAP1 mRNA and c-IAP2 mRNA in rat synovial tissues in the EA group were significantly higher than those in the methotrexate group (P＜0.01).Conclusion:EA alleviates joint swelling in rats with adjuvant arthritis.The mechanism may be related to suppressing mRNA expressions of c-IAP1 and c-IAP2,thus to induce apoptosis of synoviocytes.

Regulatory mechanism of vascular smooth muscle cell phenotype switch in aortic disease: An update / 第二军医大学学报

Aortic disease (AD) consists of a series of life-threatening diseases caused by aortic wall lesions. Up to now little has been known about the etiology of non-hereditary AD. Vascular smooth muscle cells (VSMC) are the major components of the medial aortic wall and can toggle between a contractile phenotype and a synthetic phenotype. The excessive transformation of VSMC from contractile state to synthetic state plays an important role in the development and progression of AD. Although there are many researches on the regulation of VSMS phenotype switch, how these regulatory pathways operate harmoniously and the what relationship between them remain to be elucidated. Here in this paper we reviewed the existing regulatory mechanisms of VSMC phenotype switch.

Cause analysis and coping strategy of early bioprosthesis failure: A report of three cases and literature review / 第二军医大学学报

Objective To analyze the causes of early bioprosthesis failure(EBF) and to discuss its coping strategy. Methods The clinical data of patients who received bioprosthesis replacement in Changhai Hospital between Jan. 2001 and Jan. 2014 were reviewed. We also searched PubMed for related articles which were published from 1994 to 2014 using “bioprosthesis”, “heart valve prosthesis”, “early failure” and “bioprosthesis failure“ as the keywords. Results Only three EBF cases (0.5%) were found among a total of 650 cases who received bioprosthesis replacement in our hospital, and the reasons for EBF in the 3 cases were: native valve attachment, early calcification caused by metabolic syndrome, and early valve thrombosis. PubMed searched identified 14 EBF case reports, and the reasons for these 14 cases were as follows: native valve attachment in 6(42.9%) cases, metabolic abnormalities in 3(21.4%) cases, early valve thrombosis in 2(14.3%) cases, chronic inflammation in 2(14.3%) cases, and improper operation in 1 (7.1%) case. Conclusion EBF is a rare but serious complication after bioprosthesis replacement, with complicated causes. Appropriate preventive measures should be applied according to the different conditions of patients.

Research progress of tenascin-C in acute aortic dissection / 第二军医大学学报

Acute aortic dissection(AAD) is a medical emergency caused by the destruction of the aortic tunica media and is always fatal. Genetic disorders are known to be responsible for AAD, but little is known about the etiology of other non-genetic cases. Tenascin-C(TnC) is a large extracellular matrix glycoprotein and mechanical stretching can up-regulate TnC expression. TnC knockout (TnC-KO) mice have higher blood pressure in the aortic artery and are liable to develop AAD; and mice with AAD have more inflammatory cells in the aortic tissue. TnC prevents aorta from AAD by regulating ECM structure, regulating vascular smooth muscle cell function and inhibiting inflammatory response in the aorta. In this paper we reviewed the role of TnC in the development and progression of AAD.

Effects of jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke / 中国针灸

<p><b>OBJECTIVE</b>To observe improved effects of Jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke.</p><p><b>METHODS</b>Fifty cases were randomly divided into an observation group and a control group, 25 cases in each one. Regular western medicine treatment, rehabilitation training and regular acupuncture (in which Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. were selected) were applied in both groups. Additionally, muscles in palm side of affected hand, dorsal metacarpophalangeal joints and proximal interphalangeal joints were treated with acupuncture in the observation group, once every other day and electroacupuncture was applied when arrival of qi was acquired. Baxie (EX-UE 9) in the affected hand were needled in the control group, and electroacupuncture was added when arrival of qi was acquired. Ten days of treatment was considered a treatment course, and after two courses Lindmark score, Brunnstrom movement function grade, joint range of hand and Barthel index (BI) were observed in two groups.</p><p><b>RESULTS</b>Compared before the treatment, the Lindmark score in two groups were both improved after the treatment (both P < 0.01). Compared with the control group, the motor coordination ability, sensory function and total score of Lindmark in observation group were obviously improved (differences before and after treatment: 8.24 +/- 3.07 vs 6.84 +/- 2.43, 3.52 +/- 2.33 vs 2.16 +/- 2.12, 11.76 +/- 3.55 vs 9.00 +/- 3.62, all P < 0.05). The Brunnstrom movement function grade was significantly improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group (P < 0.05). The joint range of hemiplegic hand was improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group [differences before and after treatment: (25.35 +/- 10.91) degrees vs (18.65 +/- 7.86) degrees, p < 0.05]. The score of BI was also significantly improved after treatment in two groups (both P < 0.01).</p><p><b>CONCLUSION</b>The Jingjin acupuncture could effectively improve fine activity of hemiplegic hand in recovery period of stroke prove daily life ability.</p>

Treatment of stage 3b diabetic kidney disease patients with macroalbuminuria by qizhi jiangtang capsule: a multicenter randomized control clinical study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety of Qizhi Jiangtang Capsule (QJC) in treating stage 3b diabetic kidney disease (DKD) patients with macroalbuminuria.</p><p><b>METHODS</b>Patients who conformed to the diagnostic criteria of stage 3b DKD were randomly assigned to two groups according to random digital table, the experiment group and the control group, 84 in each group. All patients received a two-week elution period, and then were treated with basic Western therapy. Patients in the experiment group took QJC, 5 pills per time, 3 times a day, while those in the control group took Valsartan Capsule 160 mg each time, once daily. The observation period of follow-ups was limited within 6 months, and the time points were set as the baseline, 1st month, 3rd month, and 6th month. Systolic blood pressure (SBP), diastolic blood pressure (DBS), 24 h urine protein quantitative (24 h UPQ), plasma albumin (ALB), and serum creatinine (SCr) were detected and recorded, and estimated glomerular filtration rate (eGFR) was calculated. The occurrence of hypoglycemic reaction, coagulation disorder, gastrointestinal tract reaction, allergy, hyperkalemia, doubling of creatinine, and overall adverse events were observed and recorded at same time.</p><p><b>RESULTS</b>Finally 81 patients in the experiment group and 80 patients in the control group were effectively included. Compared with the baseline level, SBP and DBS obviously decreased in the control group at month 1 of treatment (P < 0.05), and more significantly decreased at month 6 of treatment (P < 0.01). SBP at month 1, 3, and 6 of follow-ups; DBS at month 6 of follow-ups was lower in the control group than in the experiment group (P < 0.05). At month 1, 3, and 6 of follow-ups, 24 h UPQ of the experiment group was significantly lower than the baseline level (P < 0.01). It was also significantly lower than the level of the control group at the same time point (P < 0.05). There was no significant difference in 24 h UPQ at month 1, 3, and 6 of follow-ups between the control group and the baseline level (P > 0.05). ALB of the experiment group showed an increasing trend. It was significantly higher than the baseline level at month 6 (P < 0.05), which was also higher than that of the control group at same period (P < 0.05). There was no significant difference in the ALB level in the control group (P > 0.05). SCr of two groups showed an increasing trend. SCr of the experiment group was significantly higher at month 1, 3, and 6 follow-ups than the baseline level (P < 0.05). But the increment of SCr was higher in the control group than in the experimental group, and obviously higher than the baseline levels (P < 0.05). eGFR of both groups showed a decreasing trend. The decrement was higher in the control group than in the experimental group (P < 0.05). The proportion of progression of renal functions at month 1, 3, and 6 of follow-ups in the experimental group was 0.0% (0 case), 9.55% (8 cases), and 21.4% (18 cases), while they were 8.3% (7 cases), 21.4% (18 cases), and 40.5% (34 cases) in the control group. There was no statistical difference in the proportion of progression of renal functions between the two groups at month 3 and 6 of follow-ups (P < 0.05). There was no statistical difference in the incidence of adverse reactions between two groups (P > 0.05).</p><p><b>CONCLUSION</b>QJC could effectively reduce urinary protein of patients with stage 3b DKD, and delay the progression of renal functions.</p>

Clinical observation of compound xiatianwu tablets in treatment of 120 cases with active rheumatoid arthritis / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy of Compound Xiatianwu tablets in the treatment of active rheumatoid arthritis.</p><p><b>METHOD</b>One hundred and eighty cases with active rheumatoid arthritis were randomly divided into the control group (60 cases) with leflunomide, sulfasalazine, and celecoxib; the treatment group (120 cases) given compound Xiatianwu tablets on the basis of the control group, 2 tablets each time, 3 times/day, with the course of treatment of 3 month. Patients of the two groups were observed for clinical symptoms, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and immunoglobulin changes before and after the treatment.</p><p><b>RESULT</b>The treatment group showed an overall efficiency of 94. 2% , the Xiatianwu group showed an overall efficiency of 80. 0%, while the control group showed an overall efficiency of 81.7%. The difference among the three groups was statistically significant (P <0. 05 or P <0. 01) , indicating that the treatment group was superior to the Xiatianwu group, while the Xiatianwu group was superior to the control group.</p><p><b>CONCLUSION</b>Compound Xiatianwu tablets has remarkable effect in the treatment of active rheumatoid arthritis.</p>

Stability of the hydrogenase from Tetraselmis subcordiformis and its preliminary purification / 生物工程学报

Tetraselmis subcordiformis, a marine green alga, can produce hydrogen by photobiologically hydrolyzing seawater with hydrogenase. In this study, the preliminary purification of the enzyme was explored by ammonium sulfate precipitation, and the impact of sodium dithionite, beta-mercaptoethanol and glycerol on the enzyme stability during the process was investigated. The experimental results illustrated that sodium dithionite provided significant protection on the hydrogenase by depleting oxygen, while glycerol, a protectant against the structure instability of the enzyme, also presented protection. Crude enzyme with specific activity of 0.557 U/mg protein was extracted using 60%-70% saturated ammonium sulfate solution supplemented with 200 mmol/L sodium dithionite and 5% glycerol, and the hydrogenase recovery yield was about 30%.

Subcellular localization and identification of hydrogenase isolated from the marine green alga Platymonas subcordiformis using immunoprecipitation and MALDI-TOF MS / 生物工程学报

A marine unicellular green alga, Platymonas subcordiformis, was demonstrated to photobiologically produce hydrogen gas from seawater. The objective of this study was to localize and identify the hydrogenase isolated from P. subcordiformis. Adaptation in the presence of inhibitors of protein biosynthesis indicated that the hydrogenase was much more inhibited by cycloheximide than that by chloramphenicol. The result suggested that the hydrogenase isolated from P. subcordiformis is probably synthesized in cytoplasmic ribosomes. Both Western blot analysis and immunogold electron microscopy demonstrate that the P. subcordiformis hydrogenase is mainly located in the chloroplast stroma. The proteins that reacted specifically with the antibodies against the iron hydrogenase isolated from Chlamydomonas reinhardtii were concentrated by immunoprecipitation. The separated protein bands were cut out of the SDS-PAGE gel, in-gel digested by trypsin, and analyzed by Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Mascot was employed for analysis of the MALDI data using the public databases NCBInr. The hydrogenase isolated from P. subcordiformis was identified to be the Fe-hydrogenase.