Role of TXNIP/NLRP3 pathway in renal interstitial fibrosis after renal ischemia-reperfusion injury / 中华急诊医学杂志

Objective:To explore the role of thioredoxin interaction protein (TXNIP)/NOD-like receptor protein 3 (NLRP3) pathway in renal interstitial fibrosis induced by renal ischemia-reperfusion injury (IRI) in mice.Methods:Adult male C57BL/6J mice aged 6 to 8 weeks and TXNIP knockout mice with the same genetic background were selected. The wild type mice were divided into the sham operation (Sham) group and renal IRI group. The TXNIP knockout mice were divided into the sham+TXNIP KO group and IRI+TXNIP KO group, with 12 mice in each group. The model of renal ischemia-reperfusion injury was established by clamping bilateral renal pedicles for 45 min and then restoring perfusion. The sham operation model was only dissociated bilateral renal arteries without other treatment. Blood creatinine, urea nitrogen, kidney injury molecule-1 (Kim-1) and neutrophil gelatinase-associated lipocalin (NGAL), blood transforming growth factor-β (TGF-β) and interleukin 6 (IL-6) were measured on the 1st, 7th and 28th days after reperfusion. The renal cortex was taken on the 1st and 28th days for Masson staining, in which the renal tubule-interstitial injury score was obtained. TGF-β and IL-6 mRNA expression were detected by qPCR, TXNIP, NLRP3, Pro-IL-1β, IL-1β and α-SMA protein expression were detected by Western blot, and MDA and SOD levels were detected by ELISA. Homogeneity test of variance was performed before the statistics of normal distribution measurement data, one-way ANOVA was used for the comparison between multiple groups, and LSD- t test was used for the comparison between the two groups. Results:On the 1st, 7th and 28th days after IRI, compared with the sham group, the Scr, BUN, Kim-1, NGAL, TGF-β and IL-6 were increased continuously in the IRI group ( P<0.05). On the 28th day after IRI, large areas of collagen fibers and inflammatory cell infiltration were observed in the renal interstitium of the IRI group. In the IRI group, the scores of renal tubular injury and renal interstitial fibrosis on the 28th day were significantly higher than those on the 1st day (all P<0.05). On the 1st, 7th and 28th days after IRI, compared with the IRI group, the levels of Scr, BUN, Kim-1, NGAL, TGF-β and IL-6 were significantly decreased in the IRI+TXNIP KO group (all P<0.05). On the 1st and 28th days after IRI, compared to the IRI group, the areas of collagen fibers and inflammatory cell infiltration in the renal interstitium of the IRI+TXNIP KO group were decreased. The renal tubule injury score [Day 1, (192.2 ± 62.4) vs. (103.2 ± 49.1); Day 28, (154.3 ± 93.6) vs. (64.3 ± 24.8), both P<0.05] and interstitial fibrosis score [Day 1, (7.3 ± 3.2) vs. (4.8 ± 1.7); Day 28, (12.8 ± 3.9) vs. (2.3 ± 0.8), both P<0.05] were all decreased. The expression of TGF-β, IL-6 mRNA, TXNIP, NLRP3, Pro-IL-1 β, IL-1 β and α-SMA protein in renal cortex were significantly decreased (both P<0.05). In renal cortex, MDA level was decreased and SOD level was increased (all P<0.05). Conclusions:TXNIP/NLRP3 pathway is involved in the development of renal interstitial inflammation and fibrosis after renal ischemia and reperfusion. Knockout or inhibition of TXNIP can inhibit the progression of acute renal injury to chronic renal disease.

Oblique lumbar interbody fusion combined with posterior fixation for degenerative lumbar spondylolisthesis can further improve the lumbar segmental alignment / 中华骨科杂志

Objective:To evaluate the effect of oblique lateral interbody fusion (OLIF) combined with posterior fixation on segmental alignment in the treatment of degenerative spondylolisthesis (DS).Methods:The clinical data of 40 patients with DS who underwent OLIF combined with posterior fixation from July 2017 to December 2019 were retrospectively analyzed. There were 7 males and 33 females, aged 45-81 years, with an average age of 65.7±9.06 years. The total number of slip segments was 43, including 37 levels at L 4, 5, 5 levels at L 3, 4, and 1 level at L 2, 3. According to the decompression methods, the patients were divided into two groups. 22 patients with 23 levels were treated with direct decompression combined with laminectomy, and 18 patients with 20 levels were treated with indirect decompression without laminectomy. All patients underwent preoperative and intraoperative imaging examination. The disc height (DH), slip ratio (SR) and segmental lordosis (SL) were measured by preoperative CT and intraoperative fluoroscopy images. One-way repeated measures ANOVA was used to compare the radiographic parameters of the segmental alignment prior to cage implantation, following cage insertion and posterior fixation. Bonferroni test was used to compare the radiographic parameters between groups. Results:In the OLIF combined with the posterior fixation, there were statistically significant differences in the radiographic parameters of segmental alignment at different stages of operation [DH ( F=147.786, P<0.001) , SR ( F=83.754, P<0.001) , SL ( F=38.296, P<0.001) ]. DH increased from 7.99±1.39 mm to 11.69±1.72 mm ( P<0.001), SR decreased from 10.67%±4.67% to 8.66%±4.50% ( P=0.001) and SL increased from 7.26°±2.73° to 7.85°±2.30° ( P=0.425). After combined posterior fixation, SR further decreased from 8.66%±4.50% to 2.07%±4.00% ( P<0.001), SL further increased from 7.85°±2.30° to 10.72°±3.08° ( P<0.001), and DH had no significant change ( P=1.000). There was no significant difference in radiographic parameters between the direct decompression group and the indirect decompression group when prior to cage implantation, following cage insertion and following posterior fixation, respectively. Conclusion:OLIF combined with posterior fixation in the treatment of DS can further reduce the slip rate of patients with lumbar degenerative spondylolisthesis and increase the lordosis angle of the surgical segment. At the same time, the direct decompression combined with laminectomy has no significant effect on the segmental alignment.

Effect of carotid artery stenting on cognitive function in patients with severe carotid artery stenosis / 国际脑血管病杂志

Objective:To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with severe carotid artery stenosis.Methods:From January 2019 to December 2020, consecutive patients with severe carotid artery stenosis (stenosis degree ≥70%) treated in the Department of Neurology, Bozhou People's Hospital were selected. According to different treatment schemes, all patients were divided into a CAS group and a control group. The CAS group received CAS combined with the best drug treatment, while the control group only received the best drug treatment. The cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) before treatment and at 6 months after treatment.Results:During the study, 52 patients with severe carotid artery stenosis were enrolled, including 37 patients in the CAS group and 15 in the control group. There were no significant differences in demographic and baseline clinical data between the two groups. All patients in the CAS group completed procedure successfully without any complications. MoCA score in the CAS group was significantly higher than that before treatment ( P<0.001), but not in the control group. There was no significant difference in MoCA score between the patients in the CAS group and the control group before treatment; the MoCA score in the CAS group was significantly higher than that in the control group at 6 months after treatment ( P=0.007). Conclusion:CAS may improve the short-term postoperative cognitive function of patients with severe carotid artery stenosis.

Risk factors for cognitive impairment in patients with asymptomatic carotid stenosis / 国际脑血管病杂志

Objective To investigate the risk factors for cognitive impairment in patients with asymptomatic carotid stenosis (ACS).Methods Patients with ACS were enrolled.The related clinical data were collected,including age,gender,blood pressure,blood lipid,glycosylated hemoglobin,homocysteine (Hcy),white matter lesion (WML) and the degree of carotid stenosis.Montreal cognitive assessment (MoCA) was used to evaluate cognitive function.The patients were divided into either a cognitive impairment group (＞26) or non-cognitive impairment group (≥26).Multivariate logistic regression analysis was used to identify the risk factors for cognitive impairment in patients with ACS.Results A total of 123 patients with ACS were enrolled in the study,including 45 (36.6％) in the cognitive impairment group and 78 (63.4％) in the non-cognitive impairment group.There were significant differences in the degree of carotid stenosis,WML severity,years of education,age,and Hcy level between the 2 groups (all P ＞0.05).Multivariable logistic regression analysis showed that severe carotid artery stenosis (odds ratio [OR] 3.232,95％ confidence interval [CI] 1.134-9.208;P =0.028),severe WML (OR 8.930,95％ CI 2.683-31.688;P =0.015),and hyperhomocysteinemia (OR 2.671,95％ CI 1.877-3.609;P =0.037) were the independent risk factors for cognitive impairment in patients with ACS,while years of education were an independent protective factor of cognitive impairment in patients with ACS (OR 0.607,95％ CI 0.461-0.817;P =0.043).Conclusions Cognitive impairment may occur in patients with ACS.Years of education are an independent protective factor of cognitive impairment in patients with ACS,and severe carotid artery stenosis,severe WML,and hyperhomocysteinemia are its independent risk factors.

Correlation between levels of serum 25OHD and PTH with osteoporosis degree in elderly patients with fracture / 重庆医学

Objective To investigate the relationship between.serum 25-hydroxy vitamin D (25OHD) and parathyroid hormone (PTH) with the severity in elderly patients with osteoporosis.Methods A total of 160 patients with fractures treated in this hospital from January 2015 to January 2016 were selected and divided into the normal bone mass group(53 cases),osteopenia group (63 cases) and osteoporosis group(44 cases) according to the bone mineral density (BMD) in the lumbar vertebra 1-4,total hip and femoral neck any position.Then the serum levels of 25OHD,PTH,T value of BMD,serum osteocalcin (BGP) and bone alkaline phosphatase (ALP) were compared among 3 groups.Results The serum PTH detection value had no statistically significant difference among the normal group,osteopenia group and osteoporosis group (P＞0.05).The serum 25OHD level in the normal group was higher than that in the osteopenia group and osteoporosis group (P＜0.05);the serum BGP and.ALP levds in the normal group were significantly lower than those in the osteopenia group and osteoporosis group (P＜0.05).The level of serum 25OHD in the osteopenia group was higher than that in the osteoporosis group (P＜0.05).The level of serum BGP and ALP in the osteopenia group was significantly lower than that in the osteoporosis group (P＜0.05).The BMD value of the lumbar vertebra 1-4,total hip and femoral neck in the normal group was significantly higher than that in the steopenia group and osteoporosis group (P＜0.05).There was a significant positive correlation between serum 25OHD and the BMD value in lumbar vertebra 1-4,total hip joint and femoral neck (P＜0.05).Conclusion The level of serum 25OHD is significantly decreased in the patients with osteoporosis,and.is positively correlated with the BMD level.

Influence of SRT1720 on apoptosis ofhigh glucose-induced mouse mesangial cells / 中国药理学通报

Aim To investigate the effect of Sirt1 activator SRT1720 on high glucose(HG)-induced apoptosis in mouse mesangial cells(MMCs).Methods Cultured mouse MMCs were divided into normal glucose group(NG),NG plus mannitol group(M),high glucose group(HG),HG plus SRT1720 group(HG+SRT).Apoptosis of MMCs was analyzed by DeadEndTM Fluorometric TUNEL System and flow cytometry.Reactive oxygen species(ROS)production was observed by flow cytometry.The expression levels of caspase-3,cleaved caspase-3,Bax,Bcl-2,p38 MAPK,p-p38 MAPK,p53,acetylated p53 and cytochrome C protein were observed by Western blot.The mRNA levels of Bax and Bcl-2 were detected by real-time PCR.Results Compared with normal glucose group,the production of ROS,the number of cell apoptosis,the expression of cleaved caspase-3,p-p38 MAPK and acetylated p53 and ratio of Bax/Bcl-2 were significantly increased,the expression of Sirt1 was decreased,meanwhile,the release of cytochrome C from mitochondria to cytoplasm was significantly increased in MMCs in high glucose group.Treatment with SRT1720 inhibited HG-induced increase of ROS production,cell apoptosis,expression of cleaved caspase-3,acetylated p53 and p-p38 MAPK,ratio of Bax/Bcl-2 and release of cytochrome C,and reversed HG-induced Sirt1 expression.Conclusion SRT1720 could prevent HG-induced apoptosis maybe by decreasing ROS production,preserving mitochondrial function and inhibiting p53 acetylation and activation of p38 MAPK in MMCs.

Study on quality standard of Fushukang Granules / 中成药

Objective: To establish the quality standard of Fushukang Granules (Radix Astragali, Radix Angelicae sinensis, Rhizoma Chuanxiong, Radix Paeoniae Alba, etc.). Methods: TLC was used in qualitative identification of the Radix Astragali, Radix Angelicae Sinensis, Rhizoma Chuanxiong, Radix Paeoniase Alba. And TLC-scanning was used for assay of astragaloside I in the preparation. Results: Radix Astragali, Radix Angelicae Sinensis, Rhizoma Chuanxiong, Radix Paeoniae Alba could be detected by TLC. Astragaloside I had a good linear relationship within the range of 1.001～5.005?g(r=0.9998). The average recovery was 92.46%, and the RSD was 2.82%, respectively. Conclusion: The method established is stable and reliable. It can be used for quality control of the preparation.