Pharmacodynamic Evaluation and Mechanism of Ginseng Polysaccharide against Nephrotoxicity Induced by Hexavalent Chromium.

Hexavalent chromium is a common pollutant in the environment. Long-term exposure to hexavalent chromium can cause damage to multiple organs. The kidney is one of the main organs that metabolizes heavy metal toxicity, and the accumulation of Cr (VI) in the body can lead to serious damage to kidney function. Studies have shown that ginseng polysaccharides have the function of preventing cisplatin-induced endoplasmic reticulum stress, inflammatory response, and apoptosis in renal cells, but their efficacy and mechanisms against hexavalent chromium-induced nephrotoxicity need to be explored. The aim of this study was to explore the efficacy and mechanism of ginseng polysaccharide against hexavalent chromium-induced nephrotoxicity. The results of pharmacodynamic experiments showed that ginseng polysaccharide could significantly reduce the kidney index, urea nitrogen (BUN), and serum creatinine (Cre) values of K2Cr2O7-treated mice. The results of mechanistic experiments showed that ginseng polysaccharides could alleviate oxidative stress, apoptosis, and biofilm damage in renal tissues caused by Cr (VI). Lipidomic correlation analysis showed that ginseng polysaccharides could protect the organism by regulating the expression of differential lipids. This study opens new avenues for the development of alternative strategies for the prevention of kidney injury caused by hexavalent chromium.

[Characteristics and influencing factors of early pain in patients after total knee arthroplasty].

OBJECTIVE: To investigate the current status of early pain in patients after total knee arthroplasty under enhanced recovery mode and analyze the influencing factors. METHODS: In the study, 142 patients with total knee arthroplasty of a hospital in Beijing were investigated by convenient sampling. Visual analog scale (VAS) was used to describe the degree of pain (including resting pain and activity pain) within 3 days after operation, and the nature and location of pain and satisfaction with the analgesic effect of the patients were recorded. The influencing factors included age, gender, place of residence, education level, body mass index (BMI), years of pain, chronic medical history, surgical history, surgical duration, whether to indwell a drainage tube, type of carer, severity of the disease, sleep quality, anxiety, depression, and preoperative pain level. The investigation tools of influencing factors were the general information questionnaire of patients, pain assessment questionnaire, Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Firstly, single factor analysis was carried out on the included influencing factors, and then multiple stepwise regression analysis was carried out on the statistically significant variables to clarify the main influencing factors of early pain in patients after total knee arthroplasty. RESULTS: The peak pain of the patient occurred at night on the first postoperative day and in the afternoon on the second postoperative day, with resting pain scores of (2.5±1.2) and (2.7±1.1), and activity pain scores of (3.8±1.5) and (4.0±1.6); the most common pain site was posterior knee pain (68, 47.9%), followed by anterior knee combined with posterior knee pain (32, 22.5%), anterior knee pain (27, 19.1%), anterior knee combined with medial knee pain (10, 7.0%), and anterior knee combined with lateral knee pain (5, 3.5%); the nature of pain was mostly composed of soreness combined with swelling pain (58, 40.8%), while the rest included simple soreness (26, 18. 3%), simple swelling pain (24, 16.9%), hot burning pain (10, 7.0%), pricking pain (9, 6.3%), spasmodic traction pain (5, 3.5%), tearing pain (4, 2.8%), knife cutting pain (3, 2.2%), and stabbing pain combined with soreness (3, 2.2%); the patients who were satisfied and very satisfied with the analgesic effect were 114 (80.3%). The results of univariate analysis showed that there were significant differences in sleep quality, disease severity, types of care-givers and depression score (P<0.05). The results of multiple stepwise regression analysis showed that the main factors affecting the patients' early postoperative pain were preoperative sleep quality, depression, the Knee Society score and the type of care (P=0.002). CONCLUSION: Most patients under enhanced recovery after surgery are satisfied with the effect of pain control after operation. Medical staff can carry out predictive intervention in patients' sleep quality, depression to reduce the patients' early postoperative pain. At the same time, the research results suggest that choosing family members to accompany the patients can effectively improve the patients' early postoperative pain experience.

Investigation of the Mechanism of Action of Periploca forrestii Schltr. Extract on Adjuvant Collagen Rats Based on UPLC-Q-Orbitrap-HRMS Non-Targeted Lipidomics.

Periploca forrestii Schltr. (P. forrestii) is a classical medicinal plant and is commonly used in traditional medicine for the treatment of rheumatoid arthritis, soft tissue injuries, and traumatic injuries. The aim of this study was to evaluate the anti-arthritic effects of three fractions of P. forrestii alcoholic extracts (PAE), P. forrestii water extracts (PWE), and total flavonoids from P. forrestii (PTF) on Freund's complete adjuvant (FCA)-induced arthritis in rats, and to use a non-targeted lipidomic method to investigate the mechanism of action of the three fractions of P. forrestii in the treatment of rheumatoid arthritis. To assess the effectiveness of anti-rheumatoid arthritis, various indicators were measured, including joint swelling, histopathological changes in the joints, serum cytokines (tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6)), and the joint inflammatory substance prostaglandin E2 (PGE2). Finally, ultra-performance liquid chromatography-quadrupole-orbitrap-high-resolution mass spectrometry (UPLC-Q-Orbitrap-HRMS) was used to determine the non-targeted lipid histology of the collected rat serum and urine samples to investigate the possible mechanism of action. PWE, PAE, and PTF were all effective in treating FCA-induced rheumatoid arthritis. The administered groups all reduced joint swelling and lowered serum inflammatory factor levels in rats. In the screening of lipid metabolite differences between serum and urine of the rat model group and the normal group, a total of 52 different metabolites were screened, and the levels of lipid metabolites in PWE, PAE, and PTF were significantly higher than those in the normal group after administration. In addition, PWE, PAE, and PTF may have significant therapeutic effects on FCA-induced arthritis by modulating nicotinic acid, nicotinamide, and histidine metabolic pathways.