Advances in relationship between pyroptosis and pulmonary arterial hypertension and therapeutic drugs / 中国药理学通报

Pyroptosis is the programmed death of cells accompanied by an inflammatory response and is widely involved in the development of a variety of diseases, such as infectious diseases, cardiovascular diseases, and neurodegeneration. It has been shown that cellular scorching is involved in the pathogenesis of pulmonary arterial hypertension ( PAH) in cardiovascular diseases. Patients with PAH have perivascular inflammatory infiltrates in lungs, pulmonary vasculopathy exists in an extremely inflam-matory microenvironment, and pro-inflammatory factors in cellular scorching drive pulmonary vascular remodelling in PAH patients. This article reviews the role of cellular scorch in the pathogenesis of PAH and the related research on drugs for the treatment of PAH, with the aim of providing new ideas for clinical treatment of PAH.

Application of peripherally inserted central catheter in immune tolerance induction treatment of children with hemophilia A and accompanying inhibitors in China.

OBJECTIVE: To explore the feasibility, safety and cost effectiveness of the use of peripherally inserted central catheter (PICC) in children with hemophilia A and inhibitors who underwent ITI treatment. METHOD: This retrospective cohort study evaluated the effect of PICC placement and ITI on bleeding rates, costs, and parents' satisfaction before and within 6 months after PICC placement in children with hemophilia A and inhibitors. RESULTS: A total of 20 children with hemophilia A and high-titer inhibitors were included, with a success rate for PICC placement of 100%, at a cost of ¥6730.50. Parents' satisfaction with PICC was 100%, and the total length of catheter indwelling was 6055 days. In terms of curative effect, the success rate of ITI treatment was 75%, and the annualized bleeding rate was decreased from 10.90 ± 12.16 times before placement to 2.10 ± 3.32 times (p < 0.05). The transportation expense for children and their parents to the clinic decreased from ¥20,920 ± 32,274.57 before catheter placement to ¥2915 ± 2195.99 (p < 0.05). Time of children missed school and their parents missed work decreased from 10.85 ± 22.36 days to 1.90 ± 3.58 (p < 0.05) days and 40.33 ± 46.11 days to 3.83 ± 7.11 days (p < 0.05), respectively. CONCLUSION: The use of PICC for ITI treatment in children with hemophilia A and accompanying inhibitors in developing countries (e.g. China) can ensure the effect of ITI, reducing expense and improving the quality of life without obvious side effects.

Advances in neuroprotective effects of dihydromyricetin / 中国药理学通报

Dihydromyricetin is a dihydroflavone compound which widely exists in ampelopsis of grapevine family. It has many pharmacological effects, such as anti-inflammatory, antibacterial, anti-tumor, antioxidant, regulating blood glucose, reducing blood lipid, liver protection and so on. In recent years, it has been found that dihydromyricetin has a good neuroprotective effect and can play a certain pharmacological role in a variety of neurological diseases, including Alzheimer' s disease, depression, Parkinson's disease and stroke. The purpose of this paper is to review the research on the neuroprotective effect of dihydromyricetin in the past decade.

Progress on the neuroprotective effects of ginsenoside Rg1 / 药学学报

Ginsenoside Rg1 is one of the most important saponins in ginseng. It has a wide range of pharmacological activities. It is considered to be a powerful neuroprotective agent. It has neuroprotective effects such as anti-neuroinflammation, anti-oxidative stress, anti-neuronal apoptosis, and enhancing memory. Rg1 shows a good application prospect in the prevention and treatment of neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, stroke, and mental diseases such as depression. This paper reviews the research on the neuroprotective mechanism of Rg1 at home and abroad in recent years, in order to provide new research ideas for the clinical treatment of nervous system diseases.

MiR-223 promotes pyroptosis of enteritis cells through activating NF-κB signalling pathway by targeting SNIP1 in inflammatory bowel disease.

Inflammatory bowel disease (IBD) is a common inflammation-related intestinal disease. Studies have shown that excessive pyroptosis of intestinal cells is involved in the development of IBD. However, the regulatory mechanism of pyroptosis in IBD remains unclear. Here, our study purposed to clarify the underlying regulatory mechanism of miR-223 to promote pyroptosis in IBD.MiR-223 and Smad Nuclear Interacting Protein 1 (SNIP1) expression in colon tissues collected from IBD patients and healthy volunteers were evaluated using qRT-PCR. Cell viability and pyroptosis were evaluated by CCK8 and flow cytometry assay, respectively. Pyroptosis-related proteins and nuclear factor κB (NF-κB) signals were determined by WB. Dual-luciferase reporter gene assay was employed to investigate the binding relationship between miR-223 and SNIP1.MiR-223 was significantly upregulated in IBD colon tissues and cell models, while SNIP1 was significantly decreased. Silence of miR-223 markedly enhanced cell viability and inhibited pyroptosis in the IBD cell model. MiR-223 could bind to 3'-UTR of SNIP1 and SNIP1 could activate NF-κB signalling pathway. Further rescued experiment found that knockdown of SNIP1 dramatically abolished the bio-effects mediated by miR-223 silence on the cell viability and pyroptosis of the IBD cell model. Likewise, the inactivation of NF-κB signalling markedly weakened the regulatory roles of SNIP1 downregulation in the IBD cell model. Besides, inhibition of NF-κB signalling attenuated the pyroptosis-promoting effect of overexpressing miR-223.Our data suggested that miR-223 activated the NF-κB pathway via targeting SNIP1, thus promoting the process of cell pyroptosis, and ultimately participating in the pathogenesis of IBD.

Pharmacokinetic variability of factor VIII concentrates in Chinese pediatric patients with moderate or severe hemophilia A.

IMPORTANCE: The use of factor VIII (FVIII) concentrates under pharmacokinetic (PK) guidance has become the main approach for treatment of hemophilia. However, limited PK research has been conducted in Chinese pediatric patients. OBJECTIVE: To investigate the PK parameters of various FVIII concentrates in Chinese pediatric patients. METHODS: Seventy-nine patients were enrolled (28 treated with Kogenate FS®, 23 treated with Advate ®, and 28 treated with GreenMono™). All enrolled patients participated in single-dose PK analysis after at least a 3-day washout period. Blood samples were collected predose, as well as at 1 h, 9 h, 24 h, and 48 h after infusion; FVIII levels were measured using a one-stage clotting assay. von Willebrand Factor Antigen (VWF:Ag) levels and blood types were also determined. PK parameters were evaluated by WAPPS-Hemo. RESULTS: Mean values of terminal elimination half-life time (t1/2) for the Kogenate FS®, Advate®, and GreenMono™ FVIII groups were 12.24 h, 10.18 h, and 9.62 h; median clearance values were 4.16, 6.23, and 5.11 mL·kg-1·h-1; and median in vivo recovery values were 1.97, 1.55, and 1.61 IU/dL per IU/kg. Longer t1/2, higher in vivo recovery, and lower clearance were observed in patients with higher VWF:Ag level who were treated with recombinant concentrates. INTERPRETATION: Chinese pediatric patients with hemophilia had FVIII PK characteristics similar to those previously observed in non-Chinese children, including large variation among individuals. VWF:Ag level and FVIII brand were associated with differences in FVIII PK. Thus, PK-guided dosing should be used to optimize individualized therapy in Chinese children.

[Intervention mechanism of electroacupuncture in rats with ulcerative colitis: an analysis based on the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-kappa B signaling pathway].

OBJECTIVE: To investigate the protective effect of electroacupuncture(EA) on rats with ulcerative colitis (UC) and its effect on the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-kappa B (NF-κB) signaling pathway. METHODS: Sprague-Dawley rats were randomly divided into blank group, model group, salicylazosulfapyridine (SASP) group, low-intensity EA group, and high-intensity EA group, with 8 rats in each group. Enema with 2，4，6-trinitrobenzenesulfonic acid was performed to establish a model of UC. The rats in the two EA groups were given EA at"Tianshu" (ST25), "Guanyuan" (CV4), and "Zusanli"(ST36) for 15 min each time, once a day, with a current intensity of 1 mA for the low-intensity EA group and 5 mA for the high-intensity EA group(among them, "Tianshu" "Zusanli" bilateral alternate acupoints); the rats in the SASP group were given SASP suspension 3 mL every day by gavage. The course of treatment was 15 days for all groups. HE staining was used to observe the pathology of the colon and determine tissue damage index(TDI); ELISA was used to measure the serum levels of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-17 (IL-17), and prostaglandin E2 (PGE2); immunohistochemical staining and real-time PCR were used to measure the protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue. RESULTS: Compared with the blank group, the model group had significant reductions in body weight, serum IL-4, and IL-10 (P<0.05) and significant increases in colonic mucosa TID, the serum levels of IL-17 and PGE2 and the protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05). Compared with the model group, the SASP group and the EA groups had significantly higher body weight and serum levels of IL-4 and IL-10 (P<0.05), as well as significantly lower colonic TDI, serum levels of IL-17 and PGE2, and integrated optical density and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05). Compared with the SASP group, the low-intensity EA group had significantly higher colonic TDI and protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05), and compared with the SASP group, the high-intensity EA group had a significantly higher body weight (P<0.05) and lower colonic TDI and protein and mRNA expression of TLR4, MyD88, and NF-κB in colonic tissue (P<0.05). Compared with the low-intensity EA group, the high-intensity EA group had significantly higher body weight (P<0.05), and lower colonic TDI and protein and mRNA expression of TLR4, MyD88, and NF-kB in colonic tissue (P<0.05). CONCLUSION: Electroacupuncture exerts a protective effect on the colonic mucosa in rats with UC possibly by inhibiting the TLR4/MyD88/NF-κB signaling pathway and reducing the release of inflammatory cytokines, and high-intensity EA may have a better effect than low-intensity EA.

Multidisciplinary team for treatment of hip fracture in the elderly / 中华创伤骨科杂志

Objective:To explore multidisciplinary team (MDT) for the treatment of hip fracture in the elderly.Methods:A retrospective analysis was done of the 196 elderly patients who had been admitted to Department of Joint Surgery, Beijing Shijitan Hospital from September 2017 to December 2018 for hip fractures. They were divided into 2 groups depending on whether MDT had been applied or not. In the MDT group of 102 patients, there were 43 males and 59 females with an age of 81.9±8.4 years, and 63 femoral neck fractures and 39 intertrochanteric fractures. In the traditional treatment group of 94 patients, there were 37 males and 57 females with an age of 81.3±8.6 years, and 55 femoral neck fractures and 39 intertrochanteric fractures. The 2 groups were compared in terms of complications and mortality during hospitalization, interval from admission to surgery, total hospital stay, and Harris hip scores at 6 months after surgery.Results:There were no statistically significant differences in general data before surgery between the 2 groups, indicating comparability ( P>0.05). Eighty-four patients (89.4%) in the traditional treatment group and 98 patients (96.1%) in the MDT group underwent surgery, showing no significant difference between the groups ( χ2=3.327, P=0.068). In the patients undergoing surgery in the MDT group, the incidences of postoperative delirium [12.2% (12/98)], pulmonary infection [11.2% (11/98)], cardiogenic disease [13.3%(13/98)], electrolyte disturbance[12.2%(12/98)] and deep venous thrombosis of lower extremity [6.1% (6/98)] were significantly lower, the interval from admission to surgery (1.9 d±0.9 d) and total hospital stay (10.2 d±0.9 d) significantly shorter, and Harris hip scores (81.3±6.2) at 6 months after surgery significantly higher than those in the patients undergoing surgery in the traditional treatment group [31.0%(26/84), 22.6% (19/84), 25.0% (21/84), 28.6% (24/84), 16.7%(14/84); 3.1 d±1.6 d and 14.1 d±6.2 d; 75.4±7.8; respectively] (all P<0.05). Conclusion:In the treatment of hip fracture in the elderly, multidisciplinary team is effective in reducing complications during hospitalization, shortening the interval from admission to surgery and total hospital stay, and promoting functional recovery of the hip.

Analysis of the arthropathies on no-bleeding history joints in pre-school age severe hemophilia A children / 中华儿科杂志

Objective@#To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A.@*Methods@#This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted. The target joints (six joints of bilateral elbows, knees and ankles) of thirty-four children aged 1-7 years old with severe hemophilia A were examined by ultrasound, X-ray and joint function examination (4-7 years old, hemophilia joint health score (HJHS)). To find out whether there are arthropathies in patient's joints with no bleeding history and analyze the relevant factors by chi-square test, rank sum test and other statistical methods.@*Results@#There were 32 analyzable cases with 112 no-bleeding history target joints, 42.9% (48/112) were elbow joints. Arthropathies were revealed in 34.8% (39/112) of them by joint structural and functional examination and 46.2% (18/39) were ankles (χ2=8.379, P=0.015) . Ultrasound showed abnormalities in 18.3% (20/109) joints, X-ray showed abnormalities in 3.8% (3/79) joints and HJHS showed abnormalities in 25.3% (20/79) joints. There was no correlation between ultrasound and HJHS (r=0.015, P=0.895), no correlation was found between X-ray and HJHS (r=-0.101, P=0.390) either, which suggested that joint structural and functional examination could not replace each other. The related risk factors of arthropathies in this group were >4.91 years old (OR=3.917, 95%CI:1.610-9.528) and combining with target joint (OR=3.530, 95%CI:1.316-9.465).@*Conclusions@#Detecting the joint structure and function on no bleeding history joints in pre-school hemophilia A children could reveal the arthropathies and majority of them were ankle arthropathies. Joint structural and functional examinations could not replace each other. For patients more than 5 years old and those with target joints, the joints with no complaint of bleeding should be examined regularly to reveal the arthropathies in time.

Cannulated screws internal fixation plus three-column reconstruction for treatment of Lisfranc' s joint injuries / 中华创伤杂志

Objective To evaluate the preliminary outcome of cannulated screw internal fixation in treatment of the tarsometatarsal joint injuries.Methods From January 2005 to October 2010,21 patients(14 males and 7 females)with the tarsometatarsal joint injuries were treated.Their age ranged from 21 to 62 years(average 38.2 years).According to anatomical three-column classification,there were four patients with single medial column injury,four with medial and middle column injuries,three with middle and lateral column injuries,two with single lateral column injury and eight with three column injuries.The injury causes included traffic injury in nine patients,machine injury in eight and fall from height injury in four.The period from injury to admission was 2-15 hours(mean 5 hours).During operation,open reduction was performed,followed by internal fixation with the cannulated screw.X-ray examination was done in the regular follow-up and function was evaluated by using Maryland scoring system.Results Of all,19 patients were followed up for 4-47 months(mean 20 months),which showed no infection,loosing or breakage of the internal fixation.According to the Maryland scoring system,the clinical outcome was rated as excellent in eight patients,good in seven,fair in two and poor in two,with excellence rate of 79％.Conclusions The three-column theory plays an important role in clinical diagnosis and therapy of the tarsometatarsal joint injuries.Open reduction and cannulated screw internal fixation may attain satisfactory clinical results in treatment of the tarsometatarsal joint injuries.