Danggui-Shaoyao San alleviates cognitive impairment via enhancing HIF-1α/EPO axis in vascular dementia rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Invigorating blood circulation to remove blood stasis is a primary strategy in TCM for treating vascular dementia (VaD). Danggui-Shaoyao San (DSS), as a traditional prescription for neuroprotective activity, has been proved to be effective in VaD treatment. However, its precise molecular mechanisms remain incompletely understood. AIM OF THE STUDY: The specific mechanism underlying the therapeutic effects of DSS on VaD was explored by employing network pharmacology as well as in vivo and in viro experiment validation. MATERIALS AND METHODS: We downloaded components of DSS from the BATMAN-TCM database for target prediction. The intersection between the components of DSS and targets, PPI network, as well as GO and KEGG enrichment analysis were then performed. Subsequently, the potential mechanism of DSS predicted by network pharmacology was assessed and validated through VaD rat model induced by 2VO operation and CoCl2-treated PC12 cells. Briefly, the DSS extract were first quantified by HPLC. Secondly, the effect of DSS on VaD was studied using MWM test, HE staining and TUNEL assay. Finally, the molecular mechanism of DSS against VaD was validated by Western blot and RT-QPCR experiments. RESULTS: Through network analysis, 137 active ingredients were obtained from DSS, and 67 potential targets associated with DSS and VaD were identified. GO and KEGG analysis indicated that the action of DSS on VaD primarily involves hypoxic terms and HIF-1 pathway. In vivo validation, cognitive impairment and neuron mortality were markedly ameliorated by DSS. Additionally, DSS significantly reduced the expression of proteins related to synaptic plasticity and neuron apoptosis including PSD-95, SYP, Caspase-3 and BCL-2. Mechanistically, we confirmed DSS positively modulated the expression of HIF-1α and its downstream proteins including EPO, p-EPOR, STAT5, EPOR, and AKT1 in the hippocampus of VaD rats as well as CoCl2-induced PC12 cells. HIF-1 inhibitor YC-1 significantly diminished the protection of DSS on CoCl2-induced PC12 cell damage, with decreased HIF-1α, EPO, EPOR expression. CONCLUSION: Our results initially demonstrated DSS could exert neuroprotective effects in VaD. The pharmacological mechanism of DSS may be related to its positive regulation on HIF-1α/EPO pathway.

Progress in diagnosis and treatment of Riedel's thyroiditis / 中华内分泌外科杂志

Riedel's thyroiditis (RT) is a rare form of thyroid disease,and the rate of misdiagnosis is high due to the low incidence of RT and the lack of understanding of the disease by clinicians.There is currently no standard and guidance for the diagnosis and treatment of RT.Improving the understanding of RT is of great significance for standardizing diagnosis and treatment and improving the life quality of patients.

The necessity and strategy of multidisciplinary team in management of thyroid carcinoma / 中华内分泌外科杂志

Thyroid carcinoma is the most common malignancy in the endocrine system.Most patients cannot be cured with operation alone.The concept and implementation of multidisciplinary team (MDT) in clinical oncology attributes to improved diagnosis and treatment of cancer.MDT plays an important role in diagnosis,treatment,and post operational management of thyroid carcinoma,as well as in the application of novel techniques and translational medicine.MDT can maximize the expertise of various disciplines,strengthen inter disciplinary cooperation,and provide standardized and individualized comprehensive treatment for patients with thyroid cancer.The most important benefit of MDT is that individual patient gets the most appropriate treatment decision made by a team of experts,including endocrinologists,nuclear medicine specialists,pathologists,radiologists,radiation therapists,and surgeons.This will be of great significance to improve quality of life and prognosis,at the same time,avoid over-treatment of thyroid cancer.

Evaluation of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction / 中国介入心脏病学杂志

Objective Evaluation of the benefit and safety of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction by retrospective analysis. Methods Precutaneous coronary intervention were performed in 45 patients with acute myocardial infarction immediately after thrombolysis. The clinical and angiographic data were compared with that of 31 patients with thrombolysis alone and 74 patients with primary precutaneous coronary intervention in the same period. Results Angiographic data showed that patients with PCI plus thrombolysis had more frequency of TIMI 3 flow than patients with thrombolysis alone (88.9% vs. 74.2%, P=0.087). Patients with PCI plus thrombolysis and with primary PCI had similar frequency of TIMI 3 flow (88.9% vs. 91.9% P=0.404). Clinical data showed that patients with PCI plus thrombolysis had less major adverse cardiovascular events in hospital than patients with thrombolysis alone (4.4% vs. 12.9%, P=0.181). Patients with PCI plus thrombolysis and with primary PCI had similar major adverse cardiovascular events (4.4% vs. 1.4%, P=0.319). Patients with three strategies of treatment had similar mortality (4.4% vs. 6.5% vs. 4.1%). Patients with three strategies of treatment had similar major bleeding events (4.4% vs. 3.2% vs. 1.4%) in hospital. Conclusion Combined thrombolysis and precutaneous coronary intervention maybe surpass thrombolysis alone, at least similar to primary PCI. This strategy of treatment is safe.