Analyzing the potential mechanism of Buyang Huanwu decoction for the treatment of salt-sensitive hypertension based on network pharmacology and in vivo experiments

Background:Buyang Huanwu decoction(BHD)is a traditional Chinese medicine herbal formula used for treating hypertension,particularly in the later stages of hypertension when it is associated with intracerebral hemorrhage.This study aims to investigate the treatment mechanism of BHD to provide a basis for its clinical application in hypertension treatment.Methods:Network pharmacology analysis and cell culture experiments were performed to explore the potential proteins and mechanisms of action of BHD against hypertension.Bioactive compounds related to BHD were screened,and relevant targets associated with hypertension and BHD were retrieved.Molecular docking technology was used to identify the effective signaling pathway based on the Kyoto Encyclopedia of Genes and Genomes and protein-protein interaction network cores.Lastly,the effects and mechanisms of BHD on salt-sensitive hypertensive endothelial cells were investigated.Results:Ninety-three potential therapeutic targets for BHD and salt-sensitive hypertension were found to be closely associated with the PI3K/Akt/eNOS signaling pathway and oxidative stress.Cell experiments further indicated the pivotal role of endothelial cells in hypertension,and validation analysis showed that BHD significantly preserved cell morphology,suppressed oxidative stress reactions,activated the PI3K/Akt/eNOS signaling pathways,preserved normal endothelial cell function,and reduced cell apoptosis.Conclusion:BHD effectively activates the PI3K/Akt/VEGF signaling pathway,attenuates oxidative stress-induced injury in endothelial cells exposed to high salt levels,and mitigates apoptosis,supporting the use of traditional Chinese medicine BHD in the treatment of salt-sensitive hypertension.

Role of Ring Finger Protein 213 in Moyamoya Disease

Objective：The aim of this study was to help people comprehensively understand the research advances related to ring finger protein 213 （RNF213） in moyamoya disease （MMD） and to understand the disease at the molecular level to provide a new perspective of the diagnosis of the disease.Data Sources：This review was based on data in articles published between 2005 and 2015 that were retrieved from the PubMed database.The search terms included RNF213,MMD,intracranial major artery stenosis/occlusion （ICASO）,genotype,phenotype,mutant and variants,and the combinations of these terms.Study Selection：Articles related to MMD and RNF213 were selected for review,and we also reviewed publications related to ICASO.Results：RNF213 is not only associated with MMD but also associated with intracranial major artery stenosis.In addition,RNF213 variants exhibit apparent ethnic diversity;specifically,the c.14576G〉A variant is mainly detected in Korean,Chinese,and Japanese populations,particularly the latter population.The genotypes of RNF213 correlate with the phenotypes of MMD;for example,the homozygous c.14576G〉A variant is associated with early-onset,severe symptoms,and an unfavorable prognosis.Furthermore,the RNF213 c.14576G〉A variant should be considered during the diagnosis of MMD because no patients with quasi-MMD have been reported to carry the RNF213 c.14576G〉A variant whereas 66 of 78 patients with definite MMD have been found to carry this variant.Conclusions：The growing literature demonstrates that MMD is primarily caused by the synergy of genetic and environmental factors,and unknown genetic modifiers might play roles in the etiology of MMD.Further research should be conducted to clarify the pathogenic mechanism of MMD.

Surgical factors contributing to nonunion in femoral shaft fracture following intramedullary nailing

Purpose： To explore the possible surgical factors related with nonunion in femoral shaft fracture following intramedullary nailing. Methods： We retrospectively analyzed totally 425 patients with femoral shaft fracture in level I urban trauma center, including 254 males and 171 females, with an average age of 37.6 （ranging from 21 to 56） years old. The inclusion criteria included： （1） traumatically closed fracture of femoral shaft, with preoperative films showing non-comminuted fracture, such as transverse fracture, oblique fracture or spiral fracture; （2） closed reduction and fixation with interlocking intramedullary nail at 3-7 days after trauma; （3） complete follow-up data available. The relationship between the following factors （fracture site, reduction degree, direction of nail insertion and nail size） and nonunion was studied. Results： The incidence of femoral nonunion was 2.8%; in patients with closed simple fracture undergoing interlocking intrameduallary nailing, including 11 cases of hypertrophic nonunion. Nonunion was related significantly to distal fracture, unsatisfactory reduction and unreamed nail （p 〈 0.05）. There was no significant difference between antegrade nail and retrograde nail （p 〉 0.05）. Conclusions： Nonunion in femoral shaft facture following interlocking intramedullary nailing is related to fracture site, fracture reduction and nail diameter. The choice of reamed nails or unreamed nails depends on the fracture site and reduction degree.