Network-pharmacology-based research on protective effects and underlying mechanism of Shuxin decoction against myocardial ischemia/reperfusion injury with diabetes

BACKGROUND Patients with diabetes mellitus are at higher risk of myocardial ischemia/reperfusion injury(MI/RI).Shuxin decoction(SXT)is a proven recipe modification from the classic herbal formula"Wu-tou-chi-shi-zhi-wan"according to the traditional Chinese medicine theory.It has been successfully used to alleviate secondary MI/RI in patients with diabetes mellitus in the clinical setting.However,the underlying mechanism is still unclear.AIM To further determine the mechanism of SXT in attenuating MI/RI associated with diabetes.METHODS This paper presents an ensemble model combining network pharmacology and biology.The Traditional Chinese Medicine System Pharmacology Database was accessed to select key components and potential targets of the SXT.In parallel,therapeutic targets associated with MI/RI in patients with diabetes were screened from various databases including Gene Expression Omnibus,DisGeNet,Genecards,Drugbank,OMIM,and PharmGKB.The potential targets of SXT and the therapeutic targets related to MI/RI in patients with diabetes were intersected and subjected to bioinformatics analysis using the Database for Annotation,Visualization and Integrated Discovery.The major results of bioinformatics analysis were subsequently validated by animal experiments.RESULTS According to the hypothesis derived from bioinformatics analysis,SXT could possibly ameliorate lipid metabolism disorders and exert anti-apoptotic effects in MI/RI associated with diabetes by reducing oxidized low density lipoprotein(LDL)and inhibiting the advanced glycation end products(AGE)-receptor for AGE(RAGE)signaling pathway.Subsequent animal experiments confirmed the hypothesis.The treatment with a dose of SXT(2.8 g/kg/d)resulted in a reduction in oxidized LDL,AGEs,and RAGE,and regulated the level of blood lipids.Besides,the expression of apoptosis-related proteins such as Bax and cleaved caspase 3 was down-regulated,whereas Bcl-2 expression was up-regulated.The findings indicated that SXT could inhibit myocardial apoptosis and improve cardiac function in MI/RI in diabetic rats.CONCLUSION This study indicated the active components and underlying molecular therapeutic mechanisms of SXT in MI/RI with diabetes.Moreover,animal experiments verified that SXT could regulate the level of blood lipids,alleviate cardiomyocyte apoptosis,and improve cardiac function through the AGE-RAGE signaling pathway.

Omental fibroma combined with right indirect inguinal hernia masquerades as a scrotal tumor: A case report

BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by external tumors of the scrotum is rare.The patient had both a greater omentum tumor and an inguinal hernia,and the tumor protruded into the scrotum through the hernia sac,which is even rarer.Moreover,omental tumors are mostly metastatic,and primary omental fibroma is rare.CASE SUMMARY Here,we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months.Preoperative examination and multidisciplinary discu-ssions considered intra-abdominal tumor displacement and inguinal hernia,and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum.Therefore,tumor resection and tension-free inguinal hernia repair were performed.The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.CONCLUSION This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking,physical examination,and imaging before surgery.

Feasibility of Transabdominal Real-time CDFI and HDFI Techniques for Fetal Pulmonary Vein Display in the First Trimester

Objective This study aimed to assess the feasibility and usefulness of transabdominal color Doppler flow imaging(CDFI)technology and the high-definition flow imaging(HDFI)technique in detecting fetal pulmonary veins(PVs)in the first trimester(11–13^(+6)weeks).Methods From December 2018 to October 2019,328 pregnant women with 328 normal singleton fetuses(crown-rump length:45–84 mm)who had undergone CDFI and HDFI scans for fetal heart and vessel examination were enrolled in this study.The cases were divided into three groups according to the gestational age:group A,11^(+0)−11^(+6)weeks;group B,12^(+0)−12^(+6)weeks;and group C,13^(+0)−13^(+6)weeks.Baseline sonograms and CDFI and HDFI images were analyzed by two senior radiologists independently and blindly.The abilities of CDFI and HDFI to display PVs were compared.Results Successful PV display rates via CDFI and HDFI were 2.3%and 68.2%(P<0.01),22.4%and 82.4%(P<0.01),41.5%and 91.2%(P<0.01)for group A,group B,and group C,respectively.The total successful display rates for the two methods were 28.9%(CDFI)and 84.8%(HDFI)(P<0.01).Conclusions The HDFI technique is more valuable than CDFI for detecting PVs in early pregnancy(11–13^(+6)weeks).HDFI can detect at least one PV in all cases and may be used to detect pulmonary venous anomalies early.

老年患者出院后跌倒发生率及影响因素的调查研究

目的了解老年人出院后1年内累积跌倒发生率及其影响因素。方法2019年5月至2020年8月,对重庆市一所三级甲等医院的出院老年患者进行前瞻性调查研究。采用中文版跌倒风险自评量表、衰弱评估量表(FRAIL scale)和9项患者健康问卷(Patient Health Questionnaire-9,PHQ-9)、Barthel指数评定量表(Bar-thel index,BI)调查出院老年人跌倒风险、衰弱、抑郁、自理能力状况并在其出院后电话追踪1年。应用累积发生率函数估计老年人出院后1年内跌倒的累积发生率,利用竞争风险模型中部分分布风险函数探讨跌倒的危险因素。结果共有1077例老年患者参与此研究,出院后1、6、12个月跌倒累计发生率分别为4.45%、9.03%和10.80%。出院时伴有抑郁和衰弱的老年人在出院后1、6、12个月的跌倒累计发生率分别26.19%、49.93%、58.53%和21.59%、41.67%、48.73%,远高于没有抑郁和衰弱的老年人(P<0.05)。出院时伴有抑郁、衰弱、Barthel指数得分61~80分、住院时间>20 d、随访时间内再次入院、由他人照料和跌倒风险是影响老人出院后1年内跌倒的因素。结论住院老年人出院后1年内跌倒发生率随出院时间的延长具有累积效应,且受多种因素影响,未来构建预出院老年人跌倒预防策略时应关注这些影响因素,并重点关注老年人抑郁和衰弱。

Antibody response and cross-neutralization after Omicron BA.2 infection

Dear Editor,The Omicron(B.1.1.529)variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)was first identified in November 2021,in South Africa and Botswana.The first Omicron sub-lineage that emerged was BA.1,which was supplanted by BA.2 in many countries.One of the most notable features of the Omicron variant is its ability to evade neutralizing antibodies(nAbs)targeting the original virus lineages.

Gingerol improves cardiac function in rats with cardiorenal syndrome via inhibiting fibrosis

Background Cardiorenal syndrome(CRS)is a clinical syndrome with a complex mechanism,and there is currently no specific treatment.Gingerol was confirmed to possess anti-inflammatory,antioxidant and cardiotonic properties as cardiovascular pharmacological effects.However,in vivo studies have yet to prove that it can improve cardiac function and inhibit fibrosis in rats with cardiorenal syndrome.Methods In this study,34 male Sprague-Dawley(SD)rats were randomly divided into control(n=9),model(n=12)and gingerol groups(n=13).The model and the gingerol groups underwent ligation of the left anterior descending coronary artery and 5/6 subtotal nephrectomy to construct a type 2 cardiorenal syndrome rat model.The rats in gingerol group were injected intraperitoneally with 50 mg/kg gingerol.The same amount of saline was administered to both the control and the model groups.Following 4 weeks of treatment,the rat cardiac function and myocardial fibrosis were evaluated by cardiac ultrasound and blood biochemistry.Results Biochemical results showed that the brain natriuretic peptide(BNP)levels of gingerol group decreased(P<0.05).Cardiac ultrasound revealed that gingerol improved cardiac systolic function and ventricular remodeling(P<0.05).The systolic function of the model group was significantly decreased compared with the control group.Masson staining confirmed that the fibrosis area in the model group was significantly augmented than that in the control group,while the area of fibrosis in the gingerol group was diminished compared to the model group(P<0.01).Moreover,immunofluorescence showed that compared with the control group,the expression of collagen 1,TGF-β1 andα-SMA was significantly increased in the model group,and both collagen deposition and the expression of collagen I,TGF-β1 andα-SMA decreased in gingerol group.Immunohistochemistry revealed that the expression of collagen 1 andα-SMA was significantly increased in the model group compared with the control group,while it was decreased in gingerol group(P<0.05).Conclusions Gingerol can improve the cardiac function and cardiac fibrosis in rats with cardiorenal syndrome.