Table of Content

Volume 28 Issue 6
26 June 2023

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Effects of AMI-1 on the activity of pancreatic cancer cells in vitro by down-regulating PRMT5 expression

ZHANG Jinghui, WEI Haoliang, WANG Li, LI Jingkai, ZHANG Baolai, YANG Xiaolai

2023, 28(6):  601-608.  doi:10.12092/j.issn.1009-2501.2023.06.001

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AIM: To explore the effect and mechanism of AMI-1 on the proliferation, migration and apoptosis of human pancreatic cancer MIAPaca-2 cells. METHODS: MIAPaca-2 cells were randomly divided into the control groups and the treatment groups with different concentrations of AMI-1 (0.6, 1.2 and 2.4 mmol/L). MTT assay, colony formation assay, scratch assay and Transwell assay respectively were used to detect the effects of AMI-1 on the proliferation, colony formation and migration of MIAPaca-2 cells. The cell apoptosis was detected by flow cytometry. The effect of AMI-1 on the protein expression of caspase3, cleaved-caspase3, PRMT5, H4R3me2s and PCNA in MIAPaca-2 cells were detected by western blot. RESULTS: Compared with control group, after treatment with different concentrations of AMI-1, the cell survival rate of MIAPaca-2 cells decreased gradually in a time- and dose-dependent manner (P<0.01), the rate of cell clone formation decreased (P<0.01), the cell migration ability were diminished (P<0.01), the apoptosis rate was increased (P<0.01), and the protein level of cleaved-caspase3/caspase3 were increased, the protein level of PRMT5, H4R3me2s and PCNA were reduced (P<0.01). CONCLUSION: AMI-1 significantly inhibited the proliferation migration and apoptosis of pancreatic cancer cells in vitro, which may be associated with AMI-1 down-regulating the expression of PRMT5, H4R3me2s and PCNA, and up-regulation the expression of cleaved-caspase3/caspase3.

Mulberry exerts antioxidant stress effect in rats with nonalcoholic fatty liver disease

WANG Donghui, JIANG Suwen, HU Airong, ZHU Bo, HE Zheyun, ZHANG Lukan, WANG Jialan, FAN Ying, LIN Ken

2023, 28(6):  609-616.  doi:10.12092/j.issn.1009-2501.2023.06.002

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AIM: To explore the effects of mulberry on antioxidant stress injury in rats with nonalcoholic fatty liver disease (NAFLD) induced by high-fat diet. METHODS: Sixty male Sprague-Dawley rats were randomly divided into normal group (10 rats) and model making group (50 rats, high-fat feed for 8 weeks). From the 9th week, the NAFLD rats were randomly divided into model group, intervention groups (mulberry low, moderate, and high dosage, 2.5 g/kg, 5.0 g/kg, and 10.0 g/kg, respectively), and positive control group (magnesium?isoglycyrrhizinate, the original solution diluted to 1.0 g/L, 15 mL·kg-1·d-1), 10 rats per group, and were gavaged?once daily for 6 weeks. The levels of malondiaIdehyde (MDA) and adenosine triph osphate (ATP) in liver homogenate were measured. The HE staining and the oil red O staining were used to observe the distribution of lipid droplets and the pathologic changes of liver tissue. The gene expressions of nuclear factor-E2-related factor 2 (Nrf2)-antioxidant response element (ARE) [Nrf2, heme oxygenase-1 (HO-1), γ-glutamylcysteine synthetase (γ-GCS) and glutathione S-transferase P-1 (GSTP-1)] in liver were detected by real-time qPCR. RESULTS: Compared with the normal group: the levels of MDA in liver homogenate increased. The levels of ATP, the gene expressions of γ-GCS, GSTP-1, HO-1 and Nrf2 in liver were significantly decreased (P<0.01). Liver fat deposition was obvious, liver steatosis became significant. Compared with the model group: with the increase of mulberry dosage, the MDA level in liver homogenate decreased (P<0.05), the gene expressions of GSTP-1 and HO-1 increased (P<0.05), liver steatosis gradually decreased. The liver ATP level, the gene expressions of γ-GCS and Nrf2 in moderate dosage group and high dosage group were significantly increased (P<0.05). CONCLUSION: Mulberry has a good preventive and protective effect on liver steatosis of NAFLD in rats, and may play antioxidant stress effect by affecting the expression of Nrf2-ARE related genes.

Effects of different dosage forms of Qianzheng powder on facial nerve injury in rats 

LI Hongqin, CAO Limin, JIN Manyi, WANG Jianlong, CHAI Xiaoping, TIAN Miaomiao

2023, 28(6):  617-623.  doi:10.12092/j.issn.1009-2501.2023.06.003

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AIM: To compare the therapeutic effects of rats with facial nerve injury in different dosage forms of Qianzheng Powder and explore its optimal treatment. METHODS: The 60 SD rats were randomly divided into model group, powder group, decoction group with 18 rats in each group and 6 control groups. In addition to the control group, the remaining 3 groups were rat models with vascular clamping of the closed facial nerve causing facial nerve damage. The powder group was given by Qianzheng powder and rice wine to mix well. The decoction group was given 2 mL of Qianzheng Powder decoction for gastric filling (Qianzheng Powder 2 430 mg·kg-1·d-1）. Once a day for 14 consecutive days, followed by normal feeding for 7 days. The control and model groups were fed normally for 21 days. Behavioral scoring, neuroelectrophysiology detection, and facial nerve tissue were observed on the rats of each module at 7 days, 14 days, and 21 days, respectively. RESULTS: Behavioral score comparison: The 14th postoperative powder group and decoction group scored lower than the model group (P<0.05). Comparison of facial nerve electrophysiological tests: The 14th postoperative, compared with model group, CMAP latency in both decoction group and powder group was decreased (P<0.05), while the latency of powder group was faster (P<0.01). At 21st postoperative, the amplitude of CMAP in the powder group was significantly higher than that in the decoction group.Histological observations show: In the 7th day after surgery, the model group, the powder group, and the decoction group all showed atrophy of the neural basement membrane, a large number of cell vacuole degeneration and inflammatory cell infiltration. 14 days after surgery, the model group still had nerve bundle atrophy; In the powder group and decoction group, the tissue structure of the neural basement membrane was partially restored, the nerve bundle membrane was partially visible, the cell swelling had subsided, and some cell vacuole degeneration could still be seen. 21 days after surgery, the atrophy of the basal membrane of the model group was restored, and the nerve structure part showed that some cells still had vacuolar degeneration; In the powder group and decoction group, the neural tissue structure was restored, the cells were arranged in an orderly manner, and the swelling and degeneration were significantly reduced. However, a small amount of angioplasia and nerve cell hyperplasia could be seen in the powder group. In the control group, the structure of each layer of the tissue was clear, the cells were arranged in an orderly manner, and there was no obvious positive expression. CONCLUSION: The Qianzheng powder have a significant effect on rats with facial nerve injury. The powder can better promote the recovery of facial nerve electrophysiology and tissue structure in rats with facial nerve injury, and has good safety.

miR-718 from exosomes of lung cancer cells induces angiogenesis by targeting PTEN

FU Ting, LI Fang, PAN Dayan, XIA Yuanyuan, ZHANG Qiuyuan

2023, 28(6):  624-632.  doi:10.12092/j.issn.1009-2501.2023.06.004

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AIM: To explore the effect and mechanism of lung cancer cell exosomes on angiogenesis. METHODS: The exosomes secreted by human lung epithelial cells HFL-1 and human lung cancer cells A549, H522, and H460 cells were extracted and denoted as HFL-1 exo, A549 exo, H522 exo, and H460 exo. Above exosomes and a volume of PBS buffer were incubated with HUVEC cells of vascular endothelial cells, which were denoted as HFL-1 exo group, A549 exo group, H522 exo group, H460 exo group, and PBS group, the PBS group was used as the control group. HUVECs were transfected with PTEN siRNA and Negative control, denoted as si-PTEN group and si-NC group. Extract exosomes secreted by A549 cells transfected with miR-NC, miR-718 mimic, miR-718 inhibitor, and denote them as A549/miR-NC exo, A549/miR-718 mimic exo, A549/ miR-718 inhibitor exo, the above exosomes were incubated with HUVEC cells, and they were marked as A549/miR-NC exo group, A549/miR-718 mimic exo group, A549/miR-718 inhibitor exo group. After incubated with A549/miR-718 mimic exo group, the PTEN overexpression plasmid was transfected into HUVECs, and recorded as the A549/miR-718 mimic exo+PTEN group. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-718 in each group of cells and exosomes, Transwell chamber method and tubule formation experiment were used to detect the migration ability and tubule formation of each group of cells. Western blot was used to detect the expression of PTEN protein. The LSD-t test was used to compare the two groups, and P<0.05 indicated that the difference was statistically significant. RESULTS: The HFL-1 exo, A549 exo, H522 exo, and H460 exo extracted in this paper are in line with the structural characteristics of exosomes. Compared with the PBS group, the number of HUVEC cell migration in the A549 exo, H522 exo, and H460 exo groups and the number of tubule formation were significantly increased (P<0.05). Compared with HFL-1 cells, the expression levels of miR-718 in A549, H522, and H460 cells were significantly higher (P<0.05). Compared with HFL-1 exo, the expression levels of miR-718 in A549 exo, H522 exo, and H460 exo were significantly increased (P<0.05), and miR-718 could target and regulate the expression of PTEN. Compared with the si-NC group, the HUVEC cell tubule formation in the si-PTEN group and the number of cell migration were significantly increased (P<0.05). Compared with the A549/miR-NC exo group, the cell migration ability and the numbers of tubule formation in A549/miR-718 mimic exo group were significantly increased (P<0.05), while those were decreased in the A549/miR-718 inhibitor exo group. Compared with A549/miR-NC exo group, the cell migration ability and the number of tubule formation were significantly higher in A549/miR-718 mimic exo+PTEN group (P<0.05). CONCLUSION: Lung cancer cell exosomal miR-718 could promote angiogenesis by targeting to inhibit the expression of PTEN.

Value of ABCB1 G2677T gene polymorphism detection in lipid-lowering therapy with atorvastatin in patients suffered from ischemic stroke

LI Qinghua, ZHAO Yan, ZHAO Haigang, GAO Pengfei, XU Bingxin

2023, 28(6):  633-640.  doi:10.12092/j.issn.1009-2501.2023.06.005

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AIM: To explore the value of adenosine triphosphate-binding cassette transporter B1 (ABCB1) G2677T gene polymorphism detection in lipid-lowering therapy with atorvastatin in patients suffered from ischemic stroke. METHODS: This study was a prospective study. 116 patients with ischemic stroke were recruited consecutively as subjects. The ABCB1 G2677T (rs2032582) gene polymorphism was detected by fluorescence staining in situ hybridization. According to the detection results, the patients were divided into GG genotype, GT genotype and TT genotype groups. All patients in the three groups were given atorvastatin 20 mg/d for lipid-lowering treatment. The changes of serum HDL-C, LDL-C, TC and TG levels in the three groups before and after treatment were compared by repeated measures analysis of variance. The serum LDL-C level<1.8 mmol/L was considered as the effective treatment for lowering blood lipid, and the difference of effective rate among the three groups was compared. The adverse drug reactions of the three groups were recorded. RESULTS: There were 47 (40.5%), 43 (37.1%) and 26 (22.4%) patients in GG genotype, GT genotype and TT genotype groups, respectively. There was no significant difference in serum TC, TG, HDL-C and LDL-C levels among the three groups before treatment (P>0.05); After treatment, the levels of serum TC, TG and LDL-C in the three groups were lower than those before treatment, and the levels of HDL-C were higher than those before treatment, and there was a trend of change with treatment time (FTC=77.780, P<0.001; FTG=14.218, P<0.001; FLDL-C=105.106, P<0.001; FHDL-C=6.811, P=0.010); The interaction existed between different gene types of ABCB1G2677T and treatment time in serum LDL-C (F=3.604, P=0.030), and the change trend of serum LDL-C level with time was different in the three groups; There was no interaction between different gene types of ABCB1 and treatment time inserum TC, TG, HDL-C (FTC=2.545, P=0.083; FTG=0.585, P=0.559; FHDL-C=0.012, P=0.988), and the change trend of serum TC, TG, HDL-C levels with time was the same in the three groups. The decrease of serum LDL-C level in GG genotype group was 36.99% (16.03%, 50.13%), which was higher than 22.75% (12.43%, 41.11%) in GT genotype group and 16.66% (7.37%, 24.82%) in TT genotype group. The difference in the decrease of serum LDL-C level among the three groups was statistically significant (c2=11.630, P=0.003), and the decrease in GG genotype group was significantly higher than that in TT genotype group (P=0.002). The effective rate of lipid-lowering treatment in GG genotype group was 72.34%, higher than 44.18% in GT genotype group and 38.46% in TT genotype group. There was a statistically significant difference in the effective rate among the three groups (c2=10.565, P=0.005), and the effective rate in GG genotype group was significantly higher than that in TT genotype group (c2=8.024, P=0.005). The total incidence of adverse drug reactions in the three groups was similar (c2=1.649, P=0.438). CONCLUSION: The blood lipid lowering extent and effective rate of GG genotype patients with ABCB1 G2677T gene are higher than those of GT genotype and TT genotype patients. Detection of ABCB1 G2677T gene polymorphism has certain application value in the treatment of ischemic stroke patients with atorvastatin.

Baseline serum 25-hydroxyvitamin D3 levels and risk of metabolic syndrome: a prospective cohort study

XIE Jingjing, YIN Hongtao, LIU Jinjin, SUN Weiming, ZHEN Donghu

2023, 28(6):  641-652.  doi:10.12092/j.issn.1009-2501.2023.06.006

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AIM: To investigate the association between baseline serum 25-(OH)D3 level and the risk of metabolic syndrome in middle-aged and elderly people in Lanzhou. METHODS: A total of 2 754 non-MS people were selected from three communities in Lanzhou in 2011 to establish a cohort study population, In 2014, 2 309 subjects with complete data from two surveys were followed up for an average of 3.1 years. According to the quartile level of 25-(OH)D3, the baseline population was divided into Q1, Q2, Q3 and Q4 groups. The incidence of MS at different levels of 25-(OH)D3 was compared, and the correlation between 25-(OH)D3 and MS was analyzed. RESULTS: With the increase of baseline serum 25-(OH)D3 level, the prevalence of MS decreased (P<0.05). Baseline serum 25-(OH)D3 level was negatively correlated with WC, TG, FPG, 2h-PG, HbA1c and SBP (P<0.01).Logistic regression analysis showed that baseline serum 25-(OH)D3 level is an independent protective factor for the increase of WC, TG, FPG and MS (P<0.05). After an average follow-up of 3.1 years, a total of 341 patients developed MS (14.8%). Cox regression analysis showed that baseline serum 25-(OH)D3 level was correlated with the risk of abnormal HDL-C and 2 h-PG after follow-up (P<0.05). CONCLUSION: In the middle-aged and elderly population in Lanzhou, Gansu Province, baseline serum 25-(OH)D3 level is an independent protective factor for the increase of WC, TG, FPG and MS, the lower serum 25-(OH)D3 level is associated with the risk of decreased HDL-C level after follow-up. It has not been found that the baseline serum 25-(OH)D3 level is associated with the risk of MS and other components.

Analysis of the diagnostic value of fine-needle aspiration cytology and BRAF and RAS gene mutation screening for thyroid cancer

ZHANG Wei, LIU Lei, GUAN Shaoyang, SHENG Zhao, SUN Wenwen

2023, 28(6):  653-657.  doi:10.12092/j.issn.1009-2501.2023.06.007

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AIM: To evaluate the diagnostic value of thyroid fine needle aspiration cytology (FNAC) and BRAF and RAS gene mutation screening for thyroid cancer. METHODS: From January 2022 to December 2022, a total of 597 patients underwent FNAC in our hospital, of which 25 patients were removed due to specimen dissatisfaction, 282 patients had BRAF/RAS genetic testing, and 227 patients underwent surgery. Using postoperative pathological results as the gold standard to analyze the sensitivity, specificity and diagnostic accuracy of FNAC, BRAF/RAS and their combined detection in the diagnosis of thyroid cancer. RESULTS: For patients with FNAC and postoperative thyroid malignancy, the positive rate of BRAF/RAS gene was 42.9%, and the positive rate of BRAF in TI-RADS above 4B was 69.2%, but the difference was not significant (P=0.116).The sensitivity of FNAC alone for thyroid cancer was 82.8% and specificity was 100.0%. Combined with BRAF gene detection, the sensitivity was improved to 89.3%, specificity was 96.6%, and the accuracy of diagnosis increased from 82.8% to 85.9%.CONCLUSION: In patients with thyroid nodules, high-risk patients (especially 4B and above) were screened by ultrasound TI-RADS classification, and combined FNAC and BRAF gene testing can improve the diagnostic rate of thyroid cancer.

Influence factors of serum NT-proBNP level in elderly patients with acute myocardial infarction after PCI and its influence on short-term prognosis

QIAN Jin, WANG Fengyan

2023, 28(6):  658-665.  doi:10.12092/j.issn.1009-2501.2023.06.008

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AIM: To investigate the influencing factors of serum NT-proBNP level in elderly patients with acute myocardial infarction (AMI) after PCI, and to analyze its predictive value for the short-term prognosis of patients. METHODS: A total of 98 elderly patients with AMI in our hospital from May 2020 to August 2022 were selected, all of whom underwent PCI. The level of serum NT-proBNP before and after PCI was detected. The level of serum NT-probNP after PCI was ≥125 pg/mL, and the level of serum NT-probNP after PCI was normal. Univariate analysis of the general data of the elevated NT-proBNP group and the normal group, Lasso regression model was used to screen the screening variables, and Logistic regression was used to analyze the influencing factors of serum NT-proBNP level in elderly AMI patients after PCI. The prognosis recovery of patients with different NT-proBNP and the level of NT-proBNP in patients with different prognosis were compared and analyzed. ROC curve was drawn to analyze the predictive value of NT-proBNP level in patients with short-term prognosis after PCI. RESULTS: Logistic regression analysis showed that the time from onset to PCI, age, left ventricular ejection fraction (LVEF), stroke, number of stents implanted, no recirculation and stent diameter were the influencing factors of serum NT-proBNP level in elderly AMI patients after PCI. The incidence of adverse cardiovascular events (MACE) was 21.43% (21/98) in 98 patients followed up 6 months after surgery, and the incidence of NT-proBNP increased group was 68.00% (17/25), which was significantly higher than that of normal group (5.48% (4/73)) (P<0.05). The level of NT-proBNP in the group with MACE was significantly higher than that in the group without MACE (P<0.05). ROC curve showed that AUC was 0.813 (95%CI: 0.721-0.884), sensitivity and specificity were 80.95% and 79.22%, respectively, suggesting that serum NT-proBNP level after PCI had certain predictive value for short-term prognosis of patients. CONCLUSION: Serum NT-proBNP level in elderly AMI patients after PCI has a good ability to predict the short-term prognosis of patients. Comprehensive consideration of the number of stents inserted, the presence of stroke, the presence of reflow and age and other factors to strengthen the monitoring of NT-proBNP level is helpful to prevent and control the occurrence of MACE, so as to improve the prognosis of patients.

A comparative investigation of the impact of oral midazolam solution and dexmedetomidine nasal spray on preoperative anxiety in pediatric patients

WU Xiongzhi, WANG Xuan, XU Siqi, JU Xia, WANG Shengbin, CHEN Yongquan

2023, 28(6):  666-670.  doi:10.12092/j.issn.1009-2501.2023.06.009

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AIM:　To investigate the impact of oral midazolam solution and dexmedetomidine nasal spray on preoperative anxiety in pediatric patients.  METHODS: A total of 90 children who planned to receive elective surgery in our hospital from June to December 2022 were selected and divided into midazolam oral solution group, dexmedetomidine nasal spray group and normal saline nasal drops group by random number table method. Thirty minutes before anesthesia, midazolam oral solution 0.5 mg/kg was administered to midazolam oral solution group. Dexmedetomidine nasal spray group received 2 μg/kg dexmedetomidine nasal spray and normal saline nasal drops group received 2 mL normal saline nasal drip. Drug acceptance was recorded in the three groups. modified Yale preoperative anxiety scale-short form (m-YPAS-SF) score of the three groups of children were analyzed before administration (T1), while separated from their parents (T2), while during anesthesia induction (T3), while 24 hours after surgery (T4). The scores of induction Cooperation Scale (ICC) in induction of anesthesia were recorded in the three groups. The recovery time and PACU residence time of the three groups were recorded. RESULTS: Compared with dexmedetomidine nasal spray group and normal saline nasal drops group, midazolam oral solution group exhibited a lower drug acceptance score (P<0.05), as well as lower m-YPAS-SF scores at T2, T3, and T4 (P<0.05). Additionally, midazolam oral solution group had a lower ICC score (P<0.05) and longer recovery time (P<0.05), but no significant difference in the length of PACU stay was observed (P>0.05). CONCLUSION: Oral midazolam solution is more readily accepted by pediatric patients compared to dexmedetomidine nasal spray, and it exhibits superior efficacy in alleviating preoperative anxiety, however, its recovery time is prolonged. 

Effects of stains on hyperlipidemia and pain relieve of patients with chronic migraine 

ZHAO Lu, LI Fuyong, WEN Binhong, LI Daowei

2023, 28(6):  671-675.  doi:10.12092/j.issn.1009-2501.2023.06.01

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AIM: To investigate the clinical efficacy of statins in the treatment of patients with migraine and hyperlipidemia. METHODS: A retrospective analysis was performed on the clinical data of 118 patients with hyperlipidemia and migraine diagnosed and treated in our hospital from September 9, 2016 to August 2021. According to hyperlipidemia and previous cardio-cerebral vascular disease history, Atorvastatin and Rosuvastatin were given different doses respectively, and the improvement of blood lipid index was compared. The average VAS, headache frequency and headache frequency at 3 months after treatment were compared with those before treatment.Comparison of the same indicator within 3 months. RESULTS: The total effective rate of blood lipid control in each group was satisfactory, which was 91.7%, 94.1%, 88.2% and 92.9%, respectively. Group B and Group D had a slightly higher control rate in the high-dose statin group compared with similar groups A and C. After treatment, all four groups of patients had different degrees of migraine reduction, and group A was the lowest group with response rate of 36.1%, and group D was the highest group with response rate of 53.6%. The average VAS of pain in the high-dose statin group was greater and the pain relief was more pronounced. There was no significant statistical difference between the groups in the pain onset of VAS score reduction by 50% and the frequency of attacks by 50%, P>0.05. CONCLUSION: The use of statins in the treatment of patients with hyperlipidemia and migraine has satisfactory control of hyperlipidemia, and there is no significant difference in statin categories. The migraine symptoms associated with them can be relieved to varying degrees, and some patients have reliable clinical effects.

New progress in research on novel control strategies for methicillin-resistant staphylococcus aureus infection

QIAO Hongliang, DING Ning, DENG Kaihong, LIU Binbin, DONG Chuanjiang, CHEN Xiaobo, ZOU Lili

2023, 28(6):  676-687.  doi:10.12092/j.issn.1009-2501.2023.06.011

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Methicillin-resistant staphylococcus aureus (MRSA) is one of the most common multi-drug resistant bacteria in clinical practice and is known as a "superbug". With the evolution of MRSA resistance mechanisms, it is increasingly difficult to treat MRSA infections with conventional antibiotics. In recent years, novel control strategies for MRSA infections have been developed at various levels. The unique structure of nanomaterials has antimicrobial activity and can also be used as an efficient transport carrier. Photodynamic therapy promotes cellular oxidative stress by light-activated photosensitizer (PS) interacting with molecular oxygen or substrates to generate reactive oxygen species (ROS). The antimicrobial properties of herbal medicines by multiple mechanisms have been widely demonstrated. Immunotherapy has made breakthroughs in the use of immune escape mechanisms, polyvalent vaccines, and mixed antibodies against MRSA. Gene targets represented by the mecA gene are being explored. Novel candidate antibacterial compounds targeting TDRS, especially the Trx system, will be a promising force in the future. In this paper, novel control strategies for MRSA are reviewed and prospected.

Research progress of traditional Chinese medicine regulating mitochondrial function in the treatment of steroid-induced femoral head necrosis

HU Kangyi, CAO Linzhong, WAN Chaochao, SHANG Zhengya, YANG Xiaorui, ZHANG Yongjie

2023, 28(6):  688-696.  doi:10.12092/j.issn.1009-2501.2023.06.012

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Steroid-induced avascular necrosis of the femoral head (SANFH) is a common and intractable disease with high disability rate and poor prognosis, which is a serious threat to human health. The pathogenesis of SANFH is very complex, but more and more studies have shown that high doses of glucocorticoids would cause abnormal mitochondrial function of bone tissue cells, oxidative stress, mitochondrial autophagy, and altered mitochondrial dynamics, resulting in cell damage or death. These would then lead to imbalance of bone metabolism and abnormal blood flow in the femoral head, accelerating the occurrence and development of SANFH. With advantages of high safety and low side effects, Chinese medicinals have a good effect in the treatment of SANFH. Compound formulas, single Chinese medicinal and active ingredients of Chinese medicinals can directly or indirectly regulate the expression of key molecules in the corresponding signaling pathways, improve mitochondrial function at multiple targets, and significantly prevent the occurrence and development of SANFH, which have attracted wide attention from scholars. This paper reviews the relationship between SANFH and mitochondrial function, and the mechanism of Chinese medicinals preventing and treating SANFH by modulating mitochondrial function, in order to provide certain ideas and methods for the treatment of SANFH by applying Chinese medicinals to modulate mitochondrial function.

Research progress of the classical TCM formula Huaihua powder 

CHEN Cheng, DENG Yu, GONG Youlan, ZHANG Zhenming, DUAN Wulei, QING Jun, ZHANG Bo

2023, 28(6):  697-704.  doi:10.12092/j.issn.1009-2501.2023.06.013

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Huaihua powder, a classical TCM formula, was initially recorded in Pu Ji Ben Shi Fang by the prestigious physician Xu Shuwei. It is a classical prescription for treating "chang-feng-zang-du"(chang-feng-xia-xue). Modern research shows that the main components of Huaihua powder are flavonoids, volatile oil, saponins and so on, which have anti-inflammatory, antioxidant, hemostatic, antibacterial, anti-tumor and other pharmacological effects.The clinical application is mostly used for the treatment of ulcerative colitis, radioactive enteritis, hemorrhoid postoperative bleeding and other skin diseases. Its modern clinical application is slightly better than the ancient clinical application. This paper summarized and summarized the chemical composition and analysis method, process research and quality control, modern pharmacology and clinical application, and discussed the material basis and research direction of its efficacy. Based on the research results, combined with the modern pharmacology and clinical application of Huaihua powder, it is recommended to develop the entire pharmacological active ingredients of this classic formula, as well as the main effective ingredients, anti-inflammatory targets, and mechanism of action for the treatment of radiation induced enteritis, allergic purpura, and other skin diseases.

Research progress on signaling pathway of tanshinoneIIA in treatment of nerve injury after ischemic stroke

QIN Wenxiu, XU Junfeng, YANG Ting, WANG Pingfei

2023, 28(6):  705-713.  doi:10.12092/j.issn.1009-2501.2023.06.014

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Tanshinone IIA is one of the main active components of traditional Chinese medicine Salvia miltiorrhiza, which plays a pharmacological role, and has been proved by modern research to have the effect of anti ischemic stroke nerve damage. This article reviews the signal pathway and mechanism of tanshinone IIA on nerve damage after ischemic stroke in recent years through literature search, and finds that tanshinone IIA can regulate the activity and release of PI3K/Akt/mTOR, Nrf2, NF-κB. NLRP3, MAPK and other signal pathways, inhibit IL-6, IL-8 and TNF-α, up regulate the expression of neuron specific structural proteins, inhibit the activation and proliferation of astrocytes, play the role of anti neuroinflammation, oxidative stress, neuronal apoptosis, etc., thus reducing the damage of neurons after ischemic stroke, showing the mechanism characteristics of multi target, multi-channel and multi-level interaction. Based on this, this article briefly reviewed the neuroprotective mechanism of tanshinone IIA intervention on the above signal pathways after ischemic stroke, in order to provide reference for the clinical application and drug development of tanshinone IIA.

Research progress of norepinephrine reuptake inhibitor combined with antimuscarinic in the treatment of obstructive sleep apnea

WANG Juan, LIU Weiying, YE Yucai, FU Wenli, ZHANG Sha, LI Leping

2023, 28(6):  714-720.  doi:10.12092/j.issn.1009-2501.2023.06.015

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Obstructive sleep apnea is caused by repeated apnea and/or hypopnea during sleep, which leads to chronic intermittent hypoxia with hypercapnia and sleep structure disorder, and then causes damage to systemic organs. Recent studies have found that in addition to the abnormal structure of the upper airway, the dysfunction of the pharyngeal dilator muscle and the instability of the upper airway are also prone to cause upper airway stenosis, and are related to the withdrawal of norepinephrine and the increase of acetylcholine during sleep. The combined use of norepinephrine reuptake inhibitor and muscarinic can reduce the severity of OSA by increasing genioglossus activity and improving airway stability, with good safety.