Table of Content

Volume 28 Issue 9
26 September 2023

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Research on serum metabolic markers of menopausal syndrome based on 1H-NMR metabolomics

DU Caifeng, MAO Yunan, GAO Jia, WANG Juan, LI Xiaoye, TIAN Junsheng, LIU Hongqi

2023, 28(9):  961-968.  doi:10.12092/j.issn.1009-2501.2023.09.001

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AIM: To find specific metabolic markers for women entering peri-menopausal period and patients with menopausal syndrome based on 1H-NMR metabolism serum metabolite analysis combined with pattern recognition. METHODS: Eighty patients with menopausal syndrome, 40 peri-menopausal women of the same age and 40 healthy women of childbearing age as controls were selected. Then the serum samples were detected by nuclear magnetic resonance spectroscopy (1H-NMR), and the metabolites were compared by partial least square discriminant analysis (PLS-DA) and orthogonal partial least square discriminant analysis (OPLS-DA). RESULTS: There were nine serum metabolites with significant differences among the three groups of menopausal syndrome patients and the healthy women during the perimenopausal and childbearing period, which include lactic acid, acetic acid, glutamic acid, pyruvate, creatine, TMAO, N-acetylglycoprotein, alanine and choline. Compared with the healthy women of childbearing age, there were six serum metabolites of menopausal syndrome decreased significantly, but they had no diagnostic value yet. Compared with the healthy peri-menopausal women, the contents of alanine and TMAO were significantly increased, while the contents of glutamate, pyruvate, N-acetylglycoprotein and choline were significantly decreased in patients with menopausal syndrome. And the changes of glutamic acid, pyruvic acid, N- acetylglycoprotein and choline had certain diagnostic value. CONCLUSION: Peri-menopausal period is a special physiological stage of women's transition from reproductive period to old age. Though healthy women have some changes compared with childbearing age, they do not have diagnostic value. However, the differential metabolic markers in patients with menopausal syndrome have a certain diagnostic value, which can provide a certain objective basis for the clinical diagnosis of menopausal syndrome.

Molecular mechanism of artesunate attenuates the release of proinflammatory cytokines from macrophages

LIAO Mengling, WANG Yan, LUO Jing, WANG Nuoyan, HUA Ling, ZHANG Yu, DENG Fei, YUAN Yue, ZHOU Jun, ZHOU Hong

2023, 28(9):  969-978.  doi:10.12092/j.issn.1009-2501.2023.09.002

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AIM: Lipopolysaccharide (LPS) on the cell membrane of gram negative bacteria is closely related to the occurrence and development of severe acute pancreatitis (SAP). Local and systemic monocyte/macrophages play an important role in the inflammatory process of SAP. Artesunate (AS) was reported to protect rats with severe acute pancreatitis by reducing the release of proinflammatory cytokines. This study further explored the molecular mechanism of anti-inflammatory effect of AS. METHODS: The release of proinflammatory cytokines in the supernatant were studied by enzyme-linked immunosorbent assay. Then, the mRNA expressions of PI3K-III and its key molecules in signaling pathway were detected by real-time quantitative PCR. Finally, the phosphorylation levels of PI3K-III were detected by Western blot. RESULTS: AS could significantly inhibit the release of proinflammatory cytokines from mouse macrophage induced by LPS. Autophagy inhibitor 3-methyladenine (3-MA) could significantly inhibit the release of TNF-α from mouse macrophages induced by LPS; LPS significantly increased the mRNA expression of PI3K-III and its key molecules in mouse peritoneal macrophages (PMs). Finally, AS could significantly inhibit the increase of PI3K-III phosphorylation induced by LPS in PMs. CONCLUSION: The anti-inflammatory mechanism of AS is closely related to the inhibition of PI3K-III phosphorylation.

Sinomenine inhibits oxidative stress and pulmonary fibrosis by activating the Keap1/Nrf2 signaling pathway

LIU Lijing, QIAN Hong, MENG Qingxin, ZHANG Xiang, HE Bin, HE Jianbin, WEI Yingmin

2023, 28(9):  979-987.  doi:10.12092/j.issn.1009-2501.2023.09.003

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AIM: To explore the protective effects of sinomenine (SIN) on oxidative stress and pulmonary fibrosis and its relationship with the Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. METHODS: MRC-5 cells were treated with hydrogen peroxide (H2O2) to establish the oxidative stress injury model, followed by administration with SIN. Cell viability was detected using the CCK-8 method. The biochemical kits were employed to measure malondialdehyde (MDA) content and superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) activities. The protein expression of Keap1 and Nrf2 was examined by western blot. Thirty SD rats were randomly divided into control group, bleomycin A5 (BLM) group and BLM+SIN group, with 10 animals in each group. Bleomycin A5 were intratracheally administered to the rats in BLM group and BLM+SIN group to establish the pulmonary fibrosis model. The rats in control group received the same volume of 9 g/L sodium chloride solution. The second day after model construction, the rats in BLM+SIN group were gavaged with SIN, while the rats in the other two groups were treated with 9 g/L sodium chloride solution. On day 28, all rats were sacrificed. Pulmonary tissue was isolated, and HE and Masson staining was performed to observe the pathological changes. The MDA content and SOD, GSH-Px and CAT activities in pulmonary tissue were evaluated. Western blot was used to assay pulmonary tissues Keap1 and Nrf2 protein expression. RESULTS: When compared with H2O2 group, SIN treatment increased cell viability, decreased MDA content, elevated SOD, GSH-Px and CAT activities, down-regulated Keap1 expression, and promoted nuclear translocation of Nrf2 in MRC-5 cells. In comparison with BLM group, administration of SIN decreased alveolitis and pulmonary fibrosis pathological changes and scores as well as pulmonary tissue MDA content, enhanced pulmonary tissues SOD, GSH-Px and CAT activities, down-regulated pulmonary tissues Keap1 expression, and raised Nrf2 levels in the nucleus. CONCLUSION: SIN alleviates oxidative stress and pulmonary fibrosis possibly by activating the Keap1/Nrf2 signaling pathway.

Mechanism of compound kushen injection in the treatment of lung cancer based on serum metabolomics and network pharmacology

YOU Rongli, HUANG Yurong, MAORui, HAI Lina, WANG Yingli, WANG Yan

2023, 28(9):  988-999.  doi:10.12092/j.issn.1009-2501.2023.09.004

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AIM: To explore the mechanism of action of alkaloid components of compound kushen Injection (CKI) in the treatment of lung cancer based on serum metabolomics, network pharmacology, and molecular docking techniques. METHODS: A lung cancer model was established in C57 mice by inoculation of Lewis mouse lung cancer tumor strain. Thirty male mice were randomly divided into normal group, model group and CKI group. The drug was administered by tail vein injection once daily for 17 consecutive days. Mouse serum was examined by ultrahigh performance liquid chromatography tandem mass spectrometry (LC-MS) metabolomics, and several multivariate statistical analyses including principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA), combined with databases such as the human metabolic database (HMDB) and related literature to identify and identify differential metabolites, the relevant metabolic pathways were searched for by the metaboanalyst online tool. Using network pharmacology, construct the “component-target-disease” network of CKI in the treatment of lung cancer. Molecular docking method was used to verify the interaction between potential active ingredients and core targets. Serum metabolomics was jointly analyzed with network pharmacology to construct a “metabolite-germinal-enzyme-gene” network. RESULTS: Through metabolomics technology, 16 differential metabolites associated with lung cancer were screened from serum, and CKI addback these differential metabolite levels compared with the model group. Metabolic pathways mainly involve retinol metabolism, tryptophan metabolism, glycerophospholipid metabolism and other metabolic pathways. Network pharmacology analysis indicated that CKI treatment of lung cancer mainly targets STAT3, MAPK3, and MAPK1, which are closely related to proteoglycans, cellular senescence, and HIF?1 signaling pathways in cancer. CONCLUSION: This article explains the mechanism of CKI in treating lung cancer from the perspective of metabonomics and network pharmacology, and provides basis for further study of CKI.

Therapeutic effect of lienal polypeptide injection on bone marrow suppression and immunodeficiency in KM mice following chemotherapy

WANG Ruyue, XIE Fei, WANG Xin, LI Hongyu

2023, 28(9):  1000-1007.  doi:10.12092/j.issn.1009-2501.2023.09.005

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AIM: To assess the therapeutic effect of lienal polypeptide injection (LPI) on bone marrow suppression and poor immunity in Kunming (KM) mice after the intervention of chemotherapy drug carboplatin (CBP), as well as its potential mechanisms. METHODS: KM female mice were randomly divided into control group, model group, low-dose lienal polypeptide,and high-dose lienal polypeptide treatment groups. On day 1, mice in the treatment group and model group were subjected to intraperitoneal single injection of carboplatin (70 mg/kg), to induce chemotherapy-induced bone marrow suppression in mice,while the control group was intervened with normal saline. From Day 2 to Day 16, the treatment groups received daily intraperitoneal injections of lienal polypeptide (60 mg·kg-1·d-1), while the control and model groups received saline injections. At the end of the drug intervention, the number of platelets, leukocytes and erythrocytes in the peripheral blood of mice were measured. Mice body weight, organ indices of mice thymus and spleen were obtained; Flow cytometry was used to obtain changes in CD4+ T cell subsets, CD8+ T cell subsets, and CD4+CD25+Foxp3+ regulatory T cell (Treg) subsets in the thymus and spleen of KM female mice. RESULTS: Compared to the control group, mice in the model group exhibited significant reductions in white blood cell and platelet counts on Day 16, decreased organ indices of thymus and spleen, and reduced proportions of thymic and splenic Treg lymphocyte subsets.  Following high-dose lienal polypeptide intervention, white blood cell and platelet counts significantly recovered, and proportions of thymic and splenic Treg lymphocyte subsets were restored (P<0.05). CONCLUSION: Lienal polypeptide injection exhibits a therapeutic effect on bone marrow suppression and immune deficiency in KM mice post chemotherapy, as evidenced by the restoration of blood parameters and Treg lymphocyte subsets in the thymus and spleen.

Real-world study of ceftazidime-avibactam in the treatment of multidrug-resistant gram-negative bacterial infections

JIANG Daoli, CHOU Xiaohua, LIU Zhidong, LI Wei, ZHANG Bo, XU Sang, TAN Defei, FANG Yi, LV Dongmei, WANG Tao

2023, 28(9):  1008-1017.  doi:10.12092/j.issn.1009-2501.2023.09.006

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AIM: To describe and evaluate the clinical characteristics, treatment management and clinical outcomes of ceftazidime-avibactam (CZA) in the treatment of patients with multidrug-resistant gram-negative bacterial (MDR-GNB) infections. METHODS: A retrospective cohort study was performed on patients hospitalized in the Affiliated Hospital of Xuzhou Medical University from September 2019 to December 2021. Adult patients who received CZA for ≥ 72 hours consecutively were eligible for inclusion. The primary outcome was clinical failure, defined as a composite of 30-day all-cause mortality, microbiological failure and/or failure to resolve or improve signs and symptoms of infection during treatment with CZA. RESULTS: A total of 198 patients with MDR-GNB infections were described and evaluated, including 132 in the carbapenem-resistant Enterobatceriaceae (CRE) cohort and 66 in the Pseudomonas spp. cohort. The main infection sites were lung infection (92.42%), abdominal infection (10.61%), and intracranial infection (10.61%), among which 63 patients (31.82%) were positive for blood culture. Clinical failure, 30-day all-cause mortality and microbiological failure occurred in 61(30.81%), 33(16.67%) and 11(5.56%) patients, respectively. Body mass index (BMI), acute physiology and chronic health evaluation scoring system (APACHE Ⅱ) and polymicrobial infections were positively associated with clinical outcome failure ［adjusted OR 1.109, 95%CI 1.017,1.209; adjusted OR 1.071, 95%CI 1.015,1.129; adjusted OR 2.844, 95%CI 1.391,5.814］, however, initiation of CZA within 48 hours of admission was protective (adjusted OR 0.424, 95%CI 0.205, 0.879). A total of 15 patients had adverse reactions possibly related to CZA, including 2 cases of rash, 6 cases of nausea and vomiting, and 7 cases of antibiotic-related diarrhea. CONCLUSION: CZA can be used to treat infections caused by a range of MDR-GNB, including Pseudomonas spp. and CRE.

Correlation between 25(OH)D and metabolically related fatty liver in T2DM population

MA Yan, TIAN Gaopeng, SHI Xingwen, SUN Ting, XIE Jingjing, ZHEN Donghu

2023, 28(9):  1018-1026.  doi:10.12092/j.issn.1009-2501.2023.09.007

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AIM: To investigate the correlation between 25-hydroxyvitamin D and metabolically associated fatty liver disease in type 2 diabetes mellitus. METHODS: A total of 2 406 subjects in Standardized Metabolic Disease Control were recruited from the National Center for Standardized Metabolic Disease Control in The First Hospital of Lanzhou University. The population was divided into Q1, Q2, Q3 and Q4 according to 25(OH)D quartile. The prevalence of MAFLD and related clinical indicators among the four groups were compared, and the influencing factors of MAFLD were analyzed by Logistic regression. Restricted cubic spline (RCS) was used to explore the relationship between 25(OH)D and MAFLD. RESULTS: The prevalence of MAFLD was different with different vitamin D levels. The prevalence of MAFLD was lower in the group with high 25(OH)D level. The level of 25(OH)D in patients with MAFLD was lower than that in patients with T2DM alone, and the number of vitamin D deficiency was relatively higher. Multivariate regression analysis showed that 25(OH)D was not associated with the risk of MAFLD. RCS analysis also suggested that 25(OH)D was not associated with the risk of MAFLD. CONCLUSION: The prevalence of MAFLD is high in people with low vitamin D level, and vitamin D is not associated with the risk of MAFLD after multivariate adjustment.

Evaluation of tegacycline regimens in treatment of gram-negative bacterial infections with Monte Carlo simulation

WU Yujie, ZHAO Chengcheng, XI Qing

2023, 28(9):  1027-1033.  doi:10.12092/j.issn.1009-2501.2023.09.008

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AIM: To evaluate the dose regimens of tegacycline for treatment of hospital-acquired pneumonia, complex abdominal infection and complex skin and soft tissue infection caused by Gram-negative bacterial infections with Monte Carlo model. METHODS: The minimum inhibitory concentrations (MICs) of tegacycline against Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were collected from the CHINET in 2018. The target probability (PTA) and cumulative response fraction (CFR) of different regimens were calculated using Monte Carlo simulation based on PK/PD theory of tegacycline. RESULTS： In the treatments of HAP caused by gram-negative bacteria, when MIC≤0.5 μg/mL, the PTA of 50 mg q12h was greater than 90%, and when MIC≥1 μg/mL, PTA and CFR of 100 mg q12h were both greater than 90%, When MIC≥2 μg/mL, 50 mg q12h, 75 mg q12h and 100 mg q12h doses of PTA were less than 90%. In the treatment of cIAI, when MIC≤0.5 μg/mL, PTA of 50 mg q12h reached the target value, and when MIC=1 μg/mL, PTA of 100 mg q12h was greater than 90%. For complex skin and soft tissue infection, when the MIC≤0.25 μg/mL, the PTA of 75 mg q12h and 100 mg q12h was greater than 90%, and the PTA of the three administration regimen was less than 90%, when the MIC≥0.5 μg/mL. CONCLUSION： The dose of 50 mg q12h is more suitable for the treatment of HAP, when MIC>0.5 μg/mL, tigecycline may need 100 mg q12h to obtain the best clinical efficacy in the treatment of cIAI. For cSSSI. when MIC≤0.25 μg/mL, tigecycline can be administered with 75 mg q12h and 100 mg q12h. For the three types of infections caused by Escherichia coli, the conventional dose of tigecycline may achieve clinical efficacy.

Clinical efficacy and anti-inflammation/anti-fibrosis effect of tripterygium glycosides in the treatment of diabetic nephropathy

XU Yiqi, WU Qian, LIU Shu, LIU Fan, XING Chunyan, LI Qin, HE Junjun, HE Chunling, ZHAO Yongli, GAO Jialin

2023, 28(9):  1034-1042.  doi:10.12092/j.issn.1009-2501.2023.09.009

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AIM: To observe the clinical efficacy of multi-glycoside of tripterygium wilfordii (GTW) on diabetic nephropathy. METHODS: Fifty-one patients with diabetic kidney disease (DKD) with a history of GTW dosing admitted to the outpatient clinic of Yijishan Hospital affiliated to Wannan Medical College from June 2019 to October 2022 were selected as study subjects, and were followed up regularly to observe the changes in laboratory indexes before and after GTW dosing and adverse drug reactions after 6 months of treatment. The t-test, Mann-Whitney U-test or χ2 test were applied using own before-and-after control. RESULTS: After 6 months of treatment, the patient's albumin was (40.72±4.87) g/L, which was statistically different (P<0.05) compared with (35.86±7.90) g/L before treatment. The urinary albumin excretion rate (UACR) was (2 145±253) mg/g before treatment and (1 263±238) mg/g after treatment, with statistical differences before and after treatment (P<0.05); the total number of patients with severe urinary semiquantitative urine protein (3+, 4+) decreased compared with before, with statistically significant differences before and after treatment (P<0.05). Fasting Blood-Glucose (FPG) and Glycosylated Hemoglobin (HbA1c) were (8.42±3.31) mmol/L and (7.41±1.48)%, respectively, in patients after 6 months of treatment, which decreased compared with baseline FPG (7.20±1.95) mmol/L and HbA1c (6.63±1.00)% (P<0.05); During the treatment, the number of patients with glomerular filtration rate (eGFR) ≥3a stage blood creatinine (Scr) double increased was 1 (3.80%), the number of UACR double increased was 2 (7.70%), and the number of eGFR ≤3b stage was 0 and 1 (4.00%), respectively, and the difference between the two groups was not statistically significant (P>0.05); 3 cases (5.90%) had abnormal liver function and 1 case (2.00%) had leukopenia, which improved after treatment with liver protection and leukocyte-raising drugs. The difference of blood sugar, blood lipid and blood pressure before and after treatment did not show statistically significant (P>0.05). CONCLUSION: The use of GTW treatment in DKD patients can significantly reduce urinary protein, increase albumin and improve renal function, which is worthy of clinical promotion.

Influence of argumented renal clearance on teicoplannin serum concentrations in critical ill patients

WANG Fei, HANG Yongfu, WANG Wei

2023, 28(9):  1043-1048.  doi:10.12092/j.issn.1009-2501.2023.09.010

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AIM: By analyzing the teicoplannin serum concentration in patients with severe infection and comparing the monitoring results in patients with hyperrenal function and non-hyperrenal function, to provide reference for clinical rational drug use. METHODS: A retrospective analysis was conducted on 64 patients admitted to the department of critical care medicine of a tertiary level hospital from August 2019 to March 2021, and statistical analysis was performed on the monitoring results of teicoplannin, together with medication information and other biochemical indicators of these patients. RESULTS: Sixty-four patients had total 110 times of drug monitoring. 32.7% of ICU patients had renal hyperfunction, and the average serum concentration was 13.6 mg/L. Nearly half of blood concentrations of the monitored patients could not reach the therapeutic target of teicoplanin. For patients without argumented real clearance, increasing the maintenance dose of teicoplanin can significantly increase the blood concentration. While for those with argumented real clearance, the blood concentration of teicoplanin had no significant difference in different maintenance dose groups. Further correlation study found that the serum concentration of teicoplanin in patients with argumented real clearance was significantly positively correlated to cystatin C level, and significantly negatively correlated to albumin level. CONCLUSION: The incidence of renal hyperfunction in ICU patients is high, and the maintenance dose of teicoplanin 600 mg may not be effective for severe infection. To improve the effect of teicoplanin in severe patients, the drug concentration should be monitored to adjust the dose.

Analysis of the efficacy and safety of Peg-IFN-α in the treatment of essential thrombocythemia

XIAO Yue, LI Tangfei, XUE Qianfu

2023, 28(9):  1049-1055.  doi:10.12092/j.issn.1009-2501.2023.09.011

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AIM: To evaluate the clinical efficacy and safety of pegylated interferon-alpha (Peg-IFN-α) in the treatment of essential thrombocythemia (ET).?METHODS: A total of 50 ET patients were treated with Peg-IFN-α for more than 12 months. 180 μg was injected subcutaneously once every two weeks as the initial dose, and then the treatment interval was adjusted according to blood routine. The clinical efficacy and adverse reactions were analyzed.?RESULTS: The hematologic response of ET patients treated with Peg-IFN-α occurred quickly, and the platelet decreased significantly after 3 months (508.56±120.75 vs. 931.44±209.13, P=0.000). Hematologic complete remission rate and overall remission rate at 12 months were 70% and 98%, respectively.?The JAK2-V617F mutation burden of ET patients treated with Peg-IFN-α was significantly lower at 6 months of treatment than at initial diagnosis (0.254 1±0.122 8 vs. 0.315 3±0.133 2, P<0.000 1). The 1-year molecular biology complete remission rate was 12.5%, and overall remission rate was 31.75%. MPN-SAF-TSS scores decreased significantly within 6 months after Peg-IFN-α treatment (P<0.001), but there was no significant change in the score at 12 months compared with 6 months (P>0.05).?Hematological adverse reactions were rare, and all of them were grade 1-2 adverse reactions. Non-hematological adverse reactions were mainly influenza-like symptoms. Most of the patients were grade 1-2, and occasionally had grade ≥3 adverse reactions. All adverse reactions could be tolerated after extending medication interval or symptomatic treatment, and no patient terminated treatment because of adverse reactions.?CONCLUSION: Peg-IFN-α is effective and safe in the treatment of ET.

Effect and safety of flurbiprofen axetil in the analgesic treatment of patients with craniocerebral injury

MAO Jun, RONG Yu, LI Yangen, XIONG Dengxi, ZHAO Peng, ZHA Zhengjiang

2023, 28(9):  1056-1060.  doi:10.12092/j.issn.1009-2501.2023.09.012

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AIM：To observe the efficacy and safety of flurbiprofen axidate in postoperative analgesia in patients with craniocerebral injury. METHODS: A total of 60 patients with acute craniocerebral injury admitted to the Department of Neurosurgery in our hospital from May 2021 to May 2023 were selected. They were randomly divided into flurbiprofen axetil group (flurbiprofen + fentanyl analgesia) and fentanyl group (fentanyl analgesia), and the CPOT score of analgesia target was ≤3 points. The onset time of analgesia, the dosage of fentanyl within 48 h, and the occurrence times of nausea and vomiting, upper gastrointestinal hemorrhage, bradycardia and hypotension during analgesia treatment were observed in the two groups. Serum CRP, IL-6, TNF-α, NSE and S100β protein levels were detected before and 24 h and 48 h after the operation. RESULTS: There were no significant differences in gender, age, BMI, admission GCS score between the two groups. When analgesia reached the target value of CPOT score ≤3 points, the time required for flurbiprofen ester group was shorter than that of fentanyl group (P<0.05), and the total amount of fentanyl used in flurbiprofen axetil group was lower than that of control group within 48 hours (P<0.05). There were no significant differences in postoperative nausea and vomiting, upper gastrointestinal hemorrhage, bradycardia and hypotension between the two groups (P>0.05). CRP, IL-6, TNF-α, NSE and S100β in flurbiprofen axetil group were significantly lower than those in fentanyl group at 24 h and 48 h after operation (P<0.05). CONCLUSION: Flurbiprofen exate can reduce the amount of analgesic fentanyl in patients with craniocerebral injury, and has anti-inflammatory effect to reduce brain injury, and can be effectively and safely used in the analgesic management of patients with craniocerebral injury.

Clinical evaluation of the efficacy against helicobacter pylori by amoxicillin from volume-based procurement and potassium amoxicillin clavulanate 

HUA Zhihui, LIU Dong, ZHANG Jiandong, CAI Siyu, GE Chunli, CHEN Nan, QI Qi

2023, 28(9):  1061-1066.  doi:10.12092/j.issn.1009-2501.2023.09.013

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AIM: To evaluate the clinical efficacy of amoxicillin from volume-based procurement (VBP) and potassium amoxicillin clavulanate in the eradication of helicobacter pylori (Hp) infection, providing basis for the selection of treatment programs. METHODS: Data from the patients who received Hp eradication therapy from May 2021 to May 2022 were recruited from the rational drug use management system. The data from the patients treated by amoxicillin (amoxicillin 1.0 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) and potassium amoxicillin clavulanate (potassium amoxicillin clavulanate 0.914 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) were selected and compared. RESULTS: A total of 171 cases were collected in the group treated by Amoxicillin program, and the eradication rate was 87.8% (150/171). A total of 69 cases were collected in the group of potassium amoxicillin clavulanate, and the eradication rate was 76.8% (53/69). There was no significant difference in baseline data between the two groups (P>0.05). There was a significant difference in clinical efficacy between the two groups (P<0.05). In addition, the cost-effectiveness ratio (C/E) of the Amoxicillin treatment program was lower than that of the potassium amoxicillin clavulanate program CONCLUSION: The clinical efficacy of VBP Amoxicillin program in eradicating Hp infection is better than that of the potassium amoxicillin clavulanate program, which is worthy of clinical recommendation.

Research progress of nuclear factor erythroid 2-related factor 2 in pulmonary fibrosis

WANG Jie, LI Long, CHEN Feng, LIU Shengfei

2023, 28(9):  1067-1072.  doi:10.12092/j.issn.1009-2501.2023.09.014

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Pulmonary fibrosis is a common chronic interstitial lung disease. It is characterized by excessive deposition of extracellular matrix and remodeling of lung tissue structure, resulting in severe impairment of lung function. The cause of its pathogenesis is still unclear. Therefore, it is urgent to explore its pathogenesis and find new targets to combat pulmonary fibrosis. Studies have shown that nuclear factor erythroid 2-related factor 2 can maintain the body's redox homeostasis by regulating antioxidant genes and combining antioxidant response components, thereby protecting tissues and cells from oxidative stress. In recent years, many studies have proved that nuclear factor erythroid 2-related factor 2 can play an anti-fibrotic role by alleviating oxidative stress, inhibiting macrophage polarization, activating autophagy, inhibiting ferroptosis, and blocking epithelial-mesenchymal transition. This paper provides a brief review of the association and research progress of nuclear factor erythroid 2-related factor 2 with pulmonary fibrosis, with the aim of providing a new direction for the precise treatment of pulmonary fibrosis.

Recent progress in understanding the neuroprotective mechanism of carnosic acid in Parkinson's disease

WANG Jingang, LI Qiang, SUN Huiyan, WANG Hongquan

2023, 28(9):  1073-1080.  doi:10.12092/j.issn.1009-2501.2023.09.015

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Carnosic acid (CA) is a natural phenolic diterpene compound found in rosemary (Rosmarinus officinalis) characterized as an ortho-dihydroquinone-type molecule.Multiple lines of studies have shown that CA has potent neuroprotective effects in vitro and in vivo in Parkinson's disease (PD). The aim of the present review is to summarize the pharmacological neuroprotective actions of CA, and provide a comprehensive review of the molecular mechanism by which CA exert neuroprotective effect in PD. The current review highlights CA is a therapeutic potential for PD.

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2023, 28(9):  1074. 

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