Ischemia–reperfusion injury is a common pathophysiological mechanism in retinal degeneration.PANoptosis is a newly defined integral form of regulated cell death that combines the key features of pyroptosis,apoptosis,...Ischemia–reperfusion injury is a common pathophysiological mechanism in retinal degeneration.PANoptosis is a newly defined integral form of regulated cell death that combines the key features of pyroptosis,apoptosis,and necroptosis.Oligomerization of mitochondrial voltage-dependent anion channel 1 is an important pathological event in regulating cell death in retinal ischemia–reperfusion injury.However,its role in PANoptosis remains largely unknown.In this study,we demonstrated that voltage-dependent anion channel 1 oligomerization-mediated mitochondrial dysfunction was associated with PANoptosis in retinal ischemia–reperfusion injury.Inhibition of voltage-dependent anion channel 1 oligomerization suppressed mitochondrial dysfunction and PANoptosis in retinal cells subjected to ischemia–reperfusion injury.Mechanistically,mitochondria-derived reactive oxygen species played a central role in the voltagedependent anion channel 1-mediated regulation of PANoptosis by promoting PANoptosome assembly.Moreover,inhibiting voltage-dependent anion channel 1 oligomerization protected against PANoptosis in the retinas of rats subjected to ischemia–reperfusion injury.Overall,our findings reveal the critical role of voltage-dependent anion channel 1 oligomerization in regulating PANoptosis in retinal ischemia–reperfusion injury,highlighting voltage-dependent anion channel 1 as a promising therapeutic target.展开更多
Cerebral ischemia restricts cerebral blood flow(CBF),leading to unstable hemodynamics.Past studies of ischemia mainly focused on cortical CBF reduction.However,its impact on hemodynamic changes,especially temporal var...Cerebral ischemia restricts cerebral blood flow(CBF),leading to unstable hemodynamics.Past studies of ischemia mainly focused on cortical CBF reduction.However,its impact on hemodynamic changes,especially temporal varying characteristics,remains poorly understood.Here,we collected cortical resting-state CBF in rats with left carotid artery blockage during occlusion–reperfusion,and measured the temporal variability and changes in laterality using a novel state-space method.This method was also applied to stroke EEG datasets to validate its effectiveness.After arterial occlusion,the left marginal motor,sensory,auditory,and visual cortices exhibited severe temporal variability impairments.The laterality analysis indicated that affected left regions showed inferior unilateral mean,inter-hemispheric transition probability,time fraction,and laterality duration,while the right side had a higher laterality time fraction and duration.These impairments recovered partially following blood flow restoration.Besides,the ischemic state-space metrics were positively correlated with the pre-occlusion baseline appearance.Stroke patients exhibited impaired temporal variability in the affected ischemic hemisphere.The state-space analysis revealed damaged CBF temporal variability during cerebral ischemia and predicted baseline-ischemia connections.展开更多
Myocardial infarction(MI)is a disease with a very high mortality rate among cardiovascular diseases.It causes extensive damage to myocardial cells due to prolonged and repeated ischemia and hypoxia.Early coronary reva...Myocardial infarction(MI)is a disease with a very high mortality rate among cardiovascular diseases.It causes extensive damage to myocardial cells due to prolonged and repeated ischemia and hypoxia.Early coronary revascularization is the best method for treating MI.However,the reperfusion process in MI can produce reactive oxygen species,further damaging myocardial tissue,and triggering MI-reperfusion injury(MI/RI).Although various traditional treatment strategies exist,the treatment of myocardial ischemia including MI and MI/RI remain a significant challenge.Mitochondrial dysfunction plays an important role in the emergence and development of myocardial ischemia.In recent years,with the advancement of nanobiomedicine,therapeutic strategies for targeting mitochondria have gained increasing attentions in diseases'therapy.Thus,nanobiomedicine targeting mitochondria has shown great promise in the treatment of myocardial ischemia.This review first comprehensively elaborates on the mechanisms of mitochondrial homeostasis in MI and MI/RI,and then focuses on the application progress of nanomaterials targeting mitochondrial homeostasis(oxidative stress,mitophagy,mitochondrial fusion and fission,etc.)in improving myocardial ischemia.Ultimately,this article looks forward to the prospects of nanomaterials in the targeting treatment of MI and MI/RI,aiming to provide more effective and innovative ideas for clinical treatments.展开更多
BACKGROUND Acute mesenteric ischemia(AMI)is associated with high mortality owing to delayed diagnosis and the absence of biomarkers capable of distinguishing disease subtypes or inflammatory burden.Mesenchymal stem ce...BACKGROUND Acute mesenteric ischemia(AMI)is associated with high mortality owing to delayed diagnosis and the absence of biomarkers capable of distinguishing disease subtypes or inflammatory burden.Mesenchymal stem cells(MSCs)exosomal circular RNAs(circRNAs)show diagnostic potential in other diseases.AIM To evaluate the utility of MSCs exosomal circRNAs in AMI,particularly for early detection and subtyping.METHODS Peripheral blood-derived MSCs(PBMSCs)from 80 patients with AMI(stratified by etiology:48 arterial AMI,32 venous AMI,36 early reversible,44 late necrotic)and 125 controls were obtained at initial hospital admission.Exosomal circRNAs were isolated via ultracentrifugation,validated by transmission electron microscopy and nanoparticle tracking analysis,and quantified by quantitative real-time polymerase chain reaction.Plasma intestinal fatty acid binding protein(IFABP),d-lactate,interleukin-6(IL-6),tumor necrosis factor-α,IFABP,D-lactate,IL-6,and neutrophil-to-lymphocyte ratio were measured.Pearson’s test was used to assess the diagnostic performance of receiver operating characteristic analysis.RESULTS Patients with AMI exhibited significantly elevated PBMSCs exosomal circ-Eya3(P<0.001)and reduced circEZH2_005 levels(P<0.001).Circ-Eya3 correlated positively with IFABP(r=0.606),D-lactate(r=0.384),IL-6(r=0.551),and neutrophil-to-lymphocyte ratio(r=0.601)(all P<0.001),whereas circEZH2_005 showed inverse correlations(r=-0.580 to-0.403;P<0.001).Critically,circEZH2_005 expression was lower in arterial AMI than in venous AMI(P=0.003).The combination of circ-Eya3,circEZH2_005,and D-lactate achieved excellent diagnostic accuracy(area under the curve=0.891).Post-reperfusion,circ-Eya3 increased(P<0.05),while circEZH2_005 decreased(P<0.05).CONCLUSION PBMSCs exosomal circ-Eya3 and circEZH2_005 serve as novel biomarkers for AMI,reflecting intestinal injury severity,systemic inflammation,and disease subtype.Their integration with D-lactate enables high-accuracy diagnosis,whereas differential expression across arterial/venous AMI and ischemia stages offers clinical utility for guiding intervention strategies.展开更多
Objective:Leucine-rich alpha-2 glycoprotein 1(Lrg1)could regulate diverse cells in cerebral ischemiareperfusion.Our study seeks to uncover Lrg1’s impact on endothelial cell heterogeneity via differentiation pathways ...Objective:Leucine-rich alpha-2 glycoprotein 1(Lrg1)could regulate diverse cells in cerebral ischemiareperfusion.Our study seeks to uncover Lrg1’s impact on endothelial cell heterogeneity via differentiation pathways and transcription factors.Method:The CSOmap model measured cell-to-brain-center distances using single-cell RNA sequencing(scRNA-seq)data in middle cerebral artery occlusion reperfusion(MCAO/R).Monocle2 mapped endothelial differentiation paths.Gene set enrichment analysis(GSEA)analyzed endothelial subcluster variations.Database searches revealed a zinc finger MIZ-type containing 1 protein-frizzled 3(Zmiz1-Fzd3)promoter interaction.Endothelial cells were transfected with a Fzd3 promoter-luciferase plasmid.Polymerase chain reaction(PCR)and western blotting assessed MCAO/R or Zmiz1 overexpression effects on Fzd3-related mRNA and proteins.A retroviral vector carrying Zmiz1 was injected into the brains of mice to study its effect on Fzd3.Result:Lrg1−/−mice exhibited elevated cell adhesion proteins and decreased microvascular leakage after MCAO/R.CSOmap showed widened astrocyte spacing in thesemice.RSS revealed Zmiz1 overexpression inMCAO/R+Lrg1−/−mice.MCAO/R and pcDNA3-Zmiz1 transfection both enhanced luciferase activity with Fzd3,indicating Zmiz1 binding to Fzd3.Retroviral Zmiz1 injection or knockdown disrupted ischemic brain tight junctions,highlighting Zmiz1’s key role in blood-brain barrier protection,likely through Fzd3 pathway modulation.Conclusion:The findings indicate Lrg1 knockout induces endothelial differentiation by activating Zmiz1,which is crucial for maintaining blood-brain barrier function,possibly via modulating the Fzd3 pathway.展开更多
Introduction.Ischemic stroke,spinal cord injury(SCI),and acute primary angle-closure glaucoma constitute three major clinically prevalent and highly disabling central nervous system(CNS)disorders.Their core pathogenes...Introduction.Ischemic stroke,spinal cord injury(SCI),and acute primary angle-closure glaucoma constitute three major clinically prevalent and highly disabling central nervous system(CNS)disorders.Their core pathogenesis universally originates from ischemiaeperfusion(I/R)injury affecting the cerebral,spinal cord,and/or retina.展开更多
OBJECTIVE:To find alternatives to natural musk,this study compared the pharmacological effects of cultivated musk,synthetic musk,and natural musk.The aim is to address the dual challenge of clinical demand for muskbas...OBJECTIVE:To find alternatives to natural musk,this study compared the pharmacological effects of cultivated musk,synthetic musk,and natural musk.The aim is to address the dual challenge of clinical demand for muskbased medicines and the endangered status of the musk deer population.METHODS:This study aimed to establish a rat model of acute cerebral ischemiaeperfusion injury(CI/RI)by creating a middle cerebral artery occlusion and reperfusion model.Methods including enzyme-linked immunosorbent assay kits,hematoxylin and eosin staining,Nissl staining,immunohistochemistry,and Western blot were employed to compare the extent of brain tissue damage,inflammatory factor levels,and platelet-related indicators in rats treated with musk from different sources(natural musk,cultivated musk,and synthetic musk),thereby evaluating their differences in neuroprotection.Analysis was performed using one-way analysis of variance.RESULTS:Results indicated that pretreatment with musk demonstrated a positive impact on neurological function by reducing cerebral infarction size,decreasing cerebral edema severity,increasing calcitonin gene related peptide levels,inhibiting 5-hydroxytryptamine release,and preserving the blood-brain barrier integrity.Notably,natural musk exhibited superior antithrombotic properties compared to cultivated and synthetic musk,primarily evidenced by its ability to inhibit platelet aggregation rate,improve cerebral blood perfusion,reduce platelet activating factor receptor protein expression,and lower thromboxane A2 levels.Cultivated musk was observed to elevate catalase and superoxide dismutase levels while concurrently dampening inducible nitric oxide synthase activity,thereby mitigating oxidative damage and also diminishing tumor necrosis factor-αand interleukin-1βcontents along with Glial fibrillary acidic protein expression,enhancing anti-inflammatory capacity.CONCLUSION:Musk sourced from diverse origins exhibits profound neuroprotective qualities against acute CI/RI in rats.Particularly,natural musk demonstrated a specific propensity towards reinforcing antithrombotic effects,whereas cultivated musk excelled in augmenting anti-inflammatory and antioxidative defenses,offering efficacious protection against acute CI/RI.The findings bolster the credibility of strategically employing diverse sources of musk as a preventive strategy against ischemic strokes.展开更多
Ischemic stroke(IS)presents a major threat to human life and health due to its high disability and mortality rates.3-n-Butylphthalide(NBP),derived from celery seeds of the Apiaceae family native to the Mediterranean r...Ischemic stroke(IS)presents a major threat to human life and health due to its high disability and mortality rates.3-n-Butylphthalide(NBP),derived from celery seeds of the Apiaceae family native to the Mediterranean region,was first introduced in China for acute IS treatment in 2004.NBP demonstrates multiple therapeutic actions,including reconstruction of microcirculation in the cerebral ischemia area,inhibition of platelet aggregation,reduction of cerebral infarction volume,maintenance of blood-brain barrier(BBB)integrity,and enhancement of cerebral blood perfusion.However,its overall efficacy remains moderate,limited by poor water solubility and low bioavailability,which constrains its clinical application.To address these limitations,researchers have actively pursued the development of NBP derivatives and analogs,achieving notable progress.These efforts,including substituent introduction,ring opening derivatization,esterification,and atom substitution,have generated diverse NBP derivatives.Several of these derivatives have advanced to clinical studies.Specifically,potassium 2-(1-hydroxypentyl)-benzoate(PHPB),brozopentyl sodium(BZP),and XY-03-EA(ZONK1103)have reached phase II clinical trials,while(S)-2-(1-acetoxypentyl)benzoic acid L-arginine salt(AAPB)has received clinical trial approval for 2024.This review examines the structural modification and optimization of NBP over the past two decades from a medicinal chemistry perspective,aiming to facilitate the development of superior derivatives and advance cerebral ischemia treatment.展开更多
BACKGROUND Colon ischemia(CI)is a common disorder with heterogeneous etiology,whereas CI secondary to inferior mesenteric vein(IMV)pathology is rare and presents distinct diagnostic challenges.Delayed diagnosis and in...BACKGROUND Colon ischemia(CI)is a common disorder with heterogeneous etiology,whereas CI secondary to inferior mesenteric vein(IMV)pathology is rare and presents distinct diagnostic challenges.Delayed diagnosis and inappropriate management may worsen prognosis.AIM To explore the clinical characteristics of IMV-related CI and increase awareness of this rare condition.METHODS This retrospective case series described 11 IMV-related CI inpatients at Peking Union Medical College Hospital and summarized their clinical characteristics,imaging and endoscopic features,and prognosis.An additional cohort of 29 arterial-related CI patients was included,and univariate analyses were conducted to compare features between arterial-and IMV-related CI patients.RESULTS IMV-related CI patients were all male,with a median age of 44.5(41.5-63.3)years.Tenesmus is a common symptom,occurring in 72.7%of patients.Concurrent venous thrombosis was identified in 5 patients(45.5%).On contrast-enhanced computed tomography,all patients demonstrated continuous thickening of the colonic wall.Vessel opacification defects were observed in 10 patients(90.9%),frequently accompanied by compensatory arterial enlargement(81.8%).Compared with arterial-related CI,IMV-related CI was more frequently associated with rectal involvement(90.9%vs 24.1%,P<0.001)and luminal stenosis(81.8%vs 27.6%,P=0.005).CONCLUSION IMV-related CI patients have a chronic course,thrombosis comorbidities,and predominant rectal involvement with marked stenosis.Anticoagulation constitutes a cornerstone of therapy.展开更多
Myocardial ischemia,a core pathological process underlying diverse cardiovascular diseases such as coronary artery disease,poses a severe threat to global human health by frequently leading to acute myocardial infarct...Myocardial ischemia,a core pathological process underlying diverse cardiovascular diseases such as coronary artery disease,poses a severe threat to global human health by frequently leading to acute myocardial infarction,heart failure,and even sudden cardiac death.A comprehensive understanding of its intricate underlying pathogenic mechanisms is not only crucial for developing effective therapeutic strategies but also essential for accelerating the translation of basic research findings into clinical practice.However,the complex regulatory networks that drive myocardial ischemia remain to be systematically clarified.These networks encompass the intricate interactions among multiple pathological processes,including energy metabolism disorder,intracellular calcium overload,mitochondrial structural and functional dysfunction,excessive oxidative stress,persistent inflammatory response,cardiomyocyte apoptosis,and autophagic imbalance.While existing research has laid a preliminary foundation by exploring individual mechanisms,it lacks an integrated overview of how these pathological processes synergistically or sequentially intertwine to induce progressivemyocardial cell injury and irreversible cardiac dysfunction.Therefore,this review aims to systematically summarize the latest research advancements on the key molecular mechanisms and critical signaling pathways involved in myocardial ischemia.It will specifically focus on dissecting the dynamic crosstalk between different pathological processes,with the ultimate objective of providing a solid theoretical basis for the development of multi-targeted precision therapy.This work is expected to offer new insights into the pathological progression of myocardial ischemia and further guide the design and development of innovative clinical intervention strategies.展开更多
Background:The purpose is to define the contribution of the interferon regulatory factor-1–dual-specificity tyrosine phosphorylation-regulated kinase 1α(IRF-1–DYRK1α)axis to hepatocellular ferroptosis during liver...Background:The purpose is to define the contribution of the interferon regulatory factor-1–dual-specificity tyrosine phosphorylation-regulated kinase 1α(IRF-1–DYRK1α)axis to hepatocellular ferroptosis during liver ischemiaeperfusion injury(LIRI).Methods:Ferroptosis was induced in AML12 hepatocytes with erastin.After gain-or loss-of-function manipulation of IRF-1 and DYRK1α,we quantified glutathione peroxidase 4(GPX4)and acyl-Co A synthetase long-chain family member 4(ACSL4),reactive oxygen species(ROS),malondialdehyde(MDA),and glutathione(GSH).In vivo,wild-type(WT)mice,IRF-1 knockout(Irf1-/-)mice,and WT mice treated with the DYRK1αinhibitor harmine underwent a 70%warm LIRI model.Liver and blood were collected for histology,serum transaminases,cytokine ELISA,protein analyses,and flow cytometry.Results:IRF-1 knockdown attenuated LIRI,accompanied by suppression of hepatocellular ferroptosis.DYRK1αinhibition reversed IRF-1–mediated decreases in GSH and GPX4 and prevented increases in MDA,ROS,and ACSL4 in AML12 cells,indicating DYRK1αparticipation in IRF-1–driven ferroptosis.In mice,pharmacologic inhibition of DYRK1αwith harmine reduced hepatic ferroptosis and ameliorated LIRI.Conclusion:IRF-1 aggravates LIRI,at least in part,by promoting hepatocellular ferroptosis via DYRK1α.Targeting the IRF-1–DYRK1αaxis may offer a therapeutic strategy to limit perioperative liver injury.展开更多
Background:American ginseng has been used in the food processing and pharmaceutical industry as a medicinal plant with both nutritional value and economic benefit.Panax quinquefolius saponins(PQS),the main active comp...Background:American ginseng has been used in the food processing and pharmaceutical industry as a medicinal plant with both nutritional value and economic benefit.Panax quinquefolius saponins(PQS),the main active component,have significant antioxidant,neuroprotective,and cardioprotective effects.Clinically,myocardial ischemia(MI)and depression often interact,which has increasing morbidity and mortality rates.However,the mechanism of PQS on MI with depression remains unclear.Methods:The study employed both in vivo and in vitro experiments.Depression-like behaviour changes and cardiac function were observed in mice with MI and depression induced by a high-fat diet(HFD)and intraperitoneal injection of isoproterenol(ISO)plus chronic unpredictable mild stress(CUMS).Both ISO-exposed H9c2 cells and corticosterone(CORT)-induced HT22 cells were selected for in vitro experiments.Biochemical indices and PI3K/Akt/eNOS pathway-related proteins were measured through enzyme-linked immunosorbent assay(ELISA)and Western blotting.Results:PQS significantly improved depression-like behaviour and heart damage in mice and substantially increased H9c2 and HT22 cell activities in vitro.Western blotting analysis showed that PQS could dramatically reverse the changes in the PI3K/AKT/eNOS signalling pathway both in vivo and in vitro.In addition,applying the PI3K inhibitor LY294002 weakened the neuroprotective and cardioprotective effects of PQS.Conclusion:PQS can effectively improve MI with depression,probably through activating PI3K/Akt/eNOS pathway.展开更多
BACKGROUND Spinal cord ischemia-reperfusion injury(IRI),which can occur as a result of temporary aortic occlusion during resection of thoracoabdominal aneurysms,can be an unpredictable and devastating complication of ...BACKGROUND Spinal cord ischemia-reperfusion injury(IRI),which can occur as a result of temporary aortic occlusion during resection of thoracoabdominal aneurysms,can be an unpredictable and devastating complication of aortic surgery.There are no specific medications or guidelines for the prevention and treatment of spinal cord IRI(SCIRI).It is now known that IRI not only exacerbates local tissue damage when blood flow is restored but also affects distant organs,such as the liver,lungs,and brain,through mediators released into the systemic circulation.Studies show that ozone pretreatment reduces oxidative damage by increasing antioxidant capacity,promotes anti-inflammatory signaling,improves blood circulation,and ameliorates IRI.Our study is one of the first to examine the effects of ozone on remote organs(liver,lung,and brain)when administered via different routes(intrathecal,intraperitoneal,rectal)in a spinal cord ischemia-reperfusion model.AIM To determine whether ozone administered by different routes offers multiorgan protection in SCIRI.METHODS Thirty adult Wistar albino rats were randomly divided into five groups(n=6,each):A control(C group),an IR group,an IR rectal ozone(IRRO)group,an IR intrathecal ozone(IRITO),and an IR intraperitoneal ozone(IRIPO).In the IR groups,the spinal cord IR models(a 30-minute ischemia period was applied to the infrarenal abdominal aorta using an atraumatic vascular clamp,and then a 120-minute reperfusion period was applied by removing the clamp)were applied.An ozone-oxygen mixture of 1 mg/kg(50μg/mL)was administered by rectal insufflation to the IRRO group,0.7 mg/kg(50μg/mL)via the peritoneum to the IRIPO group,and 20μL(20μg/mL)intrathecally to the IRITO group 30 minutes before midline laparotomy.At the end of the reperfusion procedure,histopathological and biochemical analyses of liver,lung,and brain tissues were performed.RESULTS Liver tissue malondialdehyde(MDA)levels were significantly lower,and catalase(CAT)enzyme activities were significantly higher in the IRRO,IRITO,and IRIPO groups than in the IR group.Histopathologically,we had favorable results from all three ozone applications compared to the IR group.Lung tissue MDA levels were significantly lower,and CAT enzyme activities were significantly higher in the IRITO and IRIPO groups than in the IR group.We had more positive results in the IRRO group than in the IR group,but the difference was not found to be significant.Histopathologically,we obtained significantly more positive results in the IRITO and IRIPO groups compared with the IR group regarding all the criteria we evaluated.Our results in the IRRO group were also positive.Brain tissue MDA levels were significantly lower and CAT enzyme activities significantly higher in the IRITO and IRIPO groups than in the IR group.We had positive results in the IRRO group compared with the IR group.Histopathologically,we obtained significantly more positive results in the IRITO group regarding all the criteria we evaluated.CONCLUSION We observed histopathologically that single-dose ozone pretreatment administered intrathecally,intraperitoneally,or rectally had positive effects on liver,lung,and brain tissues compared to the IR group in an SCIRI model in rats due to its antioxidant effect.The best histopathological results were obtained with intrathecal,intraperitoneal,and rectally administered ozone,in that order,in all three tissues.展开更多
Acute mesenteric ischemia is a rare but often fatal complication in patients with cirrhosis.A combination of circulatory changes,endothelial dysfunction,and unstable coagulation increases the risk of both occlusive an...Acute mesenteric ischemia is a rare but often fatal complication in patients with cirrhosis.A combination of circulatory changes,endothelial dysfunction,and unstable coagulation increases the risk of both occlusive and non-occlusive forms.Yet,due to nonspecific symptoms and clinical overlap with other complications of cirrhosis,diagnosis is frequently delayed.In this review,we describe the pathophysiologic mechanisms that underlie acute mesenteric ischemia in cirrhosis and outline current diagnostic and management strategies.Computed tomography angiography remains the first-line imaging modality,while laboratory findings are supportive but not diagnostic.Medical treatment includes fluid resuscitation,early anticoagulation,and infection control,with vasodilator therapy considered in select cases.Surgical intervention may be required in the setting of bowel infarction or confirmed vascular occlusion,but the risks in patients with cirrhosis are significant and require careful assessment.We also review four published case reports,which illustrate a range of clinical presentations,diagnostic challenges,and outcomes.Together,these cases highlight the need for early imaging,attention to thrombotic risk,and thoughtful use of both medical and surgical therapies.Ongoing research is needed to guide management in this high-risk population.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)substantially increases the risk of cardiovascular disease,including ischemia with non-obstructive coronary artery disease(INOCA).Coronary computed tomography angiography(CCTA)...BACKGROUND Type 2 diabetes mellitus(T2DM)substantially increases the risk of cardiovascular disease,including ischemia with non-obstructive coronary artery disease(INOCA).Coronary computed tomography angiography(CCTA)enables early detection of coronary abnormalities;however,it may fail to identify INOCA due to the absence of overt stenosis.Pericoronary adipose tissue attenuation(PCATa)values derived from CCTA in the proximal segments of the left anterior descending(LAD),left circumflex(LCX),and right coronary artery(RCA)serve as effective imaging biomarkers for coronary inflammation.However,its clinical use for identifying INOCA in patients with T2DM remains poorly defined.AIM To investigate PCATa differences and their diagnostic value for identifying INOCA in patients with T2DM.METHODS This retrospective study involved 228 T2DM patients underwent CCTA and 120 healthy individuals.The mean PCATa values within the proximal segments of the three major coronary arteries were compared between groups.Further subgroup analysis was performed to assess the differences in PCTAa and clinical characteristics between T2DM patients with and without INOCA.Logistic regression analysis was conducted to identify the independent risk factors for INOCA,and the receiver operating characteristic curves were generated to evaluate the diagnostic performance of each indicator.RESULTS Compared with controls,T2DM patients exhibited significantly higher PCATa values in all three major coronary arteries.Among them,those with concomitant INOCA showed further increases compared to those without INOCA(all P<0.05).Multivariate logistic regression identified age;female sex;elevated glycated hemoglobin;and increased PCATa in the LAD,LCX,and RCA as independent risk factors for INOCA.Receiver operating characteristic analysis showed good diagnostic performance for PCATa[LAD area under the curve(AUC)=0.809;LCX AUC=0.777;RCA AUC=0.758],outperforming traditional clinical indicators(AUC=0.731).Combining PCATa with clinical parameters yielded the highest diagnostic accuracy(LAD AUC=0.851;LCX AUC=0.842;RCA AUC=0.841).CONCLUSION Elevated proximal PCATa is an independent risk factor for INOCA in T2DM.Combining PCATa with clinical data improves diagnostic performance in this population.展开更多
Cerebral ischemia is a common acute cerebrovascular disease characterized by transient insufficient cerebral blood supply,manifesting as transient ischemic attacks.It has a high incidence,mortality,and disability rate...Cerebral ischemia is a common acute cerebrovascular disease characterized by transient insufficient cerebral blood supply,manifesting as transient ischemic attacks.It has a high incidence,mortality,and disability rate,and seriously affects human health and quality of life.The pathogenesis is complex and diverse,mainly involving inflammatory response,oxidative stress,and excitatory amino acid toxicity.As traditional blood-tonifying and strengthening herbs,Astragali Radix(Huangqi)and Angelicae Sinensis Radix(Danggui)not only exert favorable effects in treating cerebral ischemia,such as alleviating neurological damage,resisting inflammation,preventing thrombosis,and inhibiting cell death,but also achieve remarkable therapeutic efficacy.Furthermore,the two herbs can be used in combination to form the classic prescription Danggui Buxue Tang.This paper reviews how Astragali Radix,Angelicae Sinensis Radix,and their active ingredients synergistically exert anti-hypoxic effects in the brain.展开更多
BACKGROUND Peripheral endovascular intervention(PEVI)is performed using radiation.Radiation has deleterious health consequences for patients and operators.AIM To investigate the gender radiation disparities and proced...BACKGROUND Peripheral endovascular intervention(PEVI)is performed using radiation.Radiation has deleterious health consequences for patients and operators.AIM To investigate the gender radiation disparities and procedural outcomes in PEVI.METHODS A prospective observational study was performed in 186 consecutive patients(65±12 years)at an academic medical center from January 2019 to April 2020(mean follow-up of 3.9±3.6 months)comparing the gender radiation disparity and outcomes of PEVI(n=147 underwent intervention,79.0%).Groups were divided into women(n=99,53.2%)and men(n=87,48.4%).Primary endpoints included air kerma,dose area product(DAP),fluoroscopy time,and contrast use.Secondary endpoints included all-cause mortality,acute myocardial infarction,acute kidney injury,stroke,repeat revascularization,major adverse limb event,and the composite of complications.RESULTS Men showed increased DAP compared with women(15221.2±25858.5µGy×m2 vs 9251.7±9555.3µGy×m2,P=0.047),but no significant difference in air kerma or any other primary endpoints.In the secondary endpoints,no significant diffe-rence was found between gender.CONCLUSION Men had increased DAP indicating more radiation absorption in the exposed area.Gender outcomes showed no difference in complications.Thus,PEVI can be safely performed in men or women.展开更多
Cerebral ischemiaeperfusion(I/R)injury is an important pathophysiological condition of ischemic stroke that involves a variety of physiological and pathological cell death pathways,including autophagy,apoptosis,necrop...Cerebral ischemiaeperfusion(I/R)injury is an important pathophysiological condition of ischemic stroke that involves a variety of physiological and pathological cell death pathways,including autophagy,apoptosis,necroptosis,and phagoptosis,among which autophagy is the most studied.We have reviewed studies published in the past 5 years regarding the association between autophagy and cerebral I/R injury.To the best of our knowledge,this is the first review article summarizing potential candidates targeting autophagic pathways in the treatment of I/R injury post ischemic stroke.The findings of this review may help to better understand the pathogenesis and mechanisms of I/R events and bridge the gap between basic and translational research that may lead to the development of novel therapeutic approaches for I/R injury.展开更多
Objective:To evaluate the cardioprotective effects of sinomenine using the ischemiaeperfusion(I/R)rat model.Methods:Wistar rats were randomly divided into 6 groups:group Ⅰ with reperfusion,group Ⅱ perfused with sino...Objective:To evaluate the cardioprotective effects of sinomenine using the ischemiaeperfusion(I/R)rat model.Methods:Wistar rats were randomly divided into 6 groups:group Ⅰ with reperfusion,group Ⅱ perfused with sinomenine,group Ⅲ perfused with 5-hydroxydecanoate(5-HD),group Ⅳ perfused with 5-HD+sinomenine,group Ⅴ perfused with L-nitro arginine methyl ester(L-NAME),group Ⅵ perfused with L-NAME+sinomenine.Myocardial ischemia was induced by interrupting the aortic blood supply for 30 min,followed by reperfusion(55 min).Cardiac,hepatic,antioxidant,and inflammatory parameters were assessed.Additionally,endothelin,tissue factor,platelet-activating factor,plasminogen activator inhibitor,plasma fibrinogen,and thromboxane B2 were also analyzed.Results:Administration of 5-HD or L-NAME,used as the selective antagonist of mitoKATP and NO system,respectively,resulted in significantly increased levels of premature ventricular complexes,lactate dehydrogenase,ventricular fibrillation,ventricular tachycardia,and arrhythmia intensity(P<0.05).In contrast,sinomenine significantly reduced the level of troponin Ⅰ,lactate dehydrogenase,creatine kinase,and creatine kinase MB compared to the 5-HD group and the L-NAME group(P<0.05).Additionally,sinomenine significantly reduced malondialdehyde level and enhanced the levels of superoxide dismutase,glutathione peroxidase,catalase,and glutathione/glutathione disulfide ratio(P<0.05).It also significantly suppressed the levels of endothelin-1,platelet-activating factor,tissue factor,plasminogen activator inhibitor 1,thromboxane B2,and plasma fibrinogen(P<0.05).Conclusions:These results suggest that sinomenine exhibits significant cardioprotection effects against I/R-induced cardiac injury in rats.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82172196(to KX),82372507(to KX)the Natural Science Foundation of Hunan Province,China,No.2023JJ40804(to QZ)the Key Laboratory of Emergency and Trauma(Hainan Medical University)of the Ministry of Education,China,No.KLET-202210(to QZ)。
摘要Ischemia–reperfusion injury is a common pathophysiological mechanism in retinal degeneration.PANoptosis is a newly defined integral form of regulated cell death that combines the key features of pyroptosis,apoptosis,and necroptosis.Oligomerization of mitochondrial voltage-dependent anion channel 1 is an important pathological event in regulating cell death in retinal ischemia–reperfusion injury.However,its role in PANoptosis remains largely unknown.In this study,we demonstrated that voltage-dependent anion channel 1 oligomerization-mediated mitochondrial dysfunction was associated with PANoptosis in retinal ischemia–reperfusion injury.Inhibition of voltage-dependent anion channel 1 oligomerization suppressed mitochondrial dysfunction and PANoptosis in retinal cells subjected to ischemia–reperfusion injury.Mechanistically,mitochondria-derived reactive oxygen species played a central role in the voltagedependent anion channel 1-mediated regulation of PANoptosis by promoting PANoptosome assembly.Moreover,inhibiting voltage-dependent anion channel 1 oligomerization protected against PANoptosis in the retinas of rats subjected to ischemia–reperfusion injury.Overall,our findings reveal the critical role of voltage-dependent anion channel 1 oligomerization in regulating PANoptosis in retinal ischemia–reperfusion injury,highlighting voltage-dependent anion channel 1 as a promising therapeutic target.
基金supported by the National Natural Science Foundation of China(82250410380 and 62171101)the Natural Science Foundation of Sichuan Province(24NSFSC6257)the China MOST2030 Brain Project(2022ZD0208500).
摘要Cerebral ischemia restricts cerebral blood flow(CBF),leading to unstable hemodynamics.Past studies of ischemia mainly focused on cortical CBF reduction.However,its impact on hemodynamic changes,especially temporal varying characteristics,remains poorly understood.Here,we collected cortical resting-state CBF in rats with left carotid artery blockage during occlusion–reperfusion,and measured the temporal variability and changes in laterality using a novel state-space method.This method was also applied to stroke EEG datasets to validate its effectiveness.After arterial occlusion,the left marginal motor,sensory,auditory,and visual cortices exhibited severe temporal variability impairments.The laterality analysis indicated that affected left regions showed inferior unilateral mean,inter-hemispheric transition probability,time fraction,and laterality duration,while the right side had a higher laterality time fraction and duration.These impairments recovered partially following blood flow restoration.Besides,the ischemic state-space metrics were positively correlated with the pre-occlusion baseline appearance.Stroke patients exhibited impaired temporal variability in the affected ischemic hemisphere.The state-space analysis revealed damaged CBF temporal variability during cerebral ischemia and predicted baseline-ischemia connections.
基金financially supported by the Key Research&Development Program of Guangxi(No.Gui Ke AB24010153)the Guangxi Natural Science Foundation(No.2025GXNSFAA069056)+2 种基金the National Natural Science Foundation of China(No.82060082)the Youth Science Foundation of Guangxi Medical University(No.GXMUYSF202334)the Major Talent Project of Guangxi Autonomous Region。
摘要Myocardial infarction(MI)is a disease with a very high mortality rate among cardiovascular diseases.It causes extensive damage to myocardial cells due to prolonged and repeated ischemia and hypoxia.Early coronary revascularization is the best method for treating MI.However,the reperfusion process in MI can produce reactive oxygen species,further damaging myocardial tissue,and triggering MI-reperfusion injury(MI/RI).Although various traditional treatment strategies exist,the treatment of myocardial ischemia including MI and MI/RI remain a significant challenge.Mitochondrial dysfunction plays an important role in the emergence and development of myocardial ischemia.In recent years,with the advancement of nanobiomedicine,therapeutic strategies for targeting mitochondria have gained increasing attentions in diseases'therapy.Thus,nanobiomedicine targeting mitochondria has shown great promise in the treatment of myocardial ischemia.This review first comprehensively elaborates on the mechanisms of mitochondrial homeostasis in MI and MI/RI,and then focuses on the application progress of nanomaterials targeting mitochondrial homeostasis(oxidative stress,mitophagy,mitochondrial fusion and fission,etc.)in improving myocardial ischemia.Ultimately,this article looks forward to the prospects of nanomaterials in the targeting treatment of MI and MI/RI,aiming to provide more effective and innovative ideas for clinical treatments.
基金Supported by the Joint Development of Disciplines by Jiaxing City and Provincial Governmentthe National Key Clinical Specialty Construction Project,No.2023-GJZK-001.
摘要BACKGROUND Acute mesenteric ischemia(AMI)is associated with high mortality owing to delayed diagnosis and the absence of biomarkers capable of distinguishing disease subtypes or inflammatory burden.Mesenchymal stem cells(MSCs)exosomal circular RNAs(circRNAs)show diagnostic potential in other diseases.AIM To evaluate the utility of MSCs exosomal circRNAs in AMI,particularly for early detection and subtyping.METHODS Peripheral blood-derived MSCs(PBMSCs)from 80 patients with AMI(stratified by etiology:48 arterial AMI,32 venous AMI,36 early reversible,44 late necrotic)and 125 controls were obtained at initial hospital admission.Exosomal circRNAs were isolated via ultracentrifugation,validated by transmission electron microscopy and nanoparticle tracking analysis,and quantified by quantitative real-time polymerase chain reaction.Plasma intestinal fatty acid binding protein(IFABP),d-lactate,interleukin-6(IL-6),tumor necrosis factor-α,IFABP,D-lactate,IL-6,and neutrophil-to-lymphocyte ratio were measured.Pearson’s test was used to assess the diagnostic performance of receiver operating characteristic analysis.RESULTS Patients with AMI exhibited significantly elevated PBMSCs exosomal circ-Eya3(P<0.001)and reduced circEZH2_005 levels(P<0.001).Circ-Eya3 correlated positively with IFABP(r=0.606),D-lactate(r=0.384),IL-6(r=0.551),and neutrophil-to-lymphocyte ratio(r=0.601)(all P<0.001),whereas circEZH2_005 showed inverse correlations(r=-0.580 to-0.403;P<0.001).Critically,circEZH2_005 expression was lower in arterial AMI than in venous AMI(P=0.003).The combination of circ-Eya3,circEZH2_005,and D-lactate achieved excellent diagnostic accuracy(area under the curve=0.891).Post-reperfusion,circ-Eya3 increased(P<0.05),while circEZH2_005 decreased(P<0.05).CONCLUSION PBMSCs exosomal circ-Eya3 and circEZH2_005 serve as novel biomarkers for AMI,reflecting intestinal injury severity,systemic inflammation,and disease subtype.Their integration with D-lactate enables high-accuracy diagnosis,whereas differential expression across arterial/venous AMI and ischemia stages offers clinical utility for guiding intervention strategies.
基金supported by the Foundation Project:National Natural Science.Foundation of China(Nos.:82460249,82100417,81760094)The Foundation of Jiangxi Provincial Department of Science and Technology Outstanding Youth Fund Project(20212BAB206022,20242BAB23080).
摘要Objective:Leucine-rich alpha-2 glycoprotein 1(Lrg1)could regulate diverse cells in cerebral ischemiareperfusion.Our study seeks to uncover Lrg1’s impact on endothelial cell heterogeneity via differentiation pathways and transcription factors.Method:The CSOmap model measured cell-to-brain-center distances using single-cell RNA sequencing(scRNA-seq)data in middle cerebral artery occlusion reperfusion(MCAO/R).Monocle2 mapped endothelial differentiation paths.Gene set enrichment analysis(GSEA)analyzed endothelial subcluster variations.Database searches revealed a zinc finger MIZ-type containing 1 protein-frizzled 3(Zmiz1-Fzd3)promoter interaction.Endothelial cells were transfected with a Fzd3 promoter-luciferase plasmid.Polymerase chain reaction(PCR)and western blotting assessed MCAO/R or Zmiz1 overexpression effects on Fzd3-related mRNA and proteins.A retroviral vector carrying Zmiz1 was injected into the brains of mice to study its effect on Fzd3.Result:Lrg1−/−mice exhibited elevated cell adhesion proteins and decreased microvascular leakage after MCAO/R.CSOmap showed widened astrocyte spacing in thesemice.RSS revealed Zmiz1 overexpression inMCAO/R+Lrg1−/−mice.MCAO/R and pcDNA3-Zmiz1 transfection both enhanced luciferase activity with Fzd3,indicating Zmiz1 binding to Fzd3.Retroviral Zmiz1 injection or knockdown disrupted ischemic brain tight junctions,highlighting Zmiz1’s key role in blood-brain barrier protection,likely through Fzd3 pathway modulation.Conclusion:The findings indicate Lrg1 knockout induces endothelial differentiation by activating Zmiz1,which is crucial for maintaining blood-brain barrier function,possibly via modulating the Fzd3 pathway.
基金supported by the National Natural Science Foundation of China(Grant nos.62576136 to Yan Huang82372507,82572869 to Kun Xiongthe National Natural Science Foundation of Hunan Province(Grant no.2026JJ30177).
摘要Introduction.Ischemic stroke,spinal cord injury(SCI),and acute primary angle-closure glaucoma constitute three major clinically prevalent and highly disabling central nervous system(CNS)disorders.Their core pathogenesis universally originates from ischemiaeperfusion(I/R)injury affecting the cerebral,spinal cord,and/or retina.
基金Supported by Key Project of National Natural Science Foundation of Sichuan:Research on the Mechanism of Detoxification and Synergistic Effects of Sichuan-Produced Toxic Authentic Medicinal Herbs Croton Seed and Aconite Root(No.2024NSFSC0054)National Interdisciplinary Innovation Team of Traditional Chinese Medicine:Multidisciplinary Innovation Team for Multidimensional Evaluation of Southwest Chinese Characteristic Traditional Chinese Medicine Resources(No.ZYYCXTD-D-202209)Sichuan Chinese Medicine Science and Technology Industry Innovation Team:Innovative Team for Multidimensional Evaluation and Product Development of Characteristic Traditional Chinese Medicine Resources(No.2022C001)。
摘要OBJECTIVE:To find alternatives to natural musk,this study compared the pharmacological effects of cultivated musk,synthetic musk,and natural musk.The aim is to address the dual challenge of clinical demand for muskbased medicines and the endangered status of the musk deer population.METHODS:This study aimed to establish a rat model of acute cerebral ischemiaeperfusion injury(CI/RI)by creating a middle cerebral artery occlusion and reperfusion model.Methods including enzyme-linked immunosorbent assay kits,hematoxylin and eosin staining,Nissl staining,immunohistochemistry,and Western blot were employed to compare the extent of brain tissue damage,inflammatory factor levels,and platelet-related indicators in rats treated with musk from different sources(natural musk,cultivated musk,and synthetic musk),thereby evaluating their differences in neuroprotection.Analysis was performed using one-way analysis of variance.RESULTS:Results indicated that pretreatment with musk demonstrated a positive impact on neurological function by reducing cerebral infarction size,decreasing cerebral edema severity,increasing calcitonin gene related peptide levels,inhibiting 5-hydroxytryptamine release,and preserving the blood-brain barrier integrity.Notably,natural musk exhibited superior antithrombotic properties compared to cultivated and synthetic musk,primarily evidenced by its ability to inhibit platelet aggregation rate,improve cerebral blood perfusion,reduce platelet activating factor receptor protein expression,and lower thromboxane A2 levels.Cultivated musk was observed to elevate catalase and superoxide dismutase levels while concurrently dampening inducible nitric oxide synthase activity,thereby mitigating oxidative damage and also diminishing tumor necrosis factor-αand interleukin-1βcontents along with Glial fibrillary acidic protein expression,enhancing anti-inflammatory capacity.CONCLUSION:Musk sourced from diverse origins exhibits profound neuroprotective qualities against acute CI/RI in rats.Particularly,natural musk demonstrated a specific propensity towards reinforcing antithrombotic effects,whereas cultivated musk excelled in augmenting anti-inflammatory and antioxidative defenses,offering efficacious protection against acute CI/RI.The findings bolster the credibility of strategically employing diverse sources of musk as a preventive strategy against ischemic strokes.
基金supported by the National Natural Science Foundation of China(Nos.21977058 and 82473840)the Key R&D Program of Jiangsu Province(No.BE2021677)+2 种基金China Postdoctoral Science Foundation(No.2018T110533)the Key Natural Science Foundation of Jiangsu Higher Education Institutions(No.20KJA350002)Jiangsu Province Innovation Project of Postgraduate Training(No.KYCX22_3380).
摘要Ischemic stroke(IS)presents a major threat to human life and health due to its high disability and mortality rates.3-n-Butylphthalide(NBP),derived from celery seeds of the Apiaceae family native to the Mediterranean region,was first introduced in China for acute IS treatment in 2004.NBP demonstrates multiple therapeutic actions,including reconstruction of microcirculation in the cerebral ischemia area,inhibition of platelet aggregation,reduction of cerebral infarction volume,maintenance of blood-brain barrier(BBB)integrity,and enhancement of cerebral blood perfusion.However,its overall efficacy remains moderate,limited by poor water solubility and low bioavailability,which constrains its clinical application.To address these limitations,researchers have actively pursued the development of NBP derivatives and analogs,achieving notable progress.These efforts,including substituent introduction,ring opening derivatization,esterification,and atom substitution,have generated diverse NBP derivatives.Several of these derivatives have advanced to clinical studies.Specifically,potassium 2-(1-hydroxypentyl)-benzoate(PHPB),brozopentyl sodium(BZP),and XY-03-EA(ZONK1103)have reached phase II clinical trials,while(S)-2-(1-acetoxypentyl)benzoic acid L-arginine salt(AAPB)has received clinical trial approval for 2024.This review examines the structural modification and optimization of NBP over the past two decades from a medicinal chemistry perspective,aiming to facilitate the development of superior derivatives and advance cerebral ischemia treatment.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-D-002Beijing Research Ward Excellence Program,No.BRWEP2024W034010110。
摘要BACKGROUND Colon ischemia(CI)is a common disorder with heterogeneous etiology,whereas CI secondary to inferior mesenteric vein(IMV)pathology is rare and presents distinct diagnostic challenges.Delayed diagnosis and inappropriate management may worsen prognosis.AIM To explore the clinical characteristics of IMV-related CI and increase awareness of this rare condition.METHODS This retrospective case series described 11 IMV-related CI inpatients at Peking Union Medical College Hospital and summarized their clinical characteristics,imaging and endoscopic features,and prognosis.An additional cohort of 29 arterial-related CI patients was included,and univariate analyses were conducted to compare features between arterial-and IMV-related CI patients.RESULTS IMV-related CI patients were all male,with a median age of 44.5(41.5-63.3)years.Tenesmus is a common symptom,occurring in 72.7%of patients.Concurrent venous thrombosis was identified in 5 patients(45.5%).On contrast-enhanced computed tomography,all patients demonstrated continuous thickening of the colonic wall.Vessel opacification defects were observed in 10 patients(90.9%),frequently accompanied by compensatory arterial enlargement(81.8%).Compared with arterial-related CI,IMV-related CI was more frequently associated with rectal involvement(90.9%vs 24.1%,P<0.001)and luminal stenosis(81.8%vs 27.6%,P=0.005).CONCLUSION IMV-related CI patients have a chronic course,thrombosis comorbidities,and predominant rectal involvement with marked stenosis.Anticoagulation constitutes a cornerstone of therapy.
基金supported partly by the Youth Program of Inner Mongolia Medical University(YKD2024QN019)the Clinical PharmacyAdvantage Specialty Approved by the State Administration of Traditional Chinese Medicine in 2024.
摘要Myocardial ischemia,a core pathological process underlying diverse cardiovascular diseases such as coronary artery disease,poses a severe threat to global human health by frequently leading to acute myocardial infarction,heart failure,and even sudden cardiac death.A comprehensive understanding of its intricate underlying pathogenic mechanisms is not only crucial for developing effective therapeutic strategies but also essential for accelerating the translation of basic research findings into clinical practice.However,the complex regulatory networks that drive myocardial ischemia remain to be systematically clarified.These networks encompass the intricate interactions among multiple pathological processes,including energy metabolism disorder,intracellular calcium overload,mitochondrial structural and functional dysfunction,excessive oxidative stress,persistent inflammatory response,cardiomyocyte apoptosis,and autophagic imbalance.While existing research has laid a preliminary foundation by exploring individual mechanisms,it lacks an integrated overview of how these pathological processes synergistically or sequentially intertwine to induce progressivemyocardial cell injury and irreversible cardiac dysfunction.Therefore,this review aims to systematically summarize the latest research advancements on the key molecular mechanisms and critical signaling pathways involved in myocardial ischemia.It will specifically focus on dissecting the dynamic crosstalk between different pathological processes,with the ultimate objective of providing a solid theoretical basis for the development of multi-targeted precision therapy.This work is expected to offer new insights into the pathological progression of myocardial ischemia and further guide the design and development of innovative clinical intervention strategies.
基金National Natural Science Foundation of China,Grant/Award Number:81970562,82270685 and 82100670Beijing Natural Science Foundation,Grant/Award Number:7242044+4 种基金Beijing Health Commission,Grant/Award Number:2020-1-2024 and 2024-1-2022Beijing Nova Program,Grant/Award Number:Z211100002121036Tianjin Science and Technology Bureau,Grant/Award Number:22JCZXJC00200Hebei Provincial Science and Technology Bureau,Grant/Award Number:XA202401102001K and 244X7704DOutstanding Scientific and Technological Innovation Team of Beijing Tongzhou District,Grant/Award Number:CXTD2024007。
摘要Background:The purpose is to define the contribution of the interferon regulatory factor-1–dual-specificity tyrosine phosphorylation-regulated kinase 1α(IRF-1–DYRK1α)axis to hepatocellular ferroptosis during liver ischemiaeperfusion injury(LIRI).Methods:Ferroptosis was induced in AML12 hepatocytes with erastin.After gain-or loss-of-function manipulation of IRF-1 and DYRK1α,we quantified glutathione peroxidase 4(GPX4)and acyl-Co A synthetase long-chain family member 4(ACSL4),reactive oxygen species(ROS),malondialdehyde(MDA),and glutathione(GSH).In vivo,wild-type(WT)mice,IRF-1 knockout(Irf1-/-)mice,and WT mice treated with the DYRK1αinhibitor harmine underwent a 70%warm LIRI model.Liver and blood were collected for histology,serum transaminases,cytokine ELISA,protein analyses,and flow cytometry.Results:IRF-1 knockdown attenuated LIRI,accompanied by suppression of hepatocellular ferroptosis.DYRK1αinhibition reversed IRF-1–mediated decreases in GSH and GPX4 and prevented increases in MDA,ROS,and ACSL4 in AML12 cells,indicating DYRK1αparticipation in IRF-1–driven ferroptosis.In mice,pharmacologic inhibition of DYRK1αwith harmine reduced hepatic ferroptosis and ameliorated LIRI.Conclusion:IRF-1 aggravates LIRI,at least in part,by promoting hepatocellular ferroptosis via DYRK1α.Targeting the IRF-1–DYRK1αaxis may offer a therapeutic strategy to limit perioperative liver injury.
基金supported by the study on the material basis and mechanism of action of American ginseng in the treatment of myocardial ischaemia comorbid depression(2024JH2/102500059).
摘要Background:American ginseng has been used in the food processing and pharmaceutical industry as a medicinal plant with both nutritional value and economic benefit.Panax quinquefolius saponins(PQS),the main active component,have significant antioxidant,neuroprotective,and cardioprotective effects.Clinically,myocardial ischemia(MI)and depression often interact,which has increasing morbidity and mortality rates.However,the mechanism of PQS on MI with depression remains unclear.Methods:The study employed both in vivo and in vitro experiments.Depression-like behaviour changes and cardiac function were observed in mice with MI and depression induced by a high-fat diet(HFD)and intraperitoneal injection of isoproterenol(ISO)plus chronic unpredictable mild stress(CUMS).Both ISO-exposed H9c2 cells and corticosterone(CORT)-induced HT22 cells were selected for in vitro experiments.Biochemical indices and PI3K/Akt/eNOS pathway-related proteins were measured through enzyme-linked immunosorbent assay(ELISA)and Western blotting.Results:PQS significantly improved depression-like behaviour and heart damage in mice and substantially increased H9c2 and HT22 cell activities in vitro.Western blotting analysis showed that PQS could dramatically reverse the changes in the PI3K/AKT/eNOS signalling pathway both in vivo and in vitro.In addition,applying the PI3K inhibitor LY294002 weakened the neuroprotective and cardioprotective effects of PQS.Conclusion:PQS can effectively improve MI with depression,probably through activating PI3K/Akt/eNOS pathway.
摘要BACKGROUND Spinal cord ischemia-reperfusion injury(IRI),which can occur as a result of temporary aortic occlusion during resection of thoracoabdominal aneurysms,can be an unpredictable and devastating complication of aortic surgery.There are no specific medications or guidelines for the prevention and treatment of spinal cord IRI(SCIRI).It is now known that IRI not only exacerbates local tissue damage when blood flow is restored but also affects distant organs,such as the liver,lungs,and brain,through mediators released into the systemic circulation.Studies show that ozone pretreatment reduces oxidative damage by increasing antioxidant capacity,promotes anti-inflammatory signaling,improves blood circulation,and ameliorates IRI.Our study is one of the first to examine the effects of ozone on remote organs(liver,lung,and brain)when administered via different routes(intrathecal,intraperitoneal,rectal)in a spinal cord ischemia-reperfusion model.AIM To determine whether ozone administered by different routes offers multiorgan protection in SCIRI.METHODS Thirty adult Wistar albino rats were randomly divided into five groups(n=6,each):A control(C group),an IR group,an IR rectal ozone(IRRO)group,an IR intrathecal ozone(IRITO),and an IR intraperitoneal ozone(IRIPO).In the IR groups,the spinal cord IR models(a 30-minute ischemia period was applied to the infrarenal abdominal aorta using an atraumatic vascular clamp,and then a 120-minute reperfusion period was applied by removing the clamp)were applied.An ozone-oxygen mixture of 1 mg/kg(50μg/mL)was administered by rectal insufflation to the IRRO group,0.7 mg/kg(50μg/mL)via the peritoneum to the IRIPO group,and 20μL(20μg/mL)intrathecally to the IRITO group 30 minutes before midline laparotomy.At the end of the reperfusion procedure,histopathological and biochemical analyses of liver,lung,and brain tissues were performed.RESULTS Liver tissue malondialdehyde(MDA)levels were significantly lower,and catalase(CAT)enzyme activities were significantly higher in the IRRO,IRITO,and IRIPO groups than in the IR group.Histopathologically,we had favorable results from all three ozone applications compared to the IR group.Lung tissue MDA levels were significantly lower,and CAT enzyme activities were significantly higher in the IRITO and IRIPO groups than in the IR group.We had more positive results in the IRRO group than in the IR group,but the difference was not found to be significant.Histopathologically,we obtained significantly more positive results in the IRITO and IRIPO groups compared with the IR group regarding all the criteria we evaluated.Our results in the IRRO group were also positive.Brain tissue MDA levels were significantly lower and CAT enzyme activities significantly higher in the IRITO and IRIPO groups than in the IR group.We had positive results in the IRRO group compared with the IR group.Histopathologically,we obtained significantly more positive results in the IRITO group regarding all the criteria we evaluated.CONCLUSION We observed histopathologically that single-dose ozone pretreatment administered intrathecally,intraperitoneally,or rectally had positive effects on liver,lung,and brain tissues compared to the IR group in an SCIRI model in rats due to its antioxidant effect.The best histopathological results were obtained with intrathecal,intraperitoneal,and rectally administered ozone,in that order,in all three tissues.
摘要Acute mesenteric ischemia is a rare but often fatal complication in patients with cirrhosis.A combination of circulatory changes,endothelial dysfunction,and unstable coagulation increases the risk of both occlusive and non-occlusive forms.Yet,due to nonspecific symptoms and clinical overlap with other complications of cirrhosis,diagnosis is frequently delayed.In this review,we describe the pathophysiologic mechanisms that underlie acute mesenteric ischemia in cirrhosis and outline current diagnostic and management strategies.Computed tomography angiography remains the first-line imaging modality,while laboratory findings are supportive but not diagnostic.Medical treatment includes fluid resuscitation,early anticoagulation,and infection control,with vasodilator therapy considered in select cases.Surgical intervention may be required in the setting of bowel infarction or confirmed vascular occlusion,but the risks in patients with cirrhosis are significant and require careful assessment.We also review four published case reports,which illustrate a range of clinical presentations,diagnostic challenges,and outcomes.Together,these cases highlight the need for early imaging,attention to thrombotic risk,and thoughtful use of both medical and surgical therapies.Ongoing research is needed to guide management in this high-risk population.
基金Supported by Health Commission of Sichuan Province Medical Science and Technology Program,China,No.24WXXT10Primary Health Development Research Center of Sichuan Province Program,No.SWFZ23-Y-36.
摘要BACKGROUND Type 2 diabetes mellitus(T2DM)substantially increases the risk of cardiovascular disease,including ischemia with non-obstructive coronary artery disease(INOCA).Coronary computed tomography angiography(CCTA)enables early detection of coronary abnormalities;however,it may fail to identify INOCA due to the absence of overt stenosis.Pericoronary adipose tissue attenuation(PCATa)values derived from CCTA in the proximal segments of the left anterior descending(LAD),left circumflex(LCX),and right coronary artery(RCA)serve as effective imaging biomarkers for coronary inflammation.However,its clinical use for identifying INOCA in patients with T2DM remains poorly defined.AIM To investigate PCATa differences and their diagnostic value for identifying INOCA in patients with T2DM.METHODS This retrospective study involved 228 T2DM patients underwent CCTA and 120 healthy individuals.The mean PCATa values within the proximal segments of the three major coronary arteries were compared between groups.Further subgroup analysis was performed to assess the differences in PCTAa and clinical characteristics between T2DM patients with and without INOCA.Logistic regression analysis was conducted to identify the independent risk factors for INOCA,and the receiver operating characteristic curves were generated to evaluate the diagnostic performance of each indicator.RESULTS Compared with controls,T2DM patients exhibited significantly higher PCATa values in all three major coronary arteries.Among them,those with concomitant INOCA showed further increases compared to those without INOCA(all P<0.05).Multivariate logistic regression identified age;female sex;elevated glycated hemoglobin;and increased PCATa in the LAD,LCX,and RCA as independent risk factors for INOCA.Receiver operating characteristic analysis showed good diagnostic performance for PCATa[LAD area under the curve(AUC)=0.809;LCX AUC=0.777;RCA AUC=0.758],outperforming traditional clinical indicators(AUC=0.731).Combining PCATa with clinical parameters yielded the highest diagnostic accuracy(LAD AUC=0.851;LCX AUC=0.842;RCA AUC=0.841).CONCLUSION Elevated proximal PCATa is an independent risk factor for INOCA in T2DM.Combining PCATa with clinical data improves diagnostic performance in this population.
基金Scientific Research Project of the Affiliated Hospital of Inner Mongolia Medical University(Project No.:2023NYFYLHZD010)Natural Science Foundation of Inner Mongolia(Project No.:2024MS08033)National Natural Science Foundation of China(Project No.:82060908)。
摘要Cerebral ischemia is a common acute cerebrovascular disease characterized by transient insufficient cerebral blood supply,manifesting as transient ischemic attacks.It has a high incidence,mortality,and disability rate,and seriously affects human health and quality of life.The pathogenesis is complex and diverse,mainly involving inflammatory response,oxidative stress,and excitatory amino acid toxicity.As traditional blood-tonifying and strengthening herbs,Astragali Radix(Huangqi)and Angelicae Sinensis Radix(Danggui)not only exert favorable effects in treating cerebral ischemia,such as alleviating neurological damage,resisting inflammation,preventing thrombosis,and inhibiting cell death,but also achieve remarkable therapeutic efficacy.Furthermore,the two herbs can be used in combination to form the classic prescription Danggui Buxue Tang.This paper reviews how Astragali Radix,Angelicae Sinensis Radix,and their active ingredients synergistically exert anti-hypoxic effects in the brain.
摘要BACKGROUND Peripheral endovascular intervention(PEVI)is performed using radiation.Radiation has deleterious health consequences for patients and operators.AIM To investigate the gender radiation disparities and procedural outcomes in PEVI.METHODS A prospective observational study was performed in 186 consecutive patients(65±12 years)at an academic medical center from January 2019 to April 2020(mean follow-up of 3.9±3.6 months)comparing the gender radiation disparity and outcomes of PEVI(n=147 underwent intervention,79.0%).Groups were divided into women(n=99,53.2%)and men(n=87,48.4%).Primary endpoints included air kerma,dose area product(DAP),fluoroscopy time,and contrast use.Secondary endpoints included all-cause mortality,acute myocardial infarction,acute kidney injury,stroke,repeat revascularization,major adverse limb event,and the composite of complications.RESULTS Men showed increased DAP compared with women(15221.2±25858.5µGy×m2 vs 9251.7±9555.3µGy×m2,P=0.047),but no significant difference in air kerma or any other primary endpoints.In the secondary endpoints,no significant diffe-rence was found between gender.CONCLUSION Men had increased DAP indicating more radiation absorption in the exposed area.Gender outcomes showed no difference in complications.Thus,PEVI can be safely performed in men or women.
基金Shanghai Rehabilitation Medical Association,Grant/Award Number:2023JGKT24China Rehabilitation Medical Association,Grant/Award Number:KFKT-2023Shanghai“14th Five-Year Plan”Traditional Chinese Medicine Specialty and Traditional Chinese Medicine Emergency Capacity Improvement Project,Grant/Award Number:ZYTSZK2-7。
摘要Cerebral ischemiaeperfusion(I/R)injury is an important pathophysiological condition of ischemic stroke that involves a variety of physiological and pathological cell death pathways,including autophagy,apoptosis,necroptosis,and phagoptosis,among which autophagy is the most studied.We have reviewed studies published in the past 5 years regarding the association between autophagy and cerebral I/R injury.To the best of our knowledge,this is the first review article summarizing potential candidates targeting autophagic pathways in the treatment of I/R injury post ischemic stroke.The findings of this review may help to better understand the pathogenesis and mechanisms of I/R events and bridge the gap between basic and translational research that may lead to the development of novel therapeutic approaches for I/R injury.
摘要Objective:To evaluate the cardioprotective effects of sinomenine using the ischemiaeperfusion(I/R)rat model.Methods:Wistar rats were randomly divided into 6 groups:group Ⅰ with reperfusion,group Ⅱ perfused with sinomenine,group Ⅲ perfused with 5-hydroxydecanoate(5-HD),group Ⅳ perfused with 5-HD+sinomenine,group Ⅴ perfused with L-nitro arginine methyl ester(L-NAME),group Ⅵ perfused with L-NAME+sinomenine.Myocardial ischemia was induced by interrupting the aortic blood supply for 30 min,followed by reperfusion(55 min).Cardiac,hepatic,antioxidant,and inflammatory parameters were assessed.Additionally,endothelin,tissue factor,platelet-activating factor,plasminogen activator inhibitor,plasma fibrinogen,and thromboxane B2 were also analyzed.Results:Administration of 5-HD or L-NAME,used as the selective antagonist of mitoKATP and NO system,respectively,resulted in significantly increased levels of premature ventricular complexes,lactate dehydrogenase,ventricular fibrillation,ventricular tachycardia,and arrhythmia intensity(P<0.05).In contrast,sinomenine significantly reduced the level of troponin Ⅰ,lactate dehydrogenase,creatine kinase,and creatine kinase MB compared to the 5-HD group and the L-NAME group(P<0.05).Additionally,sinomenine significantly reduced malondialdehyde level and enhanced the levels of superoxide dismutase,glutathione peroxidase,catalase,and glutathione/glutathione disulfide ratio(P<0.05).It also significantly suppressed the levels of endothelin-1,platelet-activating factor,tissue factor,plasminogen activator inhibitor 1,thromboxane B2,and plasma fibrinogen(P<0.05).Conclusions:These results suggest that sinomenine exhibits significant cardioprotection effects against I/R-induced cardiac injury in rats.