Stem cell therapy for intervertebral disc degeneration: Clinical progress with exosomes and gene vectors

Intervertebral disc degeneration is a leading cause of lower back pain and is characterized by pathological processes such as nucleus pulposus cell apoptosis, extracellular matrix imbalance, and annulus fibrosus rupture. These pathological changes result in disc height loss and functional decline, potentially leading to disc herniation. This comprehensive review aimed to address the current challenges in intervertebral disc degeneration treatment by evaluating the regenerative potential of stem cell-based therapies, with a particular focus on emerging technologies such as exosomes and gene vector systems. Through mechanisms such as differentiation, paracrine effects, and immunomodulation, stem cells facilitate extracellular matrix repair and reduce nucleus pulposus cell apoptosis. Despite recent advancements, clinical applications are hindered by challenges such as hypoxic disc environments and immune rejection. By analyzing recent preclinical and clinical findings, this review provided insights into optimizing stem cell therapy to overcome these obstacles and highlighted future directions in the field.

Study on the effect of deer bone in improving rheumatoid arthritis based on the "drug-target-pathway" association network

ETHNOPHARMACOLOGICAL RELEVANCE

Deer bone is rich in proteins, free amino acids, chondroitin, organic calcium, phosphorus ions, and other active components. Deer bone had been used widely in antiquity and were first compiled in renowned ancient masterpiece 'Mingyi Bielu ()' written by Hongjing Tao. The deer bone is recorded as non-toxic and has the effects of replenishing bones, strengthening sinews, expelling wind-dampness from the body, promoting muscle growth, and healing wounds. Modern pharmacological research suggests that deer bone can help promote bone density and enhance bone strength, making it potentially valuable for the prevention and treatment of diseases such as rheumatoid arthritis and osteoporosis. However, current studies on the component analysis and pharmacological effects of deer bone against rheumatoid arthritis (RA) are incomplete, which to some extent hinders the development and clinical application of deer bone drugs.

AIM OF THE STUDY

The components of deer bone were elucidated by label-free proteomics, and the drug-target-pathway association network was established by network pharmacology. The in vitro validation of the pathway provides a theoretical basis for deer bone as a potential therapeutic drug for rheumatoid arthritis, and also lays a solid foundation for the subsequent clinical application of the in vitro experiments established through serum pharmacology.

MATERIALS AND METHODS

We performed extraction of deer bone using traditional water extraction methods and employed label-free proteomics technology to identify and conduct bioinformatics analysis on the proteins and peptides in the deer bone hot water extract (DBHE). These components were considered potential drug targets, and we constructed a "drug-target-pathway" association network. Analysis revealed that the HIF-1 signaling pathway may be pivotal in DBWE's effect on RA. Hypoxia influences the occurrence and development of ferroptosis through various mechanisms. Therefore, we hypothesized that DBWE might induce ferroptosis, promoting apoptosis in RA-FLS under hypoxic conditions, thereby alleviating RA. Therefore, we performed flow cytometry, ELISA, immunofluorescence, RT-qPCR, and western blotting based on molecular docking. Considering the overall effect of drug metabolism post-ingestion, we used serum pharmacology to prepare serum for cellular administration.

RESULTS

It showed that DBWE reduces inflammation and synovial proliferation by inhibiting HO-1, increasing ROS production, upregulating ACSL4 expression and inducing RA-FLS apoptosis in hypoxic conditions. This study reveals the potential mechanism by which DBWE modulates ferroptosis to attenuate synovial proliferation in a hypoxic microenvironment and improve RA.

CONCLUSION

These findings not only provide a theoretical basis for deer bone as a potential therapeutic agent for RA, but also lay a solid foundation for subsequent clinical application through in vitro experiments established by serum pharmacology.

Quercetin Simultaneously Treats Skeletal Fluorosis and Kashin-Beck Disease by Modulating HIF-1 and Ferroptosis Signaling Pathways

Excessive fluoride exposure can lead to skeletal fluorosis (SF), and selenium deficiency is one of the important pathogenic factors of Kashin-Beck disease (KBD). Although the pathogenic factors of these two diseases vary, there are many similarities in their pathogenic mechanisms on skeletal and articular cartilage lesions. There are currently no specific drugs for either disease, and investigating their shared pathogenic mechanisms may facilitate the development of new drugs for the treatment. This study found through bioinformatics technology that the HIF-1 signaling pathway and ferroptosis pathway might exert significant effects in both SF and KBD. Targeted small molecule drug prediction was conducted for the above two signaling pathways, and quercetin was screened as the best candidate therapeutic drug. Meanwhile, molecular docking and molecular dynamics simulations once again validated our screening results. In summary, quercetin may alleviate the symptoms of SF and KBD by regulating the HIF-1 signaling pathway and the ferroptosis pathway. In other words, it can attain the objective of treating two diseases simultaneously with one drug. This will provide new theoretical references for the treatment of comorbidity.

Effect of compound kushen injection on immune function in patients with colorectal cancer: a systematic review and meta-analysis

Background

Colorectal cancer (CRC) is one of the most common malignant tumors worldwide. Chemotherapy and radiotherapy remain cornerstone treatments; however, they often lead to significant immune suppression and an increased risk of infection. Enhancing immune function in CRC patients is critical for improving clinical outcomes and prognosis.

Objective

To evaluate the effects of Compound Kushen Injection (CKI) on immune function and its role in mitigating chemotherapy-induced adverse effects in patients with CRC.

Methods

We retrieved randomized controlled trials (RCTs) evaluating the effects of CKI on immune function in patients with CRC from eight Chinese and English databases, up until 31 December 2024. The Cochrane Handbook was used to assess the quality of the included studies. For the meta-analysis, we utilized Review Manager 5.4.1 software. Sensitivity analysis and publication bias assessment were conducted using Stata 17.0 software.

Result

A total of 2,663 patients (1,550 males and 1,113 females) from 30 RCTs were included. Compared to conventional chemotherapy (CC), the combination of CKI with CC significantly enhanced immune function, increasing CD3+ levels (MD = 6.15, 95% CI: 4.78 to 7.53, p < 0.00001), CD4+ levels (MD = 8.05, 95% CI: 6.99 to 9.11, p < 0.00001), CD4+/CD8+ levels (MD = 0.36, 95% CI: 0.28 to 0.44, p < 0.00001), NK cell levels (MD = 3.60, 95% CI: 2.85 to 4.34, p < 0.00001), while reducing CD8+ levels (MD = -4.19, 95% CI: -5.11 to -3.27, p < 0.00001). CKI also improved the objective response rate (ORR, RR = 1.50, 95% CI: 1.38 to 1.62, p < 0.00001) and disease control rate (DCR, RR = 1.15, 95% CI: 1.10 to 1.19, p < 0.00001), decreased CEA levels (MD = -1.79, 95% CI: -2.81 to -0.76, p = 0.0007) and CA199 levels (MD = -0.73, 95% CI: -1.35 to -0.12, p = 0.02), and reduced chemotherapy-induced adverse reactions, including nausea, vomiting, hepatic dysfunction, myelosuppression, neurotoxicity, leukopenia, thrombocytopenia, and mouth ulcers.

Conclusion

Current evidence suggests that the combination of CKI with CC may have beneficial effects on immune function, ORR, DCR, and chemotherapy-induced adverse reactions in CRC patients. However, given the variability in study quality and the absence of disease stage stratification, these findings should be interpreted with caution. Furthermore, the lack of long-term follow-up data limits the understanding of CKI's impact on survival and quality of life. High-quality, large-scale RCTs with extended follow-up are needed to further assess the long-term efficacy, safety, and clinical applicability of CKI in CRC management.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=632516, identifier CRD42025632516.

Latent classes analysis and associated factors of knowledge of intermittent catheterization in neurogenic bladder management among medical staff

Previous studies have demonstrated that intermittent catheterization (IC) is an effective management strategy for neurogenic bladder (NB), but the knowledge of medical staff in this field remains under-researched. This cross-sectional study aimed to explore the profile of medical staff's knowledge regarding IC in NB management and its associated factors. In August 2023, we conducted a convenience sampling survey involving 207 eligible medical staff from high-prevalence departments of NB at a tertiary general hospital in Nanchong, Southwest China. Data analysis was performed using latent class analysis (LCA) and logistic regression analysis. The results showed that respondents' knowledge of IC in NB management scored 10.27 ± 2.89 (maximum possible score of 16). The LCA identified two distinct profiles: a high knowledge group (57.97%) and a low knowledge group (42.03%). Logistic regression revealed that individuals with a college degree or above (OR = 2.15, 95% CI 1.14-4.07), those focusing on NB management (OR = 4.07, 95% CI 2.21-7.49), and those who received relevant training (OR = 2.81, 95% CI 1.57-5.02) were more likely to be in the high level group. Additionally, variations in knowledge profiles were observed across different departments. These findings indicate a need to enhance medical staff's understanding of IC in NB management in high-prevalence departments of NB, with targeted training programs as a potential solution. Notably, the use of convenience sampling and a single-center design in this study may constrain the generalizability of these findings, necessitating multicenter validation studies in the future.

Polysaccharide from steamed Polygonatum sibiricum ameliorates ulcerative colitis by protecting the intestinal mucosal barrier and regulating gut microbiota

Steamed Polygonatum sibiricum is widely applied in clinical practice for its tonic effect on gastrointestinal tract. A novel polysaccharide named PSSP-EF was extracted from the steamed roots of Polygonatum sibiricum using hot water extraction, ethanol precipitation, and chromatographic purification. PSSP-EF, with a molecular weight of 2.24 × 104 Da, was consisted of mannose, glucosamine hydrochloride, glucose, galactose, xylose, and arabinose in a molar ratio of 10.25: 0.26: 3.56: 80.55: 1.72: 3.66, and its main chain was constituted by→4)-β-D-Galp-(1→4)-β-D-Galp-(1→ and →4)-β-D-Manp-(1→4)-β-D-2ace-Manp-(1→ residues, with branching from β-D-Galp-(1→ residues. PSSP-EF could dramatically relieve clinical symptoms of ulcerative colitis (UC) in mice. Treatment with PSSP-EF significantly alleviated colon inflammation (TNF-α, IL-1β, and IL-6), repaired intestinal mucosal barrier (Occludin, ZO-1, and Claudin-1) and regulated the balance of gut microbiota by increased the levels of Muribaculaeae, while decreasing the levels of Bacteroides, Erysipelatoclostridium, and Romboutsia. Notably, PSSP-EF remarkably increased the levels of acetic, propionic, isobutyric, butyric, valeric, and isovaleric acid in the cecal contents of UC mice. In conclusion, PSSP-EF has a significant therapeutic effect on UC by balancing gut microbiota, protecting intestinal mucosal barrier, and regulating short-chain fatty acid production, and can be developed as a functional food.

Enhanced BDNF and ROS in Mucosa of Lower Motor Neuron Lesioned Dog Bladder Following Somatic Motor Nerve Transfer

Neurotrophic factors and reactive oxygen species (ROS) modulate neuronal plasticity. In a model of a lower motor neuron lesioned bladder, somatic nerve transfer was used as a reinnervation strategy. Levels of neurotrophins, ROS, and TNF-α in bladder mucosa and muscle layers collected from three groups of adult female dogs: (1) Decentralized, via bilateral transection of coccygeal and sacral spinal roots, lumbar 7 dorsal roots, and hypogastric nerves, then 6-21 mo recovery; (2) reinnervated (ObNT-Reinn), after similar decentralization for 12 mo, then bilateral obturator-to-vesical nerve transfer and 8-12 mo recovery; and (3) Controls. In mucosa, BDNF and ROS levels were highest in ObNT-Reinn bladders, GDNF and TNF-α levels were restored to Control levels in ObNT-Reinn bladders (lowest in Decentralized). NT-3 and ARTN were lower in ObNT-Reinn and Decentralized bladders versus Controls. In muscle, ROS was lower in ObNT-Reinn muscle versus Controls. BDNF mucosa levels correlated with bladder axonal density and detrusor layer thickness; and GDNF mucosal correlated with bladder contraction after vesical or transferred obturator nerve electrical stimulation, as did BDNF and GDNF muscle levels. The increased BDNF and GDNF in bladders that underwent somatic nerve transfer with subsequent recovery suggest that BDNF and GDNF may help promote the reestablishment of bladder innervation.

Impact of lifestyle and mental health on colorectal adenomas in China: a prospective cross-sectional survey

Background

Colorectal adenomas, which are precancerous lesions that can develop into colorectal cancer, present a significant challenge due to the lack of comprehensive early screening and clear identification of risk factors.

Objectives

We conduct a double-blind, prospective cross-sectional analysis to examine the relationship between lifestyle, mental health, and colorectal adenomas.

Methods

Between June 2023 and July 2024, we surveyed 246 participants at Hubei Provincial Hospital of Traditional Chinese Medicine in Wuhan using a self-administered online questionnaire.

Results

The majority of participants were over the age of 50 (49.6%), married or living with a partner (87.08%), and employed as office workers or technicians (44.3%). Among the total population, 435 individuals (53.5%) were diagnosed with colorectal adenomas. A significant positive association was observed between being a manager (OR = 2.340; 95% CI = 1.043-5.248) and the presence of colorectal adenomas, as well as having a BMI over 28 (OR = 6.000; 95% CI = 1.501-23.991). After adjusting for professional role and BMI, no significant associations were found between scores on the HADS-D (AOR = 1.031; 95% CI = 0.967-1.099) or PSS-10 (AOR = 0.971; 95% CI = 0.923-1.022) scales and colorectal adenomas. However, higher scores on the AUDIT (AOR = 1.001-1.144), CDS-12 (AOR = 1.028; 95% CI = 1.003-1.054), PSQI (AOR = 1.079; 95% CI = 1.003-1.161), and HADS-A (AOR = 1.156; 95% CI = 1.059-1.262) scales were significantly associated with an increased likelihood of colorectal adenomas.

Conclusion

The study highlights the significance of addressing alcohol consumption, smoking, sleep quality, and anxiety to reduce the risk of colorectal adenomas. Targeted mental health interventions may play a crucial role in alleviating this health burden and enhancing overall population health.

Activation of the Nrf2 Signaling Pathway by Tetrahydroberberine Suppresses Ferroptosis and Enhances Functional Recovery Following Spinal Cord Injury

Recent research has identified ferroptosis, a newly recognized form of programmed cell death, is a crucial factor in spinal cord injury (SCI). Tetrahydroberberine (THB) is a tetrahydroisoquinoline alkaloid derived from the tuber of the poppy family plant, Corydalis, which is recognized for its antioxidant and neuroprotective properties. Despite these attributes, the potential protective effects of THB against SCI are yet to be thoroughly investigated. Therefore, the aim of this study was to elucidate the protective effects and underlying mechanisms of action of THB in SCI. A mouse model of SCI was used for the in vivo experiments. Functional recovery was evaluated using the Basso Mouse Scale (BMS), footprint analysis, and hematoxylin and eosin (HE), Masson's trichrome, and Nissl staining. Lipid peroxidation was quantified using malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD). The expression levels of the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway and ferroptosis markers were analyzed using western blot (WB) and immunofluorescence (IF) staining. To further elucidate the mechanism through which THB inhibits ferroptosis, an in vitro ferroptosis model was established in PC12 cells using RSL3, a known ferroptosis activator. THB markedly improved tissue and motor function restoration in mice post-SCI, with the BMS score increasing by approximately 50% compared with that in the control group. Lipid peroxidation assays revealed that THB significantly reduced MDA levels and increased GSH and SOD levels. Both in vivo and in vitro experiments demonstrated that THB significantly activated the Nrf2 pathway and inhibited ferroptosis in mice and in PC12 cells. This protective effect was reversed by the Nrf2 inhibitor, ML385, as evidenced by suppression of the Nrf2 pathway, increased lipid peroxidation, and elevated ferroptosis levels. Our in vivo and in vitro experiments indicate that THB promotes functional recovery after SCI by activating the Nrf2 signaling pathway, which attenuates lipid peroxidation and suppresses ferroptosis, thereby contributing to neuronal survival. Our findings contribute to a more comprehensive understanding of how THB exerts its recovery effects in SCI and demonstrate the potential of THB as a novel therapeutic strategy for the clinical management of SCI.

Advancements in the application of artificial intelligence in the field of colorectal cancer

Colorectal cancer (CRC) is a prevalent malignant tumor in the digestive system. As reported in the 2020 global cancer statistics, CRC accounted for more than 1.9 million new cases and 935,000 deaths, making it the third most common cancer worldwide in terms of incidence and the second leading cause of cancer-related deaths globally. This poses a significant threat to global public health. Early screening methods, such as fecal occult blood tests, colonoscopies, and imaging techniques, are crucial for detecting early lesions and enabling timely intervention before cancer becomes invasive. Early detection greatly enhances treatment possibilities, such as surgery, radiation therapy, and chemotherapy, with surgery being the main approach for treating early-stage CRC. In this context, artificial intelligence (AI) has shown immense potential in revolutionizing CRC management, serving as one of the most effective screening tools. AI, utilizing machine learning (ML) and deep learning (DL) algorithms, improves early detection, diagnosis, and treatment by processing large volumes of medical data, uncovering hidden patterns, and forecasting disease development. DL, a more advanced form of ML, simulates the brain's processing power, enhancing the accuracy of tumor detection, differentiation, and prognosis predictions. These innovations offer the potential to revolutionize cancer care by boosting diagnostic accuracy, refining treatment approaches, and ultimately enhancing patient outcomes.

The Journey of Copper-Impregnated Dressings in Wound Healing: From a Medical Hypothesis to Clinical Practice

Background/Objectives. Chronic wounds pose a substantial global healthcare burden exacerbated by aging populations and the increasing prevalence of conditions such as diabetes, peripheral vascular disease, and venous insufficiency. Impaired physiological repair mechanisms, including angiogenesis, collagen synthesis, and re-epithelialization, hinder the healing process in chronic wounds. Many of these physiological processes are dependent on their interaction with copper. We hypothesized that the targeted delivery of copper ions to the wound bed would enhance healing. Methods. Wound dressings impregnated with copper oxide microparticles were designed to ensure the controlled release of copper ions. The efficacy of these dressings was evaluated using non-infected wound models, including diabetic mouse models compared against control and silver dressings. Outcome measures included wound closure rates, epidermal skin quality assessed by histopathological examination, and gene expression profiling. Clinical applications were assessed through diverse case studies and controlled trials involving chronic wound management. Results. Copper dressings significantly accelerated wound closure and enhanced angiogenesis compared to control and silver dressings. Histopathological analyses revealed faster granulation tissue formation, epidermal regeneration, and neovascularization. Gene expression studies showed upregulation of critical angiogenic factors such as VEGF and HIF-1α. Investigations and clinical observations corroborated improved healing across various chronic wound types, including non-infected wounds. Conclusions. Copper is essential for wound healing, and copper-impregnated dressings provide a promising solution for chronic wound management. By enhancing angiogenesis and tissue regeneration, these dressings go beyond antimicrobial action, offering a cost-effective and innovative alternative to conventional therapies. Copper dressings represent a transformative advancement in addressing the challenges of chronic wound care.

Risk factors, prevention and screening of colorectal cancer: A rising problem

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide. The leading risk factors for CRC include male gender, age over 50, family history, obesity, tobacco smoking, alcohol consumption, and unhealthy diet. CRC screening methods vary considerably between countries and depend on incidence, economic resources and healthcare structure. Important aspects of screening include adherence, which can vary significantly across ethnic and socioeconomic groups. Basic concepts of CRC screening include pre-stratification of patients by identifying risk factors and then using fecal immunochemical test or guaiac-based fecal occult blood test and/or colonoscopy or radiologic imaging techniques. Technological capabilities for CRC screening are rapidly evolving and include stool DNA test, liquid biopsy, virtual colonography, and the use of artificial intelligence. A CRC prevention strategy should be comprehensive and include active patient education along with targeted implementation of screening.

Where are we in targeting hypoxia-induced pathways in inflammatory arthritis? Current understanding, insights, and future directions

INTRODUCTION

Joint tissues affected by inflammatory arthritis (IA) create hypoxic microenvironments that sustain the inflammatory response. Although targeting molecules in hypoxia-induced pathways has provided valuable insights into potential novel therapies for various types of IA, progress remains preclinical, and no clinical trials have been conducted for IA.

METHODS

A literature search was conducted to create a narrative review exploring the role of hypoxia and its signaling pathways in IA pathogenesis, as well as the potential and future directions for IA therapies that target hypoxia-induced molecules before moving forward to clinical applications.

RESULTS

Hypoxia is a prevalent feature of the IA synovial microenvironment and contributes to disease progression. Various studies and preclinical models demonstrate how hypoxia-inducible factors, vascular endothelial growth factors, and matrix metalloproteinases, among other molecules, influence rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, and juvenile idiopathic arthritis. Despite these findings, drug development targeting these molecules in IA has been limited due to challenges in delineating the mechanistic pathways of hypoxia, the distinct roles of hypoxia-induced molecules depending on anatomical sites, and concerns regarding pharmacokinetics and patient safety. However, given that hypoxia-induced molecule-targeting therapies have been successfully approved for treating cancers and cardiovascular diseases, further research is needed to advance the application of similar medications in IA.

CONCLUSIONS

Given the pathogenic effects of hypoxic microenvironments in IA, it is imperative to continue gathering compelling evidence to advance hypoxia-induced therapies. Furthermore, elucidating the safety and efficacy of such drugs in various preclinical models, in collaboration with chemists and the pharmaceutical industry, is crucial for accelerating the development of novel, optimized treatment methods.

Buyang Huanwu Decoction reduces mitochondrial autophagy in rheumatoid arthritis synovial fibroblasts in hypoxic culture by inhibiting the BNIP3-PI3K/Akt pathway

OBJECTIVES

To investigate the role of the BNIP3-PI3K/Akt signaling pathway in mediating the inhibitory effect of Buyang Huanwu Decoction (BYHWT) on mitochondrial autophagy in human synovial fibroblasts from rheumatoid arthritis patients (FLS-RA) cultured under a hypoxic condition.

METHODS

Forty normal Wistar rats were randomized into two groups (n=20) for daily gavage of BYHWT or distilled water for 7 days to prepare BYHWT-medicated or control sera. FLS-RA were cultured in routine condition or exposed to hypoxia (10% O2) for 24 h wigh subsequent treatment with IL-1β, followed by treatment with diluted BYHWT-medicated serum (5%, 10% and 20%) or control serum. AnnexinV-APC/7-AAD double staining and T-AOC kit were used for detecting apoptosis and total antioxidant capacity of the cells, and the changes in ROS, ATP level, mitochondrial membrane potential and Ca2+ homeostasis were analyzed. The changes in mRNA and protein expressions of BNIP3, PI3K and AKT and mRNA expressions of LC3, Beclin-1 and P62 were detected using RT-qPCR and Western blotting.

RESULTS

Treatment with BYHWT-medicated serum dose-dependently lowered apoptosis rate of IL-1β-induced FLS-RA with hypoxic exposure. The treatment significantly decreased T-AOC concentration, increased ROS production, autophagosome formation and ATPase levels, and lowered mitochondrial membrane potential and Ca2+ level in the cells. In IL-1β-induced FLS-RA with hypoxic exposure, treatment with BYHWT-medicated serum significantly increased BNIP3 protein expression, decreased the protein expressions of PI3K and AKT, increased the mRNA expressions of BNIP3 and P62, and lowered the mRNA expressions of PI3K, AKT, LC3 and Beclin-1 without significantly affecting Beclin-1 protein expression. The cells treated with 5% and 10% BYHWT-medicated serum showed no significant changes in LC3 expression.

CONCLUSIONS

BYHWT inhibits mitochondrial autophagy in IL-1β-induced FLS-RA with hypoxic exposure possibly by inhibiting BNIP3-mediated PI3K/AKT signaling pathway.

Clamping Catheter Versus Free Drainage for Patients With Neurogenic Bladder With Indwelling Urinary Catheter: A Meta-Analysis

Background: In the clinical setting, individuals with neurogenic bladder dysfunction commonly utilize indwelling urinary catheters for urinary management. The comparative efficacy of catheter clamping versus continuous free drainage in this patient population is yet to be established. This meta-analysis aims to explore the efficacy and safety of catheter clamping versus natural drainage in patients with neurogenic bladder, to provide evidence to support the treatment and nursing care of these patients. Methods: Two researchers conducted a literature search in Clinicaltrials et al. databases for Randomized Controlled Trials (RCTs) comparing clamping of the catheter to free drainage in patients with neurogenic bladder who have indwelling urinary catheters. The RCT bias risk assessment tool recommended by the Cochrane Handbook was used for quality assessment. RevMan 5.3 software were used for meta-analysis. Results: A total of 8 RCTs involving 772 patients with neurogenic bladder were enrolled. Catheter clamping significantly increased the volume of first urination in patients [MD = 52.86, 95%CI (42.30, 63.41), p < .001]. The difference in time to first urination [SMD = 0.10, 95%CI (-0.68, 0.89), p = .80], residual urine volume [MD = -5.18, 95%CI (-17.27, 6.90), p = .40], incidence of urinary retention [MD = 1.07, 95%CI (0.30, 3.87), p = .92], the incidence of urinary tract infection [RR = 1.38, 95%CI (0.64, 2.97), p = .42] between the catheter clamping group and the natural drainage group were not statistically significant. The results of Egger's regression analysis indicated no evidence of statistical publication bias. Conclusion: In light of the existing body of evidence, the routine practice of catheter clamping in catheterized patients with neurogenic bladder is not recommended.

The diagnostic value of serum Ephrin-A1 in patients with colorectal cancer

Colorectal cancer (CRC) is one of the most common malignant tumors worldwide, with a high incidence rate and mortality. The analysis of serum biomarkers for colorectal cancer diagnosis has attracted more and more attention because of its low cost, repeatability, and quantification. This study was aimed to evaluate the diagnostic performance of serum Ephrin-A1 in patients with CRC. We retrospectively analyzed CRC cases in a test cohort (121 patients and 108 controls) and validated them in a validation cohort (119 patients and 118 controls). The concentration of Ephrin-A1 in serum was detected by Enzyme-linked immunosorbent assay (ELISA) and the diagnostic performance of serum Ephrin-A1 was evaluated by receiver operating characteristic (ROC) analysis. In the test cohort, serum Ephrin-A1 levels in patients with all-stage CRC and early-stage CRC were significantly higher than those in healthy controls. The area under the ROC curve (AUC), sensitivity and specificity of all-stage CRC and early-stage CRC were 0.709 (95% CI 0.644-0.775) and 0.660 (95% CI 0.530-0.790), 48.76% and 45.00%, 81.48% and 81.48%, respectively. Similar results were observed in the validation cohort. Serum Ephrin-A1 might be served as a potential biomarker in the diagnosis of CRC.

Early detection of colorectal cancer using aberrant circulating cell-free mitochondrial DNA fragmentomics

BACKGROUND

Early detection of colorectal cancer (CRC) is crucial for improving the survival rates of patients.

OBJECTIVE

We aimed to develop a novel strategy for early CRC detection using the fragmentomic features of circulating cell-free mitochondrial DNA (ccf-mtDNA).

DESIGN

Here, a total of 1147 participants, including 478 healthy controls (HCs), 112 patients with advanced adenomas (AAs) and 557 patients with CRC, were enrolled from five hospitals and plasma samples were collected for capture-based ccf-mtDNA sequencing.

RESULTS

Our data analysis revealed significantly aberrant ccf-mtDNA fragmentomic features in patients with CRC and AA when compared with HCs. Then, a CRC detection (CD) model was constructed based on the fragmentomic features of ccf-mtDNA from 246 patients with CRC and 168 HC in the training cohort, showing area under the curve of 0.9863, sensitivity of 92.68% and specificity of 93.45%. Both internal and two external validation cohorts demonstrated the excellent capacity of CD model in distinguishing patients with early-stage CRC from HCs, greatly surpassing the performance of serum biomarkers. Furthermore, our CD model can also detect patients with AA with a sensitivity of 79.35% in AA cohort 1 and 85.00% in AA cohort 2.

CONCLUSION

In conclusion, based on aberrant ccf-mtDNA fragmentomic features, a novel and non-invasive approach was established for the detection of patients with early-stage CRC or AA, with high performance.

Induction of Neural Differentiation and Protection by a Novel Slow-Release Nanoparticle Estrogen Construct in a Rat Model of Spinal Cord Injury

Spinal cord injury (SCI) is a complex debilitating condition leading to permanent life-long neurological deficits. Estrogen (E2) treatment is known to be neuroprotectant in SCI. This hormone is highly pleiotropic and has been shown to decrease apoptosis, modulate calcium signaling, regulate growth factor expression, act as an anti-inflammatory, and drive angiogenesis. These beneficial effects were found in our earlier study at the low dose of 10 µg/kg E2 in rats. However, the dose remains non-physiologic, which poses a safety hurdle for clinical use. Thus, we recently devised/constructed a fast release nanoparticle (NP) estrogen embedded (FNP-E2) construct and tested a focal delivery system in a contused SCI rat model which showed protection in the short run. In the current study, we have developed a novel slow-release NP estrogen (SNP-E2) delivery system that shows sustained release of E2 in the injured spinal cord and no systemic exposure in the host. The study of E2 release and kinetics of this SNP-E2 construct in vitro and in vivo supported this claim. Delivery of E2 to the injured spinal cord via this approach reduced inflammation and gliosis, and induced microglial differentiation of M1 to M2 in rats after SCI. Analysis of spinal cord samples showed improved myelination and survival signals (AKT) as demonstrated by western blot analysis. SNP-E2 treatment also induced astrocytic differentiation into neuron-like (MAP2/NeuN) cells, supported the survival of oligodendrocyte precursor cells (OPC), and improved bladder and locomotor function in rats following SCI. These data suggest that this novel delivery strategy of SNP-E2 to the injured spinal cord may provide a safe and effective therapeutic approach to treat individuals suffering from SCI.

Evaluation of the inhibitory mechanism of Pennisetum glaucum (pearl millet) bioactive compounds for rheumatoid arthritis: an in vitro and computational approach

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial infiltration and pannus formation, and its rising incidence is significantly contributing to the global disability rate. Despite advances in biological drugs, no treatment has successfully cured or averted its progression. Consequently, natural drugs are being explored as alternative therapeutic strategies.

Objective

This study aims to evaluate the therapeutic potential of Pennisetum glaucum (pearl millet) and to identify its bioactive compounds to assess their effectiveness against RA targets.

Methods

The therapeutic potential of P. glaucum extracts was evaluated by antioxidant and anti-inflammatory assays. Gas chromatography-mass spectrometry (GC-MS) was utilized to identify the compounds in P. glaucum extract. The pharmacokinetics and safety profile of these compounds were studied by absorption, distribution, metabolism, excretion, and toxicity (ADMET) analysis. Network pharmacology, molecular docking, and molecular dynamic (MD) simulation were employed to identify the active compounds and their therapeutic targets in P. glaucum for RA treatment.

Results

Acidified methanol (AM) extract of P. glaucum showed the highest phenolic (213 ± 0.008 mg GAE/g DW) and flavonoid content (138.1 ± 0.03 mg RE/g DW), demonstrating significant antioxidant and anti-inflammatory potential. GC-MS of AM extract identified 223 compounds. Lipinski and toxicity parameters screened out 17 compounds. Protein-protein interaction (PPI) analysis shortlisted 20 key targets in RA pathways, nine of which were upregulated in five microarray datasets. Molecular docking and MD simulations revealed that compound-7 (benzenesulfonamide, 2-nitro-N-phenyl-) and compound-9 (Pregnane-3,20-diamine, (3.beta.,5.alpha.,20S)-) bind strongly with MMP9, JAK2, PTGS2, and HIF1a compared to the reference, predicting stable interaction with these upregulated genes. Finally, PASS (prediction of activity spectra for biological active substances) analysis further validated the anti-arthritic potential of these compounds based on their chemical structure.

Conclusion

This study uncovered a therapeutic drug candidate against HIF1a, MMP9, JAK2, and PTGS2 for RA from P. glaucum active compounds, laying the groundwork for future research.

Fu brick tea polysaccharides: A state-of-the-art mini-review on extraction, purification, characteristics, bioactivities and applications

Fu brick tea (FBT), a post-fermented dark tea, is highly esteemed for its abundant nutritional and medicinal values. Fu brick polysaccharides (FBTPs) are acidic heteropolysaccharides primarily composed of galactose and galacturonic acid, which are crucial components of FBT. FBTPs exhibit multiple bioactivities, including immunomodulatory, antioxidant, anti-inflammatory, regulatory effects on intestinal microbiota, anti-obesity, among others. Owing to their significant marketing potential and promising development prospects, FBTPs have attracted considerable attention from researchers worldwide. However, the specific mechanisms and underlying structure-function relationships of FBTPs are not well understood. Consequently, this review aims to provide comprehensive and cutting-edge information on the extraction, purification, structural characteristics, and biological activities of FBTPs, with an emphasis on exploring how their structural characteristics influence biological activities and therapeutic potential. We found that different materials and extraction techniques could result in differences in the structure-activity relationship of FBTPs. Furthermore, monosaccharide composition and molecular weight could also significantly impact the bioactivities of FBTPs, such as lipid-lowering effects and immunomodulatory activity. This review would further facilitate the applications of FBTPs as therapeutic agents and functional foods, thereby laying a solid foundation for their further development and utilization.

Expression level of myocardial enzymes in patients with schizophrenia: Predictive value in the occurrence of violence

BACKGROUND

Schizophrenic patients are prone to violence, frequent recurrence, and difficult to predict. Emotional and behavioral abnormalities during the onset of the disease, resulting in active myocardial enzyme spectrum.

AIM

To explored the expression level of myocardial enzymes in patients with schizophrenia and its predictive value in the occurrence of violence.

METHODS

A total of 288 patients with schizophrenia in our hospital from February 2023 to January 2024 were selected as the research object, and 100 healthy people were selected as the control group. Participants' information, clinical data, and laboratory examination data were collected. According to Modified Overt Aggression Scale score, patients were further divided into the violent (123 cases) and non-violent group (165 cases).

RESULTS

The comparative analysis revealed significant differences in serum myocardial enzyme levels between patients with schizophrenia and healthy individuals. In the schizophrenia group, the violent and non-violent groups also exhibited different levels of serum myocardial enzymes. The levels of myocardial enzymes in the non-violent group were lower than those in the violent group, and the patients in the latter also displayed aggressive behavior in the past.

CONCLUSION

Previous aggressive behavior and the level of myocardial enzymes are of great significance for the diagnosis and prognosis analysis of violent behavior in patients with schizophrenia. By detecting changes in these indicators, we can gain a more comprehensive understanding of a patient's condition and treatment.

Sinomenine Alleviates Rheumatoid Arthritis by Suppressing the PI3K-Akt Signaling Pathway, as Demonstrated Through Network Pharmacology, Molecular Docking, and Experimental Validation

Purpose

Sinomenine (SIN) is commonly used in Traditional Chinese Medicine (TCM) as a respected remedy for rheumatoid arthritis (RA). Nevertheless, the therapeutic mechanism of SIN in RA remains incompletely understood. This study aimed to delve into the molecular mechanism of SIN in the treatment of RA.

Methods

The potential targets of SIN were predicted using the TCMSP server, STITCH database, and SwissTarget Prediction. Differentially expressed genes (DEGs) in RA were obtained from the GEO database. Enrichment analyses and molecular docking were conducted to explore the potential mechanism of SIN in the treatment of RA. In vitro and in vivo studies were conducted to validate the intervention effects of SIN on rheumatoid arthritis, as determined through network pharmacology analyses.

Results

A total of 39 potential targets associated with the therapeutic effects of SIN in RA were identified. Enrichment analysis revealed that these potential targets are primarily enriched in PI3K-Akt signaling pathway, and the molecular docking suggests that SIN may act on specific proteins in the pathway. Experimental results have shown that exposure to SIN inhibits cytokine secretion, promotes apoptosis, reduces metastasis and invasion, and blocks the activation of the PI3K-Akt signaling pathway in RA fibroblast-like synoviocytes (RA-FLS). Moreover, SIN treatment alleviated arthritis-related symptoms and regulated the differentiation of CD4+ T cells in the spleen of collagen-induced arthritis (CIA) mice.

Conclusion

By utilizing network pharmacology, molecular modeling, and in vitro/in vivo validation, this study demonstrates that SIN can alleviate RA by inhibiting the PI3K-Akt signaling pathway. These findings enhance the understanding of the therapeutic mechanisms of SIN in RA, offering a stronger theoretical foundation for its future clinical application.

Selection and Mechanism Study of Q-Markers for Xanthocerais lignum Anti-Rheumatoid Arthritis Based on Serum Spectrum-Effect Correlation Analysis

OBJECTIVE

To elucidate the chemical profile of Xanthocerais lignum's extracts of different polarities and their impact on rheumatoid arthritis (RA), we identified anti-RA markers and predicted their action mechanisms.

METHODS

A collagen-induced arthritis rat model was established, and UPLC-Q-Exactive Orbitrap MS technology was employed to analyze and identify the chemical constituents within the alcohol extract of Xanthocerais lignum and its various extraction fractions, as well as their translocation into the bloodstream. Serum spectrum-effect correlation analysis was utilized to elucidate the pharmacodynamic material basis of Xanthocerais lignum against RA and to screen for Q-Markers. Finally, the potential anti-RA mechanisms of the Q-Markers were predicted through compound-target interaction data and validated using molecular docking techniques.

RESULTS

We identified 71 compounds, with flavan-3-ols and flavanones as key components. Of these, 36 were detected in the bloodstream, including 17 original and 19 metabolized forms. Proanthocyanidin A2, dihydroquercetin, catechin, and epicatechin (plus glucuronides) showed potential anti-RA activity. These compounds, acting as Q-Markers, may modulate ERK, NF-κB, HIF-1α, and VEGF in the HIF-1 pathway.

CONCLUSIONS

This research clarifies Xanthocerais lignum's pharmacodynamic material basis against RA, identifies 4 Q-Markers, and offers insights into their mechanisms, aiding quality assessment and lead compound development for RA treatment.

Evaluating Neurogenic Bladder Management in Palestinian Healthcare: A Qualitative Study

BACKGROUND

Neurogenic bladder (NB) is a prevalent urologic condition significantly impacting the health and quality of life of affected individuals. The condition, often resulting from various etiologies such as spinal cord injuries and multiple sclerosis, leads to severe life problems, including pain and impaired physical, mental, social, and emotional functioning. This study aims to explore the medical practices of urologists in the diagnosis, management, and care of NB patients within the Palestinian healthcare context, highlighting the absence of a unified treatment protocol and the reliance on private clinics for care.

METHODS

An exploratory qualitative study design was employed, adhering to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Structured interviews were conducted with 14 urologists and two urology residents across eight different cities in Palestine, including 10 governmental hospitals, two private hospitals, one university hospital, and one charity hospital. Fourteen doctors had private outpatient clinics alongside their work in hospitals. A questionnaire developed by the authors was delivered to specialists and residents to understand the evaluation, management, follow-up practices, and challenges faced in treating NB patients. The study focused on the diagnostic processes, treatment modalities, complications management, and the impact of the lack of standardized protocols on patient care. Our qualitative study consists of six major themes, each theme consisting of multiple sub-themes and different participant responses: (1) diagnosis and follow-up of NB patients; (2) general issues in the management of NB; (3) evaluation and follow-up of upper and lower urinary system function in NB patients; (4) urinary tract infections associated with NB disease and how to deal with it; (5) opinions and future attitudes in the treatment of NB patients; (6) NB in patients with multiple sclerosis.

RESULTS

The study found that urodynamic studies are crucial in NB diagnosis, yet there is no unified management protocol, leading to varied practices. Most participants preferred the American Urological Association (AUA) guidelines in the absence of Palestinian protocols. Six major themes emerged, including diagnosis and follow-up challenges, general issues in NB management, evaluation and follow-up of urinary system function, urinary tract infections management, opinions on future treatment directions, and specific considerations for NB patients with multiple sclerosis.

CONCLUSIONS

The study highlights the need for a unified, standardized protocol for the management of NB patients in Palestine. The reliance on international guidelines, primarily the AUA protocols, underscores the gap in local healthcare policies. The findings call for the establishment of national guidelines and enhanced resources for the effective management of NB, aiming to improve patient outcomes and quality of life.

Establishment of a novel obesity mouse model: the induction of intestinal microbiota dysbiosis

To establish and evaluate an intestinal microbiota dysbiosis-induced obesity mouse model. 50 C57BL/6 J male healthy mice were randomly divided into an obesity model group and the control group. The body weight, body length, and Lee's index of the two groups of mice at week 1 and week 10 were compared. Serum glucose (GLU), total cholesterol (TC) and triglyceride (TG) were measured by enzyme-labeled colorimetric methods. Illumina HiSeq 16S rDNA high-throughput sequencing technology was used to characterize intestinal microbiota in feces. The success rate of model establishment in obese mice was 52%. The body weight, body length, Lee's index, and abdominal fat (wet weight) in the obese model group were all higher than those in the control group, and the differences were statistically significant (P < 0.01). Serum GLU and TC levels in the obesity model group were higher than those in the control group (P < 0.05), and there was no difference in TG levels between the two groups (P > 0.05). The control group contained more abundant intestinal microbiota phyla and genera than did the obesity model group; the differences between the two groups were significant (FDR ≤ 0.05, P ≤ 0.05). Intestinal microbiota dysbiosis can be used to generate an obesity model in mice.

Prognostic significance of preoperative lymphocytes, albumin, and neutrophils (LANR) index in resectable pancreatic ductal adenocarcinoma

PURPOSE

The index composed of preoperative lymphocytes, albumin, and neutrophils (LANR), a new composite score based on inflammatory response and nutritional status, has been reported to be associated with the prognosis of multiple types of cancer, but the role of LANR in the prognosis of resectable pancreatic ductal adenocarcinoma (PDAC) has not yet been elucidated.

PATIENTS AND METHODS

The data of 142 patients with PDAC who underwent radical resection in the Affiliated Hospital of Jiangnan University from January 2015 to December 2018 were retrospectively analyzed. Receiver Operating Characteristic (ROC) curves were generated to determine the optimal cut-off values for these parameters, as well as the sensitivity and specificity of LANR in predicting survival. The Kaplan-Meier method was used to draw the survival curves. Log rank test was used for univariate analysis, and Cox proportional hazards regression model was used for multivariate analysis.  RESULTS: The optimal cut-off value of LANR was 18.145, and a low preoperative LANR was significantly correlated with the location of the tumor (p = 0.047). Multivariate analysis showed that tumor differentiation degree (HR:2.357, 95%CI:1.388-4.003,p = 0.002), lymph node metastasis (HR:1.755, 95%CI: 1.115-2.763, p = 0.015), TNM stage (HR:4.686, 95%CI: 2.958-7.425, p < 0.001), preoperative cancer antigen 19 - 9 levels (HR:1.001, 95%CI: 1.000-1.001, p < 0.001) and preoperative LANR (HR:0.221, 95%CI: 0.111-0.441, p < 0.001) were independent risk factors for a poor prognosis in patients undergoing radical resection of PDAC.

CONCLUSION

This study found that preoperative LANR can be used to assess the prognosis of radical resection in patients with PDAC; those with low preoperative LANR had a worse outcome.

Acute ampakines increase voiding function and coordination in a rat model of SCI

Neurogenic bladder dysfunction causes urological complications and reduces the quality of life in persons with spinal cord injury (SCI). Glutamatergic signaling via AMPA receptors is fundamentally important to the neural circuits controlling bladder voiding. Ampakines are positive allosteric modulators of AMPA receptors that can enhance the function of glutamatergic neural circuits after SCI. We hypothesized that ampakines can acutely stimulate bladder voiding that has been impaired due to thoracic contusion SCI. Adult female Sprague-Dawley rats received a unilateral contusion of the T9 spinal cord (n = 10). Bladder function (cystometry) and coordination with the external urethral sphincter (EUS) were assessed 5 d post-SCI under urethane anesthesia. Data were compared to responses in spinal-intact rats (n = 8). The 'low-impact' ampakine CX1739 (5, 10, or 15 mg/kg) or vehicle (2-hydroxypropyl-beta-cyclodextrin [HPCD]) was administered intravenously. The HPCD vehicle had no discernible impact on voiding. In contrast, following CX1739, the pressure threshold for inducing bladder contraction, voided volume, and the interval between bladder contractions were significantly reduced. These responses occurred in a dose-dependent manner. We conclude that modulating AMPA receptor function using ampakines can rapidly improve bladder-voiding capability at subacute time points following contusion SCI. These results may provide a new and translatable method for therapeutic targeting of bladder dysfunction acutely after SCI.

Vitamin D May Play a Vital Role in Alleviating Type 2 Diabetes Mellitus by Modulating the Ferroptosis Signaling Pathway

Ferroptosis is an iron-dependent death mode mediated by the aggregation of lipid peroxides and lipid-reactive oxygen species. It is characterized by iron-dependent lipid peroxide accumulation accompanied by oxidoreductase deficiency. Pancreatic beta cell dysfunction and insulin resistance are two major causes of type 2 diabetes mellitus (T2DM). Iron accumulation and metabolism may play a role in the development of T2DM. The molecular mechanism of β cell apoptosis and iron death in T2DM were reviewed. In addition, we discuss recent insights on the relationship between the trace element iron and apoptosis of β cells in T2DM.

Antipsychotics and Risks of Cardiovascular and Cerebrovascular Diseases and Mortality in Dwelling Community Older Adults

This study aims to investigate the effect of antipsychotic agents on cardiovascular and cerebrovascular diseases (CVD/CEV) and mortality risks in the older population living in a community. A cohort of 42,650 new users of antipsychotic agents was built using Quebec healthcare databases (1998-2011). The outcomes were CVD/CEV and mortality incidence in 5 years of follow-up in the total cohort, sub-cohort of patients with no schizophrenia/dementia, sub-cohort with schizophrenia, and sub-cohort with dementia. Comparisons were made between the new users who continued the treatment (adherent level ≥ 60%) vs. those ceasing treatment (adherence level < 60%) using inverse probability of treatment weighting and Cox models. Comparing high adherence vs. low levels, CVD/CEV risk was increased by 36% in the sub-cohort with schizophrenia for atypical antipsychotic users and by 25% in the sub-cohort with dementia for typical antipsychotic users. An increasing mortality risk of 2- to 3-fold was linked with the typical antipsychotic use in all cohorts except the sub-cohort with schizophrenia; in addition, mortality risk is linked with the use of high vs. low doses. Antipsychotics were not linked with CVD/CEV risk, except for atypical antipsychotics in patients with schizophrenia and typical antipsychotics in patients with dementia. The mortality risk was linked with the use of typical antipsychotics and the dose used.

Chemical components of Fu brick tea and its potential preventive effects on metabolic syndrome

As living standards advance, an escalating emphasis is placed on health, particularly in relation to prevalent chronic metabolic disorders. It is necessary to explore safe and effective functional foods or drugs. Fu brick tea (FBT) is a kind of dark tea fermented by fungi. The extracts are rich in compounds that can effectively relieve metabolic diseases such as hyperglycemia and hyperlipidemia, protect the liver, improve human immunity, enhance antioxidant activity, and regulate intestinal flora. This paper summarizes the biological activities and mechanisms of the extracts, polysaccharides, and small molecular compounds of FBT, which provides a certain theoretical basis for the rational, systematic, comprehensive development and utilization of the FBT resources. It is expected to develop and apply these active substances in health care products and natural medicines and provide more beneficial and diversified FBT products for human beings.

Rehabilitation approach and results of using the biofeedback method (GIGER MD device) in children with neurogenic bladder

Background

GIGER MD device applies a biofeedback method through stimulated coordinated rhythmic and dynamic movements of the trunk and extremities in an anti-gravity position, thus helping to regain lost motor functions.

Methods

In this article, the performance of the GIGER MD device was evaluated in 36 children with neurogenic bladder measuring gait speed, voiding bladder capacity, deviation from the age-adjusted bladder capacity (measured using the Koff scale), and urinary incontinence.

Results

Children using the GIGER MD device had an increase in voiding bladder capacity (33.79%, median volume increase of 50 ml) with a subsequent median decrease in median age-adjusted bladder capacity by 45.50% (median deviation before was 36% vs. 16% after treatment). The number of urinary incontinence episodes also reduced by 55.57% (7-3 episodes per day), and the 20-meter motor gait speed increased by 14.26% (from 23 to 19 s).

Conclusion

Children who follow the GIGER MD therapy regularly for a period of 6 months show that CNS functional damage can be significantly improved.

Differences and Clinical Significance of Serum 25-Hydroxyvitamin D3 and Vasohibin-1 (VASH-1) Levels in Patients with Diabetic Nephropathy and Different Renal Injuries

Objective

We investigate the relationship between the changes of serum 25-hydroxyvitamin D3 (25(OH)D3) and vasohibin-1 (VASH-1) and renal function injury in patients with type 2 diabetic nephropathy.

Methods

In this study, 143 patients with diabetic nephropathy (DN) were selected as DN group, and 80 patients with type 2 diabetes mellitus were selected as T2DM group. The serum 25 (OH) D3, VASH-1, blood glucose index, inflammation index and renal function index were compared between the two groups. According to the urinary microalbumin/creatinine ratio (UACR), the DN group was divided into microalbuminuria group (UACR range≥30.0mg/g and <300.0mg/g) and macroalbuminuria group (UACR≥300.0mg/g) for stratified comparison. The correlation between 25-hydroxyvitamin D3, VASH-1 and inflammation index and renal function index was analyzed by simple linear correlation analysis.

Results

The level of 25 (OH) D3 in DN group was significantly lower than that in T2DM group (P<0.05). The levels of VASH-1, CysC, BUN, Scr, 24h urine protein, serum CRP, TGF-β1, TNF-α and IL-6 in DN group were higher than those in T2DM group (P<0.05). The level of 25 (OH) D3 in DN patients with massive proteinuria was significantly lower than that in DN patients with microalbuminuria. The level of VASH-1 in DN patients with massive proteinuria was higher than that in DN patients with microalbuminuria (P<0.05). There was a negative correlation between 25 (OH) D3 and CysC, BUN, Scr, 24h urine protein, CRP, TGF-β1, TNF-α, IL-6 in patients with DN (P<0.05). VASH-1 was positively correlated with Scr, 24h urinary protein, CRP, TGF-β1, TNF-α and IL-6 in patients with DN (P<0.05).

Conclusion

The level of serum 25 (OH) D3 in DN patients was considerably decreased, and the level of VASH-1 was increased, which was related to the degree of renal function injury and inflammatory response.