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Hu Z, Wu T, Zhou Z, Zhang Y, Chen Q, Yao H, Ji M, Shen G, Dong C, Shi C, Huang Z, Jiang N, Han N, Tian X. Asiaticoside Attenuates Blood-Spinal Cord Barrier Disruption by Inhibiting Endoplasmic Reticulum Stress in Pericytes After Spinal Cord Injury. Mol Neurobiol 2024; 61:678-692. [PMID: 37653222 DOI: 10.1007/s12035-023-03605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
The blood-spinal cord barrier (BSCB) plays a vital role in the recovery of spinal cord function after spinal cord injury (SCI). Pericytes, pluripotent members of the neurovascular unit (NVU), receive signals from neighboring cells and are critical for maintaining CNS function. Therapeutic targets for the BSCB include endothelial cells (ECs) and glial cells, but few drugs target pericytes. This study was designed to explore whether asiaticoside has a positively effect on pericytes and the integrity of the BSCB. In this study, we found that asiaticoside could inhibit the loss of junction proteins just 1 day after SCI in vivo, but our in vitro study showed no significant differences in the expression of endothelial junction proteins between the control and asiaticoside treatment groups. We also found that asiaticoside could inhibit endoplasmic reticulum (ER) stress and pericyte apoptosis, which might be associated with the inhibition of junction protein reduction in ECs. Thus, we investigated the interactions between pericytes and ECs. Our results showed that asiaticoside could decrease the release of matrix metalloproteinase (MMP)-9 in pericytes and therefore upregulate the expression of junction proteins in ECs. Furthermore, the protective effect of asiaticoside on pericytes is related to the inhibition of ER stress via the MAPK signaling pathway. Taken together, our results demonstrate that asiaticoside treatment inhibits BSCB disruption and enhances functional recovery after SCI.
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Affiliation(s)
- Zhenxin Hu
- Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Tingting Wu
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ziheng Zhou
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yu Zhang
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, 315302, China
| | - Qiyue Chen
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Hanbing Yao
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Mengchu Ji
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ge Shen
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Chenling Dong
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Chengge Shi
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Zhixian Huang
- The First Clinical Medical College, Wenzhou Medical University, Wenzhou, 325035, China
| | - Nizhou Jiang
- Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Nan Han
- Department of Ultrasonography, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
| | - Xiliang Tian
- Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Wang M, Sun Z, Ou Y, Ge W, Yuan M, Xu B. Electroacupuncture Mediates Fat Metabolism and Autophagy via a Sirt3-Dependent Mechanism in Mice Fed High-Fat Diet. Adv Biol (Weinh) 2024; 8:e2300370. [PMID: 37840428 DOI: 10.1002/adbi.202300370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/02/2023] [Indexed: 10/17/2023]
Abstract
This study investigates the therapeutic potential of electroacupuncture (EA) on obesity, focusing on its influence on autophagy and energy metabolism, utilizing a high-fat diet (HFD)-induced mouse model. Treatment with EA significantly reduces body weight, fat deposition, and lipid accumulation in HFD-fed mice. Additionally, EA effectively ameliorates metabolic imbalances, reducing blood glucose levels and plasma markers of liver function. At the molecular level, EA enhances the expression of thermogenesis-associated genes in brown adipose tissue and decreases p53 expression, suggesting a decrease in apoptosis. Autophagy in white adipose tissue is inhibited by EA, as demonstrated by the suppression of key autophagy-related proteins. Further experiments highlight the critical role of Sirtuin 3 (Sirt3) in EA's anti-obesity effects. Sirt3 supplementation combined with EA results in reduced body weight, fat deposition, and lipid accumulation, along with modulations in key metabolic indicators. Moreover, EA's modulatory effect on uncoupling protein 1 (Ucp1), Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (Pgc-1α), and p53 is found to be Sirt3 dependent. In conclusion, EA exerts beneficial effects against obesity through Sirt3-dependent modulation of autophagy and energy metabolism, indicating a potential therapeutic approach for obesity and related metabolic disorders.
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Affiliation(s)
- Ming Wang
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
- Department of Acupuncture and Massage, Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210024, China
| | - Zhicheng Sun
- Department of Acupuncture and Massage, Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210024, China
| | - Yanggang Ou
- Department of Acupuncture and Massage, Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210024, China
| | - Wei Ge
- Department of Acupuncture and Massage, Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210024, China
| | - Mengqian Yuan
- Department of Acupuncture Rehabilitation, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, Jiangsu, 210024, China
| | - Bin Xu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
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Xu C, Xia L, Xu D, Liu Y, Jin P, Zhai M, Mao Y, Wang Y, Wen A, Yang J, Yang L. Cardioprotective effects of asiaticoside against diabetic cardiomyopathy: Activation of the AMPK/Nrf2 pathway. J Cell Mol Med 2024; 28:e18055. [PMID: 38113341 PMCID: PMC10826442 DOI: 10.1111/jcmm.18055] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023] Open
Abstract
Diabetic cardiomyopathy (DCM) is a chronic microvascular complication of diabetes that is generally defined as ventricular dysfunction occurring in patients with diabetes and unrelated to known causes. Several mechanisms have been proposed to contribute to the occurrence and persistence of DCM, in which oxidative stress and autophagy play a non-negligible role. Diabetic cardiomyopathy is involved in a variety of physiological and pathological processes. The 5' adenosine monophosphate-activated protein kinase/nuclear factor-erythroid 2-related factor 2 (AMPK/Nrf2) are expressed in the heart, and studies have shown that asiaticoside (ASI) and activated AMPK/Nrf2 have a protective effect on the myocardium. However, the roles of ASI and AMPK/Nrf2 in DCM are unknown. The intraperitoneal injection of streptozotocin (STZ) and high-fat feed were used to establish the DCM models in 100 C57/BL mice. Asiaticoside and inhibitors of AMPK/Nrf2 were used for intervention. Cardiac function, oxidative stress, and autophagy were measured in mice. DCM mice displayed increased levels of oxidative stress while autophagy levels declined. In addition, AMPK/Nrf2 was activated in DCM mice with ASI intervention. Further, we discovered that AMPK/Nrf2 inhibition blocked the protective effect of ASI by compound C and treatment with ML-385. The present study demonstrates that ASI exerts a protective effect against DCM via the potential activation of the AMPK/Nrf2 pathway. Asiaticoside is a potential therapeutic target for DCM.
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Affiliation(s)
- Chennian Xu
- Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine, Department of Pharmacology, School of PharmacyAir Force Medical UniversityXi'anShaanxiChina
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
- Department of Cardiovascular SurgeryGeneral Hospital of Northern Theatre CommandShenyangLiaoningChina
| | - Lin Xia
- Department of Cardiovascular SurgeryGeneral Hospital of Northern Theatre CommandShenyangLiaoningChina
| | - Dengyue Xu
- Department of Cardiovascular SurgeryGeneral Hospital of Northern Theatre CommandShenyangLiaoningChina
- School of Biomedical Engineering, Faculty of MedicineDalian University of TechnologyDalianChina
| | - Yang Liu
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
| | - Ping Jin
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
| | - Mengen Zhai
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
| | - Yu Mao
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
| | - Yiwei Wang
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
| | - Anguo Wen
- Department of Cardiothoracic SurgeryThe 79th Group Military Hospital of the Chinese People's Liberation ArmyLiaoyangLiaoning ProvinceChina
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing HospitalAir Force Medical UniversityXi'anShaanxiChina
| | - Lifang Yang
- Department of AnesthesiologyXi'an Children's HospitalXi'anShaanxiChina
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Fu Q, Wang P, Zhang Y, Wu T, Huang J, Song Z. Effects of Dietary Inclusion of Asiaticoside on Growth Performance, Lipid Metabolism, and Gut Microbiota in Yellow-Feathered Chickens. Animals (Basel) 2023; 13:2653. [PMID: 37627444 PMCID: PMC10451259 DOI: 10.3390/ani13162653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Excessive abdominal fat deposition in chickens is a major concern in the poultry industry. Nutritional interventions are a potential solution, but current options are limited. Asiaticoside (Asi), a herbal extract, has shown positive effects in animals, but its impact on poultry lipid metabolism is still unknown. In this study, the effects of dietary Asi on yellow-feathered chicken lipid metabolism and its potential mechanisms were investigated. A total of 120 chickens were randomly divided into three groups, with five replicates per group and 8 chickens per replicate. The chickens were fed a basal diet supplemented with 0, 0.01, or 0.05% Asi for 6 wk. The results showed that Asi down-regulated lipogenic gene expression and up-regulated lipid-breakdown-related genes in both the liver and fat tissues of the chickens, which resulted in a half reduction in abdominal fat while not affecting meat yield. Mechanistically, the hepatic and adipose PI3K/AKT pathway may be involved in Asi-induced fat loss in chickens as revealed by computer-aided reverse drug target prediction and gene expression analysis. Moreover, Asi ingestion also significantly modified the cecal microbiota of the chickens, resulting in a reduced Firmicutes to Bacteroidetes ratio and decreased abundance of bacteria positively correlated with abdominal fat deposition such as Ruminococcus, while increasing the abundance of bacteria inversely correlated with abdominal fat deposition such as Lactobacillus, Bacteroides, and Blautia. Collectively, these data suggest that Asi could ameliorate the abdominal fat deposition in yellow-feathered chickens, probably through modulating the PI3K/AKT pathway and gut microbiota function.
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Affiliation(s)
| | | | | | | | | | - Ziyi Song
- Guangxi Key Laboratory of Animal Breeding, Disease Control and Prevention, College of Animal Science and Technology, Guangxi University, Nanning 530004, China; (Q.F.); (P.W.); (Y.Z.); (T.W.); (J.H.)
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Wu X, Ma Y, Li X, He N, Zhang T, Liu F, Feng H, Dong J. Molecular mechanism of kidney damage caused by abamectin in carp: Oxidative stress, inflammation, mitochondrial damage, and apoptosis. Toxicology 2023; 494:153599. [PMID: 37499778 DOI: 10.1016/j.tox.2023.153599] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
Indiscriminate use of pesticides not only leads to environmental pollution problems, but also causes poisoning of non-target organisms. Abamectin (ABM), a widely used insecticide worldwide, is of wide concern due to its persistence in the environment and its high toxicity to fish. The kidney, as a key organ for detoxification, is more susceptible to the effects of ABM. Unfortunately, few studies investigated the mechanisms behind this connection. In this study, carp was used as an indicator organism for toxicological studies to investigate renal damage caused by ABM residues in carp. In this work, carp were exposed to ABM (0, 3.005, and 12.02 μg/L) for 4 d and the nephrotoxicity was assessed. Histopathological findings revealed that ABM exposure induced kidney damage in carp, as well as an increase Creatinine and BUN levels. Meanwhile, ABM as a reactive oxygen species (ROS) stimulator, boosted ROS bursts and lowered antioxidant enzyme activity while activating the body's antioxidant system, the Nrf2-Keap1 signaling pathway. The accumulation of ROS can also lead to the imbalance of the body's oxidation system, leading to oxidative stress. At the same time, NF-κB signaling pathway associated with inflammation was activated, which regulated expression levels of inflammatory cytokines (TNF-α, IL-6, IL-1β, and iNOS increased, while IL-10 and TGF-β1 decreased). In addition, ABM exposure caused structural damage to kidney mitochondria of carp, resulting in decreased mitochondrial membrane potential and ATP production capacity, and mediated apoptosis through endogenous pathways Bax/Bcl-2/Caspase-9/Caspase-3. In conclusion, ABM caused kidney damage in carp by inducing oxidative stress, inflammation, and apoptosis through mitochondrial pathway. These findings will be useful for future research into molecular mechanisms of ABM-induced nephrotoxicity in aquatic organisms.
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Affiliation(s)
- Xinyu Wu
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Yeyun Ma
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Xueqing Li
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Nana He
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Tianmeng Zhang
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Feixue Liu
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Huimiao Feng
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China
| | - Jingquan Dong
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Key Laboratory of Marine Pharmaceutical Compound Screening, School of Pharmacy, Jiangsu Ocean University, Lianyungang 222005, China.
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He Z, Hu Y, Niu Z, Zhong K, Liu T, Yang M, Ji L, Hu W. A review of pharmacokinetic and pharmacological properties of asiaticoside, a major active constituent of Centella asiatica (L.) Urb. JOURNAL OF ETHNOPHARMACOLOGY 2023; 302:115865. [PMID: 36306932 DOI: 10.1016/j.jep.2022.115865] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Centella asiatica (L.) Urb., a potential medicinal plant, is widely used in orient traditional medicine. Its major active constituents include asiaticoside (AS), madecassoside (MS), asiatic acid and madecassic acid. Thereinto, AS is a pentacyclic triterpenoid saponin with a variety of pharmacological effects including antitumor, neuroprotective and wound healing effects. AIM OF THE STUDY In this review, we summarize the pharmacokinetics, safety and pharmacological properties of AS. MATERIALS AND METHODS We gathered information about AS from articles published up to 2022 and listed in Google scholar, PubMed, Web of Science, Elsevier, and similar databases. The keywords used in our search included "asiaticoside", "Centella asiatica", "pharmacokinetics", "nerve", "cancer", "skin", etc. RESULTS: AS appeared to degrade through a first-order reaction and had low biotoxicity. However, the pharmacokinetic properties of AS differed according to species. AS is highly blood-brain-barrier permeable without any harmful side effect. It has a variety of pharmacological effects including anti-neural inflammation and anti-cancer properties, as well as protective properties for the skin, cardiovascular system, and pulmonary system. CONCLUSION This review comprehensively summarized current information regarding the pharmacokinetic and pharmacological properties of AS, and supported the pharmaceutical value of this compound. Future research should focus on improving bioavailability of AS and conducting clinical assessment.
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Affiliation(s)
- Ziliang He
- School of Chemistry and Life Sciences, Suzhou University of Science and Technology, Suzhou, China; School of Life Sciences, Huaiyin Normal University, Huaian, 223300, China.
| | - Yeye Hu
- School of Life Sciences, Huaiyin Normal University, Huaian, 223300, China.
| | - Zhiqiang Niu
- School of Life Sciences, Huaiyin Normal University, Huaian, 223300, China.
| | - Kang Zhong
- School of Life Sciences, Huaiyin Normal University, Huaian, 223300, China.
| | - Tingwu Liu
- School of Life Sciences, Huaiyin Normal University, Huaian, 223300, China.
| | - Meng Yang
- Jiangsu Food and Pharmaceutical Science College, Huaian, 223300, China.
| | - Lilian Ji
- School of Chemistry and Life Sciences, Suzhou University of Science and Technology, Suzhou, China.
| | - Weicheng Hu
- School of Life Sciences, Huaiyin Normal University, Huaian, 223300, China.
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Yao M, Wang J, Zhang J, Guo Y, Ni Z, Jia X, Feng H. Asiaticoside attenuates oxygen-glucose deprivation/reoxygenation-caused injury of cardiomyocytes by inhibiting autophagy. J Appl Toxicol 2022; 43:789-798. [PMID: 36523111 DOI: 10.1002/jat.4424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Asiaticoside is a natural triterpene compound derived from Centella asiatica, possessing confirmed cardioprotective property. However, the roles of asiaticoside in regulating oxygen-glucose deprivation/reoxygenation (OGD/R)-caused cardiomyocyte dysfunction remain largely obscure. Human cardiomyocyte AC16 cells were stimulated with OGD/R to mimic myocardial ischemia/reperfusion injury and treated with asiaticoside. Cytotoxicity was investigated by CCK-8 assay and lactate dehydrogenase (LDH) release analysis. Autophagy- and Wnt/β-catenin signaling-related protein levels were measured via western blotting. Asiaticoside (0-20 μM) did not induce cardiomyocyte cytotoxicity. Asiaticoside (20 μM) mitigated OGD/R-induced autophagy, cytotoxicity, oxidative stress, and myocardial injury. Rapamycin, an autophagy inductor, reversed the influences of asiaticoside on autophagy, cytotoxicity, oxidative stress, and myocardial injury, whereas 3-methyadanine, an autophagy inhibitor, played an opposite effect. Asiaticoside (20 μM) attenuated OGD/R-induced Wnt/β-catenin signaling inactivation, which was reversed after transfection with si-β-catenin. Transfection with si-β-catenin attenuated the influences of asiaticoside on autophagy, cytotoxicity, oxidative stress, and myocardial injury. In conclusion, asiaticoside protected against OGD/R-induced cardiomyocyte cytotoxicity, oxidative stress, and myocardial injury via blunting autophagy through activating the Wnt/β-catenin signaling, indicating the therapeutic potential of asiaticoside in myocardial ischemia/reperfusion injury.
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Affiliation(s)
- Mingyan Yao
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China.,Department of Endocrinology, Baoding No.1 Central Hospital, Baoding, China
| | - Jie Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jing Zhang
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
| | - Yifang Guo
- Cardiology Division in Geriatric Institute, Hebei Provincial People's Hospital, Shijiazhuang, China
| | - Zhiyu Ni
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
| | - Xinwei Jia
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
| | - Huiping Feng
- Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China
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