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Causal relationship between feelings and cognitive decline:An univariable and multivariable Mendelian randomization study

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World Journal of Psychiatry 2024年第3期14卷 421-433页

作者： Juan Liu Lin Liu yi-xin hu Jian-hua Li Xiao Zou Hao-Yun Zhang Li Fan Department of Cardiology The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China Department of Pulmonary and Critical Care Medicine The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China The Fourth Department of Geriatric Health Care The Second Medical Center&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China Department of Anesthesiology First Medical Center of Chinese PLA General HospitalBeijing 100853China

BACKGROUND While the impact of depression on cognition is well-documented,the relationship between feelings and cognition has received limited attention.AIM To explore the potential association between feelings and cognition with a twosample Mendelian randomization(MR)analysis.METHODS Our analysis utilized genome-wide association data on various feelings(fed-up feelings,n=453071;worrier/anxious feelings,n=450765;guilty feelings,n=45-0704;nervous feelings,n=450700;sensitivity/hurt feelings,n=449419;miserableness,n=454982;loneliness/isolation,n=455364;happiness,n=152348)in the European population and their impact on cognitive functions(intelligence,n=269867).Conducting a univariable MR(UVMR)analysis to assess the relationship between feelings and cognition.In this analysis,we applied the inverse variance weighting(IVW),weighted median,and MR Egger methods.Additionally,we performed sensitivity analysis(leave-one-out analysis),assessed heterogeneity(using MR-PRESSO and Cochran’s Q test),and conducted multiple validity test(employing MR-Egger regression).Subsequently,a multivariable MR(MVMR)analysis was employed to examine the impact of feelings on cognition.IVW served as the primary method in the multivariable analysis,complemented by median-based and MR-Egger methods.RESULTS In this study,UVMR indicated that sensitivity/hurt feelings may have a negative causal effect on cognition(OR=0.63,95%CI:0.43-0.92,P=0.017).After adjustment of other feelings using MVMR,a direct adverse causal effect on cognition was observed(OR_(MVMR)=0.39,95%CI:0.17-0.90,P_(MVMR)=0.027).While a potential increased risk of cognitive decline was observed for fed-up feelings in the UVMR analysis(ORUVMR=0.64,95%CI:0.42-0.97,PUVMR=0.037),this effect disappeared after adjusting for other feelings(OR_(MVMR)=1.42,95%CI:0.43-4.74,P_(MVMR)=0.569).These findings were generally consistent across MV-IVW,median-based,and MR-Egger analyses.MR-Egger regression revealed pleiotropy in the impact of worrier/anxious feelings on cognition,presenting a challenge in

关键词： Mendelian randomization analysis Feelings Cognition Intelligence

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High prevalence of aspirin resistance in elderly patients with cardiovascular disease and metabolic syndrome

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Journal of Geriatric Cardiology 2016年第6期13卷 531-536页

作者： Lin LIU ying-hui GAO Jian CAO hua-xin ZHANG Li FAN Guo-Liang hu yi-xin hu Xiao-Li LI Xiao ZOU Jian-hua LI Nanlou Respiratory Disease Department Chinese PLA General Hospital Beijing China Peking University Hepatology Institute Peking University People's Hospital Peking University Beijing China Nanlou Clinical Lab Chinese PLA General Hospital Beijing China Department of Clinical Laboratory of South Building Chinese PLA General Hospital Beijing China Clinical Department of South Building Chinese PLA General Hospital Beijing China

BackgroundMetabolic 症候群被知道是一个 prothrombotic 状态。我们拿了这研究检验阿司匹林抵抗可以与新陈代谢的症候群被联系的一个假设，并且与心血管的疾病(CVD ) 在病人估计阿司匹林抵抗的另外的潜在的决定因素有 CVD 的 469 个老... 详细信息

BackgroundMetabolic 症候群被知道是一个 prothrombotic 状态。我们拿了这研究检验阿司匹林抵抗可以与新陈代谢的症候群被联系的一个假设，并且与心血管的疾病(CVD ) 在病人估计阿司匹林抵抗的另外的潜在的决定因素有 CVD 的 469 个老病人全部的 .MethodsA 被招募。有新陈代谢的症候群的 172 个病人并且没有新陈代谢的症候群(控制组) ， 297 收到了每日的阿司匹林治疗(≥；75 mg ) 超过一个月。血小板聚集被轻传播 aggregometry (LTA ) 测量。阿司匹林抵抗被定义为 ≥；20% arachidonic 酸(AA )- 并且 ≥；70% 腺苷 diphosphate (自动数据处理) 根据 LTA 导致了聚集。阿司匹林半应答者被定义为遇见一个(然而并非) 这些 criteria.ResultsBy LTA， 469 中的 38 个(8.1%) 病人们是阿司匹林抵抗。阿司匹林抵抗的流行与控制组相比在新陈代谢的症候群组是更高的[11.6 % 对 6.6% ，机会比率(或)= 2.039；95% 信心间隔(CI ) ：1.047-3.973 ] 。在 multivariate 逻辑回归分析，新陈代谢的症候群(或 = 4.951， 95% CI：1.440-17.019， P = 0.011 ) 是为有 CVD 和新陈代谢的症候群的病人的重要数字是的阿司匹林 resistance.ConclusionsA 的一个重要风险因素对阿司匹林治疗抵抗。这可能进一步在这些病人增加心血管的病态和死亡的风险。

关键词：代谢综合征心血管疾病阿司匹林患者 logistic回归分析老年患病率二磷酸腺苷

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Prevalence of and risk factors for aspirin resistance in elderly patients with coronary artery disease

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Journal of Geriatric Cardiology 2013年第1期10卷 21-27页

作者： Xian-Feng Liu Jian Cao Li Fan Lin Liu Jian Li Guo-Liang hu yi-xin hu Xiao-Li Li First Geriatric Cardiology Division of South Building Chinese PLA General Hospital 28 Fuxing Road Beijing 100853 China

Objective To assess the prevalence of and related risk factors for aspirin resistance in elderly patients with coronary artery disease (CAD). Methods Two hundred and forty-six elderly patients (75.9 ±7.4 years) with CAD who received daily aspirin therapy (≥75 mg) over one month were recruited. The effect of aspirin was assessed using light transmission aggregometry (LTA) and thrombelastography platelet mapping assay (TEG). Aspirin resistance was defined as ≥20% arachidonic acid (AA)-induced aggregation and ≥70% adenosine diphosphate (ADP)-induced aggregation in the LTA assay. An aspirin semi-responder was defined as meeting one (but not both) of the criteria described above. Based on the results of TEG, aspirin resistance was defined as ≥50% aggregation induced by AA. Results As determined by LTA, 23 (9.3%) of the elderly CAD patients were resistant to aspirin therapy; 91 (37.0%) were semi-responders. As determined by TEG, 61 patients (24.8%) were aspirin resistant. Of the 61 patients who were aspirin resistant by TEG, 19 were aspirin resistant according to LTA results. Twenty-four of 91 semi-responders by LTA were aspirin resistant by TEG. Multivariate logistic regression analysis revealed that elevated fasting serum glucose level (Odds ratio: 1.517; 95% CI: 1.176–1.957; P = 0.001) was a significant risk factor for aspirin resistance as determined by TEG. Conclusions A significant number of elderly patients with CAD are resistant to aspirin therapy. Fasting blood glucose level is closely associatedwith aspirin resistance in elderlyCAD patients.

关键词： Aspirin resistance Coronary artery disease Risk factors

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Establishing a predictive model for aspirin resistance in elderly Chinese patients with chronic cardiovascular disease

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Journal of Geriatric Cardiology 2016年第5期13卷 458-464页

作者： Jian CAO Wei-Jun HAO Ling-Gen GAO Tian-Meng CHEN Lin LIU Yu-Fa SUN Guo-Liang hu yi-xin hu Li FAN Department of Geriatric Cardiology Chinese PLA General Hospital Beijing China Health Division of Guard Bureau General Staff Department of Chinese PLA Beijing China

BACKGROUND:Resistance to anti-platelet therapy is detrimental to patients. Our aim was to establish a predictive model for aspirin resistance to identify high-risk patients and to propose appropriate intervention.;METHODS:Elderly patients (n = 1130) with stable chronic coronary heart disease who were taking aspirin (75 mg) for > 2 months were included. Details of their basic characteristics, laboratory test results, and medications were collected. Logistic regression analysis was performed to establish a predictive model for aspirin resistance. Risk score was finally established according to coefficient B and type of variables in logistic regression. The Hosmer-Lemeshow (HL) test and receiver operating characteristic curves were performed to respectively test the calibration and discrimination of the model.;RESULTS:Seven risk factors were included in our risk score. They were serum creatinine (> 110 μmol/L, score of 1); fasting blood glucose (> 7.0 mmol/L, score of 1); hyperlipidemia (score of 1); number of coronary arteries (2 branches, score of 2; ≥ 3 branches, score of 4); body mass index (20-25 kg/m(2), score of 2; > 25 kg/m(2), score of 4); percutaneous coronary intervention (score of 2); and smoking (score of 3). The HL test showed P ≥ 0.05 and area under the receiver operating characteristic curve ≥ 0.70.;CONCLUSIONS:We explored and quantified the risk factors for aspirin resistance. Our predictive model showed good calibration and discriminative power and therefore a good foundation for the further study of patients undergoing anti-platelet therapy.

关键词：阿司匹林预测模型心血管疾病患者慢性老年实验室测试介入治疗

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Prevalence of and risk factors for postprandial hypotension in older Chinese men

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Journal of Geriatric Cardiology 2015年第6期12卷 600-604页

作者： Xiao ZOU Jian CAO Jian-hua LI yi-xin hu Yu-Song GUO Quan-Jin SI Li FAN Geriatric Cardiology Department Chinese PLA General Hospital Beijing China Department of Health Care in Nanlou Chinese PLA General Hospital Beijing China Healthcare Department Hainan Branch of Chinese PLA General Hospital Sanya Hainan China

ObjectiveTo 估计流行并且冒险因素因为在旧、很旧的中国 men.MethodsThe 学习之中的饭后的低血压(PPH ) 65 包括了 349 个中国人并且更旧，组织了进二个年龄范畴：组 1 (旧) 65 ～ 80 年包括了 163 个人；组 2 (很旧) 超过 80 年包括了... 详细信息

ObjectiveTo 估计流行并且冒险因素因为在旧、很旧的中国 men.MethodsThe 学习之中的饭后的低血压(PPH ) 65 包括了 349 个中国人并且更旧，组织了进二个年龄范畴：组 1 (旧) 65 ～ 80 年包括了 163 个人；组 2 (很旧) 超过 80 年包括了 186 个人。在饭以后的血压变化被估计由监视的回廊血压的每 15 min。在饭摄取以后并且在相对血压变化处于基线条件站起来和变化以后的症状连续地被观察。另外的基线数据包括了身体团索引，病历，和 PPH 的药 use.ResultsThe 流行总的来说是 59.3% 并且比组织 1 在组 2 是显著地更高的(63.4% 对 54.6% ， P <；0.05 ) 。在组 2，在早餐(33.8%) 和午餐(32.1%) 以后的 PPH 的流行在晚饭(20.9%) 以后比那高， P <；0.05。高血压和年龄是为 PPH 的重要风险因素(或 = 2.188， 95% CI：1.134 −； 4.223， P = 0.02；或 = 1.86， 95% CI：1.112 −； 3.11， P = 0.018，分别地) 。相反， acarbose 使用对 PPH 是保护的(或 = 0.4， 95% CI：0.189 −； 0.847， P = 0.017 ) 。在血压的减少在 PPH 期间是 20 −； 40 mmHg 和最大值是 90 mmHg。 PPH 通常发生在 30 − ；在饭以后的 60 min 并且持续了 30 − ； 120 min.ConclusionsThese 调查结果证明在超过 80 年的人的 PPH 的流行比在 65～80 年的人的那些显著地高，并且血压衰落为超过 80 年的人也是更高的。另外，高血压和年龄是为在老人的 PPH 的主要风险因素，它建议那阻止并且对待的 PPH 是值得的。

关键词：危险因素低血压患病率老年人男性毫米汞柱体重指数可信区间

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No association between low-dose reserpine use and depression in older hypertensive patient: result of a multicenter, cross-sectional study

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Journal of Geriatric Cardiology 2019年第8期16卷 608-613页

作者： Guo-hua Zhu Xi-Peng SUN Jing LI Lin PI Hai-Qin TANG Hai-Qing GAO Hong-Liang CONG Peng QU xin-Zheng LU xin-Jun ZHANG Luo-Sha ZHAO yi-Fang GUO Dong-Xia LIU Liang-Qing ZHANG hua TANG yi-xin hu Li FAN Qi huA Department of Cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Department of Geriatrics Hebei General HospitalShijiazhuangChina Department of Cardiology Hebei General HospitalShijiazhuangChina Department of Cardiology Shanxi Cardiovascular HospitalXianChina Department of Geriatrics Chinese PLA General HospitalBeijingChina Department of Cardiology Chuiyangliu Hospital affiliated to Tsinghua UniversityBeijingChina Department of Cardiology the First Affiliated Hospital of Anhui Medical UniversityHefeiChina Department of Cadre Health Care Qilu Hospital of Shandong UniversityJinanChina Department of Cardiology Tianjin Chest HospitalTianjinChina Department of Cardiology the Second Hospital of Dalian Medical UniversityDalianChina Department of Cardiology Jiangsu Provincial HospitalNanjingChina Department of Geriatrics West China HospitalSichuan UniversityChengduChina Department of Cardiology the First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

Background Reserpine is currently used by millions of Chinese hypertensive patients, in spite of the continued concern of its depressogenic effect, even when used in low dose. This study aimed to investigate the association between low-dose reserpine use and depression in older Chinese hypertensive patient. Methods In this cross-sectional, case-control study, we recruited patient aged 60 years or over who had regularly taken one or two tables of “compound reserpine and triamterene tablets (CRTTs)” for more than one year (reserpine user) from 26 community health centers located in 10 provinces in China. For each patient who took CRTTs, we selected an age (within five years) and sex matched hypertensive patient who had never taken any drugs containing reserpine (non-reserpine user) as control. Depressive symptoms were evaluated using a Chinese depression scale adapted from the Zung Self-Rating Depression Scale. Demographic, clinical data and laboratory examination results within six months were collected. Results From August 2018 to December 2018, 787 reserpine user and 787 non-reserpine user were recruited. The mean age of all study subjects was 70.3 years, with about equal numbers of males and females. The mean depression score was 40.4 in reserpine users and 40.6 in non-reserpine users (P = 0.7). The majority of study subject had a depression score < 53 (87.6% in reserpine users and 88.2% in non-reserpine users, respectively). There were no significant differences in the prevalence of mild, moderate or severe depression in reserpine users and non-reserpine users. Conclusions There is no association between low-dose reserpine use and depression in older hypertensive patient. The role of reserpine in the treatment and control of hypertension should be reconsidered;and further studies, especially randomized, controlled clinical trials to compare efficacy and safety of reserpine and other widely recommended anti-hypertensive agents are needed.

关键词： Depression Hypertension Reserpine

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Chinese expert consensus on the management of hypertension in the very elderly

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Journal of Geriatric Cardiology 2016年第12期13卷 945-953页

作者： Jing LI yi-xin hu Wen WANG Ning-Yuan FANG xin-Zheng LU Lin PI Mei-Lin LIU Wei-Min LI Yan-Fang LI Peng QU Qi huA Qing HE Hai-ying WU Yuan-Ming ZHANG Xiao-Ping CHEN Lu-Yuan CHEN Li FAN xing-Sheng ZHAO Zhi-Ming Zhu yi-Nong JIANG yi-Fang GUO Hong YUAN Ping-Jin GAO xin-Juan XU Jun CAI Liang-Di XIE Xuan Wu Hospital Capital Medical University Beijing China Chinese PLA General Hospital Beijing China Chinese Academy of Medical Science Fuwai Hospital Beijing China Renji Hospital Medical College of Shanghai Jiao Tong University ShanghaL China Jiang Su Province People's Hospital Jiangsu China Beijing Chui Yang Liu Hospital Beijing China Peking University First Hospital Beijing China First Affiliated Hospital of Harbin Medical University Heilongjiang China Beijing An Zhen Hospital Capital Medical University Beijing China The Second Affiliated Hospital of Dalian Medical University Liaoning China Beijing Hospital Beijing China The First Hospital of xinjiang Medical University Xinjiang Uygur Autonomous Region China West China Hospital Sichuan University Sichuan China The People's Hospital of Guangdong Province Guangdong China Inner Mongolia Autonomous Region People's Hospital Inner Mongolia Autonomous Region China Daping Hospital the Third Military Medical University Chongqing China The First Affiliated Hospital of Dalian Medical University Liaoning China Hebei Province People's Hospital Hebei China Xiangya Third Hospital Central South University Hunan China Shanghai Hypertension Research Institute Shanghai China The First Hospital of Fujian Medical University Fujian China

Population aging has become a major challenge for the healthcare in China. More than 23 million Chinese are currently > 80 years,with an annual increase of 5%. The Chinese population of 80 years or older is expected t... 详细信息

关键词：一致衰老老人高血压 Octogenarians

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Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 877-882页

作者： ying Gao Rong-xin Lu Yun Tang xin-yi Yang hu Meng Chang-Lin Zhao yi-Lu Chen Feng Yan Qian Cao Department of Ophthalmology Sir Run Run HospitalNanjing Medical UniversityNanjing 211112Jiangsu ProvinceChina Department of Ophthalmology Affiliated Jinling HospitalMedical School of Nanjing UniversityNanjing 210002Jiangsu ProvinceChina Department of Thoracic Surgery the First Affiliated Hospital with Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina Medical School Nanjing UniversityNanjing 210093Jiangsu ProvinceChina Department of Ophthalmology Taikang Xianlin Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210046Jiangsu ProvinceChina

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

关键词： diabetic retinopathy neutrophil-tolymphocyte ratio platelet-to-lymphocyte ratio systemic immune-inflammation index

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Coexistence of liver abscess, hepatic cystic echinococcosis and hepatocellular carcinoma: A case report

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World Journal of Clinical Cases 2024年第14期12卷 2404-2411页

作者： Ya-Wen hu yi-Lin Zhao Jing-xin Yan Cun-Kai Ma Department of Interventional Therapy The Affiliated Hospital of Qinghai UniversityXining 810000Qinghai ProvinceChina West China Hospital Sichuan UniversityChengdu 610000Sichuan ProvinceChina

BACKGROUND human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The coexistence of CE and HCC is exceedingly rare,and only several well-documented cases have been reported.In addition to this coexistence,there is no report of the coexistence of CE,HCC,and liver abscess to date.Herein,we aimed to report a case of coexistence of liver abscess,hepatic CE,and HCC.CASE SUMMARY A 65-year-old herdsman presented to the department of interventional therapy with jaundice,right upper abdominal distension and pain for 10 d.Laboratory test showed that he had positive results for HBsAg,HBeAb,HBcAb,and echino-coccosis IgG antibody.The test also showed an increased level of alpha fetopro-tein of 3400 ng/mL.An abdominal computed tomography(CT)scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver.In addition,CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images,the diagnoses of hepatic CE(CE4 subtype)and HCC were established.Initially,transarterial chemoembolization was performed for HCC.In the follow-up,liver abscess occurred in addition to CE and HCC;thus,percutaneous liver puncture drainage was performed.In the next follow-up,CE and HCC were stable.The liver abscess was completely resolved,and the patient was discharged with no evidence of recurrence.CONCLUSION This is the first reported case on the coexistence of liver abscess,hepatic CE,and HCC.Individualized treatment and multidisciplinary discussions should be performed in this setting.Therefore,treatment and diagnosis should be based on the characteristics of liver abscess,hepatic CE,and HCC,and in future clinical work,it is necessary to be aware of the possibility of this complex composition of liver diseases.

关键词： Cystic echinococcosis Hepatocellular carcinoma Liver abscess Multidisciplinary discussions Case report

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Ethanol extract of Abelmoschus manihot suppresses endoplasmic reticulum stress in contrast-induced nephropathy

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Asian Pacific Journal of Tropical Biomedicine 2024年第1期14卷 17-27,I0002,I0003页

作者： xin Lin xin Lu Yun-He Zhao yi-Bei Wang Ru-Ge Niu Xiao-hu Chen Department of Cardiology Affiliated Hospital of Nanjing University of Chinese MedicineJiangsu Province Hospital of Chinese MedicineNanjingJiangsu 210004China

Objective:To explore the efficacy and potential mechanisms of the ethanol extract of Abelmoschus manihot(L.)Medic in contrast-induced nephropathy(CIN).Methods:CIN rat models and human renal proximal tubular cells(HK-2)with iopromide-induced injury were employed to mimic CIN conditions.The effect of Abelmoschus manihot extract on the rat models and HK-2 cells was evaluated.In rat models,kidney function,histology,oxidative stress and apoptosis were determined.In HK-2 cells,cell viability,apoptosis,mitochondrial membrane potential,and endoplasmic reticulum stress were assessed.Results:Abelmoschus manihot extract significantly improved structural and functional impairments in the kidneys of CIN rats.Additionally,the extract effectively mitigated the decline in cellular viability and reduced iopromide-induced oxidative stress and lipid peroxidation.Mechanistic investigations revealed that Abelmoschus manihot extract prominently attenuated acute endoplasmic reticulum stress-mediated apoptosis by downregulating GRP78 and CHOP protein levels.Conclusions:Abelmoschus manihot extract can be used as a promising therapeutic and preventive agent in the treatment of CIN.

关键词： Contrast-induced nephropathy Abelmoschus manihot extract ER stress Apoptosis GRP78 CHOP

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