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  • Jia-ni JIN, Hong-mei WU, Bin WANG, Sheng-qing HE, Ai-mei LONG, Xia-ming PAN, Wan-rui MENG, Li-ping DENG
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3014-3018.
    Objective

    To observe the clinical efficacy and safety of insulin degludec and liraglutide combination with metformin tablets in the treatment of type 2 diabetes mellitus (T2DM) patients with poorly controlled insulin and oral hypoglycemic drugs.

    Methods

    The T2DM patients with poor control of insulin and oral hypoglycemic drugs were randomly divided into control group and treatment group according to the queue method. Both groups of patients received metformin tablets for basic treatment. On this basis, the control group was given premixed insulin aspartic 30 injection multiple times a day for treatment. The initial injection dose was 0.2-0.4 U·kg-1·d-1, twice a day, adjusted according to the blood glucose level, once every 3-5 days, with an increase or decrease of 1-4 U each time. The treatment group was treated with insulin degludec and liraglutide injection. The initial injection was 10 to 16 dose units, administered subcutaneously once a day. The dose was adjusted every 1 to 2 weeks based on the blood glucose level, with an increase or decrease of 2 to 4 dose units each time. Both groups of patients were treated for 3 months. The clinical efficacy, blood glucose level, lipid metabolism level, pancreatic islet function and safety of the two groups of patients were compared.

    Results

    A total of 40 cases in the control group and 40 cases in the treatment group were enrolled. After treatment, the total effective rates of the treatment group and the control group were 97.50% (39 cases/40 cases) and 80.00% (32 cases/40 cases), the difference was statistically significant (P<0.05). After 3 months of treatment, the glycosylated hemoglobin levels of the treatment group and the control group were (6.14±1.03)% and (7.20±1.08)%, respectively; the fasting blood glucose levels were (6.25±1.34) and (7.82±1.26) mmol·L-1, respectively; the 2 h postprandial blood glucose levels were (6.37±0.64) and (7.15±0.67) mmol·L-1, respectively; the triglyceride levels were (1.87±0.62) and (2.64±0.79) mmol·L-1, respectively; the serum total cholesterol levels were (4.53±0.62) and (5.18±0.76) mmol·L-1, respectively; and the fasting insulin levels were (7.16±0.71) and (8.56±0.94) μmol·L-1, respectively; islet β cell function index levels were (58.36±5.87)% and (50.72±6.14)%, respectively; while insulin resistance index levels were 1.52±0.44 and 2.09±0.47, respectively, the differences were statistically significant between the two groups (all P<0.05). The main adverse drug reactions in the treatment group were gastrointestinal reactions, dizziness, increased heart rate and hypoglycemia, while those in the control group were mainly gastrointestinal reactions, dizziness and hypoglycemia. The total incidences of adverse drug reactions in the treatment group and the control group were 15.00% and 12.50%, respectively, and there was no statistically significant difference (P>0.05).

    Conclusion

    Insulin degludec and liraglutide injection has shown significant clinical efficacy in the treatment of T2DM with poor control of insulin and oral hypoglycemic drugs. It can effectively control patients’ blood glucose and lipid metabolism levels, improve pancreatic function, and has good safety.

  • Yu LIU, Lin-mei JI, Wan-sheng ZHU, Chang-lian LI, Qiao-ling JIN
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3019-3024.
    Objective

    To observe the clinical efficacy and safety of nafurafine tablets in patients with pruritus due to uremia in China.

    Methods

    Patients diagnosed with pruritus due to uremia in the Hemodialysis Center of the Second People’s Hospital of Neijiang City and West China Fourth Hospital of Sichuan University were divided into treatment group and control group by treatment region. Control group was given conventional treatment, while treatment group was treated with nafurafine tablets (2.5 μg, orally every night, once a day, for a course of 3 months) on the basis of control group. The clinical efficacy, 5-D pruritus scale score, calcium and phosphorus metabolism indicators, blood urea nitrogen (BUN), parathyroid hormone level (PTH), β 2-microglobulin (β2-MG), substance P (SP), interleukin-6 (IL-6), interleukin-31 (IL-31) and quality of life evaluation of the two groups were compared. And conducted a safety evaluation.

    Results

    A total of 120 patients were included, including 60 cases in control group and 60 cases in treatment group. After 3 months of treatment, the total effective rates of treatment group and control group were 95.00% (57 cases /60 cases) and 81.67% (49 cases /60 cases), respectively. The treatment group was significantly higher than control group (P<0.05). After 3 months of treatment, the 5-D pruritus scale scores of treatment and control group were (5.81±3.29) and (8.12±3.22) points, respectively; the scores of the dermatology life quality index (DLQI) scale were (24.56±2.87) and (21.23±2.45) points, respectively; the blood calcium levels were (2.43±0.43) and (2.65±0.37) mmol, respectively; the blood phosphorus levels were (1.34±0.26) and (1.50±0.31) mmol, respectively; the BUN levels were (17.76±3.87) and (19.86±4.25) μmol·L-1, respectively; the PTH levels were (322.45±76.54) and (356.12±87.65) pg·mL-1, respectively; the levels of β2-MG were (14.56±4.87) and (18.12±5.45) mg·L-1, respectively; the SP levels were (82.45±18.76) and (93.06±20.45) pg·mL-1, respectively; the levels of IL-6 were (7.56±2.47) and (10.12±2.45) pg·mL-1, respectively; the levels of IL-31 were (52.45±10.87) and (58.11±12.45) pg·mL-1, respectively. Compared with control group, the above indicators in treatment group showed statistically significant differences (all P<0.05). The main adverse drug reactions in treatment group were nausea in 3 cases, insomnia in 3 cases, dizziness in 1 case and constipation in 2 cases, while those in control group were nausea in 2 cases, insomnia in 1 case, dizziness in 2 cases and constipation in 2 cases. The total incidence of adverse drug reactions in treatment and control group were 15.00% and 11.66%, respectively, and there was no statistically significant difference (P>0.05).

    Conclusion

    Nafurafine tablets can significantly improve the symptoms of skin pruritus, calcium and phosphorus metabolism disorders, renal function and inflammatory response in Chinese patients with uremia, enhance the quality of life, and has good safety.

  • Qi-gang MA, Gui GAO, Le-ye BU, Guang-hong XU
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3025-3031.
    Objective

    To observe the clinical efficacy and safety of continuous infusion of extremely low-dose dexmedetomidine hydrochloride injection combined with remifentanil hydrochloride for injection and propofol emulsion injection in elderly patients undergoing total hip arthroplasty (THA).

    Methods

    Elderly patients undergoing THA were divided into treatment group and control group according to the administration method. The control group was induced with intravenous injection of sufentanil citrate injection at a dose of 0.3 μg·kg-1, propofol emulsion injection at a dose of 1.0-2.5 mg·kg-1, and rocuronium bromide injection at a dose of 0.6-0.9 mg·kg-1. Anesthesia was maintained with intravenous infusion of propofol emulsion injection at a dose of 4-6 mg·kg-1·h-1 and remifentanil hydrochloride for injection at a dose of 0.1-0.2 μg·kg-1·h-1. The treatment group received dexmedetomidine hydrochloride injection 0.2-0.5 μg·kg-1 before anesthesia induction, followed by ultra-low dose dexmedetomidine hydrochloride injection 0.1-0.2 μg·kg1·h-1 intravenous infusion from after anesthesia induction to 30 min before the end of the operation, with other treatments the same as the control group. The vital signs of the two groups were compared after entering the room (T0), immediately after tracheal intubation (T1), at the time of upper tourniquet (T2), when necrotizing bone and tissue were removed (T3), when prosthesis was implanted (T4), when tourniquet was released (T5) and immediately after extubation (T6) and the modified alert sedation/score (MOAA/S) was improved; the dosage of anesthetics, the occurrence of postoperative delirium, preoperative and postoperative neuronal injury markers, and neurotransmitter markers were compared between the two groups, and safety was evaluated.

    Results

    A total of 120 patients were enrolled, including 63 cases in the treatment group and 57 cases in the control group. At T1, the heart rate (HR) of treatment group and control group were (79.68±7.34) and (76.79±8.40) times·min-1, respectively; at T2, they were (81.43±7.37) and (78.68±7.49) times·min-1, respectively; at T3, they were (83.83±7.53) and (80.35±7.14) times·min-1, respectively; at T4, they were (82.63±6.90) and (79.77±7.39) times·min-1, respectively; at T5, they were (81.27±7.31) and (78.16±7.51) times·min-1, respectively; at T6, they were (86.16±7.32) and (83.74±7.31) times·min-1, respectively. The heart rate of treatment group at each time were all significantly higher than those of control group (all P<0.05). At T1, the mean arterial pressure (MAP) of treatment group and control group were (80.29±9.89) and (75.32±9.73) times·min-1, respectively; at T2, they were (82.10±10.00) and (77.18±9.82) times·min-1, respectively; at T3, they were (83.16±9.95) and (79.46±10.06) times·min-1, respectively; at T4, they were (82.83±9.58) and (77.19±9.92) times·min-1, respectively; at T5, they were (81.30±9.59) and (76.09±9.82) times·min-1, respectively; at T6, they were (84.14±9.87) and (82.12±9.97) times·min-1, respectively. The MAP of treatment group at each time were all significantly higher than those of control group (all P<0.05). At T1, the MOAA/S of treatment group and control group were (2.05±0.28) and (2.23±0.46) score, respectively; at T2, the scores were (1.92±0.33) and (2.09±0.51) score, respectively; at T3, the scores were (1.95±0.42) and (2.09±0.34) score, respectively; at T4, the scores were (1.92±0.33) and (2.11±0.36) score, respectively; at T5, the scores were (1.92±0.33) and (2.07±0.37) score, respectively; at T6, the scores were (3.30±0.73) and (3.77±0.80) score, respectively. The MOAA/S scores of treatment group at each time were all significantly lower than those of control group (all P<0.05). The intraoperative propofol dosage in treatment group and control group were (381.81±46.48) and (407.25±49.36) mg, respectively; the intraoperative remifentanil dosage were (14.43±1.82) and (15.14±2.00) μg, respectively; the incidence of postoperative delirium at 72 h were 15.87% and 33.33%, respectively; the postoperative 24 h central nervous system-specific protein (S100β) levels were (0.59±0.11) and (0.66±0.14) μg·mL-1, respectively; the postoperative 24 h glial fibrillary acidic protein (GFAP) levels were (0.87±0.29) and (1.02±0.22) ng·mL-1, respectively; the postoperative 8 h 5-hydroxytryptamine (5-HT) levels were (168.91±18.25) and (159.35±17.54) μg·L-1, respectively, with statistically significant differences (all P<0.05). The total incidence of adverse drug reactions were 12.70% in treatment group and 22.81% in control group, respectively, with no statistically significant difference (P>0.05).

    Conclusion

    Continuous infusion of extremely low-dose dexmedetomidine hydrochloride injection combined with remifentanil hydrochloride for injection and propofol emulsion injection in elderly patients undergoing THA can effectively improve intraoperative vital signs and postoperative recovery quality, enhance analgesia and sedation, reduce the dosage of remifentanil hydrochloride for injection and propofol emulsion injection, reduce the incidence of postoperative delirium, regulate the levels of neuronal injury markers and neurotransmitter markers, and has good safety.

  • Zhen JIN, Zhao LIU, Ya-dong HAN, Zhao LIU, Jia-xin ZHANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3032-3037.
    Objective

    To investigate the efficacy and safety of anlotinib combined with neoadjuvant chemotherapy (NAC) in elderly patients with triple-negative breast cancer (TNBC).

    Methods

    Elderly patients with TNBC who underwent NAC followed by modified radical mastectomy were enrolled and divided into control group and treatment group based on their treatment regimens. Control group received the TEC regimen as preoperative NAC, while treatment group received additional oral administration of anlotinib hydrochloride capsules (12 mg once daily, in a 2-weeks-on/1-week-off cycle) for 4 cycles. Carbohydrate antigen 153 (CA153), carcinoembryonic antigen (CEA), growth differentiation factor-3 (GdF3), carbohydrate antigen 19-9, Ki-67 positive rate, cyclooxygenase-2 (COX2), vascular endothelial growth factor (VGEF), bone sialoprotein, prolactin, insulin-like growth factor-1, clinical efficacy and long-term survival outcomes were compared between the two groups, and the safety was conducted.

    Results

    A total of 93 patients were enrolled and divided into control group (n=48) and treatment group (n=45). After treatment, the objective response rates (ORR) were 43.75% (21 cases/48 cases) in control group and 64.44% (29 cases /45 cases) in treatment group, respectively; while the disease control rates (DCR) were 70.83% (34 cases /48 cases) and 88.89% (40 cases /45 cases), respectively; CA 153 levels were (24.59±3.57) and (22.21±3.86) μ·mL-1, respectively; GdF3 levels were (117.53±18.29) and (102.24±15.47) ng·L-1, respectively; CEA levels were (4.19±0.85) and (3.72±0.64) ng·L-1, respectively; the Ki-67 positivity rates were 37.50% and 17.78%, respectively; COX-2 levels were (88.73±21.64) and (74.38±19.51) ng·L-1, respectively; VEGF levels were (38.23±7.15) and (34.74±6.32) ng·L-1, respectively; the progression-free survival (PFS) rates were 33.33% (16 cases/48 cases) and 46.67% (21 cases/45 cases), respectively. Statistically significant differences were observed in all the above indicators between the two groups (all P<0.05, P<0.01, P<0.001). The adverse drug reactions during chemotherapy in treatment group and control group included anemia, decreased appetite, neutropenia, leukopenia, thrombocytopenia, headache, hypertension, nausea and vomiting, fatigue, elevated thyroid hormones, diarrhea, constipation, infection, alopecia, impaired liver and kidney function, and hand-foot syndrome. The total incidence of adverse drug reactions was 64.58% (31 cases/48 cases) in control group and 71.11% (32 cases /45 cases) in treatment group, with no statistically significant difference between the groups (P>0.05). The overall survival (OS) rate was 60.42% (29 cases /48 cases) in control group and 68.89% (31 cases /45 cases) in treatment group, and the difference was not statistically significant (P>0.05).

    Conclusion

    Anlotinib combined with NAC regimen for elderly TNBC patients shows good efficacy, can improve Ki-67 positive rate and serum COX-2 and vascular endothelial growth factor levels, improve long-term survival, and has high safety.

  • Bo SU, Bo ZHENG
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3038-3042.
    Objective

    To analyze the drug resistance phenotypes and genotypes of 2 307 Enterococcus faecium strains collected from 2011 to 2024.

    Methods

    The antimicrobial susceptibility testing of the strains was performed using the broth microdilution method, followed by genomic DNA extraction from the strains and polymerase chain reaction (PCR) amplification for screening of resistance genes.

    Results

    From 2011 to 2012, the detection rate of vancomycin-resistant Enterococcus faecium was 1.67%, and the detection rate of vanM gene-positive vancomycin-susceptible strains was 0.34%. In contrast, from 2023 to 2024, the detection rate of vancomycin-resistant Enterococcus faecium increased to 5.11%, while the detection rate of vanM gene-positive vancomycin-susceptible strains reached as high as 4.75%. Additionally, 22 Enterococcus faecium strains co-harboring both vanA and vanM resistance genes were identified during the period from 2021 to 2024.

    Conclusion

    The detection rate of the vanM resistance gene in Enterococcus faecium has increased year by year, and its horizontal transfer may have contributed to the increased prevalence of Enterococcus faecium co-harboring both vanA and vanM resistance genes in recent years.

  • Qun-cheng NIE, Xiao-tong JIA, Peng-fei LIU
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3043-3048.
    Objective

    To investigate the effect of total flavonoids from Patrinia on neuroprotection in rats with ischemic stroke (IS) by Rat sarcoma virus oncogene homolog (Ras) homolog gene family member (Rho) A/Rho-associated kinase (ROCK) signaling pathway.

    Methods

    The IS rat model was established by the suture method, and was randomly divided into B group (IS), C group (total senna flavonoids low dose), D group (total senna flavonoids high dose), E group (positive drug), F group (high dose of total senna flavonoids+U-46619F) and A group (the sham operation), where group A and group B were given intragastric and intraperitoneal injections of normal saline; group C was given 100 mg·kg-1 total senna flavonoids by intragastric administration; group D was given 200 mg·kg-1 total senna flavonoids by intragastric administration; group E was given 1.0 mg·kg-1 nimodipine by intraperitoneal injection; group F was given intragastric administration of 200 mg·kg-1 total senna flavonoids and 30 μg·kg-1 U-46619 by intraperitoneal injection; each group was administered once a day for two consecutive weeks. After the intervention, the modified neurological severity (mNSS) score was used to evaluate the nerve injury; the triphenyltetrazolium chloride staining (TTC) was used to detect the ratio of cerebral infarction area; the brain tissue was separated, and hematoxylin-eosin was used for pathological changes; the expression of nerve growth factor (NGF) was detected by immunohistochemistry; the apoptosis changes of striatal dopaminergic neurons were detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling method (TUNEL); the relative expression levels of Bcl-2 related X protein (Bax), RhoA, ROCK and B-cell lymphoma factor 2 (Bcl-2) proteins were detected by immunoblotting.

    Results

    The nerve injury scores for groups A, B, D, E, and F were (0.15±0), (11.24±1.26), (4.06±0.42), (3.52±0.38) and (7.18±0.73) points, respectively; the ratio of infarct area were (0±0)%, (27.86±2.81)%, (11.57±1.27)%, (12.07±1.24)% and (18.07±1.88)%; the relative expression levels of NGF were 34.11±3.51, 15.86±1.61, 32.07±3.28, 32.11±3.32 and 22.87±2.31; the apoptosis of dopaminergic neurons were (6.57±0.68)%, (27.81±2.82)%, (12.75±1.31)%, (12.52±1.27)% and (20.47±2.11)%; the aforementioned indicators of group B were compared with those of group A; those of groups C and D were compared with group B; and those of group F were compared with group D, all showing statistically significant differences (all P<0.05).

    Conclusion

    The total flavonoids of Cynanchum paniculatum have neuroprotective effects on IS rats, and the mechanism may be related to the activation of the RhoA/ROCK signaling pathway.

  • Jin-yuan ZHANG, Li LAI, Zi-yang LIN, Ting-ting DUAN, Jun-zheng YANG, Yi-qi YANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3049-3053.
    Objective

    To explore the main active components, potential targets and mechanisms of Yinpu Jiedu tablets in the treatment of diabetic renal inflammation by using network pharmacological methods and molecular docking techniques.

    Methods

    The active ingredients of Yinpu jiede tables and therapeutic targets for diabetic kidney inflammation were retrieved from databases including TCMSP, PubChem, SwissTargetPrediction and GeneCards. A protein-protein interaction (PPI) network was constructed using Venny, STRING, Metascape, Bioinformatics and Cytoscape, followed by gene enrichment analysis. Molecular docking was performed using AutoDock, and the results were visualized with PyMOL. Furthermore, a lipopolysaccharide (LPS)-induced cellular model of diabetic kidney inflammation was established. The experiment included control group, model group (4 μmol·L-1 LPS) and experimantol group (30 μg·mL-1 Yinpu jiede tables). Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to measure the messenger ribonucleic acid (mRNA) relative expression levels of AKT1 serine/threonine kinase 1(Akt1), tumor protein p53(Tp53), tumor necrosis factor-α (Tnf-α) and interleukin-6 (IL-6) to validate the network pharmacology predictions.

    Results

    A total of 30 active ingredients and 435 potential targets of Yinpu jiede tables were identified. The core active ingredients included quercetin, luteolin, acacetin, morin and pelargonin. Intersection analysis between disease-related targets and drug-targets yielded 71 key genes, from which 4 core targets, inducling AKT1, TNF-α, IL-6 and TP53. Molecular docking results indicated strong binding affinity between the core active ingredients and the core targets. gene ontolog (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses suggested that Yinpu jiede tables exerts its therapeutic effects on diabetic kidney inflammation primarily through pathways such as pathways in cancer, the JAK-STAT signaling pathway, the AMPK signaling pathway and the Wnt signaling pathway. Cellular experiments confirmed that LPS induction significantly upregulated the mRNA expression of Akt1, Tp53, TNF-α, and IL-6 in podocytes, while treatment with Yinpu jiede tables effectively reversed this trend, restoring their expression to near-normal levels, thereby validating its regulatory role on the predicted targets and inflammatory pathways.

    Conclusion

    Yinpu jiede tables may act on signal pathways such as JAK-STAT, AMPK, and Wnt through core targets such as AKT1, TNF, IL-6, and TP53, and exert therapeutic effects on diabetic kidney inflammation.

  • Gao-bo LI, Ting WANG, Yu-zhang HUO, ADILAI, Yong-rong SONG, Jian-hong LÜ, Yu-hua ZHANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3054-3060.
    Objective

    To explore the effect of Gallic acid on liver tissue damage in autoimmune hepatitis (AIH) mice by adjusting adenosine monophosphate-activated protein kinase (AMPK) / acetyl-coa carboxylase (ACC) signaling pathway.

    Methods

    An AIH mouse model was established by injecting 15 mg·kg-1 concanavalin A through the tail vein. The mice were randomly divided into model group, low-dose experimental group (50 mg·kg-1), high-dose experimental group (100 mg·kg-1), AMPK inhibitor group (5 μmol·L-1), gallic acid + AMPK inhibitor group and normal mice group with the same volume of phosphate-buffered solution as control group. After the intervention, the automatic biochemical analyzer was used to analyze glutamic pyruvic transaminase (GPT), the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in liver homogenate were detected by enzyme-linked immunosorbent assay (ELISA), and the levels of interleukin (IL)-10, IL-6 and tumor necrosis factor (TNF-α) in serum supernatant were also measured. The histopathological changes were detected by the hematoxylin-eosin (HE) staining method; the apoptosis status was examined by the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method. The relative expression levels of phosphorylated (p-) AMPK/AMPK, Bcl-2 related X protein (Bax), B-cell lymphoma/leukemia-2 protein (Bcl-2) and ACC protein were detected by Western blotting.

    Results

    The glutamic-oxalacetic transaminase (GOT) levels in control group, model group, low-dose experimental group, high-dose experimental group, AMPK inhibitor group and high-dose experimental+AMPK inhibitor group were (82.05±8.31), (210.20±21.14), (135.26±14.64), (91.02±9.21), (308.15±30.85) and (129.84±13.08) U·L-1, respectively; the GPT levels were (50.23±5.11), (324.85±33.25), (152.34±15.48), (88.64±8.95), (482.62±50.02) and (148.85±15.02) U·L-1, respectively; the TNF-α levels were (41.06±4.37), (149.85±15.28), (88.39±8.97), (51.06±5.21), (267.85±27.18) and (154.62±15.68) pg·mL-1, respectively; the IL-6 levels were (48.42±4.92), (134.52±13.58), (75.42±7.61), (57.85±5.81), (215.84±21.98) and (78.62±7.98) pg·mL-1, respectively; the IL-10 levels were (486.52±49.02), (188.72±19.08), (318.54±32.08), (445.67±45.11), (114.21±11.94) and (324.15±32.67) pg·mL-1, respectively; the SOD levels were (48.26±4.99), (19.52±2.11), (32.25±3.44), (44.21±4.57), (11.37±1.21) and (31.24±3.22) U·mg-1, respectively; the MDA levels were (0.28±0.03), (0.84±0.09), (0.56±0.06), (0.31±0.04), (1.31±0.15) and (0.64±0.07) nmol·mg-1, respectively; the tissue pathological scores were 0, 2.64±0.27, 2.27±0.24, 1.22±0.14, 3.54±0.36 and 2.19±0.23, respectively; the apoptosis rates were (5.24±0.54)%, (23.62±2.44)%, (16.42±1.72)%, (8.52±0.89)%, (34.85±3.61)% and (17.06±1.75)%, respectively. The above indexes of model group were compared with those of control group; low-dose and high-dose experimental group were compared with those of model group and high-dose experimental+AMPK inhibitor group were compared with those of high-dose experimental group, there were statistically significant differences (all P<0.05).

    Conclusion

    Gallic acid can inhibit the inflammatory response and oxidative stress level in AIH mice, reduce cell apoptosis, improve liver function, alleviate liver tissue pathological damage, down-regulate Bax and ACC expression, up-regulate p-AMPK/AMPK and Bcl-2 expression; the AMPK inhibitor reverses the protective effect of high-dose gallic acid on AIH mice. Gallic acid activates the AMPK/ACC signaling pathway to alleviate liver tissue damage in AIH mice.

  • Hao-ruo YANG, Jian-long XU, Yu ZHANG, Bin YANG
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3061-3066.
    Objective

    Based on the nuclear factor E2-related factor 2 (Nrf2)/nuclear factor kappa B inhibitor alpha (IκB-α)/nuclear factor-kappa B (NF-κB) signaling axis, this study explored the protective effects of quercetin on lipopolysaccharide (LPS)-induced acute kidney injury (AKI) in rats.

    Methods

    A total of 60 SD rats were randomly divided into control group, model group, dexamethasone (DEX) group, quercetin high dose (100 mg·kg-1) experimental group and quercetin low (10 mg·kg-1) dose experimental group, with 12 rats in each group. Except for the control group, all other groups received intraperitoneal injection of LPS (10 mg·kg-1) to prepare an AKI rat model. Enzyme-linked immunosorbent assay was used to detect serum levels of cystatin C (CysC), kidney injury molecule-1 (KIM-1) and inflammatory factors; renal tissue pathological changes were observed, and levels of myeloperoxidase (MPO), catalase (CAT) and 4-hydroxynonenal (4-HNE) in renal tissues were measured by colorimetry; immunohistochemistry was used to detect protein relative expression levels of Nrf2, IκB-α and NF-κB.

    Results

    The levels of CysC in control group, model group, quercetin high dose group, low dose group and DEX group were (93.18±8.29), (317.58±12.26), (132.73±10.52), (182.91±10.63) and (153.29±10.14) ng·mL-1, respectively; levels of KIM-1 were (12.39±1.79), (52.19±4.26), (26.83±3.89), (35.71±4.03) and (29.07±4.12) pg·mL-1, respectively; MPO were (72.52±8.23), (177.95±9.14), (116.37±8.93), (136.52±9.37) and (121.81±9.02) pg·mL-1, respectively; CAT contents were (60.73±8.12), (17.92±8.32), (38.41±8.73), (29.72±7.95) and (36.68±9.26) U·mL-1, respectively; 4-HNE were (59.82±7.38), (179.63±9.41), (97.38±8.83), (116.91±9.17) and (98.56±8.79) nmol·L-1, respectively. The levels of tumor necrosis factor-α (TNF-α) were (8.96±2.69), (58.27±5.13), (19.14±4.82), (39.56±5.37) and (16.38±4.11) pg·mL-1, respectively; IL-1β were (15.62±3.58), (52.09±5.76), (29.47±4.61), (36.17±5.23) and (25.76±4.29) pg·mL-1, respectively; IL-6 were (10.46±2.89), (71.14±6.53), (21.93±5.57), (33.28±5.96) and (19.12±5.61) pg·mL-1, respectively. The intergrated optical density (IOD) of Nrf2 protein were 92.56±6.13, 45.09±6.97, 73.22±6.02, 63.52±6.73 and 68.29±6.51; IκB-α protein IOD values were 85.62±5.75, 42.83±6.29, 70.12±6.51, 61.45±6.87 and 78.77±6.32; the IOD values of NF-κB p65 protein were 43.28±4.92, 87.59±6.35, 55.79±5.32, 68.83±6.13 and 49.18±5.08, respectively. There were significant differences in the above indexes between the control group and the model group, between the model group and the quercetin high and low dose groups, and the DEX group (all P<0.05).

    Conclusion

    Quercetin may alleviate inflammation and oxidative stress damage by regulating the expression of Nrf2/IκB-α/NF-κB signaling axis, thereby playing a protective role against LPS-induced acute kidney injury.

  • Si-can WEI, Hong-ling ZHANG, Qing-qing WU, Tian-lai LIN
    Chinese Journal of Clinical Pharmacology. 2025, 41(21): 3067-3074.
    Objective

    To explore the molecular mechanism of losartan in alleviating renal injury in sepsis.

    Methods

    In animal experiment, mice were randomly divided into the sham group, the model group (modeled by cecal ligation and perforation), losartan group (losartan treatment at 15 mg·kg-1 after modeling) and antagonist group [treated with the G protein-coupled receptor 84 (GPR84) antagonist GLPG1205 at 30 mg·kg-1 after modeling], each group contained 10 mice. Enzyme-linked immunosorbent assay (ELISA) experiments were used to detect serum renal injury indicators, and immunohistochemistry was used to detect the protein expressions of GPR84 and cluster of differentiation 86 (CD86) in renal tissues. The expression of cytokines in renal tissues was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). In cell experiment, THP-1 cells were randomly divided into control group, induce group (induced to M1-type macrophages), medicine group (inducing +10 μg·mL-1 losartan) and medicine+6-OAU group (induction +10 μg·mL-1 losartan +1 μmol·L-1 GPR84 antagonist 6-OAU), the relative expression levels of GPR84 protein was detected by Western blot assay, the relative expression level of CD86 was detected by immunofluorescence assay, and the expression of cytokines in cells was detected by RT-qPCR.

    Results

    In animal experiments, the levels of blood urea nitrogen (BUN) in mice of the sham group, model group, losartan group and antagonist group were (48.55±4.54), (111.28±5.83), (71.52±4.79) and (79.10±8.12) mmol·L-1, respectively; serum creatinine (SCr) were (13.33±1.58),(64.12±6.91), (30.43±5.80) and (40.09±4.49) μmol·L-1, respectively; the average optical density values of GPR84 were 0.05±0.01, 0.08±0.01, 0.05±0.01 and 0.05±0.01, respectively; the average optical density values of CD86 were 0.03±0, 0.08±0.01, 0.05±0.01, 0.06±0.01, respectively; the relative expression levels of GPR84 mRNA were 1.00±0.13, 2.70±0.23, 1.78±0.15 and 1.12±0.09, respectively; interleukin (IL)-1β mRNA were 1.00±0.14, 1.78±0.24, 1.41±0.13 and 1.50±0.19, respectively; tumor necrosis factor-alpha (TNF-α) mRNA were 1.00±0.10, 1.85±0.12, 1.39±0.10 and 1.56±0.12, respectively; the relative expression levels of inducible nitric oxide synthase (iNOS) mRNA were 1.00±0.14, 3.33±0.23, 1.93±0.16 and 2.30±0.24, respectively. Compared between the model group and the sham group; compared the losartan group or the contagonist group with the model group and compared between the losartan group with antagonist group, the differences of the above-mentioned indicators were statistically significant (P<0.05, P<0.01, P<0.001). In cell experiments, the relative expression levels of GPR84 protein in the control group, induce group, medicine group and medicine+6-OAU group were 0.58±0.06, 0.94±0.11, 0.63±0.07 and 1.45±0.09, respectively; the fluorescence intensities of CD86 were (1 072.36±105.92), (3 209.59±206.38), (1 903.95±172.73) and (2 471.43±273.18) a.u.; the relative expression levels of iNOS mRNA were 1.00±0.11, 3.06±0.23, 1.98±0.27 and 2.85±0.24, respectively, the above-mentioned indicators compared between the control group and the induce group, compared between the medicine group and the induce group, and compared between the medicine+6-OAU group and the medicine group, the differences were all statistically significant (all P<0.001).

    Conclusion

    Losartan can alleviate renal injury in sepsis, which is related to the inhibition of GPR84-mediated M1 polarization of macrophages.