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The brain, heart, liver, kidney, and other organs are susceptible to the harmful effects of ischemia-reperfusion injury (IRI), where the excessive production of reactive oxygen species (ROS) following IRI contributes to tissue damage and ensuing inflammation. In recent years, researchers have designed various nanoparticles that are responsive to ROS for the treatment of IRI. Empagliflozin (EMPA), an inhibitor of the sodium-glucose cotransporter-2 commonly used in type 2 diabetes mellitus, shows promise in mitigating IRI. However, its water-insolubility and low bioavailability present challenges in fully realizing its therapeutic efficacy. To tackle this issue, we formulated EMPA-loaded nanomicelles designed to respond to ROS, aiming to prevent renal damage caused by ischemia-reperfusion. Extensive characterization confirmed the effectiveness of the formulated nanomicelles. Through simulations and release studies, we observed structural modifications in the micelles leading to the release of EMPA upon encountering ROS (H2O2). In animal studies, rats treated with EMPA-loaded micelles showed normal renal tissue architecture, with only some remaining tubular swelling. Molecular assessments revealed that IRI triggered cell apoptosis through mechanisms involving hypoxia, metabolic stress, ROS, and TNF-α elevation. EMPA treatment reversed this process by upregulating B-cell lymphoma protein 2 and reducing levels of associated X (BAX) protein, Caspase 3, and Caspase 8. These results indicate that ROS-responsive micelles could act as a spatially targeted delivery system, effectively transporting EMPA directly to the ischemic kidney. This offers a promising therapeutic strategy for alleviating the impact of renal IRI.

8-oxo-7,8-dihydro-2′-dexyoguanine (8-oxo-dG) can be tautomerized to a 6-enolate,8-keto tautomer through nearby-NH deprotonation at elevated pH. In this work, the N3-protonated 8-oxo-dG tautomers in deuterated pH-buffer solutions were studied using steady-state UV/Vis, FTIR, and ultrafast two-dimensional IR spectroscopies. The presence of 6,8-diketo and C6-anionic tautomers at neutral to basic conditions (pD = 7.4–12.0) was revealed by UV/Vis and FTIR results and was further confirmed by 2D IR signals in both diagonal and off-diagonal regions. However, the C6-enol tautomer, which may be an intermediate during the transition from 6,8-diketo to C6-enolate,C8-keto, was not observed appreciably due to its extreme low population. Furthermore, the neutral-to-anionic tautomeric transition of N3H-8-oxo-dG studied in this work occurs under more basic conditions than the N1H-8-oxo-dG reported previously, showing a higher pKa value for N3H than N1H. Finally, vibrational relaxation of the carbonyl stretching mode was found to be both molecular site dependent and pD dependent for 8oxo-dG. Taken together, this work shows that the ultrafast infrared spectroscopic method is effective for examining tautomers and their dynamics in nucleic acids. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of combining diosmin with Jiuhua hemorrhoid suppository versus diosmin alone for the treatment of hemorrhoid hemorrhage. Method: The Jiuhua hemorrhoid suppository study was conducted in 10 medical centers across China from April 1, 2019 to June 30, 2020. Patients with hemorrhoid bleeding were randomized in a ratio of 1 : 1 to either receive Jiuhua hemorrhoid suppository and diosmin tablets (the study group) or diosmin tablets alone (the control group). The suppository was used once a day after defecation or at bedtime after rinsing the anus with warm water. Diosmin tablets were administered only once a day (0.9 g). The primary endpoint of the study was the assessment of hemorrhoid bleeding relief 7 ± 2 days after treatment, classified as “very effective” “effective” and “ineffective”. The secondary endpoint included the evaluation of pain alleviation using the visual analogue scale (VAS, with scores ranging from 0 to 10) and edema (with scores ranging from 0 to 3). The safety of the two treatment regimens was evaluated 14 ± 2 days after drug administration. Results: The full analysis set (FAS) comprised 107 participants in the study group and 111 in the control group, while the per-protocol set (PPS) included 106 participants in the study group and 111 in the control group. In terms of hemorrhoid bleeding, the proportion of very effective and effective cases in the study group were significantly higher than that in the control group [106 (99.06 %) vs. 91 (81.98 %), P < 0.0001] in the FAS, and the PPS results [105 (99.06 %) vs. 91 (81.98 %), P < 0.0001] were comparable to the FAS results. The pain VAS scores at day 7 after treatment were comparable between the two groups (0.80 ± 1.17 vs. 0.80 ± 1.20, P = 0.2177). The majority of the participants in both groups had an edema score of 0 at day 7 after treatment [96 (89.72 %) vs. 99 (91.67 %), P = 0.3705]. Adverse events (AEs) occurred in 9 patients (8.4 %) in the study group and 3 patients (2.7 %) in the control group. In addition, 5 AEs in the study group and 1 AE in the control group were possibly in association with the study drug. Conclusion: Compared with the administration of diosmin oral tablets alone, the addition of Jiuhua hemorrhoid suppository to the tablets demonstrates enhanced efficacy in addressing hemorrhoid bleeding, with satisfactory patient adherence and acceptable safety.

BackgroundGuided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment. ObjectiveThis study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website. MethodsIn an urban context, 90 survivors of different trauma types were recruited via Internet advertisements and allocated to a randomized controlled trial (RCT) with a waiting list control condition. In addition, in a rural context, 93 survivors mainly of the 2008 Sichuan earthquake were recruited in-person for a parallel RCT in which the website intervention was conducted in a counseling center and guided by volunteers. Assessment was completed online on a professional Chinese survey website. The primary outcome measure was the Post-traumatic Diagnostic Scale (PDS); secondary outcome measures were Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy Scale (CSE), Post-traumatic Cognitive Changes (PCC), and Social Functioning Impairment (SFI) questionnaires adopted from the My Trauma Recovery website. ResultsFor the urban sample, findings indicated a significant group×time interaction in post-traumatic symptom severity (F1,88=7.65, P=.007). CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F1,45=15.13, Cohen’s d=0.81, P