Optimization of Processing Technology Based on Chemical Composition Difference and Anti-Fibrotic Activity

Background Cornus officinalis, a kind of edible herbal medicine, has been widely used in liver and kidney protection due to its anti-inflammatory, anti-tumor, and anti-oxidant activities, which can be enhanced with wine-steamed (WS) processing. Methods Based on the activations of HSC-T6 and HK-2, our study used single-factor plus orthogonal design to investigate the anti-fibrosis of C. officinalis processed with steamed (S), high-pressure steamed (HPS), WS, high-pressure wine-steamed (HPWS), wine-dipped (WD), and wine-fried (WF). The chemical constituents in processed C. officinalis with higher anti-fibrotic activities were detected by UPLC-Q-TOF-MS/MS. Results Results showed that C. officinalis with HPWS significantly inhibited the activations of HSC-T6 and HK-2. Moreover, compounds in C. officinalis with HPWS were obtained via UHPLC-Q-TOF-MS/MS, indicating that 27 components were changed compared with raw C. officinalis. Conclusions These results demonstrated that HPWS is the optimal processing technology for anti-fibrosis of C. officinalis.

Renal Recovery after the Implementation of an Electronic Alert and Biomarker-Guided Kidney-Protection Strategy Following Major Surgery

Background: The facilitation of early recovery of acute kidney injury (AKI) is an important step to improve outcome, particularly because of the limited therapeutic interventions currently available for AKI. The combination of an electronic alert and biomarker-guided kidney-protection strategy implemented in the routine care may have an impact on the incidence of early complete reversal of AKI after major non-cardiac surgery. Methods: We studied 294 patients in two cohorts before (n = 151) and after protocol implementation (n = 143). Data collection required 6 months for each cohort. The kidney-protection protocol included an electronic alert to detect patients who were eligible for urinary biomarker [TIMP2 × IGFBP7]-guided kidney-protection intervention. Intervention was stratified according to three levels of immediate AKI risk: low, moderate, and high. After intervention, postoperative changes in the glomerular filtration rate (eGFR) were identified with a tracking software that included an alert for nephrology consultation if the eGFR had declined by >25% from the preoperative reference value. Primary outcome was early AKI recovery, i.e., the complete reversal of any AKI stage to absence of AKI within the first 7 postoperative days. Results: Protocol implementation significantly increased the recovery of AKI (36/46, 78% compared to control 27/48, 56%, (p = 0.025)) and reduced the length of the ICU stay (p < 0.001). There was no significant difference in the overall incidence of all AKI and moderate and severe AKI in the first 7 postoperative days: 46/143 (32%) and 12/151 (8%) in the protocol implementation group compared to 48/151 (32%) and 18/151 (12%) in the historical control group. Patients with AKI reversal within the first 7 postoperative days had lower in-hospital mortality than patients without AKI reversal. Conclusions: Implementing a combined electronic alert and biomarker-guided kidney-protection strategy in routine care improved early recovery of AKI after major surgery.

Bioactivity and uses of Cnidoscolus aconitifolius (Mill.) I.M. Johnst

Cnidoscolus aconitifolius has been long used by ethnic groups in Indonesia for vegetables and traditional medicine. This study aims to explain the benefits of C. aconitifolius for food and its bioactivity. The method for writing is library research on scientific articles published online at Google Scholar by using the keywords: uses of C. aconitifolius and bioactivity of C. aconitifolius. All available articles were synthesized to provide comprehensive information on C. aconitifolius for food and its bioactivity. C. aconitifolius has two to three times more nutrients than spinach, spinach, Chinese cabbage, and lettuce. Cnidoscolus aconitifolius bioactivity includes antimicrobial, antidiabetic, hepatoprotective, antioxidant, antihypercholetrol, analgesic, antianemia, and kidney protection. Cnidoscolus aconitifolius leaves contain macronutrients such as carbohydrates, proteins, fats, vitamins and minerals so that they have the potential to be developed for cheap and easily available food. On the other hand, C. aconitifolius also contains anti-nutrients such as phytate and oxalate but with proper processing the antinutrients will be degraded.

A Novel Treatment for Glomerular Disease: Targeting the Activated Macrophage Folate Receptor with a Trojan Horse Therapy in Rats

Since activated macrophages express a functional folate receptor β (FRβ), targeting this macrophage population with folate-linked drugs could increase selectivity to treat inflammatory diseases. Using a macrophage-mediated anti-glomerular basement membrane (anti-GBM) glomerulonephritis (GN) in WKY rats, we investigated the effect of a novel folic acid-aminopterin (AMT) conjugate (EC2319) designed to intracellularly deliver AMT via the FR. We found that treatment with EC2319 significantly attenuated kidney injury and preserved renal function. Kidney protection with EC2319 was blocked by a folate competitor, indicating that its mechanism of action was specifically FRβ-mediated. Notably, treatment with methotrexate (MTX), another folic acid antagonist related to AMT, did not protect from kidney damage. EC2319 reduced glomerular and interstitial macrophage infiltration and decreased M1 macrophage recruitment but not M2 macrophages. The expression of CCL2 and the pro-fibrotic cytokine TGF-β were also reduced in nephritic glomeruli with EC2319 treatment. In EC2319-treated rats, there was a significant decrease in the deposition of collagens. In nephritic kidneys, FRβ was expressed on periglomerular macrophages and macrophages present in the crescents, but its expression was not observed in normal kidneys. These data indicate that selectively targeting the activated macrophage population could represent a novel means for treating anti-GBM GN and other acute crescentic glomerulonephritis.

Copper Sulfate Drowning: A Case Report

Cases of copper sulfate poisoning are rarely reported with a higher mortality rate. Herein, we reported a middle-aged man who had a copper sulfate drowning accident at work, resulting in airway damage, respiratory failure, intravascular hemolysis, hemolytic anemia, impaired liver function, and skin and conjunctival damage. After the rapid and effective treatments, including plasma exchange, irrigation under tracheoscopy, blood transfusion, liver and kidney protection and chelation therapy, the patient finally recovered and was discharged from hospital.