Mechanism of Xueshuantong injection combined with intravenous thrombolysis with alteplase in treatment of patients with acute cerebral infarction based on high mobility group protein B1/Toll-like receptor 4 signaling pathway

ZHAO Congcong; QI Wenmei

doi:10.7619/jcmp.20234027

Journal of Clinical Medicine in Practice > 2024 > 28(13): 41-46. > DOI: 10.7619/jcmp.20234027

ZHAO Congcong, QI Wenmei. Mechanism of Xueshuantong injection combined with intravenous thrombolysis with alteplase in treatment of patients with acute cerebral infarction based on high mobility group protein B1/Toll-like receptor 4 signaling pathway[J]. Journal of Clinical Medicine in Practice, 2024, 28(13): 41-46. DOI: 10.7619/jcmp.20234027

Citation:

PDF (1184 KB)

Mechanism of Xueshuantong injection combined with intravenous thrombolysis with alteplase in treatment of patients with acute cerebral infarction based on high mobility group protein B1/Toll-like receptor 4 signaling pathway

Xingtai City Third Hospital in Hebei Province, Xingtai, Hebei, 054000

More Information

Received Date: December 12, 2023
Revised Date: April 14, 2024
Available Online: July 19, 2024

Graphical Abstract

Abstract

Abstract

Objective
To analyze the mechanism of Xueshuantong injection combined with intravenous thrombolysis with alteplase in the treatment of patients with acute cerebral infarction (ACI) based on the high mobility group protein B1 (HMGB1)/Toll-like receptor 4 (TLR4) signaling pathway.
Methods
A total of 106 ACI patients were randomly divided into control group (n=53) and study group (n=53). The control group received intravenous thrombolysis with alteplase, while the study group received Xueshuantong injection treatment on the basis of the control group. Clinical efficacy and adverse reactions, the National Institutes of Health Stroke Scale (NIHSS) scores before treatment and on the 7th and 14th day after treatment, the expression levels of HMGB1 mRNA and TLR4 mRNA in mononuclear cells of peripheral blood before and after treatment as well as the protein contents of HMGB1 and TLR4 in serum, and the levels of inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] before and after treatment were compared between two groups. Pearson test and Spearman test were used to analyze the correlations of the expression levels of HMGB1 mRNA and TLR4 mRNA in mononuclear cells of peripheral blood and the protein contents of HMGB1 and TLR4 in serum with the NIHSS score and the total effective rate in patients with ACI.
Results
The NIHSS score of the study group was significantly lower than that of the control group at 7 and 14 days after treatment (P < 0.05); after treatment, the expression levels of HMGB1 mRNA and TLR4 mRNA in both groups decreased significantly when compared to those before treatment, and the expression levels of HMGB1 mRNA and TLR4 mRNA in the study group were significantly lower than those in the control group (P < 0.05); after treatment, the serum protein contents of HMGB1 and TLR4 in both groups decreased significantly when compared to those before treatment, and the serum protein contents of HMGB1 and TLR4 in the study group were significantly lower than those in thecontrol group (P < 0.05); after treatment, the levels of serum TNF-α and IL-6 in both groups decreased significantly when compared to those before treatment, and serum TNF-α and IL-6 levels in the study group were significantly lower than those in the control group (P < 0.05). The total effective rate was 75.47% in the control group and 94.34% in the study group, and there was a significant difference between two groups (P < 0.05); the total incidence of adverse reactions was 9.43% in the control group and 15.09%in the study group, and there was no significant difference between two groups (P>0.05). Pearson test showed that the expression levels of HMGB1 mRNAand TLR4 mRNA in mononuclear cells of peripheral blood and the serum protein contents of HMGB1 and TLR4 in ACI patients were positively correlated with NIHSS score (r=0.431, 0.443, 0.396, 0.375, P < 0.001); Spearman test showed that the expression levels of HMGB1 mRNA and TLR4 mRNA in mononuclear cells of peripheral blood and the serum protein contents of HMGB1 and TLR4 in ACI patients were negatively correlated with the total effective rate of treatment (r=-0.536, -0.481, -0.475, -0.506, P < 0.001).
Conclusion
Combination of Xueshuantong injection and intravenous thrombolysis with alteplase can effectively improve the neurological function of patients with ACI and reduce the level of inflammation in the body, and the therapeutic mechanism may be related to downregulation of the HMGB1/TLR4 signaling pathway.

FullText(HTML)

References (19)

References

[1]	闫雯, 赵于飞, 宫玉哲, 等. 缺血性脑卒中分子流行病学筛查及其危险因素分析[J]. 临床军医杂志, 2023, 9(1): 65-68. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGZ202301018.htm
[2]	GROTTA J C. Intravenous thrombolysis for acute ischemic stroke[J]. Continuum: Minneap Minn, 2023, 29(2): 425-442.
[3]	YUAN Q, WANG F J, JIA Z Z, et al. Xueshuantong injection combined with Salvianolate lyophilized injection improves the synaptic plasticity against focal cerebral ischemia/reperfusion injury in rats through PI3K/AKT/mTOR and RhoA/ROCK pathways[J]. Brain Res, 2022, 1787: 147923. doi: 10.1016/j.brainres.2022.147923
[4]	黄红丽, 陈建, 王化强, 等. 急性脑梗死患者血浆高迁移率族蛋白B1/Toll样受体4变化及其与脑梗死体积、神经功能缺损及预后的关系[J]. 国际神经病学神经外科学杂志, 2022, 8(2): 15-19. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSK202202004.htm
[5]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJB201911024.htm
[6]	GLIDDEN M, TEMPLETON E, BARTLETT S, et al. Inconsistency in the Application of National Institutes of Health Stroke Scale Scores (NIHSS) Between Neurologist and Emergency Room Nurses During Acute Ischemic Stroke[J]. Stroke, 2021, 52(1): 180-182.
[7]	武磊. 阿加曲班丁苯酞在治疗急性缺血性脑卒中的临床疗效[J]. 中国药物与临床, 2021, 21(3): 411-413. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC202103022.htm
[8]	CHEN N, GUO M, YU D, et al. Bioinformatics Study of Plasma Differentially Expressed Proteins in H-Type Hypertension with or without Acute Cerebral Infarction[J]. Journal of Behavioral and Brain Science, 2021, 11(1): 1-9. doi: 10.4236/jbbs.2021.111001
[9]	SUN F, LIU H, FU H X, et al. Comparative study of intravenous thrombolysis with rt-PA and urokinase for patients with acute cerebral infarction[J]. J Int Med Res, 2020, 48(5): 300060519895352.
[10]	张健, 丁砚兵, 陈小敏, 等. 活血类口服中成药联合阿替普酶静脉溶栓术治疗急性脑梗死的系统评价[J]. 药物评价研究, 2022, 8(3): 557-567. https://www.cnki.com.cn/Article/CJFDTOTAL-YWPJ202203022.htm
[11]	LI W H, XU F, HUANG R Y, et al. Xueshuantong injection in treating deep venous thrombosis: a systematic review and trial sequential analysis[J]. Evid Based Complement Alternat Med, 2021, 2021: 6622925.
[12]	芦君. 三七总皂苷对脑梗死大鼠神经细胞Wnt/β-连环素信号通路的影响[J]. 安徽医药, 2022, 26(12): 2395-2398, 2547. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYY202212013.htm
[13]	周玉嘉, 张允岭, 周晶, 等. 三七总皂苷对脑缺血再灌注大鼠TLR4/NF-κB信号通路及炎性细胞因子的影响[J]. 中国中医急症, 2021, 30(8): 1340-1344. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ202108007.htm
[14]	LIU L, LUO G Q, LIU Q, et al. Hemorrhagic risk factors after rt PA thrombolysis in acute cerebral infarction[J]. Eur Rev Med Pharmacol Sci, 2023, 27(12): 5542-5551.
[15]	张婷婷, 席春华, 董斌, 等. 银杏叶提取物注射液联合阿替普酶静脉溶栓治疗急性脑梗死的疗效及对血液流变学和炎症因子的影响[J]. 现代生物医学进展, 2021, 21(9): 1759-1762, 1800. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX202109035.htm
[16]	WANG G R, CHEN Z Y, SONG Y Y, et al. Xueshuantong injection alleviates cerebral microcirculation disorder in middle cerebral artery occlusion/reperfusion rats by suppressing inflammation via JNK mediated JAK2/STAT3 and NF-κB signaling pathways[J]. J Ethnopharmacol, 2022, 298: 115592. doi: 10.1016/j.jep.2022.115592
[17]	张梅. 重症脑梗死患者血浆HMGB1/TLR4表达及其与脑水肿相关性研究[D]. 南充: 川北医学院, 2019.
[18]	赵浩茜, 邹慧玲, 胡芳. 有氧运动抑制自发性高血压大鼠心肌中HMGB1/TLR4炎症通路[J]. 现代生物医学进展, 2018, 18(19): 3633-3636, 3697. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201819008.htm
[19]	BAO Z C, ZHANG S G, LI X L. MiR-5787 attenuates macrophages-mediated inflammation by targeting TLR4/NF-κB in ischemic cerebral infarction[J]. Neuromolecular Med, 2021, 23(3): 363-370. doi: 10.1007/s12017-020-08628-w

[1]	GUO Sijin, YAN Changjiao, WANG Yang, CAO Xiaohua, WANG Ting. Establishment and application of artificial intelligence voice follow-up system for differentiated thyroid cancer[J]. Journal of Clinical Medicine in Practice, 2024, 28(16): 1-4, 9. DOI: 10.7619/jcmp.20241127
[2]	SUN Lu, TIAN Hu, CHEN Shuai, LIANG Lifeng. Application of Wenshen Formula in patients with spleen and kidney yang deficiency syndrome after operation of Hashimoto's thyroiditis complicated with differentiated thyroid carcinoma[J]. Journal of Clinical Medicine in Practice, 2023, 27(19): 118-122. DOI: 10.7619/jcmp.20231076
[3]	YAO Min, ZHANG Yan. Application of procalcitonin detection in thyroid diseases[J]. Journal of Clinical Medicine in Practice, 2022, 26(1): 95-98. DOI: 10.7619/jcmp.20212098
[4]	CHAI Jixin, CHEN Yong, QI Yantao, WANG Jingjing, LI Bo, AO Yazhou. A nomogram model for early lymph node metastasis of differentiated thyroid carcinoma on basis of thyroglobulin and antibody quantification[J]. Journal of Clinical Medicine in Practice, 2021, 25(21): 7-11. DOI: 10.7619/jcmp.20213894
[5]	YANG Zhisen, GENG Li, TIAN Guijin, HAO Nana, LIU Shukai, ZHANG Xiumei. Effects of different doses of iodine-131 on tumor suppressor gene expression, thyroid hormone and chromosomal aberrations in patients after thyroid cancer surgery[J]. Journal of Clinical Medicine in Practice, 2021, 25(17): 88-91, 96. DOI: 10.7619/jcmp.20211901
[6]	MEI Yan, WANG Qiao, WU Hongwen, XU Rongsheng, ZHAO Liwei. Combined diagnosis for lateral neck lymph node metastasis in differentiated thyroid carcinoma[J]. Journal of Clinical Medicine in Practice, 2021, 25(10): 67-70. DOI: 10.7619/jcmp.20210650
[7]	WU Jie, WANG Huan, LIANG Changping, WANG Min, HE Tao. Value of serum stimulant thyroglobulin level in the diagnosis and predicting prognosis of differentiated thyroid carcinoma[J]. Journal of Clinical Medicine in Practice, 2021, 25(10): 57-61. DOI: 10.7619/jcmp.20210124
[8]	ZHOU Shuwei, SU Beibei, FENG Yueqing, JIANG Dongbao, XIAO Xuezhen. Correlation between serum matrix metalloproteinase-13 expression levels and lung metastasis in patients with differentiated thyroid carcinoma[J]. Journal of Clinical Medicine in Practice, 2021, 25(1): 77-80. DOI: 10.7619/jcmp.20200593
[9]	ZHOU Ke, PAN Junfeng, LONG Binbin, LI Wenfang, WANG Geng. Effect of central lymph node dissection on the clinical efficacy and prognosis in treating differentiated thyroid carcinoma patients[J]. Journal of Clinical Medicine in Practice, 2018, (3): 63-65. DOI: 10.7619/jcmp.201803017
[10]	WANG Lei, WANG Ling, LIN Rui, ZHANG Juliang, WANG Ting. Clinical application of preventive central lymph node dissection in differentiated thyroid carcinoma with negative neck lymph node[J]. Journal of Clinical Medicine in Practice, 2013, (11): 41-43. DOI: 10.7619/jcmp.201311013

Cited By

Cited by

Periodical cited type(4)

1.	殷华芳，沙莎，蔡依玲，于波，刘佳，何佳，孙玲娣，王坚. 宫颈癌放射治疗相关卵巢损伤的分子机制及防治策略研究进展. 实用临床医药杂志. 2024(10): 141-144 . 本站查看
2.	张玉洲，李晓敏，孙少霖. 蓝萼乙素通过Akt/BAD通路对宫颈癌裸鼠移植瘤生长的影响. 现代药物与临床. 2024(06): 1384-1389 .
3.	沈静，张丽华，徐晶晶，吕萌萌，吴东辰. 卡瑞利珠单抗联合白蛋白结合型紫杉醇对晚期宫颈癌患者肿瘤标志物、免疫功能和血管新生指标的影响. 现代生物医学进展. 2024(13): 2592-2595 .
4.	曾美男. 早期宫颈癌术后不同治疗方法的临床效果分析. 实用妇科内分泌电子杂志. 2023(24): 28-30+85 .

Other cited types(0)

Get Citation

PDF

XML

Article views (86) PDF downloads (3) Cited by(4)

Turn off MathJax

Article Contents

Abstract

References

Mechanism of Xueshuantong injection combined with intravenous thrombolysis with alteplase in treatment of patients with acute cerebral infarction based on high mobility group protein B1/Toll-like receptor 4 signaling pathway