Diabetic nephropathy (DN) has been recognized as a severe complication of diabetes mellitus and a dominant pathogeny of end-stage kidney disease, which causes serious health problems and great financial burden to human society worldwide. Conventional strategies, such as renin-angiotensin-aldosterone system blockade, blood glucose level control, and bodyweight reduction, may not achieve satisfactory outcomes in many clinical practices for DN management. Notably, due to the multi-target function, Chinese medicine possesses promising clinical benefits as primary or alternative therapies for DN treatment. Increasing studies have emphasized identifying bioactive compounds and molecular mechanisms of reno-protective effects of Chinese medicines. Signaling pathways involved in glucose/lipid metabolism regulation, antioxidation, anti-inflammation, anti-fibrosis, and podocyte protection have been identified as crucial mechanisms of action. Herein, we summarize the clinical efficacies of Chinese medicines and their bioactive components in treating and managing DN after reviewing the results demonstrated in clinical trials, systematic reviews, and meta-analyses, with a thorough discussion on the relative underlying mechanisms and molecular targets reported in animal and cellular experiments. We aim to provide comprehensive insights into the protective effects of Chinese medicines against DN.

This case report describes a 50-year-old-woman from Southeast Asia with extensive atherosclerotic cardiovascular disease, found to have homozygous familial hypercholesterolemia caused by variants of uncertain significance in both the APOB and LDLR genes. Medications were insufficient, and thus LDL apheresis was initiated to further decrease LDL-C. (Level of Difficulty: Beginner.).

BACKGROUND: Although apolipoprotein (apo) CIII gene polymorphisms have proved to be related to the increased serum lipid level in foreign studies, the results have not always been consistent among diverse populations. In addition, the research focuses on the impact of the apoCIII on the serum lipid levels of Han Chinese subjects which was not conducted before.
OBJECTIVE: To explore the relationship between the apoCIII gene C3175G and T3206G polymorphisms and serum lipid levels as well as other risk factors for hyperlipidaemia, in Han Chinese males.
METHODS: A total of 337 healthy male participants undergoing physical examinations were randomly selected from two hospitals in Chongqing, China. Through DNA sequencing, apoCIII gene C3175G and T3206G polymorphisms were identified and their relationships with serum lipid levels were further analysed.
RESULTS: Carriers of apoCIII(3175) GG genotypes have higher levels of TG than other genotypes (P < 0.05). After the stratified selection of triacylglycerol (TG), G gene loci of apoCIIIT3206G are associated with decreasing the content of total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) in relatively high TG group while the G gene loci of apoCIIIC3175G have an inverse effect. The outcome of TG unconditional logistic regression shows that the G gene loci of apoCIIIT3206G polymorphism are also beneficial for decreasing TG.
CONCLUSIONS: The detection of TG in apoCIII(3175) GG genotype carriers is an efficient predictor of hypertriglyceridaemia in Han Chinese males. The G gene loci of apoCIII(3206) may be beneficial for decreasing serum lipid level.