1.Combined Therapy of Traditional Chinese and Western Medicine for Hepatitis B Virus Infection: A Review
Xuan WU ; Hui LI ; Jian HUANG ; Xikun YANG ; Yan ZENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):279-288
Hepatitis B virus (HBV) infection is the primary cause of viral hepatitis and represents a substantial disease burden in China. However, effective and safe agents capable of completely eliminating HBV DNA are still lacking. In modern medicine, anti-HBV strategies mainly target covalently closed circular DNA (cccDNA), among other mechanisms, and multiple novel drugs are currently under clinical investigation. Traditional medicine has been shown to exert anti-HBV effects through direct pathways, such as blocking viral entry, as well as indirect pathways, including the regulation of programmed cell death. Studies have confirmed that the integration of traditional Chinese medicine (TCM) and Western medicine in treating HBV infection and its related complications offers complementary advantages, particularly in enhancing HBV clearance rates, improving liver function, preventing various complications, and delaying the progression from hepatic fibrosis to hepatocellular carcinoma. This review focuses on advances in anti-HBV research involving TCM, Western medicine, and their integrated application, aiming to provide a basis for integrated HBV therapy and new drug development.
2.Current strategies and future directions in the treatment of age-related macular degeneration
Jian XU ; Jie WANG ; Haixin FU ; Chaopeng LI
International Eye Science 2026;26(1):56-62
Age-related macular degeneration(ARMD)is a progressive visual impairment fundus disease that frequently occurs in individuals aged >55 years. The main risk factors are aging, long-term smoking, genetics, and racial differences. Pathogenesis includes abnormal function of the retinal pigment epithelium, damaged blood-retinal barrier, and abnormal immune function. Currently, intravitreal injection(IVI)of anti-vascular endothelial growth factor(VEGF)drugs is the preferred treatment option for ARMD in clinical practice. However, it also faces challenges such as repeated treatments, high medical costs, and poor patient compliance. The predicament in the treatment of ARMD has given rise to several new treatment options. This article aims to review the treatment methods and progress of dry ARMD and wet ARMD, providing new ideas for addressing the limitations of the current clinical anti-VEGF treatment.
3.Guizhi Shaoyao Zhimutang and Active Components of Its Single Herbs in Treatment of Rheumatoid Arthritis: A Review
Jian LIU ; SHIPEIRU ; Shuang LI ; Jinzhao ZHAO ; Naijun CAO ; Mingxiu JIN ; Jing YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):346-354
Rheumatoid arthritis (RA) is a common autoimmune disease characterised clinically by symmetrical joint pain, swelling, and stiffness. Long-term chronic synovial inflammation can lead to severe joint damage and even disability, thereby affecting quality of life for patients. Current clinical treatment of RA emphasises an integrated approach combining traditional Chinese and Western medicine, with traditional Chinese medicine offering certain advantages in reducing disease activity of RA, preventing relapses, and other aspects. Modern clinical evidence confirms that Guizhi Shaoyao Zhimutang (GSZT) is effective in improving symptoms such as immune metabolism, joint stiffness, and joint pain in RA patients. Pharmacological studies have revealed that GSZT primarily contains components such as cinnamaldehyde, total glucosides of paeony, total alkaloids of Aconiti Lateralis Radix Praeparata, glycyrrhetinic acid, zingiberone, isoimperatorin, ephedra polysaccharides, and cedrol. It improves RA symptoms via multiple mechanisms and targets, including enhancing immune responses, exerting anti-inflammatory and analgesic effects, regulating relevant signalling pathways, inhibiting cell apoptosis, and suppressing bone destruction. This paper reviewed the syndrome patterns and pharmacological basis of GSZT in the treatment of RA, as well as its clinical applications and related mechanisms, thereby providing a theoretical basis and reference for the further development and utilisation of GSZT in the treatment of RA.
4.Exploring Mechanism of Xiaoqinglongtang Against High Altitude Pulmonary Edema Based on Integrative Pharmacology Model
Rongrong WANG ; Chuchu WANG ; Qi XU ; Qin JIAN ; Junzhi LIN ; Ruli LI ; Chuan ZHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):137-148
ObjectiveTo explore the potential mechanism of Xiaoqinglongtang(XQL) in the prevention and treatment of high altitude pulmonary edema(HAPE) by network pharmacology, molecular docking, and molecular dynamics simulation, and to verify it by in vivo animal model. MethodsIn this study, the active ingredients, drug targets, and HAPE-related targets of XQL were collected from BATMAN-TCM, GeneCards, and Online Mendelian Inheritance in Man(OMIM) databases. The protein-protein interaction(PPI) network was constructed by using intersection targets, and the core targets were screened and visualized by Cytoscape software. Functional annotation and pathway analysis of the intersection targets were performed by gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) functional enrichment. AutoDock and GROMACS were used to evaluate the binding ability of active ingredients to key targets. In the experimental verification part, a mouse model of HAPE induced by hypobaric hypoxia(simulated 6 000 m altitude for 48 h) was established. The control effect was evaluated by hematoxylin-eosin(HE) staining, lung tissue water content, lung tissue wet/dry weight ratio, real-time quantitative polymerase chain reaction(Real-time PCR) detection of gene expression levels, and immunohistochemistry and Western blot detection of key protein expression. ResultsA total of 355 active ingredients of XQL, 2 142 targets, 716 HAPE-related targets, and 236 intersection targets were obtained by network pharmacology analysis. Key core targets such as interleukin (IL)-6, tumor necrosis factor (TNF), protein kinase B1 (Akt1), and hypoxia-inducible factor-1α (HIF-1α) were screened. The results of GO analysis of common targets involved 738 biological processes(BP), 72 cellular components(CC), and 135 molecular functions(MF). KEGG analysis effectively enriched two important signaling pathways: Phosphoinositol 3-kinase (PI3K)/Akt and HIF-1α. The results of molecular docking and molecular dynamics simulation showed that the screened active ingredients had good binding ability with key targets. In the HAPE model induced by hypobaric hypoxia(6 000 m, 48 h), the lung tissue water content, lung tissue wet/dry weight ratio, and pathological injury score of the model group were significantly increased(P<0.01), accompanied by exudation of a large number of red blood cells in the alveoli and alveolar interstitium, a significant increase in inflammatory cells, a significant widening of the alveolar septum, and mutual fusion between the alveoli. The XQL administration group significantly improved the above pathological changes(P<0.01). The results of inflammatory factor expression showed that compared with the control group, the model group showed significantly up-regulated expression of TNF-α, IL-6, and IL-1β in the lung tissue(P<0.01). Compared with the model group, the XQL administration group had significantly decreased expression of inflammatory factors(P<0.05, P<0.01). The mRNA expression of key pathway related genes PI3K, Akt1, mammalian target of rapamycin(mTOR), and HIF-1α was significantly increased in the model group(P<0.01), and decreased in a concentration-dependent manner after XQL administration(P<0.05, P<0.01). The expression levels of key proteins PI3K, phosphorylation(p)-PI3K, Akt1, p-Akt1, mTOR, p-mTOR, and HIF-1α in lung tissue were analyzed by immunohistochemistry and Western blot. Compared with the blank group, the model group showed increased expression of key proteins(P<0.05, P<0.01). Compared with the model group, the XQL administration group exhibited decreased expression of key proteins(P<0.05, P<0.01). ConclusionXQL can reduce lung inflammation and improve HAPE. The mechanism may be related to the regulation of PI3K/Akt/mTOR and HIF-1α pathways. This study provides a new idea and a theoretical basis for the treatment of HAPE with XQL.
5.Exploring Mechanism of Xiaoqinglongtang Against High Altitude Pulmonary Edema Based on Integrative Pharmacology Model
Rongrong WANG ; Chuchu WANG ; Qi XU ; Qin JIAN ; Junzhi LIN ; Ruli LI ; Chuan ZHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):137-148
ObjectiveTo explore the potential mechanism of Xiaoqinglongtang(XQL) in the prevention and treatment of high altitude pulmonary edema(HAPE) by network pharmacology, molecular docking, and molecular dynamics simulation, and to verify it by in vivo animal model. MethodsIn this study, the active ingredients, drug targets, and HAPE-related targets of XQL were collected from BATMAN-TCM, GeneCards, and Online Mendelian Inheritance in Man(OMIM) databases. The protein-protein interaction(PPI) network was constructed by using intersection targets, and the core targets were screened and visualized by Cytoscape software. Functional annotation and pathway analysis of the intersection targets were performed by gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) functional enrichment. AutoDock and GROMACS were used to evaluate the binding ability of active ingredients to key targets. In the experimental verification part, a mouse model of HAPE induced by hypobaric hypoxia(simulated 6 000 m altitude for 48 h) was established. The control effect was evaluated by hematoxylin-eosin(HE) staining, lung tissue water content, lung tissue wet/dry weight ratio, real-time quantitative polymerase chain reaction(Real-time PCR) detection of gene expression levels, and immunohistochemistry and Western blot detection of key protein expression. ResultsA total of 355 active ingredients of XQL, 2 142 targets, 716 HAPE-related targets, and 236 intersection targets were obtained by network pharmacology analysis. Key core targets such as interleukin (IL)-6, tumor necrosis factor (TNF), protein kinase B1 (Akt1), and hypoxia-inducible factor-1α (HIF-1α) were screened. The results of GO analysis of common targets involved 738 biological processes(BP), 72 cellular components(CC), and 135 molecular functions(MF). KEGG analysis effectively enriched two important signaling pathways: Phosphoinositol 3-kinase (PI3K)/Akt and HIF-1α. The results of molecular docking and molecular dynamics simulation showed that the screened active ingredients had good binding ability with key targets. In the HAPE model induced by hypobaric hypoxia(6 000 m, 48 h), the lung tissue water content, lung tissue wet/dry weight ratio, and pathological injury score of the model group were significantly increased(P<0.01), accompanied by exudation of a large number of red blood cells in the alveoli and alveolar interstitium, a significant increase in inflammatory cells, a significant widening of the alveolar septum, and mutual fusion between the alveoli. The XQL administration group significantly improved the above pathological changes(P<0.01). The results of inflammatory factor expression showed that compared with the control group, the model group showed significantly up-regulated expression of TNF-α, IL-6, and IL-1β in the lung tissue(P<0.01). Compared with the model group, the XQL administration group had significantly decreased expression of inflammatory factors(P<0.05, P<0.01). The mRNA expression of key pathway related genes PI3K, Akt1, mammalian target of rapamycin(mTOR), and HIF-1α was significantly increased in the model group(P<0.01), and decreased in a concentration-dependent manner after XQL administration(P<0.05, P<0.01). The expression levels of key proteins PI3K, phosphorylation(p)-PI3K, Akt1, p-Akt1, mTOR, p-mTOR, and HIF-1α in lung tissue were analyzed by immunohistochemistry and Western blot. Compared with the blank group, the model group showed increased expression of key proteins(P<0.05, P<0.01). Compared with the model group, the XQL administration group exhibited decreased expression of key proteins(P<0.05, P<0.01). ConclusionXQL can reduce lung inflammation and improve HAPE. The mechanism may be related to the regulation of PI3K/Akt/mTOR and HIF-1α pathways. This study provides a new idea and a theoretical basis for the treatment of HAPE with XQL.
6.The prognostic value and immune regulatory role of BRF1 in pan-cancer, and its function in esophageal squamous cell carcinoma
Jianxin XU ; Zihao LI ; Wang LÜ ; ; Zhiyang XU ; Yunfeng YI ; Songlin CHEN ; Jian HU ; Luming WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):122-131
Objective To investigate the expression profile, prognostic value, gene co-expression network, and immunomodulatory role of BRF1 in a pan-cancer context, and to explore its biological functions and molecular regulatory mechanisms in esophageal squamous cell carcinoma (ESCC). Methods The pan-cancer dataset from The Cancer Genome Atlas (TCGA) was utilized to analyze the differential expression of BRF1 in tumor versus normal tissues, its association with patient survival, pathway enrichment for co-expressed genes, and immune features (including immune checkpoints, cytokines, and immune cell infiltration). The expression profile of BRF1 in ESCC was validated using the Gene Expression Omnibus (GEO) database. In vitro, BRF1 was knocked down in ESCC cells using siRNA. Cell proliferation and migration were assessed by MTT and Transwell assays, respectively. The expression levels of proliferation- and migration-related proteins were detected by Western blotting. The correlation between BRF1 and ferroptosis was analyzed using TCGA data. Results BRF1 was significantly upregulated in over 20 types of cancer, and its high expression was associated with poor prognosis in patients with adrenocortical carcinoma and prostate adenocarcinoma. BRF1 was found to positively regulate the T-cell-mediated cell death pathway in esophageal adenocarcinoma and was associated with the circadian rhythm regulation pathway in pancreatic adenocarcinoma. The correlation of BRF1 with immune checkpoints, cytokine networks, and immune cell infiltration was found to be cancer type-specific. In vitro experiments demonstrated that knocking down BRF1 significantly inhibited the proliferation of ESCC cells, accompanied by the downregulation of the proliferation marker PCNA. Cell migration was also significantly impaired, with decreased expression of Vimentin and MMPs and increased expression of E-cadherin. Furthermore, the expression of BRF1 was positively correlated with that of ferroptosis-antagonizing genes, such as GPX4, HSPA5, and SLC7A11. Conclusion BRF1 plays complex roles in pan-cancer, participating in the regulation of tumorigenesis, progression, and immune infiltration. BRF1 promotes the proliferation and migration of ESCC cells, a mechanism potentially associated with the regulation of ferroptosis resistance. These findings suggest that BRF1 could be a potential therapeutic target for ESCC.
7.Advances in perioperative nutritional management for patients with esophageal cancer
Zuyu ZHANG ; Bo YANG ; Rong NIU ; Jijun XUE ; Jian CHEN ; Dong LI ; Wentao ZHAO ; Wenfeng HAN ; Yue BAI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):157-162
Esophageal cancer is a prevalent malignant tumor of the digestive tract in China, and radical surgery remains the cornerstone of its comprehensive treatment. However, multifactorial challenges such as postoperative gastrointestinal tract reconstruction, traumatic stress, and tumor-related metabolic disturbances render esophageal cancer patients highly susceptible to malnutrition. Perioperative nutritional support therapy plays a crucial role in enhancing surgical safety, improving clinical outcomes, and elevating patients' quality of life by regulating metabolic homeostasis, preserving organ function, and optimizing the immune microenvironment. This article reviews the mechanisms underlying malnutrition in esophageal cancer, methods for nutritional status assessment, and precision intervention pathways based on multi-omics evaluations. The aim is to strengthen clinicians' awareness of standardized perioperative nutritional management for esophageal cancer patients and promote its clinical implementation, thereby facilitating postoperative recovery and improving long-term quality of life.
8.Transcatheter aortic valve replacement for aortic regurgitation complicated by Takayasu arteritis: A case report
Jianbin GAO ; Jian LI ; Yu YANG ; Mier MA ; Kairui YANG ; Wei LUO ; Ning WANG ; Da ZHU ; Wenbin OUYANG ; Xiangbin PAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):163-166
Patients with Takayasu arteritis combined with aortic valve disease often have a poor prognosis following surgical valve replacement, frequently encountering complications such as perivalvular leakage, valve detachment, and anastomotic aneurysm. This article presents a high-risk case wherein severe aortic valve insufficiency associated with Takayasu arteritis was successfully managed through transcatheter aortic valve implantation via the transapical approach. The patient had satisfactory valve function with no complications observed during the six-month postoperative follow-up. This case provides a minimally invasive and feasible alternative for the clinical management of such high-risk patients.
9.Effect of remote ischemic preconditioning on preoperative heart rate variability in patients undergoing heart valve surgery: A randomized controlled trial
Zhipeng GUO ; Jian ZHANG ; Qiaoli WAN ; Fengyan SHI ; Rui LI ; Zongtao YIN ; Jinsong HAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(04):592-596
Objective To explore the effect of remote ischemic preconditioning (RIPC) on preoperative heart rate variability in patients with heart valves. Methods Patients scheduled to undergo on-pump cardiac valve surgery in the Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, between January and July 2022 were initially enrolled. Eligible patients were randomly assigned at a 1 : 1 ratio to either the RIPC group or the control group. Relevant indicators of heart rate variability [standard deviation of NN interval (SDNN), standard deviation of mean value of NN interval in every five minutes (SDANN), mean square root of difference between consecutive NN intervals (RMSSD), percentage of adjacent RR interval>50 ms (PNN50), low frequency (LF) component, high frequency (HF) component and LF/HF] at 8 hours in the morning on the surgical day between two groups were compared. Results A total of 118 patients were initially assessed. After screening, 58 patients were excluded, and 60 patients provided written informed consent and were enrolled in the trial, with 30 allocated to the RIPC group and 30 to the control group. Seven patients in the control group and 5 patients in the RIPC group were subsequently excluded due to missing heart rate variability data resulting from cancelled operations. Finally, 23 patients in the control group and 25 patients in the RIPC group were included in the analysis. There was no statistical difference in baseline characteristics between the two groups, and there was no significant difference in heart rate variability 24 hours before intervention (P>0.05). After the intervention measures were taken, the comparison of the results of heart rate variability at 8 hours on the day of operation showed that SDNN and SDANN of patients in the RIPC group were higher than those in the control group, with statistical differences (P<0.05). Conclusion RIPC can stabilize the preoperative heart rate variability of patients undergoing cardiac valve surgery.
10.Strategies and challenges for hepatitis D prevention and control
Journal of Clinical Hepatology 2026;42(2):260-264
Hepatitis D is an inflammatory liver disease caused by hepatitis D virus (HDV) infection, and co-infection of HDV and hepatitis B virus dramatically accelerates the progression of liver disease and significantly increases the risk of liver cirrhosis and hepatocellular carcinoma. However, due to insufficient awareness and concern about hepatitis D among the public, clinicians, and public health workers, the screening rate of hepatitis D remains at a relatively low level around the world. The true disease burden of hepatitis D has been seriously underestimated, and it has become one of the major challenges in the global campaign of hepatitis elimination. This article systematically reviews the current epidemiological situation of hepatitis D, prevention and control strategies, and related issues and challenges and analyzes the future strategies and measures for prevention and control, in order to provide a reference for promoting the achievement of the goal to eliminate viral hepatitis as a public health threat.

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