1.Unraveling the Heterogeneity of CD8+ T-Cell Subsets in Liver Cirrhosis: Implications for Disease Progression
Kepu ZHENG ; Leiyang DAI ; Shengning ZHANG ; Yingpeng ZHAO ; Wang LI ; Yang GAO ; Yuanyi MANG ; Lingfeng JIAO ; Yu TANG ; Jianghua RAN
Gut and Liver 2025;19(3):410-426
Background/Aims:
Liver cirrhosis involves chronic inflammation and progressive fibrosis.Among various immune cells, CD8+ T cells are considered a major contributor to hepatic inflammation and fibrosis. However, the exact molecular pathways governing CD8+ T-cell-mediated effects in cirrhosis remain unclear.
Methods:
This study analyzed transcriptomic and single-cell sequencing data to elucidate CD8+ T-cell heterogeneity and implications in cirrhosis.
Results:
Weighted gene co-expression analysis of bulk RNA-seq data revealed an association between cirrhosis severity and activated T-cell markers like HLA and chemokine genes. Furthermore, single-cell profiling uncovered eight CD8+ T-cell subtypes, notably, effector memory (Tem) and exhausted (Tex) T cells. Tex cells, defined by PDCD1, LAG3, and CXCL13 expression, were increased in cirrhosis, while Tem cells were decreased. Lineage tracing and differential analysis highlighted CXCL13+ Tex cells as a terminal, exhausted subtype of cells with roles in PD-1 signaling, glycolysis, and T-cell regulation. CXCL13+ Tex cells displayed T-cell exhaustion markers like PDCD1, HAVCR2, TIGIT, and TNFRSF9. Functional analysis implicated potential roles of these cells in immunosuppression. Finally, a CXCL13+ Tex-cell gene signature was found that correlated with cirrhosis severity and poorer prognosis of liver cancer.
Conclusions
In summary, this comprehensive study defines specialized CD8+ T-cell subpopulations in cirrhosis, with CXCL13+ Tex cells displaying an exhausted phenotype associated with immune dysregulation and advanced disease. Key genes and pathways regulating these cells present potential therapeutic targets.
2.Clinical Observation of the Effect of Kidney Tonifying and Blood Stasis Removing Formula on Nutritional Status and Quality of Life in Patients with Osteoporosis Combined with Hemodialysis
Lei WANG ; Fei-ran LI ; Jian-xiang XIAO ; Yan-huan DAI ; Xue-wen WU
Progress in Modern Biomedicine 2025;25(18):2925-2932
Objective:To explore the effect of kidney-strengthening and blood stasis-eliminating formula on nutritional status and quality of life in patients with osteoporosis combined with hemodialysis.Methods:From January 2024 to January 2025,60 patients with liver and kidney yin deficiency and blood stasis obstruction were selected from the Pizhou City Traditional Chinese Medicine Hospital's Hemodialysis Center.60 patients were randomly divided into two groups,30 in each group.The matched group received general treatment plus paricalcitol,while the treatment group received the same treatment plus Yishen Zhuyu Fang(a traditional Chinese medicine formula for kidney and blood stasis).The treatment course lasted 12 weeks.Changes in TCM syndrome scores,the Modified Subjective Global Assessment(MQSGA),the Kidney and Life Quality(KDQOLTM-36)scale,lipid levels,and nutritional indicators were compared before and after treatment.Results:After treatment,the TCM syndrome scores in both groups decreased(P<0.05),with a more pronounced decrease in the treatment group(P<0.05).The KDQOLTM-36 score in the treatment group increased(P<0.05),while the increase was not significant in the matched group(P>0.05),indicating that the treatment group performed better than the matched group(P<0.05).Both groups experienced a decrease in the MQSGA score(P<0.05),although the difference was not statistically significant(P>0.05),the treatment group showed a more noticeable decline.The TC,TG,LDL,and TG/HDL levels in the treatment group all decreased significantly,while HDL levels increased(P<0.05).In contrast,the TC and HDL levels in the matched group did not change(P>0.05),while the TG,LDL,and TG/HDL levels increased(P<0.05).The treatment group performed significantly better than the matched group(P<0.05).The TRF,Hb,and ALB levels in the treatment group increased(P<0.05),while the increase was not significant in the matched group(P>0.05).The total effective rate of the treatment group was 90%,higher than the matched group(23.3%)(P<0.05).Conclusion:The formula of tonifying the kidney and removing stasis can improve the nutritional status and quality of life of patients with liver and kidney yin deficiency and blood stasis obstruction in hemodialysis combined with osteoporosis.
3.Unraveling the Heterogeneity of CD8+ T-Cell Subsets in Liver Cirrhosis: Implications for Disease Progression
Kepu ZHENG ; Leiyang DAI ; Shengning ZHANG ; Yingpeng ZHAO ; Wang LI ; Yang GAO ; Yuanyi MANG ; Lingfeng JIAO ; Yu TANG ; Jianghua RAN
Gut and Liver 2025;19(3):410-426
Background/Aims:
Liver cirrhosis involves chronic inflammation and progressive fibrosis.Among various immune cells, CD8+ T cells are considered a major contributor to hepatic inflammation and fibrosis. However, the exact molecular pathways governing CD8+ T-cell-mediated effects in cirrhosis remain unclear.
Methods:
This study analyzed transcriptomic and single-cell sequencing data to elucidate CD8+ T-cell heterogeneity and implications in cirrhosis.
Results:
Weighted gene co-expression analysis of bulk RNA-seq data revealed an association between cirrhosis severity and activated T-cell markers like HLA and chemokine genes. Furthermore, single-cell profiling uncovered eight CD8+ T-cell subtypes, notably, effector memory (Tem) and exhausted (Tex) T cells. Tex cells, defined by PDCD1, LAG3, and CXCL13 expression, were increased in cirrhosis, while Tem cells were decreased. Lineage tracing and differential analysis highlighted CXCL13+ Tex cells as a terminal, exhausted subtype of cells with roles in PD-1 signaling, glycolysis, and T-cell regulation. CXCL13+ Tex cells displayed T-cell exhaustion markers like PDCD1, HAVCR2, TIGIT, and TNFRSF9. Functional analysis implicated potential roles of these cells in immunosuppression. Finally, a CXCL13+ Tex-cell gene signature was found that correlated with cirrhosis severity and poorer prognosis of liver cancer.
Conclusions
In summary, this comprehensive study defines specialized CD8+ T-cell subpopulations in cirrhosis, with CXCL13+ Tex cells displaying an exhausted phenotype associated with immune dysregulation and advanced disease. Key genes and pathways regulating these cells present potential therapeutic targets.
4.Unraveling the Heterogeneity of CD8+ T-Cell Subsets in Liver Cirrhosis: Implications for Disease Progression
Kepu ZHENG ; Leiyang DAI ; Shengning ZHANG ; Yingpeng ZHAO ; Wang LI ; Yang GAO ; Yuanyi MANG ; Lingfeng JIAO ; Yu TANG ; Jianghua RAN
Gut and Liver 2025;19(3):410-426
Background/Aims:
Liver cirrhosis involves chronic inflammation and progressive fibrosis.Among various immune cells, CD8+ T cells are considered a major contributor to hepatic inflammation and fibrosis. However, the exact molecular pathways governing CD8+ T-cell-mediated effects in cirrhosis remain unclear.
Methods:
This study analyzed transcriptomic and single-cell sequencing data to elucidate CD8+ T-cell heterogeneity and implications in cirrhosis.
Results:
Weighted gene co-expression analysis of bulk RNA-seq data revealed an association between cirrhosis severity and activated T-cell markers like HLA and chemokine genes. Furthermore, single-cell profiling uncovered eight CD8+ T-cell subtypes, notably, effector memory (Tem) and exhausted (Tex) T cells. Tex cells, defined by PDCD1, LAG3, and CXCL13 expression, were increased in cirrhosis, while Tem cells were decreased. Lineage tracing and differential analysis highlighted CXCL13+ Tex cells as a terminal, exhausted subtype of cells with roles in PD-1 signaling, glycolysis, and T-cell regulation. CXCL13+ Tex cells displayed T-cell exhaustion markers like PDCD1, HAVCR2, TIGIT, and TNFRSF9. Functional analysis implicated potential roles of these cells in immunosuppression. Finally, a CXCL13+ Tex-cell gene signature was found that correlated with cirrhosis severity and poorer prognosis of liver cancer.
Conclusions
In summary, this comprehensive study defines specialized CD8+ T-cell subpopulations in cirrhosis, with CXCL13+ Tex cells displaying an exhausted phenotype associated with immune dysregulation and advanced disease. Key genes and pathways regulating these cells present potential therapeutic targets.
5.Unraveling the Heterogeneity of CD8+ T-Cell Subsets in Liver Cirrhosis: Implications for Disease Progression
Kepu ZHENG ; Leiyang DAI ; Shengning ZHANG ; Yingpeng ZHAO ; Wang LI ; Yang GAO ; Yuanyi MANG ; Lingfeng JIAO ; Yu TANG ; Jianghua RAN
Gut and Liver 2025;19(3):410-426
Background/Aims:
Liver cirrhosis involves chronic inflammation and progressive fibrosis.Among various immune cells, CD8+ T cells are considered a major contributor to hepatic inflammation and fibrosis. However, the exact molecular pathways governing CD8+ T-cell-mediated effects in cirrhosis remain unclear.
Methods:
This study analyzed transcriptomic and single-cell sequencing data to elucidate CD8+ T-cell heterogeneity and implications in cirrhosis.
Results:
Weighted gene co-expression analysis of bulk RNA-seq data revealed an association between cirrhosis severity and activated T-cell markers like HLA and chemokine genes. Furthermore, single-cell profiling uncovered eight CD8+ T-cell subtypes, notably, effector memory (Tem) and exhausted (Tex) T cells. Tex cells, defined by PDCD1, LAG3, and CXCL13 expression, were increased in cirrhosis, while Tem cells were decreased. Lineage tracing and differential analysis highlighted CXCL13+ Tex cells as a terminal, exhausted subtype of cells with roles in PD-1 signaling, glycolysis, and T-cell regulation. CXCL13+ Tex cells displayed T-cell exhaustion markers like PDCD1, HAVCR2, TIGIT, and TNFRSF9. Functional analysis implicated potential roles of these cells in immunosuppression. Finally, a CXCL13+ Tex-cell gene signature was found that correlated with cirrhosis severity and poorer prognosis of liver cancer.
Conclusions
In summary, this comprehensive study defines specialized CD8+ T-cell subpopulations in cirrhosis, with CXCL13+ Tex cells displaying an exhausted phenotype associated with immune dysregulation and advanced disease. Key genes and pathways regulating these cells present potential therapeutic targets.
6.Characteristics of hospitalized injury cases in Huangpu District
MA Shuli ; DAI Ran ; YANG Chun ; HAO Xiaomeng ; LIU Jiacong ; WU Huaguo ; WU Mengqi
Journal of Preventive Medicine 2025;37(5):494-498,502
Objective:
To investigate the characteristics of hospitalized injury cases in Huangpu District, Guangzhou City in 2022, so as to provide evidence for optimizing injury prevention interventions.
Methods:
Data on hospitalized injury cases admitted between January to December 2022 were collected through the hospitalization registry system from 17 healthcare institutions in Huangpu District. The population distribution characteristics, causes of injury, injury sites, duration of hospital stay, and hospitalization costs were descriptively analyzed.
Results:
A total of 6 729 hospitalized injury cases were reported in Huangpu District in 2022, including 4 277 males and 2 452 females, with a male-to-female ratio of 1.74∶1. The average age was (49.57±19.82) years, with 2 064 cases (30.67%) aged 45 to <60 years and 1 921 cases (28.55%) aged ≥60 years. The median length of hospitalization was 9.00 (interquartile range, 11.00) days, with median hospitalization costs of 15 968.93 (interquartile range, 25 786.69) yuan. In the months of June to August, there were more cases of injury hospitalization,with 1 904 cases accounting for 28.30%. The top three causes of injury were falls (2 895 cases, 43.02%), transportation accidents (1 247 cases, 18.53%) and exposure to inanimate mechanical forces (1 104 cases, 16.41%). The top three injured sites were lower limb injuries (1 850 cases, 27.49%), upper limb injuries (1 596 cases, 23.72%) and other sites (1 178 cases, 17.51%). The three leading causes of injury with longest hospitalization duration were burns and scalds, transport accidents and falls, with the median duration being 12.00 (interquartile range, 8.00) days, 10.00 (interquartile range, 13.00) days and 10.00 (interquartile range, 11.00) days, respectively. The top three injury sites associated with the longest hospitalization duration were others, lower limb injuries, and head and neck injuries, with the median duration being 11.00 (interquartile range, 13.00) days, 11.00 (interquartile range, 11.00) days, and 10.00 (interquartile range, 12.00) days, respectively. The causes of injury associated with higher hospitalization costs were falls and transportation accidents, with the median hospitalization cost being 23 550.13 (interquartile range, 30 087.76) yuan for falls and 20 301.94 (interquartile range, 30 589.86) yuan for transportation accidents. The injury sites associated with higher hospitalization costs were lower limb injuries and upper limb injuries, with the median hospitalization cost being 24 257.32 (interquartile range, 34 145.54) yuan for lower limb injuries and 16 506.33 (interquartile range, 20 052.27) yuan for upper limb injuries.
Conclusions
In Huangpu District, hospitalized injury mainly occurred among males and individuals aged ≥45 years, with the higher incidence observed between June and August. Fall was the primary cause of injury, while lower limb injuries was the main injury sites. The injury resulted in substantially higher hospitalization costs.
7.Relationship between dried fruit intake and risk of colorectal cancer:a two-sample Mendelian randomization study
Zhichao JIN ; Hong DAI ; Ran YANG
Journal of Clinical Medicine in Practice 2025;29(13):39-43,49
Objective To investigate the causal relationship between dried fruit intake and color-ectal cancer(CRC)by using a two-sample Mendelian randomization(MR)approach.Methods Two-sample MR analysis was conducted utilizing summary data from genome-wide association studies on dried fruit intake and colorectal cancer.Separate analyses were performed using data for colon cancer and rectal cancer for validation.Genetic variants significantly and independently associated with dried fruit intake were selected as instrumental variables.The inverse variance weighted method,MR-Egger regression,weighted median method,simple mode method,and weighted mode method were employed as the primary analytical approaches.Heterogeneity tests,pleiotropy analysis,and sensitivity analysis were conducted to evaluate the reliability of the study.Results A total of 21 single nucleotide poly-morphisms(SNPs)associated with dried fruit intake were included as instrumental variables.The in-verse variance weighted analysis revealed that increased dried fruit intake was associated with a reduced risk of colorectal cancer(OR=0.55,95%CI,0.32 to 0.96,P=3.53 × 10-2),with consistent results observed for both colon cancer and rectal cancer.The findings of this study were not influenced by plei-otropy or heterogeneity,and the reliability of the results was validated by sensitivity analysis.Conclu-sion Increasing dried fruit intake has potential preventive value against colorectal cancer.
8.A Case of Severe Dysphagia Suspected to Result from Acute Oropharyngeal Palsy in which Balloon Dilation was Effective
Masamune EBARA ; Dai FUJIWARA ; Taiki ITO ; Ran KIGUCHI ; Yosuke TOMIYAMA
The Japanese Journal of Rehabilitation Medicine 2025;():25019-
Acute oropharyngeal palsy is a rare subtype of Guillain-Barré syndrome. It is characterized by dysphagia and diminished deep tendon reflexes, while notably sparing limb muscle weakness and orbicularis oculi paralysis. Due to its rarity, dysphagia caused by acute oropharyngeal palsy may remain undiagnosed. We report a case of dysphagia that developed following diabetic ketoacidosis. The patient was a man in his 70s who was transported to our hospital by emergency services due to diabetic ketoacidosis. Severe dysphagia persisted despite the successful management of his diabetic ketoacidosis. Although the diagnosis was challenging, we established a diagnosis of acute oropharyngeal palsy based on physical examination findings and cerebrospinal fluid analysis results. We observed improvement in dysphagia caused by acute oropharyngeal palsy following balloon dilation therapy. We present this case to emphasize the importance of including acute oropharyngeal palsy in the differential diagnosis when evaluating patients with bulbar palsy.
9.A Case of Severe Dysphagia Suspected to Result from Acute Oropharyngeal Palsy in which Balloon Dilation was Effective
Masamune EBARA ; Dai FUJIWARA ; Taiki ITO ; Ran KIGUCHI ; Yosuke TOMIYAMA
The Japanese Journal of Rehabilitation Medicine 2025;62(12):1252-1260
Acute oropharyngeal palsy is a rare subtype of Guillain-Barré syndrome. It is characterized by dysphagia and diminished deep tendon reflexes, while notably sparing limb muscle weakness and orbicularis oculi paralysis. Due to its rarity, dysphagia caused by acute oropharyngeal palsy may remain undiagnosed. We report a case of dysphagia that developed following diabetic ketoacidosis. The patient was a man in his 70s who was transported to our hospital by emergency services due to diabetic ketoacidosis. Severe dysphagia persisted despite the successful management of his diabetic ketoacidosis. Although the diagnosis was challenging, we established a diagnosis of acute oropharyngeal palsy based on physical examination findings and cerebrospinal fluid analysis results. We observed improvement in dysphagia caused by acute oropharyngeal palsy following balloon dilation therapy. We present this case to emphasize the importance of including acute oropharyngeal palsy in the differential diagnosis when evaluating patients with bulbar palsy.
10.Clinical Utilization Analysis of Rituximab Biosimilar: A Single-Center Retrospective Study
Yuzhen ZOU ; Ran XIAO ; Shaohong WANG ; Rui DAI ; Xiaoli DU
Medical Journal of Peking Union Medical College Hospital 2025;16(6):1484-1492
To investigate the clinical utilization of Rituximab biosimilar (Rituximab injection) in order to provide references for evaluating its rationality and economic value in clinical application. A retrospective analysis was conducted on medical records of inpatients who received Rituximab injection at Peking Union Medical College Hospital between January 1, 2020, and December 31, 2023. The clinical usage patterns, off-label use, economic benefits compared to the originator drug, and adverse drug reactions (ADRs) were analyzed. A total of 725 patients treated with Rituximab injection were included. The majority of patients were from the Department of Nephrology (80.69%), followed by Rheumatology and Immunology (9.24%), Hematology (8.41%), and Dermatology (0.97%). The drug was used for 27 different diseases, with the top five being membranous nephropathy (62.90%), minimal change disease (7.31%), systemic lupus erythematosus (4.41%), anti-neutrophil cytoplasmic antibody-associated vasculitis (3.72%), and granulomatosis with polyangiitis or microscopic polyangiitis (3.59%). The off-label use rate was as high as 96.28% (698/725). The overall incidence of ADRs was 21.24%. The total consumption of Rituximab injection was 1183.2 g, resulting in calculated cost savings of about ¥7.35 million compared to the originator drug. Rituximab injection is widely used in hematologic malignancies and immune-mediated diseases, with a low overall incidence of ADRs and greater cost-effectiveness compared to the originator drug. The extremely high rate of off-label use is supported by corresponding guidelines or clinical studies.


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