1.Analysis of the Correlation between Plasma Fibrinogen and Osteoporosis Defined by Quantitative Computed Tomography
Yingna CHEN ; Kan SUN ; Na LI ; Chengzhi WANG ; Chulin HUANG ; Lingling LI ; Huisheng XIAO ; Guojuan LAO
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(1):147-153
[Objective]To clarify the associations between plasma fibrinogen(Fbg)and volumetric bone mineral density(vBMD)as well as osteoporosis measured by quantitative computed tomography(QCT),and to explore the role of plasma Fbg in early screening and diagnosis of osteoporosis.[Methods]Patients with hypertension who were hospitalized in the Department of Endocrinology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to June 2022 and underwent QCT examinations were included for cross-sectional analysis.The study analyzed the correlation between plasma Fbg and osteoporosis in patients.The diagnostic efficacy of plasma Fbg for osteoporosis was evaluated by the area under the receiver operating characteristic(ROC)curve(AUC).[Results]Totally 441 subjects were included in the analysis,with an average age of 46.0±14.5 years and a prevalence of osteoporosis of 6.4%(28/441).As the level of plasma fibrinogen increased,the incidence of osteoporosis significantly increased(P<0.000 1)while the average bone mineral density of L1 and L2 were significantly decreased(P<0.05).Compared with the first quartile of plasma Fbg(1.99g/L-2.37g/L),the risk of osteoporosis in the fourth quartile of plasma Fbg(3.67g/L-4.46g/L)increased by 8.85 times after adjusting for related confounding factors.[Conclusion]This study found a negative correlation between plasma fibrinogen levels and bone density in patients with hypertension.Plasma fibrinogen levels may serve as a potential screening indicator for osteoporosis,aiding in early diagnosis and therapeutic monitoring.This discovery offers a new perspective for the study of bone metabolic diseases and warrants further investigation.
2.Invasion and Metastasis in Colorectal Cancer Mediated by Traditional Chinese Medicine via Cell Signaling Pathway: A Review
Min GUO ; Wenyan YU ; Naicheng ZHU ; Yuwei YAN ; Chen ZHONG ; Xiudan CHEN ; Nanxin LI ; Guojuan WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):323-330
Colorectal cancer is a common and malignant tumor in the digestive tract. Invasion and metastasis of cancer cells are key factors leading to the high mortality rate and postoperative recurrence of colorectal cancer. Chemotherapy is the main treatment method for preventing recurrence of this disease. However, there are many toxic side effects in clinical application, which seriously hinder the treatment process. Therefore, it is imperative to search for efficient and low-toxicity drugs. Traditional Chinese medicine (TCM) has a long history of treating colorectal cancer and offers advantages such as safety, effectiveness, multiple targets, multiple pathways and minimal toxic side effects, which have made it increasingly popular worldwide. According to TCM, the pathogenesis of colorectal cancer is rooted in both deficiency and excess. TCM formulas mainly focus on tonifying the body to address the invasion and metastasis of colorectal cancer, such as Jianpi compound, Jianpi Xiaoai decoction, and Bushen Jiedu Sanjie decoction. TCM monomers, such as emodin, berberine, and tanshinone, mainly focus on clearing heat and removing toxin, circulating blood and transforming stasis, and resolving swelling and dispersing nodules. Signaling pathways play a crucial role for analyzing invasion and metastasis, and research has shown that pathways such as Wnt/β-catenin, phosphatidylinositol-3 kinase/protein kinase (PI3K/Akt), Janus kinase 2/signal transduction and transcription activating factor 3 (JAK2/STAT3), nuclear factors-κB (NF-κB), vascular endothelial growth factor (VEGF) play important roles in the invasion and metastasis of colorectal cancer. The invasion and metastasis of colorectal cancer can be inhibited via regulating the key proteins and related factors in these pathways. In this review, we searched various literature databases, such as PubMed, China National Knowledge Infrastructure (CNKI), and VIP, using keywords such as "colorectal cancer", "signaling pathway", "invasion and metastasis", and "traditional Chinese medicine", to summarize and analyze the relevant pathways of TCM compounds and monomers against invasion and metastasis of colorectal cancer published in the past five years. The review aims to provide new insights and references for in-depth research on the therapy for invasion and metastasis of colorectal cancer and new drug development.
3.Role of neutrophil extracellular traps in hepatocellular carcinoma
Xueru TIAN ; Weiyu CHEN ; Luyi YAN ; Yang HONG ; Han WANG ; Shouqin LIU ; Lei QING ; Guojuan MA ; Dewen MAO ; Chun YAO
Journal of Clinical Hepatology 2025;41(11):2410-2417
Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence and mortality rates worldwide. Recent studies have shown that neutrophil extracellular traps (NETs) play an important role in the development, progression, and immune escape of HCC. NETs are released by neutrophils and mainly consist of DNA, histones, and antimicrobial molecules, and in addition to immune defense, they are also involved in the initiation, metastasis, and thrombosis of HCC. This article elaborates on the formation and regulatory mechanisms of NETs, explores their potential mechanisms in the initiation, metastasis, immune escape, and thrombosis of HCC, and discusses the prospect of NETs as a target for the diagnosis and treatment of HCC, in order to provide new ideas for the precise treatment of HCC in the future and promote the early diagnosis and effective treatment of HCC.
4.Predictive value of growth differentiation factor 15 for atrial fibrillation in elderly patients with coronary heart disease
Hunan XIAO ; Lü LÜ ; Cui XU ; Xiaofan WANG ; Li SHENG ; Guojuan TAN ; Feng TIAN ; Hongbin LIU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(9):1183-1187
Objective To explore the predictive value of growth differentiation factor 15(GDF-15)for atrial fibrillation(AF)in patients with coronary heart disease(CHD).Methods A prospective observation cohort of 1261 elderly CHD patients was randomly sampled from the First Medical Center of Chinese PLA General Hospital from January 2012 to December 2015.ELISA was used to detect GDF-15 level in all the subjects,and their baseline data were collected.Until March 2023,93 patients were lost during the follow-up period,and finally 1168 patients completed the follow-up,with a median time of 9.4 years.According to AF occurred or not during the period,the eligible patients were divided into an AF group(197 cases)and a non-AF group(971 cases),and based on their medical history,also assigned into a stable angina pectoris(SAP,n=304)and an acute coronary syndrome group(ACS,n=864).Logistic regression analysis was used to determine whether GDF-15 is a risk factor for AF in elderly CHD patients.ROC curve was plotted to assess the predictive value of GDF-15,guideline recommended CHARGE-AF scoring model,and their combination for AF events in the patients.Results The AF group had significantly advanced age,larger proportions of smoking history,type 2 diabetes,hypertension,old myocardial infarction,stroke,ACS and administration of statins,higher ratio of angiotensin converting enzyme inhibi-tor/angiotensin receptor blocker,and elevated levels of GDF-15 and N-terminal pro-B-type natri-uretic peptide,and lower left ventricular ejection fraction,SAP incidence,and low-density lipopro-tein cholesterol,total cholesterol and triglycerides levels when compared with the non-AF group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that GDF-15 was not a risk factor for AF in elderly CHD patients(OR=0.92,95%CI:0.74-1.16,P=0.489),but was a risk factor for AF in SAP patients(OR=1.38,95%CI:1.07-2.79,P=0.015),and in ACS patients,still not a risk factor for AF(OR=0.81,95%CI:0.63-1.05,P=0.814).ROC curve analysis showed that the AUC value of GDF-15 combined with the CHARGE-AF scoring model in predic-ting AF was 0.682 in the elderly CHD patients,0.746 in the SAP patients,and 0.680 in the ACS patients.Conclusion Elevated GDF-15 level is an independent risk factor and predictor of AF in elderly SAP patients.In SAP patients,the combination of GDF-15 and CHARGE-AF scoring model further improves the predictive performance of AF occurrence.
5.Clinical management of autoimmune oophoritis
Chengzhi WANG ; Yanning YANG ; Lingling LI ; Chulin HUANG ; Na LI ; Guojuan LAO ; Huisheng XIAO ; Kan SUN
Chinese Journal of Endocrinology and Metabolism 2025;41(11):953-957
Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.
6.Clinical management of autoimmune oophoritis
Chengzhi WANG ; Yanning YANG ; Lingling LI ; Chulin HUANG ; Na LI ; Guojuan LAO ; Huisheng XIAO ; Kan SUN
Chinese Journal of Endocrinology and Metabolism 2025;41(11):953-957
Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.
7.Clinical safety of sodium-glucose cotransporter 2 inhibitors: a study based on adverse drug reaction monitoring data in Beijing from 2019 to 2024
Yue XIE ; Zhihui SONG ; Junhan LIU ; Huiying ZHAO ; Guojuan ZHANG ; Jiawei WANG
Adverse Drug Reactions Journal 2025;27(11):660-666
Objective:To analyze the characteristics of adverse reactions of sodium-glucose cotransporter 2 inhibitors (SGLT2i), and provide a basis for the rational clinical application.Methods:The adverse drug reaction (ADR) cases of SGLT2i reported by Beijing from January 1, 2019 to June 30, 2024 were collected through searching the National Adverse Drug Reaction Monitoring System of China. The Medical Dictionary for Regulatory Activities (MedDRA) terminology set was used to standardize the description of ADR, and the involving system organ class (SOC) and preferred term (PT) was extracted. Data of ADR were analyzed descriptively and statistically. Results:A total of 409 SGLT2i-related adverse reaction reports involving 409 patients were included. Among these patients, there were 232 females and 177 males; the median age was 62(52, 70) years, and 231 cases (56.48%) were under the age of 65 years; 5 types of SGLT2i (dapagliflozin, empagliflozin, canagliflozin, ertugliflozin, and henagliflozin proline) were involved, and reports of dapagliflozin was the most (279 cases, 68.22%). The primary indication for medication was diabetes (404 cases, 98.78%). The majority of ADRs did not reach the severe level (395 cases, 96.58%). The 14 cases (3.42%) of severe ADR were primarily about diabetic ketoacidosis (11 cases, 11/14), of which 7 cases presented with normal blood glucose levels and 5 cases occurred after medical stress events. The outcomes of patients were improvement in 241 cases (58.92%) and recovery in 127 cases (31.05%). In total, 476 ADR occurrences were recorded among the 409 patients, involving 82 PTs, 24 of which were not listed in the drug labels. The top 2 SOCs were the infections and infestations [26.26% (125/476)] and renal and urinary disorders [13.87% (66/476)]; the top 3 PTs were urinary tract infection [23.32% (111/476)], urinary ketone detection [6.51% (31/476)], and vulvovaginal pruritus [5.88% (28/476)]; the top 3 newly identified possible ADRs (PTs) were dizziness [2.31% (11/476)], palpitations [1.89% (9/476)], and decreased appetite [1.05% (5/476)].Conclusions:Based on the ADR monitoring data in Beijing in the past 5 and a half years, SGLT2i-associated adverse reactions primarily involved the infections and infestations, and renal and urinary disorders. ADRs identified in the study such as dizziness and palpitations are not documented in the drug labels, euglycaemic ketoacidosis accounts for a high proportion of severe reactions, and most of them occur after acute stress events.
8.Clinical safety of sodium-glucose cotransporter 2 inhibitors: a study based on adverse drug reaction monitoring data in Beijing from 2019 to 2024
Yue XIE ; Zhihui SONG ; Junhan LIU ; Huiying ZHAO ; Guojuan ZHANG ; Jiawei WANG
Adverse Drug Reactions Journal 2025;27(11):660-666
Objective:To analyze the characteristics of adverse reactions of sodium-glucose cotransporter 2 inhibitors (SGLT2i), and provide a basis for the rational clinical application.Methods:The adverse drug reaction (ADR) cases of SGLT2i reported by Beijing from January 1, 2019 to June 30, 2024 were collected through searching the National Adverse Drug Reaction Monitoring System of China. The Medical Dictionary for Regulatory Activities (MedDRA) terminology set was used to standardize the description of ADR, and the involving system organ class (SOC) and preferred term (PT) was extracted. Data of ADR were analyzed descriptively and statistically. Results:A total of 409 SGLT2i-related adverse reaction reports involving 409 patients were included. Among these patients, there were 232 females and 177 males; the median age was 62(52, 70) years, and 231 cases (56.48%) were under the age of 65 years; 5 types of SGLT2i (dapagliflozin, empagliflozin, canagliflozin, ertugliflozin, and henagliflozin proline) were involved, and reports of dapagliflozin was the most (279 cases, 68.22%). The primary indication for medication was diabetes (404 cases, 98.78%). The majority of ADRs did not reach the severe level (395 cases, 96.58%). The 14 cases (3.42%) of severe ADR were primarily about diabetic ketoacidosis (11 cases, 11/14), of which 7 cases presented with normal blood glucose levels and 5 cases occurred after medical stress events. The outcomes of patients were improvement in 241 cases (58.92%) and recovery in 127 cases (31.05%). In total, 476 ADR occurrences were recorded among the 409 patients, involving 82 PTs, 24 of which were not listed in the drug labels. The top 2 SOCs were the infections and infestations [26.26% (125/476)] and renal and urinary disorders [13.87% (66/476)]; the top 3 PTs were urinary tract infection [23.32% (111/476)], urinary ketone detection [6.51% (31/476)], and vulvovaginal pruritus [5.88% (28/476)]; the top 3 newly identified possible ADRs (PTs) were dizziness [2.31% (11/476)], palpitations [1.89% (9/476)], and decreased appetite [1.05% (5/476)].Conclusions:Based on the ADR monitoring data in Beijing in the past 5 and a half years, SGLT2i-associated adverse reactions primarily involved the infections and infestations, and renal and urinary disorders. ADRs identified in the study such as dizziness and palpitations are not documented in the drug labels, euglycaemic ketoacidosis accounts for a high proportion of severe reactions, and most of them occur after acute stress events.
9.Predictive value of growth differentiation factor 15 for atrial fibrillation in elderly patients with coronary heart disease
Hunan XIAO ; Lü LÜ ; Cui XU ; Xiaofan WANG ; Li SHENG ; Guojuan TAN ; Feng TIAN ; Hongbin LIU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(9):1183-1187
Objective To explore the predictive value of growth differentiation factor 15(GDF-15)for atrial fibrillation(AF)in patients with coronary heart disease(CHD).Methods A prospective observation cohort of 1261 elderly CHD patients was randomly sampled from the First Medical Center of Chinese PLA General Hospital from January 2012 to December 2015.ELISA was used to detect GDF-15 level in all the subjects,and their baseline data were collected.Until March 2023,93 patients were lost during the follow-up period,and finally 1168 patients completed the follow-up,with a median time of 9.4 years.According to AF occurred or not during the period,the eligible patients were divided into an AF group(197 cases)and a non-AF group(971 cases),and based on their medical history,also assigned into a stable angina pectoris(SAP,n=304)and an acute coronary syndrome group(ACS,n=864).Logistic regression analysis was used to determine whether GDF-15 is a risk factor for AF in elderly CHD patients.ROC curve was plotted to assess the predictive value of GDF-15,guideline recommended CHARGE-AF scoring model,and their combination for AF events in the patients.Results The AF group had significantly advanced age,larger proportions of smoking history,type 2 diabetes,hypertension,old myocardial infarction,stroke,ACS and administration of statins,higher ratio of angiotensin converting enzyme inhibi-tor/angiotensin receptor blocker,and elevated levels of GDF-15 and N-terminal pro-B-type natri-uretic peptide,and lower left ventricular ejection fraction,SAP incidence,and low-density lipopro-tein cholesterol,total cholesterol and triglycerides levels when compared with the non-AF group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that GDF-15 was not a risk factor for AF in elderly CHD patients(OR=0.92,95%CI:0.74-1.16,P=0.489),but was a risk factor for AF in SAP patients(OR=1.38,95%CI:1.07-2.79,P=0.015),and in ACS patients,still not a risk factor for AF(OR=0.81,95%CI:0.63-1.05,P=0.814).ROC curve analysis showed that the AUC value of GDF-15 combined with the CHARGE-AF scoring model in predic-ting AF was 0.682 in the elderly CHD patients,0.746 in the SAP patients,and 0.680 in the ACS patients.Conclusion Elevated GDF-15 level is an independent risk factor and predictor of AF in elderly SAP patients.In SAP patients,the combination of GDF-15 and CHARGE-AF scoring model further improves the predictive performance of AF occurrence.
10.Research progress on animal models of colon cancer in Traditional Chinese and Western Medicine
Yang SHEN ; Guojuan WANG ; Naicheng ZHU ; Min GUO ; Wenjing LIAO ; Wenyan YU
Tumor 2024;44(11):1116-1129
Colon cancer is a common malignant tumor in the gastrointestinal tract,with morbidity and mortality rates increasing every year.Currently,the etiology of colon cancer has not been fully elucidated.With the deepening of colon cancer research and treatment,it is especially important to establish corresponding preclinical in vivo models.In the treatment of colon cancer,Chinese medicine follows the principle of diagnosis and treatment,adopts the method of supporting the positive and dispelling the evil,adjusts the body's qi and blood,and the deficiency of internal organs to maintain the balance of the body's yin and yang,so as to achieve the purpose of anti-tumor.Chinese medicine animal models of colon cancer can be broadly divided into five categories:damp-heat accumulation,qi stagnation and blood stasis,qi and blood deficiency,spleen and kidney yang deficiency and liver and kidney yin deficiency.Western animal models of colon cancer are commonly divided into 4 categories:spontaneous,induced,transplanted and genetically engineered.The paper summarizes the construction methods and characteristics of colon cancer animal models currently commonly used in Chinese and western medicine,and summarizes,analyzes and concludes the colon cancer animal models based on three aspects:how to select animal models,comparison of Chinese and western medicine modeling methods and evaluation of modeling success,with a view to finding suitable modeling methods for preclinical experiments,so as to provide guidance for the selection of animal models of colon cancer.

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