1.Effect of Changji'an Formula (肠激安方) on the miR-29b-3p/TRAF3/NF-κB/MLCK Axis in Colonic Tissues in Diarrhea-predominant Irritable Bowel Syndrome Model Rat with Liver Depression and Spleen Deficiency Syndrome
Yongfu WANG ; Wei KE ; Xiangyu XIE ; Hongmei TANG ; Liuze SI ; Yuna CHAI
Journal of Traditional Chinese Medicine 2026;67(4):439-446
ObjectiveTo explore the potential mechanism of Changji'an Formula (肠激安方) on intestinal permeability for rats with diarrhea-predominant irritable bowel syndrome (IBS-D) of liver depression and spleen deficiency syndrome by the microRNA-29b-3p (miR-29b-3p)/tumor necrosis factor receptor-associated factor 3 (TRAF3)/nuclear factor-κB (NF-κB)/myosin light chain kinase (MLCK) axis. MethodsTwenty-four 1-day-old male Sprague-Dawley (SD) suckling rats were selected, and the IBS-D rat model of liver depression and spleen deficiency syndrome was established via a three-factor method,i.e. maternal separation plus acetic acid stimulation and restraint stress, for 6 consecutive weeks. After successful modeling, the rats were randomly divided into a model group, pinaverium bromide group, low-dose and high-dose Changji'an Formula groups, with 6 rats in each group. Another 6 age-matched non-modeled SD rats were included as the control group. The low-dose and high-dose Changji'an Formula groups were given intragastric administration of Changji'an Formula solution at doses of 16.74 g/(kg·d) and 33.48 g/(kg·d), respectively; the pinaverium bromide group received intragastric administration of pinaverium bromide tablets at 0.018 g/(kg·d); and the control group was given distilled water at 10 ml/(kg·d) via intragastric gavage. The intervention was conducted once daily for 14 consecutive days. After the gavage treatment, the fecal water content of rats in each group was measured. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of intestinal permeability indicators, including D-lactic acid (D-LA), diamine oxidase (DAO), and lipopolysaccharide (LPS). Quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to determine the mRNA expression levels of miR-29b-3p, TRAF3, tumor necrosis factor-α (TNF-α), p65, p50, and MLCK in colonic tissues. Western Blot analysis was employed to detect the protein expression levels of TRAF3, TNF-α, p65, phosphorylated p65 (p-p65), MLCK, myosin light chain (MLC), phosphorylated MLC (p-MLC), and tight junction proteins including junctional adhesion molecule-A (JAM-A), Occludin, and Claudin-1 in colonic tissues. ResultsCompared with the control group, the model group exhibited significantly increased fecal water content and serum levels of D-LA, DAO, and LPS, along with decreased protein expression levels of JAM-A, Occludin, and Claudin-1 in colonic tissues (P<0.05 or P<0.01). Additionally, in the model group, the mRNA expression levels of miR-29b-3p, TNF-α, p65, p50, and MLCK in colonic tissues were up-regulated, while the mRNA and protein expression levels of TRAF3 were down-regulated; the protein levels of TNF-α and MLCK, as well as the ratios of p-p65/p65 and p-MLC/MLC, significantly elevated (P<0.01). Compared with the model group, all treatment groups showed reduced fecal water content and serum levels of D-LA, DAO, and LPS, along with down-regulated mRNA expression levels of miR-29b-3p, TNF-α, p65, p50, and MLCK, and up-regulated TRAF3 mRNA expression in colonic tissues. Moreover, the pinaverium bromide group and high-dose Changji'an Formula group presented increased protein levels of Occludin, Claudin-1, and TRAF3, as well as decreased protein levels of TNF-α and MLCK, and reduced ratios of p-p65/p65 and p-MLC/MLC in colonic tissues (P<0.05 or P<0.01). Compared with the low-dose Changji'an Formula group, the high-dose group had lower fecal water content and serum levels of DAO and LPS (P<0.01). In comparison with the pinaverium bromide group, the high-dose Changji'an Formula group showed a significant decrease in serum DAO level (P<0.01). ConclusionsChangji'an Formula can reduce intestinal permeability and restore intestinal barrier function in IBS-D rats of liver depression and spleen deficiency syndrome by regulating the miR-29b-3p/TRAF3/NF-κB/MLCK axis.
2.Research progress on the relationship between brown adipose tissue and weight loss therapy
Jiaojiao LIU ; Zhitian ZHANG ; Yin CHEN ; Xijia HE ; Hongmei YAN ; Ruwen WANG
Chinese Journal of Clinical Medicine 2026;33(1):113-120
In recent years, the rising prevalence of obesity and its associated metabolic syndromes has emerged as a critical global public health concern. Sustained weight loss exceeding 10% of total body weight has been shown to ameliorate obesity-related comorbidities, including type 2 diabetes mellitus, hypertension, and hepatic steatosis. Recently, the potential of brown adipose tissue (BAT) to improve metabolism has garnered significant attention. However, evidence regarding weight loss therapies that promote BAT activation remains limited in preclinical models and is even scarcer in clinical studies, partly due to the paucity of appropriate BAT assessment techniques. This review aims to explore the potential impact of various weight loss therapies on BAT, with the goal of providing novel insights and strategies for the treatment of obesity.
3.Research progress on the bidirectional association between periodontal disease and depression/anxiety
WANG Liwen ; CAI Yutai ; RUAN Yaru ; ZHANG Fan ; YU Hongmei ; GAO Yanhui
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(3):281-291
There are practical and cost-effective opportunities for the prevention and early intervention of periodontal disease, a common oral condition. Depression and anxiety represent major global mental health challenges, and they are characterized by high prevalence rates and an elevated suicide risk. Their clinical management is complicated by extended treatment timelines and substantial healthcare costs. Accumulating evidence demonstrates a statistically significant bidirectional association between periodontal disease and depression/anxiety disorders. However, established clinical pathways integrating these conditions remain lacking. This review presents a comprehensive analysis of current research examining the relationship between periodontal disease and mood disorders, specifically depression and anxiety. This study explored the bidirectional mechanisms within the microbiota-oral-brain axis, which includes both periodontal disease inducing neuroinflammation through pro-inflammatory factors, such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) activating the TLR-4/NF-κB signaling pathway, and depression and anxiety leading to “glucocorticoid resistance” through hypothalamic-pituitary-adrenal (HPA) axis dysregulation, thus causing dual immune dysfunction that exacerbates periodontal tissue destruction, as well as the mechanisms by which biological, psychological, and social factors contribute to the bidirectional association between periodontal disease and depression/anxiety. We propose implementing bidirectional referral protocols between dental and psychiatric services in clinical practice, incorporating mental health screening tools, such as Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7(GAD-7), for patients with moderate-to-severe periodontal disease, and incorporating periodontal examination into routine assessment during psychiatric services. This multidisciplinary approach aims to break the vicious circle between these conditions and provide clinicians with pragmatic intervention strategies.
4.Regulatory Effect and Mechanisms of Liuhuang Zhike Prescription on Glycemic Control in db/db Mice via AMPK/Akt/GSK-3β Signaling Pathway
Fangyuan DENG ; Ting WANG ; Qianli KANG ; Hongmei LIN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):122-132
ObjectiveTo investigate the regulatory effects and underlying mechanisms of Liuhuang Zhike prescription (LHZK) on blood glucose in type 2 diabetic db/db mice based on the AMP-activated protein kinase/protein kinase B/glycogen synthase kinase-3β (AMPK/Akt/GSK-3β) signaling pathway. MethodsDb/db mice were used as the model animals, and db/m mice served as the blank control. Forty db/db mice were randomly divided into the model group, metformin group (0.14 g·kg-1), and low-, medium-, and high-dose (4.11, 8.21, 16.43 g·kg-1) LHZK groups, with 8 mice in each group. The db/db mice in the metformin and LHZK groups were administered the corresponding drugs by gavage, while the blank control and model groups were given distilled water by gavage once daily for 8 consecutive weeks. Food intake, water consumption, body weight, and fasting blood glucose (FBG) were measured weekly. An automatic biochemical analyzer was used to determine glycated serum protein (GSP), serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels. Hematoxylin-eosin (HE) staining was used to observe pathological morphological changes in the liver and pancreatic tissues. Oil red O staining was used to assess lipid accumulation in liver tissue. The anthrone colorimetric method was used to determine hepatic glycogen content. Real-time quantitative PCR (Real-time PCR) was used to detect the mRNA expression levels of insulin receptor substrate-1 (IRS-1), Akt2, phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6-phosphatase (G6Pase) in liver tissue. Western blot was used to detect the protein expression of AMPKα, phosphorylated AMPKα (p-AMPKα), GSK-3β, p-GSK-3β, glycogen synthase (GS), and phosphorylated GS (p-GS) in liver tissue. ResultsCompared with the blank control group, the model group showed significantly increased food intake, water consumption, body weight, FBG, and GSP levels (P<0.01). Pancreatic islets exhibited marked parenchymal cell hyperplasia and interstitial inflammatory cell infiltration. Liver tissue showed obvious steatosis, accompanied by a compensatory increase in hepatic glycogen content (P<0.01). Hepatic G6Pase mRNA expression was increased, while IRS-1 and Akt2 mRNA expression levels were significantly decreased (P<0.01). The p-AMPKα/AMPKα protein expression ratio showed a decreasing trend, whereas the p-GSK-3β/GSK-3β and p-GS/GS protein expression ratios were significantly increased (P<0.01). Compared with the model group, food intake and water consumption showed decreasing trends in all treatment groups. Food intake was significantly reduced in the low- and high-dose LHZK groups and in the metformin group (P<0.05, P<0.01), and water consumption was significantly reduced in the low-dose LHZK group and in the metformin group (P<0.05, P<0.01). No statistically significant differences in body weight were observed among the LHZK groups, whereas body weight in the metformin group was significantly increased (P<0.05, P<0.01). FBG showed a decreasing trend in all treatment groups, with significant decreases in the low-dose LHZK group and the metformin group (P<0.05, P<0.01). GSP levels were significantly reduced in the low-dose LHZK group and in the metformin group (P<0.05, P<0.01). Hepatic steatosis and pancreatic pathological injury were alleviated to varying degrees in all treatment groups. Hepatic glycogen content further increased in all treatment groups, with significant increases in the medium- and high-dose LHZK groups (P<0.05). Real-time PCR results showed that all treatment groups downregulated the mRNA expression of G6Pase and PEPCK in the liver tissues of db/db mice, with significant downregulation of PEPCK mRNA in the low-dose LHZK and metformin groups (P<0.01). Meanwhile, all treatment groups upregulated IRS-1 and Akt2 mRNA expression, with the most pronounced upregulation observed in the medium-dose LHZK group (P<0.01). The p-AMPKα/AMPKα protein expression ratio was significantly increased in the low- and medium-dose LHZK groups (P<0.01). The p-GSK-3β/GSK-3β protein expression ratio was significantly increased in all treatment groups (P<0.05, P<0.01), whereas the p-GS/GS protein expression ratio was significantly decreased in all treatment groups (P<0.01). ConclusionLHZK effectively reduces FBG and GSP levels in type 2 diabetic mice and improves hepatic steatosis and pancreatic islet pathological injury. Its hypoglycemic mechanism may be associated with regulation of the AMPK/Akt/GSK-3β signaling pathway and promotion of hepatic glycogen synthesis.
5.Mechanisms of Dihuang Yinzi in Treating Advanced Parkinson's Disease Based on Gut Microbiota-SCFAs-inflammation Axis
Renzhi MA ; Yasi LIN ; Tingyue JIANG ; Hongmei ZHU ; Jiayuan LI ; Yu WANG ; Ge ZHANG ; Wenxin FAN ; Jinli SHI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):11-21
ObjectiveTo observe the effects of Dihuang Yinzi (DY) on motor dysfunction in rats with advanced Parkinson's disease (PD) and to investigate the mechanisms by which DY improves advanced PD symptoms through the "gut microbiota-short-chain fatty acids (SCFAs)-inflammation-neuroprotection pathway". MethodsAn advanced PD rat model was induced by rotenone. Rats were divided into a normal group, model group, positive drug group (levodopa, 50 mg·kg-1), and DY low-, medium-, and high-dose groups (5.2, 10.4, 20.8 g·kg-1). After 7 days of administration, motor function was evaluated using the open-field, pole-climbing, and inclined plate tests. Hematoxylin-eosin (HE) staining was used to observe pathological changes in the substantia nigra and colon, and immunohistochemistry was performed to detect α-Synuclein (α-Syn) and tyrosine hydroxylase (TH) expression in the substantia nigra. Enzyme-linked immunosorbent assay (ELISA) was used to measure levels of dopamine (DA), 5-hydroxytryptamine (5-HT), 3,4-dihydroxyphenylacetic acid (DOPAC), Levodopa, homovanillic acid (HVA), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β). Western blot analysis was used to detect the expression of zonula occludens-1 (ZO-1) and occludin. Gut microbiota diversity was analyzed by 16S rRNA sequencing, and gas chromatography (GC) was used to determine the content of SCFAs in colonic contents. ResultsCompared with the normal group, the model group showed significantly decreased movement speed and distance in the open-field test, prolonged pole-climbing time, and reduced retention angle on the inclined plate (P<0.01), accompanied by increased α-Syn expression (P<0.01) and decreased TH expression (P<0.01) in the brain. Compared with the model group, all DY dose groups improved motor dysfunction in advanced PD rats to varying degrees (P<0.05, P<0.01) and alleviated pathological damage in the brain and colon. High-dose DY significantly reduced α-Syn aggregation in the substantia nigra (P<0.01) and increased TH expression (P<0.01). ELISA and Western blot results showed that, compared with the normal group, the model group exhibited decreased levels of DA, 5-HT, DOPAC, Levodopa, and HVA in the striatum (P<0.01), increased levels of TNF-α, IL-6, and IL-1β in the colon and striatum (P<0.01), and significantly reduced expression of ZO-1 (P<0.05) and occludin in the colon (P<0.01). Compared with the model group, all DY dose groups increased the levels of DA, 5-HT, DOPAC, Levodopa, and HVA in the striatum to varying degrees (P<0.05, P<0.01). In the high-dose DY group, the levels of TNF-α, IL-6, and IL-1β in the colon and striatum were reduced (P<0.01), while the expression of ZO-1 (P<0.05) and occludin in the intestine was increased. The 16S rRNA sequencing results indicated that the relative abundances of Actinobacteriota, Enterobacteriaceae, and Erysipelotrichaceae were increased in the model group, whereas the relative abundances of Bacteroidota, class Clostridia, Lachnospiraceae, and Akkermansia muciniphila were decreased. These changes were effectively reversed after high-dose DY intervention. GC analysis showed that the content of SCFAs in the colonic contents of rats in the model group was decreased (P<0.05, P<0.01), while after high-dose DY intervention, the levels of acetate, propionate, isobutyrate, and butyrate were significantly increased (P<0.05, P<0.01). ConclusionDY may exert therapeutic effects in advanced PD by regulating the gut microbiota-SCFAs-inflammation pathway.
6.LSS deficiency ameliorates MASLD by downregulating NPC1L1 and activating the CD36/TLR4/JNK pathway
Zihan WANG ; Hongmei BAI ; Qingya HE ; Wenjing ZHOU ; Jian ZHONG ; Xiaoli JIANG ; Sumei ZHANG ; Shengquan ZHANG
Acta Universitatis Medicinalis Anhui 2026;61(5):812-818
ObjectiveTo investigate whether intestinal deficiency of lanosterol synthase (LSS), a key enzyme in cholesterol synthesis, influences the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) by regulating intestinal cholesterol absorption and immune response. MethodsLSS heterozygous knockout (LSS+/-) mice and wild-type (WT) controls were generated using CRISPR/Cas9 technology and fed either a high-fat diet (HFD) or regular chow (CHOW). The model was validated by genotyping. Hepatic steatosis was assessed by HE and oil red O staining. Immunohistochemistry was used to detect the localization and expression of NPC1L1 and CD36 proteins in the intestine. Western blot analysis was performed to measure JNK phosphorylation and TLR4 protein levels in intestinal tissues. Real-time quantitative polymerase chain reaction (qPCR) was employed to examine the mRNA expression of TLR4 and IL-6. ResultsLSS+/- mice were successfully validated by genotyping and reduced intestinal LSS protein expression. HE and oil red O staining of liver sections showed that, compared with WT mice fed a CHOW diet, WT mice fed a HFD exhibited a marked increase in hepatic lipid vacuoles. In contrast, compared with HFD-fed WT mice, HFD-fed LSS+/- mice displayed significantly attenuated hepatic lipid deposition and reduced serum ALT levels (P<0.05). Immunohistochemical analysis revealed that, compared with WT mice, the expression of the cholesterol absorption protein NPC1L1 in the intestinal villi of LSS+/- mice was downregulated under both CHOW and HFD conditions (PHFD<0.001). Conversely, the expression of the fatty acid transporter CD36 was upregulated in the intestines of LSS+/- mice (PCHOW<0.05, PHFD<0.01). Western blot analysis demonstrated that, compared with WT mice, TLR4 protein expression in the intestines of LSS+/- mice significantly increased under both CHOW and HFD conditions (both P<0.05). JNK phosphorylation level was significantly elevated in LSS+/- mice under CHOW condition (both P<0.05). Under HFD condition, total JNK protein expression increased, but its phosphorylation level showed no significant change. qPCR analysis showed that, compared with WT mice, the mRNA levels of TLR4 (PCHOW<0.01, PHFD<0.000 1) and IL-6 (PCHOW<0.001, PHFD<0.01) were significantly upregulated in the intestines of LSS+/-mice. ConclusionLSS deficiency counteracts hepatic lipid deposition by orchestrating a synergistic reprogramming involving restricted intestinal cholesterol absorption, enhanced fatty acid utilization, and activation of immune pathways, suggesting intestinal LSS as a potential therapeutic target of MASLD.
7.The value of IVIM in the differential diagnosis of benign and malignant breast nodules
Xinyu WANG ; Jingjing ZHANG ; Songli ZHANG ; Chaofan WANG ; Weiying SHEN ; Hongmei QIAO ; Yuan CHEN ; Yu ZHANG ; Hu LIU
China Modern Doctor 2025;63(21):5-9
Objective To explore the application value of intravoxel incoherent motion(IVIM)imaging parameters in the differential diagnosis of benign and malignant breast nodules and their correlation with the expression of Ki-67 receptor in breast cancer.Methods The data of 41 female patients who completed 3.0 T breast magnetic resonance imaging(MRI)with complete surgical pathology results in the Second Hospital of Jiaxing City from October 2022 to January 2025 were analysed and evaluated.Conventional images and diffusion-weighted images with 11 b values were collected.The IVIM imaging parameters of real diffusion coefficient(D),perfusion related diffusion coefficient(D*)and perfusion fraction(f)were measured and calculated in the region of interest of each lesion.The receiver operating characteristic curve were plotted to quantify the differential diagnostic efficacy of each parameter of IVIM imaging in benign and malignant breast nodules.The differences of parameters between benign and malignant breast nodules and between the groups with different expression levels of Ki-67 receptor in breast cancer were analysed,and the correlation between each parameter and the expression level of Ki-67 in breast cancer was counted.Results The D value of benign breast nodules group(benign groups)was significantly higher than that of malignant breast nodules group(malignant groups),and the D*value was significantly lower than that of malignant group,and the differences between benign group and malignant group were statistically significant(t=-4.773,t=2.063,P<0.05);Thefvalue of benign group was slightly lower than that of malignant group,and the differences between two groups were not statistically significant(t=0.035,P>0.05).Among the parameters of IVIM imaging,D value had the best differential diagnostic efficacy for benign and malignant breast nodules,with area under the curve(AUC)of 0.870(95%CI:0.755-0.985)and a specificity of 75.0%;D*value had the second best differential diagnostic efficacy after D value,with an AUC of 0.789(95%CI:0.658-0.920),but it had the highest sensitivity of 88.2%;And the differential diagnosis efficiency off value was the worst,much less than D and D*values.The D value in the high Ki-67 expression group of breast cancer was lower than that in the low expression group,while the D* and f values in the high expression group were higher than that in the low expression group,and the differences of each imaging parameter of IVIM were not statistically significant between two groups(t=-2.617,t=2.169,t=0.647,P>0.05).There was a significant negative correlation between the expression of the Ki-67 receptor and the D value(r=-0.615,P<0.05),and no significant correlation was seen with either D *or f value(r=0.223,r-0.031,P>0.05).Conclusion The D and D*values of IVIM imaging parameters have great clinical value in the differential diagnosis of benign and malignant breast nodules.
8.Exploration on the Mechanism of Shugan Zhixie Prescription in Irritable Bowel Syndrome with Diarrhea Based on Network Pharmacology and Experimental Validation
Jinxue ZHANG ; Junhong LIU ; Lining SU ; Xueqian LAI ; Dan WANG ; Jiale CHEN ; Yajie CHEN ; Hongmei LI ; Yajing LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):39-45
Objective To investigate the mechanism of Shugan Zhixie Prescription in treating irritable bowel syndrome with diarrhea(IBS-D)using network pharmacology;To validate the findings through in vivo experiments.Methods Active components and potential targets of Shugan Zhixie Prescription were identified via the TCMSP database.Disease targets for IBS-D were retrieved from GeneCards,DisGeNET and OMIM databases.The intersection of drugs and disease targets was taken,and the protein interaction network was constructed by using STRING database.GO and KEGG pathways were enriched to identify the key signaling pathways of Shugan Zhixie Prescription in the treatment of IBS-D.The rat model of liver depression and spleen deficiency type IBS-D was established by the method of abnormal hunger and satiety,restraint pinch stress and intestinal perfusion of acetic acid.The rats were intervened with low-,medium-and high-dosage of Shugan Zhixie Prescription respectively for 14 days.Serum contents of diamine oxidase(DAO),interleukin(IL)-8,and IL-18 were measured by ELISA.Protein expressions and mRNA expressions of relevant targets in colonic tissue were detected using Western blot and RT-qPCR.Results A total of 26 active components and 553 targets of Shugan Zhixie Prescription were obtained,and 1 930 targets of IBS-D disease were obtained,with 184 drug-disease intersection targets.The possible mechanism was related to NF-κB,AGE-RAGE,Th17 cell differentiation and other signaling pathways.Animal experiments demonstrated that Shugan Zhixie Prescription could significantly reduce defecation frequency,fecal water content,and inflammatory cytokine levels in model rats.It markedly decreased TLR4 and NF-κB protein expressions(P<0.01),while increased AQP3,AQP8 and Occludin protein expressions in colonic tissue(P<0.01,P<0.05).Conclusion Shugan Zhixie Prescription exerts therapeutic effects on IBS-D through multiple pathways and targets,and the mechanism may be related to inhibiting TLR4/NF-κB signaling pathway and promoting intestinal barrier repair.
9.Monomorphic epitheliotropic intestinal T-cell lymphoma: a clinicopathological and genetic mutation characteristics analysis of forty-two cases
Dage FAN ; Yizeng WANG ; Anqi LI ; Binshen OUYANG ; Minghui QU ; Haimin XU ; Lei DONG ; Chunlin WU ; Chaofu WANG ; Hongmei YI
Chinese Journal of Pathology 2025;54(9):932-939
Objective:To investigate the clinicopathological and genetic characteristics of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL).Methods:The forty-two MEITL cases diagnosed in the Department of Pathology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China from 2016 to 2022 was retrospectively analyzed. Clinical data were collected, and follow-up was performed. Morphological characteristics were observed. Immunohistochemistry, Epstein-Barr virus (EBV) in situ hybridization, clonal rearrangement analysis of T-cell receptor (TCR) genes, and targeted next-generation sequencing (NGS) were performed.Results:Among the 42 patients (male/female ratio of 2.8∶1.0), the age range was 32-77 years with a median age of 59.5 (52.0-65.0) years. Grossly, the tumors were presented as ulcerative or exophytic lesions, with a maximum diameter of 2-18 cm. There were 34 cases with a single lesion and 8 cases with more than 1 lesion. The tumor cells in all 42 cases were relatively monotonous in histology and small or medium in size. They had round or oval nuclei, moderately pale or clear cytoplasm, evenly distributed nuclear chromatin, inconspicuous nucleoli, and frequent mitotic figures. In one of the cases, there were moderately large cells, vacuolated nuclei, and clear nucleoli. Lymphoepithelial lesions were observed in 36 (85.7%) of the 42 cases, tumor necrosis in 4 (9.5%) cases, scattered eosinophils and/or plasma cell infiltration in the background in 9 (21.4%) cases, and a "starry sky" phenomenon in 1 (2.4%) case. The tumor cells in all cases exhibited high expression of CD3, CD2, CD7, CD8, CD56, TIA1, Granzyme B, and Perforin, while some also expressed CD4 (5/41, 12.2%), CD5 (3/41, 7.3%), CD20 (4/41, 11.9%), CD79α (2/37, 5.4%), and CD30 (1/34, 2.9%). The Ki-67 proliferation index ranged from 40% to 90%. EBER in situ hybridization tests were negative in all cases. TCR gene clonal rearrangement was detected in 96.4% (27/28) of the tested cases. Targeted NGS revealed commonly mutated genes including SETD2, STAT5B, JAK3, TP53, and CREBBP. The primary treatment was chemotherapy, with 2 cases undergoing autologous hematopoietic stem cell transplantation. Follow-up information was obtained for 29 cases, with a follow-up period of 1-73 months. The mortality was 93.1% (27/29).Conclusions:MEITL is a rare and highly aggressive peripheral T-cell lymphoma. Its clinical manifestations are diverse, and diagnosis primarily relies on a comprehensive assessment of pathological morphology, immunohistochemical profiles, and EBV infection status, supplemented by genetic testing if necessary. At present, there is no effective treatment, and its overall prognosis is poor.
10.Clinical efficacy and safety of CLAE regimen for refractory/relapsed T cell acute lymphoblastic leukemia/lymphoma: a prospective, multicenter, single-arm study
Yan LI ; Xian ZHANG ; Xiuhua SUN ; Jia SONG ; Rong ZHANG ; Ping YANG ; Wei WAN ; Fei DONG ; Jijun WANG ; Hongmei JING
Chinese Journal of Hematology 2025;46(11):1005-1013
Objective:To evaluate the efficacy and safety of the CLAE (cladribine + cytarabine + etoposide) regimen in refractory/relapsed T cell acute lymphoblastic leukemia/lymphoma (R/R T-ALL/LBL) .Methods:Patients with R/R T-ALL/LBL received the CLAE regimen in a prospective, multicenter, single-arm clinical study or compassionate use. From March 2019 to August 2024, data from 25 patients (18 in the study across five centers and 7 receiving compassionate treatment in Peking University Third Hospital) were collected. Outcomes included objective response rate, complete response (CR) rate, partial response (PR) rate after 1–2 cycles, bridging to allo-HSCT, progression-free survival (PFS), overall survival (OS), and treatment-related adverse effects.Results:Median age was 29 years (range, 13–63) ; 17 were male. Among the 24 evaluable patients, CR rate was 33.3% overall and 41.2% among enrolled patients. Median OS and PFS time were 199 (46–1 310) and 49 (28–1 310) days, respectively. Cumulative OS rate at 6 months, 1 year, and 2 years was (52.1±10.2) %, (29.7±9.3) %, and (27.1±9.1) %, respectively; cumulative PFS rate was (32.6±9.6) %, (24.9±8.9) %, and (23.8±8.7) %, respectively. Among patients achieving CR or PR (8 cases), median OS and PFS were not reached. Cumulative OS rate at 6 months, 1 year, and 2 years was (86.8±12.0) %, (78.3±14.6) %, and (72.9±15.7) %, respectively, and the cumulative PFS rate was (86.4±12.1) %, (74.8±15.3) %, and (72.9±15.7) %, respectively. Adverse events were mainly hematologic; no treatment-related mortality occurred. Seven patients achieving CR were bridged to allo-HSCT, with 5 remaining in continuous remission.Conclusion:The CLAE regimen is safe and effective for R/R T-ALL/LBL, facilitating CR as a bridge to allo-HSCT and potentially improving patient prognosis.


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