1.Full-endoscopic direct pars repair of lumbar spondylolysis with percutaneous pedicle screw fixation
Zheng CAO ; Zhenzhou LI ; Hongliang ZHAO ; Jialiang ZHU ; Shuxun HOU
Chinese Journal of Orthopaedics 2025;45(1):29-36
Objective:To investigate the clinical efficacy of Full-endoscopic pars debridement, graft with autograft and recombinant human bone morphogenetic protein 2 (rhBMP-2), and percutaneous pedicle screw (PPS) fixation for the treatment of lumbar spondylolysis.Methods:A retrospective analysis was performed for the case data of 8 patients (7 males and 1 female) of lumbar spondylolysis treated with full-endoscopic pars bone graft with autograft and rhBMP-2 combined with PPS fixation in the fourth medical center of PLA general hospital. The mean age was 21.8±4.1 years (range, 16-29 years). All cases had mono-segmental bilateral pars defects, including 2 cases of L 4 and 6 cases of L 5. The visual analogue scale (VAS) and the Oswestry disability index (ODI) were recorded before and after surgery. MacNab score was used to evaluate the final clinical outcome of lumbar function at 1 year after the removal of internal fixation. Multi-planar reconstruction of CT scans was used to evaluate the bone healing at 6 and 12 months after the operation, and par condition at 1 year after the removal of internal fixation. Pfirrmann's grading system through MRI was used to grade disc degeneration in the fixed and adjacent discs respectively before the operation, before the removal of internal fixation, and 1 year after the removal of internal fixation. Results:All the operations were successfully completed. All patients were followed up for 24-30 months, with an average follow-up time of 27.75±3.11 months. Both VAS of back pain (1.63±0.74, 1.25±0.71、1.00±0.53) and ODI (10.25%±5.17%、6.33%±5.03%、4.86%±3.35%) at 6 and 12 months after the operation and 1 year after the removal of internal fixation were improved compared with those preoperatively (7.25±1.04 and 40.67%±9.67%), with significant differences ( P<0.05). The improvement rates of VAS and ODI at one year after pars repair were 83.31%±8.85% and 85.22%±9.60%, respectively. The improvement rates of VAS and ODI at one year after the removal of internal fixation were 85.96%±6.97% and 88.05%±7.25%, respectively. At the final follow-up, 7 patients had excellent results and 1 patient had good results according to the MacNab criteria. There were 3 patients bony healed in 6 months postoperatively and the remaining 5 patients bony healed in 12 months postoperatively. There was no pars re-rupture at the one-year follow-up after the removal of internal fixation. Disc degeneration increase one grade at the fixed disc in one patient before and after the removal of internal fixation than before pars repair surgery. Disc degeneration increase one grade at the adjacent disc in one patient before and after the removal of internal fixation than before pars repair surgery. There were no intraoperative or postoperative complications, such as nerve injury, cerebrospinal fluid leakage, incision exudation, infection, or breakdown of internal fixation device. Conclusions:Full-endoscopic pars bone debridement, graft with autograft and rhBMP-2, followed by PPS fixation is a safe and effective minimally invasive spine surgery for treating lumbar spondylolysis. It has the advantages of a high fusion rate, low incidence of complications, no pars re-rupture after the removal of internal fixation and no significantly increasing intervertebral disc degeneration in fixed and adjacent discs.
2.Research progress in the developmental process of non-viral CAR-T technology.
Haipeng LI ; Qiyu ZHU ; Jialiang ZHU ; Jingting MIN
Chinese Journal of Cellular and Molecular Immunology 2025;41(5):461-467
Chimeric antigen receptor T (CAR-T) lymphocytes are at the forefront of adoptive immunotherapy research, and this technology has significantly advanced the prospects of tumor immunotherapy. CAR-T therapy has demonstrated remarkable efficacy in haematological tumours of lymphoid origin and provided therapeutic possibility for solid tumours. Currently, CAR-T cell preparation predominantly involves transfection of T cells with viral vectors. However, the production of viral vectors is time-consuming, expensive, and the vectors have low loading capacity, along with insertion instability. Consequently, there is a pressing need to develop more convenient and precise non-viral gene delivery methods. This paper reviews the most promising non-viral gene delivery technologies, including CRISPR/Cas9 gene editing, transposon systems such as Sleeping Beauty (SB) and PiggyBac (PB), and mRNA, and anticipates the future development of non-viral vector-based CAR-T therapies.
Humans
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Immunotherapy, Adoptive/methods*
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Receptors, Chimeric Antigen/immunology*
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Animals
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Gene Transfer Techniques
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Genetic Vectors/genetics*
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Gene Editing
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CRISPR-Cas Systems/genetics*
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DNA Transposable Elements/genetics*
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T-Lymphocytes/immunology*
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Neoplasms/immunology*
3.Optimized lipid nanoparticles enable effective CRISPR/Cas9-mediated gene editing in dendritic cells for enhanced immunotherapy.
Kuirong MAO ; Huizhu TAN ; Xiuxiu CONG ; Ji LIU ; Yanbao XIN ; Jialiang WANG ; Meng GUAN ; Jiaxuan LI ; Ge ZHU ; Xiandi MENG ; Guojiao LIN ; Haorui WANG ; Jing HAN ; Ming WANG ; Yong-Guang YANG ; Tianmeng SUN
Acta Pharmaceutica Sinica B 2025;15(1):642-656
Immunotherapy has emerged as a revolutionary approach to treat immune-related diseases. Dendritic cells (DCs) play a pivotal role in orchestrating immune responses, making them an attractive target for immunotherapeutic interventions. Modulation of gene expression in DCs using genome editing techniques, such as the CRISPR-Cas system, is important for regulating DC functions. However, the precise delivery of CRISPR-based therapies to DCs has posed a significant challenge. While lipid nanoparticles (LNPs) have been extensively studied for gene editing in tumor cells, their potential application in DCs has remained relatively unexplored. This study investigates the important role of cholesterol in regulating the efficiency of BAMEA-O16B lipid-assisted nanoparticles (BLANs) as carriers of CRISPR/Cas9 for gene editing in DCs. Remarkably, BLANs with low cholesterol density exhibit exceptional mRNA uptake, improved endosomal escape, and efficient single-guide RNA release capabilities. Administration of BLANmCas9/gPD-L1 results in substantial PD-L1 gene knockout in conventional dendritic cells (cDCs), accompanied by heightened cDC1 activation, T cell stimulation, and significant suppression of tumor growth. The study underscores the pivotal role of cholesterol density within LNPs, revealing potent influence on gene editing efficacy within DCs. This strategy holds immense promise for the field of cancer immunotherapy, offering a novel avenue for treating immune-related diseases.
4.Quality Evaluation of Qiangli Pipa Lu Based on National Drug Sampling and Testing
Jia WU ; Jun ZENG ; Xiangmin ZHOU ; Jialiang ZHU
Herald of Medicine 2025;44(10):1576-1580
Objective Based on the national drug sampling inspection work,a systematic evaluation of the quality of Qiangli Pipa Lu was conducted and the existing problems were analyzed to provide reference and suggestions for the quality control of this variety.Methods A total of 328 batches of samples were tested according to the statutory standard,and based on the testing results and prescription characteristics,gas chromatography,high performance liquid chromatography,ultra-high performance liquid chromatography-tandem high resolution mass spectrometry and other methods were subsequently established or improved for the exploratory research.Results The established methods for the determination of menthol,poppy shell,flavoring agents and preservatives were simple to operate,durable and highly specific,and can be applied to the quality control and evaluation of Qiangli Pipa Lu.Conclusion The overall quality of Qiangli Pipa Lu is good.Propose unified quality standard quality control projects;Enterprises should strengthen the quality control of raw materials;enterprises need to pay attention to the stability of production process.
5.Study of Related Substances and Impurity Profiles of Ornidazole Active Pharmaceutical Ingredient and Injection Based on National Drug Sampling and Testing
Qingqing ZHANG ; Xiaodie HE ; Qing HUANG ; Yue GENG ; Minwen HUANG ; Minhui CHEN ; Jialiang ZHU
Herald of Medicine 2025;44(10):1580-1587
Objective To determine the related substances in ornidazole active pharmaceutical ingredient(API)and injections using high performance liquid chromatography(HPLC)and to study the impurity profile of ornidazole using liquid chromatography-tandem mass spectrometry(LC-MS/MS)combined with forced degradation tests,aiming to clarify the sources of impurities and their correlation with the prescription and production process and providing technical support for the unified evaluation and quality control of this product.Methods A Phenomenex Luna C18column(4.6 mm×250 mm,5 μm)was used for the separation of ornidazole and its impurities,with 0.000 5%formic acid as mobile phase A and methanol as mobile phase B under gradient elution.The impurity content of 4 batches of APIs,3 batches of reference preparations,and 11 batches of domestic generic preparations were determined.The structure of unknown impurities was predicted using Jet Stream Ion Focusing Electrospray Ionization-Time of Flight Mass Spectrometry(AJS-TOF-MS/MS),and the sources of impurities were identified combined with forced degradation experiments,the prescription and the production process of various manufacturers.Results Ornidazole and its known impurities were well separated under the chromatographic conditions.The structures of five unknown impurities were inferred,and the sources of the impurities were identified.Conclusion This study provides a reference for impurity analysis,quality control,and overall evaluation of ornidazole API and injection.
6.Quality Evaluation on Xiaoer Huatan Zhike Granules Based on National Drug Sampling and Testing
Lihua YIN ; Longhua YANG ; Zhengwei CHEN ; Xuewei QIU ; Manyun SU ; Hang YUAN ; Jialiang ZHU
Herald of Medicine 2025;44(10):1588-1594
Objective To identify potential quality risks of Xiaoer Huatan Zhike Granules(Pediatric Phlegm-Resolving and Cough-Relieving Granules)through National Drug Sampling and Inspection,evaluate their overall quality,and propose improvements to the quality standards.Methods Samples from 34 manufacturers were tested using official standards.Exploratory methods were developed to enhance risk analysis,including thin-layer chromatography(TLC)identification,content uniformity testing,quantitative assays,and screening for unauthorized additives(e.g.,colorants).Results All batches met the official standards(100.0%compliance rate).However,deficiencies were observed:most manufacturers lacked controls for ephedrine hydrochloride content uniformity and quantification,omitted key ingredient identifications(e.g.,herbal components),and exhibited insufficient TLC specificity(e.g.,TLC of Ipecac tincture showed only one spot instead of multiple alkaloid-specific spots).Exploratory studies revealed risks in total emetine/cephaeline content,morroniside A/platycodin D content,ephedrine hydrochloride uniformity,and unauthorized colorant addition.Conclusions The overall quality of this variety is good,but the enterprise should improve the quality control measures throughout the entire process and establish stricter internal control standards;The official standards,unchanged for approximately 30 years,fail to address current regulatory requirements.The statutory quality standards need to be revised and improved.Qualitative or quantitative indicators for all drug flavors in the prescription should be added,and the content uniformity inspection of ephedrine hydrochloride should be increased.
7.Quality Analysis and Suggestion of Zukamu Preparation Based on National Drug Sampling and Testing
Shengyun DAI ; Dongxue WU ; Rui WU ; Meng XIAO ; Jie LIU ; Chaojie LIAN ; Xiaoru HU ; Feng WEI ; Jian ZHENG ; Jialiang ZHU
Herald of Medicine 2025;44(10):1600-1605
Objective To examine the quality of Zukamu preparations through the national drug sampling and testing,and further understand their current quality status and existing problems.This work is benefit for improving the quality standard of Zukamu preparations and providing technical support for the drug regulatory authorities.Methods Samples of Zukamu preparations were collected from a total of 29 provinces in China,and were tested for description,identification,other requirements(weight variation,particle size,determination of water,disprsion,and microbial limit items),and assay in accordance with the national pharmaceutical standards.The test data were analyzed to evaluate the quality status of the Zukamu preparations,and exploratory research was carried out to address the problems found in the test.Results A total of 97 batches of Zukamu preparations were sampled,and the passing rate was 100.0%according to the current quality standard.Exploratory study,revealed that Zukamu preparation were subject to 4 testing standards,with uneven test items,missing items,poor operability,and lack of exclusivity in some items.The test based on the existing standards can't comprehensively evaluate the quality of the preparation.Conclusions Based on the national drug sampling and testing,combined with exploratory research on drug safety,authenticity and effectiveness,it is recommended to unify the quality standards of Zukamu preparations by combining with the work of standard improving,revising the identification method of thin-layer chromatography,increasing the content determination,and establishing the quick test method,thereby effectively evaluating and controling the quality of the samples of Zukamu preparations.
8.Quality Evaluation on Xuanmai Ganjie Preparation Based on National Drug Sampling and Testing
Jingyun LI ; Liang HU ; Jiangnan LUO ; Yinghong WANG ; Xunyou TANG ; Sheng LIANG ; Liqin ZHAN ; Jingkai ZENG ; Yan LUO ; Hui SUN ; Ye DING ; Wenli LI ; Jialiang ZHU
Herald of Medicine 2025;44(10):1606-1611
Objective Based on the national drug sampling inspection program,this study aims to comprehensively and systematically evaluate the quality of Xuanmai Ganjie preparations,analyze existing quality issues,and provide references and suggestions for quality control of this variety.Methods A total of 237 batches of Xuanmai Ganjie preparations were tested using legal standards,and methods were established for detecting adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels,and determining the content of platycodin D in Xuanmai Ganjie preparations.These methods were applied to the quality control and evaluation of Xuanmai Ganjie preparations.Results Through statutory inspection,one batch of Xuanmai Ganjie granules was found non-compliant.Specific batches were identified to contain the following irregularities:adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels exceeding proposed limits,and platycodin D content below the established threshold.Conclusion The overall quality of Xuanmai Ganjie granules was average,while the overall quality of Xuanmai Ganjie capsules and lozenges was relatively good.Manufacturing enterprises should strengthen their sense of primary responsibility and enhance control over the entire drug production process.
9.Research on Analysis Method of Ketoconazole Related Substancse Based on National Drug Sampling and Testing
Changying XIN ; Yanbin XUN ; Xinying YU ; Yu HAN ; Qiong WU ; Longshan ZHAO ; Liqun LIU ; Jialiang ZHU
Herald of Medicine 2025;44(10):1611-1617
Objective To establish the HPLC analysis method for ketoconazole related substances,and to provide technical support for the improvement of the quality standard and the purity of ketoconazole.Methods Gradient elution conditions were optimized based on the chromatographic parameters outlined in the 2024"British Pharmacopoeia"for ketoconazole cream.A C18 column(4.6 mm×150 mm,3 μm)was used to facilitate the elution process using a gradient of acetonitrile and acetate buffer,and detection performed at a wavelength of 230 nm.Results The known impurities and potentially genotoxic impurities in the material drugs of ketoconazole can be more effectively separated using the established methods,which are both robust and highly sensitive.The content of the two potentially geno toxic impurities,six known impurities and unknown impurities in the 21 batches of ketoconazole sourced from five raw material pharmaceutical companies is below the specified limit requirements.Conclusion This method contributes to improving the quality of ketoconazole ingredients,ensuring the safety of ketoconazole preparations,and better supporting the regulatory supervision.
10.Determination of Three Stereoisomers in Baloxavir Marboxil by Reversed-phase HPLC
Kai SHI ; Kai YAN ; Ting SUN ; Xue FENG ; Fugang ZHOU ; Yuxia HE ; Xueli LIU ; Jialiang ZHU
Herald of Medicine 2025;44(4):633-638
Objective To establish a reversed-phase HPLC method for determining three stereoisomers in baloxavir marboxil and provide a basis for the quality specification of baloxavir marboxil.Methods The chromatographic column was CHIRALPAK IC-3(4.6 mm × 150 mm,3 μm),The mobile phase was acetonitrile-0.1%formic acid aqueous solution-isopropanol(35:50:15).The column temperature was 40 ℃.The flow rate was 0.5 mL·min-1.The injection volume was 10 μL.The detection wavelength was 259 nm.Result The isomer peaks were completely separated from the principal component peak.The detection limits for stereoisomers 1,2 and 3 were 0.024 7,0.038 7,0.038 1 μg·mL-1 respectively.The quantitation limits for stereoisomers 1,2 and 3 were 0.049 4,0.077 3,0.076 1 μg·mL-1 respectively.There were good linear relationships between the concentrations and peak area within the ranges of the study,and the linearity concentration ranges of stereoisomers 1,2 and 3 were 0.049 5-0.989 0 μg·mL-1,0.051 6-1.031 0 μg·mL-1,0.050 8-1.015 0 μg·mL-1 respectively.The linear correlation coefficients were 0.999 4.The recovery was 92.28%-103.90%.The sample solution was stable in 48 h at room temperature.Conclusion The method is accurate and reliable for determining stereoisomers in baloxavir marboxil,and provide a guideline of quality standards of baloxavir marboxil and safety evalution.

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