1.Expert Consensus on Clinical Application of Qidong Yixin Oral Liquid
Changkuan FU ; Xiaochang MA ; Mingjun ZHU ; Yue DENG ; Hongxu LIU ; Mingxue ZHANG ; Ying CHEN ; Yan ZHOU ; Ling ZHANG ; Jianhua FU ; Wei YANG ; Yu'er HU ; Ming CHEN ; Yanming XIE ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):147-158
The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis (VMC). It has the functions of tonifying Qi, nourishing the heart,calming the mind, and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However,the understanding of its efficacy evidence, advantageous aspects, dosage and administration, and medication safety remains insufficient in clinical practice. Therefore,the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid (hereinafter referred to as consensus) was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine,successively completing multiple tasks such as the consensus project initiation,determination of clinical problems,evidence search and evaluation,formation of recommendation opinions and consensus suggestions,solicitation of opinions,peer review, submission for review and release, and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions,clarifying the clinical positioning,efficacy advantages,syndrome differentiation,dosage and administration,combination therapy,timing of medication,adverse reactions,contraindications, and precautions of Qidong Yixin oral liquid,indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease,providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23, 2024. Standard number:GSCACM-376-2024.
2.Pre-operative risk assessment of hepatocellular carcinoma recurrence in liver transplant recipients by non-invasive detection of pre-existing genetic lesions
Suqin YANG ; Sunbin LING ; Jianhua LI ; Yan WANG ; Jiapei WANG ; Qiwei HUANG ; Fanming LIU ; Yiqi ZHUANG ; Yingyu ZHENG ; Rui WANG ; Zhe YANG ; Xiaoping ZHENG ; Kai WANG ; Zhikun LIU ; Jun CHEN ; Jianguo WANG ; Haiyang XIE ; Lin ZHOU ; Leiming CHEN ; Guoqiang CAO ; Dandan CHEN ; Junfang JI ; Bin ZHAO ; Chao JIANG ; Di LU ; Xuyong WEI ; Hangjin JIANG ; Qiaonan SHAN ; Hengbo SHI ; Yong-Zhen XU ; Shusen ZHENG ; Zhengxin WANG ; Shengda LIN ; Xiao XU
Clinical and Molecular Hepatology 2026;32(2):884-903
Background/Aims:
Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy.
Methods:
We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues.
Results:
We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts.
Conclusion
Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.
3.Clinical Efficacy of Fengyintang Combined with Western Medicine in Treatment of Parkinson's Disease with Excessive Heat Generating Wind and Its Effects on TLR4 and Inflammatory Factor Levels in Peripheral Blood
Jingyi ZHANG ; Meiru CHANG ; Shouzhen LUO ; Wenlei LI ; Xinyu XU ; Jianhua LIN ; Yan ZHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(17):184-191
ObjectiveToll-like receptor 4 (TLR4), a receptor for pathogen-associated molecular patterns of innate immunity, is associated with neurodegenerative diseases. Interleukin (IL)-6, IL-1β, and tumor necrosis factor-α (TNF-α) as common pro-inflammatory cytokines and high-sensitivity C-reactive protein (hs-CRP) are related to inflammatory responses. This study evaluated the clinical efficacy and possible mechanisms of therapeutic effects of Fengyintang on early and mid-stage PD with excessive heat generating wind by observing the effects of Fengyintang on the serum levels of TLR4, IL-6, IL-1β, TNF-α, and hs-CRP in the patients with PD. MethodsSixty-eight PD patients who met the inclusion criteria were randomly assigned into the control group and the observation group (n=34). Both groups were treated with anti-PD Western medicine and the observation group was additionally treated with Fengyintang. Both groups were treated for 8 weeks. Before and after 8 weeks of treatment, the patients in the two groups were measured for their TCM symptom scores, International Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) score, Parkinson's Disease Non-Motor Symptom Scale (NMSS) score, Patient Assessment of Constipation Symptom (PAC-SYM) score, Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA) score, Hamilton Depression Scale (HAMD) score, and changes in serum TLR4, IL-6, IL-1β, TNF-α, and hs-CRP levels. ResultsOne case in the control group was removed due to loss of visit, and a total of 67 PD patients (33 in the control group and 34 in the observation group) who met the criteria were included for analysis. After treatment, patients in the observation group showed decreases in scores of TCM symptoms, MDS-UPDRS, NMSS, PAC-SYM, PSQI, HAMA, and HAMD (P<0.05, P<0.01). Moreover, the observation group had lower scores of TCM symptoms, MDS-UPDRS, NMSS, PAC-SYM, PSQI, HAMA, and HAMD than the control group (P<0.05, P<0.01). The observation group showed higher efficacy in terms of TCM symptoms and MDS-UPDRS score than the control group (Z=-0.57, P<0.05). The overall response rate was higher in the observation group than in the control group (Z=-0.62, P<0.05, P<0.01). The serum TLR4, TNF-α, IL-1β, IL-6, and hs-CRP levels of the observation group were lower than those of the control group (P<0.05, P<0.01). ConclusionFengyintang combined with Western medicine can safely and effectively alleviate the clinical symptoms, reduce the levels of inflammatory factors, improve the quality of life, and delay the disease progression of PD patients by inhibiting peripheral TLR4 expression and thus suppressing the downstream inflammatory response.
4.Iron Homeostasis Imbalance Promotes Atherosclerosis and Therapeutic Mechanisms of Traditional Chinese Medicine
Maohong WANG ; Jianhua XIONG ; Hao ZHANG ; Xiaohong YAN ; Qiang WAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):279-286
Iron is an indispensable trace element for the human body to maintain normal physiological functions, widely participating in key processes such as oxygen transport, energy metabolism, and cell signal transduction. The homeostasis of iron is crucial for maintaining the structural integrity and functional stability of the cardiovascular system. Recent studies have shown that iron homeostasis imbalance, especially iron overload, has become a major risk factor for the occurrence and development of atherosclerosis (AS). The downstream-induced ferroptosis can form a "iron overload-lipid peroxidation-inflammation" vicious triangle through multiple pathways such as promoting oxidative stress, lipid peroxidation, and inflammatory response, and the three mutually reinforce each other to accelerate plaque formation and progression. Traditional Chinese medicine (TCM) has demonstrated unique advantages in the prevention and treatment of AS, with definite clinical efficacy. Its mechanism of action, in addition to improving lipid metabolism and protecting vascular endothelium, is closely related to the regulation of iron homeostasis in the body. From the new perspectives of systemic iron homeostasis imbalance and the "iron overload-lipid peroxidation-inflammation" vicious triangle, this article reviews the research progress in the association between iron homeostasis imbalance and AS in recent years, and integrate the mechanism of iron homeostasis imbalance in modern medicine with the TCM theory of stasis and toxin interconnection. It focuses on exploring the potential molecular mechanisms of TCM in regulating iron homeostasis through intervention in key pathways of iron overload and inhibition of ferroptosis, summarizes the "iron reduction-antioxidation-anti-inflammation" network constructed by TCM compound prescriptions, and the characteristics of TCM active components in synergistically resisting systemic iron homeostasis imbalance through sharing key targets such as nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor (NF)-κB. This article provides ideas and a theoretical basis that combine the characteristics of TCM theory with modern scientific evidence for the prevention and treatment of AS.
5.Toosendanin enhances the efficacy of cytosine arabinoside against acute myeloid leukemia by regulating autophagy via the mTORC1 signaling pathway
Xianfeng OUYANG ; Jianhua KANG ; Ying GUO ; Yan HUANG ; Wei JIANG ; Jianguo YAN
China Pharmacy 2026;37(17):2264-2271
OBJECTIVE To investigate the effect and potential mechanism of toosendanin in enhancing the antileukemic activity of cytosine arabinoside against acute myeloid leukemia (AML) based on the mammalian target of rapamycin complex 1 (mTORC1) signaling pathway.METHODS Female NSG immunodeficient mice were used to establish an AML model via a single γ-ray irradiation followed by a single tail-vein injection of a U937 cell suspension. The effects of cytosine arabinoside (2.5 mg/kg), toosendanin (1.0 mg/kg), and cytosine arabinoside+toosendanin (2.5 mg/kg+1.0 mg/kg) on body weight, survival time, peripheral blood routine indicators, histopathological morphology, and the expressions of autophagy-related proteins were explored. Using U937 cells as the subject, the effects of cytosine arabinoside (1 μmol/L), toosendanin (160 nmol/L), and cytosine arabinoside+toosendanin (1 μmol/L+160 nmol/L) on the expressions of autophagy-related proteins, mTORC1 signaling pathway-related proteins and mRNAs were investigated. The targeting relationship between toosendanin and the selective autophagy ligand 1 (also known as p62) was validated, and the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, as well as molecular docking, were performed. A p62 -knockdown U937 stable cell line was constructed, and the underlying mechanism of toosendanin-induced sensitization was verified.RESULTS Animal experiments confirmed that the combination of toosendanin and cytosine arabinoside significantly improved body weight, survival time and peripheral blood routine indicators in AML mice ( P <0.05), alleviated pathological changes such as leukemic cell infiltration and focal necrosis in bone marrow, liver, and spleen tissues, and modulated the expressions of autophagy-related proteins. Cell experiments confirmed that toosendanin could reverse cytosine arabinoside-induced activation of the autophagy cascade (manifested by downregulation of the protein expressions of microtubule-associated protein 1 light chain 3B and Beclin-1, upregulation the protein expression of p62), and might inhibit the expression of the downstream Unc-51-like autophagy activating kinase 1 (ULK1) complex (including ULK1, ULK2, autophagy-related protein 13, and FAK family interacting protein of 200 kDa) by activating the mTORC1 signaling pathway ( P <0.05). The sensitizing effect of toosendanin was associated with the inhibition of autophagy and the regulation of the mTORC1 signaling pathway; it could stably bind to p62 via hydrophobic interactions. Mechanism verification experiments indicated that upon p62 knockdown, toosendanin was no longer able to activate the mTORC1 signaling pathway or inhibit autophagy.CONCLUSIONS Toosendanin may enhance chemo-sensitivity of AML cells to cytosine arabinoside by directly targeting the p62 protein, which subsequently activates the mTORC1 signaling pathway, and thereby suppresses cytosine arabinoside-induced protective autophagy.
6.Development and validation of the rapid health aging assessment scale for the Chinese population
Bingqi YE ; Jialu YANG ; Jianhua LI ; Wunong CHEN ; Jianhua YE ; Xiaotao ZHOU ; Yong WANG ; Siqi LI ; Qi ZHANG ; Wanying ZHAO ; Jiayi SONG ; Chun WANG ; Yan LIU ; Min XIA
Chinese Journal of Preventive Medicine 2025;59(7):1078-1083
Objective:To develop a rapid assessment scale for healthy aging suitable for the Chinese population.Methods:Based on existing healthy aging assessment scales, national standards, and expert consensus, an initial Healthy Aging Rapid Assessment Scale was drafted through two rounds of expert consultation. A pre-survey was conducted with 3 220 subjects recruited from Guangzhou between July 2023 and July 2024. Items were screened through item analysis and exploratory factor analysis to form the final scale. Reliability and validity of the final scale were validated across five cities: Guangzhou, Dongguan, Shenzhen, Baoding, and Chuxiong.Results:The initial version comprised 36 items, while the finalized scale contained 18 items across three dimensions: metabolic health, mental health, and cognitive health. Test-retest reliability ranged from 0.71 to 0.81 across all study sites. The Spearman-Brown coefficient varied between 0.91-0.96, Cronbach′s α between 0.77-0.83, comparative fit index (CFI) between 0.90-0.98, goodness-of-fit index (GFI) between 0.90-0.99, and root-mean-square error of approximation (RMSEA) between 0.03-0.09. For the three dimensions, reliability and validity metrics demonstrated consistency: Spearman-Brown coefficients 0.87-0.99, Cronbach′s α 0.77-0.83, CFI 0.90-0.98, GFI 0.90-0.99, and RMSEA 0.03-0.09 across four regions.Conclusion:The developed Healthy Aging Rapid Assessment Scale for the Chinese population exhibits robust reliability and validity.
7.Progress on CLCN5 gene in Dent disease type 1
Lidan HU ; Haidong FU ; Jingjing WANG ; Langping GAO ; Guozhen WANG ; Yan WANG ; Xiaobei XIE ; Jianhua MAO
International Journal of Pediatrics 2025;52(10):653-659
Dent disease is a rare X-linked recessive renal tubular disease characterized by low molecular weight proteinuria,hypercalcemia and nephrocalcinosis. It is also a major cause of tubular proteinuria in children. According to different causative genes,Dent disease can be divided into three types:type 1 is caused by mutations in the CLCN5 gene,accounting for about 60%-70%;type 2 is caused by mutations in the OCRL gene,accounting for about 15%-20%;type 3 has a similar clinical phenotype but no known pathogenic gene mutations. CLCN5 encodes the voltage-dependent 2Cl -/1H +exchange channel CIC-5,which is involved in proximal renal tubule endocytosis. Its mutations can cause a variety of proximal tubular dysfunction symptoms,mainly including low molecular weight proteinuria. The use of gene detection technology has resulted in an increase in reports on Dent disease year after year. At present,the specific mechanism underlying Dent disease remains unknown. This article reviews the research progress of CLCN5,hoping to provide new insight for the mechanism research of CLCN5 and the specific treatment of Dent disease type 1.
8.Expert consensus on integrated diagnosis and treatment techniques for oropharyngeal squamous cell carcinoma
Wei SHANG ; Haoyue XU ; Zongxuan HE ; Xiaoying LI ; Haijun LU ; Xiaohong ZHAN ; Dapeng HAO ; Yan SUN ; Wei GUO ; Zhangui TANG ; Guoxin REN ; Zhijun SUN ; Jian MENG ; Jie ZHANG ; Jichen LI ; Yue HE ; Chunjie LI ; Jianhua WEI ; Lizheng QIN ; Yaowu YANG ; Qing XI ; Wei WU ; Kai YANG ; Bing HAN ; Lingxue BU ; Shuangyi WANG ; Kai SONG ; Jiaqi ZHU ; Hongyu HAN ; Yu KONG ; Jieying LI ; Man HU ; Mingjin XU ; Moyi SUN
Journal of Practical Stomatology 2025;41(6):725-736
In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.
9.Optimization of clinical target volume delineation for prostate cancer radiotherapy based on prostate bed occurrence patterns in prostate-specific membrane antigen positron emission tomography
Huan ZHANG ; Xin QI ; Xuhe LIAO ; Cheng CHEN ; Jingyun WU ; Jianhua ZHANG ; Yan FAN ; Xianshu GAO ; Hongzhen LI
Chinese Journal of Radiological Medicine and Protection 2025;45(10):966-972
Objective:To explore the optimization potential of clinical target volume (CTV) delineation proposed in the guidelines of the Oncology Group (RTOG), the Francophone Group of Urological Radiotherapy (GFRU), and the European Society for Radiotherapy and Oncology (ESTRO) based on prostate bed local occurrence patterns after radical prostatectomy identified using prostate-specific membrane antigen positron emission tomography (PSMA PET).Methods:A retrospective analysis was conducted on patients with local prostate bed recurrence after radical prostatectomy who underwent PSMA PET at the Department of Nuclear Medicine, Peking University First Hospital from September 2021 to February 2024. The central point of each recurrence was marked. A six-zone method was established based on prostate bed anatomy and the characteristics of cross-sectional imaging. Then, the positional relationships (within or outside) were recorded with respect to recurrences and CTV defined by the RTOG, GFRU, and ESTRO (CTV RTOG, CTV GFRU, and CTV ESTRO), followed the analysis of the recurrence rates and distribution characteristics of various zones. Results:A total of 63 patients with prostate bed recurrence after radical prostatectomy were enrolled in this study, including 97 recurrences. The recurrence rates in the six zones were as follows: 10% of zone 1, 22% of zone 2, 29% of zone 3, 2% of zone 4, 12% of zone 5a, 18% of zone 5b, and 7% of zone 6. Among these zones, zones 2 and 3 showed the highest and second-highest recurrence rates, respectively. CTV GFRU and CTV ESTRO completely covered zones 2 and 3, while CTV RTOG covered zone 2 completely and zone 3 partially. Zone 4, characterized by a low recurrence rate, was not covered by CTV GFRU and CTV ESTRO but was entirely covered by CTV RTOG. Zone 5a, with a recurrence rate of 12%, was completely covered by CTV RTOG but was partially covered by CTV GFRU and CTV ESTRO. The range of 1.3 cm in front of the posterior wall of the bladder covered all recurrences in zone 5a. Conclusions:For CTV delineation of the prostate cancer surgical bed, zone 4, the anterior half of the bladder above the pubic symphysis midpoint, should be contracted due to the low recurrence rate in this zone. In contrast, the anterior boundary above the pubic symphysis midpoint should extend to 1.3 cm in front of the posterior wall of the bladder to completely cover the recurrence zones.
10.Development and validation of the rapid health aging assessment scale for the Chinese population
Bingqi YE ; Jialu YANG ; Jianhua LI ; Wunong CHEN ; Jianhua YE ; Xiaotao ZHOU ; Yong WANG ; Siqi LI ; Qi ZHANG ; Wanying ZHAO ; Jiayi SONG ; Chun WANG ; Yan LIU ; Min XIA
Chinese Journal of Preventive Medicine 2025;59(7):1078-1083
Objective:To develop a rapid assessment scale for healthy aging suitable for the Chinese population.Methods:Based on existing healthy aging assessment scales, national standards, and expert consensus, an initial Healthy Aging Rapid Assessment Scale was drafted through two rounds of expert consultation. A pre-survey was conducted with 3 220 subjects recruited from Guangzhou between July 2023 and July 2024. Items were screened through item analysis and exploratory factor analysis to form the final scale. Reliability and validity of the final scale were validated across five cities: Guangzhou, Dongguan, Shenzhen, Baoding, and Chuxiong.Results:The initial version comprised 36 items, while the finalized scale contained 18 items across three dimensions: metabolic health, mental health, and cognitive health. Test-retest reliability ranged from 0.71 to 0.81 across all study sites. The Spearman-Brown coefficient varied between 0.91-0.96, Cronbach′s α between 0.77-0.83, comparative fit index (CFI) between 0.90-0.98, goodness-of-fit index (GFI) between 0.90-0.99, and root-mean-square error of approximation (RMSEA) between 0.03-0.09. For the three dimensions, reliability and validity metrics demonstrated consistency: Spearman-Brown coefficients 0.87-0.99, Cronbach′s α 0.77-0.83, CFI 0.90-0.98, GFI 0.90-0.99, and RMSEA 0.03-0.09 across four regions.Conclusion:The developed Healthy Aging Rapid Assessment Scale for the Chinese population exhibits robust reliability and validity.

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