1.Inhibitory effects of different concentrations of auranofin on M1 macrophage function and its therapeutic potential in diabetic wound healing
Hongfei PAN ; Zhenbing ZHUANG ; Baiyun XU ; Zhangyang YANG ; Kairui LIN ; Bingqing ZHAN ; Jinghan LAN ; Heng GAO ; Nanbo ZHANG ; Jiayu LIN
Chinese Journal of Tissue Engineering Research 2026;30(6):1390-1397
BACKGROUND:During diabetic wound healing,the sustained activation of M1 macrophages exacerbates the inflammatory response and hinders wound repair.Auranofin,an anti-inflammatory drug,has not been clearly studied for its effects on M1 macrophages and its potential role in diabetic wound healing.OBJECTIVE:To investigate the effects of different concentrations of auranofin on the biological function of M1 macrophages and evaluate its potential application in diabetic wound healing.METHODS:RAW264.7 and THP-1 cells were used as research models.M1 polarization was induced using different concentrations of interferon-γ and lipopolysaccharide.M1 macrophages were treated with 1 and 2 μmol/L auranofin.Cell counting kit-8 assay was used to evaluate the effect of auranofin on cell viability.Quantitative real-time PCR was performed to detect mRNA expression of interleukin-1β,interleukin-6,and tumor necrosis factor-α.ELISA was employed to measure the levels of interleukin-1β,interleukin-6,and tumor necrosis factor-α in the supernatant.Western blot analysis was used to assess the expression of nuclear factor-κB(p65),phosphorylated mitogen-activated protein kinases(MAPK),and total MAPK proteins.Additionally,6-8-week-old male C57BL/6J and db/db diabetic mice were used for wound healing experiments,with the mice divided into C57 control,db/db control and auranofin treatment groups,each containing six animals.Dorsal skin defect modeling and treatment with intraperitoneal injection of auranofin were performed to observe wound healing in mice.RESULTS AND CONCLUSION:(1)Cell experiments showed that co-treatment with interferon-y(10 ng/mL)and lipopolysaccharide(100 ng/mL)significantly induced M1 polarization in RAW264.7 and THP-1 cells,resulting in increased mRNA expression of interleukin-1β,interleukin-6,and tumor necrosis factor-α.Treatment with auranofin(1 and 2 μmol/L)reduced the mRNA expression of these inflammatory factors in the cells and inhibited the secretion of inflammatory factors in the cell supernatant.(2)Auranofin treatment significantly suppressed the activation of nuclear factor-κB(p65)and phosphorylated MAPK signaling pathways.(3)Animal experiments showed that auranofin promoted wound healing in db/db diabetic mice,suggesting that auranofin has strong anti-inflammatory effects and may facilitate the healing of wounds in diabetic mice.
2.Analysis of influencing factors for successful detoxification in patients undergoing methadone maintenance therapy
Guodong MO ; Yue LIN ; Yinghui CHEN ; Lichuang ZHUANG ; Leisheng ZHENG ; Baoguo WANG
China Pharmacy 2026;37(2):210-214
OBJECTIVE To explore the influencing factors for successful detoxification in patients undergoing methadone maintenance therapy. METHODS A retrospective selection of 161 methadone maintenance therapy patients from the South Branch of Zhongshan Second People’s Hospital (including methadone maintenance treatment sites in Shiqi District, Xiqu District, Development Zone of Zhongshan City) from January 1, 2012, to January 1, 2025, was conducted as the study object. Data collected included patients’ sociodemographic information, drug abuse history, laboratory test results, medication records, etc. Patients were divided into the unsuccessful detoxification group and the successful detoxification group based on whether methadone detoxification was achieved. Univariate, univariate Cox regression, and multivariate Cox proportional hazards regression were used for influencing factor analysis, and the Kaplan-Meier method was employed for survival analysis. RESULTS Among the 161 methadone maintenance therapy patients, 96 were in the successful detoxification group and 65 in the unsuccessful detoxification group, yielding a successful detoxification rate of 59.63%. Multivariate Cox proportional hazards regression analysis revealed that age, registered residence status, age at first drug use, and duration of drug abuse were key influencing factors for successful detoxification in methadone maintenance therapy patients (P<0.05). Specifically, the successful detoxification rate for patients with Zhongshan local registered residence was 8.364 times higher than that for patients with non-local registered residence; for every 1-year increase in patient age, the successful detoxification rate decreased by 22.7%; for every 1-year increase in age at first drug use, the successful detoxification rate rose by 33.4%; and for every 1-year increase in duration of drug abuse, the successful detoxification rate increased by 33.5%. Survival analysis showed that the successful detoxification rate in the methadone low-dose group (≤30.8 mg) was significantly higher than that in the methadone high-dose group (>30.8 mg) (P=0.015), and the successful detoxification rate in the population with Zhongshan local registered residence was significantly higher than that in those with non-local registered residence (P<0.001). CONCLUSIONS Age, registered residence status, age at first drug use, and duration of drug abuse are key influencing factors for successful detoxification in patients undergoing methadone maintenance therapy, and the last methadone dose may be associated with successful detoxification.
3.Inhibitory effects of different concentrations of auranofin on M1 macrophage function and its therapeutic potential in diabetic wound healing
Hongfei PAN ; Zhenbing ZHUANG ; Baiyun XU ; Zhangyang YANG ; Kairui LIN ; Bingqing ZHAN ; Jinghan LAN ; Heng GAO ; Nanbo ZHANG ; Jiayu LIN
Chinese Journal of Tissue Engineering Research 2026;30(6):1390-1397
BACKGROUND:During diabetic wound healing,the sustained activation of M1 macrophages exacerbates the inflammatory response and hinders wound repair.Auranofin,an anti-inflammatory drug,has not been clearly studied for its effects on M1 macrophages and its potential role in diabetic wound healing.OBJECTIVE:To investigate the effects of different concentrations of auranofin on the biological function of M1 macrophages and evaluate its potential application in diabetic wound healing.METHODS:RAW264.7 and THP-1 cells were used as research models.M1 polarization was induced using different concentrations of interferon-γ and lipopolysaccharide.M1 macrophages were treated with 1 and 2 μmol/L auranofin.Cell counting kit-8 assay was used to evaluate the effect of auranofin on cell viability.Quantitative real-time PCR was performed to detect mRNA expression of interleukin-1β,interleukin-6,and tumor necrosis factor-α.ELISA was employed to measure the levels of interleukin-1β,interleukin-6,and tumor necrosis factor-α in the supernatant.Western blot analysis was used to assess the expression of nuclear factor-κB(p65),phosphorylated mitogen-activated protein kinases(MAPK),and total MAPK proteins.Additionally,6-8-week-old male C57BL/6J and db/db diabetic mice were used for wound healing experiments,with the mice divided into C57 control,db/db control and auranofin treatment groups,each containing six animals.Dorsal skin defect modeling and treatment with intraperitoneal injection of auranofin were performed to observe wound healing in mice.RESULTS AND CONCLUSION:(1)Cell experiments showed that co-treatment with interferon-y(10 ng/mL)and lipopolysaccharide(100 ng/mL)significantly induced M1 polarization in RAW264.7 and THP-1 cells,resulting in increased mRNA expression of interleukin-1β,interleukin-6,and tumor necrosis factor-α.Treatment with auranofin(1 and 2 μmol/L)reduced the mRNA expression of these inflammatory factors in the cells and inhibited the secretion of inflammatory factors in the cell supernatant.(2)Auranofin treatment significantly suppressed the activation of nuclear factor-κB(p65)and phosphorylated MAPK signaling pathways.(3)Animal experiments showed that auranofin promoted wound healing in db/db diabetic mice,suggesting that auranofin has strong anti-inflammatory effects and may facilitate the healing of wounds in diabetic mice.
4.Association between the incidence of hemorrhagic fever with renal syndrome and meteorological factors in Shenzhen City from 2012 to 2019
Liangqiang LIN ; Dongfeng KONG ; Lanbin XIANG ; Zhigao CHEN ; Yanmin QIN ; Yuefa ZHUANG ; Yang LIU ; Jianfeng LI
Chinese Journal of Schistosomiasis Control 2026;38(2):194-199
Objective To examine the association between epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) and meteorological factors in Shenzhen City during the period from 2012 to 2019. Methods Average atmospheric pressure, average air temperature, average relative humidity, precipitation, wind speed, and sunshine duration were captured from Meteorological Bureau of Shenzhen City each month from 2012 to 2019. The average monthly rodent densities in Shenzhen City from 2012 to 2019 were acquired from the Vector Surveillance Management System of Guangdong Provincial Center for Disease Control and Prevention, and the monthly HFRS incidence was retrieved from Shenzhen Municipal Disease Surveillance System from 2012 to 2019. The correlation between meteorological factors and the monthly incidence of HFRS was examined us ing Spearman’s rank correlation in Shenzhen City, and the temporal trends in monthly HFRS incidence and the degrees of freedom for the rodent density were determined in Shenzhen City with a generalized additive model. The optimal lag time was identified using excess risk (ER) and its 95% confidence interval (CI), and univariate and multivariate models were fitted to evaluate the impact of meteorological factors on HFRS incidence in Shenzhen City. Results The median number of incident HFRS cases was 3.00 (interquartile range, 3.25) in Shenzhen City from 2012 to 2019, with an average air temperature of (23.44 ± 4.91) °C, average relative humidity of (76.05 ± 7.61)%, median precipitation of 4.10 (interquartile range, 6.83) mm, average wind speed of (1.97 ± 0.26) m/s, average sunshine duration of (5.17 ± 1.64) h, and median monthly rodent density of 1.74% (interquartile range, 2.52%). Spearman’s rank correlation analysis showed that the average air temperature positively correlated with average relative humidity (rs = 0.420, P < 0.05), precipitation (rs = 0.658, P < 0.05) and sunshine duration (rs = 0.633, P < 0.05), and the atmospheric pressure negatively correlated with average air temperature (rs = −0.925, P < 0.05), relative humidity (rs = −0.614, P < 0.05), precipitation (rs = −0.789, P < 0.05) and sunshine duration (rs = −0.437, P < 0.05), while the average relative humidity correlated positively with precipitation (rs = 0.724, P < 0.05) and negatively with sunshine duration (rs = −0.218, P < 0.05). Univariate modeling analysis showed that the ERs and their 95% CI were 0.639% (0.540%, 0.737%) for average atmospheric pressure, −7.157% (−8.113%, −6.190%) for average air temperature, −3.603% (−4.219%, −2.985%) for average relative humidity, −5.889% (−7.085%, −4.669%) forprecipitation,21.881% (−5.149%, 56.612%) for average wind speed, and −13.877% (−16.641%, −11.022%) for sunshine duation (all P values < 0.05). Multivariate modeling analysis showed that in the ensemble model combining average atmospheric pressure and precipitation, the highest ER (6.686%) was caused by increased average atmospheric pressure, and the highest absolute ER values for average air temperature (6.615%), average relative humidity (3.107%) and precipitation (5.386%) were seen after adjustment only for sunshine duration (all P values < 0.05), while the highest absolute ER for sunshine duration (11.875%) was found after adjustment for precipitation (P < 0.05). Conclusions An increase in average air temperature, relative humidity, precipitation and sunshine duration resulted in a reduced incidence rate of HFRS in Shenzhen City from 2012 to 2019, and an increase in average atmospheric pressure increased the incidence of HFRS. Meteorological factors are important determinants affecting HFRS incidence in Shenzhen City.
5.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.
6.Research advances of biohybrid robotics in medical applications
Wenwei WU ; Miao LIN ; Jun ZHUANG
Journal of Pharmaceutical Practice and Service 2026;44(7):335-340
Biohybrid robots are hybrid systems that deeply integrate living biological components (such as cells, tissues, organs, or microorganisms) with artificial synthetic components (including sensors, actuators, control systems, and structural materials). Focusing on key advancements in cellular/microbial-level and tissue-level biohybrid robots, the applications in two major scenarios: targeted drug delivery in vivo and drug evaluation in vitro were reviewed. International research progress demonstrated that biohybrid robots offered novel solutions for overcoming deep tissue delivery barriers, enhancing biocompatibility, and enabling real-time monitoring. However, their clinical translation still faced critical challenges, including reproducibility, in vivo/in vitro nutrient supply, encapsulation technologies, and safety regulatory frameworks.
7.Epidemiological characteristics of imported malaria cases in Guangxi Zhuang Autonomous Region from 2017 to 2024
Kangming LIN ; Shujiao WEI ; Jun LI ; Weiwei ZHANG ; Hui YAN ; Jun MENG
Chinese Journal of Schistosomiasis Control 2026;38(4):389-398
Objective To analyze the epidemiological characteristics of imported malaria cases in Guangxi Zhuang Autonomous Region from 2017 to 2024, so as to formulate the targeted control strategies for imported malaria. Methods The demographic and epidemiological data of malaria cases reported in Guangxi Zhuang Autonomous Region from 2017 to 2024 were collected through the China Disease Prevention and Control Information System. The source of malaria cases acquiring infections, composition of malaria parasite species, regional distribution of malaria cases, population characteristics of malaria cases, temporal distribution of malaria cases, time of diagnosis, deaths and institutions reporting malaria cases were statistically analyzed with a descriptive statistical method. Results A total of 1 308 malaria cases were reported in Guangxi Zhuang Autonomous Region from 2017 to 2024, and all cases were overseas imported cases, with no secondary cases identified. Plasmodium falciparum malaria (57.11%, 747/1 308) and P. ovale malaria (27.68%, 362/1 308) were two most common forms of malaria, and three deaths occurred among P. falciparum malaria cases. The number of malaria cases appeared an overall tendency towards a decline from 2017 to 2022, followed by a rise after 2023. The malaria cases predominantly acquired infections from Africa (1 284 cases, accounting for 98.17%), with Ghana (432 cases, accounting for 33.03%) and Cameroon (145 cases, accounting for 11.09%) as two most frequent origin countries, and P. falciparum malaria (58.02%, 745/1 284) was the predominant form of malaria among African imported malaria cases; however, P. vivax malaria cases comprised 89.58% (86/96) of all malaria cases derived from Ethiopia. In terms of regional distribution, malaria cases were highly concentrated in Nanning City (1 075 cases, accounting for 82.19%), with the most prominent situated in Shanglin County (903 cases, accounting for 69.04%), and these cases were predominantly found among individuals at ages of 20 to 59 years (1 280 cases, accounting for 97.86%), males (1 265 cases, accounting for 96.71%), and gold/coal mining workers (1 042 cases, accounting for 79.66%). In terms of temporal distribution, malaria cases were reported throughout the year, with the peak incidence in April (146 cases, accounting for 11.16%). The median duration from onset of disease to initial diagnosis was 1 (interquartile range, 2) day, and the median duration from initial diagnosis to definitive diagnosis was 1 (interquartile range, 1) day. Malaria cases were predominantly reported by medical institutions (1 075 cases, accounting for 82.19%), and the proportion of malaria cases reported by medical institutions increased from 75.92% in 2017 to 96.27% in 2024, while the proportion of malaria cases reported by disease control and prevention institutions reduced from 24.08% in 2017 to 3.73% in 2024. There was a significant difference in the proportion of malaria cases reported by medical institutions and disease control and prevention institutions from 2017 to 2024 (both P < 0.001). The 3 dead imported P. falciparum malaria cases predominantly received initial diagnosis at townshipand lower-level institutions (66.67%, 2/3), with 1 (interquartile range, 2) day median duration from onset of disease to initial diagnosis, 2 (interquartile range, 4) days median duration from initial diagnosis to definitive diagnosis, and 1 (interquartile range, 19) day median duration from definitive diagnosis to death. Conclusions Imported P. falciparum malaria from Africa is predominant among malaria cases in Guangxi Zhuang Autonomous Region, and malaria cases are highly concentrated in specific regions and among specific occupational groups. It is recommended to strengthen inter-departmental collaboration, implement refined management among labors going to Africa, improve the integration of medical treatment and disease prevention, and enhance the diagnosis and treatment of severe malaria cases.
8.Effect of different melphalan formulation pretreatment on the incidence and severity of diarrhea in patients with lymphoid tumors undergoing autologous hematopoietic stem cell transplantation
Peiying ZHUANG ; Danxia LIN ; Yuemei CHEN ; Zheng WEI
Chinese Journal of Clinical Medicine 2026;33(5):851-857
Objective To explore the differences in the incidence and severity of diarrhea between patients receiving propylene glycol-melphalan (PG-MEL) or propylene glycol-free-melphalan (PGF-MEL) pretreatment during autologous hematopoietic stem cell transplantation (AHSCT). Methods The clinical data of 30 patients who underwent AHSCT with high-dose melphalan (HDM) pretreatment at the Department of Hematology, Zhongshan Hospital (Xiamen), Fudan University, from January 2024 to November 2025 were retrospectively analyzed. Patients were divided into the PG-MEL group (n=15) and the PGF-MEL group (n=15) according to the formulation. The incidence, onset time, maximum daily frequency, duration, type, and severity of diarrhea were compared between the two groups. Oral mucositis, vomiting, infection, fever, and other related adverse events, as well as hematopoietic recovery, were also observed. Results The overall incidence of diarrhea was 93.3% in both groups. There was no significant difference in the onset time of diarrhea between the two groups ([4.0±2.0] d vs [3.0±2.0] d). Compared with the PG-MEL group, the PGF-MEL group had a higher maximum daily frequency of diarrhea (8 [6,14] times vs 6 [4,6] times, P=0.009), a higher proportion of grade 3–4 diarrhea (57.1% vs 14.3%, P=0.046), and a longer duration of diarrhea ([8.0±4.0] d vs [5.0±2.0] d, P=0.033). No statistically significant differences were observed between the two groups in the incidence of other adverse events such as oral mucositis, vomiting, infection, fever, or neutrophil and platelet engraftment times. Conclusions PG-MEL and PGF-MEL showed the same overall incidence of diarrhea in AHSCT. However, the PGF-MEL group experienced more severe diarrhea and longer duration. There were no significant differences between the two formulations in other adverse reactions or short-term transplant outcomes.
9.Mediating effects of coping styles and activities of daily living on social support and depressive symptoms among elderly patients with type 2 diabetes mellitus
LI Dan ; JIE Jinhu ; LI Hong ; LIN Qi ; ZHUANG Hailin
Journal of Preventive Medicine 2026;38(3):279-283,290
Objective:
To analyze the mediating effects of coping styles and activities of daily living on social support and depressive symptoms among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide evidence for promoting mental health in elderly T2DM patients.
Methods:
From March 2019 to June 2020, elderly T2DM patients aged ≥60 years were selected from 11 community health service centers in Taijiang and Gulou Districts, Fuzhou City using a multi-stage sampling method. Basic information such as gender and age was collected through self-designed questionnaires. Social support, depressive symptoms, coping styles (positive coping style and negative coping style), and activities of daily living (physical self-care ability and instrumental activities of daily living) were assessed using the Social Support Rating Scale, the Geriatric Depression Scale (Chinese version), the Simplified Coping Style Questionnaire, and the Activities of Daily Living Scale, respectively. The mediating effects of coping styles and activities of daily living on social support and depressive symptoms were analyzed using Process macro 4.1, and the significance of mediating effects was tested using the Bootstrap method.
Results:
A total of 2 013 elderly T2DM patients were surveyed, including 910 males (45.21%) and 1 103 females (54.79%). The scores of social support, positive coping style, negative coping style, physical self-care ability, and instrumental activities of daily living were (38.56±7.17), (30.93±6.81), (16.52±4.74), (6.20±1.10), and (8.71±2.50), respectively. The score of depressive symptoms was (8.14±4.97), and 622 cases were detected with depressive symptoms, with a detection rate of 30.90%. Mediating effect analysis showed that social support could directly affect depressive symptoms (β=-0.048, 95%CI: -0.063-0.033), and could also indirectly affect depressive symptoms through positive coping style (β=-0.014, 95%CI: -0.020-0.009), negative coping style (β=0.005, 95%CI: 0.002-0.009), and instrumental activities of daily living (β=0.002, 95%CI: 0.000-0.004), respectively. The mediating effects of positive coping style, negative coping style, and instrumental activities of daily living accounted for 25.45%, -9.09%, and -3.63% of the total effect, respectively.
Conclusions
Higher level of social support can directly reduce the risk of depressive symptoms among elderly T2DM patients, and also exert effects through indirect pathways of increasing positive coping, reducing negative coping, and delaying the decline of instrumental activities of daily living.
10.Distribution characteristics of TCM syndromes in diabetic kidney disease and their relationship with microinflammatory status and nutritional status
Wenpeng CHEN ; Danlei WEI ; Chunting LIN ; Xuhuang ZHUANG
International Journal of Traditional Chinese Medicine 2025;47(12):1670-1676
Objective:To investigate the distribution characteristics of TCM syndromes in patients with diabetic nephropathy (DN) and their relationship with microinflammatory status and nutritional status.Methods:A retrospective study. Gender, age, TCM syndrome types, chronic kidney disease (CKD) staging, nutritional status and other medical records of 302 patients with DN from January 2021 to October 2024 in Affiliated Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine were collected and retrospectively analyzed. The neutrophil count and lymphocyte count were detected by automatic blood cell analyzer, and the neutrophil lymphocyte ratio (NLR) was calculated; the levels of IL-1β and IL-10 were detected by ELISA; malnutrition inflammation score (MIS) was used to evaluate nutritional status. Cramer's V and Eta2 correlation coefficient were used to analyze the correlation between TCM syndrome types and CKD stage, micro inflammatory state and nutritional status in patients with DN. Results:Among the 302 patients, the primary syndromes in descending order were qi-yin deficiency (106 cases), spleen-kidney deficiency (94 cases), liver-kidney yin deficiency (71 cases), and yin-yang deficiency (31 cases). The associated syndromes in descending order were blood stasis (75 cases), phlegm-stasis (66 cases), dampness-turbidity (62 cases), damp-heat (52 cases), and none (47 cases). The top three combined syndromes were spleen-kidney deficiency with damp-heat, qi-yin deficiency with blood stasis, and qi-yin deficiency with phlegm-stasis. For primary syndromes, CKD stage I was mainly qi-yin deficiency and liver-kidney yin deficiency; stage Ⅱ, qi-yin deficiency and liver-kidney yin deficiency; stage Ⅲ, qi-yin deficiency and spleen-kidney deficiency; stage Ⅳ, spleen-kidney deficiency. Differences across CKD stages were statistically significant ( χ2=86.08, P<0.001). For associated syndromes, CKD stage Ⅰ was mainly none; stage Ⅱ and Ⅲ, blood stasis; stage Ⅳ, dampness-turbidity, with statistical significance ( χ2=58.92, P<0.001). NLR and IL-1β levels in yin-yang deficiency, spleen-kidney deficiency, and liver-kidney yin deficiency were higher than in qi-yin deficiency, while IL-10 levels were lower ( P<0.05); for associated syndromes, dampness-turbidity showed higher NLR and IL-1β and lower IL-10 compared with blood stasis and phlegm-stasis ( P<0.05). There was statistical significance in the distribution of DN patients with different syndrome types and nutritional status ( χ2=75.16, P<0.001); there was no statistical significance in the distribution of patients with different syndrome types and nutritional status ( χ2=13.93, P>0.05). Qi-yin deficiency and liver-kidney yin deficiency were mainly mildly malnourished, while spleen-kidney deficiency and yin-yang deficiency were mainly moderately malnourished. Cramer's V/ Eta2 analysis indicated that primary TCM syndromes were correlated with CKD stage, nutritional status (Cramer's V values were 0.308, 0.288), NLR, IL-1β, IL-10 ( Eta2 values were 0.865, 0.984, 0.916) ( P<0.001), while associated syndromes were correlated with CKD stage (Cramer's V=0.255), NLR, IL-1β, and IL-10 ( Eta2 values were 0.891, 0.958, 0.908) ( P<0.001). Conclusions:DN patients is mainly qi-yin deficiency syndrome, and blood-stasis syndrome. The TCM syndrome type is mainly spleen-kidney deficiency and damp-heat syndrome, and the TCM syndrome type is related to micro inflammatory state and nutritional status.


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