1.Mechanism Exploration of Doxorubicin and Sepsis Induced Myocardial Injury: Differences and Convergences
Tao ZHANG ; Zihan NAN ; Lixia LIU ; Jiaqi LIU ; Xiukai CHEN ; Xiaoting WANG ; Suwen SU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):23-32
Doxorubicin (DOX)-induced cardiotoxicity and sepsis-induced myocardial injury (SIMI) represent significant clinical challenges in patients undergoing chemotherapy, sharing a common pathological basis of oxidative stress and mitochondrial dysfunction. Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has recently been shown to play a critical role in DOX-induced cardiotoxicity and lipopolysaccharide (LPS)-induced SIMI. This article systematically reviews the mechanisms underlying myocardial injury caused by DOX and sepsis, identifying ferroptosis as a central common pathway. DOX triggers a burst of reactive oxygen species within mitochondria and inhibits glutathione peroxidase 4 (GPX4) activity through redox cycling of its quinone group and high-affinity accumulation in mitochondrial cardiolipin. LPS, by activating pattern recognition receptors and related inflammatory signaling pathways, provokes a cytokine storm and mitochondrial dysfunction. Both can disrupt the core regulatory axis of cysteine-glutathione (GSH)-GPX4, synergistically promoting ferroptosis in cardiomyocytes. Moreover, epigenetic regulation plays a key role in DOX- and LPS-induced cardiomyocyte ferroptosis and may serve as a promising therapeutic target. A deeper understanding of the ferroptosis mechanism and its epigenetic regulatory network in the synergistic injury induced by DOX and sepsis is of great importance for developing novel strategies to mitigate chemotherapy-related cardiotoxicity and improve outcomes in cancer patients with concurrent infections.
2.Effect of Shixiaosan on Neurological Function and Ferroptosis in Rats with Cerebral Ischemia-reperfusion Injury Based on Nrf2/SLC7A11/GPX4 Signaling Pathway
Ying WEI ; Lixia WANG ; Junjun YIN ; Xiaohong CHEN ; Lijuan SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):22-31
ObjectiveTo investigate whether Shixiaosan can improve neurological function and inhibit ferroptosis in rats with cerebral ischemia-reperfusion injury (CIRI) by regulating the nuclear factor E2-related factor 2 (Nrf2)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) pathway. MethodsA rat model of CIRI was established using the intraluminal filament method. Briefly, cervical blood vessels were separated, branches of the external carotid artery were ligated, and the common carotid artery and internal carotid artery were clamped. A nylon filament was inserted through the opening of the external carotid artery to the origin of the middle cerebral artery to block blood flow and induce cerebral ischemia. After 60-120 min of ischemia, the filament was withdrawn to restore blood flow, and the external carotid artery incision was ligated. The rats were divided into a CIRI group, a Shixiaosan low-dose (-L) group (intragastric administration of 1.26 g·kg-1 Shixiaosan), a Shixiaosan high-dose (-H) group (intragastric administration of 2.52 g·kg-1 Shixiaosan), a donepezil hydrochloride tablet (DON) group (intragastric administration of 0.45 mg·kg-1 DON), and a Shixiaosan -H + Nrf2 inhibitor (ML385) group (intragastric administration of 2.52 g·kg-1 Shixiaosan combined with intraperitoneal injection of 30 mg·kg-1 ML385). An additional 12 rats underwent cervical artery separation followed by incision suturing and served as the control group. Equal volumes of double-distilled water were administered to the CIRI and control groups. Neurological function impairment was assessed using the modified Garcia JH score. Magnetic resonance imaging was used to determine the cerebral infarct volume ratio. Hematoxylin-eosin (HE) staining and Prussian blue staining were performed to observe neuronal injury and iron accumulation in the ischemic penumbra, respectively. Transmission electron microscopy was used to examine the ultrastructure of neuronal mitochondria in the ischemic penumbra. Commercial kits were used to measure ferrous iron (Fe2+), malondialdehyde (MDA), reduced glutathione (GSH) content, and reactive oxygen species (ROS) activity in the ischemic penumbra. The BODIPY (581/591) C11 fluorescent probe was used to detect intracellular lipid peroxidation levels. Western blot was performed to detect protein expression levels of Nrf2, SLC7A11, GPX4, transferrin receptor 1 (TFRC), ferritin heavy chain (FHC), and ferritin light chain (FLC) in the ischemic penumbra. ResultsCompared with the control group, the CIRI group exhibited neuronal injury in the ischemic penumbra, characterized by reduced neuron numbers, nucleolar shrinkage, and interstitial edema. Marked iron accumulation was observed in the tissue. Neuronal mitochondria showed atrophy and rupture, with reduced mitochondrial cristae and increased membrane density. The cerebral infarct volume ratio, Fe2+ content, MDA content, ROS activity, and lipid peroxidation levels were increased, whereas the modified Garcia JH score, GSH content, and protein expression levels of Nrf2, SLC7A11, GPX4, FHC, and FLC were decreased, and TFRC protein expression was increased (P<0.05). Compared with the CIRI group, the Shixiaosan -L group, Shixiaosan -H group, and DON group showed attenuated neuronal injury in the ischemic penumbra, reduced iron accumulation, alleviated mitochondrial damage, decreased cerebral infarct volume ratio, Fe2+ and MDA contents, ROS activity, and lipid peroxidation levels, as well as increased modified Garcia JH scores, GSH content, and protein expression levels of Nrf2, SLC7A11, GPX4, FHC, and FLC, while TFRC protein expression was decreased (P<0.05). The magnitude of changes in all indicators was greater in the Shixiaosan -H group than in the Shixiaosan -L group (P<0.05). Compared with the Shixiaosan -H group, all measured indicators in the Shixiaosan -H + ML385 group showed opposite trends (P<0.05). ConclusionShixiaosan may inhibit ferroptosis and restore neurological function in rats with CIRI by activating the Nrf2/SLC7A11/GPX4 pathway.
3.Early-stage diabetes induces structural damage and functional deficits in the mouse primary visual cortex
Hanlu CHEN ; Haoqiong TANG ; Lixia FENG
Acta Universitatis Medicinalis Anhui 2026;61(5):872-879
ObjectiveTo investigate morphological and functional neural network alterations in the primary visual cortex (V1) during early-stage diabetes. Methods32 SPF male C57BL/6J mice were randomly divided into control and diabetic groups(n=16). Type 1 diabetes was induced by intraperitoneal injection of streptozotocin (STZ), with model validation via oral glucose tolerance test (OGTT) at week 4. Nissl staining was used to assess morphological changes in brain slices of the two groups. Immunohistochemistry was performed to detect the expression of calcium/calmodulin-dependent protein kinase Ⅱ (CaMKⅡ) and somatostatin (SST) in the V1 area. The co-localization density of SST-positive signals on CaMKⅡ+ neurons was then quantified by ImageJ software. In vivo electrophysiology was used for studying neuronal firing and functional connectivity. ResultsCompared with the control mice, nissl staining showed diabetic mice exhibited significant V1 thinning (P=0.02), reduced neuronal density (P=0.01). Immunohistochemistry found decreased SST integral optical density (P=0.02) and elevated mean fluorescence intensity (P=0.01), and lower SST density on CaMKⅡ+ neurons in the diabetic group than in the control group. Compared with the control mice, in vivo electrophysiology studies indicated that diabetic mice showed reduced action potential peak-to-trough ratio and the absolute values of slope (P<0.01), as well as impaired functional connectivity, including conditional firing, mutual information, and Granger causality (P<0.000 1). ConclusionEarly diabetes induces V1 structural atrophy accompanied by SSTergic system disruption and multi-level functional degradation from single neurons to neural networks.
4.Global Trends and Research Hotspots in Exercise Intervention for Overweight and Obesity: A Bibliometric Analysis
Yuanchun ZHU ; Yuhang ZHANG ; Mingnan SHI ; Houqiang ZHANG ; Shufen LIU ; Qing LI ; Lixia CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(4):1051-1062
To analyze global trends and research hotspots in exercise intervention for overweight and obesity from 2010 to 2024, to provide novel perspectives for comprehensive management research on overweight and obesity. Relevant literature published between January 1, 2010, and December 31, 2024, was retrieved from all sub-databases of the Web of Science Core Collection, including articles and reviews. CiteSpace 6.4.R1 was used to perform co-occurrence and burst analysis of journals, institutions, authors and keywords. VOSviewer 1.6.20 was applied to construct co-citation networks among countries/regions and references. SPSS 26.0 was utilized to analyze trends in publication volume and citation frequency. A total of 113 080 publications on exercise interventions for overweight and obesity were obtained, including 98 188 articles and 14 892 reviews. Both annual publications ( Over the past 15 years, the field of exercise intervention for overweight and obesity has received considerable academic attention. Key research hotspots focus on monitoring the incidence of overweight and obesity and the correlation between physical activity and the health outcomes of individuals with overweight and obesity. Future research directions emphasize the effect of high-intensity interval training on the cardiometabolic health of individuals with overweight and obesity, the interaction of dietary habits and physical activity, and the focus on enhance physical activity levels are the primary global trends in this research field.
5.Analysis of oral health status and knowledge, attitude and practice intervention effects among third grade primary school students in Guizhou Province
Chinese Journal of School Health 2026;47(7):945-949
Objective:
To evaluate oral health status and knowledge, attitude and practice (KAP) among third grade primary school students after the implementation of the Comprehensive Intervention Project for Childhood Oral Diseases in Guizhou Province, so as to provide evidence for program optimization.
Methods:
Using a multistage cluster sampling method, oral examinations and questionnaire surveys were conducted among third grade primary school students in schools covered by the Comprehensive Intervention Project for Childhood Oral Diseases in Guizhou Province (intervention group, n =1 030) and schools not covered by the program (control group, n =1 130) in November 2023. A follow up survey was conducted one year after the project s implementation (December 2024) to evaluate the differences in oral health status and KAP between the two groups. The t-test and χ 2 test were used to compare means and rates, respectively.
Results:
One year after implementation, the permanent caries prevalence, caries filling ratio, mean dmft/DMFT, and mean simplified debris index in the intervention group were 33.3%, 22.3 %, 3.44±3.10, 0.77±0.56, which were all better than those in the control group (39.8%, 17.3%, 3.89±2.85, and 0.87± 0.63 ) ( χ 2/ t =9.87, 8.78, -2.59, -3.91,all P <0.05). After intervention, the levels of oral health knowledge, attitude and behaviors in the intervention group were better than those in the control group ( Z =7.69, 2.35, 2.10, all P <0.05). Except for the item "fluoride has no protective effect on teeth", the correct response rates of other oral health knowledge items in the intervention group were higher than those in the control group ( χ 2=3.92-163.94, all P <0.05). The reported rates of tooth brushing related behaviors and sugary beverage consumption were higher in the intervention group than in the control group ( χ 2=4.02-11.42,all P <0.05).
Conclusions
The Comprehensive Intervention Project for Childhood Oral Diseases improves children s oral health status, oral health knowledge, and some oral health behaviors, but has limited effects on some behaviors and oral health attitudes. Future efforts should focus on the factors influencing the transformation of children s oral health attitudes and behaviors, along with strengthening long term follow up evaluations.
6.Exploring Content and Distribution Patterns of 22 Ginsenosides in Stems and Leaves of Panax ginseng with Different Stem Colors by UHPLC-QqQ-MS
Tianxin ZHANG ; Yang YANG ; Jiabing ZHANG ; Lixia WANG ; Xiaoxu CHEN ; Xiaoyu ZHU ; Dade YU ; Hongwei WU ; Zhuju WANG ; Kaiyang LIU ; Liying TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):198-209
ObjectiveTo systematically elucidate the accumulation characteristics of secondary metabolites in the stems and leaves of Panax ginseng with different stem colors. MethodsUltra-high-performance liquid chromatography-triple quadrupole-tandem mass spectrometry (UHPLC-QqQ-MS) was employed to determine the of 22 ginsenosides in the stems and leaves of 2- to 5-year-old P. ginseng plants with green and purple stems. Principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), and one-way analysis of variance (ANOVA) were performed to explore the distribution patterns of ginsenosides from three dimensions: tissue distribution, growth duration, and stem color. Results① Tissue distribution: Leaves served as the primary organ for ginsenoside accumulation, exhibiting significantly higher total ginsenoside content than stems, which indicated distinct tissue-specific distribution of ginsenosides. ② Growth duration: Ginsenoside levels in stems generally peaked in the 2-year-old plants before stabilizing, while those in leaves displayed a declining-rebounding pattern, indicating that the 2-year-old plants (harvest stage) was a critical time point for the resurgence of leaf ginsenosides. ③ Stem color: A stage-specific correlation was observed between stem color and ginsenoside accumulation. In stems, the early-growth stage (2-year-old) of purple-stemmed plants exhibited higher content of specific ginsenosides (e.g., ginsenoside Rk1 and notoginsenoside R1), which may be associated with its stronger early-stage stress resistance. In leaves, the content of core ginsenosides (e.g., ginsenosides Re and Rd) in 5-year-old plants with green stems showed a surpassing trend, demonstrating higher potential of resource development. ConclusionThe accumulation of ginsenosides in P. ginseng stems and leaves is multidimensionally regulated by tissue type, growth duration, and stem color phenotypes. Purple-stemmed plants exhibit early-stage specific ginsenoside accumulation and stress resistance potential, whereas green-stemmed plants are more advantageous for core leaf ginsenoside development at the harvest stage. The findings confirm that aboveground stem color can serve as a biomarker for directed breeding and efficient resource utilization of P. ginseng.
7.Exploring Content and Distribution Patterns of 22 Ginsenosides in Stems and Leaves of Panax ginseng with Different Stem Colors by UHPLC-QqQ-MS
Tianxin ZHANG ; Yang YANG ; Jiabing ZHANG ; Lixia WANG ; Xiaoxu CHEN ; Xiaoyu ZHU ; Dade YU ; Hongwei WU ; Zhuju WANG ; Kaiyang LIU ; Liying TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):198-209
ObjectiveTo systematically elucidate the accumulation characteristics of secondary metabolites in the stems and leaves of Panax ginseng with different stem colors. MethodsUltra-high-performance liquid chromatography-triple quadrupole-tandem mass spectrometry (UHPLC-QqQ-MS) was employed to determine the of 22 ginsenosides in the stems and leaves of 2- to 5-year-old P. ginseng plants with green and purple stems. Principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), and one-way analysis of variance (ANOVA) were performed to explore the distribution patterns of ginsenosides from three dimensions: tissue distribution, growth duration, and stem color. Results① Tissue distribution: Leaves served as the primary organ for ginsenoside accumulation, exhibiting significantly higher total ginsenoside content than stems, which indicated distinct tissue-specific distribution of ginsenosides. ② Growth duration: Ginsenoside levels in stems generally peaked in the 2-year-old plants before stabilizing, while those in leaves displayed a declining-rebounding pattern, indicating that the 2-year-old plants (harvest stage) was a critical time point for the resurgence of leaf ginsenosides. ③ Stem color: A stage-specific correlation was observed between stem color and ginsenoside accumulation. In stems, the early-growth stage (2-year-old) of purple-stemmed plants exhibited higher content of specific ginsenosides (e.g., ginsenoside Rk1 and notoginsenoside R1), which may be associated with its stronger early-stage stress resistance. In leaves, the content of core ginsenosides (e.g., ginsenosides Re and Rd) in 5-year-old plants with green stems showed a surpassing trend, demonstrating higher potential of resource development. ConclusionThe accumulation of ginsenosides in P. ginseng stems and leaves is multidimensionally regulated by tissue type, growth duration, and stem color phenotypes. Purple-stemmed plants exhibit early-stage specific ginsenoside accumulation and stress resistance potential, whereas green-stemmed plants are more advantageous for core leaf ginsenoside development at the harvest stage. The findings confirm that aboveground stem color can serve as a biomarker for directed breeding and efficient resource utilization of P. ginseng.
8.Analysis of Bone Health Status in Adult Hemophilia Patients
Ying LIU ; Ying GE ; Mingnan SHI ; Li ZHANG ; Chengjie YIN ; Lixia CHEN ; Weibo XIA
JOURNAL OF RARE DISEASES 2025;4(4):446-452
To investigate the bone health status and potential influencing factors of bone mineral density in adult patients with hemophilia, providing a reference for improving their bone health and for the prevention, treatment, and rehabilitation intervention of osteoporosis. This study is a retrospective analysis. Adult male patients with hemophilia A who visited the department of rehabilitation medicine at Peking Union Medical College Hospital from July 2022 to February 2024 were selected. Dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) were used to assess the bone mineral density (BMD) of the patients. Anterolateral X-rays and Pettersson radiology scores were performed on the left ankle joint. Hemophilia Joint Health Score (HJHS) version 2.1 was used to calculate the HJHS score of the left ankle and evaluate the joint health status of the included patients. Serum bone metabolism indexes including total procollagen Ⅰ N-terminal propeptide (TP1NP) and C-terminal crosslinking β-isomerized carboxy-telopeptide of type Ⅰ collagen (β-CTX), and serum 25-(OH)D3 were detected. The patients' body composition parameters were measured, including the body mass index(BMI)and the skeletal muscle mass index (SMI). The correlation analysis of BMD detection values and its possible influencing factors was carried out. A total of 33 adult male patients with hemophilia A were selected, including 22 severe patients and 11 moderate patients, with an average age of 31.1±8.4 years. The hip BMD of the included patients was lower than the predicted value of age to varying degrees, and the minimum The hip BMD of adult hemophilia patients decreased.Joint dysfunction may be one of the factors associated with reduced bone density in patients with hemophilia. The increase in osteoclast activity may be accompanied by an increase in compensatory osteoblast activity.
9.Treatment of Glaucoma Based on "Jueyin (厥阴) as the Closing Phase" from the Perspective of Spatiotemporal Theory
Xue WU ; Shuang CHEN ; Lixia ZHANG ; Piao JIANG ; Zhiyi ZHOU ; Wenying SUN ; Aixiang JIA
Journal of Traditional Chinese Medicine 2025;66(13):1400-1404
This paper explores the therapeutic approach for glaucoma based on the concept of "jueyin (厥阴) as the closing phase" from the perspectives of time and space. In traditional Chinese medicine, jueyin governs inward, converging aspect of qi, representing the crucial turning point between the end of yin and the emergence of yang, as well as the transformation between yin and yang. When the closing and descending function of jueyin operates smoothly, it promotes the inward convergence and smooth descent of qi, enabling the internal retention of blood, spirit, and emotions, which nourishes the internal organs and moistens the meridian-sinews. Conversely, dysfunction of this "closing" mechanism results in a disturbance of yin and yang, a mixture of cold and heat, and disharmony of qi and blood. It is proposed that "failure of jueyin to properly close and descend" is a core pathomechanism of glaucoma. From the perspective of spatiotemporal theory, clinical treatment should focus on "regulating the closing function of jueyin and harmonizing yin and yang". The modified Wumei Pill (乌梅丸) is recommended to adjust the ascending-descending and entering-exiting dynamics of jueyin qi transformation, thereby restoring its free flow, achieving yin and yang balance, and ensuring nourishment to the ocular system.
10.Polygonatum Sibiricum Polysaccharides Improve Colonic Injury in a Mouse Model of Chronic Obstructive Pulmonary Disease by Regulating Bile Acid Metabolism in the Colon
Wanrong LI ; Mengting TAO ; Yuanfeng ZOU ; Dan HE ; Nengyuan TANG ; Xin TAN ; Lixia LI ; Dandan CHEN
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(3):431-443
ObjectiveTo investigate the effect and mechanism of Polygonatum neutral polysaccharides from sibiricum (PSP-NP) on colon injury in mice with chronic obstructive pulmonary disease (COPD). MethodsMale C57BL/6J mice were randomly divided into a control group, a COPD model group, and a PSP-NP group. The COPD model was established using smoke exposure combined with intranasal LPS administration. The PSP-NP group was simultaneously treated daily with 200 mg/kg of PSP-NP via intragastric gavage, while the other groups received an equal volume of saline. HE staining was used to observe the pathological changes in the colon. ELISA was employed to detect the levels of LPS in serum and the expressions of ZO-1, Occludin, IL-6, and TNF-α in colon tissue. UPLC-MS was used to detect the types and contents of bile acids in colonic content, and to screen for differential bile acids. Differential microbial flora were identified using 16S rRNA gene sequencing, and correlation analysis was conducted with differential bile acids. PSP-NP was combined with the differential bile acids cholic acid (CA), and deoxycholic acid (DCA) in vitro to analyze the binding capacity of PSP-NP for CA and DCA. PSP-NP was applied to NCM460 normal colonic epithelial cells cultured in CA and DCA. Cell migration ability was assessed using the scratch assay, and the mRNA expression levels of inflammatory cytokines TNF-α, IL-6, and NF-κB were measured by RT-qPCR. ResultsPSP-NP effectively improved colonic damage in COPD model mice, enhanced mechanical barrier function, alleviated inflammatory response, and regulated abnormal changes in colonic flora and bile acid metabolism. Correlation analysis further revealed that PSP-NP regulated colonic bile acid metabolism and reduced the redundancy of secondary bile acids by increasing the relative abundance of Bacteroidota, Verrucomicrobiota, Bacteroides, and Akkermansia, while decreasing the relative abundance of Lactobacillus and Bifidobacterium. Notably, in vitro binding assays demonstrated that PSP-NP bound to differential bile acids DCA and CA, with the strongest binding capacity for DCA at 58.2%. In cellular functional studies, DCA inhibited the migration ability of colonic epithelial cells NCM460 and significantly increased the relative mRNA expression levels of inflammatory factors TNF-α, IL-6, and NF-κB. Importantly, co-treatment with PSP-NP significantly ameliorated the impact of DCA on NCM460 cells. ConclusionsPSP-NP may significantly improve colonic damage in COPD model mice. The mechanism may involve the regulation of colonic bile acid metabolism and bile acid profiles through both microbial modulation and direct binding, thereby reducing the damage caused by secondary bile acids such as DCA to colonic epithelial cells.


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