1.Expert consensus on the medication catalog for drug-induced liver injury and rational drug use
Jianchun LI ; Di CHEN ; Pengfei JIN ; Gerontology NATIONAL ; Association GERIATRIC ; Research PHARMACY ; Society PHARMACY ; Association GERIATRIC
China Pharmacy 2026;37(3):273-280
OBJECTIVE To systematically sort out the drugs causing drug-induced liver injury (DILI) and their relevant information, and to develop the Expert consensus on the medication catalog for drug-induced liver injury and rational drug use (hereinafter referred to as the Consensus), so as to provide a reference for rational clinical use. METHODS Systematic searches were conducted across various literature databases, guideline retrieval websites and professional liver injury websites. Drugs identified as causing DILI from the included literature and online resources were extracted and assigned scores based on source credibility: three points for LiverTox A-class drugs and two points for B-class drugs; two points for drugs from Hepatox and guidelines; and one point for drugs from consensus and related literature sources. Drugs classified as LiverTox category A/B or with total scores ≥4 were included in the preliminary list of DILI-causing drugs. Opinions were collected and integrated from a multidisciplinary expert panel comprising 45 medical and pharmaceutical experts from 27 provinces across China through three rounds of the Delphi method (including questionnaires and discussion sessions), and after revision, the final version of Consensus was formed. RESULTS & CONCLUSIONS This Consensus included 12 traditional Chinese medicines (TCMs) such as Polygoni Multiflori Radix and Ephedrae Herba, 151 Western medicines including amiodarone and atorvastatin, along with rational use information. For TCM, eight rational use information were included: evidence-based score, liver injury classification based on pathogenesis, liver injury classification based on biochemical abnormality pattern, clinical phenotype, laboratory examination manifestations, latency period, recovery time, and management strategies. For Western medicines, six additional items were included based on the TCM, namely liver function monitoring, discontinuation, contraindications, cautions, dose adjustments, and risk factors, totaling 14 items. This Consensus systematically compiles DILI drugs and their rational use information, which will support clinicians in enhancing the prevention, identification, and management of DILI, reducing the incidence of liver injury, and ensuring patient medication safety and efficacy.
2.Regulatory Pathways of Cell Apoptosis in Diabetic Kidney Disease and Intervention by Traditional Chinese Medicine: A Review
Yunjie YANG ; Mingqian JIANG ; Chen QIU ; Yaqing RUAN ; Senlin CHEN ; Wenxin HUANG ; Hangbin ZHENG ; Yi WEI ; Pengfei LI ; Xueqin LIN ; Jing WU ; Shiwei RUAN ; Jianting WANG ; Yuliang QIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):294-306
Diabetic kidney disease(DKD) is a chronic kidney structural and functional disorder caused by diabetes. With the global prevalence of diabetes continuing to rise, DKD has gradually become a major cause of chronic kidney disease and end-stage renal disease(ESRD), posing a serious threat to patients' quality of life and long-term health outcomes. Studies have shown that apoptosis plays a pivotal role in the development and progression of DKD, with its mechanisms involving abnormal activation of multiple signaling pathways such as Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)/B-cell lymphoma-2(Bcl-2)/cysteinyl aspartate-specific proteinase(Caspase)-3, protein kinase R-like endoplasmic reticulum kinase(PERK)/eukaryotic initiation factor 2α(eIF2α)/activating transcript factor 4(ATF4)/CCAAT enhancer-binding protein homologous protein(CHOP), phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/glycogen synthase kinase-3β(GSK-3β), Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3), adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) and silent information regulator 1(SIRT1)/tumor suppressor protein 53(p53), thereby accelerating renal pathological damage in DKD. Extensive evidence-based medical studies have confirmed that traditional Chinese medicine(TCM), leveraging its unique therapeutic advantages of multi-target, multi-component and multi-pathway approaches, has demonstrated remarkable efficacy and favorable safety profiles in treating DKD. Recent studies have demonstrated that active components of TCM can specifically target and modulate key effectors in apoptotic signaling pathways. Meanwhile, traditional compound formulations exert synergistic effects through multiple approaches such as replenishing deficiency and activating blood circulation, detoxifying and dredging collaterals, tonifying kidney essence, and removing stasis and purging turbidity, thereby comprehensively regulating critical pathological processes including endoplasmic reticulum stress and mitochondrial apoptosis pathways. This combined therapeutic approach of molecular targeting and holistic regulation provides novel strategies for delaying the progression of DKD. Based on this, this paper provides an in-depth analysis of key apoptotic signaling pathways and their regulatory mechanisms, while systematically summarizing recent research advances regarding the therapeutic effects of TCM active components, compound formulations, and proprietary Chinese medicines on DKD through modulation of these pathways, with particular emphasis on their underlying molecular mechanisms. These findings not only elucidate the modern scientific connotation and theoretical basis of TCM in treating DKD but also establish a solid theoretical and practical foundation for promoting the wider clinical application and further research of TCM in the field of DKD treatment.
3.Ameliorative effect and mechanism of vitexin on inflammation in ulcerative colitis mice
Lin ZHOU ; Pengfei XIA ; Yuling LIU ; Zhichao MENG ; Geng LI ; Yuanyuan YU
China Pharmacy 2026;37(6):758-763
OBJECTIVE To explore the ameliorative effect and potential mechanism of vitexin on inflammation in ulcerative colitis (UC) mice. METHODS The UC mice model was established by continuous administration of 3% dextran sulfate sodium solution for 5 days. Mice with successful modeling were randomly divided into UC group, vitexin low- and high-dose groups (vitexin-L and vitexin-H groups, 40, 80 mg/kg), mesalazine group (400 mg/kg), and vitexin-H+recombinant Jagged canonical Notch ligand 1 (rJagged-1) group (vitexin-H+rJagged-1 group, 80 mg/kg vitexin+1 mg/kg rJagged-1), with 12 mice in each group. Another 12 normal mice were used as the control (CK) group. Mice in each group were administered the corresponding drugs or the corresponding drugs and normal saline by gavage and intraperitoneal injection once daily for 7 consecutive days. General conditions were observed during the experiment. At 24 h after the last administration, the disease activity index (DAI) score was evaluated. Colonic histopathological morphology was observed and scored. Macrophage polarization levels in the spleen and colon tissues were measured. The protein expressions of interleukin-6 (IL-6), IL-10, tumor necrosis factor-α (TNF-α), transforming growth factor-β 1 (TGF-β 1 ), Jagged-1, Notch1 and Notch intracellular domain (NICD) in colonic tissues were determined. RESULTS Compared with the UC group, the symptoms (reduced food and water intake, dull fur, etc.) and pathological changes (epithelial cell shedding, inflammatory cell infiltration, etc.) were significantly improved in the vitexin-L, vitexin-H and mesalazine groups. DAI scores, colonic histopathological scores, M1 macrophage contents in spleen tissue, M1/M2 macrophage ratios, M1 macrophage proportions in colon tissue, and protein expressions of IL-6, TNF-α, Jagged-1, Notch1 and NICD in colon tissue were significantly decreased ( P <0.05). Meanwhile, the M2 macrophage contents in spleen tissue, M2 macrophage proportions in colon tissue, and protein expressions of IL-10 and TGF-β 1 in colon tissue were significantly increased ( P <0.05). Moreover, the improvement effects in the vitexin-H and mesalazine groups were significantly superior to those in the vitexin-L group ( P <0.05). Compared with the vitexin-H group, the above symptoms and pathological changes were aggravated, and all quantitative indicators were significantly reversed in the vitexin-H+rJagged-1 group ( P <0.05). CONCLUSIONS Vitexin can ameliorate the inflammation of UC mice, which is associated with its inhibition of the Jagged-1/Notch1 pathway and regulation of macrophage polarization (inhibition of M1-type polarization and promotion of M2-type polarization).
4.Fascioliasis in the common bile duct: a case report
Pengfei ZHANG ; Qiong TANG ; Li LIU ; Jingxin LI ; Weiming LAN
Chinese Journal of Schistosomiasis Control 2026;38(2):219-222
This article reports the diagnosis and treatment of one patient with fascioliasis of the common bile duct, aiming to provide reference for the clinical diagnosis and treatment of this disease. The patient sought medical attention due to long-term symptoms such as abdominal pain, abdominal distension, nausea, and vomiting. Imaging examinations displayed dilatation of the common bile duct and intrahepatic bile ducts, and the patient was admitted to the hospital with a diagnosis of “common bile duct stone”. Through endoscopic retrograde cholangiopancreatography and choledochoscopy, two worms were collected from the common bile duct, which were identified as Fasciola hepatica by high-throughput sequencing.
5.Correlation analysis of the severity of OSAHS with visual field defects and visual evoked potentials in patients with AION
Pengfei DUAN ; Shuo LI ; Yuman WU ; Yufeng MA ; Sujuan JI
International Eye Science 2026;26(7):1258-1263
AIM: To investigate the correlation between different severity grades of obstructive sleep apnea-hypopnea syndrome(OSAHS)and visual field defects as well asvisual evoked potential(VEP)parameters in patients with anterior ischemic optic neuropathy(AION). METHODS: A retrospective case-control study. Patients diagnosed with AION complicated by OSAHS at the Department of Ophthalmology, the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, between June 2022 and October 2025 were selected as the study subjects. According to the AHI and mSaO2, the patients were divided into three groups: a mild group(AHI 5-15 events/h, mSaO2 85%-90%), moderate group(AHI 16-30 events/h, mSaO2 80%-85%), and severe group(AHI >30 events/h, mSaO2 <80%). General demographic data, retinal nerve fiber layer(RNFL)thickness, visual field defect indicators including mean defect(MD)and pattern standard deviation(PSD), as well as VEP parameters(P100 latency and amplitude)were compared among the three groups. RESULTS: This study included a total of 110 patients with AION complicated by OSAHS. Based on the severity of OSAHS, the patients were divided into a mild group of 37 patients(21 men and 16 women, mean age 62.15±9.37 y), a moderate group of 35 patients(20 men, 15 women; mean age 61.82±8.94 y), and a severe group of 38 patients(22 men, 16 women; mean age 63.02±9.61 y). There were no significant differences among the three groups in terms of age, sex, TG, TC, LDL-C, HDL-C levels, or AION severity(all P>0.05); however, there were significant differences in history of hypertension, history of diabetes, systolic blood pressure, diastolic blood pressure, and FPG levels(all P<0.05). The mean RNFL thickness in the severe group(63.27±5.58 μm)was significantly lower than that in the moderate group(74.14±6.28 μm)and the mild group(83.22±7.02 μm), and the moderate group was lower than the mild group(all P<0.05); The MD value(-11.57±1.82 dB)and PSD value(7.35±0.87 dB)in the severe group were both higher than those in the moderate group [(-7.62±1.31 dB),(4.89±0.62 dB)] and the mild group [(-4.38±1.05 dB),(2.57±0.45 dB)](all P<0.05); the P100 latency in the severe group(132.41±8.57 ms)was longer than that in the moderate group(118.75±7.32 ms)and the mild group(105.62±6.14 ms), and the amplitude(7.65±1.53 μV)was lower than that of the moderate group(11.24±1.89 μV)and the mild group(15.38±2.11 μV)(all P<0.05). Spearman's correlation analysis revealed that the severity of OSAHS was negatively correlated with the MD value(rs=-0.901, P<0.05)and positively correlated with the PSD value and P100 latency(rs=0.947, 0.807, P<0.05), and was negatively correlated with P100 amplitude(rs=-0.878, P<0.05). CONCLUSION:The severity of OSAHS is closely associated with RNFL thickness, visual field defects, and VEP parameters in patients with AION; the more severe the OSAHS, the more pronounced the structural and functional damage to the optic nerve. Monitoring AHI and mSaO2 can aid in assessing the condition of patients with AION and developing personalized intervention plans.
6.Analysis on effective components and biological activity of volatile oil in anti-URTI formula
Heming FAN ; Yue LI ; Tuoxin LI ; Liying JIA ; Pengfei GAO ; Dongping LIU ; Donghe HAN ; Xian ZHANG ; Lin ZHANG
International Journal of Traditional Chinese Medicine 2025;47(6):843-848
Objective:To analyze the extraction, chemical composition, antioxidant, and anti-inflammatory activity of the TCM formula essential oil for the treatment of upper respiratory tract infections (URTI); To provide a scientific basis for its further development.Methods:The formula essential oil was extracted using the steam distillation method and analyzed for chemical composition by gas chromatography-mass spectrometry (GC-MS). The DPPH, ABTS scavenging ability, and hydroxyl radical scavenging ability of volatile oils were measured. The effect of the essential oil on the viability of RAW264.7 cells was assessed using the CCK-8 assay. ELISA and Western blot methods were used to determine the effects of volatile oil on LPS induced inflammatory cytokines IL-6 and TNF-α.Results:The average extraction rate of the formula essential oil was 1.12%, with a density of 0.973 2 g/ml. Twelve main chemical components were identified, with 1,8-cineole (42.9%) and patchoulol (19.9%) being the predominant constituents. The essential oil exhibited DPPH and ABTS radical scavenging capacities of 52% and 59%, respectively, and a hydroxyl radical scavenging capacity exceeding 70%. Essential oil could reduce the levels of IL-6 and TNF-α ( P<0.05). Conclusion:TCM formula essential oil for the treatment of URTI contains multiple bioactive components and demonstrates significant antioxidant and anti-inflammatory effects.
7.Advances in the diagnosis and treatment of hepatocellular carcinoma with bile duct tumor thrombus
Yuxiang GUO ; Maosen WANG ; Zhongyuan LIU ; Xudong ZHANG ; Pengfei MA ; Xiangkun WANG ; Renfeng LI
Journal of Clinical Hepatology 2025;41(2):359-364
Hepatocellular carcinoma (HCC) with biliary duct tumor thrombus (BDTT) is currently not common in clinical practice and is easily misdiagnosed, and previously, it was often considered an advanced stage of the disease with a poor prognosis, making its treatment challenging. However, in-depth studies in recent years have gradually deepened our understanding of this disease, leading to significant changes in diagnostic and treatment concepts. Currently, comprehensive treatment, mainly surgery, is used for treatment, but there is still controversy over the selection of clinical treatment strategies. This article provides a detailed discussion on surgical methods and prognosis, in order to provide a reference for clinical treatment options.
8.GAO Shuzhong's Experience in Treating Idiopathic Tinnitus with Combination of Acupuncture and Chinese Materia Medica
Pengfei WANG ; Yiyang SUN ; Xiaoyan LI ; Wenli YAN ; Ningning MENG ; Guirong YANG ; Yuxia MA
Journal of Traditional Chinese Medicine 2025;66(3):233-237
To summarize Professor GAO Shuzhong's clinical experience in treating idiopathic tinnitus with a combination of acupuncture and Chinese meteria medica. It is believed that idiopathic tinnitus is mostly caused by weak lungs and spleen, kidney essence deficiency, liver constraint transforming into fire, and binding constraint of heart qi. Treatment advocates the combination of acupuncture and Chinese meteria medica in clinical practice. Acupuncture treatment mainly focus on the method of opening the orifices by syndrome identification in combination with Ermen (TE 21), Tinggong (SI 19), Tinghui (GB 2), Shenmai (BL 62) to regulate qi and blood, and supporting with Baihui (GV 20), Yintang (EX-HN 3), Taichong (LR 3), and Yanglingquan (GB 34) to soothe the liver, resolve constraint, and calm the mind. Oral administration of Chinese medicinal prescription usually includes modified Yiqi Congming Decoction (益气聪明汤) and Tongqi Powder (通气散), and the external administration of Chinese medicinal prescription can apply self-prescribed Wenqing Powder (温清散) to navel moxibustion.
9.Research progress of mitochondrial unfolded protein response in eye diseases
Liang GU ; Pengfei LI ; Huaijin GUAN ; Min JI
International Eye Science 2025;25(9):1425-1430
The mitochondrial unfolded protein response(UPRmt)represents a crucial intracellular stress response mechanism that plays a fundamental role in maintaining mitochondrial and cellular homeostasis. Growing evidence suggests that dysregulation of UPRmt contributes significantly to the pathogenesis of various systemic disorders, including neurodegenerative diseases such as Parkinson's and Alzheimer's diseases, as well as age-related pathologies. Emerging research has particularly highlighted the involvement of UPRmt in ocular diseases, including cataracts, glaucoma, and diabetic retinopathy. This comprehensive review examines the physiological functions of UPRmt and its regulatory mechanisms in age-related eye diseases. The roles of key UPRmt downstream effector molecules in ocular cell populations such as lens epithelial cells, retinal pigment epithelial cells, and retinal ganglion cells are systematically analyzed. Importantly, the dual regulatory nature of UPRmt in ocular pathophysiology is discussed, that is, its moderate activation promotes mitochondrial homeostasis, mitigates oxidative stress, and suppresses inflammatory responses, its chronic or excessive activation triggers apoptotic pathways, induces metabolic dysfunction, and ultimately accelerates disease progression. By elucidating these mechanisms, our review provides novel insights into ocular disease pathogenesis and proposes potential therapeutic strategies targeting UPRmt modulation for the prevention and treatment of age-related eye disorders.
10.Relationship between triglyceride-glucose index and acute ischemic stroke with anterior circulation large vessel occlusion
Ruyue LIN ; Jianqiang FAN ; Lijun WANG ; Xiaoxi ZHANG ; Hongjian SHEN ; Pengfei XING ; Lei ZHANG ; Zifu LI ; Yongwei ZHANG ; Pengfei YANG ; Jianmin LIU ; Rui ZHAO
Academic Journal of Naval Medical University 2025;46(4):435-441
Objective To explore the relationship between triglyceride-glucose index(TyG)and acute ischemic stroke with large vessel occlusion(AIS-LVO)of anterior circulation.Methods A retrospective study was conducted on patients with anterior circulation AIS-LVO who underwent emergency endovascular thrombectomy at Neurovascular Center of The First Affiliated Hospital of Naval Medical University from Jan.2018 to Dec.2019.According to modified Rankin scale(mRS)score 90 d after operation,the patients were assigned to favorable outcome group(mRS score 0-2)or unfavorable outcome group(mRS score 3-6),and the TyG was compared.According to the median of TyG,the patients were assigned to low-TyG group(TyG<8.57)or high-TyG group(TyG ≥8.57),and the clinical data,laboratory indexes,and imaging characteristics were compared.Receiver operating characteristic curve was used to evaluate the predictive value of TyG for poor prognosis.Results A total of 135 patients were enrolled,with 72 in the favorable outcome group and 63 in the unfavorable outcome group.The TyG of the unfavorable outcome group was significantly higher than that of the favorable outcome group(8.82+0.63 vs 8.43+0.60,P<0.001).There were 67 patients in the low-TyG group and 68 in the high-TyG group.Compared with the low-TyG group,the proportion of patients with hyperlipidemia history(P=0.003),systolic blood pressure at admission(P=0.018),fasting blood glucose level(P<0.001),and triglyceride level(P<0.001)were significantly higher in the high-TyG group,the infarct core volume was significantly larger(P=0.025),the high density lipoprotein-cholesterol level was significantly lower(P=0.013),and the mRS score 90 d after operation was significantly higher(3[1,5]vs 1[0,5],P=0.049).The TyG had certain predictive value for poor prognosis in anterior circulation AIS-LVO patients(area under curve value=0.662,95%confidence interval 0.571-0.753).Conclusion TyG is elevated in anterior circulation AIS-LVO patients with poor prognosis,and may be a potential prognostic indicator for anterior circulation AIS-LVO patients.

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