1.Lumbar Oscillatory Manipulation for Lumbar Disc Herniation:A Randomized Controlled Trial
Shiyi LIU ; Yuelai CHEN ; Nan ZHOU ; Qiang LYU
Journal of Traditional Chinese Medicine 2025;66(16):1672-1678
ObjectiveTo observe clinical effectiveness and safety of lumbar oscillatory manipulation in the treatment of patients with lumbar disc herniation. MethodsThis study recruited 90 lumbar disc herniation patients who were randomly divided into 45 cases each in the treatment group and the control group. The treatment group was given lumbar oscillatory manipulation, while the control group was given traditional lumbar obliquely pulling manipulation, and both groups were treated twice a week for 4 weeks. The Oswestry dysfunction index (ODI) score, lumbar spine mobility, and the absolute values of difference in hardness between the left and right sides of the lumbar erector spinae muscle were compared between groups of patients before treatment and after 2 and 4 weeks of treatment; the shear wave elastic modulus of multifidus muscle and abdominal muscle thickness were compared between groups before treatment and after 4 weeks of treatment; the clinical effectiveness of the treatment was compared, and the safety evaluation was carried out. ResultsCompared with the group before treatment, the ODI scores and the the absolute values of difference in hardness between the left and right sides of the lumbar erector spinae muscle decreased after 2 and 4 weeks treatment in both groups, and the mobility of the lumbar vertebrae in all directions of anterior flexion, posterior extension, left lateral flexion, and right lateral flexion increased; the shear wave elastic modulus of bilateral multifidus muscles of the fourth lumbar vertebral segments decreased, and the thickness of abdominal muscle increased after 4 weeks of treatment in both groups (P<0.05). Compared with the control group, the ODI score of the treatment group decreased after 2 weeks of treatment, and the shear wave elastic modulus value of bilateral multifidus muscle of the fourth lumbar vertebral segment decreased and the thickness of abdominal muscle increased after 4 weeks of treatment (P<0.05). The total effective rate was 90.48% (38/42) in the treatment group and 71.43% (30/42) in the control group, and the clinical effectiveness of the treatment group was better than that of the control group (P<0.05). No adverse events occurred in both groups during the study. ConclusionLumbar oscillatory manipulation is superior to traditional lumbar obliquely pulling manipulation in relieving symptoms of lumbar disc herniation and improving lumbar spine function, which may be related to its improvement in the elasticity of the multifidus muscle.
2.Mechanism of Xiangsha Liujunzi Decoction in improving autophagy in interstitial cells of Cajal of rats with functional dyspepsia by regulation of IRE1/ASK1/JNK pathway.
Ming-Kai LYU ; Yong-Qiang DUAN ; Jin JIN ; Wen-Chao SHAO ; Qi WU ; Yong TIAN ; Min BAI ; Ying-Xia CHENG
China Journal of Chinese Materia Medica 2025;50(8):2237-2244
This study explored the mechanism of Xiangsha Liujunzi Decoction(XSLJZD) in the treatment of functional dyspepsia(FD) based on inositol-requiring enzyme 1(IRE1)/apoptosis signal-regulating kinase 1(ASK1)/c-Jun N-terminal kinase(JNK) pathway-mediated autophagy in interstitial cells of Cajal(ICC). Forty-eight SPF-grade male SD suckling rats were randomly divided into a blank group and a modeling group, and the integrated modeling method(iodoacetamide gavage + disturbance of hunger and satiety + swimming exhaustion) was used to replicate the FD rat model. After the model replications were successfully completed, the rats were divided into a model group, high-dose, medium-dose, and low-dose groups of XSLJZD(12, 6, and 3 g·kg~(-1)·d~(-1)), and a positive drug group(mosapride of 1.35 mg·kg~(-1)·d~(-1)), and the intervention lasted for 14 days. The gastric emptying rate and intestinal propulsion rate of rats in each group were measured. The histopathological changes in the gastric sinus tissue of rats in each group were observed by hematoxylin-eosin(HE) staining. The ultrastructure of ICC was observed by transmission electron microscopy. The immunofluorescence double staining technique was used to detect the protein expression of phospho-IRE1(p-IRE1), TNF receptor associated factors 2(TRAF2), phospho-ASK1(p-ASK1), phospho-JNK(p-JNK), p62, and Beclin1 in ICC of gastric sinus tissue of rats in each group. Western blot was used to detect the related protein expression of gastric sinus tissue of rats in each group. Compared with those in the blank group, the rats in the model group showed decreased body weight, gastric emptying rate, and intestinal propulsion rate, and transmission electron microscopy revealed damage to the endoplasmic reticulum structure and increased autophagosomes in ICC. Immunofluorescence staining revealed that the ICC of gastric sinus tissue showed a significant elevation of p-IRE1, TRAF2, p-ASK1, p-JNK, and Beclin1 proteins and a significant reduction of p62 protein. Western blot revealed that the expression levels of relevant proteins in gastric sinus tissue were consistent with those of proteins in ICC. Compared with the model group, the body weight of rats in the high-dose and medium-dose groups of XSLJZD was increased, and the gastric emptying rate and intestinal propulsion rate were increased. Transmission electron microscopy observed amelioration of structural damage to the endoplasmic reticulum of ICC and reduction of autophagosomes, and the p-IRE1, TRAF2, p-ASK1, p-JNK, and Beclin1 proteins in the ICC of gastric sinus tissue were significantly decreased. The p62 protein was significantly increased. Western blot revealed that the expression levels of relevant proteins in gastric sinus tissue were consistent with those of proteins in ICC. XSLJZD can effectively treat FD, and its specific mechanism may be related to the inhibition of the expression of molecules related to the endoplasmic reticulum stress IRE1/ASK1/JNK pathway in ICC and the improvement of autophagy to promote gastric motility in ICC.
Animals
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Male
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Drugs, Chinese Herbal/administration & dosage*
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Autophagy/drug effects*
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Rats
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Rats, Sprague-Dawley
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Interstitial Cells of Cajal/metabolism*
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Dyspepsia/physiopathology*
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Protein Serine-Threonine Kinases/genetics*
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MAP Kinase Kinase Kinase 5/genetics*
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MAP Kinase Signaling System/drug effects*
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Humans
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Endoribonucleases/genetics*
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Multienzyme Complexes
3.Domestication progress of endangered Chinese medicinal material Fritillariae Cirrhosae Bulbus.
Ting XIAO ; Ming-Hao YANG ; Qiu-Ling WANG ; Qiang LYU ; Yu-Qing ZHENG ; Lian-Cheng XU ; Ma YU ; Jian-He WEI
China Journal of Chinese Materia Medica 2025;50(16):4483-4489
Fritillariae Cirrhosae Bulbus is the dried bulb of perennial herbaceous plants in the Fritillaria genus(Liliaceae family) and is a representative traditional Chinese medicinal material with distinctive regional characteristics. Clinically, it is widely used in the treatment of dry cough, bronchial asthma, and other respiratory diseases, possessing significant medicinal and economic value and being highly esteemed in TCM. Currently, Fritillariae Cirrhosae Bulbus primarily relies on wild harvesting. However, due to excessive collection, its wild resources have drastically declined, and all source species have been classified as category Ⅱ in the List of National Key Protected Wild Plants, exacerbating the supply-demand imbalance in the market. To mitigate this issue, large-scale cultivation through the domestication of wild Fritillariae Cirrhosae Bulbus has become an inevitable trend. However, its strict environmental requirements, low propagation efficiency, high seedling mortality, and immature cultivation techniques have severely hindered industrialization. This study investigates the domestication process of Fritillariae Cirrhosae Bulbus, focusing on seed propagation, seedling cultivation, and medicinal material production. It also reviews the species and distribution of wild resources, their endangered status, market supply-demand dynamics, and the historical and current development of domestication. The findings indicate that enhancing propagation efficiency, optimizing cultivation models, and distinguishing between seed propagation and medicinal material production are key measures to accelerate the industrialization of domesticated Fritillariae Cirrhosae Bulbus. This research aims to promote the industrialization of Fritillariae Cirrhosae Bulbus domestication and provide a reference model for the conservation and sustainable utilization of rare and endangered medicinal plant resources.
Fritillaria/chemistry*
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Endangered Species
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Plants, Medicinal/growth & development*
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Drugs, Chinese Herbal/economics*
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China
4.Taxifolin attenuates liver fibrosis by regulating the phosphorylation of NDRG1 at Thr328 via hepatocyte-stellate cell cross talk.
Chuan DING ; Zeping WANG ; Kao SHI ; Sunan LI ; Xinyue DOU ; Yan NING ; Gang CHENG ; Qiao YANG ; Xianan SANG ; Mengyun PENG ; Qiang LYU ; Lu WANG ; Xin HAN ; Gang CAO
Acta Pharmaceutica Sinica B 2025;15(4):2059-2076
Taxifolin (TAX) is a natural compound known for its liver protection effect, but the mechanism remains unknown. Phosphorylated proteomics analyses discovered that the phosphorylation level of NDRG1 at T328 was a key event of TAX-improved liver fibrosis. We established models with NDRG1 knockout (KO) in vivo and in vitro, demonstrating that NDRG1 KO attenuated the development of hepatocyte injury, and combining NDRG1 KO and TAX administration did not result in a reduction in protection against liver injury. Cellular thermal shift assay and surface plasma resonance analysis showed that TAX directly binds to NDRG1 rather than its upstream kinase, subsequently demonstrating that TAX regulated phosphorylation of NDRG1 at T328 through binding to its C289 site. NDRG1 T328A (phosphorylated mutation) and T328E (mimic phosphorylation) in vivo and in vitro confirmed that pNDRG1T328 exacerbates hepatocyte injury along with DNA damage, inflammatory response, and apoptosis, thereby contributing to hepatic stellate cells (HSCs) activation. In contrast, TAX can inhibit the above pathological abnormalities and block hepatocyte injury-triggered HSCs activation and fibrosis. Overall, TAX is a potent liver protection drug primarily targeting NDRG1 and inhibiting pNDRG1T328 in hepatocytes.
5.Advances on physiology and pathology of subpopulations of macrophages in the lung tissue
Xiaohui ZHONG ; Chengjie LYU ; Dengming LAI ; Qiang SHU
Journal of Zhejiang University. Medical sciences 2024;53(5):650-658
Macrophages are vital in maintaining tissue homeostasis in the lungs by modulating and regulating immune responses.Based on different origins and anatomical locations,macrophages in the lungs are categorized into alveolar macrophages,interstitial macrophages,perivascular macrophages,and inflammatory macrophages.Alveolar macrophages are located in the alveolar spaces and are primarily responsible for maintaining alveolar surfactant homeostasis,defending against pathogens and regulating immune responses.Interstitial macrophages can maintain homeostasis,regulate immunity and anti-inflammation in the lung tissue.Perivascular macrophages play a crucial role in inhibiting lung inflammation,improving pulmonary fibrosis,and regulating lung tumor progression due to antigen-presenting and immunomodulatory effects.Inflammatory macrophages,which are differentiated from monocytes during inflammation,regulate the inflammatory process.This article reviews the origins of various subpopulations of macro-phages in the lung tissue and their physiological and pathological functions as well as discusses the underlying mechanisms and potential therapeutic targets.
6.Prognostic value of CAR combined with CPR duration in patients with cardiac arrest
Yan ZHOU ; Chao LAN ; Ruyi LEI ; Qiang ZHANG ; Qing LYU ; Tangjuan ZHANG ; Xinya JIA ; Renjie LI
Chinese Journal of Emergency Medicine 2024;33(7):955-962
Objective:Explore the predictive value of the C-reactive protein to albumin ratio (CAR) and combined indicators for the prognosis of cardiac arrest (CA) patients.Methods:Retrospective analysis was conducted on patients who recovered spontaneous circulation after cardiopulmonary resuscitation (CPR) admitted to the First Affiliated Hospital of Zhengzhou University from January 2021 to May 2023. Patients were divided into survival and non-survival groups based on their status at discharge. Baseline characteristics, CPR data, and laboratory indicators were compared between the two groups. Statistically significant indicators were further analyzed using multivariate logistic regression to identify independent risk factors affecting the prognosis of CA patients. Receiver operating characteristic (ROC) curves were constructed to assess the predictive value of each independent factor and combined indicators for the prognosis of CA patients.Results:A total of 145 patients were included in the study, including 33 patients in the survival group and 112 patients in the non-survival group. There were statistically significant differences between the survival group and the non-survival group in terms of CPR duration, the dosage of vasopressor drugs used, ICU length of stay, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score at ICU admission, lactate, fibrinogen, aspartate aminotransferase, albumin, procalcitonin, C-reactive protein, CAR, myoglobin, and creatine kinase isoenzyme (all P < 0.05). Multivariate logistic regression analysis revealed that CAR and CPR duration were independent risk factors affecting the prognosis of CA patients (CAR: OR=2.372, 95% CI: 1.094~5.146, P=0.029; CPR duration: OR=1.170, 95% CI: 1.020~1.342, P=0.025). ROC curve analysis showed that the areas under the curve for CAR, CPR duration, and their combination in predicting patient prognosis were 0.792, 0.731, and 0.859, respectively. The cut-off values for CAR and CPR duration were 1.455 and 11.5 minutes, respectively. Conclusions:The CAR and CPR duration are independent risk factors affecting the prognosis of CA patients, and the predictive value is higher when both CAR and CPR duration are combined. A CAR greater than 1.455 and a CPR duration longer than 11.5 minutes suggest a poorer prognosis for the patients.
7.Rapid On-Site Screening of Six Kinds of Pesticide Residues in Cosmetics Containing Plant Extracts by Fan-shaped Paper Spray Ionization and Miniature Mass Spectrometry
Yue-Guang LYU ; Jia-Yu ZHAO ; Hong-Yu XUE ; Qiang MA
Chinese Journal of Analytical Chemistry 2024;52(6):838-845
Cosmetics containing plant extracts may pose health risks to consumers due to inadequate control over the quality of plant raw materials,which may lead to residues of pesticides such as carbendazim in cosmetics. Developing rapid detection methods is of paramount importance for regulating product quality and safeguarding human health. A rapid on-site analytical method was developed for the screening of six kinds of pesticide residues in plant extract-based cosmetics using fan-shaped paper spray ionization with chromatographic enrichment functionality coupled with a miniature mass spectrometer. Cosmetic samples were directly loaded onto the fan-shaped paper substrate drop by drop,followed by chromatographic enrichment,paper spray ionization,and the miniature mass spectrometry analysis. The entire analysis time for a single run was less than 1 min. By loading samples in a dropwise manner,significantly improved chromatographic enrichment on the tip and 6 to 32-fold signal enhancement were achieved on the fan-shaped paper substrate compared to traditional triangle-shaped paper substrate. The limits of detection (LODs) and quantitation (LOQs) for the six kinds of pesticides were 0.02-0.05 mg/kg and 0.05-0.10 mg/kg,respectively. The recoveries were 82.6%-101.8% with relative standard deviations of 8.3%-16.5%. The established method was convenient,sensitive,and suitable for rapid,on-site screening of pesticide residues in plant extract-based cosmetics.
8.Correlation study of tumor-infiltrating lymphocytes on the prognosis of Hangzhou standard liver transplantation for hepatocellular carcinoma
Xiaodi DAI ; Shaocheng LYU ; Bing PAN ; Xin ZHAO ; Lixin LI ; Qiang HE
International Journal of Surgery 2024;51(8):522-528
Objective:To investigate the impact of Tumor-Infiltrating Lymphocytes (TILs) density in the tumor stroma on the long-term prognosis of hepatocellular carcinoma (HCC) liver transplant patients meeting the Hangzhou criteria.Methods:This study is a retrospective cohort study. The clinical data of 83 patients with hepatocellular carcinoma who met the Hangzhou criteria and underwent allogeneic liver transplantation from January 2018 to December 2023 in the Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital affiliated to Capital Medical University were collected and analyzed. Hematoxylin and Eosin (HE) staining was used to study the density of TILs in the resected liver grafts. Patients were divided into TILs-negative group (TILs<10%, n=31) and TILs-positive group (TILs≥10%, n=52) based on whether the TILs density exceeded 10%. Clinical and pathological characteristics were analyzed, and the significance of alpha-fetoprotein (AFP), TILs density, and microvascular invasion on the prognosis of HCC patients who met the Hangzhou criteria was studied. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s) and compared between groups using t-test. Measurement data with skewed distribution were expressed as M ( Q1, Q3) and compared using rank-sum tests. Categorical data were compared using chi-square test. Kaplan-Meier method was used to study the relationship between various observation indicators and overall survival, and survival curves were plotted. Log-rank test was used to compare the survival rates between groups, and multivariate Cox regression model was used to adjust for the distribution of risk factors between groups. Results:The preoperative AFP level in the TILs-negative group was (15.69±1.21) U/mL, and in the TILs-positive group was (12.17±0.13) U/mL, with a statistically significant difference between the two groups ( P<0.05). In the TILs-negative group, 8 cases had microvascular invasion, and the number of low, moderate, and high differentiation tumors was 8, 23, and 0, respectively. In the TILs-positive group, 3 cases had microvascular invasion, and the number of low, moderate, and high differentiation tumors was 2, 31, and 19, respectively. The results indicated that patients in the TILs-negative group were more likely to have microvascular invasion and poorer tumor differentiation ( P<0.05). All patients were regularly followed up, and the 1-, 2-, and 3-year survival rates in the TILs-negative group and TILs-positive group were 84.0%, 77.6%, 69.8%, and 94.7%, 91.7%, 86.6%, respectively ( P<0.01). Cox proportional hazards model indicated that microvascular invasion ( RR=4.474, 95% CI: 1.172-17.072, P=0.028) and TILs-negative status ( RR=5.081, 95% CI: 1.420-18.184, P=0.012) were independent risk factors for the long-term prognosis of HCC patients who met the Hangzhou criteria. Conclusions:Among HCC patients meeting the Hangzhou criteria, the density of TILs in the tumor stroma is related to AFP levels, tumor differentiation, and the presence of microvascular invasion. TILs-negative status indicates a poorer prognosis for these patients.
9.Global burden of thyroid cancer in 2022: Incidence and mortality estimates from GLOBOCAN
Zhangyan LYU ; Yu ZHANG ; Chao SHENG ; Yubei HUANG ; Qiang ZHANG ; Kexin CHEN
Chinese Medical Journal 2024;137(21):2567-2576
Background::Thyroid cancer (TC) is the most common malignancy of the endocrine system. This study aimed to assess the global distribution of TC incidence and mortality in 2022, as well as to predict the burden for the year 2050.Methods::Data from the GLOBOCAN 2022 database were used to analyze the age-standardized incidence and mortality rates of TC by sex, age group (<55 years and ≥55 years), country, world region, and level of Human Development Index (HDI) for 185 countries. The predicted incidence and mortality burden for 2050 was calculated based on demographic projections.Results::In 2022, an estimated 821,214 new TC cases and 47,507 TC-related deaths occurred worldwide. The age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) were higher in women (ASIR: 13.60 per 100,000; ASMR: 0.53 per 100,000) than in men (ASIR: 4.60 per 100,000; ASMR: 0.35 per 100,000). The ASIR in high HDI countries was approximately ten times higher than that in low HDI countries for both sexes, with relatively similar ASMR across regions. Among 185 countries, China had the largest number of TC cases (accounting for 56.77% of total cases) and TC-related deaths (accounting for 24.35% of global TC-related deaths), with the highest ASIR in men (13.30 per 100,000). Worldwide, approximately 64.63% of TC cases occurred in populations under 55 years old, while nearly 82.99% of TC-related deaths occurred in populations aged 55 years and above. If the rates stay the same as in 2022, it is projected that approximately 1,100,000 new TC cases and 91,000 TC-related deaths will occur in 2050, indicating a 34.15% and 89.58% increase, respectively.Conclusions::TC is a highly frequent cancer worldwide with disparities across regions, genders, and age groups. Our results provide light on the worldwide TC disease burden and facilitate regionally customized prevention measures.
10.Research progress in perioperative management of portal vein thrombosis in liver transplantation
Organ Transplantation 2024;15(1):26-32
Portal vein thrombosis is one of the common complications of liver cirrhosis. The incidence of portal vein thrombosis is increased with the progression of diseases. The incidence and progression of portal vein thrombosis are associated with multiple factors. The indications of anticoagulant therapy remain to be investigated. At present, portal vein thrombosis is no longer considered as a contraindication for liver transplantation. Nevertheless, complicated portal vein thrombosis will increase perioperative risk of liver transplantation. How to restore the blood flow of portal vein system is a challenge for surgical decision-making in clinical practice. Rational preoperative typing, surgical planning and portal vein reconstruction are the keys to ensure favorable long-term prognosis of liver transplant recipients. In this article, epidemiological status, risk factors, typing and identification of portal vein thrombosis, preoperative and intraoperative management of portal vein thrombosis in liver transplantation, and the impact of portal vein thrombosis on the outcomes of liver transplantation were reviewed, aiming to provide reference for perioperative management of portal vein thrombosis throughout liver transplantation.

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