1."Weibing" in traditional Chinese medicine-biological basis and mathematical representation of disease-susceptible state.
Wanyang SUN ; Rong WANG ; Shuhua OUYANG ; Wanli LIANG ; Junwei DUAN ; Wenyong GONG ; Lianting HU ; Xiujuan CHEN ; Yifang LI ; Hiroshi KURIHARA ; Xinsheng YAO ; Hao GAO ; Rongrong HE
Acta Pharmaceutica Sinica B 2025;15(5):2363-2371
"Weibing" is a fundamental concept in traditional Chinese medicine (TCM), representing a transitional state characterized by diminished self-regulatory abilities without overt physiological or social dysfunction. This perspective delves into the biological foundations and quantifiable markers of Weibing, aiming to establish a research framework for early disease intervention. Here, we propose the "Health Quadrant Classification" system, which divides the state of human body into health, sub-health, disease-susceptible state, and disease. We suggest the disease-susceptible stage emerges as a pivotal point for TCM interventions. To understand the intrinsic dynamics of this state, we propose laboratory and clinical studies utilizing time-series experiments and stress-induced disease susceptibility models. At the molecular level, bio-omics technologies and bioinformatics approaches are highlighted for uncovering intricate changes during disease progression. Furthermore, we discuss the application of mathematical models and artificial intelligence in developing early warning systems to anticipate and avert the transition from health to disease. This approach resonates with TCM's preventive philosophy, emphasizing proactive health maintenance and disease prevention. Ultimately, our perspective underscores the significance of integrating modern scientific methodologies with TCM principles to propel Weibing research and early intervention strategies forward.
2.Diagnosis of pancreatic mucinous cystic neoplasm with associated invasive carcinoma on CT and MRI
Shuhua DUAN ; Saiqun LÜ ; Yedong XIN ; Yuqiang WANG
Journal of Practical Radiology 2025;41(4):614-616,645
Objective To explore the CT and MRI characteristics of pancreatic mucinous cystic neoplasm with associated invasive carcinoma(MCN-AIC)and their clinical application.Methods A retrospective analysis was conducted on the CT and MRI manifes-tations,clinical presentations,and laboratory results of 10 patients with pathologically confirmed MCN-AIC.Results Four of 10 patients presented to the clinic with abdominal pain.Plain CT showed all 10 lesions with hypointensity,and enhanced CT showed 8 lesions with mild delayed enhancement.MRI showed 8 lesions with limited diffusion on diffusion weighted imaging(DWI).2 lesions had cal-cification and 8 lesions had no calcification.6 lesions were located at the pancreatic head,3 at the pancreatic tail,and remaining one at the pancreatic neck.In addition,main pancreatic duct dilatation in 6 leisons,no main pancreatic duct dilatation in 4 lesions,thickened cyst wall in 10 lesions,wall nodules in 4 lesions,no wall nodules in 6 lesions,and intratumoral segregations in 5 lesions,5 lesions without segregations.Conclusion The CT and MRI manifestations of MCN-AIC have certain characteristics and play an important role in imaging diagnosis,which can provide a reference basis for the treatment.
3.Correlation of FBXL5 and IREB2 with iron homeostasis and efficacy of neoadju-vant chemotherapy in colorectal cancer
Miaomiao WANG ; Ruizhe ZHANG ; Xiaoyang XU ; Shuang HE ; Feifei WEN ; Yangyang LI ; Shuhua WU
Chinese Journal of Clinical and Experimental Pathology 2025;41(10):1280-1290
Purpose The current study aims to elucidate the interrelationships among IREB2,FBXL5,iron ho-meostasis,and the therapeutic efficacy of neoadjuvant chemotherapy.Methods A total of 97 samples,classified into colorectal cancer neoadjuvant chemotherapy-resistant and-sensitive groups,along with their corresponding paracancer-ous normal mucosa were collected.The expression levels of FBXL5,IREB2,TFRC and FTH1 were detected by immu-nohistochemistry,Werstern blot and RT-qPCR.The contents of ferroptosis-related markers Fe2+,MDA,ROS and GSH were detected by applying the kit,and the levels of these markers were analyzed.The relationship between each factor in different colorectal cancer tissues and tumor regression rate and prognosis of neoadjuvant chemotherapy were ana-lyzed.Results(1)The expression of IREB2,FBXL5,TFRC and FTH1 in colorectal cancer was higher than that in normal intestinal mucosa(P<0.05),and the expression of FBXL5 and FTH1 in colorectal cancer drug-resistant group was lower than that in the sensitive group,whereas the expression of IREB2 and TFRC was higher than that in the sen-sitive group(P<0.05);(2)The correlation analysis showed a positive correlation between the expression of IREB2 and TFRC in the drug-resistant group,and a negative correlation with the expression of FBXL5 and FTH1 in the drug-resistant group.TFRC expression in the colorectal cancer resistance group were positively correlated(P<0.05)and negatively correlated with the expression of FBXL5 and FTH1(P<0.05);(3)the content of Fe2+and GSH was high-er than that of the sensitivity group in the colorectal cancer resistance group,and the level of ROS was lower than that of the sensitivity group(P<0.05);(4)Fe2+was positively correlated with the expression of IREB2,TFRC,and neg-atively correlated with the expression of FBXL5 and FTH1,and was negatively correlated with the expression of FBXL5 and FTH1.FTH1 expression were both negatively correlated(P<0.05);(5)tumor regression rate was positively cor-related with the expression of FBXL5 and FTH1,and negatively correlated with the expression of IREB2 and TFRC,as well as positively correlated with the level of ROS,and negatively correlated with Fe2+and GSH(P<0.05);(6)The expression of IREB2 and TFRC was positively correlated with tumor diameter and lymph node metastasis,and the ex-pression of FBXL5 and FTH1 was negatively correlated with tumor diameter and lymph node metastasis,and the expres-sion of FBXL5 was also negatively correlated with the depth of tumor infiltration(P<0.05);(7)Kaplan-Meier analy-sis showed that lymph node metastasis,FBXL5,IREB2,TFRC,FTH1,and TRG grading were closely related to the prognosis of colorectal cancer patients(P<0.05).Cox multivariate regression analysis indicated that lymph node me-tastasis,high expression of IREB2 and TFRC,low expression of FBXL5 and FTH1,and low tumor regression grade(TRG)were risk factors for the ineffectiveness of neoadjuvant chemotherapy in colorectal cancer patients.Conclusion FBXL5 and IREB2 are not only associated with high iron homeostasis,but also closely related to the efficacy and prognosis of neoadjuvant chemotherapy for colorectal cancer.In the future,they may become new targets for the treat-ment of colorectal cancer and improve the prognosis of patients.
4.Expert consensus on point-of-care testing pre-hospital quality management standards
Shuhua BAO ; Baoyun SUN ; Jiangang WANG ; Jungeng ZHANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2025;32(2):129-133
With the development of point-of-care testing(POCT)technology,the demand for pre-hospital applications has gradually increased.Blood glucose,troponin,blood gas analysis and other projects have been gradually carried out in pre-hospital.The development of the above projects has played an important role in the timely diagnosis of critical diseases such as pre-hospital stroke,chest pain,and out-of-hospital cardiac arrest.However,due to the shortcomings of trained professionals and standardized equipment in pre-hospital systems,it is challenging to carry out quality control work such as POCT in-house quality control,comparison,ability verification,etc.,and POCT pre-hospital quality management has shortcomings.In order to improve the quality of POCT and eliminate potential safety hazards,the"expert consensus on POCT pre-hospital quality management standards"was formulated after consultation between pre-hospital and in-hospital experts.The consensus focuses on the establishment of POCT pre-hospital quality management system,management organization,quality control plan formulation and implementation path,personnel access,equipment access,digital intelligence integration and other issues,which can be used by pre-hospital medical emergency institutions at all levels to carry out POCT quality management.
5.Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury (version 2025)
Aijun XU ; Shuixia LI ; Bo CHEN ; Mengyuan YE ; Lejiao LANG ; Ning NING ; Lin ZHANG ; Changqing LIU ; Zhonglan CHEN ; Weihu MA ; Weishi LI ; Xiaoning WANG ; Dongmei BIAN ; Jiancheng ZENG ; Xin WANG ; Yuan GAO ; Yaping CHEN ; Jiali CHEN ; Yun HAN ; Xiuting LI ; Yang ZHOU ; Xiaojing SU ; Qiong ZHANG ; Tianwen HUANG ; Ping ZHANG ; Hua LIN ; Xingling XIAO ; Ruifeng XU ; Fanghui DONG ; Bing HAN ; Luo FAN ; Yanling PEI ; Suyun LI ; Xiaoju TAN ; Rongchen GUO ; Yefang ZOU ; Xiaoyun HAN ; Junqin DING ; Yi WANG ; Shuhua DENG ; Jinli GUO ; Yinhua LIANG ; Yuan CEN ; Xiaoqin LIU ; Junru CHEN ; Haiyang YU ; Lunlan LI ; Ying REN ; Yunxia LI ; Jianli LU ; Ying YING ; Lan WEI ; Yin WANG ; Qinhong XU ; Yanqin ZHANG ; Yang LYU ; Shijun ZHANG ; Sui WENJIE ; Sanlian HU ; Shuhong YANG ; Guoqing LI ; Jingjing AN ; Baorong HE ; Leling FENG
Chinese Journal of Trauma 2025;41(6):530-541
Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.
6.Rituximab combined with intensive immunochemotherapy for sporadic adult Burkitt lymphoma: efficacy and prognosis analyse
Changming DONG ; Hesong ZOU ; Wen ZHANG ; Wei LIU ; Yi WANG ; Huimin LIU ; Ting XIE ; Heng LI ; Qi WANG ; Wenyang HUANG ; Shuhua YI ; Gang AN ; Lugui QIU ; Dehui ZOU
Chinese Journal of Hematology 2025;46(2):134-139
Objective:To explore the therapeutic efficacy and prognostic factors of combined rituximab and intensive chemotherapy for sporadic adult Burkitt lymphoma (BL) .Methods:This retrospective study examined the clinical and survival data of 30 patients newly diagnosed with BL between July 2011 and February 2023 at the Blood Diseases Hospital. Kaplan-Meier method was used for survival analysis, and the log-rank test was used for univariate analysis of prognostic factors.Results:The median age of the 30 patients was 43 years (24 - 66 years), and the male to female ratio was 3: 2. Extranodal invasion was present in 80% of the patients, with involvement of the bone marrow in 53.3% and central nervous system in 10.0%. The Ann Arbor stage was Ⅲ and Ⅳ in 86.7%. According to the number of Burkitt Lymphoma International Prognostic Index (BL-IPI) risk factors, patients were classified as low risk (0) in 20.0%, intermediate risk (1) in 43.3%, and high risk (≥2) in 36.7%. All patients were treated with an induction regimen of rituximab combined with intensive chemotherapy, with objective and complete response rates of 80.0% and 76.7%, respectively. The median follow-up was 49 months (6-153 months), and the 5-year progression-free survival (PFS) and overall survival (OS) rates were both (76.7±7.7) %. All patients with limited stage ( n=4) achieved continuous complete remission (CCR). Patients who had high risk, advanced stage sensitive to induction therapy ( n=10) sequentially received first-line autologous hematopoietic stem cell transplantation (auto-HSCT) as consolidation therapy; 9 patients achieved CCR, whereas 1 patient with central nervous system invasion developed early disease progression and died. The BL-IPI low, intermediate, and high risk groups had respective 5-year PFS rates of (83.3±15.2) %, 100.0%, and (45.5±15.0) % ( P=0.0069) and OS rates of (83.3±15.2) %, 100.0%, and (45.5±15.0) % ( P=0.0075). The main adverse effects of induction therapy were myelosuppression and secondary infections, which were effectively managed by appropriate symptomatic treatment. Univariate analysis demonstrated that worse PFS was associated with BL-IPI score ≥2 ( HR=4.90, 95% CI 1.02-23.45, P=0.0329) ; extranodal invasion at ≥2 sites ( HR=12.62, 95% CI 2.59-61.62, P=0.0021) ; and failure to achieve first complete response (CR1) after induction therapy ( HR=31.86, 95% CI 4.19-242.20, P<0.0001) . Conclusions:Intensive immunochemotherapy regimens were effective and well-tolerated by adult patients with highly aggressive BL. Treatment efficacy was ideal in patients with limited-stage disease, whereas prognosis was unsatisfactory in patients with high-risk BL-IPI. Sequential first-line auto-HSCT consolidation therapy may further improve outcomes in patients with high-risk advanced-stage disease who are sensitive to induction therapy. BL-IPI score ≥2, extranodal invasion at ≥2 sites, and failure to achieve CR1 after induction therapy were adverse prognostic factors in adult patients with BL.
7.Research progress of alveolar socket bone remodeling and its influencing factors after tooth extraction
Renjie LIN ; Anna DAI ; Shuhua WANG ; Peihui DING
STOMATOLOGY 2025;45(7):540-545
The healing of the alveolar socket following tooth extraction is a complex process,which is influenced by multiple factors.After tooth extraction,the soft and hard tissues surrounding the extraction site undergo remodeling.During this process,systemic factors and local anatomical structure of the extraction site play a significant role.This review provides a detailed discussion of the alveolar socket healing process and its potential influencing factors.It aims to offer clinicians a comprehensive reference when assessing the healing potential of different extraction sites,thereby providing more informed and precise clinical decision-making.
8.Effects of bioactive peptides combined with probiotics on serum uric acid in patients with hyperuricemia
HAN Dan ; ZHAO Ya ; HUANG Enshan ; YE Shuhua ; WANG Wanjin ; WU Fangmin ; WANG Dingliang ; ZHANG Ronghua
Journal of Preventive Medicine 2025;37(1):40-45
Objective:
To evaluate the effect of bioactive peptides combined with probiotics on serum uric acid (SUA) in patients with hyperuricemia (HUA), so as to provide the evidence for prevention and treatment of HUA.
Methods:
The patients with HUA aged 18 to 65 years were selected and randomly divided into an intervention group and a control group. The patients in the intervention group received bioactive peptides combined with probiotics for 28 days at a dose of 3 g/d, while the patients in the control group received an equal dose of placebos. Demographic information, body mass index (BMI), blood pressure and blood lipid were collected through questionnaire surveys, physical examination and laboratory tests. SUA levels were detected before and after 14 days and 28 days of interventions. The differences of SUA levels between the two groups were compared using generalized estimation equation.
Results:
Totally 108 patients with HUA were recruited, including 54 patients in the intervention group and 53 patients in the control group (1 dropout). Before interventions, there were no statistically significant differences in gender, age, course of HUA, exercise duration, frequency of alcohol consumption, frequency of meat broth consumption, BMI, prevalence of hypertension and prevalence of dyslipidemia between the two groups (all P>0.05). After 14 days of interventions, the SUA levels of the patients in the intervention group decreased by 3.00 μmol/L, while those in the control group increased by 7.00 μmol/L. After 28 days of interventions, the SUA levels of the patients in the intervention group and the control group decreased by 26.00 μmol/L and 16.00 μmol/L, respectively. However, there was no statistically significant interaction between the intervention time and group (both P>0.05). Subgroup analysis showed that after 28 days of interventions, the decrease in SUA levels in the patients aged 55 years and older and without hypertension in the intervention group was greater than those in the control group (both P<0.05).
Conclusions
Bioactive peptides combined with probiotics showed no significant difference in reducing SUA levels in patients with HUA compared to the control group. The effect was more significant for patients aged 55 years and older and without hypertension.
9.The current situation and quality management countermeasures of pre-hospital medical emergency point-of-care testing in Hangzhou City
SUN Baoyun ; ZHANG Jungen ; BAO Shuhua ; YUAN Yijun ; WANG Jiangang ; WANG Mingjia
Journal of Preventive Medicine 2025;37(6):637-639
Point-of-care testing (POCT) provides key support for clinical decision-making through rapid detection. This article introduces the development background of POCT in the field of pre-hospital emergency, as well as the development status of POCT in Hangzhou City, and analyzes the problems of quality management. Pre-hospital emergency medical institutions in Hangzhou City have been equipped with POCT equipment, and the test items include blood glucose, cardiac troponin, etc. The implementation rates of internal quality control, comparison test, and proficiency testing were 58.2%, 50.3% and 42.6%, respectively. POCT quality management has problems such as unclear responsibility subjects, insufficient professional personnel, and a lack of standardization of the process. It is proposed to build a hierarchical collaborative management system, strengthen the double access mechanism of personnel and equipment, implement the whole process quality control, and build a digital management platform, so as to provide the reference for the high-quality development of POCT in pre-hospital medical emergency institutions.
10.Study on characteristics and drug resistance of neonatal sepsis caused by different pathogenic bacteria
Yunfei GAO ; Shuhua ZHAO ; Ruilai LIU ; Xufang LI ; Zitian WANG ; Yue ZHANG ; Hong SHA ; Jing HE ; Xiaoyu YANG ; Na WU
International Journal of Pediatrics 2025;52(3):211-216
Objective:To investigate the differences in clinical characteristics and antibiotic resistance of neonatal sepsis(NS)caused by different Gram-staining pathogens.Methods:A retrospective study was conducted on confirmed NS cases admitted to the Neonatal Ward of the Pediatric Department at The First Affiliated Hospital of Dali University,from June 1,2014,to May 31,2024.Patients were divided into Gram-positive and Gram-negative groups based on blood or cerebrospinal fluid(CSF)culture results.Clinical characteristics,pathogen distribution,and antibiotic resistance were compared between the two groups.Results:A total of 98 cases were included,with 81 in the Gram-positive group and 17 in the Gram-negative group.Multivariate logistic regression analysis revealed that NS cases with a high neutrophil percentage( OR=0.933,95% CI:0.899-0.969)or hemorrhagic symptoms/signs( OR=0.059,95% CI:0.008-0.458)were less likely to have Gram-positive pathogens detected in blood or CSF cultures( P<0.05).Common Gram-positive pathogens included Staphylococcus epidermidis with 35 strains(33.65%)and Staphylococcus hominis with 22 strains(21.15%).The predominant Gram-negative pathogen was Escherichia coli with 14 strains(13.46%).Gram-positive pathogens exhibited high resistance to oxacillin(91.30%),erythromycin(90.91%),and penicillin G(90.00%),but low resistance to tigecycline(0),linezolid(0),and vancomycin(0).Gram-negative pathogens showed high resistance to ampicillin(92.31%),cefazolin(90.00%),and ampicillin/sulbactam(75.00%),but low resistance to amikacin(6.25%),latamoxef(0),and ertapenem(0).The incidence of concurrent purulent meningitis was lower in the Gram-positive group than in the Gram-negative group(9.88% vs.47.06%, χ2=11.628, P<0.05),and there was significant difference. Conclusion:NS cases with high neutrophil percentages or hemorrhagic symptoms/signs are less likely to be caused by Gram-positive pathogens.Staphylococcus epidermidis and Staphylococcus hominis are common Gram-positive pathogens,while Escherichia coli is the predominant Gram-negative pathogen in NS.Both Gram-positive and Gram-negative pathogens exhibit resistance to specific antibiotics.NS caused by Gram-positive pathogens is less likely to be complicated by purulent meningitis compared to those caused by Gram-negative pathogens.


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