1.Prokaryotic expression of Echinococcus granulosus Polo-like kinase 2 and immunoprotective efficacy of its recombinant protein
Xue WANG ; Mingzhi YAN ; Wenjing QI ; Chuanchuan WU ; Guowu ZHANG ; An GENG ; Mengxiao TIAN ; Jun LI ; Wenbao ZHANG
Chinese Journal of Schistosomiasis Control 2026;38(2):184-193
Objective To prepare the recombinant Echinococcus granulosus Polo-like kinase 2 (rEgPLK2) protein and evaluate its immunoprotective efficacy against cystic echinococcosis, so as to provide insights into research and development of novel vaccines against echinococcosis. Methods The Polo-like kinase (PLK) protein sequences were retrieved from 12 species in the NCBI protein database, including E. granulosus and E. multilocularis. Multiple sequence alignment was performed using the Clustal Omega program, and structural visualization and homology analysis were conducted using the ESPript 3.2 program. The recombinant plasmid pET-30a-EgPLK2 was transformed into BL21(DE3) competent cells. Protein expression was induced with isopropyl-β-D-thiogalactoside (IPTG), and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was performed to characterize the expression and molecular weight of the rEgPLK2 protein. The purified rEgPLK2 protein was thoroughly emulsified with Freund’s complete adjuvant at a 1 : 1 volume ratio. Two New Zealand white rabbits were immunized with multipoint subcutaneous injection on the back at a dose of 300 μg per rabbit for primary immunization. For booster immunizations, the protein was emulsified with Freund’s incomplete adjuvant at a 1 : 1 volume ratio and administered on days 14, 28, and 42 after the primary immunization at a dose of 150 μg per rabbit. Serum was sampled from the rabbit ear vein on day 7 after the final immunization to yield anti-rEgPLK2 polyclonal antibodies. Antibody titer was determined by indirect enzyme-linked immunosorbent assay (ELISA), and antibody specificity was verified by Western blotting. The tissue localization of the EgPLK2 protein was detected in E. granulosus protoscoleces and adult worms using immunofluorescence assay (IFA). Eighteen 6- to 8-week-old female SPF-grade BALB/c mice were randomly divided into three groups, including the blank control group, rEgPLK2-ISA immunization group, and PBS-ISA adjuvant control group, of 6 mice each group. Mice in the rEgPLK2-ISA immunization group and PBSISA group received three primary immunizations via intramuscular injection, and animals in the rEgPLK2-ISA immunization group was inoculated with immunogens prepared by emulsifying rEgPLK2 protein with ISA 201 adjuvant at a 1 : 1 volume ratio (6 μg per mouse), while mice in the PBS-ISA adjuvant control group received an equal volume of PBS emulsified with ISA adjuvant at a 1 : 1 volume ratio. A fourth booster immunization was administered via intraperitoneal injection. Mice in the rEgPLK2-ISA immunization group received a booster immunization with 8 μg of rEgPLK2 protein per mouse, and animals in the PBS-ISA group received an equal volume of PBS, with immunizations given at 2-week intervals. Mice in the blank control group were given no treatment, and housed under standard conditions. Tail vein blood was collected from all mice 7 days after the final immunization, and levels of specific anti-rEgPLK2 IgG antibody and its subclasses (IgG1, IgG2a, IgG2b, IgG3) were measured by indirect ELISA. E. granulosus infection was modelled in mice through injection with 1 000 E. granulosus protoscoleces via intrahepatic portal vein in the rEgPLK2-ISA immunization group and PBS-ISA adjuvant control group 2 weeks after the last immunization. All mice were sacrificed and dissected. The number of cysts was counted in mouse livers, and the cyst reduction rate was calculated. Liver tissues were processed for paraffin sectioning and stained with hematoxylin and eosin (HE), and histopathological changes were examined under a light microscope. Results Sequence analysis revealed that EgPLK2 shared a high amino acid sequence homology with E. multilocularis PLK2 (EmPLK2) and contained the typical domains of the Polo-like kinase family, including the serine/threonine protein kinase catalytic domain (STKc) and Polo-box. The IPTG-induced rEgPLK2 protein was mainly expressed in the form of inclusion bodies, and the purified rEgPLK2 protein showed a relative molecular mass of approximately 70 kDa. The prepared rabbit anti-rEgPLK2 polyclonal antibody had a titer of 1 : 256 000, and Western blotting assay showed that this anti-body specifically recognized the rEgPLK2 protein with a relative molecular mass of approximately 70 kDa. Immunofluorescence assay showed that the EgPLK2 protein was localized in the excretory bladder and rostellum of E. granulosus protoscoleces, as well as the tegument, suckers, and inter-proglottid junctions of adult worms. Immunoprotective assay showed that the serum levels of specific anti-rEgPLK2 IgG, IgG1, IgG2a, and IgG2b antibodies were 2.92 ± 0.49, 0.33 ± 0.10, 0.31 (0.36), and 3.12 (1.73) in mice in the rEgPLK2-ISA immunization group, which were all significantly higher than those in the PBS-ISA adjuvant control group (0.14 ± 0.04, 0.07 ± 0.01, 0.12 ± 0.04, and 0.11 ± 0.04, respectively) (t = 19.28 and 8.46, Z = 3.75 and 4.15; all P values < 0.001); however, there was no significant difference in the serum anti-IgG3 antibody level between the rEgPLK2-ISA immunization group and the PBS-ISA adjuvant control group [0.07 (0.01) vs. 0.073 (0.07); Z = 0.69, P > 0.05)]. In the mouse model of E. granulosus infections, the area of hepatic lesions was reduced and the inflammatory infiltration was alleviated in the rEgPLK2-ISA immunization group than in the PBS-ISA adjuvant control group, and the number of hepatic cysts was higher in the PBS-ISA adjuvant control group than in the rEgPLK2-ISA immunization group [8.00 (2.00) vs. 1.00 (0.75); Z = −2.93, P < 0.01], with a cyst reduction rate of 80.40%. Indirect ELISA assay measured higher serum levels of specific anti-rEgPLK2 IgG (3.28 ± 0.48 vs. 0.11 ± 0.04; t = 15.86, P < 0.01), IgG1 (0.29 ± 0.02 vs. 0.09 ± 0.01; t = 15.67, P < 0.01), IgG2a [3.71 (1.09) vs. 0.08 (0.03); Z = 2.88, P < 0.01], and IgG2b antibodies [3.34 (1.01) vs. 0.08 (0.03); Z = 2.88, P < 0.01] in the rEgPLK2-ISA immunization group than in the PBS-ISA adjuvant control group, and there was no significant difference in the serum level of the specific anti-rEgPLK2 IgG3 antibody between the rEgPLK2-ISA immunization group and the PBS-ISA adjuvant control group (0.07 ± 0.01 vs. 0.07 ± 0.01; t = 1.29, P > 0.05). Conclusions The prokaryotic expression system has been successfully constructed for the EgPLK2 gene and the anti-rEgPLK2 polyclonal antibody has been obtained. The rEgPLK2 protein exhibits a high immunogenicity, and is effective to protect against E. granulosus infection, and inhibits cyst development, which is a promising candidate vaccine target against cystic echinococcosis.
2.Effect and mechanism of action of 2,5-dihydroxybenzoic acid on an in vitro cell model of metabolic dysfunction-associated fatty liver disease
Junjiao XU ; Tong LIU ; Sutong LIU ; Lihui ZHANG ; Yijia SONG ; Wenjing WU ; Beilei CUI ; Yajie GUAN ; Minghao LIU
Journal of Clinical Hepatology 2026;42(7):1586-1596
ObjectiveTo investigate the potential targets of 2,5-dihydroxybenzoic acid (2,5-DHBA) in the treatment of metabolic dysfunction-associated fatty liver disease (MAFLD) and the molecular mechanism by which it regulates the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsA network pharmacology analysis was performed at first, and related databases were used to obtain the common action targets of 2,5-DHBA and MAFLD, followed by molecular docking and pathway enrichment analysis to predict the potential biological processes and signaling pathways regulated by these targets. Then mouse normal hepatocytes AML-12 were used for cell experiments, and CCK-8 assay was used to determine the three optimal intervention concentrations of 2,5-DHBA. AML-12 cells were divided into control group, model group (cells cultured in a medium containing 2 mmol/L free fatty acid [FFA] to establish a cell model of MAFLD), and three 2,5-DHBA intervention groups (cells cultured with FFA and 2,5-DHBA at the three different concentrations of 1.25, 5, and 20 μmol/L, respectively). Oil red O staining was used to observe intracellular lipid accumulation; the fluorescent probe DCFH-DA was used to measure the level of intracellular reactive oxygen species (ROS); biochemical assays were used to measure the content of triglyceride (TG) and total cholesterol (TC); quantitative real-time PCR and Western Blot were used to measure the expression levels of related genes and proteins. A one-way analysis of variance was used for comparison between multiple groups, and the Tukey’s test was used for further comparison between two groups. ResultsA total of 32 common targets were obtained for 2,5-DHBA and MAFLD. Within a concentration range of 1.25 — 20 μmol/L, 2,5-DHBA treatment, starting from the concentration of 2.5 μmol/L, increased the viability of AML-12 cells in a dose-dependent manner. The minimum effective concentration of 1.25 μmol/L, the intermediate gradient concentration of 5 μmol/L, and the maximum safe concentration within the effective range of 20 μmol/L were selected for low-, middle-, and high-dose intervention, respectively. Compared with the model group, 2,5-DHBA intervention at concentrations of 1.25, 5, and 20 μmol/L could significantly reduce lipid droplet accumulation in cells (all P<0.05), and there were significant differences in TG and TC between the model group and the three intervention groups (all P<0.05). Compared with the control group, the model group had a significant increase in ROS fluorescence intensity (P<0.05), and compared with the model group, there was a dose-dependent reduction in intracellular ROS level after treatment with 5 μmol/L or 20 μmol/L 2,5-DHBA (P<0.05). Compared with the model group, 2,5-DHBA treatment at concentrations of 5 and 20 μmol/L significantly downregulated the mRNA expression levels of the lipogenic genes SREBf1 and FASN and upregulated the mRNA expression levels of the key antioxidant gene Nrf2 and its downstream target gene HO-1 (all P<0.05). Compared with the control group, the expression of p-PI3K/PI3K and p-Akt/Akt in the model group was significantly increased (all P<0.05). Compared with the model group, the protein expression levels of p-PI3K/PI3K and p-Akt/Akt were significantly decreased after 5 μmol/L 2,5-DHBA treatment (P<0.05). Compared with the control group, the expression levels of Nrf2 and HO-1 protein in the model group were significantly decreased (all P<0.05). The protein levels of Nrf2 and HO-1 were significantly increased after treatment with 1.25 μmol/L 2,5-DHBA (P<0.05). ConclusionNetwork pharmacology and cellular experiments confirm that 2,5-DHBA can alleviate lipid deposition and oxidative stress by regulating the PI3K/Akt signaling pathway, thereby exerting a therapeutic effect on MAFLD.
3.Preliminary study on the similarity of key physicochemical properties between six gene modified pig red blood cells and human red blood cells
Zhaodi MI ; Pengkai LI ; Shen LI ; Mengyi CUI ; Sice WANG ; Xiwei PENG ; Yanbin WU ; Hao WANG ; Man YUAN ; Junming ZHANG ; Yazhou LI ; Chonghui LI ; Wenjing XU ; Jiang PENG
Organ Transplantation 2026;17(5):817-826
Objective To systematically evaluate the similarities between six-gene-modified pig red blood cells and human red blood cells in multiple dimensions, including cell morphology, hematological parameters, microbial safety and serological compatibility, and to verify the feasibility of using six-gene-modified pig red blood cells as an alternative for blood transfusion in cases of traumatic hemorrhage. Methods Blood samples from O-type human donor, six-gene-modified O-type pig and wild-type O-type pig were collected. The pig gene-modified phenotype was identified by flow cytometry. The morphology was observed using field emission scanning electron microscopy and the diameter was measured. Hematological tests, including blood routine, osmotic fragility test, adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) content and partial pressure of oxygen at 50% hemoglobin saturation (P50), were conducted to assess the deformability of red blood cells. Real-time fluorescent quantitative polymerase chain reaction was used to screen for zoonotic viruses, and cross-matching was performed using column gel method, condensation amine method and saline tube method. Results The six-gene-modified pig red blood cells successfully knocked out the α-Gal, Neu5Gc and Sda antigens and expressed hCD55. Wild-type pig red blood cells expressed these three antigens but did not express human complement regulatory proteins. All three types of red blood cells presented a biconcave discoid morphology. The diameter of O-type human red blood cells was larger than that of the six-gene-modified porcine red blood cells and wild-type pig red blood cells (all P < 0.05). The average red blood cell volume and average red blood cell hemoglobin of O-type humans were higher than those of the six-gene-modified pig red blood cells, and the distribution width-variable coefficient of O-type human red blood cells was lower than that of the six-gene-modified pig red blood cells (all P < 0.05). There were no statistically significant differences in the permeability fragility, ATP content, 2,3-DPG content, P50 and red blood cell deformability indicators of the three types of red blood cells (all P > 0.05). The screening for zoonotic viruses in human and animal cells of the six-gene-modified pigs and wild-type pigs was negative. The cross-matching results showed that in the column gel method and condensation amine method, the primary and secondary sides of the six-gene-modified pig red blood cells did not agglutinate with human red blood cells, while the wild-type pig red blood cells agglutinated with human red blood cells in all cross-matching methods. Conclusions The six-gene-modified pig red blood cells are highly similar to human red blood cells in terms of morphology, key hematological parameters, energy metabolism, oxygen-carrying capacity, mechanical properties, microbial safety and serological compatibility, providing an experimental basis for the clinical transformation of xenotransfusion.
4.Ameliorative effect of Weiling decoction on metabolic associated fatty liver disease based on the gut-liver axis
Beilei CUI ; Yijia SONG ; Yajie GUAN ; Qizhen ZHANG ; Wenjing WU ; Junjiao XU ; Minghao LIU
China Pharmacy 2026;37(19):2501-2508
OBJECTIVE To investigate the ameliorative effect of Weiling decoction on metabolic associated fatty liver disease (MAFLD) based on the gut-liver axis theory.METHODS Male C57BL/6J mice were divided into a blank group ( n =9) and a modeling group ( n =47). The modeling group was fed a high-fat diet for 12 weeks to establish the MAFLD model. Forty-five modeled mice were randomly divided into a model group, a positive control group [metformin, 0.2 g/(kg·d)], and Weiling decoction low-, medium-, and high-dose groups [6.17, 12.34, 24.68 g/(kg·d), calculated as crude drug], with 9 mice in each group. Mice in each group received intragastric administration of the corresponding drug solution or normal saline once daily for 4 consecutive weeks. After the last administration, the body weight, liver weight, and liver index were compared among groups; the levels of liver function indicators (alanine transaminase, aspartate transaminase), lipid indicators (total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol), inflammatory indicators [tumor necrosis factor-α, interleukin-6 (IL-6), IL-1β], oxidative stress indicators (malondialdehyde, superoxide dismutase, glutathione peroxidase), and intestinal barrier indicators [lipopolysaccharide (LPS), diamine oxidase, D-lactic acid] were measured; hepatic pathological changes were observed; the expressions of tight junction proteins [zonula occludens-1 (ZO-1), occludin] in jejunal tissue and proteins related to lipid metabolism [sterol regulatory element-binding protein-1 (SREBP-1), fatty acid synthase (FASN), peroxisome proliferator-activated receptor α (PPARα)] and inflammatory pathways [Toll-like receptor 4 (TLR4), myeloid differentiation primary response protein 88 (MyD88), nuclear factor-κB p65 (NF-κB p65)] in liver tissue were detected; and changes in gut microbiota were analyzed.RESULTS Compared with the model group, hepatic steatosis and inflammatory injury were significantly alleviated in all Weiling decoction dose groups; body weight (at week 16), liver weight, liver index, and the levels of liver function indicators, lipid indicators, inflammation indicators, oxidative stress indicators, and intestinal barrier indicators were all generally improved ( P <0.05). The expressions of SREBP-1, FASN, TLR4, and MyD88 and the phosphorylation level of NF-κB p65 in liver tissue were generally decreased or downregulated ( P <0.05), while the expressions of ZO-1 and occludin in jejunal tissue and PPARα in liver tissue were generally increased or upregulated ( P <0.05). Compared with the model group, the Observed species, Chao1, and Ace indices of gut microbiota in the Weiling decoction high-dose group were significantly increased ( P <0.05), and the relative abundances of Verrucomicrobiota, Akkermansia , etc. were significantly increased, while those of Actinomycetota, Alistipes , Faecalibaculum , etc. were significantly decreased ( P <0.05).CONCLUSIONS Weiling decoction can ameliorate MAFLD, and its effect may be associated with regulating gut microbiota, repairing the intestinal mechanical barrier, reducing LPS translocation, thereby inhibiting the TLR4/MyD88/NF-κB inflammatory pathway, alleviating oxidative stress, and regulating SREBP-1/FASN and PPARα-mediated lipid metabolism.
5.Pharmacological mechanism of hawthorn fruit and its herb pairs for improving metabolic dysfunction-associated fatty liver disease
Yajie GUAN ; Qizhen ZHANG ; Wenjing WU ; Beilei CUI ; Junjiao XU ; Yijia SONG ; Wenxia ZHAO ; Minghao LIU
Journal of Clinical Hepatology 2026;42(9):2203-2208
Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the leading chronic liver disease worldwide. As a classic food-medicine homologous Chinese herb, hawthorn fruit has the functions of promoting digestion to resolve food stagnation and activating blood circulation to resolve blood stasis. Modern pharmacological studies have shown that hawthorn fruit and its active components exert diverse pharmacological activities in regulating lipid metabolism, improving insulin resistance, inhibiting inflammatory response, delaying hepatic fibrosis, and protecting hepatocytes. These effects precisely match the “multiple-hit” pathological features of MAFLD, and thus hawthorn fruit shows significant advantages in the prevention and treatment of MAFLD. Drug pair combination is a key strategy in traditional Chinese medicine to enhance efficacy and reduce toxicity. In clinical practice, hawthorn fruit is often combined with Salvia miltiorrhiza, Alisma orientalis, cassia seed, and Poria cocos, and such combination adheres to the principle of “mutual reinforcement and assistance” to enhance efficacy and expand their application in different syndromes of MAFLD. This article systematically reviews the core pharmacological mechanisms of hawthorn fruit in intervening against MAFLD and the research advances in its classic drug combinations, in order to provide a scientific reference for the in-depth development of hawthorn fruit and its combinations and the precise clinical intervention of MAFLD.
6.Kinesiophobia in relation to illness perception and cardiac discomfort among convalescent AMI patients
Ying WU ; Xinting CAO ; Wenjing GAO ; Qian MA
Journal of Public Health and Preventive Medicine 2026;37(3):104-107
Objective To explore the correlation between kinesiophobia and disease uncertainty, personal mastery, cardiac discomfort symptoms in patients with acute myocardial infarction (AMI) during recovery period. Methods A total of 320 patients with AMI admitted to the hospital were enrolled between January 2020 and January 2024. According to the results of Tampa Scale for Kinesiophobia Heart (TSK-H), they were divided into AMI kinesiophobia group (n=166) and simple AMI group (n=154). The disease uncertainty was evaluated by Mishel Uncertainty in Illness Scale for Adults (MUIS-A), personal mastery was evaluated by Personal Mastery Scale (PMS), and cardiac discomfort symptoms were evaluated by cardiac discomfort symptom scale. The correlation between kinesiophobia and disease uncertainty, personal mastery, cardiac discomfort symptoms in AMI patients was analyzed by Pearson correlation analysis. Results The scores of MUIS-A and cardiac discomfort symptoms in AMI kinesiophobia group were higher than those in simple AMI group (P<0.05), and PMS scores were lower than those in simple AMI group (P<0.05). The score of kinesiophobia was significantly positively correlated with scores of disease uncertainty and cardiac discomfort symptoms (r=0.628, 0.689, P<0.05), while significantly negatively correlated with the score of personal mastery (r=-0.526, P<0.05). Conclusion Kinesiophobia is related to disease uncertainty, personal mastery and cardiac discomfort symptoms in AMI patients during recovery period. Clinical medical staffs should focus on patients with the above characteristics. The targeted intervention measures can improve kinesiophobia and promote recovery of patients.
7.Shaoyaotang Regulates TLR4/MyD88/NF-κB Signaling Pathway to Protect Intestinal Mucosal Barrier in Ulcerative Colitis
Dongsheng WU ; Yu ZHANG ; Wenjing QUAN ; Wanqing XIONG ; Bo ZOU ; Youwei XIAO ; Ruoru HUANG ; Yan GONG ; Hui CAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):69-75
ObjectiveTo investigate the role of the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway in intestinal mucosal barrier damage in ulcerative colitis, as well as the intervention mechanism of Shaoyaotang. MethodsSixty SD rats were allocated into a blank group, a model group, a mesalazine (0.42 g·kg-1) group, and low-, medium-, and high-dose (11.1, 22.2, 44.4 g·kg-1, respectively) Shaoyaotang groups. A model of ulcerative colitis was induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS). After successful modeling, rats were administrated with corresponding agents via gavage for 7 days. Changes in colon length and colon weight were observed. Hematoxylin-eosin staining was performed to examine the pathological changes of the colon, and immunohistochemistry was employed to detect the expression of the inflammatory cytokine interleukin-8 (IL-8), cyclooxygenase-2 (COX-2), junction adhesion molecule-1 (JAM-1), and claudin-1 in the colon. Western blot analysis was performed to determine the protein levels of TLR4, MyD88, and NF-κB in the colon. ResultsCompared with the blank group, the model group showed elevated DAI score (P<0.01), reduced colon length and colon weight (P<0.01), down-regulated protein levels of JAM-1 and claudin-1 (P<0.01), and up-regulated protein levels of IL-8, COX-2, TLR4, MyD88, and NF-κB p65 (P<0.01) in the colon tissue. Compared with the model group, each treatment group showed decreased DAI score (P<0.05, P<0.01), increased colon length and colon weight (P<0.05, P<0.01), up-regulated protein levels of JAM-1 and claudin-1 (P<0.01), and down-regulated protein levels of IL-8, COX-2, TLR4, MyD88, and NF-κB p65 (P<0.01) in the colon tissue. ConclusionShaoyaotang alleviates intestinal inflammation and intestinal mucosal damage to protect intestinal barrier integrity by regulating the TLR4/MyD88/NF-κB signaling pathway.
8.Current status and advances in the diagnosis and treatment of inflammatory breast cancer
Wenjing ZENG ; Juan HUANG ; Shouman WANG ; Yangyi LI ; Weizhi XIA ; Yulong ZHANG ; Jun WU ; Taohong SHEN ; Fangli ZHOU ; Ayong CAO
Chinese Journal of General Surgery 2025;34(5):1044-1055
Inflammatory breast cancer(IBC)is a rare but highly aggressive subtype of breast cancer characterized by rapid clinical progression and poor prognosis.Although it accounts for only 2%-4%of all breast cancer cases,it is responsible for 8%-10%of breast cancer-related mortality.The etiology of IBC is multifactorial,involving genetic,hormonal,environmental,and socioeconomic factors.Pathologically,IBC is marked by the presence of dermal lymphatic tumor emboli,and molecular subtypes are predominantly HER2-positive and triple-negative,indicating high tumor invasiveness.Diagnosis relies on characteristic clinical manifestations and histopathological confirmation,while imaging techniques such as MRI and PET/CT play important roles in evaluating disease extent and metastasis.Given that IBC is often diagnosed at a locally advanced or metastatic stage,there is currently no specific treatment protocol.Instead,management generally follows the treatment paradigm of non-IBC,emphasizing systemic therapy within a multidisciplinary framework.HER2-positive IBC benefits from chemotherapy combined with dual-targeted anti-HER2 therapy;triple-negative IBC may respond to immune checkpoint inhibitors;and CDK4/6 inhibitors show potential efficacy in hormone receptor-positive subtypes.Despite advancements,the prognosis remains poor,with a high risk of early recurrence and distant metastasis.Prognostic factors include lymph node involvement,molecular subtype,and response to neoadjuvant therapy.As research into the tumor microenvironment and molecular mechanisms deepens,targeted and individualized therapies hold promise for improving outcomes.This review summarizes the epidemiology,pathology,diagnostic criteria,treatment strategies,and prognostic factors of IBC,aiming to inform clinical practice and future research.
9.Clinical Value of Cardiac Magnetic Resonance Feature-tracking Strain Analysis in Risk Stratification of Diabetic Heart Failure With Preserved Ejection Fraction
Wenjing YANG ; Leyi ZHU ; Weichun WU ; Huaying ZHANG ; Jing XU ; Di ZHOU ; Zhaoxin TIAN ; Mengdi JIANG ; Yining WANG ; Gang YIN ; Xinxiang ZHAO ; Shihua ZHAO ; Minjie LU
Chinese Circulation Journal 2025;40(3):246-253
Objectives:To investigate the clinical value of cardiac magnetic resonance imaging(CMR)feature-tracking strain analysis in risk stratification of diabetic heart failure with preserved ejection fraction(HFpEF).Methods:In this retrospective study,a total of 215 patients with diabetic HFpEF who underwent CMR at Chinese Academy of Medical Sciences Fuwai Hospital from January 2012 to December 2018 were included.Myocardial strain parameters were calculated using CMR feature-tracking technology.Patients were followed up by medical records or telephone calls.Composite endpoint event,all-cause death or heart failure hospitalization during follow-up were recorded.Patients were divided into event group and event-free group.Univariable and multivariable Cox proportional hazard regression analyses were performed to determine the risk factors for the outcomes in diabetic HFpEF.The effects of hypertension and obesity on the prognosis of diabetic HFpEF patients and whether they affect the prognostic value of CMR feature-tracking strain analysis were also analyzed.Results:During a follow-up of(7.1±1.8)years,93(43.3%)patients had endpoint events(event group),including 28 all-cause deaths and 65 heart failure hospitalization.Compared with the event-free group(n=122),patients in the event group had significantly lower left ventricular ejection fraction,higher prevalence and extent of late gadolinium enhancement,and significantly reduced global longitudinal strain(GLS),global circumferential strain,global radial strain,and global systolic longitudinal strain rate(all P<0.05).The absolute GLS value was significantly lower in event group than in event-free group,regardless of the presence of hypertension and obesity.Multivariate Cox regression analysis showed that estimated glomerular filtration rate(HR=0.983,95%CI:0.972-0.993,P=0.001),left atrial volume index(HR=1.015,95%CI:1.005-1.026,P=0.004),and GLS(HR=1.142,95%CI:1.060-1.231,P<0.001)were independent risk factors for adverse cardiovascular events in diabetic HFpEF patients.However,adjusted N-terminal pro-brain natriuretic peptide was not an independent prognostic factor.The cut-offvalue of GLS to predict outcome was-14.09%from ROC curve analysis.The Kaplan-Meier curve showed that in patients with and without hypertension and obesity,patients with the GLS>-14.09%had lower event-free survival compared to patients with GLS≤-14.09%(all P<0.05),and the ability of GLS to predict adverse outcomes was not affected by hypertension and obesity.Conclusions:GLS obtained by CMR feature-tracking strain analysis is an independent predictor of adverse outcomes in diabetic HFpEF,and its ability to predict adverse outcomes is independent of hypertension and obesity.
10.Role and clinical application prospect of epigenetics in lean nonalcoholic fatty liver disease
Junjiao XU ; Sutong LIU ; Qizhen ZHANG ; Yajie GUAN ; Beilei CUI ; Wenjing WU ; Minghao LIU
Journal of Clinical Hepatology 2025;41(6):1161-1166
Epigenetic mechanisms play a crucial role in the development and progression of nonalcoholic fatty liver disease (NAFLD), especially among lean individuals. The research on related epigenetic mechanisms has provided new clues and directions for revealing the underlying causes and treatment strategies of NAFLD. This article introduces the role of epigenetics in the development and progression of NAFLD among lean individuals in recent years, analyzes the latest research advances in the epigenetics of NAFLD in this population, and briefly describes the basic concepts of epigenetics, including DNA methylation, histone modifications, and non-coding RNA regulation. This article also discusses how epigenetic alterations impact the pathogenesis, disease progression, and treatment strategies of NAFLD in lean individuals.


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