1.Effect of Feiyanning Granules on Inducing Ferroptosis in Lung Cancer Cells and Its Regulatory Function onNrf2/SLC7A11/GPX4 Signaling Pathway
Xin LIU ; Wenjie WANG ; Zhenye XU ; Zhan ZHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):100-107
ObjectiveThis study aims to explore the effect of Feiyanning granules on ferroptosis in lung cancer cells and its regulatory function within the nuclear transcription factor E2-related factor 2 (Nrf2)/mouse solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway. MethodsThe cell counting kit-8 (CCK-8) method was used to detect the effect of Feiyanning granule on the proliferation of A549 lung cancer cells. A549 lung cancer cells were categorized into a blank group, a ferroptosis inhibitor-1 (Fer-1) group (10 μmol·L-1), a Feiyanning granules (600 mg·L-1) group, and a Feiyanning granules + Fer-1 group. After 48 hours of intervention, the activity and morphology of the cells were observed. The CCK-8 method was employed to measure cell viability. Biochemical assays were carried out to measure the levels of reactive oxygen species (ROS), malondialdehyde (MDA), glutathione (GSH), and ferrous ions (Fe²⁺) in A549 cells. Western blot was utilized to evaluate the expression levels of Kelch-like ECH-associated protein 1 (Keap1), Nrf2, SLC7A11, and GPX4 proteins. A549 lung cancer cells were categorized into a blank group and a Feiyanning Granule group (600 mg·L-1), and mitochondrial morphology was examined via transmission electron microscopy (TEM). ResultsAfter the intervention of Feiyaning granules, the proliferation of A549 cells was significantly inhibited in a concentration-dependent manner compared with that in the blank group (P<0.01). Compared with the blank group, the Feiyanning granules group exerted an significantly inhibitory effect on the viability of lung cancer cells (P<0.01). Compared with that in the Feiyanning granules group, the cell viability in the Feiyanning granules +Fer-1 group was obviously restored (P<0.05). Compared with the blank group, the Feiyanning Granule group showed a significant increase in the levels of ROS, MDA, and Fe²⁺ (P<0.01), a significant decrease in the GSH level (P<0.01), and facilitated ferroptosis. Compared with the blank group, the Feiyanning granules group showed significantly decreased expression of Nrf2, SLC7A11, and GPX4 proteins and enhanced expression of Keap1 (P<0.01). Compared with those in the Feiyanning Granule group, the protein levels of Nrf2, SLC7A11, and GPX4 increased significantly (P<0.01), and the expression of Keap1 decreased significantly in the Feiyanning granules + Fer-1 group (P<0.01). Compared with the blank group, the Feiyaning granules group exhibited reduced mitochondrial size and increased matrix electron density. ConclusionFeiyanning granules can induce ferroptosis in lung cancer cells, and its underlying mechanism might be associated with the inhibition of the Nrf2/SLC7A11/GPX4 signaling pathway.
2.Quercetin Ameliorates Gouty Arthritis in Rats via ROS/NLRP3/IL-1β Signaling Pathway
Baowei FENG ; Yan WANG ; Chang LI ; Yujing ZHANG ; Dingxing FAN ; Xin LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):145-153
ObjectiveTo investigate the effect of quercetin on acute gouty arthritis (GA) in rats by inhibiting the reactive oxygen species (ROS)/NOD-like receptor protein 3 (NLRP3)/interleukin-1β (IL-1β) signaling pathway. MethodsSixty SPF-grade male SD rats were randomized into normal, model, colchicine (0.3 mg·kg-1), and low-, medium-, and high-dose (25, 50, 100 mg·kg-1, respectively) quercetin groups (n=10). The rats in the dosing groups were administrated with the corresponding drugs (10 mL·kg-1) by gavage once a day for one week. An equal volume of normal saline was given by gavage to rats in normal and model groups. One hour after drug administration on day 5, an acute GA model was established in other groups except the control group via intra-articular injection of monosodium urate (MSU) suspension into the right posterior ankle joint cavity. The joint swelling and gait were scored at the time points of 6, 12, 24, 48 h after modeling. Histopathological alterations in the ankle joint tissue from each group were assessed by hematoxylin-eosin (HE) staining. Malondialdehyde (MDA), xanthine oxidase (XOD), and total superoxide dismutase (T-SOD) assay kits were used to assess the levels of MDA, XOD, and T-SOD in the serum. The levels of tumor interleukin-6 (IL-6), necrosis factor-α (TNF-α), and IL-1β in the rat serum, as well as ROS in the ankle joint tissue, were measured by enzyme-linked immunosorbent assay (ELISA). Western blot was performed to determine the protein levels of NLRP3, thioredoxin-interacting protein (TXNIP), apoptosis-associated speck-like protein containing a CARD domain (ASC), precursor cysteinyl aspartate-specific proteinase-1 (pro-Caspase-1), cleaved Caspase-1 (Caspase-1 p20), and IL-1β in the ankle joint tissue. Real-time PCR was employed to assess the mRNA levels of TXNIP, NLRP3, ASC, IL-1β, and TNF-α in the ankle joint tissue. ResultsCompared with the normal group, the model group exhibited decreased spontaneous activity, mental fatigue, increased ankle joint swelling and gait scores (P<0.01), aggravated synovial tissue edema and inflammatory cell infiltration (P<0.01), elevated levels of XOD, MDA, TNF-α, IL-1β, and IL-6 in the serum and ROS in the joint tissue (P<0.01), a declined level of T-SOD (P<0.01), up-regulated protein levels of NLRP3, TXNIP, ASC, pro-Caspase-1, Caspase-1 p20, and IL-1β in the ankle joint tissue (P<0.01), and up-regulated mRNA levels of NLRP3, TXNIP, ASC, IL-1β, and TNF-α in the ankle joint tissue (P<0.01). Compared with the model group, the medium- and high-dose quercetin groups showed improved general conditions, decreased gait scores (P<0.05, P<0.01), reduced joint swelling (P<0.01), alleviated synovial tissue edema and inflammatory cell infiltration (P<0.05, P<0.01), lowered levels of XOD, MDA, TNF-α, IL-1β, and IL-6 in the serum and ROS in the joint tissue (P<0.01), increased levels of T-SOD (P<0.01), down-regulated protein levels of TXNIP, NLRP3, ASC, pro-Caspase-1, Caspase-1 p20, and IL-1β in the ankle joint tissue (P<0.05, P<0.01), and down-regulated mRNA levels of TXNIP, NLRP3, ASC, IL-1β, and TNF-α in the ankle joint tissue (P<0.01). Low-dose quercetin also ameliorated some of the above parameters (P<0.05, P<0.01). ConclusionQuercetin exerts anti-GA effects by blocking the ROS/NLRP3/IL-1β signaling pathway, downregulating NLRP3 inflammasome activation, and inhibiting the production of pro-inflammatory cytokines including TNF-α, IL-1β, and IL-6.
3.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
4.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
5.Multicenter machine learning-based construction of a model for predicting potential organ donors and validation with decision curve analysis
Xu WANG ; Wenxiu LI ; Fenghua WANG ; Shuli WU ; Dong JIA ; Xin GE ; Zhihua SHAN ; Tongzuo LI
Organ Transplantation 2026;17(1):106-115
Objective To evaluate the predictive value of different machine learning models constructed in a multicenter environment for potential organ donors and verify their clinical application feasibility. Methods The study included 2 000 inpatients admitted to five domestic tertiary hospitals from January 2020 to December 2023, who met the criteria for potential organ donation assessment. They were randomly divided into a training set and an internal validation set (7∶3). Another 300 similar patients admitted to the First Affiliated Hospital of Harbin Medical University from January 2024 to April 2025 were included as an external validation set. The area under the curve (AUC), sensitivity, specificity, accuracy and F1-score of three models were compared, and the consistency of the potential organ donor determination process was tested. Multivariate logistic regression analysis was used to identify predictive factors of potential organ donors. Decision curve analysis (DCA) was employed to verify the resource efficiency of each model, and the threshold interval and intervention balance point were assessed. Results Apart from age, there were no significant differences in other basic characteristics among the centers (all P>0.05). The consistency of the potential organ donor determination process among researchers in each center was good [all 95% confidence interval (CI) lower limits >0]. In the internal validation set, the XGBoost model had the best predictive performance (AUC=0.92, 95% CI 0.89-0.94) and the best calibration (P=0.441, Brier score 0.099). In the external validation set, the XGBoost model also had the best predictive performance (AUC=0.91, 95% CI 0.88-0.94), outperforming logistic regression and random forest models. Multivariate logistic regression showed that mechanical ventilation had the greatest impact (odds ratio=2.06, 95% CI 1.54-2.76, P<0.001). DCA indicated that the XGBoost model had the highest net benefit in the threshold interval of 0.2-0.6. The “treat all” strategy only had a slight advantage at extremely low thresholds. The recommended threshold interval, which balances intervention costs and clinical benefits, considers ≥50% positive predictive value (PPV) and ≤50 referrals per 100 high-risk patients. Conclusions The XGBoost model established in a multicenter environment is accurate and well-calibrated in predicting potential organ donors. Combined with DCA, it may effectively guide the timing of clinical interventions and resource allocation, providing new ideas for the assessment and management of organ donation after brain death.
6.OBE-CDIO model of teaching for curriculum of exercise rehabilitation training
Hua LIU ; Liyuan WANG ; Xin MA ; Jing LI ; Li WANG
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):270-275
ObjectiveTo investigate the effectiveness of teaching pedagogy based on outcome-based education (OBE) and conceive-design-implement-operate (CDIO) model in the teaching of exercise rehabilitation training. MethodsTwenty-seven postgraduate students majoring in exercise rehabilitation training of grade 2024 at Capital University of Physical Education and Sports were randomly divided into control group (n = 13) and experimental group (n = 14). The control group received routine teaching methods, while the experimental group received teaching of OBE-CDIO. After the course, theoretical scores, objective structured clinical examination (OSCE) scores and teaching satisfaction via questionnaire were compared between two groups. ResultsAfter the course, there was no significant difference in theoretical scores between two groups (t = 1.103, P > 0.05). Scores in all stations of OSCE were higher in the experimental group than in the control group (t > 2.181, P < 0.05), as well as the satisfaction scores of learning, enthusiasm, organization, group interaction, individual affinity, workload and examination (|t| > 3.781, P < 0.001). ConclusionThe teaching pedagogy based on the OBE-CDIO model can improve practical competence and teaching satisfaction among postgraduate students majoring in exercise rehabilitation training.
7.Distribution of end digits in standardized blood pressure measurement recordings and evaluation of its effect on initial blood pressure readings
Yiming YAN ; Xin ZHANG ; Jiehua CHEN ; Haijuan SHI ; Bin ZHU ; Yanming WANG ; Chuanying CHEN
Journal of Public Health and Preventive Medicine 2026;37(2):175-179
Objective To analyze the distribution status of the end digits of standardized blood pressure measurement recordings in the clinic and the effectiveness of standardized blood pressure measurement for community hypertension screening. Methods The first visit blood pressure measurement data from the Community Health Service Center in Jing'an District, Shanghai from June 2023 to May 2024 were collected and analyzed. According to different measurement methods, the data were divided into two groups: standardized blood pressure measurement and conventional blood pressure measurement. SPSS 19.0 software was used for data analysis. The differences in the distribution balance of the end digits of blood pressure values and the detection rate of blood pressure elevation between the two different groups were analyzed. Results The frequency range of the end digits of blood pressure recorded values in the standardized pressure measurement group was 9.42% to 10.83%, and the detection rate of elevated blood pressure was 24.89%. The conventional pressure measurement group had a preference of the end digit "0", and the detection rate of elevated blood pressure was only 2.12%. The results of multiple logistic regression analysis showed that gender, age, season, and different blood pressure measurement modes were all influencing factors for the detection rate of elevated blood pressure. Conclusion The standardized blood pressure measurement mode in the clinic is suitable for community hypertension screening and pressure measurement, with higher data quality than the conventional pressure measurement mode.
8.Glucocorticoids Combined with Cyclophosphamide and Rituximab in the Treatment of Elderly Patients with ANCA-associated Vasculitis and Renal Involvement: A Single Center Retrospective Study
Jiahui WANG ; Xin LEI ; Xiaohan HUANG ; Liangliang CHEN ; Yaomin WANG ; Pingping REN ; Lan LAN ; Jianghua CHEN ; Fei HAN
Medical Journal of Peking Union Medical College Hospital 2026;17(2):346-357
To investigate the efficacy and safety of glucocorticoids combined with cyclophosphamide (CTX) and rituximab (RTX) in elderly patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis with renal involvement. Elderly patients (age ≥60 years) with ANCA-associated vasculitis and renal involvement admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from December 2019 to November 2022 were retrospectively enrolled. Based on different induction treatment regimens, patients were divided into a control group (glucocorticoids + CTX) and a combination therapy group (glucocorticoids + CTX + RTX). Differences in disease remission, end stage renal disease (ESRD), mortality, relapse, and incidence of adverse events were compared between the two groups. A total of 60 elderly patients with ANCA-associated vasculitis and renal involvement were ultimately included, with a median follow-up of 29.7(17.2, 38.7) months. The control group comprised 26 patients, with a median follow-up of 35.0(28.1, 40.3) months; the combination therapy group comprised 34 patients, with a median follow-up of 26.2(16.1, 35.1) months. The remission rate at 3 months (64.7% For elderly patients with ANCA-associated vasculitis and renal involvement, the regimen of glucocorticoids combined with CTX and individualized RTX demonstrates potential advantages in early remission rate, glucocorticoid tapering, and control of cumulative CTX dose, without increasing the risk of serious adverse events. This regimen may represent an alternative treatment option for this patient population; however, its long-term efficacy and safety require further validation through prospective randomized controlled trials.
9.Development of A Prognostic Prediction Model for Primary Membranous Nephropathy in the Elderly Based on Machine Learning
Yuzhu XU ; Shuqin LIU ; Dingding WANG ; Wei CHEN ; Xin WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(2):370-381
Elderly patients with primary membranous nephropathy (PMN) exhibit significant prognostic heterogeneity and poor tolerance to immunotherapy. However, there is a lack of early prognostic prediction tools specifically for this population. This study aimed to develop a prognostic prediction model applicable to elderly PMN patients. This study retrospectively included elderly patients with PMN confirmed by renal biopsy. The primary endpoint was a adverse composite outcome including end-stage renal disease (ESRD), a ≥50% decline in estimated glomerular filtration rate (eGFR), or all-cause death. Patients were randomly divided into a training cohort and a validation cohort at a ratio of 7∶3. Key prognostic features were identified using least absolute shrinkage and selection operator (LASSO) regression combined with random survival forest, and a predictive model was constructed based on penalized Cox regression. Model performance was evaluated using the concordance index (C-index), time-dependent area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis. The SurvSHAP (t) method was employed for interpretability analysis of the model. A total of 309 elderly patients with PMN were included in this study, with a median age of 65.00 years (IQR, 62.00-68.00) and a male predominance 61.2%(189/309).During a median follow-up of 47.00 months (IQR, 25.00-89.00), 38.2%(118/309) reached the endpoint event. The final model included nine key features, including eGFR, total protein (TP), glomerular capsular adhesion, urine glucose, segmental glomerulosclerosis proportion, fibrinogen, urea, age, and activated partial thromboplastin time (APTT). In the validation cohort, the model demonstrated good discrimination, with a C-index of 0.731(95% CI: 0.652-0.797). The time-dependent AUROCs for predicting adverse outcomes at 3, 5, and 10 years were 0.758(95% CI: 0.614-0.901), 0.781(95% CI: 0.646-0.916), and 0.866(95% CI: 0.740-0.993), respectively. Calibration curves demonstrated a high degree of concordance between predicted probabilities and actual event rates. Decision curve analysis confirmed the net clinical benefit of the model.SurvSHAP (t) analysis showed that eGFR, TP, glomerular capsular adhesion, urine glucose, and the proportion of segmental glomerular sclerosis were the top five variables contributing to the model. This prognostic model effectively predicts the risk of adverse outcomes in elderly patients with PMN in the internal validation cohort, offering a potential scientific basis for individualized risk stratification and treatment decision-making in this population.
10.Eculizumab for Refractory Immune Complex-Mediated Glomerulonephritis Following Acute Hepatitis B Infection: A Case Report
Jinyuan LIU ; Dan WANG ; Shuqin LIU ; Wenfang CHEN ; Wei CHEN ; Xin WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(2):389-395
Infection-related glomerulonephritis (IRGN) is an immune-mediated glomerular injury triggered by infectious agents. This article reports a case of immune complex-mediated glomerulonephritis following acute hepatitis B virus infection, which continued to progress despite standard antiviral and immunosuppressive therapy. Given the significant elevation of soluble complement membrane attack complex (sC5b-9), an indicator of terminal complement pathway activation, the patient was treated with eculizumab. Following treatment, the patient's urine protein-to-creatinine ratio significantly decreased, hypoalbuminemia and hematuria markedly improved, and sC5b-9 levels declined. This case suggests that abnormal complement system activation may be a key mechanism driving disease persistence in some patients with IRGN. For those unresponsive to conventional therapy, complement function screening and targeted terminal complement pathway inhibition may represent an effective salvage strategy.


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