1.Predictive model for the risk of postoperative lung infection in esophageal cancer patients: A systematic review and meta-analysis
Yuqi LIU ; Ying ZHOU ; Ziyue SONG ; Linmei FENG ; Wenjing TU ; Qian WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(08):1290-1298
Objective To systematically evaluate the risk prediction models for postoperative pulmonary infection in patients with esophageal cancer, providing an objective basis for clinical selection and optimization of models. Methods A systematic search was conducted in Chinese and English databases such as VIP, Wanfang, CNKI, CBM, PubMed, Cochrane Library, Embase, and Web of Science for studies related to the risk prediction models of postoperative pulmonary infection in patients with esophageal cancer from the inception to September 30, 2024. The PROBAST tool was used to assess the quality of prognostic model research, and the RevMan 5.4 software was used for meta-analysis of predictive factors. Results A total of 17 articles were included, containing 26 pulmonary infection risk prediction models. The area under the receiver operating characteristic curve (AUC) ranged from 0.627 to 0.942, among which 21 models had good predictive performance (AUC>0.7). Quality assessment through the PROBAST tool revealed that all 17 articles had a high risk of bias. Meta-analysis results showed that common predictive factors for postoperative pulmonary infection in esophageal cancer included smoking history (OR=1.97), smoking index ≥200 (cigarettes-years) (OR=4.38), smoking index ≥400 (cigarettes-years) (OR=2.00), age (OR=1.27), comorbid diabetes (OR=2.13), comorbid emphysema or chronic obstructive pulmonary disease (OR=1.55), low plasma albumin levels (OR=1.17), prognostic nutritional index (OR=4.45), history of related lung diseases (OR=2.10), tumor location (OR=2.32), surgical approach (OR=2.21), operation time (OR=1.73), preoperative serum procalcitonin levels (OR=3.06), anastomotic leakage (OR=3.39), reduced forced expiratory volume in the first second/forced vital capacity ratio (OR=0.86), and hoarseness (OR=2.23). Conclusion At present, the risk prediction models for postoperative pulmonary infection in esophageal cancer are still in the stage of continuous development and optimization, and their research quality needs to be further improved. Future research can refer to the predictive factors summarized in this study based on meta-analysis, combined with clinical practice, to select appropriate methods to construct and validate the risk prediction models for postoperative pulmonary infection in esophageal cancer, thus providing early targeted preventive strategies for high-risk patients.
2.Application of Novel Environmentally Friendly Reagents in Pathological Section Preparation and Immunohistochemistry
Jieying LI ; Shujun LIANG ; Ying DING ; Shuying LIU ; Lina QIN ; Zhaoliang PAN ; Lianqiang FENG ; Huijie YUAN
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(3):509-517
ObjectiveTo explore the application effects of environmentally friendly reagents versus traditional reagents in tissue processing, paraffin sectioning, hematoxylin-eosin (HE) staining, special staining, and immunohistochemistry. MethodsPancreatic, renal, splenic, hepatic, pulmonary, skeletal muscle, and cardiac tissues were collected from mice and New Zealand rabbits, and randomly divided into a traditional group (Group A), an environmentally friendly reagent I group (Group B), and an environmentally friendly reagent Ⅱ group (Group C). The processed tissue sections from all three groups were subjected to paraffin sections, HE staining, phosphotungstic acid-hematoxylin staining, and Mallory trichrome staining. The pancreatic tissue sections were subjected to immunohistochemical detection of insulin protein. Evaluation criteria included tissue morphological integrity, embedding operability, section quality, and staining effects. ResultsNo significant differences were observed among the three groups of samples in terms of fixation efficacy, embedding operations, and section quality. After HE staining, all groups exhibited bright nuclear and cytoplasmic staining with clear contrast, with excellent-and-good rates of 98%, 99%, and 97% for Groups A, B, and C, respectively, showing no statistically significant differences (A vs. B, P=0.561; A vs. C, P=0.651). In phosphotungstic acid-hematoxylin staining, Groups A and C showed clear structural contrast and bright staining for striated muscle and collagen fibers, whereas Group B exhibited uneven staining. The excellent-and-good rates were 100%, 10%, and 95% for Groups A, B, and C, respectively, with significant differences between Group A and Group B (P<0.01) but no statistical difference between Group A and Group C (P=0.311). In Mallory trichrome staining, Groups A and B outperformed Group C. The excellent-and-good rates were 95%, 90%, and 15% for Groups A, B, and C, respectively, with significant differences between Group A and Group C (P<0.01), but no statistical difference between Group A and Group B (P=0.548). Immunohistochemical results showed that Group A had a clean background with no non-specific staining, while Groups B and C exhibited significant non-specific staining, with statistically significant differences in non-specific staining rates between the groups (A vs. B, 5% vs. 100%, P<0.01; A vs. C, 5% vs.100%, P<0.01). ConclusionIn HE staining, environmentally friendly reagents demonstrated effective tissue fixation and staining results comparable to traditional reagents, meeting the teaching requirements. For special staining, Group B and Group C performed better in Mallory trichrome staining and phosphotungstic acid-hematoxylin staining, respectively. However, environmentally friendly reagents exhibited non-specific staining issues in immunohistochemistry, where further optimization is required.
3.Interpretation and thoughts on the formulation and revision of the standards for exogenous harmful residues in traditional Chinese medicinal materials in the Chinese Pharmacopoeia 2025 Edition
WANG Ying ; SHEN Mingrui ; LIU Yuanxi ; ZUO Tiantian ; WANG Dandan ; HE Yi ; CHENG Xianlong ; JIN Hongyu ; LIU Yongli ; WEI Feng ; MA Shuangcheng
Drug Standards of China 2025;26(1):083-092
As people’s attention to health continues to increase, the market demand for traditional Chinese medicine (TCM) is growing steadily. The quality and safety of Chinese medicinal materials have attracted unprecedented social attention. In particular, the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society. The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM. This not only reflects China’s high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision. Basis on this study, by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detection standards in the Chinese Pharmacopoeia 2025 Edition, deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition. Moreover, it interprets the future development directions of the detection of exogenous residues in TCM, aiming to provide a reference for the formulation of TCM safety supervision policies.
4.Identification of GSK3 family and regulatory effects of brassinolide on growth and development of Nardostachys jatamansi.
Yu-Yan LEI ; Zheng MA ; Jing WEI ; Wen-Bing LI ; Ying LI ; Zheng-Ming YANG ; Shao-Shan ZHANG ; Jing-Qiu FENG ; Hua-Chun SHENG ; Yuan LIU
China Journal of Chinese Materia Medica 2025;50(2):395-403
This study identified 8 members including NjBIN2 of the GSK3 family in Nardostachys jatamansi by bioinformatics analysis. Moreover, the phylogenetic tree revealed that the GKS3 family members of N. jatamansi had a close relationship with those of Arabidopsis. RT-qPCR results showed that NjBIN2 presented a tissue-specific expression pattern with the highest expression in roots, suggesting that NjBIN2 played a role in root growth and development. In addition, the application of epibrassinolide or the brassinosteroid(BR) synthesis inhibitor(brassinazole) altered the expression pattern of NjBIN2 and influenced the photomorphogenesis(cotyledon opening) and root development of N. jatamansi, which provided direct evidence about the functions of NjBIN2. In conclusion, this study highlights the roles of BIN2 in regulating the growth and development of N. jatamansi by analyzing the expression pattern and biological function of NjBIN2. It not only enriches the understanding about the regulatory mechanism of the growth and development of N. jatamansi but also provides a theoretical basis and potential gene targets for molecular breeding of N. jatamansi with improved quality in the future.
Brassinosteroids/metabolism*
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Steroids, Heterocyclic/metabolism*
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Gene Expression Regulation, Plant/drug effects*
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Plant Proteins/metabolism*
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Phylogeny
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Nardostachys/metabolism*
;
Plant Growth Regulators/pharmacology*
;
Plant Roots/drug effects*
5.Impact of anticentromere antibody on the clinical features and prognosis of patients with primary biliary cholangitis
Shengzhu HE ; Guiqin ZHOU ; Kexin QIAO ; Yaxing LIU ; Bin LI ; Ying FENG ; Xianbo WANG
Journal of Clinical Hepatology 2025;41(5):872-877
ObjectiveTo investigate the impact of anticentromere antibody (ACA) on the clinical features and prognosis of patients with primary biliary cholangitis (PBC) by comparing clinical classification, ursodeoxycholic acid (UDCA) response, GLOBE score, and UK-PBC score between ACA-positive PBC patients and ACA-negative PBC patients. MethodsA total of 749 patients who were admitted to Beijing Ditan Hospital, Capital Medical University, from August 2013 to December 2022 and were diagnosed with PBC were enrolled and divided into ACA-positive group with 147 patients and ACA-negative group with 602 patients. According to their conditions on admission, the two groups were compared in terms of the distribution of clinical types, i.e., chronic progression-type PBC, portal hypertension-type PBC, and standard jaundice/liver failure-type PBC. There were 261 patients with complete data after 1-year follow-up, among whom there were 53 patients with positive ACA and 208 with negative ACA. A statistical analysis was performed, and propensity score matching was performed based on sex and age at a ratio of 1∶2. The two groups were compared in terms of 1-year UDCA response rate, GLOBE score, and UK-PBC score before and after matching. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. ResultsCompared with the ACA-negative group, the ACA-positive group had a significantly higher age (61.28±10.35 years vs 56.74±12.17 years, t=4.164, P<0.001), a significantly higher proportion of female patients (93.9% vs 77.6%, χ2=20.221, P<0.001), a significantly higher proportion of patients with portal hypertension (48.3% vs 27.6%, χ2=23.289, P<0.001), and a significantly lower proportion of patients with jaundice/liver failure (24.5% vs 38.5%, χ2=10.205, P<0.001). After 1-year follow-up, for the 261 PBC patients with complete data, there was no significant difference in UDCA response rate before propensity score matching between the ACA-positive group and the ACA-negative group (41.5% vs 41.8%, P>0.05), and there was a significant difference in the proportion of patients with a GLOBE score of >0.3 between the ACA-positive group and the ACA-negative group (92.5% vs 80.3%, χ2=3.935, P=0.047). There were 53 patients in the ACA-positive group and 106 patients in the ACA-negative group after propensity score matching, and there were no significant differences between the two groups in UDCA response rate, GLOBE score, and UK-PBC score (all P>0.05). ConclusionACA-positive patients tend to have an older age, with a higher proportion of female patients or patients with portal hypertension, while there is a relatively low proportion of patients with jaundice/liver failure. Positive ACA has no significant impact on UDCA response rate, GLOBE score, and UK-PBC score.
6.Research progress on strategies to target intestinal microbiota to improve drug resistance in tumor immunotherapy
Hui-ling LI ; Bi-qing LIU ; Ying-nan FENG ; Xin HU ; Lan ZHANG ; Xian-zhe DONG
Acta Pharmaceutica Sinica 2025;60(2):260-268
A growing body of research points out that gut microbiota plays a key role in tumor immunotherapy. By optimizing the composition of intestinal microbiota, it is possible to effectively improve immunotherapy resistance and enhance its therapeutic effect. This article comprehensively analyzes the mechanism of intestinal microbiota influencing tumor immunotherapy resistance, expounds the current strategies for targeted regulation of intestinal microbiota, such as traditional Chinese medicine and plant components, fecal microbiota transplantation, probiotics, prebiotics and dietary therapy, and explores the potential mechanisms of these strategies to improve patients' resistance to tumor immunotherapy. At the same time, the article also briefly discusses the prospects and challenges of targeting intestinal microbiota to improve tumor immunotherapy resistance, which provides a reference for related research to help the strategy research of reversing tumor immunotherapy resistance.
7.Status of Clinical Practice Guideline Information Platforms
Xueqin ZHANG ; Yun ZHAO ; Jie LIU ; Long GE ; Ying XING ; Simeng REN ; Yifei WANG ; Wenzheng ZHANG ; Di ZHANG ; Shihua WANG ; Yao SUN ; Min WU ; Lin FENG ; Tiancai WEN
Medical Journal of Peking Union Medical College Hospital 2025;16(2):462-471
Clinical practice guidelines represent the best recommendations for patient care. They are developed through systematically reviewing currently available clinical evidence and weighing the relative benefits and risks of various interventions. However, clinical practice guidelines have to go through a long translation cycle from development and revision to clinical promotion and application, facing problems such as scattered distribution, high duplication rate, and low actual utilization. At present, the clinical practice guideline information platform can directly or indirectly solve the problems related to the lengthy revision cycles, decentralized dissemination and limited application of clinical practice guidelines. Therefore, this paper systematically examines different types of clinical practice guideline information platforms and investigates their corresponding challenges and emerging trends in platform design, data integration, and practical implementation, with the aim of clarifying the current status of this field and providing valuable reference for future research on clinical practice guideline information platforms.
8.Research progress in chemical constituents and pharmacological activities of Abelmoschi Corolla and prediction of its quality markers.
Shi-Han GUAN ; Chang LIU ; Xiao-Tong YAN ; Jin-Wei HAN ; Feng-Ting YIN ; Hui SUN ; Guang-Li YAN ; Ling KONG ; Ying HAN ; Xi-Jun WANG
China Journal of Chinese Materia Medica 2025;50(4):908-921
Abelmoschi Corolla, the dried corolla of Abelmoschus manihot, has anti-inflammatory, antioxidant, and anti-fibrosis activities. Its chemical constituents mainly include flavonoids, organic acids, steroids, and polysaccharides. This study reviewed the research progress in the chemical constituents and pharmacological activities of Abelmoschi Corolla in recent 20 years. According to the concept of quality marker(Q-marker), the Q-markers of Abelmoschi Corolla were predicted from plant phylogeny, chemical constituent specificity, traditional efficacy, chemical constituent measurability, and absorbed constituents. The primary Q-markers for Abelmoschi Corolla were anticipated to include quercetin-3'-O-β-D-glucopyranoside, gossypetin-8-O-β-D-glucuronide, isoquercetin, myricetin,quercetin, and hyperoside, with the aim of providing reference data for improving the quality evaluation system of Abelmoschi Corolla.
Abelmoschus/chemistry*
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Drugs, Chinese Herbal/pharmacology*
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Flowers/chemistry*
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Humans
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Animals
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Quality Control
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Flavonoids/chemistry*
9.Biosynthesis of ganoderic acid and its derivatives.
Hong-Yan SONG ; Wan YANG ; Li-Wei LIU ; Xia-Ying CHENG ; Dong-Feng YANG ; Zong-Qi YANG
China Journal of Chinese Materia Medica 2025;50(5):1155-1163
Ganoderic acid is a class of lanostane-type triterpenoids found in Ganoderma species, and is one of the most important pharmacologically active components in G. lucidum, exhibiting antioxidant, anti-neuropsychiatric, anti-tumor, and immune-enhancing properties. The content of ganoderic acid in G. lucidum is very low, and the traditional extraction process is complex, yielding minimal amounts at high cost. The biosynthetic pathway of G. lucidum triterpenoids(GLTs), including the synthesis of different structural forms of ganoderic acid from lanosterol, as well as the molecular regulatory mechanisms involving key regulatory enzyme genes and their functions, are not yet fully understood. With the continuous development of synthetic biology technologies, there has been a deeper understanding of the biosynthesis and metabolic regulation pathways of ganoderic acid and its derivatives at the molecular level. Research has explored the key regulatory enzyme genes related to ganoderic acid biosynthesis and their functions. Moreover, through the optimization of synthetic biology and culture conditions, large-scale production and preparation of GLTs at the cellular level have been achieved. This paper reviews and analyzes the latest research progress on the biosynthesis pathways and metabolic regulation of GLTs, focusing on the configuration of ganoderic acid and its derivatives, the biosynthetic pathways, key enzyme genes, transcription factors related to ganoderic acid biosynthesis, signal transduction mechanisms, and factors affecting triterpenoid biotransformation. This review is expected to provide a theoretical basis and technical reference for improving the efficient production of triterpenoid pharmacological components and the exploitation and utilization of G. lucidum resources.
Triterpenes/chemistry*
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Reishi/chemistry*
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Biosynthetic Pathways
;
Lanosterol
10.Metabolomics and pharmacokinetics of Corni Fructus in ameliorating myocardial ischemic injury.
Xiang-Feng LIU ; Yu WU ; Chao-Yan YANG ; Hua-Wei LIAO ; Yan-Fen CHEN ; Xin HE ; Ying-Fang WANG ; Jin-Ru LIANG
China Journal of Chinese Materia Medica 2025;50(5):1363-1376
This study aims to investigate the ameliorating effect of Corni Fructus(CF) on the myocardial ischemic injury and the pharmacokinetic properties of characteristic components of CF. The mouse model of isoproterenol-induced myocardial ischemia was established and administrated with the aqueous extract of CF. The general efficacy of CF in ameliorating the myocardial ischemic injury was evaluated based on the cardiac histopathology and the levels of myocardial injury markers: creatine kinase isoenzyme(CK-MB) and cardiac troponin I(cTn-I). The metabolomics analysis was carried out for the heart and serum samples of mice to screen the biomarkers of CF in ameliorating the myocardial ischemic injury and then the predicted biomarkers were submitted to metabolic pathway enrichment. The pharmacokinetic analysis was performed for morroniside, loganin, and cornuside Ⅰ in mouse heart and serum samples to obtain the pharmacokinetic parameters of these components. The pharmacokinetic parameters were then integrated on the basis of self-defined weighting coefficients to simulate an integrated pharmacokinetic profile of CF iridoid glycosides in the heart and serum of the mouse model of myocardial ischemia. The results indicated that CF reduced the pathological damage to cardiac cells and tissue(hematoxylin-eosin staining) and lowered the levels of CK-MB and cTn-I in the serum of the mouse model of myocardial ischemia(P<0.01). Metabolomics analysis screed out 31 endogenous metabolites in the heart and 35 in the serum as biomarkers of CF in ameliorating the myocardial ischemic injury. These biomarkers were altered by modeling and restored by CF. Six metabolic pathways in the heart and 5 in the serum were enriched based on these metabolic markers. The main integrated pharmacokinetic parameters of CF iridoid glycosides were T_(max)=1 h, t_(1/2)=(1.52±0.05) h in the heart and T_(max)=1 h, t_(1/2)=(1.56±0.50) h in the serum. Both concentration-time curves showed a double-peak phenomenon. In conclusion, CF demonstrated the cardioprotective effect by regulating metabolic pathways such as taurine and hypotaurine metabolism, and pantothenic acid and coenzyme A biosynthesis. The integrated pharmacokinetics reflect the general pharmacokinetic properties of characteristic components in CF.
Animals
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Cornus/chemistry*
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Mice
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Metabolomics
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Drugs, Chinese Herbal/administration & dosage*
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Male
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Myocardial Ischemia/metabolism*
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Humans
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Troponin I/metabolism*
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Myocardium/pathology*
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Disease Models, Animal
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Biomarkers/metabolism*
;
Creatine Kinase, MB Form/metabolism*

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