1.Mechanism of action of organelle interactions in the progression of liver fibrosis and traditional Chinese medicine prevention and treatment strategies
Yuanyuan ZHENG ; Chenlu ZHAO ; Lihui ZHANG ; Sutong LIU ; Wenxia ZHAO
Journal of Clinical Hepatology 2026;42(3):711-717
Liver fibrosis is the core pathological stage of the progression of various chronic liver diseases to liver cirrhosis, and hepatic stellate cell (HSC) activation and the abnormal accumulation of collagen fibers are important processes for the development and progression of liver fibrosis. In recent years, studies have shown that HSC activation is regulated by the complex interactions between various organelles (including mitochondria, endoplasmic reticulum, Golgi apparatus, lysosome, and peroxisomes), and such interactions affect the key cellular processes such as energy metabolism, protein synthesis and folding, reactive oxygen species balance, and autophagy, thereby participating in the progression of liver fibrosis. Meanwhile, traditional Chinese medicine and its active ingredients with multi-target synergistic effects have attracted wide attention. From the perspective of the interaction between organelles, this article systematically elaborates on the specific mechanism of such interactions in the progression of liver fibrosis and reviews how traditional Chinese medicine inhibits HSC activation and collagen production by regulating the function of these organelle and their interaction networks, thereby exerting an anti-liver fibrosis effect, in order to provide a theoretical basis for in-depth understanding of the pathological mechanism of liver fibrosis and the development of new traditional Chinese medicine intervention strategies.
2.Construction of a full-cycle management model for T2DM patients led by clinical pharmacists
Yuanyuan JIANG ; Guimei ZHENG ; Yaohua CAO ; Zeyu XIE ; Weiling CAO
China Pharmacy 2026;37(1):92-98
OBJECTIVE To establish a full-cycle management model for type 2 diabetes mellitus (T2DM) patients led by clinical pharmacists. METHODS Based on literature research, a basic framework and items of full-cycle management model led by clinical pharmacists were initially formulated. The Delphi method was adopted to conduct questionnaire inquiries among 26 experts to determine the specific implementation items of the model. The analytic hierarchy process (AHP) method was used to determine the weight values of items at all levels, and the reliability and validity of the model items were analyzed. RESULTS The recovery rates of the two rounds of expert consultation questionnaires were 86.67% and 100%, respectively, and the expert authority coefficient was 0.88. Kendall’s concordance coefficients of the tertiary-level items were 0.064 and 0.084, respectively, and the P values from the χ 2 tests were all less than 0.05; the consistent ratios of the judgment matrices for all levels of AHP model were all less than 0.1. The established full-cycle management led by clinical pharmacists comprised three primary-level items (pharmacy service pathway for T2DM patients during hospitalization, pharmacy management pathway for hypoglycemia in T2DM inpatients, and the pharmacy follow-up pathway for T2DM discharged patients, with weights of 0.098, 0.568 and 0.334, respectively), twelve secondary-level items (e.g. pharmaceutical care during hospitalization for 1 to 2 days, admission assessment and education, with weights ranging from 0.143 to 0.333) and thirty-seven tertiary-level items (e.g. assessment of medication compliance, verification of the medication plan for discharge, with weights ranging from 0.068 to 0.750). Cronbach’s α coefficients for primary-level items and the overall questionnaire were 0.762, 0.879, 0.928 and 0.951, respectively. The item-level and scale-level content validity indexes were 0.967 and 0.808, respectively. CONCLUSIONS A full-cycle management model for T2DM patients led by clinical pharmacists has been constructed successfully, demonstrating high scientificity and reliability.
3.Relationship between physical development and onset and progression of myopia among children and adolescents
MA Xiaohui, GONG Yizhuo, QIU Tingting, LIU Zheng, HUO Huanhuan, HU Yuanyuan, BI Hongsheng
Chinese Journal of School Health 2026;47(5):723-727
Objective:
To investigate the relationship between physical development indicators and the onset and progression of myopia among children and adolescents, so as to provide theoretical support for coordinated vision and physical health management.
Methods:
A prospective cohort study was conducted. In September 2022, 3 102 students from grade one in primary school to grade three in junior high school (five year primary school and four year junior high school) from six schools in Huantai County, Shandong Province, were selected using multistage cluster random sampling method to participate in an epidemiological survey on myopia, with follow up completed in September 2023. Follow up value minus baseline value( d ) was used to assess changes in physical development and vision indicators. Multivariate Logistic regression analysis was used to examine the relationship between physical development indicators and the incidence of myopia. Generalized linear models were established to analyze the relationship between physical development indicators and changes in d spherical equivalent (SE) and d axial length (AL) .
Results:
Multivariate Logistic regression analysis showed that, after adjusting for factors such as gender, age, and baseline body mass index, the third ( Q 3)and fourth ( Q 4)quartiles of d height showed increased risks of myopia onset within one year compared to the first quartile( Q 1) ( OR =1.85,95% CI =1.18-2.88; OR =1.74,95% CI =1.09-2.78,both P <0.05). Results from the generalized linear model indicated that, after adjusting for confounding factors such as gender, age, and baseline SE, d SE was negatively correlated with d height and d weight in children and adolescents ( β =-0.024, 95% CI =-0.031 to -0.018; β =-0.006, 95% CI =-0.011 to -0.001), d AL was positively correlated with d height and d weight in children and adolescents ( β =0.011, 95% CI =0.008-0.013; β =0.005, 95% CI =0.003-0.007) (all P <0.05).
Conclusions
Physical development indicators in children and adolescents were associated with the onset and progression of myopia. Dynamic monitoring and early intervention of myopia should be strengthened for children and adolescents with rapid height and weight gain to achieve coordinated management of myopia and physical development.
4.Metabolic dysfunction-associated fatty liver disease with different clinical phenotypes: Pathogenesis and strategies for integrated traditional Chinese and Western medicine treatment
Wenxia ZHAO ; Lei GAO ; Xinju CHEN ; Yuanyuan ZHENG ; Sutong LIU ; Lihui ZHANG ; Qing ZHAO ; Chenlu ZHAO
Journal of Clinical Hepatology 2026;42(4):930-937
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a chronic metabolic liver disorder with complex etiologies. Different clinical phenotypes of MAFLD (such as obesity, hyperlipidemia, type 2 diabetes mellitus, the postmenopausal state, and chronic hepatitis B) have different mechanisms of action in the development and progression of MAFLD, leading to high heterogeneity in its clinical progression and prognosis. This article systematically reviews the pathogeneses and clinical features of the above five clinical phenotypes of MAFLD and elaborates on the corresponding individualized diagnosis and treatment regimens integrating traditional Chinese medicine and Western medicine, in order to provide a reference for clinical practice and improve clinical diagnosis and treatment.
5.Xueshisanjia San Prevents Liver Fibrosis via PINK1/Parkin Signaling Pathway-mediated Mitophagy
Baojia WANG ; Mulan HU ; Yuanyuan GONG ; Jie MA ; Xiuli ZHENG ; Xiongbin CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):166-175
ObjectiveTo investigate the therapeutic effect and mechanism of Xueshisanjia San against liver fibrosis by regulating PTEN-induced putative kinase (PINK1)/Parkin signaling pathway-mediated mitophagy. MethodsForty specific pathogen free (SPF)-grade male C57BL/6 mice were randomized into the control, model, silibinin (100 mg·kg-1), high-dose (15.16 g·kg-1) Xueshisanjia San, and low-dose (7.58 g·kg-1) Xueshisanjia San groups. The mouse model of liver fibrosis was constructed by intraperitoneal injection of 20% carbon tetrachloride solution. The treatment lasted for 6 weeks. Blood was collected from the abdominal aorta after intraperitoneal anesthesia, and the liver was separated. Liver pathology was examined by hematoxylin-eosin (HE) staining, Masson staining, and Sirius Red staining. Transmission electron microscopy (TEM) was employed to observe the mitochondrial morphology in the liver tissue. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), total bilirubin (TBil), transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) in the serum of mice were measured by enzyme-linked immunosorbent assay. Immunohistochemistry, immunofluorescence assay, and Western blot were employed to determine the protein levels of liver fibrosis markers α-smooth muscle actin (α-SMA) and collagen Ⅰ, as well as mitophagy markers microtubule-associated protein 1 light chain 3 (LC3), p62, Beclin-1, PINK1, Parkin, and translocase of outer mitochondrial membrane 20 (TOM20). ResultsCompared with the control group, the model group exhibited elevated levels of ALT, AST, CRP, TBil, IL-6, TGF-β1, and TNF-α in the serum (P<0.05), pathological changes such destroyed structure of hepatic lobules, disarrangement of hepatic cells, and collagen accumulation, swollen, vacuolated, and fragment mitochondria, down-regulated expression of p62 and TOM20, and up-regulated expression of LC3, Beclin-1, PINK1, and Parkin (P<0.05). Compared with the model group, all the treatment groups exhibited declined levels of ALT, AST, CRP, TBil, IL-6, TGF-β1, and TNF-α in the serum (P<0.05), alleviated pathological damage of liver tissue and mitochondrial damage, up-regulated expression of p62 and TOM20, and down-regulated expression of α-SMA, COL1A1, LC3, Beclin1, PINK1, and Parkin (P<0.05)
6.Effects of loganin on inflammatory response and intestinal barrier damage in septic rats
Can WANG ; Yantao LI ; Zheng ZHOU ; Lupeng WANG ; Yuanyuan GAO ; Shaoxi FAN
China Pharmacy 2025;36(5):574-578
OBJECTIVE To investigate the effects of loganin on inflammatory response and intestinal barrier damage in septic rats by regulating the Ras homolog gene family member A (RhoA)/Rho-associated coiled-coil forming protein kinase 1 (ROCK1) signaling pathway. METHODS A sepsis rat model was established by cecal ligation and puncture, and randomly divided into sepsis group, loganin low-dose group (50 mg/kg loganin, gavage), loganin high-dose group (200 mg/kg loganin, gavage), positive control group (0.2 mg/kg atorvastatin, intraperitoneal injection), and loganin high-dose + lysophosphatidic acid (LPA) group (200 mg/kg loganin gavage and intraperitoneal injection of 10 mg/kg RohA activator LPA). An additional sham surgery group was established. Each group consisted of 10 rats, and medications were administered once every 6 hours for 4 times. After 24 hours of the last intervention, the levels of serum inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and IL-1β were detected. The pathological changes of ileal tissue were observed and Chiu’s intestinal mucosal injury score was also performed. The levels of intestinal function-lactate dehydrogenase (D-lactate), D-amino acid oxidase (DAO) and endotoxin, the percentages of zonula occludens-1 protein (ZO-1) and Occludin positive staining area, as well as protein expressions of RhoA, and ROCK1 were all detected. com RESULTS Compared with the sepsis group, the percentages of ZO-1 and Occludin positive areas increased significantly in loganin low-dose and high-dose groups; while the levels of IL-6, TNF-α, IL-1β, DAO, D-lactate and endotoxin, Chiu’s intestinal mucosal injury score as well as protein expressions of RhoA and ROCK1 decreased significantly (P<0.05); the destruction of rat ileal tissue was alleviated, and tissue edema and inflammatory infiltration were significantly reduced; moreover, the improvement effect in loganin high-dose group was superior to that in loganin low-dose group (P<0.05). Compared with loganin high-dose group, RhoA activator LPA reversed the trend of changes in the above indicators (P<0.05). CONCLUSIONS Loganin can alleviate inflammatory response and intestinal barrier damage in septic rats, the mechanism of which may be associated with inhibiting RhoA/ROCK1 signaling pathway.
7.Research on the Construction and Optimization of TCM Word Network for TCM-clinical Decision Support System
Shanrong HUANG ; Ling ZHU ; Shaolei TIAN ; Wanting ZHENG ; Yuanyuan TONG ; Jinghua LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(2):58-63
Objective To discuss the method of constructing TCM word network and the subsequent optimization method;To solve the problems of natural language processing in the TCM-clinical decision support system using TCM terminology.Methods This study was based on several national standards and terminology dictionaries of TCM,such as Zhong Yi Lin Chuang Zhen Liao Shu Yu Ji Bing Part and Zhong Yi Yao Xue Zhu Ti Ci Biao,supplemented with related corpus on the Internet,and the framework of TCM word network was constructed with ontology as the guide.Word2Vec was used to load pre-trained models for similarity calculation,statistical and rule-based new word discovery,bibliometric analysis,and other methods to add or delete concept words and synonyms such as symptom terms and prescription terms.Results The TCM word network contained 55 semantic types and 13 semantic relationships,more than 110 000 concept words,and more than 300 000 synonyms.In addition to classifying concept words by semantic types,more detailed semantic classification was carried out in the upper and lower tree structures,in which more than 30 000 concept words had superordinate words,and nearly 2 600 concept words had subordinate words.At the same time,a process-based terminology supplementation mechanism,update review mechanism and cleaning mechanism were created.Conclusion TCM word network can not only be applied to the natural language processing process of TCM-clinical decision support system,but also can be applied to the normalization of data and the automatic construction of knowledge graph.
8.Research on the Construction and Optimization of TCM Word Network for TCM-clinical Decision Support System
Shanrong HUANG ; Ling ZHU ; Shaolei TIAN ; Wanting ZHENG ; Yuanyuan TONG ; Jinghua LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(2):58-63
Objective To discuss the method of constructing TCM word network and the subsequent optimization method;To solve the problems of natural language processing in the TCM-clinical decision support system using TCM terminology.Methods This study was based on several national standards and terminology dictionaries of TCM,such as Zhong Yi Lin Chuang Zhen Liao Shu Yu Ji Bing Part and Zhong Yi Yao Xue Zhu Ti Ci Biao,supplemented with related corpus on the Internet,and the framework of TCM word network was constructed with ontology as the guide.Word2Vec was used to load pre-trained models for similarity calculation,statistical and rule-based new word discovery,bibliometric analysis,and other methods to add or delete concept words and synonyms such as symptom terms and prescription terms.Results The TCM word network contained 55 semantic types and 13 semantic relationships,more than 110 000 concept words,and more than 300 000 synonyms.In addition to classifying concept words by semantic types,more detailed semantic classification was carried out in the upper and lower tree structures,in which more than 30 000 concept words had superordinate words,and nearly 2 600 concept words had subordinate words.At the same time,a process-based terminology supplementation mechanism,update review mechanism and cleaning mechanism were created.Conclusion TCM word network can not only be applied to the natural language processing process of TCM-clinical decision support system,but also can be applied to the normalization of data and the automatic construction of knowledge graph.
9.Visual analysis of the research hotspots and frontiers of the"gut-liver axis"theory
Linrong ZHU ; Xiaping LIU ; Xiaoqu ZHU ; Jinlian ZHENG ; Qianqian HU ; Yuanyuan WU
China Modern Doctor 2025;63(11):1-4
Objective To analyze the literature on the"gut-liver axis"theory,and to understand the hotspots and development trends of the"gut-liver axis"theory.Methods Literatures related to the"gut-liver axis"in databases were searched from the establishment of the database to October 1,2024.A total of 292 Chinese and 1591 English articles were included.CiteSpace 6.4R1 and VOSviewer1.6.20 software were used for analysis.Results High-frequency Chinese keywords included"gut-liver axis""intestinal flora""non-alcoholic fatty liver disease"etc,10 clusters were formed.High-frequency English keywords included"gut-liver axis""gut microbiota""inflammation",etc,14 clusters were formed.Conclusion The research on the"gut-liver axis"is increasing year by year,and the direction of liver fibrosis and immunity will be the hot direction in the future.
10.Preliminary Study on Value of Carotid Artery Non-enhanced High-resolution MRI in Evaluating Carotid Stenosis in Patients Before Carotid Endarterectomy
Jingchao FANG ; Yuanyuan ZHENG ; Lin WANG
Chinese Journal of Minimally Invasive Surgery 2025;25(3):158-163
Objective To investigate clinical diagnostic efficacy of carotid artery non-enhanced high-resolution magnetic resonance imaging(MRI)for carotid artery stenosis.Methods We analyzed 122 cases of symptomatic carotid stenosis who underwent carotid endarterectomy(CEA)for the first time in our hospital from January to September 2024.Preoperative computed tomography angiography(CTA)and non-enhanced high-resolution MRI of the carotid artery were performed.According to the North American Symptomatic Carotid Endarterectomy Trial(NASCET)criteria,two radiologists independently measured degree of stenosis in 244 carotid arteries on CTA and MRI images.The sensitivity,specificity,accuracy,missed diagnosis rate,and misdiagnosis rate of MRI for the diagnosis of carotid stenosis were calculated with CTA as the control and carotid stenosis rates of≥50%,≥70%,and 100%as the thresholds.Results Taking the carotid stenosis rate of≥50%as the threshold,the sensitivity,specificity,accuracy,missed diagnosis rate,and misdiagnosis rate of MRI were 99.4%(161/162),100.0%(82/82),99.6%(243/244),0.6%(1/162),and 0.0%(0/82),respectively.Taking the carotid stenosis rate of≥70%as the threshold,the sensitivity,specificity,accuracy,missed diagnosis rate,and misdiagnosis rate of MRI were 100.0%(129/129),100.0%(115/115),100.0%(244/244),0.0%(0/129),and 0.0%(0/115),respectively.Taking the carotid stenosis rate of 100%as the threshold,the sensitivity,specificity,accuracy,missed diagnosis rate,and misdiagnosis rate of MRI were 100.0%(30/30),99.5%(213/214),99.6%(243/244),0.0%(0/30),and 0.5%(1/214),respectively.The Kappa values(κ)were in good agreement among different radiologist groups(CTA:κ=0.967,P=0.000;MRI:κ=0.956,P=0.000).Conclusion Carotid artery non-enhanced high-resolution MRI can accurately evaluate carotid stenosis.


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