1.From Gene Expression to Transcriptome-wide Association Study: Development and Comparison of Methodology
Kun FANG ; Guozhuang LI ; Linting WANG ; Qing LI ; Kexin XU ; Lina ZHAO ; Zhihong WU ; Jianguo ZHANG ; Nan WU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):223-229
Over the past two decades, genome-wide association study(GWAS) has identified numerous genetic variants and loci associated with heritable diseases. With the gradual maturation and saturation of GWAS methodologies, transcriptome-wide association study(TWAS) offers a novel perspective by linkinggenetic phenotypes to gene expression levels. By integrating TWAS with other multi-omics analyses, researchers can gain a deeper understanding of heritable diseases. This article provides an overview of recent groundbreaking and representative TWAS methods and tools, analyzes their strengths and limitations, and discusses future trends in TWAS development.
2.Age,blood eosinophils,FeNO and serum IgE as biomarkers for the prediction of eosinophilic phenotype among asthmatic patients
Jiameng GAO ; Yuan MA ; Yao SHEN ; Fang WANG ; Yuhao QIAN ; Zhihong CHEN
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(5):631-639
AIM:To identify surrogate clinical bio-markers for profiling the eosinophilic status of an individual patient over induced sputum analysis.METHODS:We conducted a cross-sectional study on 100 asthmatic patients whose induced sputum was successfully collected.Subjects were further classified into either EA or NEA based on whether the percentage of sputum eosinophil count(SEC%)was≥3%.Demographic and clinical data were col-lected,including basic information,routine blood tests,lung function tests,bronchodilator reversibili-ty tests,fractional exhaled nitric oxide(FeNO),the Asthma Control Test(ACT)and the Asthma Control Questionnaire(ACQ).All variables significantly asso-ciated with EA were candidates for multivariate lo-gistic regression analysis.A scoring system present-ed as a nomogram for the prediction of EA was de-veloped.RESULTS:In the univariate analysis,com-pared with NEA subjects,those with EA were of older age and had worse asthma control and lung function in addition to higher values of blood eosin-ophils,serum IgE and FeNO.Multivariable logistic regression analysis revealed that age,FeNOx serum IgE and blood eosinophil count(BEC)were identi-fied as independent risk factors for eosinophilic asthma,which were all included in the nomogram.CONCLUSION:A combination assessment including age,FeNOx serum IgE and BEC could be applicable to clinicians in identifying eosinophilic asthma and is easier,faster,more inexpensive and more readily available than the induced sputum test.
3.Pathogenesis explanation of hepatolenticular degeneration along the"liver-kidney-brain"axis and differentiation and treatment strategies of traditional Chinese medicine
Zhihong RAO ; Wenming YANG ; Yulong YANG ; Wenjie HAO ; Yue YANG ; Ke DIAO ; Shuzhen FANG ; Yuchen LI
Journal of Beijing University of Traditional Chinese Medicine 2025;48(9):1270-1277
Hepatolenticular degeneration is an autosomal recessive hereditary disease characterized by copper metabolism disorder,which affects the liver,kidneys,and brain.In traditional Chinese medicine,this disease is closely associated with dysfunction of the"liver-kidney-brain"axis.The liver,kidney,and brain form a physiological whole through the mutual transformation and distribution of essence and blood,the coordination of qi transformation,and the connection of meridians and collaterals.This article explores the pathogenesis of hepatolenticular degeneration based on the"liver-kidney-brain"axis.The deficiency of liver and kidney essence leads to the malnutrition of brain marrow,which is the fundamental cause of the disease.The internal accumulation of copper toxins generates dampness-heat and phlegm-stasis,which are the key factors causing the disease.In view of the characteristics of this disease with deficiency in nature and excess in superficiality,the principle of dynamic treating both manifestation and root cause of disease is established:treating the manifestation starts with eliminating copper and detoxifying,combined with clearing heat and dampness,and removing phlegm and stasis;treating the root cause follows the concept of the same origin of yi and gui,emphasizing the simultaneous treatment of liver and kidney to nourish the brain marrow.Throughout the treatment process,copper elimination(treating the symptoms)should be taken into account,and stratified measures should be applied based on the primary focus of the lesion:either treating the liver as the main focus and supplemented by tonifying the kidney and filling the marrow;or treating the kidney as the main focus and assisted by regulating the liver and nourishing the brain;or co-regulating the three zang-organs of liver,kidney,and brain,to achieve the therapeutic goal of eliminating pathogenic factors and restoring normal functions,and combining tonification and purgation.
4.Treatment of Renal Injury in Wilson Disease Based on Pathogenesis of Latent Toxin in Kidney Collaterals
Ke DIAO ; Wenming YANG ; Xiang LI ; Yue YANG ; Yulong YANG ; Zhihong RAO ; Shuzhen FANG ; Yufeng DING
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):132-139
Hepatolenticular degeneration, also known as Wilson disease (WD), is a hereditary disease caused by mutations in the ATP7B gene, leading to copper metabolism disorders. Gene mutations result in impaired synthesis of copper-binding protein, and abnormal excretion of copper through bile leads to pathological deposition of copper in various organs, ultimately causing multi-organ damage. The insidious onset and low specificity of symptoms make it difficult to diagnose this disease. On the basis of existing studies and the theory of latent toxin, this paper proposes that latent toxin in kidney collaterals is the main pathogenesis of renal injury in WD. It is pointed out that health Qi deficiency and latent pathogen are the premises for the occurrence of this disease, and the transformation of latent pathogen into toxin is the ley pathological process. Toxin damaging kidney collaterals is the ultimate result. According to the pathogenesis, this paper proposes the treatment principle of reinforcing healthy Qi and resolving toxin and treatment based on syndrome differentiation. This review provides new ideas for the diagnosis and treatment of renal injury in WD with traditional Chinese medicine.
5.Clinical Efficacy of Gandouling Decoction Combined with Neuromuscular Electrical Stimulation on Dysphagia in Wilson Disease with Combined Phlegm and Stasis
Zhihong RAO ; Wenming YANG ; Yue YANG ; Xiang LI ; Peng HUANG ; Yulong YANG ; Ke DIAO ; Shuzhen FANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):155-162
ObjectiveTo observe the clinical efficacy of Gandouling decoction combined with neuromuscular electrical stimulation (NMES) in the treatment of dysphagia in Wilson disease (WD) with combined phlegm and stasis. MethodsA total of 80 WD patients with dysphagia due to combined phlegm and stasis treated in the Department of Encephalopathy, the First Affiliated Hospital of Anhui University of Chinese Medicine were randomized into a control group and an observation group, with 40 patients in each group. In addition, 40 healthy volunteers were recruited as the normal group. The control group was treated with basic copper drainage combined with NMES. The observation group was treated with Gandouling Decoction on the basis of the therapy in the control group. Each course of treatment lasted for 8 days, and the patients were treated for a total of 4 courses. All subjects underwent video fluoroscopic swallowing study (VFSS) before and after treatment. During the examination, contrast agents with 4 different characters were used for the swallowing action, and the passing time was recorded. The TCM syndrome score, water swallow test score, standard swallowing assessment (SSA) score, and 24-h urinary copper level before and after treatment were analyzed. ResultsWhen performing VFSS, the passing time of contrast agents of different characters in the oral stage was longer in the WD group than in the normal group (P<0.01), while it had no significant difference in the pharyngeal stage. After treatment, the passing time in the oral stage shortened in the control and observation groups (P<0.01), and the observation group outperformed the control group (P<0.01). After treatment, both the control and observation groups showed declines in TCM syndrome score and SSA score (P<0.01) and an increase in water swallow test score (P<0.01), and the changes were more obvious in the observation group than in the control group (P<0.01). In addition, the treatment in the control and observation groups elevated the 24-h urinary copper level (P<0.01), and the elevation in the observation group was more obvious than that in the control group (P<0.01). Neither group showed obvious adverse reaction. ConclusionGandouling decoction combined with NMES can significantly ameliorate dysphagia in WD patients with the syndrome of combined phlegm and stasis regarding the TCM syndrome score, water swallow test score, and SSA score, demonstrating definite clinical efficacy and high safety.
6.Clinical characteristics and D-mannose treatment outcomes in 5 children with mannose phosphate isomerase-congenital disorders of glycosylation
Yan ZHANG ; Liting LI ; Nengli WANG ; Yuchuan LI ; Zhihong GUAN ; Jingzhuo TIAN ; Lian CHEN ; Weiyuan FANG ; Jianshe WANG
Chinese Journal of Pediatrics 2025;63(10):1136-1141
Objective:To analyze the clinical characteristics of mannose phosphate isomerase-congenital disorders of glycosylation (MPI-CDG) and evaluated the outcomes following D-mannose treatment.Methods:This case-series study analyzed clinical manifestations, laboratory findings, imaging results, genetic data, and outcomes after D-mannose therapy in 5 children with MPI-CDG diagnosed at the Children′s Hospital of Fudan University between December 2014 and December 2024.Results:The age of onset ranged from 0.3 to 0.4 years in all 5 children, who initially presented with diarrhea and hypoglycemia. Associated manifestations included short stature (3 cases), anemia (3 cases), splenomegaly (3 cases), hepatomegaly (4 cases), elevated transaminases (4 cases), and hypoalbuminemia (4 cases). Liver pathology revealed hepatic fibrosis in 3 cases. Genetic testing identified 8 variants in the MPI gene, including 2 novel variants. Following D-mannose treatment, diarrhea and hypoglycemia resolved within 1-2 weeks in all children, with concurrent improvement in anemia. Notably except for Patient 1, who developed progressive splenomegaly, worsening hepatic fibrosis, and portal hypertension despite persistently normal transaminase and albumin levels, the other 4 children showed improvement in transaminase levels, resolution of hypoalbuminemia and amelioration of imaging abnormalities.Conclusions:MPI-CDG typically manifests in infancy with diarrhea and hypoglycemia, often accompanied by multi-system involvement. D-mannose treatment significantly improves metabolic abnormalities and most organ damages. However, close surveillance of liver status is warranted due to the risk of hepatic fibrosis progression in some cases.
7.Interpretation of Chinese Expert Consensus on Integrated Chinese and Western Medicine Management of Wilson Disease-related Renal Damage
Wenming YANG ; Ke DIAO ; Hu XI ; Zhihong RAO ; Taohua WEI ; Yulong YANG ; Shuzhen FANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):168-176
Wilson disease is a copper metabolism disorder caused by mutations in the ATP7B gene, which encodes a copper-transporting ATPase β, and can result in multisystem damage. The kidneys are the third most commonly affected organs after the liver and brain. In recent years, numerous diagnostic and treatment guidelines for Wilson disease have emerged. However, most of these focus primarily on hepatic and neurological manifestations and their management, with limited coverage of renal involvement. The high incidence, low awareness, and lack of clinical specificity of Wilson disease-related renal damage (WDRD) have made early detection and intervention particularly challenging in clinical practice. To further optimize the treatment of patients with WDRD, improve clinical diagnosis and management, and enhance patients' quality of life, the Neurology Committee of the Chinese Association of Integrative Medicine, in April 2024, initiated a revision of the first expert consensus on the integrated diagnosis, treatment, and management of WDRD. This effort brought together experts in hepatology, encephalopathy (neurology), and nephrology from many tertiary-level grade A hospitals and research institutions across China. Through comprehensive literature review and integration of frontline clinical experience, the expert group jointly developed Chinese Expert Consensus on Integrated Chinese and Western Medicine Management of Wilson Disease-related Renal Damage (hereinafter referred to as the "Consensus"). This article provides a detailed interpretation of the Consensus in terms of diagnostic criteria, traditional Chinese medicine (TCM) syndrome differentiation and treatment classification, and comprehensive disease management, aiming to better guide clinical application. Regarding diagnostic criteria, the Consensus integrates the latest standards in China and abroad, highlights the importance of biochemical diagnosis, and compensates for the limitations of genetic testing. In the area of TCM syndrome differentiation and treatment, the Consensus refines four major syndrome types, introduces a newly defined syndrome, i.e., phlegm, blood stasis, and heat accumulation, and elaborates on treatment principles, prescriptions, and clinical modification rules for each syndrome. For comprehensive disease management, the Consensus emphasizes multi-dimensional intervention strategies, including diet, exercise, emotional regulation, medication, and medical care, with the goal of maximally controlling the progression of renal dysfunction and helping patients achieve a better quality of life.
8.Analysis of red blood cell blood group gene polymorphism and applicability evaluation of PCR-TaqMan technology in the Hui ethnic blood donor population in Suzhou
Jia JIANG ; Zhihong FANG ; Zihao XU ; Kai WANG ; Nina JIANG
Chinese Journal of Blood Transfusion 2025;38(9):1218-1224
Objective: To investigate the characteristics of allele frequencies for 9 red blood cell (RBC) blood group systems in the Hui ethnic voluntary blood donor population of Suzhou using real-time fluorescence PCR technology, so as to provide technical support for establishing a RBC blood group genetic database. Methods: PCR-TaqMan technology was employed to perform genotyping detection for 9 RBC blood group systems using 144 samples from Hui voluntary blood donors in Suzhou, collected between October 2023 and August 2024. Results: Blood group allele frequencies among Suzhou Hui voluntary blood donors were distributed as follows: MNS system (M=0.566 0, N=0.434 0; S=0.079 9, s=0.920 1); Lutheran system (Lu
=0.003 5, Lu
=0.996 5; Au
=0.895 8, Au
=0.104 2); Kell system (K=0.000 0, k=1.000 0; Kp
=0.003 5, Kp
=0.996 5; JS
=0.000 0, JS
=1.000 0); Duffy system (Fy
=0.899 3, Fy
=0.100 7); Kidd system (JK
=0.451 4, JK
=0.548 6); Diego system (Di
=0.041 7, Di
=0.958 3); Yt system (Yt
=0.996 5, Yt
=0.003 5); Dombrock system (Do
=0.128 5, Do
=0.871 5); Colton system (Co
=1.000 0, Co
=0.000 0). The PCR-TaqMan-based RBC blood group genotyping technology successfully completed testing for all samples. Conclusion: The MNS, Lutheran, Duffy, Kidd, Diego, and Dombrock blood group systems in the Suzhou Hui population exhibited polymorphic distribution patterns, whereas the Colton system was monomorphic. Standardized application of PCR-TaqMan technology facilitates the establishment of an RBC blood group genetic database.
9.Expert consensus on digital restoration of complete dentures.
Yue FENG ; Zhihong FENG ; Jing LI ; Jihua CHEN ; Haiyang YU ; Xinquan JIANG ; Yongsheng ZHOU ; Yumei ZHANG ; Cui HUANG ; Baiping FU ; Yan WANG ; Hui CHENG ; Jianfeng MA ; Qingsong JIANG ; Hongbing LIAO ; Chufan MA ; Weicai LIU ; Guofeng WU ; Sheng YANG ; Zhe WU ; Shizhu BAI ; Ming FANG ; Yan DONG ; Jiang WU ; Lin NIU ; Ling ZHANG ; Fu WANG ; Lina NIU
International Journal of Oral Science 2025;17(1):58-58
Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans
;
Denture, Complete
;
Computer-Aided Design
;
Denture Design/methods*
;
Consensus
;
Printing, Three-Dimensional
10.Exploration of the Dosage Pattern and Mechanism of Chinese Medicines for the Treatment of Alzheimer's Disease Based on Data Mining,Network Pharmacology and Molecular Simulation
Shuyang ZHAO ; Jianhe ZHAO ; Zhihong LIU ; Jun WU ; Ailin LIU ; Jiansong FANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(6):1766-1779
Objective Based on the Ancient and Modern Medical Case Cloud Platform V2.3.7,analyze the medication pattern and mechanism of action of Chinese medicines commonly used in famous medical cases for the treatment of Alzheimer's disease(AD).Methods The core Chinese medicines for AD were screened according to the inclusion and exclusion criteria by searching the famous Chinese medicine cases in the platform,then established the disease-core Chinese medicines-active ingredients-common targets network.The protein-protein interaction network(PPI)was established through the common targets.Gene oncology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were performed by David platform.Molecular docking and dynamics simulations were employed to evaluate the binding affinity and stability between key targets and active ingredients.Results Data mining was performed on all the famous medical cases from the time of database construction to October 2023,and the results were summarized as follows.The high-frequency regulating Qi medications and tonifying Qi medications were Citri Reticulatae Pericarpium and Aurantii Fructus Immaturus;Panax ginseng,Ziziphi Jujubae Fructus,Codonopsis pilosula,Astragali Radix,Atractylodis Macrocephalae Rhizoma,Dioscoreae Rhizoma,and Glycyrrhizae Radix et Rhizoma.The core herbs contained 778 active ingredients and 377 targets;1986 disease targets;79 common targets were obtained after intersection with AD targets,and 7 core targets were identified through PPI network topology analysis,including TNF,AKT1,TP53,PPARG,etc.GO and KEGG pathway enrichment analyses confirmed that the targets of the active ingredients of the core herbs involved 138 pathways,and the core herbs could regulate chemical carcinogenesis-receptor activation、serotonergic synapse、chemical carcinogenesis-reactive oxygen species pathways to treat AD.Molecular docking and molecular dynamics simulation results showed good binding ability and stability between the key targets and the core components.Conclusion Through data mining to analyze the core herbs for the treatment of AD,the present investigation showing the pharmacological mechanism of 12-O-Nicotinoylisolineolone and Odoratin in the treatment of Alzheimer's disease at the molecular level,lay a certain theoretical foundation of 12-O-Nicotinoylisolineolone and Odoratin in the future.

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