1.Application and Advance of Image Compression Algorithms in Medical Imaging
Jiawen SHANG ; Peng HUANG ; Zhixing CHANG ; Yuhan FAN ; Zhihui HU ; Ke ZHANG ; Jianrong DAI ; Hui YAN
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1281-1290
Medical imaging technology plays a crucial role in clinical diagnosis and treatment. Image compression technology provides robust technical support for the storage and transmission of massive medical imaging data, serving as an effective safeguard for hospital data backup and telemedicine. The technology holds broad application prospects in the medical field, enabling the processing of various imaging modalities, multidimensional imaging, and medical video imaging. This study elaborates on general image and video compression algorithms, the application of compression algorithms in the medical field, and the performance metrics of medical image compression, thereby providing critical technical support for enhancing clinical diagnostic efficiency and data management security.
2.Oxylipidomics Combined with Transcriptomics Reveals Mechanism of Jianpi Huogu Prescription in Treating Steroid-induced Osteonecrosis of Femoral Head in Rats
Lili WANG ; Qun LI ; Zhixing HU ; Qianqian YAN ; Liting XU ; Xiaoxiao WANG ; Chunyan ZHU ; Yanqiong ZHANG ; Weiheng CHEN ; Haijun HE ; Chunfang LIU ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):190-199
ObjectiveTo unveil the mechanism of Jianpi Huogu prescription (JPHGP) in ameliorating the dyslipidemia of steroid-induced osteonecrosis of the femur head (SONFH) by oxylipidomics combined with transcriptomics. MethodsSixty SD rats were assigned into normal, model, low-, medium-, and high-dose (2.5, 5, 10 g·kg-1, respectively) JPHGP, and Jiangushengwan (1.53 g·kg-1) groups. Lipopolysaccharide was injected into the tail vein at a dose of 20 μg·kg-1 on days 1 and 2, and methylprednisolone sodium succinate was injected at a dose of 40 mg·kg-1 into the buttock muscle on days 3 to 5. The normal group received an equal volume of normal saline. Drug administration by gavage began 4 weeks after the last injection, and samples were taken after administration for 8 weeks. Hematoxylin-eosin staining was conducted to reveal the histopathological changes of the femoral head, and the number of adipocytes, the rate of empty bone lacunae, and the trabecular area were calculated. Micro-computed tomography was used for revealing the histological and histomorphometrical changes of the femoral head. Enzyme-linked immunosorbent assay was employed to measure the serum levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB). At the same time, the femoral head was collected for oxylipidomic and transcriptomic detection. The differential metabolites and differential genes were enriched and analyzed, and the target genes regulating lipid metabolism were predicted. The predicted target proteins were further verified by molecular docking, immunohistochemistry, and Western blot. ResultsCompared with the normal group, the model group showcased thinning of the femoral head, trabecular fracture, karyopyknosis, subchondral cystic degeneration, increases in the number of adipocytes and the rate of empty bone lacunae (P<0.01), a reduction in the trabecular area (P<0.01), decreases in BMD, Tb.Th, Tb.N, and BV/TV, and increases in Tb.Sp and BS/BV (P<0.01). Compared with the model group, the JPHGP groups showed no obvious thinning of the femoral head or subchondroidal cystic degeneration. The high- and medium-dose JPHGP groups presented declines in the number of adipocytes and the rate of empty bone lacunae, an increase in the trabecular area (P<0.05, P<0.01), rises in BMD, Tb.Th, Tb.N, and BV/TV, and decreases in Tb.Sp and BS/BV (P<0.05, P<0.01). Compared with the normal group, the model group showcased raised serum levels of TG, TC, LDL, and ApoB and lowered serum levels of HDL and ApoA1 (P<0.01). Compared with the model group, the JPHGP groups had lowered serum levels of TG, TC, LDL, and ApoB (P<0.05, P<0.01) and a risen serum level of ApoA1 (P<0.05, P<0.01). Moreover, the serum level of HDL in the high-dose JPHGP group increased (P<0.01). A total of 19 different metabolites of disease set and drug set were screened out by oxylipidomics of the femoral head, and 119 core genes with restored expression were detected by transcriptomics. The enriched pathways were mainly concentrated in inflammation, lipids, apoptosis, and osteoclast differentiation. Molecular docking, immunohistochemistry, and Western blot results showed that compared with the normal group, the model group displayed increased content of 5-lipoxygenase (5-LO) and peroxisome proliferator-activated receptor γ (PPARγ) in the femoral head (P<0.01). Compared with the model group, medium- and high-dose JPHGP reduced the content of 5-LO and PPARγ (P<0.05, P<0.01). ConclusionJPHGP can restore the levels of oxidized lipid metabolites by regulating the 5-LO-PPARγ axis to treat SONFH in rats. Relevant studies provide experimental evidence for the efficacy mechanism of JPHGP in the treatment of SONFH.
3.Oxylipidomics Combined with Transcriptomics Reveals Mechanism of Jianpi Huogu Prescription in Treating Steroid-induced Osteonecrosis of Femoral Head in Rats
Lili WANG ; Qun LI ; Zhixing HU ; Qianqian YAN ; Liting XU ; Xiaoxiao WANG ; Chunyan ZHU ; Yanqiong ZHANG ; Weiheng CHEN ; Haijun HE ; Chunfang LIU ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):190-199
ObjectiveTo unveil the mechanism of Jianpi Huogu prescription (JPHGP) in ameliorating the dyslipidemia of steroid-induced osteonecrosis of the femur head (SONFH) by oxylipidomics combined with transcriptomics. MethodsSixty SD rats were assigned into normal, model, low-, medium-, and high-dose (2.5, 5, 10 g·kg-1, respectively) JPHGP, and Jiangushengwan (1.53 g·kg-1) groups. Lipopolysaccharide was injected into the tail vein at a dose of 20 μg·kg-1 on days 1 and 2, and methylprednisolone sodium succinate was injected at a dose of 40 mg·kg-1 into the buttock muscle on days 3 to 5. The normal group received an equal volume of normal saline. Drug administration by gavage began 4 weeks after the last injection, and samples were taken after administration for 8 weeks. Hematoxylin-eosin staining was conducted to reveal the histopathological changes of the femoral head, and the number of adipocytes, the rate of empty bone lacunae, and the trabecular area were calculated. Micro-computed tomography was used for revealing the histological and histomorphometrical changes of the femoral head. Enzyme-linked immunosorbent assay was employed to measure the serum levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB). At the same time, the femoral head was collected for oxylipidomic and transcriptomic detection. The differential metabolites and differential genes were enriched and analyzed, and the target genes regulating lipid metabolism were predicted. The predicted target proteins were further verified by molecular docking, immunohistochemistry, and Western blot. ResultsCompared with the normal group, the model group showcased thinning of the femoral head, trabecular fracture, karyopyknosis, subchondral cystic degeneration, increases in the number of adipocytes and the rate of empty bone lacunae (P<0.01), a reduction in the trabecular area (P<0.01), decreases in BMD, Tb.Th, Tb.N, and BV/TV, and increases in Tb.Sp and BS/BV (P<0.01). Compared with the model group, the JPHGP groups showed no obvious thinning of the femoral head or subchondroidal cystic degeneration. The high- and medium-dose JPHGP groups presented declines in the number of adipocytes and the rate of empty bone lacunae, an increase in the trabecular area (P<0.05, P<0.01), rises in BMD, Tb.Th, Tb.N, and BV/TV, and decreases in Tb.Sp and BS/BV (P<0.05, P<0.01). Compared with the normal group, the model group showcased raised serum levels of TG, TC, LDL, and ApoB and lowered serum levels of HDL and ApoA1 (P<0.01). Compared with the model group, the JPHGP groups had lowered serum levels of TG, TC, LDL, and ApoB (P<0.05, P<0.01) and a risen serum level of ApoA1 (P<0.05, P<0.01). Moreover, the serum level of HDL in the high-dose JPHGP group increased (P<0.01). A total of 19 different metabolites of disease set and drug set were screened out by oxylipidomics of the femoral head, and 119 core genes with restored expression were detected by transcriptomics. The enriched pathways were mainly concentrated in inflammation, lipids, apoptosis, and osteoclast differentiation. Molecular docking, immunohistochemistry, and Western blot results showed that compared with the normal group, the model group displayed increased content of 5-lipoxygenase (5-LO) and peroxisome proliferator-activated receptor γ (PPARγ) in the femoral head (P<0.01). Compared with the model group, medium- and high-dose JPHGP reduced the content of 5-LO and PPARγ (P<0.05, P<0.01). ConclusionJPHGP can restore the levels of oxidized lipid metabolites by regulating the 5-LO-PPARγ axis to treat SONFH in rats. Relevant studies provide experimental evidence for the efficacy mechanism of JPHGP in the treatment of SONFH.
4.Tissue-resident peripheral helper T cells foster hepatocellular carcinoma immune evasion by promoting regulatory B-cell expansion.
Haoyuan YU ; Mengchen SHI ; Xuejiao LI ; Zhixing LIANG ; Kun LI ; Yongwei HU ; Siqi LI ; Mingshen ZHANG ; Yang YANG ; Yang LI ; Linsen YE
Chinese Medical Journal 2025;138(17):2148-2158
BACKGROUND:
Peripheral helper T (T PH ) cells are uniquely positioned within pathologically inflamed non-lymphoid tissues to stimulate B-cell responses and antibody production. However, the phenotype, function, and clinical relevance of T PH cells in hepatocellular carcinoma (HCC) are currently unknown.
METHODS:
Blood, tumor, and peritumoral liver tissue samples from 39 HCC patients (Sep 2016-Aug 2017) and 101 HCC patients (Sep 2011-Dec 2012) at the Third Affiliated Hospital of Sun Yat-sen University were used. Flow cytometry was used to quantify the expression, phenotype, and function of T PH cells. Log-rank tests were performed to evaluate disease-free survival and overall survival in samples from 39 patients and 101 patients with HCC. T PH cells, CD19 + B cells, and T follicular helper (T FH ) cells were cultured separately in vitro or isolated from C57/B6L mice in vivo for functional assays.
RESULTS:
T PH cells highly infiltrated tumor tissues, which was correlated with tumor size, early recurrence, and shorter survival time. The tumor-infiltrated T PH cells showed a unique ICOS hi CXCL13 + IL-21 - MAF + BCL-6 - phenotype and triggered naïve B-cell differentiation into regulatory B cells. Triggering programmed cell death protein 1 (PD-1) induced the production of C-X-C motif chemokine ligand 13 (CXCL13) by T PH cells, which then suppressed tumor-specific immunity and promoted disease progression.
CONCLUSION
Our study reveals a novel regulatory mechanism of T PH cell-regulatory B-cell-mediated immunosuppression and provides an important perspective for determining the balance between the differentiation of protumorigenic T PH cells and that of antitumorigenic T FH cells in the HCC microenvironment.
Carcinoma, Hepatocellular/metabolism*
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Liver Neoplasms/metabolism*
;
Humans
;
T-Lymphocytes, Helper-Inducer/metabolism*
;
Animals
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Mice
;
Male
;
Female
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Mice, Inbred C57BL
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Middle Aged
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B-Lymphocytes, Regulatory/metabolism*
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Flow Cytometry
;
Interleukin-21
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Aged
;
Chemokine CXCL13/metabolism*
5.The factors affecting the prognosis of complex intracranial aneurysms treated with pipeline flow-direction device and the construction of a nomogram prediction model
Ziyin ZHANG ; Dong QIU ; Ping ZHENG ; Yang AN ; Tao ZHANG ; Xuesong TANG ; Zhixing YAN ; Suwen LI ; Liping YIN ; Yongji JIANG ; Ligang HU ; Jingfeng TANG
Journal of Interventional Radiology 2024;33(9):944-949
Objective To investigate the factors influencing the prognosis of complex intracranial aneurysms treated with pipeline flow-directed device(PED)and to develop a nomogram prediction model.Methods The clinical data of a total of 98 patients with complex intracranial aneurysm,who were admitted to the Anyue County People's Hospital or the Second Affiliated Hospital of Guilin Medical College of China from January 2021 to April 2023 to receive PED treatment,were retrospectively analyzed.The influencing factors that might affect the prognosis of patients with complex intracranial aneurysm were collected.According to the modified Rankin Scale(mRS)score,the patients were divided into good prognosis group(being defined as mRS ≤2 points)and poor prognosis group(being defined as mRS>2 points).The clinical data were compared between the two groups,and a nomogram model was established and validated.Results In the 98 patients,poor prognosis was seen in 10(10.20%).The differences in age,history of hypertension,history of diabetes mellitus,clopidogrel resistance,Fisher classification,repeated aneurysm rupture,aneurysm location,aneurysm size,aneurysm neck,multiple lesions,and Hunt-Hess grade on admission between good prognosis group and poor prognosis group were statistically significant(all P<0.05).Multivariate analysis revealed that history of hypertension,clopidogrel resistance,repeated aneurysm rupture,aneurysm location,multiple lesions,and Hunt-Hess grade were the independent factors influencing the prognosis of patients with complex intracranial aneurysm after receiving PED treatment.The AUC of the nomogram model in predicting the prognosis of PED for complex intracranial aneurysms was 0.849(95%CI=0.758-0.939).The predicted curves of the model group and validation group were basically fitted to the standard curves.The results of the decision curve analysis showed that the net benefit to patients was greater than 0 when the probability threshold of the nomogram model for predicting a poor prognosis of PED for complex intracranial aneurysms was 0.10-0.90.Conclusion The factors causing poor prognosis of PED for complex intracranial aneurysms mainly include history of hypertension,clopidogrel resistance,repeated aneurysm rupture,etc.The nomogram model established in this study can predict the risk of poor prognosis in patients with complicated intracranial aneurysm after receiving PED treatment.
6.Network meta-analysis of the modeling effects of different factors on rabbit models of steroid-induced osteonecrosis of femoral head
Zhixing HU ; Qun LI ; Chao YANG ; Xiaoxiao WANG ; Luochangting FANG ; Wuqiong HOU ; Na LIN ; Weiheng CHEN ; Chunfang LIU ; Ya LIN
Chinese Journal of Tissue Engineering Research 2024;28(6):976-984
OBJECTIVE:The rabbit model of steroid-induced osteonecrosis of femoral head is the most commonly used animal model of femoral head necrosis.The pathological changes of the femoral head are close to clinical practice,however,the conditions,methods and evaluation standards of animal models reported in and outside China are not uniform,which leads to the low scientific value of animal models and is difficult to popularize.This study aimed to clarify the influence of different mold-making conditions on the establishment of steroid-induced osteonecrosis of femoral head rabbit model and analyze the appropriate conditions for the successful model establishment. METHODS:We searched the CNKI,WanFang,VIP,CBM,WoS,PubMed and EMbsae databases for the literature on the modeling of steroid-induced osteonecrosis of femoral head rabbits up to April 1,2022,completed the screening of the literature according to the inclusion and exclusion criteria and literature quality evaluation,and extracted the outcome index data in the literature.RevMan Stata and ADDIS statistical software were used to conduct a meta-analysis of the included data. RESULTS:(1)A total of 82 articles with 1 366 rabbits were included in the study.The steroid-induced osteonecrosis of femoral head modeling methods were divided into three types:steroid-alone method,steroid combined lipopolysaccharide method and steroid combined serum method.Among these,33 articles used steroid-alone method;20 articles used steroid combined lipopolysaccharide method;29 articles used steroid combined serum method.(2)Meta-analysis results showed that the three modeling methods significantly increased the rate of empty bone lacunae in the femoral head of steroid-induced osteonecrosis of femoral head rabbits(P<0.001),and significantly decreased the ratio of the trabecular bone area in the femoral head of steroid-induced osteonecrosis of femoral head rabbits(P<0.001).The order of empty bone lacunae rate of each modeling method was:steroid combined with lipopolysaccharide method>steroid-alone method>steroid combined with serum method>normal group,and the order of trabecular bone area rate of each modeling method was:normal group>steroid combined with serum method>steroid-alone method>steroid combined with lipopolysaccharide method.(3)The results of subgroup analysis suggested that the rate of empty bone lacunae in the rabbit model induced by steroid alone might be related to the rabbit variety and the type of steroid used for modeling(difference between groups P<0.05),in which the combined effect amount of New Zealand white rabbits was higher than that of Chinese white rabbits(P<0.05)and Japanese white rabbits,and the combined effect amount of dexamethasone was higher than that of other steroids.The rate of empty bone lacunae induced by steroid combined with lipopolysaccharide was related to the administration mode of lipopolysaccharide and the type of steroid(P<0.05),among which the combined effect of methylprednisolone sodium succinate was significantly higher than that of other steroids(P<0.05),and the combined effect of prednisolone was significantly lower than that of other steroids(P<0.05).The combined effect of lipopolysaccharide 100 μg/kg×twice was significantly lower than 10 μg/kg×twice and 50 μg/kg×twice(P<0.05).The rate of empty bone lacunae in the model induced by steroid combined with serum was related to serum dose and steroid type(P<0.05),among which the combined effect amount of dexamethasone sodium phosphate was significantly higher than other steroid types(P<0.05),and the combined effect amount of dexamethasone was significantly lower than other steroid types(P<0.05);the combined effect amount of serum"10 mL/kg+6 mL/kg"combined dose was lower than other serum doses(P<0.05). CONCLUSION:(1)With the rate of empty bone lacunae and the ratio of trabecular bone area as the judgment standard for the successful establishment of the model,the three modeling methods can successfully construct the rabbit steroid-induced osteonecrosis of femoral head model,of which the steroid combined with lipopolysaccharide method is the best.(2)New Zealand white rabbits and dexamethasone are recommended when selecting the steroid-alone method.Methylprednisolone sodium succinate and low-dose lipopolysaccharide are recommended when selecting the steroid combined with lipopolysaccharide method.Dexamethasone sodium phosphate is recommended when selecting the steroid combined with serum modeling method.
7.Protective Effect of Jianpi Huogu Prescription on Functional Injury of Vascular Endothelial Cells Caused by Alcohol Based on Akt/JNK/p38 MAPK Signaling Pathway
Xiaoxiao WANG ; Lianhua HE ; Changting FANG-LUO ; Qun LI ; Chao YANG ; Zhixing HU ; Weiheng CHEN ; Chunfang LIU ; Lan HAN ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(11):64-71
ObjectiveTo investigate the protective effect of Jianpi Huogu prescription (JPHGP) on the functional injury of vascular endothelial cells caused by alcohol and explore its mechanism based on protein kinase B/c-Jun amino-terminal kinase/p38 MAPK (Akt/JNK/p38 MAPK) signaling pathway. MethodThrough chick embryo allantoic membrane, thoracic aortic ring, and migration, invasion, adhesion, and lumen formation of human umbilical vein endothelial cells (HUVEC), the effect of JPHGP with different concentrations (8, 16 and 32 μg·L-1) on angiogenesis was observed in the presence or absence of alcohol. The expression levels of phosphorylation of Akt, JNK, and p38 MAPK were determined by Western blot. ResultAs compared with the normal group, the number and length of capillaries around the arterial ring in the model group were decreased, and the migration, invasion, and lumen formation capacity of HUVEC were decreased (P<0.05, P<0.01). After treatment with 16 and 32 μg·L-1 JPHGP, the length of neovascularization in chick embryo allantoic membrane was significantly increased (P<0.05, P<0.01). Compared with the model group, the 8, 16, and 32 μg·L-1 JPHGP groups increased the number of capillaries around the thoracic aortic ring in a concentration-dependent manner (P<0.05, P<0.01), and the 32 μg·L-1 JPHGP group increased the length of capillaries around the thoracic aortic ring (P<0.05). The 16 and 32 μg·L-1 JPHGP groups enhanced the migration, invasion, and lumen formation capacity of HUVEC. The results of Western blot showed that, as compared with the normal group, the protein expression levels of p-JNK/JNK, p-p38 MAPK/p38 MAPK, and p-Akt/Akt were significantly decreased in the model group (P<0.01), and as compared with the model group, the protein expression levels of p-p38 MAPK/p38 MAPK and p-Akt/Akt were significantly increased in the 8, 16, and 32 μg·L-1 JPHGP groups (P<0.01) and the protein expression level of p-JNK/JNK was increased significantly in the 16 and 32 μg·L-1 JPHGP groups (P<0.01). ConclusionJPHGP has a protective effect on the functional injury of vascular endothelial cells caused by alcohol, and its mechanism may be related to the activation of Akt/JNK/p38 MAPK signaling pathway. Relevant research results will provide certain scientific basis for clarifying the effect of JPHGP on 'invigorating spleen and promoting blood circulation'.
8.Repair Mechanism of Jianpi Huogu Prescription on Vascular Injury in Alcohol-induced Osteonecrosis of Femoral Head Based on VEGF/VEGFR2/PI3K/Akt Signaling Pathway
Changting FANG-LUO ; Qianqian WANG ; Congcong SUN ; Qun LI ; Chao YANG ; Xiaoxiao WANG ; Zhixing HU ; Chunfang LIU ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):186-194
MethodIn the experiment, 46% vol Red Star Erguotou (10 mL·kg·d-1) was used to establish the AONFH rat model, and the intervention effect of JPHGP at different doses (2.5, 5.0, 10.0 g·kg-1) was observed. Jiangusheng pill (JGS, 1.53 g·kg-1) was selected as the positive control. After 8 weeks of administration, the bone histomorphometry of the femoral head was analyzed by Micro-CT imaging, and the area of medullary microvessels in the femoral head was detected by ink perfusion. The pathological change was observed by hematoxylin and eosin (HE) staining. The protein expressions of Platelet endothelial cell adhesion molecule-1 (CD31), VEGF, VEGFR2, PI3K, phosphor-Akt (p-Akt) and phosphatase and Tensin homologue deleted on chromosome 10 (PTEN) in the femoral head were determined by immunohistochemistry and Western blot. ResultCompared with normal group, the model group presented the fracture and thinning of trabeculae in the femoral head, increased empty bone lacunae, and elevated number and diameter of adipocytes (P<0.01). Micro-CT imaging revealed a decrease in bone mineral density (BMD), bone volume fraction (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N) (P<0.05, P<0.01) while an increase in bone surface-to-volume ratio (BS/BV) and trabecular separation (Tb.Sp) (P<0.01). The results of ink perfusion showed that the area of medullary microvessels in the femoral head was reduced (P<0.01). Compared with model group, JPHGP lowered the empty bone lacunae rate as well as the number and diameter of adipocytes in the femoral head of AONFH rats. Micro-CT imaging indicated that JPHGP low-dose group had elevated BV/TV, Tb.Th and Tb.N (P<0.05, P<0.01) while decreased BS/BV (P<0.01), and there was an upward trend in BMD while a downward trend in Tb.Sp, but without statistical difference. In addition, JPHGP medium- and high-dose groups had a rise in BMD, BV/TV, Tb.Th and Tb.N (P<0.05, P<0.01), a decrease in BS/BV and Tb.Sp (P<0.05, P<0.01) and enlarged area of medullary microvessels in the femoral head (P<0.05, P<0.01). The expressions of CD31, VEGF, VEGFR2, PI3K, p-Akt in the model group were lower than those in the normal group (P<0.01), and after medium and high doses of JPHGP treatment, the expressions of CD31, PI3K and p-Akt in the femoral head of rats were up-regulated (P<0.01) while the protein expression of PTEN was down-regulated (P<0.01). Moreover, JPHGP up-regulated the expressions of VEGF and VEGFR2 (P<0.05, P<0.01). ConclusionJPHGP can repair the vascular injury in AONFH, and its mechanism may be related to the activation of VEGF/VEGFR2/PI3K/Akt signaling pathway. This study provides certain scientific basis and reference for the clinical application of JPHGP. ObjecctiveTo observe the repair effect of Jianpi Huogu prescription (JPHGP) on vascular injury in experimental alcohol-induced osteonecrosis of femoral head (AONFH), and to explore its mechanism based on vascular endothelial growth factor (VEGF)/VEGFR2/phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway.
9.Meta-analysis of Effect of Tripterygium wilfordii Polyglycoside Tablets Combined with Methotrexate and/or Leflunomide on Autoantibodies in Rheumatoid Arthritis
Chao YANG ; Zhixing HU ; Ruirui MING ; Tengteng XU ; Luochangting FANG ; Xiaoxiao WANG ; Taixian LI ; Lin CHEN ; Chunfang LIU
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(5):39-48
ObjectiveTo evaluate the effect of Tripterygium wilfordii polyglycoside tablets (TWPT) combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) including methotrexate (MTX) and/or leflunomide (LEF) on autoantibodies in rheumatoid arthritis (RA) patients. MethodPubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, Wanfang Data, and China Biomedical Literature Service System (SinoMed) were searched for randomized controlled trials (RCTs) of TWPT combined with MTX and/or LEF in the treatment of RA patients from database inception to December 1, 2021. Primary outcome indicators included rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA), and secondary outcome indicators included immunoglobulin (IgA, IgG, and IgM) and adverse drug events (ADE). ResultThirty-one RCTs, involving 2 643 adult patients, were included, including 20 RCTs of TWPT combined with MTX, 10 of TWPT combined with LEF, and one of TWPT combined with MTX and TWPT. The follow-up time ranged from two weeks to 13 months. Compared with csDMARDs alone, TWPT combined with other drugs significantly improved serum RF of RA patients [SMD=-2.45, 95% CI [-2.97, -1.93], P<0.000 01], anti-CCP [SMD=-1.41, 95% CI (-2.35, -0.48), P=0.003], IgM [SMD=-1.90, 95% CI (-3.03, -0.76), P=0.001], and IgA [SMD=-1.18, 95% CI (-2.23, -0.12), P=0.03]. There were no significant effects on IgG [SMD=-1.02, 95% CI (-2.04, 0.01), P=0.05] and ADE [RR=0.87, 95% CI (0.66, 1.15), P=0.32]. ConclusionThe results of this study show that compared with csDMARDs alone, TWPT combined with csDMARDs can effectively improve the levels of autoantibodies in RA patients without increasing the incidence of ADE. However, due to the limited quality and quantity of the included RCTs, the relevant conclusions are only used as a reference for the clinical diagnosis and treatment of RA, and more high-quality studies are still needed to further confirm their efficacy.
10.Anti-swelling and Analgesic Mechanism of Jianpi Tongluo Prescription from MAPKs Signaling Pathway
Ruirui MING ; Changting FANG-LUO ; Xiaoxiao WANG ; Zhixing HU ; Chao YANG ; Tengteng XU ; Hongjie WANG ; Chunfang LIU ; Na LIN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(12):85-93
ObjectiveTo observe the anti-swelling and analgesic effects of Jianpi Tongluo prescription (JPTL) and to explore its mechanism initially. MethodA total of 120 ICR mice were divided into normal group, model group, JPTL low-, medium- and high-dose groups (5, 10, 20 g·kg-1) and positive drug (celecoxib, 0.03 g·kg-1) group, with 10 in each group (po,once a day). Complete freund's adjuvant (CFA) was used to induce the model of chronic inflammatory pain, and xylene-induced ear swelling test, hot plate test and acetic acid writhing test were performed to observe the anti-swelling and analgesic effects of different doses of JPTL in these four acute and chronic models. Further, enzyme-linked immunosorbent assay (ELISA) was used to detect the expressions of prostaglandin E2 (PGE2), interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum and inflammatory paw of mice with chronic inflammatory pain, and the expressions of aquaporin 1 (AQP1), aquaporin 3 (AQP3), cyclooxygenase 1 (COX1), cyclooxygenase 2 (COX2) and mitogen-activated protein kinases (MAPKs) in inflammatory paw were detected by Western blot, to explore the preliminary mechanism of JPTL. ResultCompared with the conditions in the normal group, there was a significant increase in the ear swelling of xylene-induced model mice, a shortened paw withdrawal latency in the hot plate test (P<0.01). Compared with the model group, JPTL remarkably increased the inhibition rate of xylene-induced ear swelling (P<0.05, P<0.01), prolonged the latency period of writhing caused by acetic acid and reduced the number of writhing (P<0.05, P<0.01). Compared with normal group, the degree of feet swelling in chronic inflammatory pain mice was significantly increased, the threshold of mechanical pain was decreased and the threshold of cold pain was increased (P<0.05, P<0.01), the protein contents of AQP1 and AQP3 in inflammatory feet were increased, and the contents of IL-1β, IL-6, TNF-α, PGE2 and COX2 in inflammatory feet were increased in serum and/or inflammatory feet. The protein expression levels of p-p38 MAPK, p-JNK and p-ERK in inflammatory feet were increased (P<0.01). Compared with the model group, JPTL relieved paw swelling of mice with chronic inflammatory pain, elevated mechanical withdrawal threshold while decreased cold withdrawal threshold, with analgesia lasting for 4 h and the optimal time point for analgesia being 2 h after administration (P<0.05, P<0.01). Moreover, JPTL down-regulated AQP1, AQP3, COX2, p-p38 MAPK, p-JNK and p-ERK in inflammatory paw of mice with chronic inflammatory pain and reduced IL-1β, IL-6, TNF-α, and PGE2 in serum and/or inflammatory paw, but it had no significant effect on COX1 (P<0.05, P<0.01). ConclusionJPTL has anti-swelling and analgesic effects, and its mechanism is related to inhibiting the production of cytokines and inflammatory mediators via the down-regulation of MAPKs signaling pathway, which provides an experimental basis for the clinical application of JPTL.

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