1.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
2.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
3.Ancient and Modern Documentation of Classic Formula Sangjuyin
Xiaofang WANG ; Lyuyuan LIANG ; Jialei CAO ; Ziming XU ; Wangju ZHOU ; Yiping WANG ; Yujie CHANG ; Ruiting SU ; Yihan LI ; Jingwen LI ; Bingqi WEI ; Bingxiang MA ; Wenli SHI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):200-207
Sangjuyin, as a pungent and cooling agent with precise therapeutic effect, is a classic pungent formula for cooling relief of the epidermis, which is highly respected by medical practitioners. This formula is from the Wenbing Tiaobian written by WU Jutong in the Qing dynasty, on the basis of which subsequent medical practitioners have made additions and subtractions to apply it. The authors used the bibliometric method to systematically organize the medical books from the Qing dynasty and the Republic of China and modern literature to analyze the composition, concoction, decoction, efficacy, and previous and modern application of Sangjuyin. After examination, the drug base of this formula is basically clear. Armeniacae Semen Amarum is the dried mature seeds of Armeniaca vulgaris, family Rosaceae. Forsythiae Fructus is the dried fruit of Forsythia suspensa, family Mulleinaceae. Menthae Haplocalycis Herba is the dried above-ground part of Mentha haplocalyx, family Labiatae. Mori Folium is the dried leaves of Morus alba, family Moraceae. Chrysanthemi Flos is the dried head of Chrysanthemum morifolium, family Asteraceae. Platycodonis Radix is the dried root of Eryngium grandiflorum, family Eryngium. Glycyrrhizae Radix et Rhizoma is the dried root and rhizome of Glycyrrhiza uralensis of the Leguminosae family, and Phragmitis Rhizoma is the fresh or dried rhizome of Phragmites communis of the Gramineae family. It is recommended that the eight drugs be used in raw form as medicine. The dosage and method of decoction were converted into a modern single dosage of 7.46 g Armeniacae Semen Amarum, 5.60 g Forsythiae Fructus, 2.98 g Menthae Haplocalycis Herba, 9.33 g Mori Folium, 3.73 g Chrysanthemi Flos, 7.46 g Platycodonis Radix, 2.98 g Glycyrrhizae Radix et Rhizoma, and 11.19 g Phragmitis Rhizoma, with 400 mL water added, and the solution was boiled to obtain 200 mL, taken twice a day. Sangjuyin has the efficacy of dispersing wind and clearing heat, promoting lung and relieving cough, and it is used for treating the initial onset of wind-warmth and the evidence of evil spirits in the lungs and collaterals. Modern research has shown that Sangjuyin is often used in the treatment of cough, pneumonia, rhinitis, and other respiratory diseases, and the results of this study provide a reference for the later development of Sangjuyin.
4.Discussion on Scientific Connotation of Vital Qi Strengthening for Detoxification Therapy in Treatment of Community-acquired Pneumonia Based on Theory of "Vital Qi Deficiency and Toxic Stasis"
Hanxiao WANG ; Zheyu LUAN ; Haotian XU ; Xin PENG ; Ziming DANG ; Kun YANG ; Qianqian WANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):226-234
Community-acquired pneumonia (CAP) refers to an infectious inflammation of the lung parenchyma (including the alveolar wall,that is,the broad pulmonary interstitium) acquired outside the hospital. Its common pathogens include streptococcus pneumoniae,respiratory viruses, mycoplasma pneumoniae, and so on. The related factors for the occurrence and development of CAP include patient characteristics (immune function,mucus production and clearance function,coagulation function,physical condition, and comorbidity) and pathogen characteristics (susceptibility,virulence,and antibiotic resistance). The pathogenesis of CAP lies in immune deficiency,pathogen invasion,inflammatory response disorder,mucus production and clearance disorder, coagulation disorder, and so on. The pathogenesis of CAP in traditional Chinese medicine can be described as "vital Qi deficiency and toxic stasis". Vital Qi deficiency (lack of immunity) is the potential pathogenesis of the disease and easy to be invaded by external pathogens (respiratory pathogens). Toxic stasis (inflammatory disorder,mucus production and clearance disorder,and coagulation dysfunction) is the key pathogenic factor. Vital Qi deficiency and toxic stasis are intermingled in a state of deficiency and excess,which suggests that the treatment of CAP lies in strengthening vital Qi and eliminating pathogenic factors. This involves strengthening vital Qi in the whole process to consolidate body resistance and nourish promordial Qi. It also involves clearing heat,eliminating phlegm,removing dampness,and dispelling stasis to dispel pathogenic toxins based on the syndrome differentiation. Its action mechanism is to regulate immune and inflammatory responses,resist pathogens,and improve mucus production and clearance, as well as coagulation disorders. Starting from the key pathogenesis of CAP,"vital Qi deficiency and toxic stasis", this paper discussed the pathogenesis of CAP and summarized the action mechanism of vital Qi strengthening for detoxification in its treatment. It is intended to complement the theoretical system by identifying "vital Qi deficiency and toxic stasis" as the key pathogenesis underlying CAP and the scientific connotation of treating CAP with vital Qi strengthening for detoxification,thereby providing insights for its clinical application.
5.Performance Evaluation and Resource Utilization Optimization of Multidisciplinary Team Model for Lung Cancer: A Real-World Study
Meng WANG ; Xiaoli ZHANG ; Jue LIU ; Jingyi TANG ; Ziming LI
Medical Journal of Peking Union Medical College Hospital 2026;17(3):637-645
To compare the performance differences between the multidisciplinary team (MDT) model and the conventional diagnostic and treatment model for lung cancer, and to explore a high-quality development pathway for optimizing lung cancer diagnostic and treatment resources. A retrospective analysis was conducted on electronic medical record data of lung cancer patients at Shanghai Chest Hospital from March 2025 to December 2025. Patients were divided into an MDT group and a conventional care group based on whether they were admitted to the integrated oncology ward. Statistical analyses were performed using the Mann-Whitney A total of 4, 758 patients with primary lung cancer were included, comprising 365 (7.7%) in the MDT group and 4, 393 (92.3%) in the conventional care group. After adjusting for confounding factors, the MDT model significantly reduced hospitalization frequency during the observation period by 48.8% ( The MDT model for lung cancer significantly reduces hospitalization frequency; however, its effect on cost per hospitalization is population-selective, with increased costs in early-stage (stage Ⅰ) patients and decreased costs in late-stage (stages Ⅱ and Ⅳ) patients. The implementation of the MDT model should adopt precise patient stratification management, prioritizing the optimal patient population to achieve the optimal allocation of medical resources.
6.Critical role of mitochondrial dynamics in chronic respiratory diseases and new therapeutic directions.
Xiaomei WANG ; Ziming ZHU ; Haocheng JIA ; Xueyi LU ; Yingze ZHANG ; Yingxin ZHU ; Jinzheng WANG ; Yanfang WANG ; Rubin TAN ; Jinxiang YUAN
Chinese Medical Journal 2025;138(15):1783-1793
Chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH) are both chronic progressive respiratory diseases that cannot be completely cured. COPD is characterized by irreversible airflow limitation, chronic airway inflammation, and gradual decline in lung function, whereas PH is characterized by pulmonary vasoconstriction, remodeling, and infiltration of inflammatory cells. These diseases have similar pathological features, such as vascular hyperplasia, arteriolar contraction, and inflammatory infiltration. Despite these well-documented observations, the exact mechanisms underlying the occurrence and development of COPD and PH remain unclear. Evidence that mitochondrial dynamics imbalance is one major factor in the development of COPD and PH. Mitochondrial dynamics is precisely regulated by mitochondrial fusion proteins and fission proteins. When mitochondrial dynamics equilibrium is disrupted, it causes mitochondrial and even cell morphological dysfunction. Mitochondrial dynamics participates in various pathological processes for heart and lung disease. Mitochondrial dynamics may be different in the early and late stages of COPD and PH. In the early stages of the disease, mitochondrial fusion increases, inhibiting fission, and thereby compensatorily increasing adenosine triphosphate (ATP) production. With the development of the disease, mitochondria decompensation causes excessive fission. Mitochondrial dynamics is involved in the development of COPD and PH in a spatiotemporal manner. Based on this understanding, treatment strategies for mitochondrial dynamics abnormalities may be different at different stages of COPD and PH disease. This article will provide new ideas for the potential treatment of related diseases.
Humans
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Mitochondrial Dynamics/physiology*
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Pulmonary Disease, Chronic Obstructive/metabolism*
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Hypertension, Pulmonary/metabolism*
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Mitochondria/metabolism*
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Animals
7.A comparison of the efficacy between single-position robot-assisted laparoscopic and retroperitoneal laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma
Wanrong XU ; Tianyu GAO ; Ziming KANG ; Cheng WANG ; Panfeng SHANG
Journal of Modern Urology 2025;30(4):315-321
Objective: To explore the clinical safety and efficacy of a single-position robot-assisted radical nephroureterectomy (RRUN) in the treatment of upper tract urothelial carcinoma (UTUC). Methods: A retrospective study was conducted on 136 UTUC patients who underwent RRUN (n=35) and laparoscopic radical nephroureterectomy (LRUN,n=101) in our hospital during Dec.2020 and Aug.2023.The perioperative and safety indicators of the two groups were compared.The intravesical recurrence-free survival (IVRFS),recurrence-free survival (RFS),and overall survival (OS) of the two groups were compared using Kaplan-Meier method. Results: There were no significant differences in the baseline data between the two groups (P>0.05).All surgeries were successfully completed without conversion to open surgery.RRUN demonstrated superior perioperative outcomes compared to LRUN in overall postoperative complication rate [37.1%(13/35) vs. 56.4%(57/101)],postoperative hospital stay [6(5,7) days vs. 7(6,8) days],and catheter indwelling time [3(2,4) days vs. 4(3,5) days],with statistically significant differences (P<0.05).Safety indicators of both surgical approaches were similar (P>0.05).Survival analysis showed no significant difference in oncological outcomes between the two groups [IVRFS (1 year:92.1%,2 years:85.2%),RFS (1 year:82.4%,2 years:74.9%),OS (1 year:90.6%,2 years:84.2%)] (P>0.05). Conclusion: Compared with retroperitoneal LRUN,single-position RRUN for UTUC demonstrates comparable safety and oncological efficacy,while offering significant advantages in perioperative outcomes such as reducing postoperative complication rate and shortening hospital stay.
8.Early functional brain network characteristics in neonatal hypoxic-ischemic encephalopathy assessed by functional near-infrared spectroscopy
Ziming WANG ; Zhuoyu ZHAO ; Ling ZHAO ; Jiayu ZHOU ; Yingying JIANG ; Laishuan WANG
Chinese Journal of Perinatal Medicine 2025;28(4):273-279
Objective:To investigate the clinical utility of functional near-infrared spectroscopy (fNIRS) in evaluating cerebral function in neonates with hypoxic-ischemic encephalopathy (HIE).Methods:This was a case-control study. Fifteen neonates with moderate to severe HIE who were admitted to the Department of Neonatal Medical Center, Children's Hospital of Fudan University from March 2023 to August 2024 and completed fNIRS testing were selected as the HIE group, and 15 full-term infants without neurological diseases and completed fNIRS testing were selected as the control group during the same period. Resting-state fNIRS data were acquired to construct cerebral functional connectivity networks and topological properties were analyzed. Statistical analyses included independent t-tests, Mann-Whitney U tests, analysis of variance, and Chi-square tests. Results:Compared with controls, the HIE group exhibited significantly reduced global functional connectivity strength [0.15 (0.05-0.26) vs. 0.24 (0.13-0.35), Z=-7.66, P<0.001]. Both groups demonstrated small-world network properties, with no intergroup difference (1.17±0.05 vs. 1.14±0.05, t=2.02, P=0.050). The HIE group showed decreased shortest path length (6.22±0.52 vs. 13.74±0.49, t=48.18, P<0.001), global efficiency (0.26±0.04 vs. 0.30±0.05, t=2.50, P=0.018) and normalized shortest path length (1.50±0.07 vs. 1.62±0.22, t=2.43, P=0.020). No differences were observed in the clustering coefficient or local efficiency between the two groups. Regional analysis revealed reduced nodal efficiency in both left (0.30±0.06 vs. 0.35±0.05, t=2.47, P=0.021) and right hemispheres (0.30±0.06 vs. 0.37±0.06, t=2.68, P=0.013) in HIE neonates compared with that of the corresponding hemispheres in the control group. The intra-group comparison showed no statistical significance in node efficiency between the left and right hemispheres (both P>0.05). Conclusion:fNIRS captures functional network signatures in HIE, demonstrating clinical potential for early detection of cerebral dysfunction in neonates with hypoxic-ischemic injury.
9.Artificial intelligence in epidemiology: a decade-long bibliometric analysis
Conghui WANG ; Ziming YANG ; Wei SHI ; Chengwei XI ; Shucheng SI ; Liuliu WU ; Jian DU ; Shengfeng WANG ; Siyan ZHAN
Chinese Journal of Epidemiology 2025;46(9):1650-1659
Objective:To describe the hotspots and application trends of artificial intelligence (AI) in epidemiology in the past decade and analyze its advantages and challenges.Methods:The literatures with AI and epidemiology related keywords were systematically retrieved from Web of Science and China National Knowledge Infrastructure from 2014 to 2024. CiteSpace was used for bibliometric analysis of publication volume, keyword co-occurrence, clustering, emergence and cited literature co-occurrence analysis.Results:A total of 5 389 English papers and 1 659 Chinese papers were included, showing an increasing publication trend. High-frequency Chinese keywords included prediction, influencing factor, and machine learning, while English keywords frequently used were machine learning, prediction, and artificial intelligence. The Chinese keywords formed 14 clusters such as epidemiological characteristic, dietary pattern, and elderly individual, and the English keywords formed 21 clusters including prediction model, risk factor, and adult. In international studies, health policy, COVID-19, and digital health were the emerging frontier keywords. Eleven core papers were selected, covering key areas like traffic accident risk assessment, public health big data application, and deep learning in medical diagnosis.Conclusions:This study systematically summarized the research hotspots and development trends of AI applications in epidemiology over the past decade by using bibliometric methods, which indicated that current AI-based epidemiological studies are still in the exploratory phase, with the coexisting of both advantages and challenges. Continued attention should be paid to the future development of this field.
10.Analysis of prognostic influencing factors of isocitrate dehydrogenase wild-type glioma
Ziming HOU ; Zhe HOU ; Dongyuan LIU ; Yinyan WANG ; Hongbing ZHANG ; Hao WANG
Chinese Journal of Postgraduates of Medicine 2025;48(11):1029-1034
Objective:To analyze the prognostic influencing factors in patients with isocitrate dehydrogenase (IDH) wild-type glioma, and further evaluate the value of surgical resection in prognosis.Methods:The clinical data and molecular pathological information of 647 patients with IDH wild-type glioma were retrieved from the Chinese Glioma Genome Atlas (CGGA) database (from 2006 to 2019). The clinical characteristics were recorded, including gender, age, initial symptoms, preoperative Karnofsky performance status (KPS) score, tumor location, tumor laterality, extent of resection, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status and postoperative treatment. Kaplan-Meier survival curve was plotted to calculate overall survival (OS) and progression-free survival (PFS), and comparisons were performed using the log-rank test. Multivariate Cox regression analysis was used to identify the independent influencing factors of prognosis in patients with IDH wild-type glioma.Results:Among the 647 patients with IDH wild-type glioma, there were 120 cases of WHO grade Ⅱ, 115 cases of grade Ⅲ, and 412 cases of grade Ⅳ; the median OS was 20.3 months. There were statistical differences in age, initial symptoms, tumor location, preoperative KPS score, extent of resection, MGMT promoter methylation status and postoperative treatment among patients with different WHO grades (P<0.01), but there were no statistical difference in gender and tumor laterality (P>0.05). The median OS and PFS in patients with WHO grade Ⅱ were significantly longer than those in patients with WHO grade Ⅲ and WHO grade Ⅳ (169.9 months vs. 24.7 and 14.4 months, 138.8 months vs. 17.7 and 11.4 months), the indexes in patients with WHO grade Ⅲ were significantly longer than patients with WHO grade Ⅳ, and there were statistical differences (P<0.05). The median OS and PFS in patients with total resection were significantly longer than those in patients with subtotal resection and partial resection (37.2 months vs. 20.3 and 8.5 months, 29.5 months vs. 17.6 and 6.0 months), the indexes in patients with subtotal resection were significantly longer than patients with partial resection, and there were statistical differences (P<0.05). Among 153 patients with MGMT promoter methylation who received postoperative chemoradiotherapy, the median OS and PFS in patients with total resection (67 cases) were significantly longer than those in patients with subtotal resection (64 cases) and partial resection (22 cases): 28.8 months vs. 18.4 and 9.0 months, 25.6 months vs. 16.6 and 6.5 months), the indexes in patients with subtotal resection were significantly longer than patients with partial resection, and there were statistical differences (P<0.05). Among 202 patients with MGMT promoter non-methylation who received postoperative chemoradiotherapy, the median OS and PFS in patients with total resection (81 cases) were significantly longer than those in subtotal resection (81 cases) and partial resection (40 cases): 31.3 months vs. 21.9 and 14.0 months, 22.7 months vs. 16.8 and 9.7 months, and there were statistical differences (P<0.05), but there were no statistical difference in the indexes between patients with subtotal and patients with partial resection (P>0.05). Multivariate Cox regression analysis result showed that age, extent of resection, WHO grade (grade Ⅲ/grade Ⅳ) and postoperative treatment were independent OS and PFS influencing factors in patients with IDH wild-type glioma (OS: HR = 1.327, 3.295, 3.406/7.964 and 1.597; 95% CI 1.079 to 1.633, 2.627 to 4.132, 2.225 to 5.216/5.339 to 11.880 and 1.288 to 1.981; P<0.01. PFS: HR = 1.282, 2.655, 3.143/6.511 and 1.477; 95% CI 1.039 to 1.583, 2.123 to 3.322, 2.049 to 4.819/4.376 to 9.690 and 1.181 to 1.849; P<0.05 or <0.01).Conclusions:The age, extent of resection, WHO grade and postoperative treatment are independent prognosis influencing factors in patients with IDH wild-type glioma. Treatment strategies should fully consider the clinical and molecular pathological characteristics to achieve maximal safe tumor resection and optimal survival benefit.

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