1.Safety analysis of Yttrium-90 resin microsphere selective internal radiation therapy on malignant liver tumors
Jia CAI ; Shiwei TANG ; Rongli LI ; Mingxin KONG ; Hongyan DING ; Xiaofeng YUAN ; Yuying HU ; Ruimei LIU ; Xiaoyan ZHU ; Wenjun LI ; Haibin ZHANG ; Guanwu WANG
Chinese Journal of Clinical Medicine 2025;32(1):24-29
Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (90Y-SIRT) on malignant liver tumors. Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent 90Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of 90Y-SIRT. Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (99mTc-MAA) perfusion test and received the 90Y-SIRT; one patient received 90Y-SIRT after the second 99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%). Conclusion The adverse reactions of 90Y-SIRT for treating malignant liver tumors are mild, indicating good safety.
2.Characteristics of mitochondrial translational initiation factor 2 gene methylation and its association with the development of hepatocellular carcinoma
Huajie XIE ; Kai CHANG ; Yanyan WANG ; Wanlin NA ; Huan CAI ; Xia LIU ; Zhongyong JIANG ; Zonghai HU ; Yuan LIU
Journal of Clinical Hepatology 2025;41(2):284-291
ObjectiveTo investigate the characteristics of mitochondrial translational initiation factor 2 (MTIF2) gene methylation and its association with the development and progression of hepatocellular carcinoma (HCC). MethodsMethSurv and EWAS Data Hub were used to perform the standardized analysis and the cluster analysis of MTIF2 methylation samples, including survival curve analysis, methylation signature analysis, the association of tumor signaling pathways, and a comparative analysis based on pan-cancer database. The independent-samples t test was used for comparison between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Cox proportional hazards model was used to perform the univariate and multivariate survival analyses of methylation level at the CpG site. The Kaplan-Meier method was used to investigate the survival differences between the patients with low methylation level and those with high methylation level, and the Log-likelihood ratio method was used for survival difference analysis. ResultsGlobal clustering of MTIF2 methylation showed that there was no significant difference in MTIF2 gene methylation level between different races, ethnicities, BMI levels, and ages. The Kaplan-Meier survival curve analysis showed that the patients with N-Shore hypermethylation of the MTIF2 gene had a significantly better prognosis than those with hypomethylation (hazard ratio [HR]=0.492, P<0.001), while there was no significant difference in survival rate between the patients with different CpG island and S-Shore methylation levels (P>0.05). The methylation profile of the MTIF2 gene based on different ages, sexes, BMI levels, races, ethnicities, and clinical stages showed that the N-Shore and CpG island methylation levels of the MTIF2 gene decreased with the increase in age, and the Caucasian population had significantly lower N-Shore methylation levels of the MTIF2 gene than the Asian population (P<0.05); the patients with clinical stage Ⅳ had significantly lower N-Shore and CpG island methylation levels of the MTIF2 gene than those with stage Ⅰ/Ⅱ (P<0.05). Clinical validation showed that the patients with stage Ⅲ/Ⅳ HCC had a significantly lower methylation level of the MTIF2 gene than those with stage Ⅰ/Ⅱ HCC and the normal population (P<0.05). ConclusionN-Shore hypomethylation of the MTIF2 gene is a risk factor for the development and progression of HCC.
3.Investigation on the mechanisms of Colquhounia Root Tablets in reversing vascular endothelial cell dysfunction of rheumatoid arthritis via modulating NOD2/SMAD3/VEGFA signaling axis
Bing-bing CAI ; Ya-wen CHEN ; Tao LI ; Yuan ZENG ; Yan-qiong ZHANG ; Na LIN ; Xia MAO ; Ya LIN
Acta Pharmaceutica Sinica 2025;60(2):397-407
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation, joint destruction, and functional impairment. Angiogenesis plays a key role in the pathological progression of RA with dysfunction of endothelial cells to promote synovial inflammation, sustain pannus formation, subsequently leading to joint damage. Colquhounia Root Tablets (CRT), a Chinese patent drug, has shown a satisfying clinical efficacy in treating RA, while the underlying mechanism by which CRT inhibits RA-associated angiogenesis remains unclear. In this study, we applied a research approach combining transcriptomic data analysis, bio-network mapping, and
4.Buzhong Yiqitang Induces Ferroptosis by Regulating PCBP1 to Attenuate Cisplatin Resistance in Non-small Cell Lung Cancer
Yuetong LIU ; He LI ; Qirui MU ; Jingyi HUANG ; Haoran CAI ; Chunying LIU ; Yuan GAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):90-97
ObjectiveTo explore the molecular mechanism of Buzhong Yiqitang in attenuating cisplatin resistance in non-small cell lung cancer (NSCLC) by inducing ferroptosis via poly(rC)-binding protein 1 (PCBP1). MethodsThe serum containing Buzhong Yiqitang was prepared and cisplatin-resistant human non-small cell lung cancer (NSCLC) cells (A549/DDP) were cultured and randomly grouped as follows: Blank (10% blank serum), model (10% blank serum+20 mg·L-1 cisplatin), Buzhong Yiqitang (10% serum containing Buzhong Yiqitang+20 mg·L-1 cisplatin), Fe-1 (10% blank serum+20 mg·L-1 cisplatin+5 μmol·L-1 Fe-1), and Buzhong Yiqitang+Fe-1 (10% serum containing Buzhong Yiqitang+20 mg·L-1 cisplatin+5 μmol·L-1 Fe-1). Firstly, PCR Array was used to screen ferroptosis-related genes regulated by Buzhong Yiqitang, and PCBP1 was identified as the target for studying the attenuation of cisplatin resistance by Buzhong Yiqitang. Subsequently, the median inhibitory concentration (IC50) of cisplatin in each group was determined by the cell counting kit-8 (CCK-8) method and the resistance index (RI) was calculated. The ultrastructure of A549/DDP cells in each group was observed by transmission electron microscopy. The protein levels of PCBP1 and glutathione peroxidase 4 (GPX4) were determined by Western blot. The lipid reactive oxygen species (ROS) content in each group was determined by the C11-BODIRY 581/591 fluorescence probe. The ferrous ion assay kit was used to measure the ferrous ion content in each group. The malondialdehyde (MDA) assay kit was used to determine the MDA content in each group. ResultsCompared with model group, the IC50 of cisplatin and the RI of A549/DDP cells decreased in the Buzhong Yiqitang group (P<0.05) but increased in the Fe-1 group (P<0.05). The IC50 of cisplatin and the RI of A549/DDP cells in the Buzhong Yiqitang+Fe-1 group were lower than those in the Fe-1 group (P<0.05). Compared with the model group, the Buzhong Yiqitang group showed obvious mitochondrial ferroptosis, while the mitochondrial damage became less obvious after Fe-1 treatment. Compared with that in the Fe-1 group, the mitochondrial ferroptosis was aggravated after the intervention with Buzhong Yiqitang. Compared with blank group, the model group showed down-regulated expression levels of PCBP1 and GPX4 (P<0.05) and increased content of lipid ROS, ferrous ions, and MDA (P<0.05) in A549/DDP cells. Compared with model group, the Buzhong Yiqitang group showed down-regulated expression levels of PCBP1 and GPX4 (P<0.05) and increased content of lipid ROS, ferrous ions, and MDA (P<0.05), while the Fe-1 group showed up-regulated expression levels of PCBP1 and GPX4 (P<0.05) and reduced content of lipid ROS, ferrous ions, and MDA (P<0.05). Compared with the Fe-1 group, the Buzhong Yiqitang+Fe-1 group showed down-regulated expression levels of PCBP1 and GPX4 and increased content of lipid ROS, ferrous ions, and MDA (P<0.05). ConclusionBuzhong Yiqitang attenuated cisplatin resistance in NSCLC by regulating PCBP1 to induce ferroptosis.
5.Safety analysis of fondaparinux in pregnancy based on case report literature
Yin WANG ; Fengqun CAI ; Fengjiao KANG ; Liuyun WU ; Hulin WANG ; Lizhu HAN ; Qinan YIN ; Yong YANG ; Yuan BIAN
China Pharmacy 2025;36(9):1099-1104
OBJECTIVE To evaluate the safety of fondaparinux in pregnancy and provide reference for its rational clinical application. METHODS A search was conducted in databases including CNKI, Wanfang, PubMed, Embase, and Elsevier (the search time was from the construction of the database to December 17, 2024) to collect case report literature on fondaparinux use during pregnancy. Patient demographic information, fondaparinux use during pregnancy, concomitant medications, clinical manifestations, and treatment details were extracted for descriptive statistical analysis. RESULTS A total of 17 case reports regarding the use of fondaparinux during pregnancy were collected, involving 42 patients from 11 countries and 47 pregnancy records. Among these, 20 cases involved the use of fondaparinux for the prevention of pregnancy-related venous thromboembolism (VTE), while 27 cases were fondaparinux treatment due to related conditions. A total of 29 occurrences of the patients were treated with fondaparinux due to a (family) history of VTE. Nine occurrences of complicated pregnancies were reported, and 35 patients had records of comorbidities or relevant medical histories. The adverse events that occurred during pregnancy with the use of fondaparinux include postpartum hemorrhage (7 cases) and excessive anticoagulation caused by inappropriate dosage (1 case). Among the 7 cases of postpartum hemorrhage, 3 cases had a blood loss of no less than 1 000 mL (including 2 cases with uterine atony), 3 cases had a drug discontinuation time of ≤12 h. CONCLUSIONS Based on the existing literature, the safety of fondaparinux during pregnancy is generally manageable, with the main adverse event being postpartum hemorrhage. The dosage, interval between discontinuation,comorbidities/medical history, and concomitant medications of fondaparinux may be the main causes of its adverse events.
6.Dynamic Sequential Diagnosis and Treatment of Pediatric Nephrotic Syndrome Based on the "Sweat Pore-Qi and Liquid-Kidney Collaterals"
Zhenhua YUAN ; Mingyang CAI ; Yingying JIANG ; Jingjing WU ; Wenqing PAN ; Zichao DING ; Shuzi ZHANG ; Xianqing REN
Journal of Traditional Chinese Medicine 2025;66(10):1007-1010
Based on the viewpoint of "sweat pore-qi and liquid-kidney collaterals", it is believed that children's nephrotic syndrome is caused by the core mechanism of sweat pore constraint and closure, qi and liquid imbalance, and kidney collaterals impairment, and it is proposed that the treatment principle is to nourish the sweat pore, regulate qi and fluid, and supplement the kidney and unblock the collaterals. In clinic, guided by sequential therapy and according to the different disease mechanism characteristics of the four stages, including early stage of the disease, hormone induction stage, hormone reduction stage, hormone maintenance stage, the staged dynamic identification and treatment was applied. For early stage of the disease with edema due to yang deficiency, modified Zhenwu Decoction (真武汤) was applied to warm yang and drain water; for hormone induction stage with yin deficiency resulting in effulgent fire, modified Zhibai Dihuang Pill (知柏地黄丸) plus Erzhi Pill (二至丸) was used to enrich yin and reduce fire; for hormone reduction stage with qi and yin deficiency, modified Shenqi Dihuang Decoction (参芪地黄汤) was used to boost qi and nourish yin; for hormone maintenance stage, modified Shenqi Pill (肾气丸) was used to supplement yin and yang. Meanwhile, the treatment also attaches importance to the combination of vine-based or worm medicinals to dredge collaterals, so as to providing ideas for clinical treatment.
7.Aromatic Substances and Their Clinical Application: A Review
Yundan GUO ; Lulu WANG ; Zhili ZHANG ; Chen GUO ; Zhihong PI ; Wei GONG ; Zongping WU ; Dayu WANG ; Tianle GAO ; Cai TIE ; Yuan LIN ; Jiandong JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):264-272
Aromatherapy refers to the method of using the aromatic components of plants in appropriate forms to act on the entire body or a specific area to prevent and treat diseases. Essential oils used in aromatherapy are hydrophobic liquids containing volatile aromatic molecules, such as limonene, linalool, linalool acetate, geraniol, and citronellol. These chemicals have been extensively studied and shown to have a variety of functions, including reducing anxiety, relieving depression, promoting sleep, and providing pain relief. Terpenoids are a class of organic molecules with relatively low lipid solubility. After being inhaled, they can pass through the nasal mucosa for transfer or penetrate the skin and enter the bloodstream upon local application. Some of these substances also have the ability to cross the blood-brain barrier, thereby exerting effects on the central nervous system. Currently, the academic community generally agrees that products such as essential oils and aromatherapy from aromatic plants have certain health benefits. However, the process of extracting a single component from it and successfully developing it into a drug still faces many challenges. Its safety and efficacy still need to be further verified through more rigorous and systematic experiments. This article systematically elaborated on the efficacy of aromatic substances, including plant extracts and natural small molecule compounds, in antibacterial and antiviral fields and the regulation of nervous system activity. As a result, a deeper understanding of aromatherapy was achieved. At the same time, the potential of these aromatic substances for drug development was thoroughly explored, providing important references and insights for possible future drug research and application.
8.Development and validation of a multidisciplinary risk assessment scale for immune checkpoint inhibitor-associated myocarditis
Yanan DAI ; Yuan LIU ; Yuchen XU ; Qingqing CAI ; Yan WANG ; Yuhong ZHOU ; Leilei CHENG ; Junbo GE
Chinese Journal of Clinical Medicine 2025;32(4):561-567
Objective To develop a risk assessment scale for immune checkpoint inhibitor (ICI)-associated myocarditis based on multidisciplinary collaboration, and to evaluate its diagnostic performance. Methods Based on multidisciplinary cooperation, integrating clinical experience from oncology and cardiology, literature data, and patient conditions, a risk assessment scale for ICI-associated myocarditis was developed. A total of 101 patients with malignancies who received immunotherapy at Zhongshan Hospital, Fudan University, from October 2020 to October 2024 were included as the validation cohort. Patients were stratified into low-risk (0-1 point), medium-risk (2-4 points), and high-risk (≥5 points) groups based on their scale scores. The association between pretictive risk stratifications and actual assessment results was assessed using the Cox proportional hazards regression model. The predictive value of the scale for ICI-associated myocarditis was evaluated using receiver operating characteristic (ROC) curve. Agreement between the scale scores and actual assessment results was assessed using Cohen’s Kappa coefficient. Results Based on the scale pretictive results, 28(27.7%), 8(7.9%), 65(64.4%) patients were at low risk, medium risk, and high risk for ICI-related myocarditis, respectively; however, 46(45.5%), 8(7.9%), 47(46.5%) were at low risk, medium risk, and high risk actually. Kaplan-Meier survival analysis showed that the cumulative incidence of ICI-related myocarditis in the high-risk group was significantly higher than that in the medium- and low-risk groups (P<0.05). In the multivariable-adjusted Cox proportional hazards model, the ICI-related myocarditis risk in high-risk group was about 4 times that in the low-risk group. ROC curve analysis demonstrated that the average area under the curve (AUC) for predicting ICI-related myocarditis was 0.81, with an accuracy of 0.74. The Cohen’s Kappa coefficient was 0.55, indicating moderate agreement. In the actual high-risk group, no patient was predicted to be at low risk; in the actual low-risk group, 16 patients were predicted to be at high risk. Conclusions This risk assessment scale for ICI-associated myocarditis shows high predictive performance. It provides oncologists with a simple yet effective multidisciplinary diagnostic reference tool, potentially enhancing early identification of ICI-associated myocarditis.
9.Fitting Degrees of Animal Models of Diarrhea-irritable Bowel Syndrome with Clinical Characteristics of Western Medicine and Traditional Chinese Medicine
Fengru JIANG ; Youcheng HE ; Yue WU ; Keyi PAN ; Chunyu ZHOU ; Shuyu CAI ; Jianye YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):218-227
Diarrhea-irritable bowel syndrome (IBS-D) is one of the common functional bowel diseases in clinical practice. Since it pathogenesis is complex and has not been fully elucidated, effective treatment methods remains to be developed for this disease. Establishing the animal models of IBS-D in accordance with the clinical characteristics of traditional Chinese medicine (TCM) and Western medicine helps to reveal the pathogenesis of this disease and improve the treatment plan. The fitting degree of an animal model with clinical characteristics is an indicator to evaluate the effectiveness of the animal model in simulating the disease characteristics of Western medicine and the syndromes of TCM based on the latest diagnostic standards. By reviewing the relevant articles about the animal models of IBS-D, we discovered that rats were the preferred animals for modeling, and the models were mainly induced by single factors, double factors, or the combination of multiple factors. The established animal models mainly present symptoms or signs associated with visceral hypersensitivity or/and gastrointestinal motility abnormalities. The single factor-induced rat models of IBS-D had high fitting degrees with the clinical characteristics of Western medicine but low fitting degrees with the TCM syndromes. The animal models induced by two or more factors had high but varied fitting degrees with the clinical characteristics of Western medicine. In addition, the animal models of IBS-D considering TCM syndromes mainly focuses on the syndrome of liver depression and spleen deficiency, and few models were established for the syndromes of spleen-kidney Yang deficiency, spleen-stomach dampness-heat, spleen deficiency and dampness excess, and cold and heat in complexity. Therefore, it is essential to improve the existing or develop new animal models of IBS-D in the future, so as to provide more tools for deciphering the mechanisms of TCM and Western medicine and developing treatment methods for this disease.
10.Protective effects of omega-3 polyunsaturated fatty acids on chronic atrophic gastritis of rats
Dun-Huang PENG ; De-Yuan YOU ; Cai-Fa HONG ; Tai-Yong FANG
The Chinese Journal of Clinical Pharmacology 2024;40(2):234-238
Objective To investigate the effect of omega-3 polyunsaturated fatty acids(ω-3 PUFA)on chronic atrophic gastritis of rats.Methods A rat model of chronic atrophic gastritis was established by synthetic method.The rats successfully modeled were randomly divided into model group,experimental-L group,experimental-M group,experimental-H group,positive control group.Normal rats were selected as the normal group.There were 9 rats in each group.Experimental-L,-M,-H groups were given 3,6 and 12 mL·kg-1ω-3 PUFA daily,respectively.The positive control group was given 0.24 g·kg-1 vitacoenzyme suspension daily.Normal group and model group were given the same amount of 0.9%NaCl.Each group was given the drug for 12 weeks.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum interleukin-1 β(IL-1β)level.In situ end labeling staining(TUNEL)was used to detecte the apoptosis of gastric mucosa.Relevant kits were used to detect the level of superoxide dismutase(SOD)and malonaldehyde(MDA).Results IL-1 β levels in normal group,model group,experimental-L,-M,-H groups and positive control group were(58.96±8.23),(140.02±19.65),(109.81±14.35),(98.72±12.64),(85.31±11.42)and(77.64±10.23)pg·mL-1,respectively;apoptotic indices were(7.89±1.36)%,(77.12±10.05)%,(42.33±6.87)%,(31.05±5.29)%,(22.76±4.16)%and(16.89±3.05)%,respectively;SOD levels were(398.71±58.24),(170.25±29.81),(249.81±34.26),(268.04±34.11),(322.15±46.36)and(276.42±29.81)U·mg-1,respectively;MDA levels were(3.55±0.87),(11.02±2.15),(8.02±1.50),(6.92±1.23),(5.98±1.27)and(6.67±1.32)U·mg-1,respectively.Compared with normal group,the above indexes were significantly different in model group(all P<0.01);compared with model group,the above indexes were significantly different in experimental-L,experimental-M,experimental-H groups and positive control group(all P<0.01).Conclusionω-3 PUFA can ameliorate chronic atrophic gastritis of rats,and the mechanism may be related to the anti-inflammatory,anti-apoptosis and anti-oxidative stress effects of to-3 PUFA.

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