1.Successful treatment of extracorporeal membrane oxygenation bridging to lung transplantation in a patient with rapidly progressive interstitial lung disease
Yi GONG ; Xinyu LING ; Rui YAN ; Bo SUN ; Ke MA ; Guifang WANG ; Chang CHEN
Chinese Journal of Clinical Medicine 2026;33(1):154-159
A 42-year-old male with chest tightness and dyspnea was admitted to the hospital. Chest CT indicated diffuse interstitial lung infiltration. Despite receiving anti-infective therapy, glucocorticoid therapy, and immunosuppressive agents, the patient developed refractory hypoxaemia. Endotracheal intubation and invasive mechanical ventilation failed to improve oxygenation. Therefore the patient was diagnosed with rapidly progressive interstitial lung disease (RP-ILD) accompanied by type Ⅰ respiratory failure. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was initiated, and oxygenation improved in this patient. The patient subsequently underwent bilateral lung transplantation with veno-arterio-venous (VAV) ECMO support. ECMO machine was withdrawn on day 1, and extubation was achieved on day 9 after surgery. Histopathology revealed fibrotic nonspecific interstitial pneumonia (NSIP) with hyaline membrane formation. The patient developed ICU-acquired myasthenia and received early rehabilitation, with gradual recovery of muscle strength. During follow-up, graft lung function remained stable. This case demonstrates that ECMO can serve as a bridge to lung transplantation in RP-ILD patients.
2.Design and Application of an Information Management System for Experimental Marmosets
Chen WANG ; Xuebo LI ; Donghua HE ; Liangtang CHANG
Laboratory Animal and Comparative Medicine 2026;46(2):231-241
The common marmoset (Callithrix jacchus), a primate species belonging to the genus Callithrix in the family Callitrichidae, has multiple advantages including small body size, short reproductive cycle, early sexual maturity, 1-3 offspring per litter, and ease of experimental manipulation. It also exhibits behavioral characteristics such as vocal communication and strict monogamy. Common marmosets present unique advantages in neuroscience and brain disease research and are widely used in biomedical fields including neuroscience, gene editing, and ethology. Experimental common marmosets (hereinafter referred to as "experimental marmosets") require management of breeding and use to ensure traceable pedigrees and prevention of inbreeding. Existing management systems developed for rodents or Macaca often cannot effectively meet the practical needs of experimental marmoset management in key aspects such as pedigree tracking and inbreeding warning. To address this issue, the Laboratory Animal Center of the Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences (hereinafter referred to as "the Center") designed and developed a second-generation information management system for marmosets in 2021 based on its first-generation information management system, and the second-generation system was launched in 2023. This second-generation system adopts a B/S architecture, is modular, and features front-end and back-end separation. It uses mainstream technical frameworks, including Spring Boot, MySQL, and Redis, and integrates 16 functional modules such as basic information, pedigree tree, breeding and experimental selection database, microchip identification management, and ethical supervision. Compared with the first-generation system, the second-generation system optimizes the pedigree tree and basic information modules. It also adds new functions, including purpose-based database partitioning, animal status tracking, abnormal alerts, automatic microchip identification task generation, inbreeding warning, ethical document upload and review, and record management. Together, these form a systematic and refined management and service system covering the entire breeding and experimental use of experimental marmosets. From 2023 to 2025, the practical application at the center shows that it has significantly improved the management efficiency and service level of the experimental marmoset management unit, and can provide a reference for the development of information management systems in other institutions using marmosets.
3.Strategies for Building an Artificial Intelligence-Empowered Trusted Federated Evidence-Based Analysis Platform for Spleen-Stomach Diseases in Traditional Chinese Medicine
Bin WANG ; Huiying ZHUANG ; Zhitao MAN ; Lifeng REN ; Chang HE ; Chen WU ; Xulei HU ; Xiaoxiao WEN ; Chenggong XIE ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(1):95-102
This paper outlines the development of artificial intelligence (AI) and its applications in traditional Chinese medicine (TCM) research, and elucidates the roles and advantages of large language models, knowledge graphs, and natural language processing in advancing syndrome identification, prescription generation, and mechanism exploration. Using spleen-stomach diseases as an example, it demonstrates the empowering effects of AI in classical literature mining, precise clinical syndrome differentiation, efficacy and safety prediction, and intelligent education, highlighting an upgraded research paradigm that evolves from data-driven and knowledge-driven approaches to intelligence-driven models. To address challenges related to privacy protection and regulatory compliance in cross-institutional data collaboration, a "trusted federated evidence-based analysis platform for TCM spleen-stomach diseases" is proposed, integrating blockchain-based smart contracts, federated learning, and secure multi-party computation. The deep integration of AI with privacy-preserving computing is reshaping research and clinical practice in TCM spleen-stomach diseases, providing feasible pathways and a technical framework for building a high-quality, trustworthy TCM big-data ecosystem and achieving precision syndrome differentiation.
4.Association between social jetlag and depressive symptoms among junior high school students in Chongqing
WAN Xiaoke, WEI Ke, WANG Zhouyan, CHEN Gen, PENG Chang, WANG Hong
Chinese Journal of School Health 2026;47(1):55-59
Objective:
To explore the relationship between social jetlag and depressive symptoms in junior high school students, as well as the potential gender differences, so as to provide a reference for developing effective interventions for depressive symptoms and promoting adolescents mental health.
Methods:
In October 2024, a total of 3 516 students from grades 7 to 9 were recruited from 4 junior high schools in Chongqing Municipality using a combination of cluster sampling and convenience sampling. A questionnaire survey was conducted using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Munich Chronotype Questionnaire (MCTQ). Statistical analyses included the χ 2 test, binary Logistic regression analysis, and stratified Logistic regression analysis.
Results:
The detection rate of depressive symptoms among the junior high school students was 34.3%. The number of students with social jetlag >2 h was 714 (20.3%), >1-2 h was 1 455(41.4%), and ≤1 h was 1 347(38.3%). Results from the binary Logistic regression analysis showed that compared to the group with social jetlag ≤1 h, the risk of depressive symptoms in the group with social jetlag >2 h was higher ( OR=1.59, 95%CI=1.28-1.98, P <0.01). Gender stratified analysis revealed that among females, the risk of depressive symptoms was higher in the groups with social jetlag of >1-2 h and >2 h compared to the ≤1 h group ( OR = 1.34 and 2.05, 95% CI =1.03-1.75 and 1.48-2.83, both P <0.05). However, among males, the associations were not statistically significant ( OR =1.11 and 1.29, 95% CI =0.86-1.43 and 0.95-1.77, both P >0.05).
Conclusions
Social jetlag is positively associated with depressive symptoms in junior high school students, demonstrating a threshold effect and gender differences. The findings suggest that reducing social jetlag may decrease the risk of depressive symptoms in adolescents, and targeted intervention measures should be developed considering different gender characteristics.
5.Mechanisms of Antidepressant Effect of Zhizi Houpotang and Its Herbal Pairs Based on NLRP3/GSDMD Signaling Pathway
Chang CHEN ; Ziwen GUO ; Tingyu SONG ; Yan WANG ; Baomei XIA ; Weiwei TAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):72-80
ObjectiveTaking classical herbal pair compatibility research as the entry point, this study aimed to deeply investigate the material basis and compatibility rules underlying the antidepressant effects of the traditional Chinese medicine (TCM) formula Zhizi Houpotang, and to elucidate its antidepressant mechanism, with a particular focus on its regulation of neuroinflammatory responses mediated by the NOD-like receptor protein 3 (NLRP3)/gasdermin D (GSDMD) signaling pathway and the consequent improvement of neuronal synaptic plasticity. MethodsC57BL/6J mice were randomly divided into a blank control group, a chronic unpredictable mild stress (CUMS) depression model group, a Zhizi Houpotang full-formula group (6 g·kg-1·d-1), a Magnoliae Officinalis Cortex (MOC)-Aurantii Fructus Immaturus (AFI) herbal pair group (4.2 g·kg-1·d-1), a Gardeniae Fructus (GF)-MOC herbal pair group (4.2 g·kg-1·d-1), a GF-AFI herbal pair group (3.6 g·kg-1·d-1), and a positive drug group (fluoxetine, 12 mg·kg-1·d-1). Depressive-like behaviors in mice were evaluated using behavioral tests. Immunofluorescence staining was used to label and quantify the expression of the microglial marker ionized calcium-binding adaptor molecule 1 (Ibal) and the purinergic receptor P2X ligand-gated ion channel 7 (P2RX7) in the prefrontal cortex (PFC). Enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of inflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18) in serum and PFC tissues. Western blot was employed to determine the expression of pannexin 1 (Panx1), P2RX7, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), Caspase-1, GSDMD, postsynaptic density protein 95 (PSD95), and the presynaptic protein Synapsin 1 in PFC tissues. Golgi staining was used to assess dendritic spine density of neurons in the PFC. ResultsCompared with the blank control group, the depression model group exhibited significant depressive-like behaviors. In addition, the immunofluorescence areas of Ibal and P2RX7 in the PFC were significantly increased (P<0.01), the levels of IL-1β and IL-18 in serum and the PFC were significantly elevated (P<0.01), and the protein expression levels of Panx1, P2RX7, NLRP3, ASC, Caspase-1, and GSDMD in the PFC were significantly upregulated (P<0.01). In contrast, the protein expression levels of PSD95 and Synapsin 1 were significantly downregulated (P<0.01), and neuronal dendritic spine density was significantly reduced (P<0.01). Compared with the model group, the Zhizi Houpotang full-formula group and the GF-MOC herbal pair group showed significant improvement in all the above indicators (P<0.01). The GF-AFI herbal pair group improved all the above indicators except P2RX7, Caspase-1, GSDMD, and PSD95 (P<0.05, P<0.01). In contrast, the MOC-AFI herbal pair group showed no statistically significant improvement in any of the above indicators compared with the model group. ConclusionZhizi Houpotang and its key herbal pair, GF-MOC, can effectively ameliorate CUMS-induced depressive-like behaviors in mice. Its core antidepressant mechanism may involve inhibition of P2RX7/Panx1 signaling, thereby blocking the NLRP3/GSDMD-mediated pyroptosis pathway and significantly reducing the release of inflammatory cytokines IL-1β and IL-18. Simultaneously, it upregulates the expression of synapse-related proteins PSD95 and Synapsin 1 and increases dendritic spine density, promoting the recovery of synaptic plasticity. These results suggest that GF plays a key role in the antidepressant effects of this formula, and that the compatibility of GF with MOC may represent the principal herbal pair combination responsible for its core therapeutic action.
6.Preliminary study on an improved method for constructing internal quality control framework of ELISA
Youbin DUAN ; Rui WANG ; Le CHANG ; Changwen QIU ; Zhiqiang LI ; Gengrui CHEN ; Jingjuan YANG ; Qing HE ; Lunan WANG
Chinese Journal of Blood Transfusion 2026;39(1):103-108
Objective: To propose an improved method for constructing the internal quality control (IQC) framework for ELISA assays and validate its efficacy by statistically analyzing IQC data from nine blood center laboratories. Methods: 1) IQC data was collected from nine blood centers and analyzed using a domestic HBsAg ELISA detection kit as an example. 2) Differences between IQC values across batches within Blood Center 1 were assessed. 3) Statistical analyses were performed on batch usage, number of batches used, days of use, number of QC points, batch-specific means, and coefficients of variation (CV) across all nine centers. 4) Using the improved construction method for IQC framework, provisional and permanent frames were established for batches within Blood Center 1 and Blood Center 9, followed by outlier determination. Results: 1) Statistically significant differences were observed in IQC data between batches within Blood Center 1 (P<0.01). It is recommended that both the control material/reagents and the control chart framework be replaced simultaneously. 2) There were substantial differences among 9 blood centers regarding the control material/reagent lot numbers used, the number of QC runs per batch, and the QC values for identical lots. Therefore, individual laboratories should establish their own IQC chart frameworks. 3) The improved IQC framework construction method for ELISA assays is as follows: provisional frames are established via frame-shifting, using the pre-experimental mean and cumulative coefficient of variation (CV) from the preceding batch. For batches used >20 days with >20 QC points, permanent frames are constructed by aggregating in-control data accumulated over ≥20 days with ≥20 points to calculate cumulative mean and standard deviation. The provisional and permanent frames constructed by this method identified all 26 extreme outliers across Blood Centers 1 and 9 as out-of-control. Among the 218 general outliers, 10 were classified as normal by the provisional frames, while the remainder were designated as warnings or out-of-control. This method effectively monitors assay stability. Conclusion: Based on the statistical analysis of IQC practices across blood centers of varying scales, combined with the inherent characteristics of ELISA assays and the batch-to-batch instability of reagents/QC materials, it is recommended to reconstruct QC charts upon lot changes. The proposed method—utilizing frame-shifting for provisional frames and establishing permanent frames based on cumulative data—is applicable to blood center laboratories of differing sizes and effectively monitors the stability of the ELISA assay process.
7.Fibroblast growth factor 21 attenuates oxidative stress injury in retinal pigment epithelial cells under high glucose via FGFR1/PI3K/Akt signal pathway
Ye TIAN ; Guoheng ZHANG ; Tianhao YUAN ; Xin WANG ; Tianfang CHANG ; Yuan CHEN ; Guorui DOU
International Eye Science 2026;26(3):383-390
AIM:To investigate the effect of fibroblast growth factor 21(FGF21)on high glucose-induced oxidative stress in retinal pigment epithelial(RPE)cells and to clarify the underlying molecular mechanisms.METHODS:Single-cell sequencing data from the GEO database were analyzed to determine the expression profile of the FGF21 receptor FGFR1 in RPE cells. Human ARPE-19 cells were cultured and randomly assigned to control, high glucose(30 mmol/L), and high glucose+FGF21 analog treatment groups, with additional siFGFR1 and PI3K inhibitor groups. Cell viability in different treatment groups was assessed using CCK-8 assay, intracellular reactive oxygen species(ROS)levels were quantified using DCFH-DA fluorescent probing combined with immunofluorescence staining and flow cytometry. Transcriptome sequencing was performed on cells from the high glucose group and high glucose+FGF21 group to analyze the enrichment level of the PI3K/Akt signaling pathway. Western blotting was performed to detect phosphorylation levels of PI3K/Akt pathway components.RESULTS:Single-cell sequencing revealed specific expression of FGFR1 in RPE cells of retinal tissues from diabetic model mice. Under In vitro experiments, high glucose(30 mmol/L)exposure reduced ARPE-19 cell viability by 49.7% and increased ROS levels by approximately 2-fold. Whereas treatment with the FGF21 analog(60 ng/mL)restored cell viability and attenuated high glucose-induced ROS accumulation. Mechanistic studies demonstrated that FGFR1 knockdown inhibited the antioxidative stress of FGF21. Further validation of the molecular mechanism revealed that high glucose significantly suppressed the PI3K/Akt pathway activation(the levels of p-Akt and p-PI3K were decreased by 33.9% and 36.6%, respectively), while FGF21 effectively reversed this inhibitory effect and restored the expression of p-Akt and p-PI3K. Treatment with the PI3K inhibitor LY294002 inhibited the cytoprotective effect of FGF21 and significantly increased the ROS-positive cells, these findings confirm that PI3K/Akt signaling is indispensable downstream mechanism for FGF21 to exert its effects.CONCLUSION:FGF21 alleviates high glucose-induced oxidative stress and cellular injury in RPE cells by activating the PI3K/Akt signaling pathway through its receptor FGFR1.
8.Impact of number of positive regional lymph nodes in N1 stage on the prognosis of patients with non-small cell lung cancer: A propensity score matching study
Dandan LIU ; Jiachen WANG ; Lidan CHANG ; Jia CHEN ; Ranran KONG ; Shiyuan LIU ; Minxia ZHU ; Jiantao JIANG ; Shaomin LI ; Zhengshui XU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):63-71
Objective To explore the impact of number of positive regional lymph nodes (nPRLN) in N1 stage on the prognosis of non-small cell lung cancer (NSCLC) patients. Methods Patients with TxN1M0 stage NSCLC who underwent lobectomy and mediastinal lymph node dissection from 2010 to 2015 were screened from SEER database (17 Regs, 2022nov sub). The optimal cutoff value of nPRLN was determined using X-tile software, and patients were divided into 2 groups according to the cutoff value: a nPRLN≤optimal cutoff group and a nPRLN>optimal cutoff group. The influence of confounding factors was minimized by propensity score matching (PSM) at a ratio of 1 : 1. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS) and lung cancer-specific survival (LCSS) of patients. Results A total of 1316 patients with TxN1M0 stage NSCLC were included, including 662 males and 654 females, with a median age of 67 (60, 73) years. The optimal cutoff value of nPRLN was 3, with 1165 patients in the nPRLN≤3 group and 151 patients in the nPRLN>3 group. After PSM, there were 138 patients in each group. Regardless of before or after PSM, OS and LCSS of patients in the nPRLN≤3 group were superior to those in the nPRLN>3 group (P<0.001). N1 stage nPRLN>3 was an independent prognostic risk factor for OS [HR=1.52, 95%CI (1.22, 1.89), P<0.001] and LCSS [HR=1.72, 95%CI (1.36, 2.18), P<0.001]. Conclusion N1 stage nPRLN>3 is an independent prognostic risk factor for NSCLC patients in TxN1M0 stage, which may provide new evidence for future revision of TNM staging N1 stage subclassification.
9.Erchentang Ameliorates SiO2-induced Lung Injury by Regulating Oxidative Stress and Metabolic Disorders via Nrf2/HO-1 Signaling Pathway
Jun LU ; Xinyi ZHU ; Ziyi LIU ; Jixia HU ; Jialu CHEN ; Rong XIAO ; Zhibin WANG ; Chang LIU ; Fangguo LU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):32-42
ObjectiveTo observe the protective effect of Erchentang (ECT) on SiO2-induced lung injury in rats and to explore its underlying mechanism. MethodsA rat model of lung injury was established by a single intratracheal instillation of 50 mg·mL-1 SiO2 suspension. Thirty male Sprague-Dawley (SD) rats were randomly assigned to five groups: control, model, low and high-dose (4.5 g·kg-1·d-1 and 9 g·kg-1·d-1, respectively) ECT, and dexamethasone (0.2 mg·kg-1·d-1). All the groups were treated for 4 consecutive weeks. Histopathological alterations in the lung tissue were examined by hematoxylin and eosin (HE) staining. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in the lung tissue were measured through biochemical assays. The expression of key molecules in the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway was determined by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR), Western blot, and immunofluorescence assay. The primary active components of ECT were identified by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and their binding affinity to Nrf2/HO-1 was assessed by molecular docking. Untargeted metabolomics of the lung tissue was performed based on UPLC-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS), and correlation analysis was performed to identify differential metabolites and parameters closely associated with the Nrf2/HO-1 pathway. ResultsCompared with the control group, the model group exhibited a reduction in body weight gain, an increase in lung index, increased MDA content, weakened SOD and GSH-Px activities in the lung tissue, down-regulated mRNA and protein levels of Nrf2 and protein levels of HO-1 and GPX4, and an up-regulated protein level of Keap1 (P<0.05, P<0.01). Treatment with ECT attenuated the SiO2-induced decline in body weight (P<0.05), alleviated inflammatory cell infiltration and silicotic nodule formation in alveoli, and reduced the MDA content and enhanced the SOD and GSH-Px activities in the lung tissue (P<0.05, P<0.01). UPLC-MS/MS and molecular docking revealed that core components of ECT, such as hesperidin and glycyrrhizic acid, displayed strong binding affinity to Nrf2/HO-1. Molecular biological experiments demonstrated that ECT promoted nuclear translocation of Nrf2, up-regulated the mRNA and protein levels of HO-1 and GPX4, and down-regulated Keap1 expression (P<0.05, P<0.01). Metabolomic analysis indicated that ECT reversed the SiO2-induced aberrant expression of metabolites, including linoleic acid and glutamine (P<0.05, P<0.01). Correlation analysis showed that Nrf2 and HO-1 were positively correlated with SOD and GSH-Px (P<0.05, P<0.01), but negatively correlated with glutamine and serine (P<0.05, P<0.01). ConclusionECT may activate the Nrf2/HO-1 pathway through its core active components, thereby regulating oxidative stress and metabolic disorders to ameliorate SiO2-induced lung injury in rats. This study provides experimental evidence for ECT in the prevention and treatment of occupational lung injury.
10.Short-term and long-term outcomes of acute severe ulcerative colitis in Taiwan: a multicenter study with pre- and post-biologics comparison
Wei-Chen LIN ; Chun-Chi LIN ; Wen-Hung HSU ; Feng-Fan CHIANG ; Chen-Wang CHANG ; Tzu-Chi HSU ; Deng-Chyang WU ; Horng-Yuan WANG ; Jau-Min WONG ; Shu-Chen WEI
Intestinal Research 2026;24(1):117-128
Background/Aims:
Data from Asia regarding the short-term and long-term outcomes for acute severe ulcerative colitis (ASUC) are limited. We assessed the outcomes of ASUC, identified the risk factors for colectomy, and compared colectomy rates between the pre-biologics and post-biologics eras in Taiwan.
Methods:
The patients with an ASUC diagnosis between January 2013 and March 2022 at 5 tertiary medical centers were retrospectively analyzed.
Results:
In total, 98 patients were enrolled, with 68.4% diagnosed in the post-biologics era. In 78.6% of the ASUC patients initially received intravenous steroid therapy, for which the success rate was 74.1%. As for rescue therapy, 15 patients (93.8%) received biologics and 1 (6.3%) received cyclosporin. Biologics rescue therapy had a 93.3% success rate. One (1%) mortality due to septic shock occurred. The colectomy rate for index ASUC admission was 11.2%. Patients receiving colectomy were predominantly male (P= 0.012) and at older age (P= 0.016). Higher C-reactive protein (P= 0.035), lower albumin (P= 0.017), and hemoglobin (P= 0.023) levels were associated with colectomy risk. During a median follow-up of 24 months, 13 patients (15.1%) had recurrent ASUC and 23.1% of patients received colectomy. The accumulated colectomy rate at 3 years did not differ between the pre- and post-biologics eras (16.1% vs. 13.4%, P= 0.270).
Conclusions
This is the first Asian study on ASUC to compare colectomy rates between the prebiologics and post-biologics eras, revealing no significant difference. The recurrent ASUC had a higher colectomy rate than the index ASUC.


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