1.Transforaminal “in-out-in” screw technique for posterior C2 fixation in cases with a narrow C2 pedicle: anatomical considerations, technical notes, and preliminary clinical results
Jun YAN ; Cheng QIU ; Lei QI ; Lei CHENG ; Yan-ping ZHENG ; Xin-yu LIU
Asian Spine Journal 2026;20(1):134-142
Numerous techniques for C2 screw fixation have been recently reported. However, concerns remain regarding the risk of spinal cord or vertebral artery injury and inadequate biomechanical stability. To our knowledge, the specific transforaminal “in-out-in” screw fixation technique has not been previously reported. This study aimed to investigate the feasibility and preliminary clinical outcomes of a transforaminal “in-out-in” multi-cortical purchase screw for posterior C2 screw fixation. Between October 2022 and March 2023, 10 patients underwent posterior atlantoaxial internal fixation. All patients had severe hypoplasia of the C2 pedicle on at least one side, precluding the use of standard C2 pedicle screws. A transforaminal “in-out-in” screw was used as an alternative. No spinal cord injury, vascular injury, or other major complications were observed. No implant failure was noted at the final follow-up. In conclusion, the transforaminal “in-out-in” screw may achieve rigid three-column fixation with multiple cortical purchases. It represents a safe and effective alternative for posterior C2 fixation in patients with severely narrow C2 pedicles where traditional pedicle screw placement is not feasible.
2.Analysis of sarcopenia prevalence and related factors in community-dwelling older adults based on C-MSRA-7 combined with Ishii score
Lijun WANG ; Ping WU ; Haimin XU ; Kewen CHENG ; Fen RAO ; Miaomiao YAO ; Yu ZHANG
Chinese Journal of Clinical Medicine 2026;33(4):643-650
Objective To investigate the prevalence and related factors of sarcopenia among non–bedridden older adults in the community of Baoshan District using the China mini sarcopenia risk assessment 7 (C-MSRA-7) combined with Ishii scoring system. Methods The older individuals consulting at 20 community health stations in Baoshan District between April 2025 and June 2025 were enrolled. Data were collected using a general information questionnaire, a dietary and lifestyle habits survey, the C-MSRA-7, and the mini nutritional assessment-short form (MNA-SF). Handgrip strength and anthropometric measurements were also obtained. Individuals with both Ishii score and C-MSRA-7 results positive were classified into the sarcopenia risk group, while the remaining participants were assigned to the non–sarcopenia risk group. Differences in lifestyle habits, dietary patterns, and nutritional status between the two groups were compared. Results A total of 2 611 valid questionnaires were retrieved. Univariate analysis showed statistically significant differences in alcohol consumption, physical activity frequency, body mass index (BMI), nutritional status, activities of daily living, and regularity of three meals in sarcopenia risk group (n=486) and non–sarcopenia risk group (n=2 125, P<0.05). Logistic regression analysis showed that advanced age (75–84 years: OR=2.55, 95%CI 2.03–3.21; ≥85 years: OR=3.98, 95%CI 2.24–7.07), underweight status (OR=2.19, 95%CI 1.50–3.19), weight loss>2 kg (OR=4.52, 95%CI 2.68–7.64) past 3 months, lack of regular physical activity (OR=1.77, 95%CI 1.24–2.52) , and alcohol consumption (OR=1.48, 95%CI 1.07–2.05) were independent risk factors for sarcopenia (P<0.05). Behaviors related to healthy diet, including daily milk consumption (OR=0.40, 95%CI 0.30–0.52), regular three meals (OR=0.56, 95%CI 0.41–0.78), and high-quality protein intake (OR=0.70, 95%CI 0.52–0.94), were protective factors (P<0.05). Conclusions Sarcopenia among community–dwelling, non–bedridden older adults is closely associated with physical activity levels, dietary habits, and nutritional status. Early identification of individuals at risk, enhanced nutritional education, and timely implementation of nutritional interventions and exercise programs are recommended for this population.
3.Effect of Schisanlactone E on Neuroinflammation and Synaptic Damage in APP/PS1 Mice and Their Relationship with Th17/Treg Immune Balance
Wenjing YU ; Miao YANG ; Chunxiang HE ; Jiawei HE ; Zhenyan SONG ; Ping LI ; Shaowu CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):112-123
ObjectiveTo investigate the effect of schisanlactone E in ameliorating neuroinflammation and synaptic injury in APP/PS1 mice and to elucidate whether its mechanism is related to the regulation of helper T cell 17 (Th17)/regulatory T cell (Treg) immune balance. MethodsAPP/PS1 transgenic mice were assigned into model, low- and high-dose (2 mg·kg-1·d-1 and 4 mg·kg-1·d-1, respectively) schisanlactone E, and donepezil (1 mg·kg-1·d-1) groups. C57BL/6J mice were used as the control group. Each group received the corresponding drug by gavage for 30 days. Learning and memory abilities were assessed by the Morris water maze and novel object recognition tests. The percentages of Th17 and Treg cells in the peripheral blood were analyzed by flow cytometry. The mRNA levels of retinoid-related orphan receptor γt (RORγt), interleukin (IL)-17A, forkhead box protein 3 (FoxP3), and IL-4 in the hippocampus were determined by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The synaptic ultrastructure in the hippocampus was observed by transmission electron microscopy. The protein levels of synapsin Ⅰ and postsynaptic density protein 95 (PSD95) in the hippocampus were measured by Western blot. Aβ aggregation and microglial activation in the hippocampus were observed by immunofluorescence staining. The mRNA levels of tumor necrosis factor (TNF)-α, IL-6, and IL-1β in the hippocampus were determined by Real-time PCR. ResultsCompared with the control group, the model group showed prolonged escape latency (P<0.05), decreased time spent in the target quadrant, platform crossings, novel object exploration time, and percentage of novel object contact frequency (P<0.05, P<0.01), increased Aβ aggregation in the hippocampal tissue (P<0.01), an increased proportion of Th17 cells (P<0.05), a decreased proportion of Treg cells (P<0.05), and an increased Th17/Treg ratio (P<0.01) in the peripheral blood. Furthermore, the hippocampal tissue in the model group exhibited upregulated mRNA levels of RORγt and IL-17A (P<0.05, P<0.01), downregulated mRNA levels of FoxP3 and IL-4 (P<0.01), decreased synapses (P<0.05), decreased PSD density, synaptic interface curvature, and active zone length (P<0.05, P<0.01), and increased synaptic cleft width (P<0.05), downregulated protein levels of Synapsin Ⅰ and PSD95 (P<0.01), increased microglial activation (P<0.01), and upregulated mRNA levels of TNF-α, IL-6, and IL-1β (P<0.05). Compared with the model group, the high-dose schisanlactone E group and the donepezil group exhibited shortened escape latency and increased time in the target quadrant and platform crossings (P<0.05, P<0.01). The schisanlactone E groups and the donepezil group showed increased novel object exploration time (P<0.05, P<0.01) and percentage of novel object contact frequency (P<0.05, P<0.01), and reduced hippocampal Aβ aggregation (P<0.05, P<0.01). The schisanlactone E groups showed a decreased proportion of Th17 cells (P<0.05) and an increased proportion of Treg cells (P<0.05) in the peripheral blood, and all treatment groups showed a decreased Th17/Treg ratio (P<0.05, P<0.01). The high-dose schisanlactone E group showed a downregulated mRNA level of RORγt in the hippocampal tissue (P<0.05), and all treatment groups showed a downregulated mRNA level of IL-17A (P<0.05, P<0.01), and upregulated mRNA levels of FoxP3 and IL-4 (P<0.05, P<0.01). The schisanlactone E groups and the donepezil group showed increased synapses, active zone length, synaptic interface curvature, and PSD density, decreased synaptic cleft width (P<0.05, P<0.01), and upregulated protein levels of synapsin Ⅰ and PSD95 (P<0.05, P<0.01). The high-dose schisanlactone E group and the donepezil group showed decreased microglial activation in the hippocampus (P<0.01). The schisanlactone E groups and the donepezil group showed downregulated mRNA levels of TNF-α, IL-6, and IL-1β in the hippocampal tissue (P<0.05, P<0.01). ConclusionSchisanlactone E significantly improves the cognitive function in APP/PS1 mice by regulating the Th17/Treg immune balance, inhibiting neuroinflammation, and ameliorating synaptic injury.
4.Aspirin Curcumin Ester Inhibits High Glucose/Aβ1-42-induced Microglial Inflammatory Response by Regulating Glucose Metabolism Reprogramming
Wenjing YU ; Miao YANG ; Chunxiang HE ; Ze LI ; Jiawei HE ; Ping LI ; Zhenyan SONG ; Shaowu CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):124-137
ObjectiveTo observe the effect of aspirin curcumin ester (CA) on the activation and glucose metabolism reprogramming of the mouse microglia (BV2) model of inflammation induced by high glucose/β-amyloid (Aβ)1-42, and to explore the potential mechanism of CA in reducing neuroinflammatory response in the brain. MethodsThe BV2 activation model was constructed by high glucose combined with Aβ1-42 oligomers. BV2 cells were treated with Aβ1-42 oligomers (10 μmol·L-1) in a high glucose (50 mmol·L-1) environment and allocated into normal, high glucose, Aβ, and high glucose + Aβ groups. The cell morphology of each group was observed under a bright field. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was adopted to assess the mRNA levels of inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) as well as glycolysis-related glucose transporter type 1 (GLUT1), hexokinase 2 (HK2), phospofructokinase-2/fructose-2,6-bisphosphatase 3 (PFKFB3), and pyruvate kinase M2 (PKM2). To reveal the effects of CA on inflammatory response and glucose metabolism in BV2 cells exposed to high glucose/Aβ1-42, this study established the BV2 cell model of inflammatory activation by high glucose and Aβ1-42 oligomer intervention. The cells were allocated into normal, model (50 mmol·L-1 glucose + 10 μmol·L-1 Aβ1-42), CA (10 μmol·L-1), 2DG (0.2 mmol·L-1), and DADA (1 mmol·L-1) groups. Cell counting kit-8 (CCK-8) was used to detect cell survival rate. The cell morphology of each group was observed under a bright field. The expression of inflammatory factors TNF-α, IL-6, and IL-1β and glycolysis-related key enzymes GLUT1, HK2, PFKFB3, and PKM2 at the mRNA level in each group was measured by real-time PCR. The protein levels of GLUT1, HK2, PFKFB3, and PKM2 were determined by Western blot. The glycolysis rate in each group was measured by seahorse. LC-MS was employed to identify the glucose metabolism intermediates. The morphology of mitochondria in cells was observed by electron microscopy. ResultsConstruction of the BV2 cell model: Compared with the normal group, the Aβ group and the high glucose + Aβ group showed more amoeboid-shaped cells and cell aggregation. The high glucose + Aβ group exhibited increased the mRNA levels of TNF-α, IL-1β, and IL-6 (P<0.05, P<0.01), as well as those of key glycolytic enzymes GLUT1, HK2, PFKFB3, and PKM2 (P<0.01). The Aβ group also showed significantly increased mRNA levels of PKM2 and PFKFB3 (P<0.01). Effects of CA on the inflammatory response and glucose metabolism in BV2 cells exposed to high glucose/Aβ1-42: Compared with the normal group, the model group exhibited amoeboid-shaped cells and cell aggregation, upregulated mRNA levels of TNF-α, IL-1β, IL-6, iNOS, GLUT1, HK2, PFKFB3, and PKM2 (P<0.01) and protein levels of GLUT1, HK2, and PFKFB3 (P<0.05, P<0.01), an increased basal glycolysis rate (P<0.01), a decreased compensatory glycolysis rate (P<0.01), increased glycolytic intermediates and reduced TCA cycle intermediates. In addition, the mitochondria in the model group exhibited a decreased number (P<0.05), impaired crista integrity (P<0.01), an increased proportion of vacuolization (P<0.01), and abnormal mitochondrial morphology. Compared with those in the model group, the number of amoeboid-shaped BV2 cells reduced in the CA and 2DG groups, while most BV2 cells in the DADA group became elongated spindle-shaped. All the three treatment groups showed downregulated mRNA levels of TNF-α, IL-1β, IL-6, GLUT1, HK2, PFKFB3, and PKM2 (P<0.05, P<0.01), downregulated protein levels of GLUT1, HK2, and PFKFB3 (P<0.05, P<0.01), and slow compensatory glycolysis and basal glycolysis (P<0.05, P<0.01). Glycolytic intermediates were decreased and TCA cycle intermediates were increased in the CA and 2DG groups. Mitochondrial morphology largely returned to the normal level in all the three treatment groups, with an increase in mitochondrial number (P<0.05), improved crista integrity (P<0.05, P<0.01), and a decreased proportion of vacuolization (P<0.05). ConclusionAβ1-42 oligomers can activate BV2 cells and enhance glycolytic activity in the high glucose environment. CA can reduce the expression of inflammatory factors and inhibit the activation of BV2 cells by regulating the glucose metabolism reprogramming in BV2 cells.
5.Paeoniflorin Ameliorates Neuroinflammation and Cognitive Impairment in Rat Model of Alzheimer's Disease via JAK2/STAT3 Signaling Pathway
Mengfen ZHOU ; Shuyao TANG ; Xin SUN ; Gangying FU ; Xinxing ZHOU ; Jiawei HE ; Wenjing YU ; Ping LI ; Shaowu CHENG ; Zhenyan SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):138-147
ObjectiveTo investigate the effects of paeoniflorin (PF) on neuroinflammation and cognitive impairment in the rat model of Alzheimer's disease (AD) and to clarify whether its mechanism is associated with regulation of the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway. MethodsGlycosides related to AD-associated neuroinflammation were screened through bibliometric analysis, and the potential targets of PF were predicted through network pharmacology and molecular docking. A rat model of AD was established by intraperitoneal injection of D-galactose (100 mg·kg-1·d-1). Rats were assigned into a control group, a model group, a PF (200 mg·kg-1) group, and a donepezil (0.5 mg·kg-1·d-1) group, and drugs were administered by gavage for 21 days. The learning and memory abilities were evaluated by the Morris water maze (MWM). Hematoxylin-eosin (HE) staining and Nissl staining were performed to observe hippocampal neuronal morphology. The mRNA levels of inflammatory factors were determined by Real-time quantitative polymerase chain reaction (Real-time PCR), and the protein levels of molecules in the JAK2/STAT3 signaling pathway were determined by Western blot. ResultsCompared with the control group, the model group showed prolonged escape latency and decreased platform crossings and time spent in the target quadrant (P<0.05, P<0.01), accompanied by increased expression of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), as well as elevated ratios of phosphorylated (p)-JAK2/JAK2 and p-STAT3/STAT3 (P<0.01). Compared with the model group, the PF group and donepezil group exhibited shortened escape latency and increased platform crossings and time spent in the target quadrant (P<0.05, P<0.01), decreased expression levels of IL-1β and TNF-α, upregulated mRNA levels of interleukin-4 (IL-4) and interleukin-10 (IL-10), and reduced ratios of p-JAK2/JAK2 and p-STAT3/STAT3 (P<0.05, P<0.01). ConclusionPaeoniflorin can alleviate cognitive impairment and neuroinflammation in the rat model of AD by inhibiting the JAK2/STAT3 signaling pathway.
6.The epidemiologic characteristics of parasitic and vector-borne diseases in Minhang and Jinshan districts, Shanghai
Dun-jia WANG ; Xiao-lu HE ; Tian-tian ZHANG ; Tang WANG ; Zhao-peng DONG ; Can-lei SONG ; Shi-ji TAO ; Zheng-xing HOU ; Yu-ping CHENG ; Yi-bin ZHOU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(3):173-179
Objective The aim of the study is to analyze the incidence patterns and epidemiological characteristics of parasitic and vector-borne diseases in the Minhang and Jinshan districts of Shanghai, and provide evidence-based information for optimizing prevention and control measures. Methods We collected information from epidemic reports and epidemiological investigation forms for cases of parasitic and vector-borne diseases from 2005 to 2024 in Shanghai's Minhang and Jinshan districts. Descriptive epidemiological method were adopted to conduct a comparative analysis of incidence trends, epidemic characteristics, and infection sources. Results A total of 229 cases in 7 categories were reported between 2005 and 2024, with an average annual incidence rate of 0.36/100 000. The average annual incidence rate in Minhang District was significantly higher than that in Jinshan District. The most prevalent diseases were malaria and dengue fever, followed by Japanese encephalitis. Monthly case reports were available, predominantly from June to October, with a peak in July-August. A statistically significant difference was observed between the two districts in case distribution during June-October (P<0.001), whereas no significant difference was found for July-August (P=0.331). The majority of cases were young men (111/229,48.47%), aged 20-39 years. Migrant workers/farmers constituted the largest occupational group (55/229, 24.02%). Registered residents of other provinces and cities (147/229,64.19%), and the main source of infection was overseas importation (112/229,48.91%). There were no statistically significant differences in gender and household-registration composition between the two districts (P>0.05). Significant differences existed in age, occupation, and source of infection (P<0.05). The imported diseases were malaria and dengue fever, with Africa and Southeast Asia being the primary source locations. Malaria was the predominant disease imported from other provinces and cities, with cases having been imported from abroad since 2012. Local infections were mainly Japanese encephalitis, followed by malaria (with the last local case reported in 2010). Cases between 2005 and 2009 were predominantly imported from other provinces and cities. The proportion of cases imported from abroad increased sharply after 2010, particularly in Minhang District. Local infections sometimes arise in Jinshan District, with Japanese encephalitis serving as the primary type. Conclusions Incidence rates of parasitic and vector-borne diseases in Minhang and Jinshan districts have generally remained low. To further reduce this disease burden, it will be necessary to strengthen joint measures for prevention and control, eliminate the environmental risk factors of vector organisms, enhance monitoring and precise control of the environment and inbound personnel to prevent the occurrence and transmission of parasitic and vector-borne diseases.
7.Effect Analysis of Different Interventions to Improve Neuroinflammation in The Treatment of Alzheimer’s Disease
Jiang-Hui SHAN ; Chao-Yang CHU ; Shi-Yu CHEN ; Zhi-Cheng LIN ; Yu-Yu ZHOU ; Tian-Yuan FANG ; Chu-Xia ZHANG ; Biao XIAO ; Kai XIE ; Qing-Juan WANG ; Zhi-Tao LIU ; Li-Ping LI
Progress in Biochemistry and Biophysics 2025;52(2):310-333
Alzheimer’s disease (AD) is a central neurodegenerative disease characterized by progressive cognitive decline and memory impairment in clinical. Currently, there are no effective treatments for AD. In recent years, a variety of therapeutic approaches from different perspectives have been explored to treat AD. Although the drug therapies targeted at the clearance of amyloid β-protein (Aβ) had made a breakthrough in clinical trials, there were associated with adverse events. Neuroinflammation plays a crucial role in the onset and progression of AD. Continuous neuroinflammatory was considered to be the third major pathological feature of AD, which could promote the formation of extracellular amyloid plaques and intracellular neurofibrillary tangles. At the same time, these toxic substances could accelerate the development of neuroinflammation, form a vicious cycle, and exacerbate disease progression. Reducing neuroinflammation could break the feedback loop pattern between neuroinflammation, Aβ plaque deposition and Tau tangles, which might be an effective therapeutic strategy for treating AD. Traditional Chinese herbs such as Polygonum multiflorum and Curcuma were utilized in the treatment of AD due to their ability to mitigate neuroinflammation. Non-steroidal anti-inflammatory drugs such as ibuprofen and indomethacin had been shown to reduce the level of inflammasomes in the body, and taking these drugs was associated with a low incidence of AD. Biosynthetic nanomaterials loaded with oxytocin were demonstrated to have the capability to anti-inflammatory and penetrate the blood-brain barrier effectively, and they played an anti-inflammatory role via sustained-releasing oxytocin in the brain. Transplantation of mesenchymal stem cells could reduce neuroinflammation and inhibit the activation of microglia. The secretion of mesenchymal stem cells could not only improve neuroinflammation, but also exert a multi-target comprehensive therapeutic effect, making it potentially more suitable for the treatment of AD. Enhancing the level of TREM2 in microglial cells using gene editing technologies, or application of TREM2 antibodies such as Ab-T1, hT2AB could improve microglial cell function and reduce the level of neuroinflammation, which might be a potential treatment for AD. Probiotic therapy, fecal flora transplantation, antibiotic therapy, and dietary intervention could reshape the composition of the gut microbiota and alleviate neuroinflammation through the gut-brain axis. However, the drugs of sodium oligomannose remain controversial. Both exercise intervention and electromagnetic intervention had the potential to attenuate neuroinflammation, thereby delaying AD process. This article focuses on the role of drug therapy, gene therapy, stem cell therapy, gut microbiota therapy, exercise intervention, and brain stimulation in improving neuroinflammation in recent years, aiming to provide a novel insight for the treatment of AD by intervening neuroinflammation in the future.
8.Imaging guided percutaneous microwave ablation for unresectable pancreatic cancer:A multicenter retrospective study
Shuilian TAN ; Jie ZHOU ; Ping LIANG ; Xiaoling YU ; Xin YE ; Gang DONG ; Xiang JING ; Guanghui HUANG ; Zhen WANG ; Mengfan PENG ; Yan ZHOU ; Jie YU ; Zhiyu HAN ; Fangyi LIU ; Hongjian GAO ; Yubo ZHANG ; Zhigang CHENG
Chinese Journal of Medical Imaging Technology 2025;41(7):1109-1112
Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19%(38/86)at the head/neck and 55.81%(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86%(36/84).The technical success rate was 100%(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P<0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.
9.Clinical characteristics and outcomes of elderly patients with stage Ⅰ diffuse large B-cell lymphoma: a study by the Jiangsu Cooperative Lymphoma Group (JCLG)
Yi XIA ; Jing HE ; Weiying GU ; Tao JIA ; Tingxun LU ; Yongle LI ; Jiahao ZHOU ; Bingzong LI ; Haiying HUA ; Ping LIU ; Yuqing MIAO ; Yuexin CHENG ; Xiaoyan XIE ; Yunping ZHANG ; Wenzhong WU ; Zhuxia JIA ; Xuzhang LU ; Chunling WANG ; Liang YU ; Min XU ; Jinning SHI ; Weifeng CHEN ; Wanchuan ZHUANG ; Zhen QIAN ; Jun QIAN ; Haiwen NI ; Yifei CHEN ; Qiudan SHEN ; Jianyong LI ; Wenyu SHI
Chinese Journal of Internal Medicine 2025;64(6):504-513
Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.
10.Effects of Yiqi Juanbi Formula on chondrocyte pyroptosis in collagen-induced arthritic rats via NF-κB/NLRP3/Caspase-1 signaling pathway
Xin-yu CUI ; Hao-lin LI ; Wei-qing LI ; Hui-qin KANG ; Wei-gang CHENG ; Pei-xin HE ; Cai-hong YANG ; Ping CHEN ; Hai-dong WANG
Chinese Traditional Patent Medicine 2025;47(9):2880-2887
AIM To investigate the effects of Yiqi Juanbi Formula on chondrocyte pyroptosis in rat models of collagen-induced arthritis(CIA).METHODS Fifty rats were subcutaneously injected at the tail base with an emulsion containing equal volumes of bovine type Ⅱ collagen and incomplete Freund's adjuvant(IFA)to establish the CIA models.These rats were then randomly assigned to the model group,the methotrexate group(0.35 mg/kg),and the low-dose,medium-dose,and high-dose Yiqi Juanbi Formula groups(9.4,18.7,37.4 g/kg),in contrast to the ten intact rats serving in the normal control group.Following four weeks of intragastric administration,the rats had their general conditions observed;their joint swelling and arthritis indices measured;their ankle joint pathology assessed by HE staining;their serum levels of IL-1β,IL-18 and TNF-ɑ detected by ELISA;their mRNA expressions of NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ in ankle cartilage quantified by RT-qPCR;their protein expressions of NF-κB,NLRP3 and Caspase-1 in ankle cartilage analyzed by Western blot;and their NLRP3 and GSDMD positive expressions in ankle cartilage examined by immunohistochemistry.RESULTS Compared to the control group,the model group showed significantly increased joint swelling and arthritis indices(P<0.01);elevated serum levels of IL-1 β,IL-18 and TNF-ɑ(P<0.01);pathological changes including cartilage surface defects,reduced cell count,altered cellular morphology,irregular cell arrangement,and significant inflammatory cell infiltration in synovial tissue;upregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P<0.01)and increased protein expressions of NF-κB,NLRP3 and Caspase-1(P<0.01)in ankle cartilage;enhanced positive expressions of NLRP3 and GSDMD in ankle cartilage(P<0.01).Compared to the model group,the groups intervened with methotrexate or medium-or high-dose Yiqi Juanbi Formula exhibited reduced joint swelling and arthritis indices(P<0.01);alleviated pathological damage in ankle joints;decreased serum levels of IL-1β,IL-18 and TNF-ɑ(P<0.01);downregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P<0.05,P<0.01),and reduced protein expressions of NF-κB,NLRP3 and Caspase-1(P<0.05,P<0.01)in ankle cartilage;and diminished positive expressions of NLRP3 and GSDMD in ankle cartilage(P<0.01).CONCLUSION Yiqi Juanbi Formula alleviates inflammation in CIA rats,potentially by inhibiting the activation of the NF-κB/NLRP3/Caspase-1 signaling pathway,thereby suppressing chondrocyte pyroptosis.


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