1.Exploration in Relationship Between Mitochondrial Homeostasis Dysregulation and Panvascular Diseases Based on Theory of ''Positive Deficiency Phlegm Stasis''
Hongping LI ; Jie WANG ; Zhenpeng ZHANG ; Chao LIU ; Lanchun LIU ; Chengzhi HOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):30-38
Panvascular diseases represent systemic vascular disorders characterized by atherosclerosis as their core pathological feature. Their incidence rates continue to rise, posing significant challenges for clinical management. Based on Traditional Chinese Medicine (TCM) theory of ''positive deficiency phlegm stasis'', this study delved into the pivotal role of mitochondrial homeostasis dysregulation in the pathogenesis and progression of pan-vascular diseases, along with its intrinsic connection to TCM pathogenesis. Mitochondrial homeostasis dysregulation pervades the entire course of these diseases, with mitochondrial oxidative stress serving as the initiating factor. Excessive reactive oxygen species (ROS) trigger endothelial dysfunction, lipid accumulation, and inflammatory initiation. Additionally, the imbalance between mitochondrial autophagy and apoptosis constitutes a pivotal link in disease progression. Excessive or insufficient autophagy may lead to the accumulation of damaged mitochondria and excessive cellular apoptosis, thereby promoting plaque instability. Furthermore, mitochondrial metabolic reprogramming impairs energy supply and function in vascular wall cells, hindering subsequent vascular repair. These pathological processes constitute the microscopic manifestation of the core pathogenesis, which is characterized by ''the intermingle of phlegm and stasis and the deficiency of healthy Qi''. Specifically, the endogenous phlegm-turbidity drives mitochondrial oxidative stress injuries, the mutual entanglement of phlegm and stasis induces an imbalance between mitochondrial autophagy and apoptosis, while deficiency of healthy Qi propels mitochondrial energy metabolism disorders and reprogramming. In view of this, this study proposed to employ phlegm-resolving and turbidity-clearing methods to mitigate mitochondrial oxidative stress injuries, phlegm-resolving and blood-activating methods to regulate mitochondrial autophagy and apoptosis, and spleen-tonifying and kidney-nourishing methods to modulate mitochondrial metabolic reprogramming. This approach can prevent and treat panvascular diseases by multi-target regulation of mitochondrial homeostasis, providing a theoretical framework and therapeutic strategies for the prevention and treatment of panvascular diseases through integrated Chinese and Western medicine.
2.Mechanism of ductular reaction and related treatment strategies
Jiayan SHAN ; Huaqian XU ; Chengzhi BAI ; Liang ZHANG ; Chao DU ; Yong ZHANG ; Shanhong TANG
Journal of Clinical Hepatology 2026;42(3):733-738
Ductular reaction (DR) refers to the adaptive pathological changes that occur after hepatobiliary injury, and it is essentially a repair response involving the proliferation, fibrosis, and inflammation of biliary epithelial cell (BEC). With the understanding of the biological function of BEC, the potential value of DR in disease prognosis and treatment has gradually become a research hotspot. This article systematically reviews the molecular mechanism of DR, its potential as a therapeutic target, and future development directions, as well as novel therapies suggested by targeting these molecular mechanisms, in order to provide a new direction for overcoming current bottlenecks in the treatment of bile duct diseases.
3.Advances in research on fine motion control of prosthesis fingers with brain-computer interface
Di GAN ; Hui HUANG ; Chengzhi LI ; Shiyu ZHANG ; Shiyuan WANG ; Tao WANG
Chinese Journal of Clinical Medicine 2025;32(1):114-119
The deficiency of fingers due to various reasons leads to a certain degree of loss of full or part hand functions. Physical and mental health of patients are seriously affected, and patients have varying degrees of reduced quality of life. Prosthesis fingers play an important role in completing the body shape and enhancing patients’ self-confidence and self-esteem. However, how to make prosthesis fingers perform coordinated movements and restore complete functions is a crucial problem that urgently needs to be solved. This paper reviews the methods of brain-computer interface controlled fine finger movements and elaborates on the origin, current situation, and advancements of the development of this technology, laying a foundation for subsequent research, with the expectation of helping patients solve the problems arising from the insufficiency or absence of finger functions.
4.Predictive value of changes in prealbumin for the prognosis of patients with acute-on-chronic liver failure after artificial liver treatment
Chengzhi BAI ; Bo DENG ; Huaqian XU ; Xue ZHANG ; Qunru WANG ; Xue WANG ; Beijin CHEN ; Si LIU ; Su YANG ; Shanhong TANG
Chinese Journal of Digestion 2025;45(7):462-468
Objective:To explore the predictive value of changes in prealbumin for the prognosis of patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) after artificial liver treatment.Methods:From January 1, 2018 to December 31, 2021, the clinical data (including prealbumin, platelet count, lymphocyte count, alanine transaminase (ALT), etc.) of 87 patients with HBV-ACLF who received artificial liver treatment at the Department of Gastroenterology of the General Hospital of Western Theater Command PLA were retrospectively collected. The 90-day survival status of all the patients was followed up, and the patients were divided into the survival group and the mortality group according to the survival status. The clinical characteristics and the changes of prealbumin on day 1 to 3, day 3 to 7, and day 1 to 7 after artificial liver treatment were compared between the 2 groups. Multivariate logistic regression analysis was used to analyze the independent influencing factors of the 90-day prognosis of HBV-ACLF patients after artificial liver treatment, and the nomogram prediction model was established and the receiver operating characteristic curve (ROC) was drawn to assess the area under the curve (AUC). Hosmer-Lemeshow goodness-of-fit test, calibration curve and clinical decision curve were performed to evaluate the goodness of fit, consistency and clinical value of the prediction model. Paired t-test and Mann-Whitney U test were used for statistical analysis. Results:There were 69 cases enrolled into the survival group, and 18 cases enrolled into the mortality group. The levels of albumin, prealbumin, platelet count, lymphocyte count, and ALT before treatment, and the level of prealbumin at the 3rd day after treatment of the survival group were all higher than those of the mortality group (32.5 (30.6, 35.2) g/L vs. 29.4 (27.6, 32.3) g/L, 66.0 (52.5, 81.5) mg/L vs. 56.5 (39.2, 65.0) mg/L, 103.0 (72.5, 145.0)×10 9/L vs. 63.5 (40.0, 92.5)×10 9/L, 1.1 (0.8, 1.4)×10 9/L vs. 0.9 (0.5, 1.1)×10 9/L, (514.7±86.4) U/L vs. (328.2±93.4) U/L, 90.0 (69.5, 102.5) mg/L vs.68.5(60.0, 75.8) mg/L), and the age, the level of total bilirubin, international normalized ratio, and prothrombin time before treatment of the survival group were all lower than those of the mortality group (48.0 (42.0, 57.0) years old vs. 48.5 (47.0, 56.0) years old, 323.9 (261.2, 409.2) μmol/L vs. 452.2 (405.8, 510.8) μmol/L, 1.5 (1.3, 1.9) vs. 1.9 (1.4, 2.1), 17.3 (14.6, 20.8) s vs. 21.4 (16.6, 23.2) s), and the differences were statistically significant ( Z=-3.38, -2.87, -2.38 and -2.01, t=2.39, Z=-4.11, 3.00, 3.64, 2.18 and 2.37; all P<0.05). The change of prealbumin on day 1 to 3 after treatment in the mortality group was greater than that in the survival group (-0.182 (-0.321, -0.026) vs. -0.043 (-0.133, 0.093)), and the difference was statistically significant ( Z=-3.42, P=0.001). The results of multivariate logistic regression analysis showed that the age, total bilirubin before treatment, and the change of prealbumin on day 1 to 3 after treatment were independent influencing factors for the 90-day prognosis in HBV-ACLF patients after artificial liver treatment (all P<0.05), and the nomogram model was established based on the above 3 factors. The results of ROC analysis showed that the AUC of the prediction model was 0.933 (95% confidence interval: 0.866 to 1.000, P<0.001), with a sensitivity of 0.933 and a specificity of 0.825. The results of the Hosmer-Lemeshow goodness-of-fit test showed that the prediction model had a good fit( P=0.700). The results of calibration curve analysis indicated that the actual curve of the prediction model was close to the calibration curve, with an average absolute error of 0.034, the consistency between the predicted probability and the actual probability was good. The clinical decision curve analysis suggested that the prediction model had significant clinical benefits. Conclusions:The changes of prealbumin after artificial liver treatment in HBV-ACLF patients can reflect the recovery of liver function. The nomogram prediction model based on the change of prealbumin on day 1 to 3 after treatment, age, and total bilirubin before treatment can better predict the 90-day prognosis of HBV-ACLF patients after artificial liver treatment.
5.Multicenter study on the efficacy of transoral robotic surgery for malignant tongue base tumors
Ming SONG ; Chengzhi XU ; Kai XU ; Faya LIANG ; Huijun YANG ; Chunping WU ; Shuwei CHEN ; Lanjun CAI ; Ping HAN ; Longjuan CHU ; Changding HE ; Xing ZHANG ; Liang ZHOU ; Yan WANG ; Xiaoming HUANG ; Xiang LU ; Ankui YANG ; Lei TAO
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(3):278-284
Objective:To evaluate the clinical efficacy of transoral robotic surgery (TORS) in the treatment of malignant tongue base tumors.Methods:A multicenter study was conducted to collect and analyze the clinical data of patients with malignant tongue base tumors who underwent TORS at five otolaryngology-head and neck surgery centers in China, including Eye Ear Nose and Throat Hospital of Fudan University, Sun Yat-sen University Cancer Center, Tongji Hospital of Huazhong University of Science and Technology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, and the First Affiliated Hospital of China Medical University between January 2017 and January 2023. Among the patients, 38 were males and 11 were females, with a mean age of 59.0±8.8 years. Baseline characteristics, complications, and follow-up data were compared between groups. Independent sample t-tests or Mann-Whitney U tests was used for comparisons of continuous variables; chi-square tests or Fisher′s exact tests was applied for categorical variables. Survival analysis was performed using the Kaplan-Meier method to calculate overall survival and disease-free survival, and differences between groups were compared using the log-rank test. Results:Among the 49 patients, 41 (83.7%) were diagnosed with squamous cell carcinoma (SCC), with a p16 positive rate of 51.2% (21/41). There were no statistically significant differences between the p16-positive group ( n=21) and the p16-negative group ( n=20) in age, sex, or postoperative bleeding (all P>0.05). However, there was a significant difference in TNM stage between the two groups ( χ2=14.556, P=0.020), with the p16-positive group predominantly in stage I (66.7%) and the p16-negative group primarily in stages Ⅲ and Ⅳ (40.0% and 30.0%, respectively). The postoperative tracheotomy rate was 30.6% (15/49), and the incidence of postoperative bleeding was 6.1% (3/49). The 1-year and 3-year overall survival rates were 98.0% and 92.5%, respectively, while, the 1-year and 3-year disease-free survival rates were 89.2% and 84.9%, respectively. No significant differences were observed between the p16-positive and p16-negative groups in 3-year overall survival (100% vs. 83.8%, χ2=1.093, P=0.518) or 3-year disease-free survival (68.2% vs. 88.9%, χ2=2.161, P=0.382). Conclusion:TORS for malignant tongue base tumors demonstrates high clinical safety and favorable oncological outcomes.
6.Transoral robotic surgery of tonsillar squamous cell carcinoma: analysis of 157 cases from five medical centers
Lei TAO ; Faya LIANG ; Xiang LU ; Ankui YANG ; Liang ZHOU ; Quan ZHANG ; Xing ZHANG ; Chunping WU ; Huijun YANG ; Longjuan CHU ; Chao HE ; Chengzhi XU ; Jingtao CHEN ; Ping HAN ; Yan WANG ; Xiaoming HUANG ; Ming SONG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(3):258-265
Objective:To explore the clinical application value of transoral robotic surgery (TORS) in the treatment of tonsil squamous cell carcinoma (TSCC).Methods:A retrospective analysis was conducted. The clinical data of 157 TSCC patients were collected who received TORS at five medical centers, namely, the Sun Yat-sen University Cancer Center, Sun Yat-sen Memorial Hospital, Eye Ear Nose and Throat Hospital of Fudan University, the First Affiliated Hospital of China Medical University, and Tongji Hospital of Tongji Medical College, from January 1 2017 to July 31 2022. There were 130 males and 27 females, aged 24-85 years. All patients were followed-up at least for 2 years (2-year group), among them, 99 patients had a follow-up of 3 years (3-year group). The overall survival (OS), progression-free survival (PFS), clinical stage, human papillomavirus (HPV) infection status were analyzed. SPSS 25.0 and SAS 9.4 were used for statistical analysis.Results:The OS and PFS of the 2-year group were 91.7% and 87.9%, respectively. The OS and PFS of the 3-year group were 85.9% and 82.8%, respectively. The prognosis of patients with locally early-stage was better than that of locally advanced patients, with the OS of 94.4% for T1-2 vs. 78.0% for T3 ( P=0.005) and the PFS of 91.2% for T1-2 vs. 75.0% for T3 ( P=0.011) in the 2-year group; the OS of 91.1% for T1-2 vs. 65.0% for T3 ( P=0.004) and the PFS of 88.6% for T1-2 vs. 60.0% for T3 ( P=0.002) in the 3-year group; and also, the OS of 90.0% for stage Ⅰ-Ⅱ vs. 79.5% for stage Ⅲ-Ⅳ ( P=0.204) and the PFS of 86.7% for stage Ⅰ-Ⅱ vs. 76.9% for stage Ⅲ-Ⅳ ( P=0.188) in the 3-year group. The prognosis of HPV-positive TSCC patients was better than that of HPV-negative patients in the 3-year group, with the OS of 90.9% for HPV-positive vs. 80.5% for HPV-negative ( P=0.045) and the PFS of 90.9% for HPV-positive vs. 75.6% for HPV-negative ( P=0.047). The average time of postoperative tracheal cannula indwelling was 25.1 days. The indwelling rate and average indwelling time of the postoperative nasogastric tube were 94.3% (148/157) and 8.5 days, respectively. Conclusion:TORS has outstanding survival benefits for TSCC patients. HPV-positive TSCC patients have a better prognosis than HPV-negative patients. TORS treatment of TSCC patients has advantages in postoperative recovery and quality of life.
7.Multicenter retrospective analysis of transoral robotic surgery for parapharyngeal space neoplasm
Lei TAO ; Xiaoming HUANG ; Xiang LU ; Ming SONG ; Longjuan CHU ; Huijun YANG ; Liang ZHOU ; Chengzhi XU ; Chunping WU ; Faya LIANG ; Kai XU ; Ankui YANG ; Xing ZHANG ; Shuwei CHEN ; Yan WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(3):285-291
Objective:To investigate the efficacy and feasibility of transoral robotic surgery (TORS) for resection of tumors in the parapharyngeal spaces.Methods:The clinical data of 57 patients who underwent TORS for parapharyngeal space tumors from September 2018 to February 2024 were retrospectively analyzed. These patients were treated at five medical institutions: The First Affiliated Hospital of China Medical University, Eye & ENT Hospital of Fudan University, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, and Sun Yat-sen University Cancer Center. The patients were 28 males and 29 females, aged 17-77 years (median age, 47 years). The pathological types, locations, and sizes of the tumors, operation time, intraoperative bleeding volumes, postoperative hospital stays, and postoperative complications were evaluated. The data were analyzed using SPSS 27.0 software.Results:Postoperative pathological examination revealed 11 types of benign tumors. Among 57 cases, 27 cases had their tumors in the prestyloid spaces, predominantly with pleomorphic adenoma ( n=17), and 30 cases in the retrostyloid spaces, predominantly with schwannoma ( n=22). The tumor volumes ranged from 0.6 to 130.1 cm3, the intraoperative bleeding volumes ranged from 5 to 1 000 ml, the operation time ranged from 20 to 390 min, and the postoperative hospital stays ranged from 2 to 25 days. The total costs for individual cases were 36 000-100 000 yuan, with the highest cost in the case suffering from cerebrovascular accident. Four patients(7.0%) had tracheotomy and 36(63.2%) had nasogastric tube placement. Among the 57 patients, 5 had postoperative cavity effusion, 2 had wound dehiscence, 2 had cerebrovascular accidents, 1 had Horner syndrome, and 2 had other complications. The patients were followed up for 1-67 months, with only 1 patient with intracranial and extracranial communication relapsed. Conclusion:TORS is a safe and feasible approach for treating parapharyngeal space tumors, offering advantages such as minimal invasiveness, reduced blood loss, and faster recovery. It is suitable for parapharyngeal space tumors of various pathological types and locations. The postoperative complications are manageable, with favorable long-term follow-up results and low recurrence rates.
8.Progress of individualized precision therapy for peritoneal metastasis in gastric cancer
Junhua ZHAO ; Yuqing YANG ; Rui MA ; Chengzhi ZHANG ; Zhengchao HONG ; Zhenning WANG
Chinese Journal of Surgery 2025;63(7):552-557
Peritoneal metastasis represents the most aggressive form of gastric cancer metastasis and serves as a primary contributor to poor prognosis. Conventional therapeutic approaches offer limited survival benefits, making the development of novel treatment strategies an urgent medical priority. With advancements in molecular medicine and sociomedical sciences, contemporary cancer management is evolving towards individualized precision medicine. This transition has given rise to a plethora of innovative therapeutic strategies, including molecular typing-driven targeted therapy, immunotherapy, and locally targeted technology. These strategies emphasize the construction of a precise and individualized therapeutic framework through the integration of genomics, imaging genomics, and artificial intelligence-assisted decision-making, which promotes the continuous improvement of treatment strategies for peritoneal metastasis of gastric cancer. This article provides a comprehensive analysis of the prevailing individualized treatment modalities from the standpoint of precision medicine, offering novel perspectives on the management of peritoneal metastasis in gastric cancer.
9.Ultra-long-term follow-up of renal denervation in patients with resistant hypertension and mild chronic kidney disease
Li WANG ; Hao ZHANG ; Chao LI ; Xuemei YIN ; Zhuqing LI ; Qiang HE ; Xiaoqiang SUN ; Dachuan XIA ; Deling KONG ; Chengzhi LU
Chinese Journal of Cardiology 2025;53(10):1119-1125
Objective:To investigate the ultra-long-term antihypertensive efficacy, safety, major adverse events, and survival benefits of renal denervation (RDN) in patients with resistant hypertension (rHTN) and mild chronic kidney disease (CKD).Methods:This real-world, single-center retrospective study enrolled patients with rHTN and mild CKD who underwent RDN at Tianjin First Central Hospital between October 2011 and June 2016. Office blood pressure, home self-measured blood pressure, 24-hour ambulatory blood pressure, serum creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio were collected at baseline and at 1, 5, and 13 years post-RDN. The total daily defined dose of antihypertensive medications at 13 years post-RDN was recorded, along with endpoint events during follow-up, including cardiovascular death, all-cause death, hospitalization for heart failure, myocardial infarction, and stroke. Patients were stratified according to CKD stage (G1-G2 vs. G3a) and baseline systolic blood pressure (mild-to-moderate vs. severe hypertension), and follow-up data were compared across subgroups.Results:A total of 40 patients were included, aged (51±15) years, including 26 (65%) males. At the 13-year follow-up, office systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased by (-32±20) mmHg and (-15±14) mmHg (1 mmHg=0.133 kPa), respectively; reductions in home self-measured blood pressure (SBP: (-25±14) mmHg, DBP: (-10±11) mmHg) and 24-hour ambulatory blood pressure (SBP: (-16±9 mmHg, DBP: (-10±6) mmHg) were also observed, alongside a reduction in the total daily defined dose of antihypertensive medications by (1.1±0.9) compared to baseline. Renal function assessments showed no significant differences at 13 years versus baseline in serum creatinine ((105±51) μmol/L vs. (96±22) μmol/L), estimated glomerular filtration rate ((72±22) ml·min -1·1.73 m -2 vs. (78±17) ml·min -1·1.73 m -2), or urine albumin-to-creatinine ratio ((101±86) mg/g vs. (127±82) mg/g) (all P>0.05). All-cause and cardiovascular mortality rates during follow-up were 13% (5/40) and 8% (3/40), respectively. Subgroup analysis results showed that, although CKD G1-G2 patients had smaller reductions in office SBP ((-31±20) mmHg vs. (-34±19) mmHg) and DBP ((-13±10) mmHg vs. (-25±18) mmHg) compared to G3a patients at 13 years, intergroup differences were not significant (all P>0.05). In contrast, severe hypertension subgroup exhibited greater reductions in office SBP ((-55±13) mmHg vs. (-20±10) mmHg) and DBP ((-24±17) mmHg vs. (-13±10) mmHg) versus mild-to-moderate hypertension subgroup (all P<0.05). Conclusion:RDN demonstrates sustained antihypertensive efficacy with favorable renal safety in rHTN patients with mild CKD. Patients with higher baseline systolic blood pressure may exhibit better responsiveness to RDN.
10.Analysis and Discussion of Traditional Chinese Medicine and Compounds to Improve Diabetic Cardiomyopathy by Regulating Cardiomyocyte Pyroptosis
Ying ZHANG ; Chengzhi XIE ; Chang FU ; Jianxun REN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):260-267
Diabetic cardiomyopathy (DCM) is a myocardium-specific microvascular disease caused by diabetes mellitus that impairs the structure and function of the heart. It is the major cause of morbidity and mortality in diabetic individuals. Traditional Chinese medicine (TCM) has extensive clinical experience and precise efficacy in treating DCM, and its multi-target, multi-pathway, multi-component, and low side effect approach can slow the progression of DCM and improve the symptoms while effectively dealing with the complexity and long-term nature of its pathological process. Many recent studies have demonstrated that pyroptosis accompanied by inflammatory response is one of the main types of myocardial injury in DCM, which promotes the development of DCM and is closely related to pathological changes such as oxidative stress, myocardial fibrosis, myocardial hypertrophy, and decreased cardiac function in the course of DCM. These findings also provide a theoretical foundation for future research into potential therapy techniques and intervention mechanisms for DCM. By searching and analyzing relevant literature from several databases, including CNKI, PubMed, Web of Science, Excerpt Medica, Science Direct, and Springer, this study aimed to comprehensively analyze the characteristics of the effects of TCM and compounds in intervening in cardiomyocyte pyroptosis in DCM in recent years and explore the potential mechanisms. It also reveals the potential of effective components of TCM and compounds in preventing and controlling DCM from the standpoint of cardiomyocyte pyroptosis and provides a new way of thinking and more experimental evidence for the clinical application of TCM in treating DCM.

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