1.Percutaneous coronary intervention vs . medical therapy in patients on dialysis with coronary artery disease in China.
Enmin XIE ; Yaxin WU ; Zixiang YE ; Yong HE ; Hesong ZENG ; Jianfang LUO ; Mulei CHEN ; Wenyue PANG ; Yanmin XU ; Chuanyu GAO ; Xiaogang GUO ; Lin CAI ; Qingwei JI ; Yining YANG ; Di WU ; Yiqiang YUAN ; Jing WAN ; Yuliang MA ; Jun ZHANG ; Zhimin DU ; Qing YANG ; Jinsong CHENG ; Chunhua DING ; Xiang MA ; Chunlin YIN ; Zeyuan FAN ; Qiang TANG ; Yue LI ; Lihua SUN ; Chengzhi LU ; Jufang CHI ; Zhuhua YAO ; Yanxiang GAO ; Changan YU ; Jingyi REN ; Jingang ZHENG
Chinese Medical Journal 2025;138(3):301-310
BACKGROUND:
The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China.
METHODS:
This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences.
RESULTS:
Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n = 278] vs . 43.7% [ n = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses.
CONCLUSION
This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans
;
Percutaneous Coronary Intervention/methods*
;
Male
;
Female
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Coronary Artery Disease/drug therapy*
;
Retrospective Studies
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Renal Dialysis/methods*
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Middle Aged
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Aged
;
China
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Proportional Hazards Models
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Treatment Outcome
2.Efficacy and safety of Liqingtong granules in the treatment of hyperuricemia: A randomized double-blind placebo-controlled pilot clinical trial
Jinlian Liu ; Yi Yang ; Meiyu Lv ; Wenting Fei ; Songrui Di ; Mei Luo ; Qing Lin ; Chun Wang ; Linyuan Wang ; Jianjun Zhang
Journal of Traditional Chinese Medical Sciences 2024;11(4):415-422
Objective:
To investigate the efficacy and safety of Liqingtong (LQT) granules in patients with dampness-heat hyperuricemia.
Methods:
A randomized, double-blind, placebo-controlled pilot trial was conducted at the 983rd Hospital of the Joint Logistic Support Force of the People's Liberation Army from March 15, 2023, to August 10, 2023. In total, 119 participants were enrolled in this trial, and participants were given either LQT granules or placebo for 60 days based on a health education. The primary outcome was serum uric acid (SUA) level, and the secondary outcome was the traditional Chinese medicine (TCM) symptom score, measured on days 0, 30, and 60. Safety indicators, including liver function, kidney function, blood routine, glucose, blood lipid, blood pressure, and heart rate were tested on days 0 and 60 of the trial. The data were analyzed using Prism 9 software, and the significance level was set at P < .05.
Results:
Among 119 participants, six in the LQT granule group and seven in the placebo group dropped out, and 106 participants completed clinical observation. Baseline information, including SUA levels, TCM symptom scores, and other clinical characteristics, did not differ between the groups. At the end of the trial, compared with baseline values, the SUA levels in the LQT granule group decreased (P < .001), and no significant change was observed in the placebo group (P = .422); compared with the placebo group, the SUA levels decreased in the LQT granule group (P = .001). Compared with baseline values, the total TCM symptom scores in the LQT granule group decreased (P < .001), with no change in the placebo group (P = .136). Safety indicators did not differ significantly between the two groups.
Conclusion
The pilot trial demonstrated the potential of LQT granules to lower SUA levels and improve symptoms of dampness and heat.
3.Treatment of chronic prostatitis with Xiongji Formula based on the concept of"brain-heart-kidney-essence chamber"axis of medication
Zi-Wei ZHAO ; Qing-He GAO ; Yang LIU ; Hong-Yuan CHANG ; Di-Cheng LUO ; An-Min WANG ; Jun GUO
National Journal of Andrology 2024;30(5):439-443
Chronic prostatitis is a process of kidney deficiency and blood stasis mixed with various pathological factors involving the essence chamber,which is manifested as kidney deficiency and blood stasis.Based on the concept of the"brain-heart-kidney-es-sence chamber"axis of medication,Xiongji Formula is applied to the treatment of chronic prostatitis,due to its"simultaneous holistic and local action"and effects of tonifying the kidney yang and assisting the systemic yang,acting on the brain,heart and kidney as a whole,and meanwhile activating blood circulation,eliminating blood stasis and restoring the function of the essence chamber.This pa-per discusses the etiology and pathogenesis of chronic prostatitis with kidney deficiency and blood stasis in Chinese medicine,expounds the significance of"brain-heart-kidney-essence chamber"axis of medication,and explores the specific value and clinical application of Xiongji Formula.
4.Cloning and application in synthetic biology of chalcone synthase gene from Lithocarpus litseifolius.
Ha-Xiu ZHU ; Qing-Xiang FENG ; Shu-Fu SUN ; Yu-Ping TAN ; Xiao-Yan WEI ; Ke-Ke ZHANG ; Chen-Chen WANG ; Yan WANG ; Da-Yong LI ; Jin-Fu TANG ; Qiong LUO
China Journal of Chinese Materia Medica 2024;49(24):6676-6684
Lithocarpus litseifolius is rich in the chalcones phloridzin and trilobatin, the biosynthesis pathways of which have not been fully demonstrated. Chalcone synthase(CHS) is the first key rate-limiting enzyme in the biosynthesis of flavonoids in plants. To explore the functions of CHS gene family in chalcone synthesis of L. litseifolius, this study screened out two CHS genes(LlCHS1 and LlCHS2) from the transcriptome data of this plant, and then bioinformatics analysis and functional characterization were performed for the two genes. The bioinformatics analysis showed that LlCHS1 and LlCHS2 were acidic hydrophilic stable proteins with no transmembrane domain, composed of 395 and 390 amino acid residues, respectively. Both of them contained the characteristic amino acid sequence "WGVLFGFGPGL" and highly conserved active sites(Cys-164, Phe-215, His-303, and Asn-336) of the CHS family. The phylogenetic tree showed that LlCHS1 shared the same clade with similar genes in Aquilaria sinensis, and LlCHS2 was closely related to similar genes in Malus domestica. Under exogenous addition of phloretic acid, co-expression of LlCHS1 or LlCHS2 with Aa4CL from Aromatoleum aromaticum in Escherichia coli catalyzed the production of phloretin from phloretic acid. This study laid a theoretical foundation for revealing the functions of CHS in plants and provided new enzymatic modules for producing phloretin by synthetic biology.
Acyltransferases/chemistry*
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Phylogeny
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Plant Proteins/chemistry*
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Cloning, Molecular
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Amino Acid Sequence
5.Mechanism of Cordyceps militaris against non-small cell lung cancer: based on serum metabolomics.
Ying-Ying LU ; Xiao HUANG ; Zi-Chen LUO ; Ming-Yuan QI ; Jin-Jun SHAN ; Wen ZHANG ; Liu-Qing DI
China Journal of Chinese Materia Medica 2022;47(18):5032-5039
This study investigated the potential mechanism of Cordyceps militaris(CM) against non-small cell lung cancer(NSCLC) based on serum untargeted metabolomics. Specifically, Balb/c nude mice were used to generate the human lung cancer A549 xenograft mouse model. The tumor volume, tumor weight, and tumor inhibition rate in mice in the model, cisplatin, Cordyceps(low-, medium-, and high-dose), and CM(low-, medium-, and high-dose) groups were compared to evaluate the influence of CM on lung cancer. Gas chromatography-mass spectrometry(GC-MS) was used for the analysis of mouse serum, SIMCA 13.0 for the compa-rison of metabolic profiles, and MetaboAnalyst 5.0 for the analysis of metabolic pathways. According to the pharmacodynamic data, the tumor volume and tumor weight of mice in high-dose CM group and cisplatin group decreased as compared with those in the model group(P<0.05 or P<0.01). The results of serum metabolomics showed that the metabolic profiles of the model group were significantly different from those of the high-dose CM group, and the content of endogenous metabolites was adjusted to different degrees. A total of 42 differential metabolites and 7 differential metabolic pathways were identified. In conclusion, CM could significantly inhibit the tumor growth of lung cancer xenograft mice. The mechanism is the likelihood that it influences the aminoacyl-tRNA biosynthesis, the metabolism of D-glutamine and D-glutamate, metabolism of alanine, aspartate, and glutamate, metabolism of glyoxylate and dicarboxylic acid, biosynthesis of phenylalanine, tyrosine, and tryptophan, arginine biosynthesis as well as nitrogen metabolism. This study elucidated the underlying mechanism of CM against NSCLC from the point of metabolites. The results would lay a foundation for the anticancer research and clinical application of CM.
Alanine/metabolism*
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Animals
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Arginine/metabolism*
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Aspartic Acid
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Carcinoma, Non-Small-Cell Lung/drug therapy*
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Cisplatin/pharmacology*
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Cordyceps
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Glutamic Acid
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Glutamine
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Glyoxylates/metabolism*
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Humans
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Lung Neoplasms/drug therapy*
;
Metabolomics/methods*
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Mice
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Mice, Nude
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Nitrogen/metabolism*
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Phenylalanine/metabolism*
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RNA, Transfer/metabolism*
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Tryptophan/metabolism*
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Tyrosine/metabolism*
6.Expert Consensus on Rheumatic Immune Diseases Responding Specifically to Traditional Chinese Medicine
Yuan XU ; Jing LUO ; Man HAN ; Meng-tao LI ; Xiu-juan HOU ; Di WU ; Bin LI ; Yan GENG ; Yun-shan ZHOU ; Chang-hong LI ; Kun-peng LI ; Jia-bo WANG ; Yong WANG ; Xiao-xiao ZHANG ; Qing-wen TAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(9):198-204
In the clinical practice of rheumatic immune diseases in traditional Chinese medicine (TCM),it`s still unclear about the dominant diseases and breakthrough points. It`s urgent missions to formulate TCM diagnosis and treatment guidelines widely recognized and integrated by traditional Chinese medicine and Western medicine. In order to clarify the dominant diseases and breakthrough points in rheumatism,China association of Chinese medicine initiated a research group covering experts in the field of rheumatism of traditional Chinese medicine and Western medicine. Based on questionnaire survey and on-site discussion,experts had reached the following consensus. Evidence-based medicine research using modern medical methods and scientific methods should be carried out to provide objective clinical evidences. "Four mutuality" were put forward as the basis for the work of integrated traditional Chinese and Western medicine,that is the mutual communication using the exchangeable context,the mutual explanation using common theories,the mutual certification using common standards,and the mutual integration using common means. Key works should focus on solving refractory rheumatism in the future. In terms of dominant diseases and breakthrough points,this paper introduces 21 breakthrough points in 6 dominant diseases,including rheumatoid arthritis,ankylosing spondylitis,Sjogren's syndrome,hyperuricemia and gout,systemic lupus erythematosus and fibromyalgia syndrome. Advice on this discussion can provide valuable references for developing the treatment scheme of rheumatism with TCM and integrated Chinese and Western medicine and clinical practice and scientific research.
7. Analysis of the arthropathies on no-bleeding history joints in pre-school age severe hemophilia A children
Di AI ; Xiaojing LI ; Wanru YAO ; Qing ZHANG ; Min ZHOU ; Ling TANG ; Xiaobo LUO ; Ningning ZHANG ; Sheng YANG ; Yan WANG ; Ping DING ; Siyu CAI ; Zhenping CHEN ; Runhui WU
Chinese Journal of Pediatrics 2018;56(10):741-744
Objective:
To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A.
Methods:
This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted. The target joints (six joints of bilateral elbows, knees and ankles) of thirty-four children aged 1-7 years old with severe hemophilia A were examined by ultrasound, X-ray and joint function examination (4-7 years old, hemophilia joint health score (HJHS)). To find out whether there are arthropathies in patient's joints with no bleeding history and analyze the relevant factors by chi-square test, rank sum test and other statistical methods.
Results:
There were 32 analyzable cases with 112 no-bleeding history target joints, 42.9% (48/112) were elbow joints. Arthropathies were revealed in 34.8% (39/112) of them by joint structural and functional examination and 46.2% (18/39) were ankles (χ2=8.379,
8.Identification of Panax ginseng, P. notoginseng and P. quinquefolius admixture by multiplex allele-specific polymerase chain reaction.
Chao JIANG ; Yu-Qing LUO ; Yuan YUAN ; Lu-Qi HUANG ; Yan JIN ; Yu-Yang ZHAO
China Journal of Chinese Materia Medica 2017;42(7):1319-1323
To achieve a molecular method to identify Panax ginseng, P. notoginseng,P. quinquefolius and their admixture. The ITS,18S and matK sequences of Panax genus were analyzed to develop species-specific SNP marker. Three pairs of species-specific primers were designed to establish a multiplex allele-specific polymerase chain reaction (MAS-PCR) and the samples from different region were tested. The results showed that when the annealing temperature was 60 ℃ and the cycle number was 35, approximately 250, 500,1 000 bp specific band were obtained from P. ginseng, P. notoginseng and P. quinquefolius obtain, respectively. This method could also be used to authentificate admixture samples and could detect 0.5% percent of P. notoginseng or P. quinquefolius adulterated in P. ginseng, or 0.5% percent of P. ginseng or P. quinquefolius adulterated in P. notoginseng. The detect limit of P. ginseng in P. quinquefolius was 0.5% and P. notoginseng in P. quinquefolius was 1%. This results showed that the present method could be used as a promise method to identify Panax ginseng, P. notoginseng, P. quinquefolius and their admixture.
10.Recurrence and metastasis in patients with non-small cell lung cancer after minimally invasive surgery
Luo MENG ; Liu BO ; Liu DI ; Hu JIAN ; Long QIAN ; Zhang QING-BIN ; Mei HONG
China Journal of Endoscopy 2017;23(9):42-47
Objective To analyze the recurrence and metastasis in patients with non-small cell lung cancer (NSCLC) after minimally invasive surgery. Methods 123 patients with NSCLC underwent thoracoscopic lobectomy from January 2008 to December 2013 were enrolled in the study. Their perioperative data and follow-up results were analyzed, and postoperative recurrence and metastasis were recorded. Multivariate logistics regression analysis was performed to investigate the influencing factors of postoperative recurrence and metastasis. Results The median operative time was 165 min (60 ~ 430 min) and the median intraoperative blood loss was 95 ml (20 ~ 3100 ml). Postoperative complications occurred in 15 cases (12.2%). All patients were followed up regularly after discharge, and the median follow-up time was 23.5 months (6 ~ 69 months). During the follow-up period, postoperative recurrence and metastasis occurred in 36 cases (29.3%) and 42 cases (34.1%), including 16 cases (13.0%) patients simultaneously appeared recurrence and metastasis. The ipsilateral lung (52.8%) was the most common site of recurrence, followed by mediastinal lymph nodes (38.9%). Bone (28.6%) was the most common site of metastasis,followed by contralateral lung (26.2%) and brain (19.0%). Multivariate logistic regression analysis showed that stage Ⅱ-Ⅲ, mediastinal lymph node metastasis and low differentiation were independent risk factors of postoperative recurrence (P < 0.05) while stage Ⅱ ~ Ⅲ , number of lymph node metastasis ≥ 3, without postoperative radiotherapy and chemotherapy were independent risk factors of postoperative metastasis (P < 0.05). Conclusions For patients with NSCLC, recurrence and metastasis after thoracoscopic lobectomy occurred mainly in the ipsilateral lung and bone. TNM staging, mediastinal lymph node metastasis, differentiation degree, lymph node metastases, postoperative radiotherapy and chemotherapy were related with postoperative recurrence and metastasis.


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