1.Integrated traditional Chinese and Western medicine therapy for Wilson disease
Yumei GU ; Yeqing HUANG ; Bei ZHANG ; Aiqun LIU ; Zhongxing PENG ; Mingfan HONG ; Zhihua ZHOU
Journal of Clinical Hepatology 2026;42(3):529-534
Wilson disease (WD) is one of the few treatable neurogenetic disorders. Currently, Western medicine remains the main treatment method for WD, while since the 1990s, multiple studies conducted by Professor Yang Renmin and his team have shown that traditional Chinese medicine (TCM) also has a favorable therapeutic effect. Based on the principle of low-copper diet for WD, this article systematically elaborates on the advantages, limitations, and key considerations of current Western medicine therapies (pharmacotherapy, liver transplantation, and splenectomy) and reviews the research findings of TCM in China, especially the wide application of Gandou Decoction in clinical practice. Studies have shown that Gandou Decoction can effectively improve neurological symptoms, protect hepatic and renal function, and avoid the adverse drug reactions associated with metal chelating agents, and therefore, it can be used an effective long-term adjuvant therapy for WD. It should be noted that symptoms and signs should be considered in integrated traditional Chinese and Western medicine therapy for WD, and high-copper TCM drugs should be avoided to prevent deterioration.
2.Challenges and Recommendations for Implementing Key Technologies in Decentralized Clinical Trials of Traditional Chinese Medicine
Runze WANG ; Xuehan WEI ; Xiaoying CHEN ; Yingqian ZHANG ; Jin SUN ; Chunli LU
Journal of Traditional Chinese Medicine 2026;67(9):926-934
Traditional Chinese medicine (TCM) clinical trials face challenges such as low participant compliance, insufficient geographical coverage, and cost-effectiveness imbalances. Decentralized clinical trials (DCT), enabled by digital technology for remote data collection and monitoring, offer a new direction for TCM clinical trial research. This article systematically reviews three novel clinical trial design models. Combining the holistic concept and indivi-dualized treatment characteristics of TCM, it analyzes the challenges currently faced in TCM DCT practice, including the digitization and standardization of TCM theory, data security, privacy protection and patient engagement difficu-lties, insufficient ethical review and regulatory system adaptation, inadequate personnel training, and a shortage of interdisciplinary talent. Addressing these challenges, the article proposes methodological recommendations for DCT implementation that align with the principles of TCM diagnosis and treatment. These recommendations include promoting the intelligentization and standardization of TCM practices, constructing a full-chain data security and privacy protection system, improving the ethical framework and clarifying regulatory responsibilities, and cultivating and building interdisciplinary talent and capabilities, which provide theoretical and technical references for establishing standardized DCT practices in TCM.
3.Challenges and Recommendations for Implementing Key Technologies in Decentralized Clinical Trials of Traditional Chinese Medicine
Runze WANG ; Xuehan WEI ; Xiaoying CHEN ; Yingqian ZHANG ; Jin SUN ; Chunli LU
Journal of Traditional Chinese Medicine 2026;67(9):926-934
Traditional Chinese medicine (TCM) clinical trials face challenges such as low participant compliance, insufficient geographical coverage, and cost-effectiveness imbalances. Decentralized clinical trials (DCT), enabled by digital technology for remote data collection and monitoring, offer a new direction for TCM clinical trial research. This article systematically reviews three novel clinical trial design models. Combining the holistic concept and indivi-dualized treatment characteristics of TCM, it analyzes the challenges currently faced in TCM DCT practice, including the digitization and standardization of TCM theory, data security, privacy protection and patient engagement difficu-lties, insufficient ethical review and regulatory system adaptation, inadequate personnel training, and a shortage of interdisciplinary talent. Addressing these challenges, the article proposes methodological recommendations for DCT implementation that align with the principles of TCM diagnosis and treatment. These recommendations include promoting the intelligentization and standardization of TCM practices, constructing a full-chain data security and privacy protection system, improving the ethical framework and clarifying regulatory responsibilities, and cultivating and building interdisciplinary talent and capabilities, which provide theoretical and technical references for establishing standardized DCT practices in TCM.
4.A-to-I RNA editing of miR-411 attenuates post-infarction cardiac fibrosis via dual targeting of TGFBR2 and CD44
Suling DING ; Zhiwei ZHANG ; Xiyang YANG ; Dili SUN ; Jianfu ZHU ; Xiaowei ZHU ; Xiangdong YANG ; Junbo GE
Chinese Journal of Clinical Medicine 2026;33(1):191-192
Objective To explore the functional impact of A-to-I editing in the seed region of miR-411 during post-myocardial infarction (MI) fibrosis and elucidate its therapeutic potential. Methods Integrating GEO database with myocardial RNA-seq data from MI mouse models, we identified dynamic A-to-I RNA editing in small noncoding RNAs across MI progression (1 day to 8 weeks post-MI). Four miRNAs exhibited differential editing rates between MI and controls, with miR-411 showing progressive editing enhancement at seed region position 4 (P<0.01). This editing event was validated in both murine MI models and human heart failure specimens. Results The A-to-I editing ratio change of the 4th nucleotide in the seed region of miR-411 mainly occurs in cardiac fibroblasts rather than cardiomyocytes, and the editing at this site depends on ADAR2 rather than ADAR1. Edited miR-411 (ED-miR-411) diverged from wild-type miR-411 (WT-miR-411) in suppressing collagen-related pathways (extracellular matrix [ECM]-receptor interaction, collagen-containing ECM, ECM organization; P<0.01) in cardiac fibroblasts. Mechanistically, dual-luciferase assays confirmed ED-miR-411 directly targeted the 3′UTR and suppressed expression of type Ⅱ transforming growth factor (TGF)-beta receptor (TGFBR2) and CD44, which were key drivers of TGF-β-mediated fibroblast activation. ED-miR-411 overexpression blunted TGF-β-induced collagen synthesis and myofibroblast proliferation (P<0.05). In vivo, intramyocardial delivery of ED-miR-411 mimics at 1 week post-MI reduced fibrosis by 40% and improved ejection fraction by 15% (P<0.01 vs controls), whereas WT-miR-411 showed no therapeutic effect. Conclusions A-to-I editing of miR-411 emerges as an endogenous anti-fibrotic mechanism by repressing TGFBR2 and CD44, thereby disrupting TGF-β signaling and ECM dysregulation. Our findings highlight ED-miR-411 as a novel RNA-based therapeutic candidate to mitigate post-infarction cardiac remodeling.
5.Research status of mitochondria-associated endoplasmic reticulum membranes in the pathogenesis of blinding ocular diseases
Kewen ZHOU ; Qingping LIU ; Mingzhi ZHANG
International Eye Science 2026;26(3):410-416
Mitochondria-associated endoplasmic reticulum membranes(MAMs)are crucial structural links between the endoplasmic reticulum and mitochondria, formed by a complex protein network. They play a central role in cellular calcium signaling homeostasis, mitochondrial stability, endoplasmic reticulum stress, and inflammatory response. In recent years, advances in subcellular ultrastructure research techniques have gradually uncovered the relationship between MAMs dysfunction and blinding ocular diseases. Studies indicate that structural or functional impairments in MAMs can disrupt retinal pigment epithelial cells homeostasis, compromise the survival microenvironment of retinal ganglion cells, and trigger corneal endothelial cells apoptosis, thereby contributing to the pathogenesis of various blinding ocular diseases including age-related macular degeneration, diabetic retinopathy, Fuchs endothelial corneal dystrophy, and glaucoma. This article reviews the molecular mechanisms linking MAMs in common blinding ocular diseases.
6.Research status of protein N-glycosylation detection methods and their applications in ophthalmology research
Peiyi PENG ; Qingping LIU ; Mingzhi ZHANG
International Eye Science 2026;26(3):458-462
N-glycosylation is a crucial posttranslational modification of proteins that can modulate their functions and plays key roles in various biological processes. Current research has revealed that alterations in protein N-glycosylation are closely associated with the pathogenesis and progression of multiple ocular diseases. N-glycosylation detection methods can identify changes in N-glycans on proteins; therefore, understanding these techniques and their application value in ocular diseases is important. This article provides a systematic review of the current state of N-glycosylation detection methods, including techniques such as capillary electrophoresis, liquid chromatography, and mass spectrometry. It also offers a detailed discussion on the specific applications of these technologies in the study of various ocular diseases, including diabetic retinopathy, age-related macular degeneration and vernal keratoconjunctivitis/atopic keratoconjunctivitis.
7.Epidemiological characteristics and disease burden of liver cancer in Guangdong Province
Ying ZHANG ; Yixuan CHEN ; Rong CAO ; Yue GAO ; Yutong HAN ; Ye WANG ; Ruilin MENG ; Xueyan ZHENG ; Yu LIAO ; Zhuanping ZENG
Journal of Public Health and Preventive Medicine 2026;37(1):68-72
Objective To analyze the epidemiological characteristics and disease burden of liver cancer in Guangdong Province in 2020, and to provide a scientific foundation for the development of regionalized prevention and control strategies for liver cancer. Methods According to the cancer registry data of Guangdong Province, the incidence, mortality and age-standardized rate by Chinese standard population in 2020 were calculated to analyze the epidemiological characteristics of liver cancer. The disability adjusted life years (DALYs), year of life loss (YLL), year of lived with disability (YLD), and cause-eliminated life expectancy were used to assess the disease burden of liver cancer. Results In 2020, the crude incidence rate and the age-standardized incidence rate of liver cancer in Guangdong Province were 27.79/100 000 and 20.84/100 000,respectively, and the crude mortality rate and the age-standardized mortality rate of liver cancer were 25.49/100,000 and 17.64/100 000, respectively. The total DALY and DALY rate of liver cancer in Guangdong Province were 515 311 person-years and 513.83/100 000, respectively. After eliminating the causes of death from liver cancer, the life expectancy in Guangdong Province increased from 84.60 years to 84.99 years. All indicators consistently demonstrated that the burden of liver cancer was higher in males than that in females, and the burden of liver cancer was higher in rural areas than that in urban areas. Conclusion Liver cancer in Guangdong Province exhibits a high incidence, mortality and disease burden level in 2020. There are obvious differences of gender, age and region in cancer burden. It is necessary to strengthen liver cancer screening and diagnosis and treatment in men, the elderly and those in rural areas to reduce the burden of liver cancer gradually in Guangdong Province.
8.Traditional Chinese Medicine in Regulation of Relevant Signaling Pathways for Glaucoma Treatment: A Review
Weiwen QIU ; Xueqin HE ; Xinbei LIN ; Lianxiang LUO ; Qiuli ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):338-346
Glaucoma, characterized by pathological elevation of intraocular pressure, progressive optic nerve damage, and apoptosis of retinal ganglion cells, is one of the leading causes of irreversible blindness. It is strongly associated with significant vision loss and a decline in quality of life. Although pharmacological therapy remains the primary approach to managing glaucoma, clinical outcomes are often suboptimal, highlighting the urgent need for safe and effective alternative treatments. In traditional Chinese medicine (TCM), glaucoma is categorized as part of the "five wind internal obstruction" syndrome, and TCM has amassed substantial experience in the prevention and treatment of this condition. Therefore, this article provided a comprehensive review of recent findings on the relationship between glaucoma and relevant signaling pathways, as well as the regulatory effects of TCM on these pathways in the treatment of glaucoma. TCM can exert therapeutic effects by modulating key signaling pathways, including the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB (TLR4/MyD88/NF-κB) signaling pathway, Janus kinase (JAK)/signal transducer and activator of transcription (JAK/STAT) pathway, phosphoinositide 3-kinase/serine-threonine protein kinase/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway, nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway, and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) pathway. These pathways are involved in reducing inflammation, inhibiting apoptosis and ferroptosis, and ameliorating oxidative stress. By synthesizing current research, this article offers theoretical insights and practical references for advancing the understanding of the pathological mechanisms underlying glaucoma, innovating strategies for optic nerve protection, and promoting integrative TCM and Western medical approaches in glaucoma management.
9.Prediction and verification of the mechanism of Chaiqi yigan granules improving hepatocellular carcinoma
Guiping MA ; Yuanjie ZHANG ; Yichi ZHOU ; Jinzhen LYU ; Conghui WANG ; Fenping LU ; Bowen LIU ; Yun RAN ; Shiping HU
China Pharmacy 2026;37(5):620-625
OBJECTIVE To predict and validate the mechanisms of Chaiqi yigan granules (CQYG) improving hepatocellular carcinoma (HCC). METHODS The signaling pathways of CQYG intervention in HCC were predicted using network pharmacology. A mice model of transplanted hepatocellular carcinoma was established by injecting H22 hepatoma cells into the axilla. Successfully modeled mice were randomly divided into model group (normal saline), sorafenib group (positive control, 50 mg/kg), and CQYG low-, medium- and high-dose groups (24.83, 49.66, 99.32 g/kg), with 10 mice in each group. Mice in each group were administered the corresponding drug solution or normal saline intragastrically, once a day, for 14 consecutive days. After last administration, pathological morphological changes in the tumor tissues of mice were observed in each group. Immunohistochemical staining was performed to detect the expression of the nuclear proliferation antigen Ki-67 in tumor tissues of mice. Western blot assay was used to measure the expression of proteins related to epithelial-mesenchymal transition (EMT) [N-cadherin, E-cadherin, Vimentin, matrix metalloproteinase 7 (MMP7)] and the mitogen-activated protein kinase (MAPK) signaling pathway [p38 MAPK, phosphorylated p38 MAPK, c-Jun N-terminal kinase (JNK), phosphorylated JNK, extracellular regulated protein kinase 1/2 (ERK1/2), phosphorylated ERK1/2] in tumor tissue of mice. RESULTS Network pharmacology analysis revealed that metabolic pathways, pathways in cancer, and the MAPK signaling pathway were key signaling pathways through which CQYG exert their anti-hepatocellular carcinoma effects. In animal experiments, the tumor tissues of mice in the model group exhibited dense tumor cells and vigorous growth. Compared with model group, CQYG high-dose group showed a decreased density of tumor cells in the tumor tissues of mice. Moreover, the expression levels of Ki-67, N-cadherin, MMP7 and Vimentin proteins, along with the phosphorylation levels of ERK1/2 and JNK proteins, were all significantly reduced ( P <0.05). The expression level of E-cadherin protein was significantly increased ( P <0.05), the phosphorylation level of p38 MAPK protein was increased, the difference was not statistically significant ( P >0.05). CONCLUSIONS CQYG can inhibit EMT by regulating the MAPK signaling pathway, thereby suppressing tumor cell invasion and metastasis and ultimately exerting a therapeutic effect in improving HCC.
10.Signal mining of adverse reactions associated with macrolide antibiotics in pediatric patients based on the FAERS database
Zhenpo ZHANG ; Jiaxin HE ; Jingping ZHENG ; Yuting WANG ; Lin MA ; Ling SU
Journal of Pharmaceutical Practice and Service 2026;44(3):160-166
Objective To explore the adverse event signals of children using macrolide drugs (azithromycin, clarithromycin, and erythromycin), and provide reference for rational medicine use in clinical practice. Methods Data from children under 12 years old were extracted from the US FAERS database spanning from the first quarter of 2004 to the second quarter of 2023. The adverse drug reaction (ADR) signal mining for three macrolide antibiotics was conducted using the Reporting Odds Ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) methods. Special emphasis was placed on analyzing and contrasting the differences in adverse events among the three drugs. Results A total of 1 615 reports for children under 12 years old were retrieved from the FAERS database, including 1 024 reports of azithromycin, 460 reports of clarithromycin, and 131 reports of erythromycin. Among azithromycin and erythromycin, there were more reports from boys than girls, while for clarithromycin, there were more reports from girls than boys. Oral administration was the most common route of administration for all three drugs. Regarding the outcome of adverse events reported, azithromycin and clarithromycin were primarily associated with other serious adverse events, whereas erythromycin was mainly associated with hospitalization and other serious adverse events. The number of adverse events reported decreased with increasing age, with a higher number of reports in the 0-3 age group. Using the ROR and BCPNN methods for signal detection, 86 signals were identified for azithromycin, 91 for clarithromycin, and 34 for erythromycin. These signals involved 22 System Organ Classes (SOCs), with azithromycin mainly concentrated in skin and subcutaneous tissue disorders (n=21), clarithromycin in gastrointestinal disorders (n=15), and erythromycin in gastrointestinal disorders (n=8). Twenty-four signals of moderate to high risk were detected, with 13 for azithromycin, 9 for clarithromycin, and 2 for erythromycin. Conclusion The adverse events induced by the three drugs with different risks in different systems. When clinically treating Mycoplasma pneumoniae pneumonia in children, the risk profiles of drugs in different systems should be considered, and personalized dosing should be implemented.


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