1.Impact of hepatic steatosis on viral load and hepatic fibrosis progression in chronic hepatitis B
Shi YIN ; Lianxin ZHU ; Guanghui REN ; Guiqun HUANG ; Yunpeng GUAN ; Ying ZHU
Journal of Clinical Hepatology 2026;42(6):1279-1286
ObjectiveTo investigate the association of hepatic steatosis with the level of viral replication and the progression of hepatic fibrosis in patients with chronic hepatitis B (CHB) through a real-world study, and to determine the independent influencing factors for hepatic fibrosis. MethodsA total of 887 CHB patients who attended the outpatient service and inpatient ward of Hepatology in The First Affiliated Hospital of Dalian Medical University from July 2021 to March 2025 were enrolled as subjects, and according to the presence or absence of metabolic dysfunction-associated steatotic liver disease (MASLD), they were divided into CHB group with 560 patients and CHB+MASLD group with 327 patients. The association between hepatic steatosis and HBV load in CHB patients was analyzed, as well as the impact of varying degrees of hepatic steatosis on hepatic fibrosis. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups; a Spearman correlation analysis was performed; a Logistic regression analysis was used to investigate influencing factors. ResultsThe patients enrolled received antiviral therapy according to viral load; of all patients, 275 (31%) received nucleos(t)ide analogue combined with pegylated interferon-α, 532 (60%) received nucleos(t)ide analogue monotherapy, and 80 (9%) did not receive antiviral therapy. A total of 44 patients (5.0%) who were receiving PEG-IFN-α therapy and had marked thrombocytopenia were excluded, and finally 843 patients were included for comparison of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4). Compared with the CHB group, the CHB+MASLD group had a significantly higher proportion of male patients (χ2=5.917, P<0.05) and a significant increase in CAP value (t=21.646, P<0.05). The median values of liver function parameters for the population enrolled were within the normal range, and no significant inflammatory activity was observed. The virological analysis showed that compared with the CHB group, the CHB+MASLD group had significantly lower serum level of pregenomic RNA (Z=-2.894, P<0.05) and HBeAg positivity rate (χ2=8.725, P<0.05), and CAP was significantly negatively correlated with pgRNA (r=-0.117, P<0.05). In the HBeAg-negative subgroup, compared with the CHB group, the CHB+MASLD group had a significantly lower level of hepatitis B surface antigen (Z=-0.765, P<0.05); in the HBeAg-positive subgroup, the CHB+MASLD group had a significantly higher level of HBV DNA than the CHB group (Z=-2.509, P<0.05). The analysis of hepatic fibrosis showed that the CHB+MASLD group had significantly lower values of APRI (Z=-3.418, P<0.05) and FIB-4 (Z=-6.237, P<0.05). Compared with the CHB group, the CHB+MASLD S1 group had a significantly higher proportion of patients without fibrosis and a significantly lower proportion patients with liver cirrhosis (χ2=7.935, P<0.05); in the CHB+MASLD S2 group, there was no significant difference in the proportion of patients with different fibrosis stages; the CHB+MASLD S3 group had a significantly lower proportion of patients without fibrosis and a significantly higher proportion of patients with early-stage fibrosis (χ2=9.101, P<0.05). The Logistic regression analysis showed that an increase in CAP (odds ratio [OR]=1.08, 95% confidence interval [CI]: 1.03 — 1.13, P<0.05), an increase in age (OR=1.02, 95%CI: 1.01 — 1.04, P<0.05), male sex (OR=1.77, 95%CI: 1.19 — 2.64, P<0.05), an increase in HBV DNA (OR=1.35, 95%CI: 1.15 — 1.57, P<0.001), an increase in aspartate aminotransferase (OR=1.02, 95%CI: 1.01 — 1.03, P<0.001), and an increase in gamma-glutamyl transpeptidase (OR=1.00, 95%CI: 1.00 — 1.01, P=0.028) were independent influencing factors for hepatic fibrosis. The risk of hepatic fibrosis in S3 patients was higher than that in patients without steatosis (OR=5.05, 95%CI: 2.48 — 10.29, P<0.001). ConclusionThere is a lower level of HBV replication in CHB patients comorbid with MASLD. Hepatic steatosis is associated with HBV-related virological markers and the progression of hepatic fibrosis, and severe fatty liver disease may promote the progression of hepatic fibrosis in CHB patients.
2.Postoperative Stage-based Functional Protection Strategies for Lung Cancer Based on Theory of "Lungs Governing Qi"
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Wei HOU ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):86-93
Lung cancer (LC) is a significant global public health issue, with both its incidence and mortality rates ranking among the highest worldwide. The age-standardized incidence and mortality rates are increasing annually, posing a serious threat to the life and health of LC patients. Radical surgical resection is the primary treatment for malignant lung tumors. However, postoperative multidimensional functional impairments, including respiratory, mucosal, and psychological functions, are common. These impairments not only reduce patients' quality of life and affect their treatment tolerance and duration, but also negatively correlate with prognosis, facilitating disease recurrence and metastasis. At present, postoperative functional dysfunction after LC surgery remains a key clinical challenge that urgently needs to be addressed. There is a lack of standardized and regulated postoperative rehabilitation treatment management and traditional Chinese medicine (TCM) differentiation and treatment strategies for LC. Focusing on the core underlying pathogenesis of "Qi sinking" after LC surgery, and guided by the classical TCM theory of "lungs governing Qi", this study, based on the core concept of the "five perspectives on treatment" theory, innovatively proposes the respiratory dysfunction as the core pathogenesis of "Qi sinking in the chest" during the rapid rehabilitation phase, mucosal dysfunction as the core pathogenesis of "Yin deficiency and Qi sinking" during the postoperative adjuvant treatment phase, and the psychological dysfunction as the core pathogenesis of "Qi sinking with emotional constraint" during the consolidation phase. Accordingly, stage-specific dynamic functional protection strategies are constructed. In the rapid rehabilitation phase, the strategy emphasizes tonifying Qi and uplifting sinking Qi, with differentiation and treatment based on the principle of ''descending before ascending''. In the adjuvant treatment phase, the approach focuses on nourishing Yin and uplifting Qi, with prescription combinations that integrate unblocking and tonification. In the consolidation phase, the strategy aims to resolve constraint and uplift Qi, with clinical treatment emphasizing a combination of dynamic and static methods. At each stage of functional rehabilitation, clinical differentiation and treatment should support healthy Qi and eliminate pathogenic factors simultaneously. This study is the first to propose the concept of postoperative functional protection in TCM, offering a new approach for TCM differentiation and treatment in the full-cycle, stage-based, and dynamic protection of postoperative function in LC patients. It is expected to contribute to the construction and development of an integrated TCM-Western medicine comprehensive program for cancer prevention and treatment in China.
3.A Hierarchical Strategy for Differentiation and Treatment of Recurrent Aphthous Oral Ulcers Related to Targeted Therapy for Lung Cancer Based on Yin Deficiency and Qi Collapse
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Ming LIN ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):116-125
Tumor treatment-related adverse reactions are a major focus of clinical concern, among which recurrent aphthous oral ulcers (RAU) associated with targeted therapy for lung cancer (LC) are among the most painful and distressing for patients. Currently, modern medical interventions show limited efficacy, and there is an urgent need for more effective treatment strategies. This study differentiates RAU associated with targeted therapy for LC from chemotherapy-related and ordinary oral ulcers, elucidates the pathophysiological basis of such ulcers, and traces the theoretical origin of "Yin deficiency and Qi collapse". Based on the new system of "five perspectives on diagnosis and treatment" for tumor prevention and treatment, with a focus on the core and symptom perspectives and rooted in the traditional concept of "lung dominating Qi", we innovatively propose the concept of "medicine-induced ulcer" and are the first to introduce the theory of "Yin deficiency and Qi collapse" into the syndrome differentiation and treatment of RAU associated with targeted therapy for LC (i.e., medicine-induced ulcer). We propose that "Yin deficiency and Qi collapse" is the core pathogenesis of medicine-induced ulcers, in which the collapse of formless Qi is the key to their onset, while the deficiency and stasis of tangible Yin and blood constitute the root of recurrence. A hierarchical strategy for syndrome differentiation and treatment is established: first treating the collapse of formless Qi, then replenishing tangible deficiencies, and concurrently preventing recurrence. We emphasize that treatment should address both root and manifestation, with appropriate prioritization. In the acute phase, while relieving symptoms and promoting ulcer healing by nourishing Qi, uplifting collapse, and generating body fluids, attention should also be paid to nourishing spleen Yin, facilitating the circulation of nutritive Qi, and alleviating stasis to target the root pathogenesis and reduce recurrence. A verified case is presented to support this approach. This study enriches the theoretical framework and clinical methods of traditional Chinese medicine (TCM) in the treatment of RAU associated with targeted therapy for LC, promotes symptom management of treatment-related adverse reactions through integrated TCM and Western medicine, and provides theoretical support for the construction and development of a comprehensive differentiation and treatment system for lung cancer prevention, treatment, and rehabilitation.
4.USP20 as a super-enhancer-regulated gene drives T-ALL progression via HIF1A deubiquitination.
Ling XU ; Zimu ZHANG ; Juanjuan YU ; Tongting JI ; Jia CHENG ; Xiaodong FEI ; Xinran CHU ; Yanfang TAO ; Yan XU ; Pengju YANG ; Wenyuan LIU ; Gen LI ; Yongping ZHANG ; Yan LI ; Fenli ZHANG ; Ying YANG ; Bi ZHOU ; Yumeng WU ; Zhongling WEI ; Yanling CHEN ; Jianwei WANG ; Di WU ; Xiaolu LI ; Yang YANG ; Guanghui QIAN ; Hongli YIN ; Shuiyan WU ; Shuqi ZHANG ; Dan LIU ; Jun-Jie FAN ; Lei SHI ; Xiaodong WANG ; Shaoyan HU ; Jun LU ; Jian PAN
Acta Pharmaceutica Sinica B 2025;15(9):4751-4771
T-cell acute lymphoblastic leukemia (T-ALL) is a highly aggressive hematologic malignancy with a poor prognosis, despite advancements in treatment. Many patients struggle with relapse or refractory disease. Investigating the role of the super-enhancer (SE) regulated gene ubiquitin-specific protease 20 (USP20) in T-ALL could enhance targeted therapies and improve clinical outcomes. Analysis of histone H3 lysine 27 acetylation (H3K27ac) chromatin immunoprecipitation sequencing (ChIP-seq) data from six T-ALL cell lines and seven pediatric samples identified USP20 as an SE-regulated driver gene. Utilizing the Cancer Cell Line Encyclopedia (CCLE) and BloodSpot databases, it was found that USP20 is specifically highly expressed in T-ALL. Knocking down USP20 with short hairpin RNA (shRNA) increased apoptosis and inhibited proliferation in T-ALL cells. In vivo studies showed that USP20 knockdown reduced tumor growth and improved survival. The USP20 inhibitor GSK2643943A demonstrated similar anti-tumor effects. Mass spectrometry, RNA-Seq, and immunoprecipitation revealed that USP20 interacted with hypoxia-inducible factor 1 subunit alpha (HIF1A) and stabilized it by deubiquitination. Cleavage under targets and tagmentation (CUT&Tag) results indicated that USP20 co-localized with HIF1A, jointly modulating target genes in T-ALL. This study identifies USP20 as a therapeutic target in T-ALL and suggests GSK2643943A as a potential treatment strategy.
5.Direction and clinical practice of traditional Chinese medicine in the prevention and treatment of cancer
Xinyi MA ; Bowen XU ; Jie LI ; Ying ZHANG ; Luchang CAO ; Yuansha GE ; Guanghui ZHU ; Xiaoyu ZHU ; Jingyuan WU ; Xinmiao WANG
Chinese Journal of Oncology 2025;47(2):121-128
Cancer is a major chronic disease that threatens human health, while traditional Chinese medicine (TCM) is a unique method for cancer prevention and treatment in China. After about 70 years of innovation and development, TCM has made constant progress in areas such as the clinical diagnosis, treatment, evidence-based researches, and mechanism exploration of cancer. It has special advantages in aspects such as reducing toxicity, enhancing treatment efficacy, managing symptoms, accelerating recovery, preventing recurrence and metastasis, and prolonging advanced-stage survival. However, there are still bottlenecks for TCM in cancer care. This paper cuts in the key links between TCM and western medicine in their combined application in cancer prevention and treatment, and take the original TCM theories on cancer as the lead, high-quality evidence-based researches as the drive, and analysis on the dynamic mechanism as the core, to show the advantages and effects of TCM in cancer treatment in an all-round way. It also aims to provide novel strategies for sustainable and innovative development and for formulation of comprehensive schemes that integrate TCM and western medicine for cancer prevention and treatment.
6.Effectiveness of modified reed tube moxibustion based on spleen-kidney mutual assistance theory in patients with CAPD combined with spleen-kidney yang deficiency type insomnia
Ying JIN ; Guanghui ZHONG ; Dandan MAO ; Jie XING ; Furong CHEN ; Ying MAO
Chinese Journal of Modern Nursing 2025;31(27):3691-3695
Objective:To explore the effect of modified reed tube moxibustion based on spleen-kidney mutual assistance theory in patients with continuous ambulatory peritoneal dialysis (CAPD) combined with spleen-kidney yang deficiency type of insomnia.Methods:From September 2020 to December 2022, 64 patients with CAPD combined with insomnia of spleen-kidney yang deficiency type were selected from the Department of Nephrology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University by the convenience sampling method. A randomized numerical table method was used to divide study subjects into a control group and a study group, with 32 cases in each group. The control group received conventional treatment and auricular needle-embedding therapy; while the study group received traditional treatment and auricular needle-embedding therapy combined with modified reed tube moxibustion. The intervention period lasted three months. Differences in Insomnia Severity Index, Chinese medicine syndrome score, and peritoneal dialysis adequacy were compared between the two groups.Results:After intervention, the Insomnia Severity Index score of the study group was lower than those of the control group, and the difference was statistically significant ( P<0.05). The urea clearance index and creatinine clearance rate of the study group were higher than those of the control group, and the differences were statistically significant (all P<0.05) . Conclusions:Modified reed tube moxibustion based on spleen-kidney mutual assistance theory has a positive effect on improving insomnia symptoms and dialysis adequacy in patients with CAPD combined with insomnia of spleen-kidney yang deficiency type.
7.Effectiveness of modified reed tube moxibustion based on spleen-kidney mutual assistance theory in patients with CAPD combined with spleen-kidney yang deficiency type insomnia
Ying JIN ; Guanghui ZHONG ; Dandan MAO ; Jie XING ; Furong CHEN ; Ying MAO
Chinese Journal of Modern Nursing 2025;31(27):3691-3695
Objective:To explore the effect of modified reed tube moxibustion based on spleen-kidney mutual assistance theory in patients with continuous ambulatory peritoneal dialysis (CAPD) combined with spleen-kidney yang deficiency type of insomnia.Methods:From September 2020 to December 2022, 64 patients with CAPD combined with insomnia of spleen-kidney yang deficiency type were selected from the Department of Nephrology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University by the convenience sampling method. A randomized numerical table method was used to divide study subjects into a control group and a study group, with 32 cases in each group. The control group received conventional treatment and auricular needle-embedding therapy; while the study group received traditional treatment and auricular needle-embedding therapy combined with modified reed tube moxibustion. The intervention period lasted three months. Differences in Insomnia Severity Index, Chinese medicine syndrome score, and peritoneal dialysis adequacy were compared between the two groups.Results:After intervention, the Insomnia Severity Index score of the study group was lower than those of the control group, and the difference was statistically significant ( P<0.05). The urea clearance index and creatinine clearance rate of the study group were higher than those of the control group, and the differences were statistically significant (all P<0.05) . Conclusions:Modified reed tube moxibustion based on spleen-kidney mutual assistance theory has a positive effect on improving insomnia symptoms and dialysis adequacy in patients with CAPD combined with insomnia of spleen-kidney yang deficiency type.
8.Direction and clinical practice of traditional Chinese medicine in the prevention and treatment of cancer
Xinyi MA ; Bowen XU ; Jie LI ; Ying ZHANG ; Luchang CAO ; Yuansha GE ; Guanghui ZHU ; Xiaoyu ZHU ; Jingyuan WU ; Xinmiao WANG
Chinese Journal of Oncology 2025;47(2):121-128
Cancer is a major chronic disease that threatens human health, while traditional Chinese medicine (TCM) is a unique method for cancer prevention and treatment in China. After about 70 years of innovation and development, TCM has made constant progress in areas such as the clinical diagnosis, treatment, evidence-based researches, and mechanism exploration of cancer. It has special advantages in aspects such as reducing toxicity, enhancing treatment efficacy, managing symptoms, accelerating recovery, preventing recurrence and metastasis, and prolonging advanced-stage survival. However, there are still bottlenecks for TCM in cancer care. This paper cuts in the key links between TCM and western medicine in their combined application in cancer prevention and treatment, and take the original TCM theories on cancer as the lead, high-quality evidence-based researches as the drive, and analysis on the dynamic mechanism as the core, to show the advantages and effects of TCM in cancer treatment in an all-round way. It also aims to provide novel strategies for sustainable and innovative development and for formulation of comprehensive schemes that integrate TCM and western medicine for cancer prevention and treatment.
9.Health promotion measures for common allergic diseases
Shunan LIU ; Hongxiang CHEN ; Ying XIONG ; Guanghui LIU ; Weikang ZHOU
Chongqing Medicine 2024;53(1):149-154
Allergic diseases seriously affect people's health,throughout the whole life cycle,from chil-dren to adults and then to the elderly allergy,can be lifelong onset,and need comprehensive prevention and treatment of the whole life cycle.Its occurrence and development have certain rules,it is usually first manifes-ted as atopic dermatitis in infants and young children,and then gradually develops into food allergy,allergic rhinitis(AR),and allergic asthma.Intervention in atopic dermatitis and or reducing the sensitization of food allergens can inhibit the allergic process and reduce the occurrence of AR and allergic asthma.Therefore,inter-vening and blocking the allergic processes is the key to the prevention and treatment of allergic diseases.This article focuses on the comprehensive intervention measures of allergic diseases(including health education,al-lergen intervention,nutrition intervention,daily nursing,psychological intervention)and disease monitoring,in order to promote the development of the prevention and treatment of allergic diseases.
10.Postoperative Treatment and Rehabilitation of Malignant Tumor Based on the Theory of Qi Sinking in Traditional Chinese Medicine
Qianhui SUN ; Guanghui ZHU ; Bowen XU ; Ying ZHANG ; Jie LI
Journal of Traditional Chinese Medicine 2024;65(11):1120-1125
As an important concept in Chinese medicine theory, "qi sinking" is the inheritance and extension of the thought core of sinking of qi in whole body. This article explored the concept of sinking of pectoral qi, center qi, and kidney qi in the theory of qi sinking, and believed that sinking of pectoral qi, stagnation and sinking of center qi, deficiency and sinking of kidney qi were the core pathogenesis of postoperative injury in malignant tumours. Anchored to the method of reinforcing healthy qi and lifting the sunken, this article recommended to identify pattern and treat by guiding supplement and lifting the sunken. For lung gold impairment, heart yang depletion, and pectoral qi sinking, the treatment is to warm and supplement heart and lung, lift pectoral qi, and restore the respiratory function by modified Shengxian Decoction (升陷汤) plus Guizhi Decoction (桂枝汤); for spleen depletion and pathways blockage, liver failing to act freely, and center qi stagnation and sinking, the treatment is to warm and supplement center qi, raise yang and lift the sunken, and restore the digestive function by modified Buzhong Yiqi Decoction (补中益气汤); for source exhausted and essence deficiency, liver qi hiding, and kidney qi deficiency to inward invasion, the treatment is to nourish the kidney and astringe the liver, consolidate the original qi and lift qi, improve the pelvic floor dysfunction, and protect the kidney function by modified Liuwei Dihuang Pill (六味地黄丸) plus Shengma Chaihu Decoction (升麻柴胡汤). Modification need base on different disease patterns and stages, and new ideas for postoperative traditional Chinese medicine treatment and rehabilitation of malignant tumours were provided.

Result Analysis
Print
Save
E-mail