1.Value of liver and spleen stiffness measured by two-dimensional shear wave elastography in diagnosing the severity of portal hypertension
Min WANG ; Guanhua ZHANG ; Lijuan FENG ; Yuhong SUO ; Fuliang HE ; Xiangdong HU ; Min LI ; Yu WANG
Journal of Clinical Hepatology 2026;42(5):1075-1082
ObjectiveTo investigate the value of liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) measured by two-dimensional shear wave elastography (2D-SWE) in the diagnosis of severe portal hypertension (SPH) and high-risk varices (HRV), and to provide a basis for noninvasive assessment of portal hypertension. MethodsA prospective study was conducted among 78 patients with cirrhotic portal hypertension who were treated in Liver Research Center of Beijing Friendship Hospital, Capital Medical University, from December 2019 to April 2023. According to hepatic venous pressure gradient (HVPG), the patients were divided into 6 mmHg≤HVPG<12 mmHg group, 12 mmHg≤HVPG<20 mmHg group, and HVPG ≥20 mmHg group. All patients underwent gastroscopy and 2D-SWE within 1 week after HVPG measurement, and SWE-LSM and SWE-SSM measured by 2D-SWE were recorded. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. With HVPG and gastroscopy findings as the gold standard, the receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated to evaluate diagnostic performance, while the DeLong test was used for comparison of AUC. The Pearson or Spearman correlation analysis was used to investigate the correlation between variables, and the linear regression analysis and the Logistic regression analysis were used to investigate the influencing factors for HVPG and HRV. ResultsThe mean HVPG was 18.1±6.4 mmHg for the patients enrolled in this study, and HRV was observed in 62 patients (79.5%). Both SWE-LSM and SWE-SSM were significantly positively correlated with HVPG (r=0.413 and 0.633, both P<0.001), with an AUC of 0.812 and 0.902, respectively, in the diagnosis of HVPG≥12 mmHg and an AUC of 0.804 and 0.789, respectively, in the diagnosis of HVPG≥20 mmHg (all P>0.05). The multivariate linear regression analysis showed that SWE-SSM was an independent influencing factor for HVPG (β=0.17, P<0.001). In the diagnosis of HRV, only SWE-SSM showed a significant positive correlation with HRV (r=0.432, P<0.001), with a better diagnostic performance than SWE-LSM in terms of AUC (0.808 vs 0.642, Z=2.775, P=0.006). The multivariate Logistic regression analysis showed that platelet count was an independent influencing factor for HRV (odds ratio=0.97, P=0.014). ConclusionSWE-SSM is closely correlated with both HVPG and HRV, showing a good performance in the diagnosis of SPH and HRV, and therefore, it is expected to become an effective noninvasive tool for assessing portal hypertension.
2.Interpretation and Implementation Paths of Specification for Quality Control in Traditional Chinese Medicine Clinical Trials
Haoling ZHANG ; Yanling GAO ; Guanhua REN ; Panbo QIU ; Yiming WANG ; Qingna LI ; Zhenzhen QIAN ; Guoyuan ZHANG ; Xinyue DAI ; Leping WANG ; Rui GAO
Journal of Traditional Chinese Medicine 2026;67(20):2173-2178
Specification for Quality Control in Traditional Chinese Medicine Clinical Trials(GB/T 47336-2026) is the first national standard in the field of clinical research on traditional Chinese medicine (TCM), aims to address the core issue that the quality shortcomings of current TCM clinical research restrict the transformation of achievements and international recognition. Through the interpretation of the core contents of this standard, including its scope of application, graded quality control system, TCM-specific quality control requirements, implementation and responsible entities, responsibilities of quality control personnel, formulation of quality control plans, critical nodes of quality control, and quality control archive management, it is believed that the promotion and implementation of this standard are of great significance for improving the standard system of TCM clinical research, enhancing research quality, optimizing the quality management model, and promoting the internationalization process of TCM. Meanwhile, the implementation paths for the standard are discussed, including carrying out pilot applications in institutions, establishing publicity, implementation, and training mechanisms, encouraging multi-party collaborative supervision, and setting up implementation feedback mechanisms. On this basis, the challenges that may be encountered during implementation, such as resource input pressure, difficulties in implementing TCM-specific quality control, and a relative shortage of interdisciplinary composite talents, are sorted out, and corresponding strategies are proposed, which can provide references for relevant researchers and practitioners.
3.An excerpt of management of acute variceal bleeding: updated APASL guidelines (2025 edition)
Lijuan FENG ; Min WANG ; Guanhua ZHANG ; Yuhong SUO ; You DENG ; Fuliang HE ; Yu WANG ; Jidong JIA
Journal of Clinical Hepatology 2025;41(11):2252-2257
On August 31, 2025, the Asian Pacific Association for the Study of the Liver (APASL) updated and released management of acute variceal bleeding: updated APASL guidelines (2025 edition), which systematically elaborates on the definition, diagnosis, assessment, and treatment of acute variceal bleeding. This article gives an excerpt of the recommendations in this guideline.
4."Inflammation-cancer Transformation" Mechanism of Chronic Atrophic Gastritis and Intervention of Traditional Chinese Medicine: A Review
Xinfang ZHANG ; Wenzhao GUO ; Chenyang YU ; Guanhua LYU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):295-304
“Inflammation-cancer” transformation of chronic atrophic gastritis (CAG) refers to the process in which the gastric mucosa, in the context of CAG, progresses through stages of precancerous lesions of gastric cancer (PLGC), such as intestinal metaplasia and dysplasia, and eventually develops into gastric cancer (GC). In China, the incidence and mortality rates of GC rank among the highest in the world, and the proportion of GC cases caused by gastric mucosal infection and inflammation has been increasing. Modern medical treatments for CAG and PLGC mainly rely on drug therapy, endoscopic resection, and regular surveillance. Although these disease management strategies are relatively mature, they present limitations in early lesion prevention and recurrence risk control. Therefore, it is imperative to identify therapeutic approaches for CAG and PLGC that offer preventive, reversible, and recurrence-reducing benefits. With advances in research on the mechanisms underlying inflammation-cancer transformation and the integration of traditional Chinese and Western medicine, the advantages of TCM in preventing and even reversing early-stage CAG and PLGC have gradually become apparent. This review explored the mechanisms of inflammation-cancer transformation in CAG from five aspects: inflammatory microenvironment, autophagy, glycolysis, bile acids, and ferroptosis. In conjunction with TCM theory and a deeper understanding of the distinct mechanisms involved in the inflammation-cancer transformation of CAG, this review further discussed the specific mechanisms through which TCM intervened in treating CAG and PLGC, with the aim of providing theoretical support and therapeutic insights for future clinical applications.
5."Inflammation-cancer Transformation" Mechanism of Chronic Atrophic Gastritis and Intervention of Traditional Chinese Medicine: A Review
Xinfang ZHANG ; Wenzhao GUO ; Chenyang YU ; Guanhua LYU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):295-304
“Inflammation-cancer” transformation of chronic atrophic gastritis (CAG) refers to the process in which the gastric mucosa, in the context of CAG, progresses through stages of precancerous lesions of gastric cancer (PLGC), such as intestinal metaplasia and dysplasia, and eventually develops into gastric cancer (GC). In China, the incidence and mortality rates of GC rank among the highest in the world, and the proportion of GC cases caused by gastric mucosal infection and inflammation has been increasing. Modern medical treatments for CAG and PLGC mainly rely on drug therapy, endoscopic resection, and regular surveillance. Although these disease management strategies are relatively mature, they present limitations in early lesion prevention and recurrence risk control. Therefore, it is imperative to identify therapeutic approaches for CAG and PLGC that offer preventive, reversible, and recurrence-reducing benefits. With advances in research on the mechanisms underlying inflammation-cancer transformation and the integration of traditional Chinese and Western medicine, the advantages of TCM in preventing and even reversing early-stage CAG and PLGC have gradually become apparent. This review explored the mechanisms of inflammation-cancer transformation in CAG from five aspects: inflammatory microenvironment, autophagy, glycolysis, bile acids, and ferroptosis. In conjunction with TCM theory and a deeper understanding of the distinct mechanisms involved in the inflammation-cancer transformation of CAG, this review further discussed the specific mechanisms through which TCM intervened in treating CAG and PLGC, with the aim of providing theoretical support and therapeutic insights for future clinical applications.
6.Application of domestic high-flow percutaneous left ventricular assist device in patients with low cardiac output syndrome after cardiac surgery: a preclinical trial report
Liangwan CHEN ; Qilian XIE ; Xiaofu DAI ; Zhihuang QIU ; Qianzhen LI ; Guanhua FANG ; Heng LU ; Qingsong WU ; Jun XIAO ; Zhaofeng ZHANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2025;41(3):177-182
Objective:To report the preclinical trial results of the application of a domestic high-flow percutaneous left ventricular assist device (pLVAD) in patients with low cardiac output syndrome (LCOS) following cardiac surgery.Methods:Six patients who developed LCOS after direct cardiac surgery were implanted with a domestic high-flow pLVAD. Clinical outcomes, including hemodynamic changes, complications, and survival rates were observed post-implantation.Results:Four patients underwent pLVAD implantation under digital subtraction angiography (DSA) guidance, while two patients had the procedure performed under ultrasound guidance. The implantation process was straightforward, rapid, and uneventful, with no instances of bleeding or arrhythmias. The flow rate at the initiation of pLVAD support was 3.8-5.0 (4.22±0.44)L/min, and the flow rate during pump removal was 1.0-1.3(1.18±0.15)L/min. The duration of pLVAD support was 16.5-165.0(101.3±60.65)h. Hemodynamic parameters showed immediate improvement following pLVAD support: mean arterial pressure increased from (62.67±4.46)mmHg to (80.50±18.96)mmHg (1 mmHg=0.133 kPa, P=0.049), cardiac output increased from (2.45±0.66)L/min to (4.35±1.32)L/min( P=0.01), cardiac index improved from (1.95±0.21)L·min -1·m -2 to (2.77±0.33)L·min -1·m -2( P<0.001), pulmonary artery diastolic pressure decreased from (27.50±1.87) mmHg to(18.33±4.18)mmHg( P=0.001), and left ventricular ejection fraction improved from 0.27±0.04 to 0.37±0.06 ( P=0.004). No visible hemoglobinuria was noted during the support period. No malignant arrhythmias or cerebrovascular complications occurred. One patient required transition to surgical LVAD implantation, while the other five patients had the pLVAD successfully removed and were discharged. Three months later, all six patients were alive, with functional status classified as New York Heart Association (NYHA) Class Ⅰ-Ⅱ. Conclusion:The implantation of a domestic high-flow pLVAD provides a safe and effective therapeutic option for patients with LCOS following cardiac surgery.
7.Preparation of fluorescent nanoprobes based on aggregation-induced emission and their application in the diagnosis and treatment of oral cancer
Yanze WANG ; Ruixin NIE ; Guanhua WANG ; Xiaoli LIAN ; Yingbin YAN ; Xiaoyan ZHANG
International Journal of Biomedical Engineering 2025;48(5):443-453
Objective:To develop fluorescent nanoprobes with aggregation-induced emission characteristics and to systematically evaluate their optical properties, biosafety, anti-tumor activity, and imaging capability, thereby assessing their potential for early precision diagnosis and treatment of oral cancer in mice.Methods:Control probes (PEG@TPD) were prepared by encapsulating ( E)-4-(2-(4′-(1-phenyl-2,2-bis(4-methoxyphenyl)vinyl)biphenyl-4-yl)vinyl)-4-(dicyanomethylene)-4 H-chromene (TPD) using 1,2-distearoyl- SN-glycerol-3-phosphoethanolamine- N-polyethylene glycol 2000-maleimide as the carrier. Fluorescent nanoprobes (GE11-PEG@TPD) were subsequently fabricated by surface modification with the targeting GE11 peptide. The morphology and particle size of the nanoprobes were characterized by transmission electron microscopy and dynamic light scattering. The optical properties of the nanoprobes were analyzed using ultraviolet-visible spectrophotometry and fluorescence spectrophotometry. Mouse squamous carcinoma SCC-7 cells were randomly divided into six groups by the random number table method. The PBS, PEG@TPD, and GE11-PEG@TPD groups were not treated with light, while the PBS+L, PEG@TPD+L, and GE11-PEG@TPD+L groups were exposed to white light (25 W/cm 2, 10 min) at a nanoprobe concentration of 20 μg/ml (based on TPD concentration). Cell survival rate was assessed by the cell counting kit-8 assay. Cellular uptake, intracellular reactive oxygen species levels, and cytotoxicity were evaluated using laser scanning confocal microscopy. The apoptosis rate was evaluated by cell apoptosis assay. Twelve 6-week-old female C3H/HeN mice were randomly divided into two groups: PEG@TPD-1 group and GE11-PEG@TPD-1 group, with 6 mice in each group. Subcutaneous oral cancer models were established by injecting SCC-7 cell suspensions into the dorsal region of mice in two groups. Each mouse was intravenously administered 200 μl of PEG@TPD or GE11-PEG@TPD solution (1 mg/ml, based on TPD concentration). Tumor boundaries and scope were visualized using a small animal in vivo imaging system. At the optimal imaging time point, three mice from each group were euthanized, and major organs and tumor tissues were collected to measure probe accumulation. Statistical comparisons between two groups were performed using independent samples t-tests, while one-way or two-way analysis of variance was applied for multiple group comparisons. Results:Both PEG@TPD and GE11-PEG@TPD exhibited a relatively regular sphere, with average particle sizes of (92.76±8.80 and 117.50±6.40) nm, respectively. PEG@TPD showed two obvious absorption peaks at 352 and 444 nm. GE11 peptide showed a polypeptide characteristic absorption peak at 280 nm, GE11-PEG@TPD showed three characteristic absorption peaks at 280, 352 and 444 nm. Under dark conditions, cell survival rate remained above 80% even at a concentration of 160 μg/ml. After light irradiation, cell survival rate in the PEG@TPD+L group at 20 and 40 μg/ml [(68.2±5.2)% and (48.6±7.1)%] were higher than those in the GE11-PEG@TPD+L group [(55.0±2.8)% and (30.0±9.2)%], with statistically significant differences ( P<0.05, 0.01). At incubation time points of 2, 4, and 6 h, the relative fluorescence intensity of the GE11-PEG@TPD group (119.4±10.2, 192.9±14.2, and 234.1±4.8) were higher than those of the PEG@TPD group (98.6±7.5, 163.8±3.1, 204.6±11.2), with statistically significant differences (all P<0.05). The relative fluorescence intensity of the PEG@TPD+L and GE11-PEG@TPD+L group (68.5±4.7 and 86.8±10.0) were higher than those in the PBS, PEG@TPD, GE11-PEG@TPD, and PBS+L groups (6.1±8.0, 7.6±1.8, 4.7±4.2 and 21.1±7.6), with statistically significant differences (all P<0.01). And the difference between the GE11-PEG@TPD+L and PEG@TPD+L groups was also statistically significant ( P<0.05). Viable cell proportions in the PBS, PEG@TPD, GE11-PEG@TPD, and PBS+L groups all exceeded 95.0%, while those in the PEG@TPD+L and GE11-PEG@TPD+L groups decreased to (11.1±3.7)% and (4.3±1.1)%, respectively, with a statistically significant difference between them ( P<0.05). The apoptotic cell proportions in the PEG@TPD+L and GE11-PEG@TPD+L groups [(40.5±4.3)% and (55.3±7.4)%] were higher than those in the PBS, PEG@TPD, GE11-PEG@TPD, and PBS+L groups [(27.3±2.0)%, (28.2±1.9)%, (28.6±1.2)%, and (29.7±3.0)%], with statistically significant differences ( P<0.05, 0.01). Moreover, the difference between the GE11-PEG@TPD+L and the PEG@TPD+L groups was also statistically significant ( P<0.01). The mean fluorescence intensities of the GE11-PEG@TPD-1 group at 1, 3, 5, 8, and 24 h, as well as in ex vivo tumor tissues[(5.2±0.8, 5.9±0.7, 6.6±1.0, 7.9±0.6, 7.8±0.7 and 20.6±3.5)×10 6 p/s/cm 2/sr] were all higher than those in the PEG@TPD-1 group [(3.2±0.7, 4.2±0.7, 4.6±0.9, 5.1±0.9, 4.7±0.9 and 14.2±1.8)×10 6 p/s/cm 2/sr], with statistically significant differences ( P<0.05, 0.01). Conclusions:The fluorescent nanoprobes exhibit uniform particle size, high photostability, and good biocompatibility. They demonstrate significant tumor-killing effects at the cellular level and possess tumor-targeting capability in vivo, showing promising application potential for the early precision diagnosis and treatment of oral cancer.
8.Comparison of blinatumomab and chimeric antigen receptor T cells pre-haploidentical hematopoietic stem cell transplantation for pediatric Philadelphia chromosome negative B-cell acute lymphoblastic leukemia.
Guanhua HU ; Pan SUO ; Lu BAI ; Xiaohui ZHANG ; Yifei CHENG ; Xiaojun HUANG
Chinese Medical Journal 2025;138(4):472-474
9.Vitamin D supplementation inhibits atherosclerosis through repressing macrophage-induced inflammation via SIRT1/mTORC2 signaling.
Yuli WANG ; Qihong NI ; Yongjie YAO ; Shu LU ; Haozhe QI ; Weilun WANG ; Shuofei YANG ; Jiaquan CHEN ; Lei LYU ; Yiping ZHAO ; Meng YE ; Guanhua XUE ; Lan ZHANG ; Xiangjiang GUO ; Yinan LI
Chinese Medical Journal 2025;138(21):2841-2843
10.Research progress in therapeutic targets and drugs for eosinophilic gastroenteritis
Xinyi ZHANG ; Yinru JIANG ; Ziyuan ZHAO ; Longrui WANG ; Wenjing SUN ; Guanhua DU ; Linglei KONG
Chinese Journal of Pharmacology and Toxicology 2025;39(7):538-549
Eosinophilic gastroenteritis(EG)is a rare disease characterized by abnormal infiltration of eosinophils(Eos)in gastrointestinal tissues.Due to the unclear pathogenesis of EG and the lack of effective therapeutic drugs,research on its novel mechanisms,targets and drugs is critical.This article starts by outlining the research progress in the pathogenesis of EG,involving IgE mediated typeⅠimmediate allergic reactions and T helper 2 cell(Th2)mediated delayed allergic reactions.Then,the related targets of EG are summarized,including Th2 cytokines and factors regulating Eos function,but there has been no breakthrough in the treatment of these targets.Finally,the therapeutic drugs for EG are reviewed,such as glucocorticoids,antiallergic drugs and biologics.The advantages and disadvantages of various drugs are also described.However,these drugs cannot meet the current demands of clinical treatment and there is an urgent need to develop novel therapeutic drugs.It is believed that multi-target therapy is an ideal treatment for EG,and that traditional Chinese medicine and natural products should be the priorities of research and development for EG therapeutic drugs in the future.This review is expected to provide new ideas for the clinical treatment strategies and drug development of EG.

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