1.Values of non-invasive myocardial work and tissue motion annular displacement in evaluating anthracycline-induced cardiotoxicity
Wei HE ; Hong WEI ; Xiuli SUN ; Ying LIU ; Tao CONG ; Yunlong XIA
Chinese Journal of Clinical Medicine 2026;33(1):74-82
Objective To explore the clinical values of non-invasive myocardial work (MW) and tissue motion annular displacement (TMAD) in evaluation of anthracycline therapy-related cardiac dysfunction in patients with non-Hodgkin lymphoma. Methods A total of 62 patients with non-Hodgkin lymphoma who received standardized chemotherapy based on doxorubicin. Two and three dimensional transthoracic echocardiography, along with two dimensional speckle tracking echocardiography, were performed one day before chemotherapy and at 3, 6, and 9 months after chemotherapy to assess left ventricular ejection fraction, global longitudinal strain (GLS), MW parameters, and TMAD. Logistic regression analysis was used to evaluate the risk factors for cancer therapy-related cardiac dysfunction (CTRCD). The receiver operating characteristic curve was used to assess the diagnostic values of MW- and TMAD-related parameters for CTRCD. Results Compared to baseline, GLS, global work index (GWI), global constructive work (GCW), global work efficiency (GWE), TMAD at midpoint (TMADmid), and TMADmid percentage of left ventricular long-axis diameter (TMADmid%) decreased at 3 months after chemotherapy, while global wasted work (GWW) increased at 6 months after chemotherapy (P<0.05). Logistic regression analysis showed that the relative reduction in GLS and TMADmid% at 3 months after chemotherapy were independent predictors for CTRCD (P<0.05), while MW parameters were not independent predictors for CTRCD. GLS reduction≥10.3% and TMADmid% reduction≥15.8% at 3 months after chemotherapy predicted CTRCD with 0.866 and 0.824 of area under the curve (AUC), 92% and 75% of sensitivity, and 74% and 80% of specificity, respectively. AUC of combination of two indexes improved to 0.905, with 75% of sensitivity and 90% of specificity. Conclusions In non-Hodgkin lymphoma patients, the combination of GLS and TMADmid% is helpful of predicting CTRCD early, TMAD may be a novel diagnostic index for CTRCD, and GLS has superior predictive performance than MW for CTRCD.
2.Multidisciplinary expert consensus on the management of diarrhea associated with tyr-osine kinase inhibitor therapy in HER2-positive breast cancer
Chinese Journal of Clinical Oncology 2025;52(5):217-233
Human epidermal growth factor receptor 2(HER2)tyrosine kinase inhibitors(TKIs),including lapatinib,pyrotinib,neratinib,and tucatinib,have become major therapeutic options for HER2-positive breast cancer.However,the use of these agents are often associated with adverse events,of which diarrhea is one of the most common and clinically significant.Diarrhea not only negatively affects the physical health of patients but also significantly impairs their quality of life,potentially leading to treatment delays or discontinuations.Therefore,the effective management of diarrhea is crucial to ensure patient adherence to HER2-TKI therapy and improve the patients'quality of life.Cur-rently,no multidisciplinary expert consensus in China exists regarding the management of anti-HER2-TKI-related diarrhea in breast cancer.Spearheaded by the Breast Cancer Integrative Rehabilitation Professional Committee of China Anti-Cancer Association,domestic experts from multiple disciplines,including breast oncology,pharmacy,gastroenterology,nutrition,and traditional Chinese medicine,jointly de-veloped a multidisciplinary expert consensus on the management of TKI-associated diarrhea in HER2-positive breast cancer.This consensus was formulated through a comprehensive review of domestic and international guidelines,relevant literature,and evidence-based medical research while considering the clinical practice in China.This consensus aims to provide clinicians with a set of multidisciplinary,compre-hensive guidelines for managing diarrhea associated with anti-HER2-TKIs to enhance the overall treatment outcomes and quality of life of patients with HER2-positive breast cancer.
3.The integration of machine learning into traditional Chinese medicine
Yanfeng HONG ; Sisi ZHU ; Yuhong LIU ; Chao TIAN ; Hongquan XU ; Gongxing CHEN ; Lin TAO ; Tian XIE
Journal of Pharmaceutical Analysis 2025;15(8):1724-1737
Traditional Chinese medicine(TCM)is an ancient medical system distinctive and effective in treating cancer,depression,coronavirus disease 2019(COVID-19),and other diseases.However,the relatively abstract diagnostic methods of TCM lack objective measurement,and the complex mechanisms of action are difficult to comprehend,which hinders the application and internationalization of TCM.Recently,while breakthroughs have been made in utilizing methods such as network pharmacology and virtual screening for TCM research,the rise of machine learning(ML)has significantly enhanced their inte-gration with TCM.This article introduces representative methodological cases in quality control,mechanism research,diagnosis,and treatment processes of TCM,revealing the potential applications of ML technology in TCM.Furthermore,the challenges faced by ML in TCM applications are summarized,and future directions are discussed.
4.Multidisciplinary expert consensus on the management of diarrhea associated with tyr-osine kinase inhibitor therapy in HER2-positive breast cancer
Chinese Journal of Clinical Oncology 2025;52(5):217-233
Human epidermal growth factor receptor 2(HER2)tyrosine kinase inhibitors(TKIs),including lapatinib,pyrotinib,neratinib,and tucatinib,have become major therapeutic options for HER2-positive breast cancer.However,the use of these agents are often associated with adverse events,of which diarrhea is one of the most common and clinically significant.Diarrhea not only negatively affects the physical health of patients but also significantly impairs their quality of life,potentially leading to treatment delays or discontinuations.Therefore,the effective management of diarrhea is crucial to ensure patient adherence to HER2-TKI therapy and improve the patients'quality of life.Cur-rently,no multidisciplinary expert consensus in China exists regarding the management of anti-HER2-TKI-related diarrhea in breast cancer.Spearheaded by the Breast Cancer Integrative Rehabilitation Professional Committee of China Anti-Cancer Association,domestic experts from multiple disciplines,including breast oncology,pharmacy,gastroenterology,nutrition,and traditional Chinese medicine,jointly de-veloped a multidisciplinary expert consensus on the management of TKI-associated diarrhea in HER2-positive breast cancer.This consensus was formulated through a comprehensive review of domestic and international guidelines,relevant literature,and evidence-based medical research while considering the clinical practice in China.This consensus aims to provide clinicians with a set of multidisciplinary,compre-hensive guidelines for managing diarrhea associated with anti-HER2-TKIs to enhance the overall treatment outcomes and quality of life of patients with HER2-positive breast cancer.
5.Predictive efficacy of multimodal MRI-based machine learning models for glioblastoma multiforme MGMT promoter methylation states
Hong-lin LI ; Shi-ting HU ; Zi-heng ZHOU ; Bing LI ; Zhi-ping QI ; Ruo-qi LI ; Kai LIU ; Chun-feng HU ; Hai-tao GE
Chinese Medical Equipment Journal 2025;46(6):7-13
Objective To explore the predictive efficacy of several multimodal MRI-based machine learning models for the promoter methylation states of O6-methylguanine-DNA methyltransferase(MGMT)of glioblastoma muliforme(GBM)patients in terms of the GBM heterogeneity and the complexity of the tumor microenvironment.Methods Firstly,the multimodal MRI images of 317 GBM patients from The University of Pennsylvania Glioblastoma(UPENN-GBM)dataset were pre-processed,with four sequences involved in including T1-weighted imaging(T1WI)sequence,T1-weighted contrast-enhanced imaging(T1CE)sequence,T2-weighted imaging(T2WI)sequence and fluid-attenuated inversion recovery(FLAIR)sequence,and the radiomics features were extracted for two regions of interest(ROIs)such as the tumor core region and the tumor edema region.Secondly,the data of the 317 GBM patients were randomly divided into a training set(254 cases)and a test set(63 cases),which underwent normalization with Z-scores and feature selection and dimensionality reduction with Lasso regression.Finally,three models were established respectively with particle swarm optimization-support vector machine(PSO-SVM),C-support vector classification(C-SVC)and adaptive boosting(adaptive boosting(Adaboost)algorithms,and the predictive efficacy of the three models for glioblastoma multiforme MGMT promoter methylation states were evaluated in terms of accuracy and AUC.Results The Adaboost model based on T2WI sequence and radiomics features of the tumor core region had the highest predictive efficacy with accuracy and AUC values of 67%and 0.74,respectively,higher than those of other combinations of sequences,models and regions of interest.Conclusion The multimodal MRI-based machine learning models can be used for the prediction of glioblastoma multiforme MGMT promoter methylation states,which provides powerful support for personalized treatment and prognostic assessment of GBM.[Chinese Medical Equipment Journal,2025,46(6):7-13]
6.Impact of camellia honey on high-fat diet-induced intestinal inflammation and injury in Drosophila
Lili ZHANG ; Shuqiong CAO ; Mengting XU ; Tao HONG ; Meifang ZHANG ; Dan LIU ; Tao LUO ; Zhiyong LIU
Acta Laboratorium Animalis Scientia Sinica 2025;33(4):540-548
Objective To explore the effects of camellia honey on intestinal inflammation and injury induced by a high-fat diet(HFD)in Drosophila.Methods A HFD model group of fruit flies was created by feeding with standard culture medium containing 30%lard.Each camellia honey groups were fed the same high-fat medium containing different concentrations of camellia honey.The body mass,eclosion rate,climbing ability,size of lipid droplets,and levels of intestinal reactive oxygen species in adult flies were measured and analyzed.Results Compared with the model group,each camellia honey groups showed significant improvements.Specifically,camellia honey ameliorated the following HFD-induced alterations:decline in eclosion rate,increase in pupal volume,increase in adult average body mass,decrease in adult climbing ability,enlargement of the lipid droplet area,elevation in intestinal ROS levels,and intestinal damage.Conclusions Camellia honey improved the growth and development,intestinal inflammation,and injury induced by a HFD in Drosophila.
7.Research advances in mitochondrial inflammation-mediated damage in central nervous system degenerative disorders
Shu-qin LI ; Sha-sha LIU ; Qian YAN ; Han-long WANG ; Yang SUN ; Yan-ting HUANG ; Hao-jie ZHANG ; Jin-ping LIANG ; Shi-feng CHU ; Yan-tao YANG ; Qi-di AI ; Nai-hong CHEN
Chinese Pharmacological Bulletin 2025;41(12):2218-2225
Central nervous system(CNS)degenerative disorders refer to a spectrum of pathological alterations triggered by struc-tural damage to cerebral neural tissues,clinically manifested as diverse neurological dysfunction syndromes,including multiple sclerosis(MS),neurodegenerative diseases(NDs),and ische-mic stroke.The hallmark pathological features of these disorders involve irreversible neuronal damage and decompensation of functional neural networks,ultimately leading to progressive neurological deficits.Notably,with the accelerating global popu-lation aging,the incidence of these diseases has surged signifi-cantly.According to WHO statistics,they now rank among the top three global causes of disability and mortality.Current re-search has confirmed that the pathogenesis of CNS degenerative disorders exhibits high heterogeneity,encompassing multifaceted pathophysiological processes such as genetic predisposition,oxi-dative stress,protein misfolding,and metabolic dysregulation.This intricate pathogenic network not only complicates clinical differential diagnosis but also poses substantial challenges to the development of precision therapeutic strategies.Importantly,re-cent studies have revealed that mitochondrial homeostasis disrup-tion-induced inflammatory cascades(termed mitochondrial in-flammation)play a pivotal regulatory role in neurodegenerative progression.Key molecular mechanisms include impaired mito-phagy,aberrant mitochondrial DNA(mtDNA)release and NL-RP3 inflammasome activation.This review systematically deci-phers the molecular regulatory network of mitochondrial inflam-mation,with a focus on its biological effects in critical pathologi-cal events such as blood-brain barrier disruption,microglial hy-peractivation and neuronal apoptosis.The overarching aim is to provide a theoretical foundation for developing innovative thera-peutic strategies targeting mitochondrial homeostasis restoration.
8.Important factors affecting depression:modulatory effects of Cx43 on neuroinflammation
Xuan ZENG ; Zi-han YAN ; Zhi-feng TIAN ; Hong-bin WANG ; Qi-di AI ; Mei-yu LIN ; Xuan LIU ; Nai-hong CHEN ; Song-wei YANG ; Yan-tao YANG
Chinese Pharmacological Bulletin 2025;41(11):2027-2031
Numerous studies have shown that depression is main-ly associated with the abnormal expression of connexin 43(Cx43)in astrocytes(Astro)and its mediated dysfunction of gap junction(GJ).However,the molecular mechanism of post-translational modifications targeting Cx43 to regulate neuroin-flammation-associated depression is still unclear.Post-transla-tional modifications of Cx43 mainly include phosphorylation of specific amino acid sites by PKC,PKA,PKG,MAPK and PTK,and protein degradation of Cx43 through the K48/K63 polyubiq-uitylation and deubiquitination pathways,which ultimately lead to protein degradation through K48/K63 polyubiquitination and deubiquitination.These modifications are ultimately involved in the regulation of neuroinflammatory responses through the associ-ation of GJ function.In this paper,we systematically review the role of Cx43 post-translational modifications in neuroinflamma-tion,with the aim of further exploring the potential application of targeting these modifications to modulate the inflammatory re-sponse mechanism in improving depressive symptoms.
9.Effects and Efficacy of Wenyang Huayin Yangxin Prescription on the Traditional Chinese Medicine Syndromes of Patients With Chronic Heart Failure Combined With Diuretic Resistance
Jiali WU ; Dan XIAO ; Tao ZHAN ; Yi YUAN ; Yun ZHAN ; Hong LIU
Journal of Sichuan University (Medical Sciences) 2025;56(1):94-101
Objective To study the traditional Chinese medicine(TCM)syndromes of patients with chronic heart failure(CHF)combined with diuretic resistance by using the Wenyang Huayin Yangxin Prescription,and to observe its therapeutic efficacy.Methods A total of 68 CHF patients complicated with diuretic resistance and who had Yangqi deficiency and presenting blood stasis syndrome combined with Tanyin were randomly assigned to a control group and an observation group.The control group was given intravenous furosemide(≥ 80 mg/d)via infusion pump in addition to standard Western medical treatment,while the observation group was given intravenous furosemide(<80 mg/d)via infusion pump along with the Wenyang Huayin Yangxin Prescription(30 g Astragalus,15 g Poria,15 g Baizhu,15 g Chuanxiong,10 g Danfu tablet,10 g Cassia,10 g Alisma,and 10 g Zhimu).The quantitative index of diuretic resistance was used as the primary outcome measure.In addition,the differences between the two groups in TCM syndromes,cardiac function-related indicators,incidence of endpoint events,and readmission rate were compared.Results After 2 weeks of treatment,the filtration sodium excretion fraction(FENa)in the observation group was(0.18±0.04)%,while that of the control group was(0.16±0.03)%,showing a statistically significant difference(P=0.037).The 24-hour urine volume and urine Na+/K+ratio in the observation group increased significantly from baseline levels and were higher than those in the control group(P<0.05).The differences in the changes of 24-hour urine volume,urine sodium,FENa,and urine Na+/K+ratio between the two groups were statistically significant(P<0.05).The TCM syndrome scores decreased in both groups after 2 weeks of treatment,with the observation group showing a significantly greater reduction compared with the control group(P<0.001).The differences in the changes of TCM syndrome scores between the two groups were statistically significant(P<0.001).After 2 weeks of treatment,the observation group showed significant improvements in palpitations,shortness of breath,facial and limb edema,spontaneous sweating,chest tightness(pain),asthma,and oliguria compared with the baseline data(P<0.05),while the control group showed improvements only in facial and limb edema,asthma,and oliguria(P<0.05).Except for the asthma syndrome after 2 weeks of treatment,the observation group showed better outcomes in spontaneous sweating,chest tightness(pain),asthma,and oliguria at various time points after treatment compared with the control group(P<0.05).After 2 weeks of treatment,the observation group had significantly better cardiac output(CO)and stroke volume(SV)compared with those of the control group(P<0.05).The differences in the changes in N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),SV,and CO between the two groups were statistically significant(P<0.05).After 24 weeks of follow-up,no significant differences in the incidence of end-point events or readmission rates between the two groups were observed.Conclusion The Wenyang Huayin Yangxin Prescription,combined with low-dose intravenous furosemide administered through an infusion pump,can improve the TCM syndromes of patients with Yangqi deficiency and blood stasis syndrome combined with Tanyin in addition to CHF complicated by diuretic resistance.This treatment improves the patients'heart function and diuretic resistance,reduces the intravenous dosage of diuretic,and enhances clinical efficacy.This approach should be more widely applied in clinical settings.
10.Establishment and evaluation of a lipopolysaccharide-induced acute respiratory distress syndrome model in minipigs
Chuang-Ye WANG ; Ran WANG ; Jian ZHANG ; Ling-Xiao QIU ; Bin QING ; Heng YOU ; Jin-Cheng LIU ; Bin WANG ; Nan-Bo WANG ; Jia-Yu LI ; Xing LIU ; Shuang WANG ; Jin HU ; Jian WEN ; Quan LI ; Xiao-Ou HUANG ; Kun ZHAO ; Shuang-Lin LIU ; Gang LIU ; Mei-Ju WANG ; Qing XIANG ; Hong-Mei WU ; Xiao-Rong SUN ; Tao GU ; Dong ZHANG ; Qi LI ; Zhi XU
Medical Journal of Chinese People's Liberation Army 2025;50(9):1154-1161
Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

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