1.Expert consensus on neoadjuvant PD-1 inhibitors for locally advanced oral squamous cell carcinoma (2026)
LI Jinsong ; LIAO Guiqing ; LI Longjiang ; ZHANG Chenping ; SHANG Chenping ; ZHANG Jie ; ZHONG Laiping ; LIU Bing ; CHEN Gang ; WEI Jianhua ; JI Tong ; LI Chunjie ; LIN Lisong ; REN Guoxin ; LI Yi ; SHANG Wei ; HAN Bing ; JIANG Canhua ; ZHANG Sheng ; SONG Ming ; LIU Xuekui ; WANG Anxun ; LIU Shuguang ; CHEN Zhanhong ; WANG Youyuan ; LIN Zhaoyu ; LI Haigang ; DUAN Xiaohui ; YE Ling ; ZHENG Jun ; WANG Jun ; LV Xiaozhi ; ZHU Lijun ; CAO Haotian
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(2):105-118
Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.
2.Mechanism of Xiezhuo Jiedu Prescription in Treatment of Ulcerative Colitis by Inhibiting Ferroptosis and Alleviating Intestinal Mucosal Injury Based on Nrf2/SLC7A11/GPX4 Signaling Pathway
Qiang CHUAI ; Wenjing ZHAI ; Sujie JIA ; Xiaomeng LANG ; Jie REN ; Xin KANG ; Shijie REN ; Xingchi LIU ; Xin LIU ; Xiaohong JIANG ; Jianping LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):160-169
ObjectiveTo investigate the mechanism of Xiezhuo Jiedu prescription in the treatment of ulcerative colitis (UC) by inhibiting ferroptosis and alleviating intestinal mucosal injury based on the nuclear factor E2 related factor 2/solute carrier family 7 member/glutathione peroxidase 4 (Nrf2/SLC7A11/GPX4) signaling pathway. MethodsA total of 60 male SD rats were divided into a normal group, a model group, high- and low-dose Xiezhuo Jiedu prescription groups (26.64 and 13.32 g·kg-1, respectively), a ferroptosis inhibitor group (Ferrostatin-1, 0.005 g·kg-1), and a mesalazine group (0.27 g·kg-1), with 10 rats in each group. A UC rat model was established by intrarectal administration of trinitrobenzene sulfonic acid (TNBS)-ethanol. The normal group and the model group were intragastrically administered normal saline. The other groups were given intragastric administration according to the corresponding dosage for 7 d. The general condition, disease activity index (DAI) score, colon length, and mucosal injury index (CDMI) score were observed in each group. The pathological changes of colon tissue in each group were observed by hematoxylin-eosin (HE) staining. The intestinal mucosa and mitochondrial morphology in each group were observed by transmission electron microscopy. The expression levels of Occludin, Claudin-1, mucin 2 (MUC2), and E-cadherin in intestinal tissue were detected by immunofluorescence (IF). Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) in each group, and a lactic acid assay kit or ELISA was employed to detect the expression levels of reactive oxygen species (ROS), ferrous ions (Fe2+), glutathione (GSH), malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), diamine oxidase (DAO), and D-lactate (D-LA). Real-time quantitative polymerase chain reaction (Real-time PCR) was applied to detect the mRNA expression levels of Nrf2, SLC7A11, GPX4, Occludin, Claudin-1, MUC2, and E-cadherin in each group, and Western blot was adopted to detect the protein expression levels of Nrf2, p-Nrf2, SLC7A11, and GPX4 in each group. ResultsCompared with the normal group, rats in the model group exhibited listlessness, sluggish response, and mucopurulent and bloody stools. The model group also showed significantly increased DAI score, colon length, CDMI score, and expression levels of TNF-α, IL-6, ROS, Fe2+, MDA, 4-HNE, DAO, and D-LA (P<0.01). In addition, it presented significantly decreased IF values of Occludin, Claudin-1, MUC2, and E-cadherin and mRNA and protein expression levels of IL-10, GSH, Nrf2, p-Nrf2, SLC7A11, and GPX4 (P<0.01). There were different degrees of improvement in each administration group after treatment, and the improvement was the most significant in the high-dose Xiezhuo Jiedu prescription group (P<0.01). ConclusionXiezhuo Jiedu prescription may alleviate intestinal mucosal injury by inhibiting ferroptosis of intestinal epithelial cells via regulating the Nrf2/SLC7A11/GPX4 signaling pathway, thereby exhibiting efficacy in the treatment of UC.
3.Mechanism of Jinyang Dingtong Plaster in Improving Peripheral Pain Sensitization and Synovial Fibrosis in Knee Osteoarthritis by Blocking Ion Channels of TRPs
Jinliang HE ; Lu ZHANG ; Shixin XING ; Xilu REN ; Jingxing JIANG ; Junfeng KANG ; Xuliang HAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):108-116
ObjectiveThis paper aims to investigate the mechanism of Jinyang Dingtong plaster in improving the peripheral pain sensitization and synovial fibrosis in rats with knee osteoarthritis (KOA) by blocking the ion channels of transient receptor potentials (TRPs). MethodsThe active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by using ultra-high performance liquid chromatography-electrospray ionization-quadrupole ion trap tandem mass spectrometry (UPLC-MS/MS) technology. A KOA rat model was established through intra-articular injection of monoiodoacetic acid. The rats were randomly divided into blank control group, KOA group, compound Nanxing Zhitong plaster Group, and Jinyang Dingtong plaster group, with eight rats per group. Among them, the rats in the compound Nanxing Zhitong plaster group and the Jinyang Dingtong plaster group were intervened with external application treatment. After the intervention period, the cold and mechanical stimulus pain thresholds of rats in each group were detected, and the transverse diameter of the knee joint was measured. The levels of inflammatory factors in the serum such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) were determined by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential melastatin 8 (TRPM8), transient receptor potential vanilloid 1 (TRPV1), transient receptor potential vanilloid 4 (TRPV4), transforming growth factor-β (TGF-β), and vascular endothelial growth factor (VEGF) in synovial tissue were detected by Western blot. Histopathological changes in synovial tissue were observed by using hematoxylin and eosin (HE), Masson, and Sirius red staining, while the expression of type Ⅰ collagen and alpha-smooth muscle actin (α-SMA) was detected by multiplex immunofluorescence. ResultsA total of 35 active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by UPLC-MS/MS, including phenolic acids, flavonoids, quinones, alkaloids, terpenes, lignans, and coumarins. Among them, the constituents such as berberine, paeoniflorin, ferulic acid, and caffeic acid exhibit clear anti-inflammatory, analgesic, and anti-fibrotic pharmacological effects. Compared to the blank control group, rats in the KOA group showed a significant decrease in cold and mechanical stimuli pain thresholds (P<0.01). After 14 and 28 days of Jinyang Dingtong plaster intervention, the pain threshold in this group was significantly increased compared to that in KOA group (P<0.01), showing no significant difference from that in compound Nanxing Analgesic plaster group. Additionally, Jinyang Dingtong plaster reduced the levels of IL-1β, TNF-α, NGF, and CGRP in the serum of KOA rats (P<0.01), lowered the expression of TRPA1, TRPM8, TRPV1, TRPV4, TGF-β, and VEGF proteins in synovial tissue (P<0.01), improved synovial pathological damage in KOA rats, and significantly decreased fluorescence intensity of type Ⅰ collagen and α-SMA (P<0.01). ConclusionJinyang Dingtong plaster can improve the peripheral pain sensitization and synovial fibrosis in KOA rats by downregulating the expression of ion channels of TRPs and related inflammatory and fibrotic factors.
4.Mechanism of Jinyang Dingtong Plaster in Improving Peripheral Pain Sensitization and Synovial Fibrosis in Knee Osteoarthritis by Blocking Ion Channels of TRPs
Jinliang HE ; Lu ZHANG ; Shixin XING ; Xilu REN ; Jingxing JIANG ; Junfeng KANG ; Xuliang HAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):108-116
ObjectiveThis paper aims to investigate the mechanism of Jinyang Dingtong plaster in improving the peripheral pain sensitization and synovial fibrosis in rats with knee osteoarthritis (KOA) by blocking the ion channels of transient receptor potentials (TRPs). MethodsThe active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by using ultra-high performance liquid chromatography-electrospray ionization-quadrupole ion trap tandem mass spectrometry (UPLC-MS/MS) technology. A KOA rat model was established through intra-articular injection of monoiodoacetic acid. The rats were randomly divided into blank control group, KOA group, compound Nanxing Zhitong plaster Group, and Jinyang Dingtong plaster group, with eight rats per group. Among them, the rats in the compound Nanxing Zhitong plaster group and the Jinyang Dingtong plaster group were intervened with external application treatment. After the intervention period, the cold and mechanical stimulus pain thresholds of rats in each group were detected, and the transverse diameter of the knee joint was measured. The levels of inflammatory factors in the serum such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) were determined by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential melastatin 8 (TRPM8), transient receptor potential vanilloid 1 (TRPV1), transient receptor potential vanilloid 4 (TRPV4), transforming growth factor-β (TGF-β), and vascular endothelial growth factor (VEGF) in synovial tissue were detected by Western blot. Histopathological changes in synovial tissue were observed by using hematoxylin and eosin (HE), Masson, and Sirius red staining, while the expression of type Ⅰ collagen and alpha-smooth muscle actin (α-SMA) was detected by multiplex immunofluorescence. ResultsA total of 35 active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by UPLC-MS/MS, including phenolic acids, flavonoids, quinones, alkaloids, terpenes, lignans, and coumarins. Among them, the constituents such as berberine, paeoniflorin, ferulic acid, and caffeic acid exhibit clear anti-inflammatory, analgesic, and anti-fibrotic pharmacological effects. Compared to the blank control group, rats in the KOA group showed a significant decrease in cold and mechanical stimuli pain thresholds (P<0.01). After 14 and 28 days of Jinyang Dingtong plaster intervention, the pain threshold in this group was significantly increased compared to that in KOA group (P<0.01), showing no significant difference from that in compound Nanxing Analgesic plaster group. Additionally, Jinyang Dingtong plaster reduced the levels of IL-1β, TNF-α, NGF, and CGRP in the serum of KOA rats (P<0.01), lowered the expression of TRPA1, TRPM8, TRPV1, TRPV4, TGF-β, and VEGF proteins in synovial tissue (P<0.01), improved synovial pathological damage in KOA rats, and significantly decreased fluorescence intensity of type Ⅰ collagen and α-SMA (P<0.01). ConclusionJinyang Dingtong plaster can improve the peripheral pain sensitization and synovial fibrosis in KOA rats by downregulating the expression of ion channels of TRPs and related inflammatory and fibrotic factors.
5.Integrating Transcriptomics and 3D Organoids to Investigate Mechanism of Periplaneta americana Extract Against Lung Adenocarcinoma
Qiong MA ; Chunxia HUANG ; Jiawei HE ; Yuting BAI ; Xingyue LIU ; Yuxuan XIONG ; Yang ZHONG ; Hengzhou LAI ; Yuling JIANG ; Xueke LI ; Qian WANG ; Yifeng REN ; Xi FU ; Funeng GENG ; Taoqing WU ; Ping XIAO ; Fengming YOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):124-132
ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract(PAE) against human-derived lung adenocarcinoma organoids(LUAD-PDOs) and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid(Nor-PDOs) models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8(CCK-8) assay. Experimental groups included the model group(LUAD-PDOs), normal group, model administration group(LUAD-PDOs+PAE), and normal administration group(Nor-PDOs+PAE). Hematoxylin-eosin(HE) staining was used to observe the pathological structures of PDOs, immunohistochemistry(IHC) was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7(CK-7) and Napsin A, TUNEL staining was applied to detect cell apoptosis. RNA sequencing(RNA-Seq) was conducted to identify differentially expressed genes(DEGs), followed by Gene Ontology(GO), Kyoto Encyclopedia of Genes and Genomes(KEGG), and Gene Set Enrichment Analysis(GSEA), alongside protein-protein interaction(PPI) network analysis to screen core mechanisms. Finally, key targets were validated by integrating external database analysis with immunofluorescence(IF). ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures, whereas LUAD-PDOs displayed dense, solid structures. CCK-8 and TUNEL assays revealed that, compared with the model group, PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells, while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention(347 up-regulated and 372 down-regulated)(P<0.05). GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism, including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway(P<0.05). PPI network analysis indicated that breast cancer type 1 susceptibility protein(BRCA1) and checkpoint kinase 1(CHEK1) were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention(P<0.05). Furthermore, survival analysis based on The Cancer Genome Atlas(TCGA) database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD(P<0.05). ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis, its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway, with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.
6.Differentiation and Treatment Strategies for Pediatric IgA Vasculitis Based on the Correlation Between Blood Turbidity Theory and Oxidative Stress
Zhenhua YUAN ; Yingying JIANG ; Mingyang CAI ; Rongxin ZHU ; Xianqing REN
Journal of Traditional Chinese Medicine 2026;67(5):567-570
This paper explores the differentiation and treatment strategies for pediatric IgA vasculitis based on the correlation between blood trubidity theory and oxidative stress. It is proposed that pediatric IgA vasculitis follows an evolution of pathogenesis characterized by "deficiency of healthy qi leading to turbidity generation, accumulation of turbid toxin, and toxin damage to the collateral vessels", which corresponds to the pathological process of oxidative stress, namely decreased antioxidant capacity with accumulation of reactive oxygen species, metabolite deposition, and endothelial cell injury. A staged treatment strategy is proposed. In the acute stage, wind-toxin invading the colla-terals and reckless movement of heat in the blood are the main manifestations, for which the treatment should focus on dispelling wind and venting pathogens, resolving toxins and unblocking the collaterals, with a modified Yinqiao Powder (银翘散) and Xijiao Dihuang Decoction (犀角地黄汤) to regulate oxidative stress burst. In the prolonged stage, intermingling of turbidity and stasis with collateral obstruction is emphasized; treatment should focus on resolving turbidity and dispelling stasis, harmonizing the blood and stabilizing the collaterals, and a modified Simiao Powder (四妙散) and Taohong Siwu Decoction (桃红四物汤) can be used to improve microcirculatory dysfunction. In the remission stage, when healthy qi remains insufficient and residual pathogens persist, treatment should focus on strengthening the root and clearing the source, reinforcing healthy qi and nourishing the collaterals, for which modified Zhibai Dihuang Pill (知柏地黄丸) and Yupingfeng Powder (玉屏风散) is suggested to rebuild the antioxidant defense system.
7.Effects of androgens on cognitive function in castration male mice
Yaqi ZHANG ; Cancan HUI ; Fang REN ; Min XU ; Zilong JIANG ; Datong DENG
Acta Universitatis Medicinalis Anhui 2026;61(3):455-461
ObjectiveTo establish a castrated male mouse model and to preliminarily investigate the effects of testosterone replacement therapy (TRT) on behavior, serum indices, and histopathological changes in castrated mice, as well as to explore the role of androgens in cognitive function. MethodsForty 6-month-old male C57/BL6J mice were randomly divided into sham operation group, castration group, testosterone propionate (0.5,1.0 mg/kg) treated group, with 10 mice in each group. Following castration and subcutaneous administration of testosterone propionate at different doses (0.5 and 1.0 mg/kg) for TRT, learning and memory abilities were assessed using the Morris water maze (MWM) test and the passive avoidance test. Serum testosterone and serum brain-derived neurotrophic factor (BDNF) levels were measured by ELISA, and histopathological changes in the hippocampus were examined using hematoxylin-eosin (HE) staining. ResultsRoutine observations: there were no statistically significant differences in body weight among groups at any time point. MWM test: compared with castration group, sham operation group and testosterone propionate-treated groups (0.5, 1.0 mg/kg) showed significantly reduced escape latency on days 4 and 5 (P0.05), while the number of platform crossings and the time spent in the target quadrant significantly increased (P0.05). Passive avoidance test: the number of passive avoidance errors significantly decreased in sham operation group and testosterone propionate (1.0 mg/kg)-treated group (P0.05), and the passive avoidance latency was significantly prolonged in sham-operated group and testosterone propionate-treated groups (0.5, 1.0 mg/kg) (P0.05). Serum testosterone and serum BDNF assays: serum testosterone levels and serum BDNF concentrations significantly increased in sham operation group and testosterone propionate-treated groups (0.5, 1.0 mg/kg) (P0.01). HE staining: compared with sham operation group, neuronal density in all hippocampal subregions was slightly reduced in castration group; in the testosterone propionate (0.5 mg/kg)-treated group, neuronal arrangement in the CA1 and CA3 regions was improved and apoptotic cells were reduced compared with castration group; in testosterone propionate (1.0 mg/kg)-treated group, the pyramidal cell layer in the CA3 region was more compactly arranged, with fewer apoptotic cells than in castration group. ConclusionTRT improves learning and memory performance in castration male mice, potentially through modulation of hippocampal BDNF signaling pathways.
8.Effect of fatty liver on cardiac structure and function: a cross-sectional study based on health examination
Peiwen CHEN ; Xingxing REN ; Hongmei YAN ; Xinxia CHANG ; Jing ZHANG ; Hailuan ZENG ; Jingjing JIANG
Chinese Journal of Clinical Medicine 2026;33(3):434-444
Objective To investigate the cross-sectional associations between different fatty liver classifications and cardiac structure and function in people undergo health examination. Methods A total of 6 545 adults who underwent health examinations at the Health Management Center of Zhongshan Hospital, Fudan University between January 1 and December 31, 2017, were retrospectively included. Demographic characteristics and laboratory data were collected. The hepatic steatosis was graded by ultrasonography. And patients with fatty liver were further stratified according to alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels, as well as the degree of liver fibrosis. Cardiac morphology and function were assessed by transthoracic echocardiography, and left ventricular geometric patterns were classified accordingly. Multivariate logistic regression analysis was performed to evaluate the associations between fatty liver classifications and cardiac abnormalities. Results There were 2 795 patients (42.7%) with fatty liver, of whom 832 (29.8%) had significant cardiac structural alterations and 1 500 (53.7%) had diastolic dysfunction. Severe fatty liver was risk factor for concentric remodeling and increased relative wall thickness (RWT), with odds ratios (ORs) of 1.27 (P=0.012) and 1.27 (P=0.009), respectively. Fatty liver accompanied by elevated ALT or AST was risk factor for concentric remodeling (OR=1.45,1.56; P=0.001, 0.001), increased RWT (OR=1.48,1.57; P<0.001, <0.001), and diastolic dysfunction (OR=1.27, 1.32; P=0.035, 0.040), respectively. Fatty liver with liver fibrosis was risk factor for concentric remodeling (OR=1.83, P=0.046) and diastolic dysfunction (OR=2.64, P=0.034). Conclusions Advanced fatty liver, including severe hepatic steatosis, accompanied by elevated liver enzymes or liver fibrosis, could increase risks of cardiac remodeling and diastolic dysfunction, while systolic function is preserved. For patients with fatty liver, it is recommended to undergo regular ultrasonography examination.
9.Effects of acupoint catgut embedding on gut microbiota and fecal short-chain fatty acids in Parkinson's disease patients with constipation.
Xiaomei ZHANG ; Jie JIANG ; Wenying LI ; Juping CHEN ; Yin HUANG ; Wei REN ; Yafang SONG ; Jianhua SUN
Chinese Acupuncture & Moxibustion 2025;45(11):1533-1540
OBJECTIVE:
To observe the effects of acupoint catgut embedding (ACE) on gut microbiota and fecal short-chain fatty acids (SCFAs) levels in patients with Parkinson's disease (PD) with constipation.
METHODS:
A total of 80 PD patients with constipation were randomly divided into an observation group and a control group, 40 cases in each group. Additionally, 40 healthy individuals were recruited as a healthy control group. The control group received conventional Western medical treatment for PD combined with polyethylene glycol (PEG), once daily for eight weeks. The observation group received additional ACE treatment at bilateral Tianshu (ST25), Zusanli (ST36), and Shangjuxu (ST37), once every two weeks for eight weeks. The healthy control group received no intervention. The spontaneous bowel movements (SBMs) per week and patient assessment of constipation quality of life (PAC-QOL) scores were assessed at baseline and after treatment in the two groups. Fecal samples were collected at the end of treatment for the observation and the control groups and at baseline for the healthy control group. Gut microbiota composition and diversity were analyzed using 16S rRNA method, and SCFA levels were measured using high-performance liquid chromatography (HPLC).
RESULTS:
Compared before treatment, the observation group showed a significant increase in SBMs (P<0.01), and PAC-QOL scores including physical discomfort, psychosocial discomfort, worry and concern, and total score were significantly reduced (P<0.01) after treatment; the control group also showed a reduction in PAC-QOL total score after treatment (P<0.01). After treatment, the observation group had significantly more SBMs (P<0.01), and lower PAC-QOL physical discomfort, psychosocial discomfort, worry and concern scores, and total score (P<0.01), and higher PAC-QOL satisfaction score (P<0.01) than the control group. Compared with the healthy control group, the control group showed decreased Chao1 and Ace indices (P<0.01). Compared with the healthy control group, the relative abundance of Prevotella and Roseburia was increased (P<0.05), while that of Enterobacter and Ruminococcus torques (six species in total) was decreased (P<0.05) in the control group. Compared with the control group, the observation group had increased relative abundance of Dialister, Parabacteroides, and Ruminococcus torques (P<0.05), and decreased relative abundance of Prevotella and Eubacterium ruminantium (P<0.05). Compared with the healthy control group, the control group had increased fecal SCFA levels (P<0.05); compared with the control group, the observation group had reduced fecal SCFA levels (P<0.05). Compared with the healthy control group, acetic acid, propionic acid, and butyric acid levels were elevated in the control group (P<0.05); compared with the control group, acetic acid, propionic acid, and butyric acid levels were decreased in the observation group (P<0.05).
CONCLUSION
ACE could increase spontaneous bowel movements and improve the quality of life in PD patients with constipation, which may be related to the regulation of gut microbiota composition and SCFA levels.
Humans
;
Constipation/metabolism*
;
Male
;
Gastrointestinal Microbiome
;
Acupuncture Points
;
Female
;
Middle Aged
;
Parkinson Disease/complications*
;
Aged
;
Fatty Acids, Volatile/metabolism*
;
Catgut
;
Feces/microbiology*
;
Acupuncture Therapy
;
Quality of Life
;
Adult
10.Two cases of urinary retention in patients with Alzheimer's disease with agitation treated by acupuncture.
Guanhua ZONG ; Ran LI ; Yuhang JIANG ; Zehao CHEN ; Shanshan YAN ; Zongxi YI ; Xinyu REN ; Baohui JIA
Chinese Acupuncture & Moxibustion 2025;45(12):1822-1824
This article reports 2 cases of urinary retention in Alzheimer's disease with agitation treated by acupuncture. Based on patients' clinical symptoms, the etiology and pathogenesis were determined, and acupuncture was applied to Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), and bilateral Ciliao (BL32), Zhongliao (BL33), Fengchi (GB20), Taiyang (EX-HN5), etc. to regulate the mind and promote water metabolism. The positive and negative electrodes of the SDZ-Ⅴ type electroacupuncture device were attached to ipsilateral Ciliao (BL32), Zhongliao (BL33) respectively, with continuous wave, at the frequency of 15 Hz, and the current of 3 to 10 mA, depending on patients' tolerance. The needles were retained for 20 min. The treatment was delivered once every other day, 3 interventions a week and 12 interventions as 1 course. Both patients reported the micturition desire after 1 intervention with acupuncture and the catheter was removed on the same day. The urination was ameliorated without dysuresia after 1-2 courses of treatment, and the agitated behavior was alleviated. It can be the reference for the clinical treatment of urinary retention in patients with Alzheimer's disease with agitation.
Humans
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Alzheimer Disease/psychology*
;
Acupuncture Therapy
;
Urinary Retention/etiology*
;
Male
;
Female
;
Aged
;
Acupuncture Points
;
Psychomotor Agitation/complications*


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