1.Co-management of the liver and the kidney: New prospects in the clinical management of metabolic dysfunction-associated fatty liver disease with chronic kidney disease
Qiongyue FAN ; Danqin SUN ; Chunsun DAI ; Minghua ZHENG
Journal of Clinical Hepatology 2025;41(9):1744-1751
This article investigates the collaborative management of metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD). As major public health issues worldwide, MAFLD and CKD are closely related in terms of epidemiology, pathogenesis, and management strategies, and however, there are still many challenges in the multidisciplinary collaborative management of the two diseases. This article systematically elaborates on the epidemiology of MAFLD and CKD, summarizes their common risk factors such as metabolic disorder, genetic susceptibility, and active metabolites, and reviews the mutual screening strategies and combined management models based on noninvasive imaging, serum markers, FIB-4 score, and liver stiffness measurement. In addition, this article summarizes the advances in the application of lifestyle intervention and new drugs (such as GLP-1 receptor agonists and SGLT-2 inhibitors) and emphasizes the importance of multidisciplinary collaboration in improving the prognosis of patients. Due to the close association between MAFLD and CKD, their joint management is crucial, and therefore, it is necessary to establish a multidisciplinary collaboration mechanism and implement the measures of precise screening, comprehensive treatment, and long-term monitoring, so as to improve the prognosis of patients and reduce the risk of complications. Finally, this article proposes that in the future, more effective combined treatment regimens should be explored to expand the clinical options for the co-management of the liver and the kidney.
2.Lingguizhugan Decoction improves chronic heart failure by synergistically modulating ?1-AR/Gs/GRKs/?-arrestin signaling bias.
Shuting GUO ; Lei XIA ; Songru YANG ; Yueyang LIANG ; Xiaoli SHAN ; Pei ZHAO ; Wei GUO ; Chen ZHANG ; Ming XU ; Ning SUN ; Rong LU ; Huihua CHEN
Chinese Journal of Natural Medicines (English Ed.) 2025;23(5):560-571
Lingguizhugan Decoction (LGZG) demonstrates significant efficacy in treating various cardiovascular diseases clinically, yet its precise mechanism of action remains elusive. This study aimed to elucidate the potential mechanisms and effects of LGZG on isoproterenol (ISO) continuous stimulation-induced chronic heart failure (CHF) in mice, providing direct experimental evidence for further clinical applications. In vivo, continuous ISO infusion was administered to mice, and ventricular myocytes were utilized to explore LGZG?s potential mechanism of action on the ?1-adrenergic receptor (?1-AR)/Gs/G protein-coupled receptor kinases (GRKs)/?-arrestin signaling deflection system in the heart. The findings reveal that LGZG significantly reduced the messenger ribonucleic acid (mRNA) expression of hypertrophy-related biomarkers [atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP)] and improved cardiac remodeling and left ventricular diastolic function in mice with ISO-induced CHF. Furthermore, LGZG inhibited the overactivation of Gs/cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signaling and downregulated the downstream transcriptional activity of cAMP-response element binding protein (CREB) and the expression of the coactivator CBP/P300. Notably, LGZG downregulated the expression of ?-arrestin1 and GRK 2/3/5 while upregulating the expression of ?1-AR and ?-arrestin2. These results suggest that LGZG inhibits Gs/cAMP/PKA signaling and ?-arrestin/GRK-mediated desensitization and internalization of ?1-AR, potentially exerting cardioprotective effects through the synergistic regulation of the ?1-AR/Gs/GRKs/?-arrestin signaling deflection system via multiple pathways.
Animals
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Heart Failure/genetics*
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Signal Transduction/drug effects*
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Drugs, Chinese Herbal/pharmacology*
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Mice
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Male
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G-Protein-Coupled Receptor Kinases/genetics*
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Mice, Inbred C57BL
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Humans
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Isoproterenol
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Arrestins/genetics*
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Chronic Disease
3.Human infection with Gongylonema pulchrum: a case report and review of relevant literature during the recent 10 years
Feng TANG ; Xiaofeng SUN ; Xiangzhen XU ; Fanzhen MAO ; Yaobao LIU
Chinese Journal of Schistosomiasis Control 2025;37(3):332-336
This article presents the diagnosis and treatment processes, and morphological and genetic testing of Gongylonema pulchrum in a case with G. pulchrum found in the oral mucosa. In addition, this article reviews publications pertaining to G. pulchrum human infections by Chinese scientists during the recent 10 years and summarizes the demographic and clinical characteristics, location and number of parasites, diagnosis and treatment processes, and epidemiological surveys of cases infected with G. pulchrum, so as to provide insights into improving the diagnostic capability among clinicians.
4.Development and application of quick response code for prediction of healthcare-associated infection risks in ICU inpatients
Man ZHANG ; Yongsheng LIANG ; Huai YANG ; Jiangnan SUN ; Xi WANG ; Zidi XU ; Jie SONG ; Yanli ZHANG ; Di ZHAO ; Rui WANG ; Chengsong ZHAO ; Xin NI
Chinese Journal of Infection Control 2025;24(9):1259-1268
Objective To identify high-risk factors for healthcare-associated infection(HAI)in patients in inten-sive care units(ICUs),and develop a quick response(QR)code-based APP prediction tool.Methods Information of inpatients in general ICUs of three hospitals in Guizhou Province from January to December 2024 were collected.Risk factors were analyzed with a logistic regression model.QR code-based APP was constructed and validated.Results A total of 1 782 patients in general ICUs of three hospitals in Guizhou Province in 2024 were included in the analysis,out of which 410 were HAI cases,and the incidence of HAI was 23.01%.Multivariate logistic regre-ssion analysis results of HAI in ICU inpatients showed that regional gross domestic product(GDP)≥58 685 Yuan,performing pathogen culture during this hospitalization,history of diabetes mellitus,history of cancer,length of hospital stay ≥7 days before infection,and duration of persistent fever>5 days before infection were independent risk factors for HAI in ICU patients(all P<0.05).The discrimination of the model(area under the receiver operating characteristic curve[AUC]of 0.841),calibration(Brier score of 0.129),and clinical effectiveness(net benefit of 11.4%when the risk threshold was 5%-74%)all performed well.Conclusion The QR code-based APP prediction tool is of great significance for scientific research transformation and precise HAI control.
5.Quality Evaluation on Xuanmai Ganjie Preparation Based on National Drug Sampling and Testing
Jingyun LI ; Liang HU ; Jiangnan LUO ; Yinghong WANG ; Xunyou TANG ; Sheng LIANG ; Liqin ZHAN ; Jingkai ZENG ; Yan LUO ; Hui SUN ; Ye DING ; Wenli LI ; Jialiang ZHU
Herald of Medicine 2025;44(10):1606-1611
Objective Based on the national drug sampling inspection program,this study aims to comprehensively and systematically evaluate the quality of Xuanmai Ganjie preparations,analyze existing quality issues,and provide references and suggestions for quality control of this variety.Methods A total of 237 batches of Xuanmai Ganjie preparations were tested using legal standards,and methods were established for detecting adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels,and determining the content of platycodin D in Xuanmai Ganjie preparations.These methods were applied to the quality control and evaluation of Xuanmai Ganjie preparations.Results Through statutory inspection,one batch of Xuanmai Ganjie granules was found non-compliant.Specific batches were identified to contain the following irregularities:adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels exceeding proposed limits,and platycodin D content below the established threshold.Conclusion The overall quality of Xuanmai Ganjie granules was average,while the overall quality of Xuanmai Ganjie capsules and lozenges was relatively good.Manufacturing enterprises should strengthen their sense of primary responsibility and enhance control over the entire drug production process.
6.Development and application of quick response code for prediction of healthcare-associated infection risks in ICU inpatients
Man ZHANG ; Yongsheng LIANG ; Huai YANG ; Jiangnan SUN ; Xi WANG ; Zidi XU ; Jie SONG ; Yanli ZHANG ; Di ZHAO ; Rui WANG ; Chengsong ZHAO ; Xin NI
Chinese Journal of Infection Control 2025;24(9):1259-1268
Objective To identify high-risk factors for healthcare-associated infection(HAI)in patients in inten-sive care units(ICUs),and develop a quick response(QR)code-based APP prediction tool.Methods Information of inpatients in general ICUs of three hospitals in Guizhou Province from January to December 2024 were collected.Risk factors were analyzed with a logistic regression model.QR code-based APP was constructed and validated.Results A total of 1 782 patients in general ICUs of three hospitals in Guizhou Province in 2024 were included in the analysis,out of which 410 were HAI cases,and the incidence of HAI was 23.01%.Multivariate logistic regre-ssion analysis results of HAI in ICU inpatients showed that regional gross domestic product(GDP)≥58 685 Yuan,performing pathogen culture during this hospitalization,history of diabetes mellitus,history of cancer,length of hospital stay ≥7 days before infection,and duration of persistent fever>5 days before infection were independent risk factors for HAI in ICU patients(all P<0.05).The discrimination of the model(area under the receiver operating characteristic curve[AUC]of 0.841),calibration(Brier score of 0.129),and clinical effectiveness(net benefit of 11.4%when the risk threshold was 5%-74%)all performed well.Conclusion The QR code-based APP prediction tool is of great significance for scientific research transformation and precise HAI control.
7.Quality Evaluation on Xuanmai Ganjie Preparation Based on National Drug Sampling and Testing
Jingyun LI ; Liang HU ; Jiangnan LUO ; Yinghong WANG ; Xunyou TANG ; Sheng LIANG ; Liqin ZHAN ; Jingkai ZENG ; Yan LUO ; Hui SUN ; Ye DING ; Wenli LI ; Jialiang ZHU
Herald of Medicine 2025;44(10):1606-1611
Objective Based on the national drug sampling inspection program,this study aims to comprehensively and systematically evaluate the quality of Xuanmai Ganjie preparations,analyze existing quality issues,and provide references and suggestions for quality control of this variety.Methods A total of 237 batches of Xuanmai Ganjie preparations were tested using legal standards,and methods were established for detecting adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels,and determining the content of platycodin D in Xuanmai Ganjie preparations.These methods were applied to the quality control and evaluation of Xuanmai Ganjie preparations.Results Through statutory inspection,one batch of Xuanmai Ganjie granules was found non-compliant.Specific batches were identified to contain the following irregularities:adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels exceeding proposed limits,and platycodin D content below the established threshold.Conclusion The overall quality of Xuanmai Ganjie granules was average,while the overall quality of Xuanmai Ganjie capsules and lozenges was relatively good.Manufacturing enterprises should strengthen their sense of primary responsibility and enhance control over the entire drug production process.
8.An excerpt of an international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease (2023)
Danqin SUN ; Jiaqi SHEN ; Minghua ZHENG
Journal of Clinical Hepatology 2024;40(1):42-45
In 2020, an international expert panel proposed to replace nonalcoholic fatty liver disease with metabolic associated fatty liver disease (MAFLD). Recent studies have shown that there is a higher risk of chronic kidney disease (CKD) in the MAFLD population and that MAFLD is an independent risk factor for CKD. However, up to now, there are still no guidelines on the prevention and treatment of MAFLD-related CKD. Based on the Delphi method, the authors led a multidisciplinary team of 50 authoritative experts from 26 countries to reach a consensus on some open-ended research issues about the association between MAFLD and CKD, which can help to clarify the important clinical association between MAFLD and the risk of CKD and improve the understanding of the epidemiology, pathogenesis, management, and treatment of MAFLD and CKD, so as to establish a framework for the early prevention and management of these two common and interrelated diseases.
9.Advances in roles of Parabacteroides distasonis and its regulation by traditional Chinese medicines.
Dan LONG ; Meng QIN ; Pei-Peng CHEN ; Xin HUANG ; Ya-Ting CAO ; Ai-Ling YIN ; Yue-Yue CHEN ; Hai-Dan WANG ; Yun-Ke GUO ; Xuan WANG ; Hai-Jian SUN ; Jin-Jun SHAN ; Wei ZHOU
China Journal of Chinese Materia Medica 2024;49(22):5988-5997
Parabacteroides distasonis is a gram-negative bacterium initially isolated from a clinical specimen in the 1930s. The strain was re-classified to form the new genus Parabacteroides in 2006. P. distasonis can regulate intestinal barrier function and plays a key role in immune response and metabolic regulation of bodies. Traditional Chinese medicine(TCM) is closely related to the intestinal microbiota. Polysaccharides, saponins, and other ingredients of TCM can treat diseases by interacting with P. distasonis, but the specific mechanisms underlying these processes are still unclear, requiring further exploration. This study reviewed the roles and related mechanisms of P. distasonis in inflammatory-immune diseases, metabolic diseases, cardiovascular disease, neuropsychiatric diseases, cancer, and other diseases and summarized the relevant research results of TCM to prevent and treat diseases by regulating P. distasonis. This study provides a reference for subsequent exploration of P. distasonis and research on the interaction between TCM and intestinal microbiota.
Humans
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Gastrointestinal Microbiome/drug effects*
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Medicine, Chinese Traditional
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Animals
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Bacteroidetes
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Drugs, Chinese Herbal/pharmacology*

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