1.The effect of renal denervation on patients with heart failure treated by guideline-directed management and therapy
Mingyang XIAO ; Xian YANG ; Xue KUANG ; Wenjiang CHEN ; Jie YANG ; Yuehui YIN
Chinese Journal of Clinical Medicine 2025;32(6):953-959
Objective To explore whether renal denervation (RDN) could improve the left ventricular ejection fraction (LVEF) of patients with heart failure (HF) on the basis of guideline-directed management and therapy (GDMT). Methods From January 1, 2023 to August 31, 2024, HF patients diagnosed as dilated cardiomyopathy (DCM) who underwent RDN in the Second Affiliated Hospital of Chongqing Medical University were retrospectively enrolled, all patients had received GDMT for at least three months but the LVEF remained below 55%. Parameters of transthoracic echocardiography (TTE) at baseline, during GDMT, and after RDN were compared to analyze whether RDN can further improve the LVEF of patients on the basis of GDMT. Results A total of 7 HF patients diagnosed with DCM were enrolled, the mean age was (52.86±9.86) years old, and 5(71.4%) were male. After an average of (9.29±8.06) months of GDMT, LVEF significantly increased from baseline (34.86%±10.22%) to (44.57%±5.59%, P=0.024).Three months after RDN, LVEF was further significantly improved (54.43%±9.05%, P=0.026). The average follow-up after RDN was (11.00±4.12) months. The LVEF remained stable (54.86%±7.10%, P=0.805), and no adverse events occurred in the patients. Conclusions RDN can further enhance the LVEF of HF patients on the basis of GDMT.
2.Clinical trial of Morinda officinalis oligosaccharides in the continuation treatment of adults with mild and moderate depression
Shu-Zhe ZHOU ; Zu-Cheng HAN ; Xiu-Zhen WANG ; Yan-Qing CHEN ; Ya-Ling HU ; Xue-Qin YU ; Bin-Hong WANG ; Guo-Zhen FAN ; Hong SANG ; Ying HAI ; Zhi-Jie JIA ; Zhan-Min WANG ; Yan WEI ; Jian-Guo ZHU ; Xue-Qin SONG ; Zhi-Dong LIU ; Li KUANG ; Hong-Ming WANG ; Feng TIAN ; Yu-Xin LI ; Ling ZHANG ; Hai LIN ; Bin WU ; Chao-Ying WANG ; Chang LIU ; Jia-Fan SUN ; Shao-Xiao YAN ; Jun LIU ; Shou-Fu XIE ; Mao-Sheng FANG ; Wei-Feng MI ; Hong-Yan ZHANG
The Chinese Journal of Clinical Pharmacology 2024;40(6):815-819
Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P<0.05).After continuation treatment,the remission rate was 54.59%(202 cases/370 cases),and the recurrence rate was 6.49%(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35%(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.
3.Treatment of Postoperative Recurrence and Metastasis of Gastric Cancer Based on the Theory of "Controlling Channels and Collaterals"
Ziyu KUANG ; Jiaxi WANG ; Jie LI
Journal of Traditional Chinese Medicine 2024;65(15):1611-1616
Based on the theory of "controlling channels and collaterals", this paper expounds the role of channels and collaterals system in the recurrence and metastasis of gastric cancer after surgery, and puts forward the prevention and treatment idea of warming the yang qi of channels and collaterals to consolidate the essence, and removing the stasis and blockage of channels and collaterals to clear the source. In the process of pattern differentiation and treatment, attention should be paid to the influence of surgery and cold medicinals on the yang qi of middle jiao. The yang qi of middle jiao should be supplemented to warm yang and strengthen vessels to prevent chuanshe (metastasis); the channels and collaterals with pathogens should be opened to remove its stasis and blockage, and the cancer toxin should be attacked to clear the source and flow, and also the cancer toxin should be given a way out to prevent its accumulation and carcinogenesis; At the same time, envoy medicinals should be given to guide the effects of other herbs to specific channels, so as to induce the medicinals to reach the internal organs through the meridians; to achieve the organic combination of macroscopic differentiation and microscopic differentiation, and the organic combination of zang-fu pattern differentiation and channel pattern differentiation, and it is also a further extension of the treatment method of consolidating the root and clearing up the source, in the hope that it can provide reference for the pattern differentiation and treatment of recurrence and metastasis of gastric cancer after surgery.
4.Advances in crystal nucleation for amorphous drugs
Jie ZHANG ; Kang LI ; Zi-qing YANG ; Zi-han DING ; Sai-jun XIAO ; Zhi-ming YUE ; Li-mei CAI ; Jia-wen LI ; Ding KUANG ; Min-zhuo LIU ; Zhi-hong ZENG
Acta Pharmaceutica Sinica 2024;59(7):1962-1969
Amorphous solid dispersion (ASD) is one of the most effective formulation approaches to enhance the water solubility and oral bioavailability of poorly water-soluble drugs. However, maintenance of physical stability of amorphous drug is one of the main challenges in the development of ASD. Crystallization is a process of nucleation and crystal growth. The nucleation is the key factor that influences the physical stability of the ASD. However, a theoretical framework to describe the way to inhibit the nucleation of amorphous drug is not yet available. We reviewed the methods and theories of nucleation for amorphous drug. Meanwhile, we also summarized the research progress on the mechanism of additives influence on nucleation and environmental factors on nucleation. This review aims to enhance the better understanding mechanism of nucleation of amorphous drug and controlling over the crystal nucleation during the ASD formulation development.
5.Analysis of Traditional Chinese Medicine Syndrome Characteristics and Related Factors of Yang Deficiency Syndrome in Postoperative Gastric Cancer Patients: A Multicenter Cross-Sectional Study
Yuansha GE ; Ruike GAO ; Jie LI ; Bowen XU ; Jingyuan WU ; Luchang CAO ; Ziyu KUANG
Journal of Traditional Chinese Medicine 2024;65(24):2565-2571
ObjectiveTo explore the distribution characteristics of traditional Chinese medicine (TCM) syndromes in postoperative gastric cancer patients, and to analyse the factors associated with yang deficiency syndrome and its severity. MethodsTotally, 173 patients who underwent postoperative gastric cancer surgery and were treated in four centers nationwide from February 22, 2022 to March 21, 2023, were enrolled. General information and TCM syndromes were collected, and Diagnostic Scale for Yang Deficiency Syndrome in Gastric Malignancies was filled in. The frequency of TCM syndromes after gastric cancer surgery was analyzed, and univariate analysis and multivariate logistic regression analysis were performed on the related factors of yang deficiency syndrome versus non-yang deficiency syndrome and between different severity of yang deficiency syndrome. ResultsThe most common syndrome after gastric cancer surgery was qi deficiency (95 cases, 54.91%), followed by yang deficiency (87 cases, 50.29%). Patients with yang deficiency syndrome were often suffered from qi deficiency, qi stagnation, and phlegm dampness syndrome. Comparing yang deficiency syndrome with non-yang deficiency syndrome, univariate analysis showed that history of alcohol consumption, pathological stage, degree of differentiation, Lauren grade, signet ring cell carcinoma, vascular cancer thrombus, and nerve invasion were statistically significant (P<0.05); and multivariate logistic regression analysis showed that history of alcohol consumption, signet ring cell carcinoma, pathological stage Ⅲ, Ⅳ, and vascular cancer thrombus may be correlated with yang deficiency syndrome in postoperative gastric cancer patients (P<0.05). The univariate analysis showed that age, pathological stage, precancerous lesions, and body mass index grade were significantly different when compared between mild and severe yang deficiency syndrome (P<0.05); multivariate logistic regression analysis showed that age, low body weight, and pathological stage Ⅲ and Ⅳ might be correlated with severe yang deficiency syndrome after gastric cancer surgery (P<0.05). ConclusionQi deficiency and yang deficiency are common TCM syndromes in postoperative patients with gastric cancer. Alcohol consumption history, pathological staging (stage Ⅲ and Ⅳ), signet ring cell carcinoma, and the presence of vascular cancer thrombus may be correlated with the occurrence of yang deficiency syndrome, and higher age, low body weight, and pathological staging (stage Ⅲ and Ⅳ) may be the correlates of severe yang deficiency syndrome.
6.Accuracy evaluation of bioelectrical impedance analysis in assessment of appendicular skeletal muscle mass in adults aged 18-42 years
Yiying ZHENG ; Hong CHENG ; Yuxian KUANG ; Zhenxin MA ; Weiye CHEN ; Keyuan LU ; Jie MI ; Li LIU
The Journal of Practical Medicine 2024;40(4):549-553
Objective To evaluate the accuracy of bioelectrical impedance analysis(BIA)in measurement of appendicular skeletal muscle mass(ASM)of adults.Methods A total of 836 adults aged 18-42 years were recruited in Guangzhou using a convenient sampling method from April 2021 to September 2022.ASM was measured using BIA and Dual-energy X-ray absorptiometry(DXA).Using DXA as the standard method,the consistency between the BIA and DXA measurements was evaluated by intra-class correlation coefficients(ICCs)and Bland-Altman analysis in logarithmically transformed data,in order to evaluate the accuracy of BIA in ASM measurement.Receiver operating characteristic curve was plotted to evaluate the diagnostic value of BIA for screening low muscle mass.Results A total of 774 individuals were included for analysis finally.ICCs for ASM measured by BIA and DXA were 0.774 and 0.667 in males and females,respectively.Mean ratios(limits of Agreement)of ASM were 0.94(0.80-1.10)and 0.91(0.78-1.05)in males and females,respectively.Area under curve of BIA for screening low muscle mass were 0.91 and 0.94 in males and females,respectively.The optimal cut-off values of Z-score by BIA for males and females were-0.57 and-0.66,respectively.Sensitivity and specificity for males were 82.5%and 86.0%,while being 86.8%and 93.8%,for females.Conclusion BIA shows a moderate consistency with DXA for measuring ASM in adults.Furthermore,BIA yields a good diagnostic value in identifying low muscle mass in adults aged 18-42 years.
7.Total body water percentage and 3rd space water are novel risk factors for training-related lower extremity muscle injuries in young males
Liang CHEN ; Ke-Xing JIN ; Jing YANG ; Jun-Jie OUYANG ; Han-Gang CHEN ; Si-Ru ZHOU ; Xiao-Qing LUO ; Mi LIU ; Liang KUANG ; Yang-Li XIE ; Yan HU ; Lin CHEN ; Zhen-Hong NI ; Xiao-Lan DU
Chinese Journal of Traumatology 2024;27(3):168-172
Purpose::To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis.Methods::A total of 282 healthy young male volunteers aged 18 -20 years participated in this cohort study. Injury location, degree, and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries. The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly. The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5, 50, 100 and 200 kHz to obtain 4 impedance values. The Shapiro-Wilk test was used to check whether the data conformed to a normal distribution. Data of normal distribution were shown as mean ± SD and analyzed by t-test, while those of non-normal distribution were shown as median (Q 1, Q 3) and analyzed by Wilcoxon rank sum test. The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy. Results::Among the 282 subjects, 78 (27.7%) developed training injuries. Lower extremity training injuries revealed the highest incidence, accounting for 23.4% (66 cases). These patients showed higher percentages of lean body mass ( p = 0.001), total body water (TBW, p=0.006), extracellular water ( p=0.020) and intracellular water ( p=0.010) as well as a larger ratio of basal metabolic rate/total weight ( p=0.006), compared with those without lower extremity muscle injuries. On the contrary, the percentage of body fat ( p=0.001) and body fat mass index ( p=0.002) were lower. Logistic regression analysis showed that TBW percentage > 65.35% ( p=0.050, odds ratio =3.114) and 3rd space water > 0.95% ( p=0.045, odds ratio =2.342) were independent risk factors for lower extremity muscle injuries. Conclusion::TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower extremity muscle injuries in young males following training.
8.Seminoma characterized by thickening of the pituitary stalk:A case report
Bing PENG ; Xingtian WANG ; Yuhuan DENG ; Yu LIAN ; Yanling ZHENG ; Jianren KUANG ; Jinyu QIAN ; Jie LIANG ; Yanlin ZHANG
Journal of Central South University(Medical Sciences) 2024;49(6):863-869
Intracranial seminoma is a rare malignant tumor originating from the germ cells,usually occurring in the pineal gland or pituitary gland.In June 2020,the Department of Endocrinology at the First Affiliated Hospital of Army Military Medical University admitted a 20-year-old male patient with an intracranial germ cell tumor and spinal metastases.The patient presented with headache,dizziness,and visual impairment.Enhanced magnetic resonance imaging(MRI)of the head indicated thickening of the pituitary stalk.After multidisciplinary consultation,the patient underwent endonasal transsphenoidal resection of the tumor,with the pathological diagnosis confirming germ cell tumor.The patient received regular radiotherapy postoperatively.One year later,the tumor recurred and metastasized,leading to a second surgery for tumor resection in the thoracic spinal canal,followed by continued chemotherapy.The patient's clinical symptoms,such as headache and visual disturbances,improved,but he continued to experience panhypopituitarism and required long-term hormone replacement therapy.Early diagnosis of intracranial germ cell tumors is challenging,and they are prone to metastasis and highly sensitive to radiotherapy and chemotherapy.Early diagnosis and multidisciplinary comprehensive treatment can help improve the quality of life and prognosis for patients.
9.Aureane-type sesquiterpene tetraketides as a novel class of immunomodulators with interleukin-17A inhibitory activity.
Xin TANG ; Chuanxi WANG ; Lei WANG ; Feifei REN ; Runqiao KUANG ; Zhenhua LI ; Xue HAN ; Yiming CHEN ; Guodong CHEN ; Xiuqing WU ; Jie LIU ; Hengwen YANG ; Xingzhong LIU ; Chen WANG ; Hao GAO ; Zhinan YIN
Acta Pharmaceutica Sinica B 2023;13(9):3930-3944
Interleukin (IL)-17A, a pro-inflammatory cytokine, is a fundamental function in the onset and advancement of multiple immune diseases. To uncover the primary compounds with IL-17A inhibitory activity, a large-scale screening of the library of traditional Chinese medicine constituents and microbial secondary metabolites was conducted using splenic cells from IL-17A-GFP reporter mice cultured under Th17-priming conditions. Our results indicated that some aureane-type sesquiterpene tetraketides isolated from a wetland mud-derived fungus, Myrothecium gramineum, showed remarkable IL-17A inhibitory activity. Nine new aureane-type sesquiterpene tetraketides, myrogramins A-I ( 1, 4- 11), and two known ones ( 2 and 3) were isolated and identified from the strain. Compounds 1, 3, 4, 10, and 11 exhibited significant IL-17A inhibitory activity. Among them, compound 3, with a high fermentation yield dose-dependently inhibited the generation of IL-17A and suppressed glycolysis in splenic cells under Th17-priming conditions. Strikingly, compound 3 suppressed immunopathology in both IL-17A-mediated animal models of experimental autoimmune encephalomyelitis and pulmonary hypertension. Our results revealed that aureane-type sesquiterpene tetraketides are a novel class of immunomodulators with IL-17A inhibitory activity, and hold great promise applications in treating IL-17A-mediated immune diseases.
10.Ideas for Prevention and Treatment of Postoperative Recurrence and Metastasis of Gastric Cancer Based on the Theory of “Chuan-she”(传舍) and “Yang Deficiency and Toxic Knot”
Ziyu KUANG ; Jiaxi WANG ; Luchang CAO ; Jie LI
Journal of Traditional Chinese Medicine 2023;64(22):2300-2304
Based on the theory of “chuanshe”, this paper expounded the role of yang deficiency and toxic knot as the core pathogenesis in various aspects of gastric cancer recurrence and metastasis after surgery, and put forward the prevention and treatment ideas of recurrence and metastasis of gastric cancer by conjugating yang to curb the trend of “transmission (chuan)”, protecting the yang to prevent metastasis by settling its “residence (she)”, preventing immersion by warming the yang to block the way of “chuan-she”, and attacking and cutting to clear the pathogen of cancer and poison and eliminate the root of the disease. In the process of preventing and treating recurrence and metastasis after gastric cancer surgery, the three methods of conjugating yang, protecting yang and warming yang should be flexibly used based on the principle of treating yang; combined with attacking and removing cancer poison, differentiating syndromes and diseases ; meanwhile, the changes of cold and heat in the body should be identified in detail and treated by the syndromes, in order to provide reference for the clinical differentiation and treatment of recurrence and metastasis after gastric cancer accurately.

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