1.Mechanistic Insights into The Role of LEPROTs and COPI Retrograde Transport in Regulating Golgi Morphology
Jing-Hu GAO ; Lin-Yue ZHAO ; Yu-Lu ZHANG ; Yan-Fang WU ; Bing YAN
Progress in Biochemistry and Biophysics 2026;53(6):1746-1757
ObjectiveThe Golgi apparatus serves as a central hub in the eukaryotic secretory pathway, responsible for the processing, sorting, and trafficking of proteins and lipids. In mammalian cells, the Golgi typically forms a perinuclear ribbon-like structure composed of laterally connected cisternae stacks.The maintenance of Golgi ribbon structure depends on the balance of membrane flux across multiple intracellular trafficking pathways, yet the specific contributions of distinct trafficking branches to Golgi macroscopic morphology remain elusive. In mammalian cells, the Golgi ribbon is typically organized as a perinuclear, laterally connected structure composed of stacked cisternae, and its integrity is highly dynamic and sensitive to perturbations in membrane trafficking. This study aims to elucidate the role of coat protein complex I (COPI)-mediated retrograde transport in maintaining the Golgi ribbon and to dissect the functional relationship between the transmembrane cargo receptors LEPROT/LEPROTL1 (LEPROTs) and the COPI adaptor GOLPH3. MethodsUsing siRNA interference and gene-deficient cell lines, we selectively perturbed COPI- or adaptor protein complex 1 (AP-1)-mediated trafficking pathways in HeLa cells. To quantitatively evaluate Golgi morphology, we employed a “Golgi Angle”-based measurement to assess its circumferential distribution around the nucleus. The spatial distribution of the Golgi ribbon was quantitatively analyzed using confocal microscopy, while Golgi ultrastructure and vesicle density were examined via transmission electron microscopy. Additionally, the subcellular distribution of COPI components was assessed by immunofluorescence co-localization. ResultsSelective inhibition of COPI retrograde transport significantly induced the circumferential extension of the Golgi ribbon around the nucleus, whereas blocking AP-1-mediated anterograde transport resulted in Golgi compaction, indicating opposing roles. These results suggest that different trafficking branches downstream of ARF1 exert distinct and even antagonistic effects on Golgi morphology. LEPROTs-deficient cells exhibited a Golgi extension phenotype highly consistent with COPI impairment. Furthermore, knockdown of GOLPH3 in a LEPROTs double-knockout background produced a significant additive effect on Golgi extension, suggesting that LEPROTs and GOLPH3 play non-redundant roles in regulating COPI-related trafficking processes. Mechanistically, loss of either LEPROTs or GOLPH3 led to the aberrant accumulation of COPI components at endoplasmic reticulum exit sites, accompanied by a reduction in COPI-like vesicles around the Golgi. This redistribution indicates a defect in COPI recycling between the ER-Golgi interface and the Golgi apparatus. Ultrastructural analysis revealed that Golgi cisternae in defective cells became shorter and thicker while maintaining a stable number of stacks. In parallel, the density of Golgi-associated vesicles was markedly decreased, further supporting an impairment in COPI vesicle formation or budding processes. ConclusionThis study demonstrates that active COPI retrograde transport is a critical factor in restricting the over-connection of the Golgi ribbon and maintaining its compactness. Rather than causing fragmentation, partial disruption of COPI function leads to a distinct morphological outcome characterized by Golgi ribbon extension at the light microscopy level and cisternal remodeling at the ultrastructural level. LEPROTs and GOLPH3 cooperatively promote the recycling and vesiculation of COPI components, thereby imposing a structural constraint on the Golgi periphery. Our findings support a model in which multiple adaptor proteins act in parallel to sustain efficient COPI cycling, thereby maintaining Golgi structural homeostasis. These findings provide new cell biological evidence for the membrane trafficking basis of Golgi morphological homeostasis.
2.Association mechanisms between the progression of metabolic dysfunction-associated fatty liver disease and multi-system comorbidities and integrated management strategies
Liping WANG ; Ya LI ; Yuebo REN ; Tingting HE ; Zhongxia WANG ; Liping YAN ; Simiao YU ; Jing JING ; Yongqiang SUN ; Aozhe ZHANG ; Xin WANG ; Xiaohe XIAO ; Yinying LU ; Ruilin WANG
Journal of Clinical Hepatology 2026;42(8):1933-1938
Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the most common chronic liver disease worldwide. Its pathological process is centered on the “two-hit” theory, with gut-liver axis dysregulation running through the entire disease course from steatosis to liver cirrhosis and even hepatocellular carcinoma, and it forms an extensive cross-system regulatory mechanism with the metabolic, cardiovascular, renal, and psychological and nervous systems through multi-dimensional pathways such as the “gut-liver-brain axis”, the “liver-kidney axis”, and the “liver-heart axis”. Disease progression is not limited to the liver itself, and it also involves functional imbalance of multiple organ systems throughout the body. This article systematically elaborates on the association mechanism of “liver pathological progression-multi-axis regulation-comorbidity occurrence” in MAFLD, proposes synergistic management strategies integrating early screening based on risk stratification, targeted intervention, and multidisciplinary diagnosis and treatment, and analyzes the limitations of current research and future development directions, in order to provide a theoretical basis and practical guidance for precise diagnosis and treatment and individualized management of MAFLD.
3.Graphene-mediated Far-infrared Therapy Enhances Anti-non-small Cell Lung Cancer Effects of Panax quinquefolium Saponins via cGAS/STING Signaling Pathway
Huifang ZANG ; Zikai GENG ; Yan GAO ; Lu LIU ; Yifei WANG ; Bonian ZHAO ; Jing LYU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):131-145
ObjectiveTo investigate whether the inhibitory effect of Panax quinquefolium saponins (PQS) on non-small cell lung cancer (NSCLC) is enhanced under graphene-mediated far-infrared therapy (GFIR), and to analyze its relationships with mitochondrial dysfunction, mitochondrial DNA (mtDNA) leakage, and the activation of cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathways. MethodsIn the cell experiments, the cell-counting kit 8 (CCK-8) was employed to assess the inhibitory effects of PQS alone or in combination with GFIR (PQS+GFIR) on A549 cell viability. The scratch assay and the colony formation assay were adopted to evaluate cell migration and colony formation capabilities, respectively. Flow cytometry was employed to assess apoptosis, mitochondrial membrane potential, and reactive oxygen species (ROS) levels. Immunofluorescence (IF) assay was performed to assess mitochondrial localization. Real-time polymerase China reaction(PCR) was used to detect mitochondrial DNA (mtDNA) leakage. A STING knockdown cell model was established by transfecting cells with small interfering RNA (siRNA), and the knockdown efficiency was assessed by Real-time PCR and Western blot. The cell viability and apoptosis following gene knockdown were assessed through the CCK-8 assay and flow cytometry. In the animal experiments, an allogeneic xenograft mouse model was established with Lewis lung cancer cells. Mice were randomized into a control group, a model group, a cisplatin group, a low-dose PQS (PQS-Low, 90 mg·kg-1) group, a high-dose PQS (PQS-High, 180 mg·kg-1) group, a low-dose PQS combined with GFIR (PQS-Low+GFIR, 90 mg·kg-1) group, and a high-dose PQS combined with GFIR (PQS-High+GFIR, 180 mg·kg-1) group. Treatment lasted for 14 days, and the fluorescence intensity was monitored at the tumor site by small-animal in vivo imaging during the treatment period. Flow cytometry was utilized to determine the proportions of T-lymphocyte subsets, B-lymphocyte levels, and peripheral blood NK cell levels in the spleens of mice. Immunohistochemical (IHC) staining was performed to assess the infiltration of CD3+, CD4+, and CD8+ T-lymphocytes in the tumor tissue. Enzyme-linked immunosorbent assay (ELISA) was conducted to measure the levels of interferon-α (IFN-α), interferon-β (IFN-β), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in mouse tumors. The mRNA levels of cGAS, STING, TANK-binding kinase 1 (TBK1), interferon regulatory factor 3 (IRF3), interferon beta 1 (IFNB1), and nuclear factor κB p65 (NF-κB p65) were determined by Real-time PCR. The protein levels of cGAS, STING, p-STING, TBK1, p-TBK1, IRF3, p-IRF3, NF-κB p65, and p-NF-κB p65 were quantified via Western blot. ResultsThe cell experiment results showed that compared with the control group, PQS inhibited the viability and migration of A549 cells, promoted apoptosis, affected mitochondrial localization, reduced mitochondrial membrane potential, increased the ROS level, and promoted mtDNA leakage. Following STING knockdown, the reductions in cell viability and the apoptosis-inducing effects caused by PQS were partially reversed (P<0.05, P<0.01). Compared with the PQS group, the PQS+GFIR group showed inhibited A549 cell migration and colony formation, exacerbated apoptosis, downregulated mitochondrial membrane potential, elevated ROS levels, and promoted mtDNA leakage. After STING knockdown, the reduced A549 cell viability and abnormal apoptosis phenotype were further reversed (P<0.05, P<0.01). The animal experiment results showed that compared with the control group, the model group mice exhibited reduced proportions of T-lymphocyte subsets, CD19+ B-lymphocyte levels, and peripheral blood NK1.1+ cell levels in the spleen (P<0.01). Compared with the model group, the PQS group showed increased immune cell parameters in mice (P<0.05, P<0.01). Compared with the PQS group, the PQS+GFIR group exhibited enhanced levels of the aforementioned indicators (P<0.01). Compared with the model group, the PQS group showed significantly reduced fluorescence intensity in transplanted tumors, significantly upregulated expression of CD3 and CD4 in the tumor tissue, elevated levels of IFN-α and IL-6 in tumors, and upregulated mRNA levels of cGAS, STING, TBK1, IRF3, IFNB1, and NF-κB p65 as well as upregulated protein level of cGAS and phosphorylation level of STING in tumors (P<0.05, P<0.01). Compared with the PQS group, the PQS+GFIR group demonstrated further reduced tumor fluorescence intensity, elevated levels of CD3, CD4, and CD8 as well as cytokine levels in tumor tissue, and upregulated mRNA levels of genes related to the cGAS/STING pathway as well as upregulated protein level of cGAS and phosphorylation levels of STING, TBK1, IRF3, and NF-κB p65 (P<0.05, P<0.01) ConclusionGFIR enhances the inhibitory effect of PQS on NSCLC, potentially through mitochondrial dysfunction, mtDNA leakage, and activation of the cGAS/STING signaling pathway.
4.Graphene-mediated Far-infrared Therapy Enhances Anti-non-small Cell Lung Cancer Effects of Panax quinquefolium Saponins via cGAS/STING Signaling Pathway
Huifang ZANG ; Zikai GENG ; Yan GAO ; Lu LIU ; Yifei WANG ; Bonian ZHAO ; Jing LYU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):131-145
ObjectiveTo investigate whether the inhibitory effect of Panax quinquefolium saponins (PQS) on non-small cell lung cancer (NSCLC) is enhanced under graphene-mediated far-infrared therapy (GFIR), and to analyze its relationships with mitochondrial dysfunction, mitochondrial DNA (mtDNA) leakage, and the activation of cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathways. MethodsIn the cell experiments, the cell-counting kit 8 (CCK-8) was employed to assess the inhibitory effects of PQS alone or in combination with GFIR (PQS+GFIR) on A549 cell viability. The scratch assay and the colony formation assay were adopted to evaluate cell migration and colony formation capabilities, respectively. Flow cytometry was employed to assess apoptosis, mitochondrial membrane potential, and reactive oxygen species (ROS) levels. Immunofluorescence (IF) assay was performed to assess mitochondrial localization. Real-time polymerase China reaction(PCR) was used to detect mitochondrial DNA (mtDNA) leakage. A STING knockdown cell model was established by transfecting cells with small interfering RNA (siRNA), and the knockdown efficiency was assessed by Real-time PCR and Western blot. The cell viability and apoptosis following gene knockdown were assessed through the CCK-8 assay and flow cytometry. In the animal experiments, an allogeneic xenograft mouse model was established with Lewis lung cancer cells. Mice were randomized into a control group, a model group, a cisplatin group, a low-dose PQS (PQS-Low, 90 mg·kg-1) group, a high-dose PQS (PQS-High, 180 mg·kg-1) group, a low-dose PQS combined with GFIR (PQS-Low+GFIR, 90 mg·kg-1) group, and a high-dose PQS combined with GFIR (PQS-High+GFIR, 180 mg·kg-1) group. Treatment lasted for 14 days, and the fluorescence intensity was monitored at the tumor site by small-animal in vivo imaging during the treatment period. Flow cytometry was utilized to determine the proportions of T-lymphocyte subsets, B-lymphocyte levels, and peripheral blood NK cell levels in the spleens of mice. Immunohistochemical (IHC) staining was performed to assess the infiltration of CD3+, CD4+, and CD8+ T-lymphocytes in the tumor tissue. Enzyme-linked immunosorbent assay (ELISA) was conducted to measure the levels of interferon-α (IFN-α), interferon-β (IFN-β), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in mouse tumors. The mRNA levels of cGAS, STING, TANK-binding kinase 1 (TBK1), interferon regulatory factor 3 (IRF3), interferon beta 1 (IFNB1), and nuclear factor κB p65 (NF-κB p65) were determined by Real-time PCR. The protein levels of cGAS, STING, p-STING, TBK1, p-TBK1, IRF3, p-IRF3, NF-κB p65, and p-NF-κB p65 were quantified via Western blot. ResultsThe cell experiment results showed that compared with the control group, PQS inhibited the viability and migration of A549 cells, promoted apoptosis, affected mitochondrial localization, reduced mitochondrial membrane potential, increased the ROS level, and promoted mtDNA leakage. Following STING knockdown, the reductions in cell viability and the apoptosis-inducing effects caused by PQS were partially reversed (P<0.05, P<0.01). Compared with the PQS group, the PQS+GFIR group showed inhibited A549 cell migration and colony formation, exacerbated apoptosis, downregulated mitochondrial membrane potential, elevated ROS levels, and promoted mtDNA leakage. After STING knockdown, the reduced A549 cell viability and abnormal apoptosis phenotype were further reversed (P<0.05, P<0.01). The animal experiment results showed that compared with the control group, the model group mice exhibited reduced proportions of T-lymphocyte subsets, CD19+ B-lymphocyte levels, and peripheral blood NK1.1+ cell levels in the spleen (P<0.01). Compared with the model group, the PQS group showed increased immune cell parameters in mice (P<0.05, P<0.01). Compared with the PQS group, the PQS+GFIR group exhibited enhanced levels of the aforementioned indicators (P<0.01). Compared with the model group, the PQS group showed significantly reduced fluorescence intensity in transplanted tumors, significantly upregulated expression of CD3 and CD4 in the tumor tissue, elevated levels of IFN-α and IL-6 in tumors, and upregulated mRNA levels of cGAS, STING, TBK1, IRF3, IFNB1, and NF-κB p65 as well as upregulated protein level of cGAS and phosphorylation level of STING in tumors (P<0.05, P<0.01). Compared with the PQS group, the PQS+GFIR group demonstrated further reduced tumor fluorescence intensity, elevated levels of CD3, CD4, and CD8 as well as cytokine levels in tumor tissue, and upregulated mRNA levels of genes related to the cGAS/STING pathway as well as upregulated protein level of cGAS and phosphorylation levels of STING, TBK1, IRF3, and NF-κB p65 (P<0.05, P<0.01) ConclusionGFIR enhances the inhibitory effect of PQS on NSCLC, potentially through mitochondrial dysfunction, mtDNA leakage, and activation of the cGAS/STING signaling pathway.
5.Investigation of physician countermeasures for mild progression after treatment with EGFR-TKI in lung adenocarcinoma
Wang QIMING ; Wang LU ; Yu HONGFAN ; Shen BO ; Chen CHENG ; Yan ZHAO ; Huang CHENG ; Wang YUMENG ; Li KAI ; Wang JING ; Shi QIULING
Chinese Journal of Clinical Oncology 2025;52(3):109-114
Objective:To investigate the views of doctors on the incidence and treatment tactics of mild progression after epithelial growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)treatment in lung adenocarcinoma and provide suggestions to optimize the counter-measure strategies.Methods:Convenience sampling was used to conduct an online questionnaire survey for doctors specializing in onco-logy and respiratory diseases.Results:584 valid questionnaires were collected,and all the doctors expressed concerns regarding mild tumor progression after EGFR-TKI treatment.The coping strategies included maintaining the original TKI treatment,adding other treatments to the original TKI,changing the regimen,and performing secondary tissue biopsy,among which,most doctors chose to add other treatments to the original TKI.Conclusions:Doctors have noticed the enlargement of target lesions in still stable disease(SD)and most frequently chose to add other treatments to the original TKI as a coping strategy.This finding can provide a reference for framing future guidelines for large sample prospective clinical studies that are needed to find the most effective synergistic treatment options.
6.Mechanistic investigation of Fuzheng Hefu Zhiyang Formula in alleviating psoriasis inflammatory microenvironment via P38/Erk/NF-κB signaling pathway
Yi-jing LIAO ; Yan-jie LIU ; Yue LU ; Bin TANG ; Jun-hong ZHANG ; Jing-jie YU ; Hao DENG ; Ling HAN ; Chuan-jian LU ; Hai-ming CHEN
Chinese Traditional Patent Medicine 2025;47(8):2550-2558
AIM To investigate the effect of Fuzheng Hefu Zhiyang Formula(FZHFZY)on psoriasis-like skin lesions and immune regulation in mice.METHODS In the in vivo experiment,30 BALB/c mice were randomly divided into the blank group,the model group,the dexamethasone group(1.5 g/kg of compound dexamethasone acetate cream),and the low-dose(2.5 g/kg)and high-dose(5 g/kg)FZHFZY groups,with six mice in each group.The experiment groups were treated with respective FZHFZY and dexamethasone,and the other groups were given normal saline for 10 consecutive days,during which psoriatic skin lesions were induced with imiquimod cream for 7 consecutive days.The mice had their area and severity of psoriasis assessed by PASI score;their histological changes of skin lesions.observed with Hematoxylin-eosin(HE)staining;their F4/80 ratio of skin lesions observed with immunohistochemical(IHC)staining;their protein expressions of P38,p-P38,Erk,p-Erk,P65 and p-P65 detected by Western blot;and their mRNA expressions of tumor necrosis factor-α(TNF-α),IL-17,IL-23 and IL-1β detected by RT-qPCR.In the in vitro research,the cultured RAW264.7 cells were divided into the blank group,the LPS group,and the FZHFZY groups(1 200,600,300,150 μg/mL).The cells had their protein expressions of P38,p-P38,Erk,p-Erk,P65 and p-P65 detected with Western blot;and their mRNA expressions of IL-6,TNF-α,IL-23 and IL-8 detected by RT-qPCR.RESULTS The in vivo experiment showed that compared to the model group,the FZHFZY groups demonstrated decreased PASI score(P<0.01);improved epidermal thickening and parakeratosis of skin lesions as revealed by HE staining result and increased expression of F4/80 in IHC staining sections;decreased protein expression ratios of p-P38/P38,p-ERK/Erk and p-P65/P65 in skin(P<0.05,P<0.01);and reduced mRNA expressions of TNF-α,IL-17,IL-23 and IL-1β in the skin(P<0.01).FZHFZY(0~2 400 μg/mL)showed no significant cytotoxicity towards RAW264.7 cells in vitro(P>0.05).Compared to those of the LPS group,the cells exposed to FZHFZ at concentrations of 1 200 and 600 μg/mL demonstrated decreased protein expression ratios of p-P38/P38,p-ERK/Erk,and p-P65/P65(P<0.05,P<0.01);and significantly decreased mRNA expressions of TNF-α,IL-17,IL-23 and IL-1β(P<0.01).CONCLUSION FZHFZY alleviates imiquimod-induced psoriatic lesions in mice and suppresses inflammatory response in LPS-stimulated RAW264.7 cells by inhibiting P38/Erk/NF-κB signaling pathway.
7.Effects of Er Miao Wan on skin lesion inflammation in atopic dermatitis mice and the MAPK/NF-κB signaling pathway of macrophage
Sheng-jin YANG ; Yan-jiao LIU ; Cheng LU ; Shi-jun DENG ; Jing LI ; Xin-jia ZHANG ; Yi ZHANG ; Rui-rui WANG ; Li-juan ZHANG
Chinese Traditional Patent Medicine 2025;47(11):3591-3600
AIM To explore the relieving effect of Er Miao Wan on atopic dermatitis in mice.METHODS In vivo experiment:BALB/c mice were randomly divided into normal group,model group,dexamethasone group(2 mg/kg)and high,medium and low dose groups of Er Miao Wan(4.68,2.34 and 1.17 g/kg).The mouse model of atopic dermatitis was established by repeatedly smearing DNCB solution,and the model was given orally for 21 days.The skin lesion condition on the back of mice,ear swelling degree,and the weight difference between ear lobes were observed and recorded.HE staining was used to observe the histopathological changes in the skin lesion tissues of mice.Toluidine blue(TB)staining was used to observe the infiltration of mast cells in skin lesions.The expression of macrophage marker F4/80 in skin lesions was detected by IHC.The serum levels of TSLP,IL-4,IL-5 and total IgE were detected by ELISA.In vitro experiment:RAW264.7 cells in logarithmic growth period were given 400,200 and 100 μg/mL Er Miao Wan for intervention.Cell proliferation was detected by CCK-8 method.NO level in cell supernatant was detected by Griess method.TNF-α,IL-1 β and IL-6 levels in cell supernatant were detected by ELISA method.The expressions of proteins related to the MAPK/NF-κB signaling pathway in cells was detected by Western blot.RESULTS In vivo experiment:Compared with the model group,the scores of back skin lesions,the swelling degree of right ear and the weight difference between left and right ear pieces in the high-dose group of Er Miao Wan decreased(P<0.05,P<0.01),the thickness of skin lesions decreased,the infiltration of mast cells and macrophages decreased(P<0.05,P<0.01),and the inflammatory factors TSLP,IL-4,IL-5 and total IgE levels in serum decreased(P<0.05,P<0.01),and the expression of F4/80 in the skin lesions decreased(P<0.01).In vitro experiment:Compared with the model group,the levels of NO,TNF-α,IL-1 β and IL-6 in Er Miao Wan 400 and 200 μg/mL groups decreased(P<0.05,P<0.01),and the phosphorylation levels of P38,JNK and P65 proteins decreased(P<0.05,P<0.01).CONCLUSION Er Miao Wan can alleviate skin lesion inflammation in DNCB-induced atopic dermatitis mice,and its mechanism may be related to inhibiting the activation of MAPK/NF-κB signaling pathway of macrophage,reducing macrophage infiltration and reducing Th2 cytokines.
8.The role and research progress of m6A modification in sepsis and its induced multi-organ dysfunction disease
Lu-lu ZHANG ; Rui GONG ; Jin-yi ZHAO ; Fei MU ; Yan-ping YIN ; Wang-ting LI ; Ling-ling ZHENG ; Yu-ping TANG ; Jing-wen WANG
Chinese Pharmacological Bulletin 2025;41(3):421-427
Sepsis is a life-threatening organ dysfunction disease caused by a dysregulated host response to infection.It has com-plex pathophysiological changes,and in severe cases,it can rap-idly develop into septic shock and multiple organ dysfunction or multiple organ failure.At present,the pathological mechanism of sepsis and its induced organ dysfunction is complex and the in-fluencing factors are numerous.So far,there is still a lack of specific and effective treatment strategies.RNA modify-N6-methyladenosine(m6 A)is one of the most common post-tran-scriptional modifications on eukaryotic RNAs.It is involved in the regulation of the occurrence and development of a variety of inflammatory diseases,including sepsis,and even multiple organ dysfunction induced by sepsis by affecting the metabolism of RNAs.It includes cardiac dysfunction,acute lung injury(ALI)and acute kidney injury(AKI).Therefore,this article will dis-cuss the effect of m6A modification on the function of immune cells,and its important role in sepsis and its induced multiple or-gan dysfunction diseases by regulating inflammatory signals,py-roptosis,mitochondrial damage and ferroptosis.This will provide new therapeutic targets and strategies for the clinical prevention and treatment of sepsis and its induced multiple organ dysfunc-tion diseases.
9.Clinical characteristics and prognosis analysis of 229 cases of adenocarcinoma of the uterine cervix
Qing LU ; Wenyan PAN ; Zhoulan BAI ; Yan YANG ; Jing TANG ; Ying MENG ; Haiyang LU ; Yangyang FENG ; Jianping MA
Chinese Journal of Radiation Oncology 2025;34(8):790-795
Objective:To investigate the clinical characteristics of cervical adenocarcinoma and analyze the survival status and related prognostic factors.Methods:The data of 229 patients with cervical adenocarcinoma who were diagnosed pathologically in the General Hospital of Ningxia Medical University from January 2013 to October 2022 were retrospectively analyzed. Among them, 198 early stage patients were mainly treated with surgery, and 31 locally advanced stage patients were mainly treated with chemoradiotherapy. The overall survival (OS) and progression-free survival (PFS) rates in the whole cohort of patients and different treatment subgroups were calculated. Kaplan‐Meier method and log‐rank test were used for survival analysis, and Cox proportional hazards model was used for univariate and multivariate survival analyses.Results:Among the 229 patients, there were 11 subtypes of pathological classifications, predominantly of the usual‐type. At the end of follow‐up, 57 patients (24.9%) relapsed. The 3‐ and 5‐year OS rates were 86.4% and 79.3%, respectively, and the 3‐ and 5‐year PFS rates were 81.6% and 73.6%, respectively. Multivariate analysis showed that International Federation of Gynecology and Obstetrics (FIGO) staging of stages Ⅲ‐Ⅳ was an independent prognostic factor for OS and PFS ( HR=2.033, 95% CI=1.456‐2.839, P<0.001; HR=1.701, 95% CI=1.251‐2.313, P=0.001). Lymph node metastasis was an independent risk factor for PFS ( HR=1.610,95% CI=1.021‐2.539, P=0.041). Subgroup analysis of 198 patients with surgical treatment: the 3‐ and 5‐year OS rates were 90.0% and 84.9%, and the 3‐ and 5‐year PFS rates were 82.7% and 76.7%, respectively. Multivariate analysis showed that lymph node metastasis and deep invasion depth were the main risk factors for OS ( HR=6.893, 95% CI=2.592‐18.327, P<0.001; HR=1.952, 95% CI=1.164‐3.272, P=0.011) and PFS ( HR=5.507, 95% CI=2.569‐11.805, P<0.001; HR=1.638, 95% CI=1.09‐2.461, P=0.018). Ovarian preservation was an independent risk factor for PFS ( HR=3.364, 95% CI=1.115‐10.151, P=0.031). Conclusions:The pathological types of cervical adenocarcinoma are complex and diverse. Local recurrence and distant metastasis are the main reasons for treatment failure. FIGO stage, lymph node metastasis and postoperative depth of invasion are the main prognostic factors of cervical adenocarcinoma.
10.International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025).
Sheng-Sheng ZHANG ; Lu-Qing ZHAO ; Xiao-Hua HOU ; Zhao-Xiang BIAN ; Jian-Hua ZHENG ; Hai-He TIAN ; Guan-Hu YANG ; Won-Sook HONG ; Yu-Ying HE ; Li LIU ; Hong SHEN ; Yan-Ping LI ; Sheng XIE ; Jin SHU ; Bin-Fang ZENG ; Jun-Xiang LI ; Zhen LIU ; Zheng-Hua XIAO ; Jing-Dong XIAO ; Pei-Yong ZHENG ; Shao-Gang HUANG ; Sheng-Liang CHEN ; Gui-Jun FEI
Journal of Integrative Medicine 2025;23(5):502-518
Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy*
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Humans
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Medicine, Chinese Traditional/methods*
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Practice Guidelines as Topic
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Drugs, Chinese Herbal/therapeutic use*

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