1.From Gene Expression to Transcriptome-wide Association Study: Development and Comparison of Methodology
Kun FANG ; Guozhuang LI ; Linting WANG ; Qing LI ; Kexin XU ; Lina ZHAO ; Zhihong WU ; Jianguo ZHANG ; Nan WU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):223-229
Over the past two decades, genome-wide association study(GWAS) has identified numerous genetic variants and loci associated with heritable diseases. With the gradual maturation and saturation of GWAS methodologies, transcriptome-wide association study(TWAS) offers a novel perspective by linkinggenetic phenotypes to gene expression levels. By integrating TWAS with other multi-omics analyses, researchers can gain a deeper understanding of heritable diseases. This article provides an overview of recent groundbreaking and representative TWAS methods and tools, analyzes their strengths and limitations, and discusses future trends in TWAS development.
2.Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"
Haoran SHI ; Kexin LIANG ; Jing ZHI ; Zhirou ZHANG ; Luqing ZHAO
Journal of Traditional Chinese Medicine 2026;67(15):1659-1663
Based on LI Gao's theory of "heavy obstruction" and "blockage of the nine orifices", this paper proposes the pathological concept of "heavy obstruction and orifice blockage". It is suggested that the core pathogenesis of functional constipation (FC) lies in simultaneous sinking of spleen and lung, together with accumulation and obstruction of dampness and turbidity, resulting in impaired movement of intestinal qi. Within this framework, spleen deficiency with sinking of dampness is considered as the primary pathological mechanism of outlet obstructive constipation (OOC), while sinking of lung qi is regarded as the key mechanism underlying slow transit constipation (STC). When both pathological mechanisms coexist, mixed constipation (MC) develops. Guided by this theory, FC is classified into three patterns for syndrome-based treatment. OOC is treated by promoting bowel movement, descending turbid pathogens, and opening the orifices to restore function, with self-formulated Shengxian Tongqiao Decoction (升陷通窍汤). STC is treated by diffusing lung qi, regulating spleen function, raising sinking qi, and promoting transportation, with self-formulated Xuanfei Yunpi Decoction (宣肺运脾汤). MC is treated by regulating lung and spleen function, simultaneously raising clear qi and descending turbidity, with self-formulated Xuanyun Tongqiao Decoction (宣运通窍汤). In clinical practice, modifications should be made according to accompanying syndromes and individual conditions.
3.Exploration of the Pathogenesis and Syndrome-Based Treatment of Functional Constipation Based on the Theory of "Heavy Obstruction and Orifice Blockage"
Haoran SHI ; Kexin LIANG ; Jing ZHI ; Zhirou ZHANG ; Luqing ZHAO
Journal of Traditional Chinese Medicine 2026;67(15):1659-1663
Based on LI Gao's theory of "heavy obstruction" and "blockage of the nine orifices", this paper proposes the pathological concept of "heavy obstruction and orifice blockage". It is suggested that the core pathogenesis of functional constipation (FC) lies in simultaneous sinking of spleen and lung, together with accumulation and obstruction of dampness and turbidity, resulting in impaired movement of intestinal qi. Within this framework, spleen deficiency with sinking of dampness is considered as the primary pathological mechanism of outlet obstructive constipation (OOC), while sinking of lung qi is regarded as the key mechanism underlying slow transit constipation (STC). When both pathological mechanisms coexist, mixed constipation (MC) develops. Guided by this theory, FC is classified into three patterns for syndrome-based treatment. OOC is treated by promoting bowel movement, descending turbid pathogens, and opening the orifices to restore function, with self-formulated Shengxian Tongqiao Decoction (升陷通窍汤). STC is treated by diffusing lung qi, regulating spleen function, raising sinking qi, and promoting transportation, with self-formulated Xuanfei Yunpi Decoction (宣肺运脾汤). MC is treated by regulating lung and spleen function, simultaneously raising clear qi and descending turbidity, with self-formulated Xuanyun Tongqiao Decoction (宣运通窍汤). In clinical practice, modifications should be made according to accompanying syndromes and individual conditions.
4.The comparison of ferroptosis characteristics and motor deficits in Parkinson's disease mouse models
Haiyan LI ; Mengzhu LI ; Mengxuan CHEN ; Da GAO ; Kexin DUAN ; Lijun ZHAO ; Meiling ZHU
The Journal of Practical Medicine 2025;41(22):3501-3509
Objective To compare ferroptosis characteristics and motor dysfunction across different mouse models of Parkinson's disease(PD).Methods Animal models of PD were divided into five groups:the control group,sham-operated group,6-hydroxydopamine(6-OHDA)group,1-methyl-4-phenyl-1,2,3,6-tetrahydropyri-dine(MPTP)group,and lipopolysaccharide(LPS)group.Differences in ferroptosis-related features and motor dysfunction across these groups were evaluated through behavioral observation,histopathological examination,protein analysis,and assessment of lipid peroxidation and oxidative stress levels.Results In all three model groups,the number of TH-positive neurons in the substantia nigra on the lesioned side was significantly reduced,accompanied by evident neuronal degeneration and a marked decrease in Nissl bodies.Behavioral assessments revealed that the 6-OHDA group displayed the most severe motor deficits.In the substantia nigra,FTH1 protein expression was significantly downregulated in the 6-OHDA,LPS,and MPTP groups(P<0.01,P<0.05,P<0.01),respectively,while GPX4 expression was also reduced(P<0.001,P<0.001,P<0.01).Malondialdehyde(MDA)levels were significantly elevated in both the 6-OHDA and MPTP groups(P<0.05,P<0.05).Glutathione(GSH)assays demonstrated markedly reduced levels in the 6-OHDA,MPTP,and LPS groups(P<0.01,P<0.001,P<0.001).Reactive oxygen species(ROS)detection revealed a significant increase in the MPTP and LPS groups(P<0.05,P<0.05).Conclusion The 6-OHDA model is well suited for studying PD-related behaviors and the underlying mechanisms of motor symptoms,the MPTP model is particularly effective for investigating the ferroptosis pathway,and the LPS model serves as a valuable complement for research on neuroinflammation mechanisms.
5.The chain mediating role of rejection sensitivity and adaptability between maternal rejection and internet addiction in college students
Mianli ZHAO ; Yuecui KAN ; Tianyi BU ; Jiawei ZHOU ; Xiaomeng HU ; Kexin QIAO ; Xuan LIU ; Yanjie YANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(5):459-464
Objective:To explore the relationship between maternal rejection and internet addiction in college students, as well as the chain mediating role of rejection sensitivity and adaptability.Methods:From March to May 2024, a total of 1 119 college students were surveyed using the short-form Egna Minnen av Barndoms Uppforstran for Chinese(s-EMBU-C), internet addiction test(IAT), rejection sensitivity questionnaire(RSQ), and the China college student adjustment scale(CCSAS).SPSS 26.0 statistical software was used for independent sample t-test, one-way ANOVA, Pearson product moment correlation, and multiple linear regression analysis, and PROCESS 4.0 macro program was used for chain mediation analysis. Results:(1)Maternal rejection (11.19±2.97) was positively correlated with internet addiction (44.89±9.74)( r=0.60, P<0.01) and rejection sensitivity (102.93±55.63)( r=0.63, P<0.01), while negatively correlated with adaptability (200.19±14.18)( r=-0.56, P<0.01) among college students. Rejection sensitivity was positively correlated with internet addiction ( r=0.75, P<0.01) and negatively correlated with adaptability ( r=-0.76, P<0.01). Adaptability was negatively correlated with internet addiction ( r=-0.68, P<0.01). (2)Maternal rejection had a significant direct effect on internet addiction among college students (effect value=0.193, 95% CI=0.145-0.241), accounting for 32.06%(0.193/0.602) of the total effect. Rejection sensitivity mediated the relationship between maternal rejection and internet addiction (effect value=0.290, 95% CI=0.232-0.357), accounting for 48.17%(0.290/0.602) of the total effect. Adaptability also mediated this relationship (effect value=0.028, 95% CI=0.009-0.053), accounting for 4.65%(0.028/0.602) of the total effect. Additionally, there was a chain mediation effect of rejection sensitivity and adaptability on the relationship between maternal rejection and internet addiction (effect value=0.091, 95% CI=0.052-0.130), accounting for 15.12%(0.091/0.602) of the total effect. Conclusion:Maternal rejection can directly influence internet addiction in college students, and it can also indirectly influence internet addiction through the independent mediating effects of rejection sensitivity and adaptability, as well as through the chain mediating effects of both rejection sensitivity and adaptability.
6.Emerging breakthroughs and future prospects of Claudin18.2 in targeted therapy and immuno-therapy for gastric cancer
Jiayu JIANG ; Zhen FANG ; Kexin ZHENG ; Baoshan CAI ; Yulong ZHAO ; Zhaodong LIU ; Changqing JING ; Leping LI ; Liang SHANG
Chinese Journal of Digestive Surgery 2025;24(3):343-349
Gastric cancer, a highly malignant tumor, has seen a persistent rise in global incidence in recent years. Claudin 18.2, a protein with highly specific expression in gastric cancer, has emerged as a prominent research target in therapeutic development. The overexpression of Claudin 18.2 in gastric cancer cells and its abnormal surface exposure provide novel opportunities for targeted and immunotherapeutic interventions. Therapeutic approaches targeting Claudin 18.2 have shown promising initial results in clinical trials, primarily including monoclonal antibodies and chimeric antigen receptor T-cell therapies. The authors systematically summarize the biological characteristics, mechanism of action, clinical research progress, and future treatment prospects and challenges of Claudin 18.2.
7.Meta-synthesis of qualitative studies on the feeling of mental experience during dietary management for patients with inflammatory bowel disease
Xiao CONG ; Jie SONG ; Longhui XU ; Wenxuan ZHAO ; Jie SUN ; Kexin PU ; Kaili LYU
Chinese Journal of Practical Nursing 2025;41(29):2265-2272
Objective:To systematically evaluate the authentic feeling of mental experience among patients with inflammatory bowel disease (IBD) in the process of dietary management, aiming to provide insights for maintaining the psychological well-being of patients with IBD and strengthening their dietary management.Methods:The qualitative studies related to dietary management in patients with IBD from China National Knowledge Infrastructure, Wanfang, VIP, China Biomedical Database, PubMed, Web of Science, Embase, Cochrane Library, CINAHL and PsyINFO were searched from inception to January 31st 2025. Quality evaluation criteria for qualitative research of Joanna Briggs Institute, Australia, 2016 edition was used for literature evaluation. Meta integration method was used to integrate and analyze the literature findings.Results:A total of 11 articles were included in the review, from which 22 research findings were extracted and categorized into 7 groups, culminating in 3 integrated outcomes: IBD patients experienced complex emotions, IBD patients faced multiple pressures and IBD patients had ambivalent coping.Conclusions:IBD patients manifest profound psychological complexities throughout dietary management processes. Future healthcare professionals can implement multifaceted psychological intervention strategies to relieve psychological distress, promote positive emotion, overcome negative coping, and ultimately enhance the competence of dietary self-management among IBD patients.
8.Research on high-throughput detection of plasma cell-free DNA for targeted therapy-related genes screening and prognosis prediction in non-small cell lung cancer patients
Qiling DENG ; Di SONG ; Kexin XI ; Xiaoting XIE ; Xiaoyan WU ; Wei ZHAO
China Oncology 2025;35(4):355-364
Background and purpose:High-throughput detection of plasma cell-free DNA(cfDNA)is widely used for multi-cancer targeted therapy drug screening,and this study investigated the relationship between the type and number of plasma cfDNA class Ⅰ and Ⅱ targeted therapy-related gene variants and cancer survival in patients with non-small cell lung cancer(NSCLC).Methods:The sequencing results and clinical data of NSCLC patients who underwent tumor plasma cfDNA high-throughput sequencing projects in Sun Yat-sen University Cancer Center from 2021 to 2023 were collected.The survival follow-up of enrolled patients was carried out from the day of plasma collection on June 1,2021 to May 27,2024,and GraphPad Prism 8.0 and SPSS Statistics 25.0 were used.Univariate and multivariate statistical analyses were conducted on the types and numbers of class Ⅰ and class Ⅱ targeted therapy-related genes in the survival and clinical data of patients and sequencing results(Ethical approval:B2024-359-01).Results:A total of 313 patients included in this study with NSCLC were categorized into stage Ⅰ 25 patients(7.98%),stageⅡ 20 patients(6.39%),stage Ⅲ 38patients(12.14%),and stage Ⅳ 230 patients(73.48%).Pathological diagnosis results showed that adenocarcinoma accounted for 90.10%,squamous cell carcinoma accounted for 5.11%,large cell carcinoma accounted for 2.87%and other classifications accounted for 1.92%.The number and the percentage of class Ⅰ and class Ⅱ targeted therapy drug-related genes in the plasma cfDNA NSCLC patients were 0(25.24%),1(17.57%),2(19.17%),3(14.38%),4(8.31%),and 5 or more(15.34%).The results of statistical analysis showed that 3 genes with the highest mutation frequencies were EGFR,TP53 and ERBB2,and the mutation frequency of EGFR gene was 36.04%.The mutation frequency of TP53 gene was 30.63%.The mutation frequency of ERBB2 gene was 4.95%.The survival time of patients is related to not only the expression of hotspot targeted genes,but also the number of class Ⅰ and Ⅱ target-related gene variants detected by plasma cfDNA high-throughput sequencing.The survival time of the patients with no targeted therapy-related locus variants after treatment was longer compares with targeted therapy-related locus variants,which can reduce the risk of death by 63.2%.However,patients with a single gene locus variant had longer survival time and lower risk of death than those with multiple driver locus variants,and the measured class Ⅰ and Ⅱ targeted therapy drugs were within 3 genes.Overall,the smaller the number of genes,the longer the survival.Conclusions:The number of class Ⅰ and class Ⅱtargeted therapy-related gene variants in plasma cfDNA high-throughput sequencing also has an effect on the survival of patients after treatment.Plasma cfDNA level detected by high-throughput sequencing could be a prognostic factor for the NSCLC patients.
9.The chain mediating role of rejection sensitivity and adaptability between maternal rejection and internet addiction in college students
Mianli ZHAO ; Yuecui KAN ; Tianyi BU ; Jiawei ZHOU ; Xiaomeng HU ; Kexin QIAO ; Xuan LIU ; Yanjie YANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(5):459-464
Objective:To explore the relationship between maternal rejection and internet addiction in college students, as well as the chain mediating role of rejection sensitivity and adaptability.Methods:From March to May 2024, a total of 1 119 college students were surveyed using the short-form Egna Minnen av Barndoms Uppforstran for Chinese(s-EMBU-C), internet addiction test(IAT), rejection sensitivity questionnaire(RSQ), and the China college student adjustment scale(CCSAS).SPSS 26.0 statistical software was used for independent sample t-test, one-way ANOVA, Pearson product moment correlation, and multiple linear regression analysis, and PROCESS 4.0 macro program was used for chain mediation analysis. Results:(1)Maternal rejection (11.19±2.97) was positively correlated with internet addiction (44.89±9.74)( r=0.60, P<0.01) and rejection sensitivity (102.93±55.63)( r=0.63, P<0.01), while negatively correlated with adaptability (200.19±14.18)( r=-0.56, P<0.01) among college students. Rejection sensitivity was positively correlated with internet addiction ( r=0.75, P<0.01) and negatively correlated with adaptability ( r=-0.76, P<0.01). Adaptability was negatively correlated with internet addiction ( r=-0.68, P<0.01). (2)Maternal rejection had a significant direct effect on internet addiction among college students (effect value=0.193, 95% CI=0.145-0.241), accounting for 32.06%(0.193/0.602) of the total effect. Rejection sensitivity mediated the relationship between maternal rejection and internet addiction (effect value=0.290, 95% CI=0.232-0.357), accounting for 48.17%(0.290/0.602) of the total effect. Adaptability also mediated this relationship (effect value=0.028, 95% CI=0.009-0.053), accounting for 4.65%(0.028/0.602) of the total effect. Additionally, there was a chain mediation effect of rejection sensitivity and adaptability on the relationship between maternal rejection and internet addiction (effect value=0.091, 95% CI=0.052-0.130), accounting for 15.12%(0.091/0.602) of the total effect. Conclusion:Maternal rejection can directly influence internet addiction in college students, and it can also indirectly influence internet addiction through the independent mediating effects of rejection sensitivity and adaptability, as well as through the chain mediating effects of both rejection sensitivity and adaptability.
10.Association between remnant cholesterol and the risk of atherosclerotic cardiovascular disease in a community population in Shanghai
Yingqi DENG ; Minhua TANG ; Kexin ZHANG ; Xiaohua LIU ; Yanan WU ; Qian PENG ; Liping YI ; Jianhua SHI ; Yingfeng LU ; Yonggen JIANG ; Genming ZHAO
Chinese Journal of Epidemiology 2025;46(6):935-941
Objective:To analyze the association between remnant cholesterol (RC) and the risk of atherosclerotic cardiovascular disease (ASCVD) in community population in Shanghai.Methods:Using baseline and follow-up data from the Shanghai Suburban Adult Cohort and Biobank, individuals with ASCVD (including coronary heart disease, stroke, myocardial infarction, and peripheral artery disease) at baseline were excluded. A Cox proportional hazards regression model was employed to analyze the relationship between RC and ASCVD risk and the association under different LDL-C levels.Results:A total of 57 281 participants were included, with a median follow-up of 5.61 person-years. During the follow-up, 1 436 ASCVD events (2.51%) were recorded. After adjusting for potential confounders, individuals with moderate ( HR=1.18, 95% CI: 1.03-1.36) or high RC levels ( HR=1.32, 95% CI: 1.15-1.51) had an increased risk of ASCVD. The association was stronger in participants younger than 60 years-old (interaction P=0.048). Participants with RC ≥0.97 mmol/L and LDL-C <3.40 mmol/L demonstrated a 19% ( HR=1.19, 95% CI: 1.06-1.35) increased risk of ASCVD. When RC ≥0.97 mmol/L and LDL-C ≥3.40 mmol/L, ASCVD risk increased by 42% ( HR=1.42, 95% CI: 1.21-1.67). Conclusions:Elevated RC increases ASCVD risk, regardless of LDL-C levels. RC can serve as a valuable predictor and intervention target for ASCVD.

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