1.Efficacy and safety of sequential or combined therapy with tenofovir alafenamide fumarate in entecavir-treated patients with low-level viremia
Yijing ZHANG ; Lingying HUANG ; Bowu CHEN ; Wanchun ZHU ; Man LI ; Jie SHEN ; Yueqiu GAO
Journal of Clinical Hepatology 2026;42(1):66-73
ObjectiveTo investigate the efficacy of sequential tenofovir alafenamide fumarate (TAF) therapy versus the regimen of entecavir (ETV) combined with TAF in chronic hepatitis B (CHB) patients experiencing low-level viremia (LLV) after ETV therapy, as well as their impact on virologic response, liver and renal function, and blood lipid levels. MethodsA total of 217 CHB patients with LLV after ETV treatment who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from May 2020 to December 2023 were enrolled, and according to the treatment regimen, they were divided into TAF group (180 patients receiving sequential TAF therapy) and combined group (37 patients receiving ETV+TAF therapy). The propensity score matching (PSM) method was used to match the patients at a ratio of 1∶1, and finally 37 patients were included in each group to balance the baseline confounding factors. The two groups were compared in terms of hepatitis B virus DNA (HBV DNA) clearance rate, hepatitis B envelope antigen (HBeAg) clearance rate, liver and renal function parameters (liver stiffness measurement [LSM], platelet count [PLT], aspartate aminotransferase [AST], alanine aminotransferase [ALT], and creatinine [Cr]), blood lipid levels (total cholesterol [TC], triglyceride [TG], high-density lipoprotein cholesterol [HDL-C], and low-density lipoprotein cholesterol [LDL-C]), and the incidence rate of adverse reactions. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the paired t-test was used for comparison within each group; the chi-square test was used for comparison of categorical data between groups. ResultsAfter 48 weeks of treatment, compared with the TAF group, the combined group had significantly higher HBV DNA clearance rate (86.49% vs 59.46%, χ²=6.852, P=0.009) and HBeAg clearance rate (59.46% vs 35.14%, χ²=4.391, P=0.036). After treatment, compared with the TAF group, the combined group had significantly lower levels of LSM (7.01±1.50 kPa vs 7.90±1.68 kPa, t=2.404, P=0.019), AST (18.02±2.28 U/L vs 21.12±2.85 U/L, t=5.166, P<0.001), and ALT (19.85±3.86 U/L vs 22.00±3.90 U/L, t=2.383, P=0.020) and significantly higher levels of PLT [(218.35±42.60)×109/L vs (192.82±44.13)×109/L, t=2.532, P=0.014] and Cr (70.92±6.54 μmoL/L vs 67.60±6.13 μmoL/L, t=2.253, P=0.027). After treatment, there was a slight increase in the level of TC in both the TAF group (5.60±0.89 mmol/L vs 5.18±0.85 mmol/L, t=2.076, P=0.041) and the combined group (5.45±0.80 mmol/L vs 5.02±0.83 mmol/L, t=2.269, P=0.026). There was no significant difference in the incidence rate of adverse reactions between the TAF group and the combined group (21.62% vs 18.92%, χ²=0.084, P=0.772). ConclusionFor ETV-treated CHB patients experiencing LLV, compared with sequential TAF therapy, the ETV+TAF combined therapy can effectively increase virologic response rate, alleviate liver fibrosis, and improve liver function, whereas sequential TAF therapy has less impact on renal function. Sequential or combined therapy with TAF may induce a slight increase in the level of TC, which should be taken seriously in clinical practice.
2.The Role of Histone Lactylation in Diseases and Intervention by Traditional Chinese Medicine
Xin ZHANG ; Jie DU ; Zhao-Huan LI ; Feng GAO
Progress in Biochemistry and Biophysics 2026;53(4):887-904
Histone lactylation is a recently identified post-translational modification, wherein lactate mediates the enzymatic addition of lactyl groups to lysine residues on histones. Since its discovery, extensive research has demonstrated that histone lactylation is widely present in human tissues and plays a pivotal role in regulating the transcription of specific genes. Subsequent studies have further established this modification as a widespread epigenetic mark with significant physiological implications. With advancing research, accumulating evidence confirms that lactylation at distinct histone sites elicits diverse biological effects—such as promoting cell proliferation, driving inflammatory responses, and enhancing fibrosis—all of which profoundly influence disease progression and serve as key drivers of disease onset and development. Conversely, inhibiting histone lactylation can alter disease outcomes, positioning histone lactylation as a promising therapeutic target. Moreover, studies have revealed crosstalk between histone lactylation and other post-translational modifications, such as acetylation and methylation, which collectively regulate disease progression. Notably, lactylation occurs not only on histones but also on non-histone proteins. Histone lactylation activates specific gene transcription and reshapes metabolic epigenetics, while non-histone lactylation directly modulates enzyme activity, signal transduction, and protein stability. These two facets form a synergistic network through shared lactate pools, common modifying enzyme systems, and pathway crosstalk, thereby constructing a multi-dimensional regulatory framework—namely, the “histone lactylation-metabolism hub-non-histone lactylation” axis. This architecture bridges metabolism and epigenetics, and deciphering its topological structure may provide novel targets for precise intervention in diseases driven by lactate-mediated signaling hijacking. Traditional Chinese medicine (TCM), grounded in clinical practice, has been shown to regulate histone lactylation by modulating lactate metabolism and lactylation-related enzymes, thereby influencing disease progression. Moreover, certain TCM formulations exhibit potential as alternative therapies for drug-resistant diseases, underscoring the significance of further exploring TCM-mediated regulation of histone lactylation in future therapeutic strategies. This review aims to elucidate the mechanisms underlying histone lactylation, systematically delineate the associations between site-specific histone lactylation and various diseases, present a comprehensive landscape of the “lactate-histone lactylation and functional protein lactylation” axis, and summarize the mechanistic basis and research advances in TCM-mediated regulation of histone lactylation for disease treatment. Additionally, we discuss current challenges in histone lactylation research and propose future directions, ultimately aiming to deepen understanding and broaden perspectives on the roles and therapeutic potential of histone lactylation in disease.
3.Chemical Composition, Pharmacological Action, and Modern Application of Lonicerae Japonicae Flos: A Review
Jie GAO ; Liheng LI ; Yufei ZHANG ; Shurui ZHAO ; Yinuo LI ; Youcai YUAN ; Renshuai WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):327-335
Lonicerae Japonicae Flos refers to the dried flower buds or flowers about to open of Lonicera japonica (Caprifoliaceae). Its dried flower buds or early blooming flowers are listed in the Pharmacopoeia of the People's Republic of China (2020 edition) as official medicinal materials. As a Chinese medicine with "heat-clearing and detoxifying" properties and a classic medicinal-edible resource, it is mainly produced in northern authentic producing regions such as Shandong, Henan, and Hebei in China. Lonicerae Japonicae Flos contains abundant bioactive substances that are considered safe and effective, with functions including relieving sore throat, antibacterial and anti-inflammatory effects, and immune regulation. In recent years, with the modernization of traditional Chinese medicine (TCM) and the rapid development of the "big health" industry, Lonicerae Japonicae Flos has become a research hotspot in the fields of natural medicines and functional foods due to its multi-target pharmacological activities and broad application potential. To date, chemical constituents identified from Lonicerae Japonicae Flos include organic acids, flavonoids, iridoids, triterpenes, triterpenoid saponins, and volatile oils. Modern pharmacological studies have shown that Lonicerae Japonicae Flos possesses anti-inflammatory, antibacterial, antioxidant, antiviral, antidiabetic, cardiovascular and neuroprotective, and immunomodulatory activities. In terms of modern applications, Lonicerae Japonicae Flos has developed into a full industrial chain covering pharmaceuticals, health products, daily chemical products, and food additives, demonstrating high medicinal and health value. Strengthening the development of Lonicerae Japonicae Flos-based health products is of great significance. Based on relevant domestic and international literature, this paper systematically reviews the innovative applications of Lonicerae Japonicae Flos in traditional medicine, modern clinical formulations, health foods, and daily chemical products from the perspectives of chemical composition, pharmacological effects, and modern applications, aiming to further deepen basic research on Lonicerae Japonicae Flos. Meanwhile, this paper analyzes and proposes suggestions for promoting applied research on Lonicerae Japonicae Flos, in order to provide a scientific basis for its sound development and to offer references for the rational development and comprehensive utilization of medicinal and edible resources.
4.Paclitaxel Oral Preparations: A Review
Jie GAO ; Shiyang LI ; Jing GUO ; Rongsheng LI ; Zhenyu XUAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):322-330
Paclitaxel, a highly effective natural antitumor drug, has been demonstrated to be efficacious in the treatment of a variety of cancers, including breast cancer, ovarian cancer, and lung cancer. The traditional paclitaxel injections have been observed to present certain issues, including overt adverse reactions and a decline in the quality of life of patients following treatment. This ultimately leads to an inability to meet the comprehensive needs of patients, thereby limiting the clinical applications of the drugs. Compared with injectable administration, the oral administration can avoid the risk of infection present in the invasive route, is conducive to improving patient compliance and quality of life, and reduces healthcare costs, and has a good application prospect. However, paclitaxel has low solubility, poor permeability, and is susceptible to the exocytosis of P-glycoprotein, which presents a significant challenge in the development of its oral preparations. Novel drug delivery technologies can enhance the solubility of paclitaxel and facilitate its controlled release, which is beneficial for the oral absorption and efficacy. The paper reviews the development history of oral preparations of paclitaxel, and summarizes the delivery technologies such as polymer micelles, nanoparticles, nanoemulsions and nanocrystals, and discusses the application mechanisms, advantages and limitations of these technologies and their adaptability in different cancer treatments. Finally, the challenges faced in the development of oral preparations of paclitaxel are summarized, and future research directions are proposed in order to provide new ideas for the development of oral delivery of paclitaxel.
5.Concept,Organizational Structure,and Medical Model of the Traditional Chinese Medicine Myocardial Infarction Unit
Jun LI ; Jialiang GAO ; Jie WANG ; Zhenpeng ZHANG ; Xinyuan WU ; Ji WU ; Zicong XIE ; Jingrun CUI ; Haoqiang HE ; Yuqing TAN ; Chunkun YANG
Journal of Traditional Chinese Medicine 2025;66(9):873-877
The traditional Chinese medicine (TCM) myocardial infarction (MI) unit is a standardized, regulated, and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings, offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused, providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI, delivering prevention, treatment, and rehabilitation during the acute, stable, and recovery phases. Additionally, the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management, reduce the incidence of myocardial infarction, and improve quality of life.
6.Paclitaxel Oral Preparations: A Review
Jie GAO ; Shiyang LI ; Jing GUO ; Rongsheng LI ; Zhenyu XUAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):322-330
Paclitaxel, a highly effective natural antitumor drug, has been demonstrated to be efficacious in the treatment of a variety of cancers, including breast cancer, ovarian cancer, and lung cancer. The traditional paclitaxel injections have been observed to present certain issues, including overt adverse reactions and a decline in the quality of life of patients following treatment. This ultimately leads to an inability to meet the comprehensive needs of patients, thereby limiting the clinical applications of the drugs. Compared with injectable administration, the oral administration can avoid the risk of infection present in the invasive route, is conducive to improving patient compliance and quality of life, and reduces healthcare costs, and has a good application prospect. However, paclitaxel has low solubility, poor permeability, and is susceptible to the exocytosis of P-glycoprotein, which presents a significant challenge in the development of its oral preparations. Novel drug delivery technologies can enhance the solubility of paclitaxel and facilitate its controlled release, which is beneficial for the oral absorption and efficacy. The paper reviews the development history of oral preparations of paclitaxel, and summarizes the delivery technologies such as polymer micelles, nanoparticles, nanoemulsions and nanocrystals, and discusses the application mechanisms, advantages and limitations of these technologies and their adaptability in different cancer treatments. Finally, the challenges faced in the development of oral preparations of paclitaxel are summarized, and future research directions are proposed in order to provide new ideas for the development of oral delivery of paclitaxel.
7.Carvedilol to prevent hepatic decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new non-invasive model (CHESS2306)
Chuan LIU ; Hong YOU ; Qing-Lei ZENG ; Yu Jun WONG ; Bingqiong WANG ; Ivica GRGUREVIC ; Chenghai LIU ; Hyung Joon YIM ; Wei GOU ; Bingtian DONG ; Shenghong JU ; Yanan GUO ; Qian YU ; Masashi HIROOKA ; Hirayuki ENOMOTO ; Amr Shaaban HANAFY ; Zhujun CAO ; Xiemin DONG ; Jing LV ; Tae Hyung KIM ; Yohei KOIZUMI ; Yoichi HIASA ; Takashi NISHIMURA ; Hiroko IIJIMA ; Chuanjun XU ; Erhei DAI ; Xiaoling LAN ; Changxiang LAI ; Shirong LIU ; Fang WANG ; Ying GUO ; Jiaojian LV ; Liting ZHANG ; Yuqing WANG ; Qing XIE ; Chuxiao SHAO ; Zhensheng LIU ; Federico RAVAIOLI ; Antonio COLECCHIA ; Jie LI ; Gao-Jun TENG ; Xiaolong QI
Clinical and Molecular Hepatology 2025;31(1):105-118
Background:
s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model.
Methods:
Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort.
Results:
In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM).
Conclusions
Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.
8.Research and development of sterile electrode acupuncture needle for single use based on medicine-engineering integration and its clinical application.
Wanying XIA ; Tianxin LI ; Lingli QIN ; Yue GAO ; Hanxi DAI ; Jie ZHANG ; Jinsheng YANG ; Lu ZHANG
Chinese Acupuncture & Moxibustion 2025;45(10):1527-1532
The sterile electrode acupuncture needle for single use is an innovative product that combines traditional acupuncture with modern electronic technology, and it has obtained Class Ⅱ medical device registration certificate. This acupuncture device consists of a needle body and a handle. The diameter of the needle body ranges from 0.16 mm to 0.55 mm, and the length from 7 mm to 150 mm. The spiral spray technology is adopted to modify the micron-level insulating coat on stainless steel needle body. The needle holder is connected to the electroacupuncture device (conductive), the micro-film insulated needle body (non-conductive) and the membrane-free needle tip (conductive) can provide a precise electrical stimulation for different tissue layers of acupoints (such as deep nerves and fascia). The intradermal stimulation test, cytotoxicity test and hypersensitivity reaction test have showed a favorable biocompatibility, laying a solid and reliable safety for clinical application. This acupuncture device is suitable for the in-depth invasive stimulation at the sites of human body surface in combination with electroacupuncture equipment in medical institutions.
Humans
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Needles
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Acupuncture Therapy/instrumentation*
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Electrodes
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Equipment Design
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Electroacupuncture/instrumentation*
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Acupuncture Points
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Animals
9.Alzheimer's disease diagnosis among dementia patients via blood biomarker measurement based on the AT(N) system.
Tianyi WANG ; Li SHANG ; Chenhui MAO ; Longze SHA ; Liling DONG ; Caiyan LIU ; Dan LEI ; Jie LI ; Jie WANG ; Xinying HUANG ; Shanshan CHU ; Wei JIN ; Zhaohui ZHU ; Huimin SUI ; Bo HOU ; Feng FENG ; Bin PENG ; Liying CUI ; Jianyong WANG ; Qi XU ; Jing GAO
Chinese Medical Journal 2025;138(12):1505-1507
10.Intermittent fasting ameliorates rheumatoid arthritis by harassing deregulated synovial fibroblasts.
Lei LI ; Jin DONG ; Yumu ZHANG ; Chen ZHAO ; Wen WEI ; Xueqin GAO ; Yao YU ; Meilin LU ; Qiyuan SUN ; Yuwei CHEN ; Xuehua JIAO ; Jie LU ; Na YUAN ; Yixuan FANG ; Jianrong WANG
Chinese Medical Journal 2025;138(23):3201-3203

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