1.Correlation Analysis of Huanglian Jiedu Wan on Syndrome Improvement and Clinical Biomarkers of "Excess Heat-Toxicity" Based on Machine Learning Model
Qi LI ; Keke LUO ; Baolin BIAN ; Hongyu YU ; Mengxiao WANG ; Mengyao TIAN ; Wen XIA ; Yuan MA ; Xinfang ZHANG ; Pengyue LI ; Nan SI ; Hongjie WANG ; Yanyan ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):162-173
ObjectiveThis paper aims to find the identified and validated clinical biomarker data building upon a clinical study of early-phase phase Ⅱ and investigate the correlation analysis of Huanglian Jiedu Wan on syndrome improvement and clinical biomarkers in the treatment of "excess heat-toxicity" based on a machine learning model. Additionally, the effective prediction of clinical biomarker values for the main symptoms of the "excess heat-toxicity" syndrome was assessed. MethodsA total of 229 patients meeting the inclusion criteria for "excess heat-toxicity" syndrome were randomly divided into the Huanglian Jiedu Wan group and the placebo group. Syndrome score transition matrices were constructed for the Huanglian Jiedu Wan group and the placebo group based on three main symptoms of "excess heat-toxicity" syndrome, such as oral ulcers, sore throat, and gum swelling and pain. Data from the patients with these three syndromes were also integrated for an overall analysis. The corresponding syndrome score transition matrices were further constructed to visualize symptom change trends of the patients in the two groups via heatmaps. Based on the identified and validated clinical biomarkers related to inflammation, oxidative stress, and energy metabolism in the early phase, Spearman correlation analysis was employed to analyze and evaluate the associations between clinical biomarkers and syndrome improvement. Key clinical biomarkers reflecting the effect of Huanglian Jiedu Wan were screened through the comparison of differences between groups. An extreme gradient boosting (XGBoost) algorithm was used to develop a prediction model for main symptom classification, with classification performance evaluated through 10-fold cross-validation. Feature importance analysis was applied to identify variables with the greatest contribution to the prediction result. ResultsThe syndrome transition matrix results indicated that the Huanglian Jiedu Wan group showed a superior effect to the placebo group in improving oral ulcers, sore throat, and overall symptoms, with significant effects observed especially in sore throat and overall symptom analyses (P<0.01). Spearman correlation analysis revealed that several clinical biomarkers positively correlated with "excess heat-toxicity" syndrome and its main symptom improvement, were also called "heat-related biomarkers", including succinic acid, α-ketoglutaric acid, glycine, lactic acid, adenosine monophosphate (AMP), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-1β (IL-1β), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and so on. Conversely, clinical biomarkers negatively correlated with symptom severity, were also called "heat-clearing related biomarkers" after administration of Huanglian Jiedu Wan, including malic acid, fumaric acid, cis-aconitic acid, adrenocorticotropic hormone (ACTH), IL-1β, IL-4, IL-8, succinic acid, and citric acid. The XGBoost classification model using all 52 biomarkers as variables achieved an average test accuracy of 0.754 and an average F1 score of 0.777. Feature importance analysis identified the scores of glutamic acid in saliva and IL-6 were the highest in all the variables, with importance scores of 0.081 and 0.080, respectively. After screening out 14 key variables and optimizing the parameters, model performance improved to an average accuracy of 0.758 and an F1 score of 0.798. Feature importance analysis further determined that the glutamic acid in saliva and IL-6 showed obvious changes after screening the variables, confirming the good syndrome prediction ability of the model constructed by these key clinical biomarkers. ConclusionThis study systematically elucidates the correlation between syndrome improvement and clinical biomarkers of Huanglian Jiedu Wan in the treatment of "excess heat-toxicity" syndrome. An XGBoost classification model based on key clinical biomarkers is successfully established, achieving effective prediction of the symptoms related to the "excess heat-toxicity" syndrome such as oral ulcers and sore throat and providing a new insight for objective identification of traditional Chinese medicine syndromes.
2.Correlation Analysis of Huanglian Jiedu Wan on Syndrome Improvement and Clinical Biomarkers of "Excess Heat-Toxicity" Based on Machine Learning Model
Qi LI ; Keke LUO ; Baolin BIAN ; Hongyu YU ; Mengxiao WANG ; Mengyao TIAN ; Wen XIA ; Yuan MA ; Xinfang ZHANG ; Pengyue LI ; Nan SI ; Hongjie WANG ; Yanyan ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):162-173
ObjectiveThis paper aims to find the identified and validated clinical biomarker data building upon a clinical study of early-phase phase Ⅱ and investigate the correlation analysis of Huanglian Jiedu Wan on syndrome improvement and clinical biomarkers in the treatment of "excess heat-toxicity" based on a machine learning model. Additionally, the effective prediction of clinical biomarker values for the main symptoms of the "excess heat-toxicity" syndrome was assessed. MethodsA total of 229 patients meeting the inclusion criteria for "excess heat-toxicity" syndrome were randomly divided into the Huanglian Jiedu Wan group and the placebo group. Syndrome score transition matrices were constructed for the Huanglian Jiedu Wan group and the placebo group based on three main symptoms of "excess heat-toxicity" syndrome, such as oral ulcers, sore throat, and gum swelling and pain. Data from the patients with these three syndromes were also integrated for an overall analysis. The corresponding syndrome score transition matrices were further constructed to visualize symptom change trends of the patients in the two groups via heatmaps. Based on the identified and validated clinical biomarkers related to inflammation, oxidative stress, and energy metabolism in the early phase, Spearman correlation analysis was employed to analyze and evaluate the associations between clinical biomarkers and syndrome improvement. Key clinical biomarkers reflecting the effect of Huanglian Jiedu Wan were screened through the comparison of differences between groups. An extreme gradient boosting (XGBoost) algorithm was used to develop a prediction model for main symptom classification, with classification performance evaluated through 10-fold cross-validation. Feature importance analysis was applied to identify variables with the greatest contribution to the prediction result. ResultsThe syndrome transition matrix results indicated that the Huanglian Jiedu Wan group showed a superior effect to the placebo group in improving oral ulcers, sore throat, and overall symptoms, with significant effects observed especially in sore throat and overall symptom analyses (P<0.01). Spearman correlation analysis revealed that several clinical biomarkers positively correlated with "excess heat-toxicity" syndrome and its main symptom improvement, were also called "heat-related biomarkers", including succinic acid, α-ketoglutaric acid, glycine, lactic acid, adenosine monophosphate (AMP), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-1β (IL-1β), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and so on. Conversely, clinical biomarkers negatively correlated with symptom severity, were also called "heat-clearing related biomarkers" after administration of Huanglian Jiedu Wan, including malic acid, fumaric acid, cis-aconitic acid, adrenocorticotropic hormone (ACTH), IL-1β, IL-4, IL-8, succinic acid, and citric acid. The XGBoost classification model using all 52 biomarkers as variables achieved an average test accuracy of 0.754 and an average F1 score of 0.777. Feature importance analysis identified the scores of glutamic acid in saliva and IL-6 were the highest in all the variables, with importance scores of 0.081 and 0.080, respectively. After screening out 14 key variables and optimizing the parameters, model performance improved to an average accuracy of 0.758 and an F1 score of 0.798. Feature importance analysis further determined that the glutamic acid in saliva and IL-6 showed obvious changes after screening the variables, confirming the good syndrome prediction ability of the model constructed by these key clinical biomarkers. ConclusionThis study systematically elucidates the correlation between syndrome improvement and clinical biomarkers of Huanglian Jiedu Wan in the treatment of "excess heat-toxicity" syndrome. An XGBoost classification model based on key clinical biomarkers is successfully established, achieving effective prediction of the symptoms related to the "excess heat-toxicity" syndrome such as oral ulcers and sore throat and providing a new insight for objective identification of traditional Chinese medicine syndromes.
3.Study on the role of oleuropein in enhancing muscle endurance
Huan LI ; Zhen ZHANG ; Jiayi FENG ; Weidong ZHANG ; Xia LIU
Journal of Pharmaceutical Practice and Service 2026;44(3):126-131
Objective Orosomucoid1 (ORM1) is a novel target in the quest for anti-fatigue pharmacotherapy. Preliminary investigations have illuminated oleuropein (OLE) as a promising candidate molecule, poised to enhance ORM1 expression. To elucidate the influence of OLE on ORM1 protein expression and assess its ramifications on muscle endurance. Methods The impact of OLE on ORM1 protein expressions within hepatocytes and liver tissue was meticulously quantified through Western blotting; the effects of OLE on muscle endurance were evaluated via the rotarod and forced swimming tests; glycogen content within liver and muscle tissues was determined utilizing a specialized kit; and PAS staining was employed to visualize glycogen deposition in the gastrocnemius muscle. Results OLE demonstrated a capacity to elevate ORM1 protein expression in hepatocytes in a time- and dose-dependent manner, concurrently prolonging the duration of swimming and rotarod performance in mice, also in a time- and dose-dependent manner. Furthermore, OLE augmented ORM1 expression in liver tissue, elevated serum ORM1 levels, and enhanced glycogen reserves within the liver and muscle. Conclusion OLE may serve to amplify muscle endurance by elevating ORM1 levels in vivo and augmenting glycogen stores within skeletal muscle.
4.Research and innovative exploration of integrated traditional Chinese and Western medicine in preventing and treating gastric " inflammatory cancer transformation"
Xia DING ; Qi WANG ; Zhaoshen LI
Journal of Beijing University of Traditional Chinese Medicine 2026;49(1):1-9
The development of intestinal-type gastric cancer follows a progression from non-atrophic gastritis — atrophic gastritis — intestinal metaplasia — epithelial dysplasia — gastric cancer,known as the " inflammation-cancer transformation. " Leveraging the advantages of integrated traditional Chinese and Western medicine,while collaborating to inhibit this transformation,remains a research focus and challenge. The incidence of gastric cancer in China has declined with the continuous elucidation of the mechanisms behind inflammation-cancer transformation,innovations in early screening and diagnosis techniques in Western medicine,the establishment of risk stratification and treatment systems,and effective interventions through traditional Chinese medicine. Leveraging the theoretical and practical advantages of the " preventing disease before it occurs" philosophy of traditional Chinese medicine,particularly the concept of " preventing transformation in existing diseases," is essential. This approach emphasizes shifting the focus of prevention and treatment to earlier stages of disease progression. Developing more effective and reliable strategies and innovative drugs that block the dynamic progression of the " inflammation-cancer transformation" in gastric cancer remains a key goal. This article reviews the latest progress in both basic and clinical research in this field,the issues related to high-level clinical research in traditional Chinese medicine,the construction of integrated diagnosis and treatment pathways combining Chinese and Western medicine,the establishment of efficacy evaluation standards,and the elucidation of the integration mechanisms of the complex system of traditional Chinese medicine. It also explores research directions and solutions within the context of multidisciplinary collaboration to provide insights and references to block inflammation-cancer transformation and to construct a gastric cancer prevention and control system with Chinese characteristics,thereby further enhancing the level of gastric cancer prevention and control.
5.Tongnao Decoction Promotes Angiogenesis and Alleviates Cerebral Ischemic Injury via PI3K/Akt/GSK-3β Signaling Pathway
Yan LIU ; Yang WU ; Wanhui PENG ; Jingyi CHEN ; Jiale GAN ; Li LI ; Yangjingyi XIA ; Yunze LI ; Zhaoyao CHEN ; Wenlei LI ; Minghua WU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):100-110
ObjectiveTo investigate the mechanisms of Tongnao decoction (TND) in mice with acute ischemic stroke (AIS). MethodsFifty male C57BL/6J mice were randomly divided into a sham operation group, model group, TND low-dose group (1.86 g·kg-1), TND high-dose group (3.72 g·kg-1), and butylphthalide (NBP) group (10 mg·kg-1), with 10 mice in each group. A mouse model of cerebral ischemic injury was established using photochemical thrombosis (PT). The sham operation group and model group were administered an equal volume of normal saline by gavage. All five groups were treated once daily for 14 consecutive days. Behavioral tests were performed before modeling and at the end of administration. T2-weighted imaging (T2WI) was performed 3 days after modeling to evaluate the extent of injury. Hematoxylin-eosin (HE) staining was used to observe histological changes in the cerebral cortex, and Nissl staining was used to observe neuronal morphology. Cerebral blood flow in mice was detected using a laser speckle contrast imaging (LSCI) system. Immunofluorescence staining was used to detect the cell proliferation marker bromodeoxyuridine (BrdU) and the highly glycosylated type I transmembrane glycoprotein CD34. Western blot analysis was used to detect the expression levels of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), glycogen synthase kinase-3β (GSK-3β), and their phosphorylation levels, as well as tight junction-related proteins zonula occludens-1 (ZO-1), Occludin, and Claudin-5 in the peri-infarct tissue. Thirty-five zebrafish were randomly divided into normal control group, model group, TND low and high dose groups (0.16, 0.32 g·L-1) and NBP group (10 μmol·L-1), with 7 in each group. A stereoscopic fluorescence microscope was used to observe vascular growth in zebrafish. ResultsImaging showed that PT caused ischemia in the right cortical region. Behavioral tests indicated that, compared with the model group, the drug-treated groups reduced the error rate of irregular balance ladder climbing on the affected side and shortened the tape removal time (P<0.05). HE staining and Nissl staining showed that, compared with the model group, the drug-treated groups exhibited reduced brain tissue damage, fewer scars, and improved neuronal morphology. LSCI results showed that the drug-treated groups partially restored cerebral blood perfusion and promoted the establishment of collateral circulation compared with the model group. Immunofluorescence staining indicated that the drug-treated groups increased the positive rates of BrdU and CD34 compared with the model group (P<0.01), promoting angiogenesis. Meanwhile, compared with the model group, the drug-treated groups upregulated the expression levels of p-PI3K, p-Akt, p-GSK-3β, and tight junction proteins ZO-1, Occludin, and Claudin-5 (P<0.05,P<0.01), and increased the number of intersegmental vessels in zebrafish (P<0.05,P<0.01). ConclusionTND can promote angiogenesis around the infarct in PT model mice by regulating the PI3K/Akt/GSK-3β signaling pathway, thereby improving cerebral ischemic injury.
6.Cloning and Functional Characterization of O-Methyltransferase Gene in Carthamus tinctorius
Yongming HUANG ; Yaping LI ; Ping SU ; Meng XIA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):217-223
ObjectiveTo comprehensively identify the O-methyltransferase (OMT) genes in Carthamus tinctorius and explore the key OMTs that can catalyze the methylation of flavonoids, providing a basis for understanding the molecular formation mechanism of the structural diversity of flavonoids in C. tinctorius. MethodsThe hidden Markov model was used to systematically identify the type Ⅰ OMTs from the high-quality genome data of C. tinctorius. A suite of bioinformatics tools was employed to systematically analyze the physicochemical properties, gene structure, conserved motifs, chromosomal localization, gene replication events, and collinearity of the identified genes. The target gene was heterologously expressed through the prokaryotic expression system of E. coli, and the protein function was verified by in vitro enzymatic reactions. ResultsA total of 31 type Ⅰ OMTs were identified. CtFOMT1 was successfully cloned and expressed in a soluble form in Escherichia coli. The recombinant protein was purified via Ni2+ affinity chromatography to obtain a high-concentration preparation. In vitro enzymatic assays demonstrated that CtFOMT1 utilized S-adenosylmethionine as the methyl donor to catalyze the methylation of the 4′-OH of naringenin, resulting in the production of isosakuranetin. A similar process occurred with the 4′-OH of luteolin, leading to the formation of diosmetin. Subsequent methylation of the 3′-OH group of diosmetin generated 4′-methylchrysoeriol. ConclusionCtFOMT1 can catalyze the methylation of 4′-/3′-OH in the flavonoid skeleton. It is hypothesized that CtFOMT1 may play a role in the biosynthesis of various 4′-/3′-oxymethyl flavonoids in C. tinctorius.
7.Cultivation mode of rehabilitation therapy talents in local colleges and universities under the background of New Medicine
Xia LIU ; Yuanmin ZHANG ; Shuhui GE ; Jinmei LIU ; Chenming SUN ; Yuanhui WANG ; Jing LIU ; Wenfu LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):276-285
ObjectiveTo explore the training path of rehabilitation therapy professionals in local colleges and universities under the background of New Medicine. MethodsTaking Jining Medical University as an example, combining the interdisciplinary integration, intelligent driving and people-oriented New Medicine attributes of rehabilitation therapy, this study focused on the current practical problems in rehabilitation education, accurately aligned with the requirements of new medicine construction, reshaped the curriculum system with new concepts, empowered practical innovation with new technologies, and cultivated humanistic literacy with new connotations. By deeply integrating digital construction with educational practice, it carried out the construction and practice of the New Medicine talent training model in rehabilitation therapy, helping students form a stereoscopic knowledge structure, possess the ability to apply intelligent rehabilitation technology and solve complex rehabilitation problems, and become high-quality rehabilitation therapy talents with both morality and ability. ResultsThe overall construction of the rehabilitation therapy major established a model of Dual fusion foundation, Three element empowerment and Three dimensional soul casting, including reform and innovation in curriculum system, practical mode and moral education mechanism. It has formed a health oriented "vertical and horizontal integration-discipline fusion" dual-fusion stereoscopic curriculum system, an intelligent led "theory and practice-science and education-industry and education" three element integration practical mode, and a confucian medical culture "curriculum-practice-evaluation" three-dimensional integrated moral education mechanism. Through practical testing, this model achieved significant results and was widely recognized, including a significant improvement in the quality of talent cultivation, prominent achievements in resource construction, and prominent achievements in health services, providing strong support for the construction of regional rehabilitation medical systems. ConclusionThe reform of the rehabilitation treatment talent training model at Jining Medical University under the background of New Medicine provides a replicable and promotable practical paradigm for the training of rehabilitation talents in similar universities through reshaping the curriculum system, strengthening practical innovation, and cultivating humanistic literacy.
8.Cultivation mode of rehabilitation therapy talents in local colleges and universities under the background of New Medicine
Xia LIU ; Yuanmin ZHANG ; Shuhui GE ; Jinmei LIU ; Chenming SUN ; Yuanhui WANG ; Jing LIU ; Wenfu LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):276-285
ObjectiveTo explore the training path of rehabilitation therapy professionals in local colleges and universities under the background of New Medicine. MethodsTaking Jining Medical University as an example, combining the interdisciplinary integration, intelligent driving and people-oriented New Medicine attributes of rehabilitation therapy, this study focused on the current practical problems in rehabilitation education, accurately aligned with the requirements of new medicine construction, reshaped the curriculum system with new concepts, empowered practical innovation with new technologies, and cultivated humanistic literacy with new connotations. By deeply integrating digital construction with educational practice, it carried out the construction and practice of the New Medicine talent training model in rehabilitation therapy, helping students form a stereoscopic knowledge structure, possess the ability to apply intelligent rehabilitation technology and solve complex rehabilitation problems, and become high-quality rehabilitation therapy talents with both morality and ability. ResultsThe overall construction of the rehabilitation therapy major established a model of Dual fusion foundation, Three element empowerment and Three dimensional soul casting, including reform and innovation in curriculum system, practical mode and moral education mechanism. It has formed a health oriented "vertical and horizontal integration-discipline fusion" dual-fusion stereoscopic curriculum system, an intelligent led "theory and practice-science and education-industry and education" three element integration practical mode, and a confucian medical culture "curriculum-practice-evaluation" three-dimensional integrated moral education mechanism. Through practical testing, this model achieved significant results and was widely recognized, including a significant improvement in the quality of talent cultivation, prominent achievements in resource construction, and prominent achievements in health services, providing strong support for the construction of regional rehabilitation medical systems. ConclusionThe reform of the rehabilitation treatment talent training model at Jining Medical University under the background of New Medicine provides a replicable and promotable practical paradigm for the training of rehabilitation talents in similar universities through reshaping the curriculum system, strengthening practical innovation, and cultivating humanistic literacy.
9.Ameliorative effect and mechanism of vitexin on inflammation in ulcerative colitis mice
Lin ZHOU ; Pengfei XIA ; Yuling LIU ; Zhichao MENG ; Geng LI ; Yuanyuan YU
China Pharmacy 2026;37(6):758-763
OBJECTIVE To explore the ameliorative effect and potential mechanism of vitexin on inflammation in ulcerative colitis (UC) mice. METHODS The UC mice model was established by continuous administration of 3% dextran sulfate sodium solution for 5 days. Mice with successful modeling were randomly divided into UC group, vitexin low- and high-dose groups (vitexin-L and vitexin-H groups, 40, 80 mg/kg), mesalazine group (400 mg/kg), and vitexin-H+recombinant Jagged canonical Notch ligand 1 (rJagged-1) group (vitexin-H+rJagged-1 group, 80 mg/kg vitexin+1 mg/kg rJagged-1), with 12 mice in each group. Another 12 normal mice were used as the control (CK) group. Mice in each group were administered the corresponding drugs or the corresponding drugs and normal saline by gavage and intraperitoneal injection once daily for 7 consecutive days. General conditions were observed during the experiment. At 24 h after the last administration, the disease activity index (DAI) score was evaluated. Colonic histopathological morphology was observed and scored. Macrophage polarization levels in the spleen and colon tissues were measured. The protein expressions of interleukin-6 (IL-6), IL-10, tumor necrosis factor-α (TNF-α), transforming growth factor-β 1 (TGF-β 1 ), Jagged-1, Notch1 and Notch intracellular domain (NICD) in colonic tissues were determined. RESULTS Compared with the UC group, the symptoms (reduced food and water intake, dull fur, etc.) and pathological changes (epithelial cell shedding, inflammatory cell infiltration, etc.) were significantly improved in the vitexin-L, vitexin-H and mesalazine groups. DAI scores, colonic histopathological scores, M1 macrophage contents in spleen tissue, M1/M2 macrophage ratios, M1 macrophage proportions in colon tissue, and protein expressions of IL-6, TNF-α, Jagged-1, Notch1 and NICD in colon tissue were significantly decreased ( P <0.05). Meanwhile, the M2 macrophage contents in spleen tissue, M2 macrophage proportions in colon tissue, and protein expressions of IL-10 and TGF-β 1 in colon tissue were significantly increased ( P <0.05). Moreover, the improvement effects in the vitexin-H and mesalazine groups were significantly superior to those in the vitexin-L group ( P <0.05). Compared with the vitexin-H group, the above symptoms and pathological changes were aggravated, and all quantitative indicators were significantly reversed in the vitexin-H+rJagged-1 group ( P <0.05). CONCLUSIONS Vitexin can ameliorate the inflammation of UC mice, which is associated with its inhibition of the Jagged-1/Notch1 pathway and regulation of macrophage polarization (inhibition of M1-type polarization and promotion of M2-type polarization).
10.Influence of CYP2C19 gene polymorphism on platelet function and inflammatory cytokines and analysis of factors associated with poor prognosis in elderly patients with ischemic stroke
Hai LIANG ; Hong ZHANG ; Runan XIA ; Huijuan CHEN ; Mengyu JIANG ; Fanqin LI ; Panpan DI ; Miao YANG
China Pharmacy 2026;37(6):782-787
OBJECTIVE To investigate the influence of CYP2C19 gene polymorphism on platelet function and inflammatory cytokines in elderly patients with ischemic stroke, and to analyze potential factors associated with poor prognosis. METHODS A retrospective study was conducted on elderly patients with ischemic stroke admitted to our hospital from June 2024 to June 2025, wh o underwent CYP2C19 genotype testing and received antiplatelet therapy with clopidogrel. The levels of platelet function indicators and inflammatory cytokines before and after treatment were compared among patients with different metabolic phenotypes. Based on the prognosis at 6 months post-treatment, patients were divided into poor prognosis group and good prognosis group. Univariate analysis was performed on general data, metabolic phenotype, the levels of platelet function indicators and inflammatory cytokines. Variables with P <0.05 and the levels of inflammatory cytokines before treatment were included in a multivariate Logistic regression analysis to identify independent risk factors for poor prognosis. Multiple linear regression was used to further analyze the relationship between metabolic phenotypes and inflammatory cytokines. RESULTS A total of 448 elderly patients with ischemic stroke were included; among them, 162 cases were normal metabolic phenotype, 218 were intermediate metabolic phenotype, and 68 were poor metabolic phenotype. No rapid or ultrarapid metabolic phenotypes were observed. After treatment, platelet aggregation rate, the levels of P-selectin and platelet activated complex-1 (PAC-1), high-sensitivity C-reactive Protein (hs-CRP), interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) in the normal metabolic phenotype group, intermediate metabolic phenotype group, and poor metabolic phenotype group (except for platelet aggregation rate, and the levels of P-selectin and PAC-1 in the poor metabolic phenotype group) were significantly lower than those before treatment in the same group. Moreover, the above indicators in the normal metabolic phenotype group were significantly lower than those in the intermediate and poor metabolic phenotype groups at the corresponding time, and the levels of platelet function indicators in the intermediate metabolic phenotype group were significantly lower than those in the poor metabol ic phenotype group at the corresponding time ( P <0.05). Univariate and multivariate Logistic regression analyses showed that combined with hypertension, combined with diabetes mellitus, and intermediate or poor metabolic genotypes were independent risk factors for poor prognosis in elderly patients with ischemic stroke ( P <0.05). Multiple linear regression analysis showed that serum levels of hs-CRP, IL-1β, IL-6 and TNF-α before treatment were significantly higher in patients with intermediate and poor metabolic genotypes compared to those with normal metabolic genotype ( P <0.05), with a greater magnitude of increase in inflammatory cytokines observed in the patients with poor metabolic genotype. CONCLUSIONS The elderly ischemic stroke patients with CYP2C19 intermediate and poor metabolic genotypes have poor inhibition effect on platelet and higher levels of inflammatory cytokines than normal metabolic genotype; CYP2C19 gene polymorphism, and in combination with hypertension and diabetes, can be used as independent predictors of poor prognosis.


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