1.From Spleen Deficiency with Dampness Excess to Stasis-toxin Damaging Collaterals: Dynamic Management Path in Whole-course Treatment Strategies for Ulcerative Colitis
Zhili ZHENG ; Hongzheng LI ; Shaoli WANG ; Tiantong JIANG ; Yuan DING ; Qiongqiong LU ; Zhen LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):147-153
Ulcerative colitis (UC), a chronic nonspecific inflammatory bowel disease characterized by unclear etiology, complex contributing factors, and a refractory course with malignant transformation potential, imposes a substantial burden on both individual patients and healthcare systems. There is an urgent need to explore effective therapeutic strategies and pharmacological interventions. Professor LIU Zhen, based on years of clinical practice, proposed a dynamic pathogenesis chain of UC: Spleen deficiency with dampness excess as the foundation, dampness obstruction as the nexus, stasis-toxin interaction as the key, and stasis-toxin damaging intestinal collaterals as the terminal outcome. The treatment, following the progression of deficiency (depression)-dampness-toxin-stasis (toxin), should focus on invigorating the spleen and resolving dampness. A stage-specific treatment approach is emphasized. During the susceptible stage, prevention is recommended, which relies on regulating the diet, maintaining a positive mental state, and adjusting daily routines to invigorate the spleen and replenish Qi. During the acute attack and remission stages, the treatment should be tailored according to clinical typing and disease severity, flexibly employing therapeutic strategies such as tonifying deficiency, resolving depression, eliminating dampness, clearing heat, detoxifying, arresting bleeding, and resolving stasis in order to interrupt disease progression. In the recovery stage, latent pathogenic factors should be addressed while the postnatal constitutional foundation be preserved to prevent recurrence. According to the TCM principle of treating disease before its onset, a whole-course management path of early protection-interception-stratified care-consolidation has been developed, covering all stages of UC, to inform its clinical prevention and treatment.
2.Effect of virtual reality-based exergaming on multidimensional outcomes in individuals with cognitive impairment: a three-level meta-analysis based on the ICF framework
Yang JIANG ; Hao PENG ; Xingxiao YIN ; Yanqi LI ; Yanping SONG ; Na YAO ; Zhen SHEN ; Qigang CHEN
Chinese Journal of Rehabilitation Theory and Practice 2026;32(9):1003-1015
ObjectiveTo systematically quantify the multidimensional effect of virtual reality-based exergaming (VREG) on health outcomes among individuals with cognitive impairment under the framework of the International Classification of Functioning, Disability and Health (ICF). MethodsMeta-analysis was conducted in accordance with the PRISMA statement. PubMed, Cochrane Library, Embase, Scopus, Web of Science, CNKI, Wanfang Data and VIP were researched for randomized controlled trials (RCTs) investigating VREG for cognitive impairment, with the search deadline set on February 1, 2026. The Cochrane Risk of Bias 2.0 tool was adopted to evaluate the methodological quality of included studies. A three-level meta-analytic model was implemented with R 4.4.2. The GRADE framework was further used to rate the certainty of pooled evidence. ResultsA total of 22 RCTs were included. VREG might improve global cognitive function (SMD = 0.69, 95%CI 0.11 to 1.28, P = 0.022), memory (SMD = 0.47, 95%CI 0.07 to 0.87, P = 0.023), attention (SMD = 0.62, 95%CI 0.23 to 1.01, P = 0.004), executive function (SMD = 0.42, 95%CI 0.09 to 0.75, P = 0.013), balance (SMD = 0.54, 95%CI 0.07 to 1.00, P = 0.027), muscle strength (SMD = 0.63, 95%CI 0.37 to 0.88, P = 0.001), mobility (SMD = 0.29, 95%CI 0.04 to 0.54, P = 0.024) and quality of life (SMD = 0.29, 95%CI 0.03 to 0.56, P = 0.029). No significant effect was observed for depressive symptoms, comprehensive physical fitness and fall risk (all P > 0.05). Subgroup and meta-regression analyses indicated that session duration < 45 minutes produced the largest improvement in attention (SMD = 0.95, 95%CI 0.55 to 1.34, P < 0.001); intervention cycles of twelve to 24 weeks were optimal for mobility (SMD = 0.85, 95%CI 0.44 to 1.25, P < 0.001); age negatively correlated to balance improvement (β = -0.11, 95%CI -0.20 to -0.02, P = 0.020), suggesting less intervention benefits among older participants. ConclusionVREG is an effective non-pharmacological intervention to improve multidimensional physical and mental health in people with cognitive impairment. Protocols featuring short single sessions with long-term duration should be prioritized.
3.Pre-operative risk assessment of hepatocellular carcinoma recurrence in liver transplant recipients by non-invasive detection of pre-existing genetic lesions
Suqin YANG ; Sunbin LING ; Jianhua LI ; Yan WANG ; Jiapei WANG ; Qiwei HUANG ; Fanming LIU ; Yiqi ZHUANG ; Yingyu ZHENG ; Rui WANG ; Zhe YANG ; Xiaoping ZHENG ; Kai WANG ; Zhikun LIU ; Jun CHEN ; Jianguo WANG ; Haiyang XIE ; Lin ZHOU ; Leiming CHEN ; Guoqiang CAO ; Dandan CHEN ; Junfang JI ; Bin ZHAO ; Chao JIANG ; Di LU ; Xuyong WEI ; Hangjin JIANG ; Qiaonan SHAN ; Hengbo SHI ; Yong-Zhen XU ; Shusen ZHENG ; Zhengxin WANG ; Shengda LIN ; Xiao XU
Clinical and Molecular Hepatology 2026;32(2):884-903
Background/Aims:
Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy.
Methods:
We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues.
Results:
We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts.
Conclusion
Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.
4.Modified Xiaoyaosan Alleviates Neuronal Dysfunction in Rat Model of Post-myocardial Infarction Depression by Regulating Mitochondrial Quality Control Through Drp1/PINK1/Parkin Signaling Pathway
Zhen ZHONG ; Dongsheng WEI ; Xinyue XIONG ; Lin LI ; Mingli YAO ; Xinnuan SHI ; Youming JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):20-31
ObjectiveTo investigate the effects of modified Xiaoyaosan (JJXYS) on behavioral abnormalities and hippocampal mitochondrial quality control (MQC) in the rat model of post-myocardial infarction depression (PMD) and preliminarily explore its potential mechanism. MethodsA rat model of PMD was established by left anterior descending coronary artery ligation combined with chronic unpredictable mild stress (CUMS). Rats were randomized into a control group, a model group, a fluoxetine (FLX, 10 mg·kg-1) group, and low-, medium-, and high-dose JJXYS (JJXYS-L/M/H, 1.12, 2.24, 4.48 g·kg-1, respectively) groups. Depressive-like behaviors were evaluated by body weight monitoring, sucrose preference test, open field test, and forced swimming test. Hematoxylin-eosin staining and Nissl staining were used to observe hippocampal histomorphology and neuronal changes. Enzyme-linked immunosorbent assay was conducted to determine the serum levels of 5-hydroxytryptamine (5-HT), dopamine (DA), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). The mRNA levels of MQC-related genes including peroxisome proliferator-activated receptor-gamma coactivator-1 alpha (PGC-1α), nuclear respiratory factor 1 (Nrf1), and transcription factor A, mitochondrial (TFAM) in the hippocampal tissue were measured by real-time PCR. The expression of proteins related to the dynamin-related protein 1 (Drp1)/PTEN-induced putative kinase 1 (PINK1)/Parkin signaling pathway was determined by Western blot. ResultsCompared with the control group, the model group showed restricted body weight gain, aggravated depressive-like behaviors, declined serum 5-HT and DA levels, evident hippocampal neuronal damage and reduced Nissl bodies, as well as downregulated expression of MQC-related genes and proteins (P<0.05). Compared with the model group, both FLX and JJXYS alleviated the above changes to varying degrees. Moreover, the JJXYS-M and JJXYS-H groups showed more pronounced effects, improving behavioral performance, restoring 5-HT and DA levels, alleviating hippocampal pathological injury, and upregulating the expression of PGC-1α/Nrf1/TFAM mRNA and Drp1/PINK1/Parkin signaling pathway-related proteins (P<0.05). ConclusionJJXYS can significantly alleviate depressive-like behaviors and neurotransmitter imbalance in the rat model of PMD by regulating hippocampal MQC and upregulating the Drp1/PINK1/Parkin-related pathway. This study provides experimental evidence for the intervention of PMD with JJXYS.
5.Comparison of the Risk Stratification Systems of CHIC and New CCCG in the Prognostic Evaluation of Hepatoblastoma
Zhen LI ; Hong JIANG ; Wenqing WANG ; Yuanqi WANG ; Libin HUANG ; Juncheng LIU ; Hongman XUE
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(2):346-353
ObjectiveTo compare the Children's Hepatic tumors International Collaboration (CHIC) and the new Chinese Children's Cancer Group (CCCG) hepatoblastoma (HB) risk stratification systems in terms of their prognostic prediction efficacy and chemotherapy guidance value for Chinese children with HB, aiming to identify the risk stratification system more suitable for Chinese HB patients. MethodsThis retrospective study analyzed the clinical data of 403 pediatric patients with HB aged < 18 years who were initially diagnosed at The First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023. The prognostic predictive efficacy and chemotherapy-guided value of the CHIC and CCCG risk stratification systems was compared. Statistical analysis was performed using SPSS 27.0. Results①Using the new CCCG risk stratification, the 5-year event-free survival (EFS) rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 82.5% and 67.7% (P=0.002), respectively, and the 5-year overall survival (OS) rates were 91.5% and 85.1% (P=0.038). Using CHIC risk stratification, the corresponding 5-year EFS rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 80.3% and 68.5% (P=0.030), and the 5-year OS rates were 90.9% and 85.8% (P=0.151). ②Among children treated with the CCCG-HB-2016 protocol stratified by the new CCCG system, the 5-year EFS rates for the very low-risk (6 cases), low-risk (20 cases), intermediate-risk (61 cases), and high-risk (69 cases) groups were 100%, 94.1%, 94.7%, and 66.2% (P<0.001), respectively, and the 5-year OS rates were 100%, 100%, 96.5%, and 82.0% (P=0.017). Among children treated with the CCCG-HB-2016 protocol stratified by the CHIC system, the 5-year EFS rates for the very low-risk (32 cases), low-risk (22 cases), intermediate-risk (37 cases), and high-risk (54 cases) groups were 93.8%, 95.2%, 76.1%, and 66.8% (P=0.003), respectively, and the 5-year OS rates were 93.1%, 100%, 89.5%, and 85.6% (P=0.190). ③For patients receiving CCCG-HB-2016 risk-stratified chemotherapy, the P-values for EFS comparisons between the CHIC and new CCCG systems within the very low-risk, low-risk, intermediate-risk, and high-risk groups were 0.537, 0.879, 0.023, and 0.934, respectively. Among patients who received stratified chemotherapy according to the CCCG-HB-2016 regimen, the intermediate-risk group in the new CCCG risk stratification system exhibited a significant advantage in 5-year event-free survival (EFS) compared with the intermediate-risk group in the CHIC risk stratification system (94.7% vs. 76.1%). ConclusionCompared to the CHIC risk stratification, the new CCCG stratification may offer better prognostic prediction and guidance value for chemotherapy in Chinese HB patients, with the intermediate-risk group showing superior outcomes.
6.Epidemiological characteristics of imported dengue fever cases in Fengtai District, Beijing, from 2007 to 2025
Yan MENG ; Yang YANG ; Xiao-xing YANG ; Jun-yong YANG ; Ruo-yi DU ; Li-na TIAN ; Ruo-xi LI ; Gui-yin LIN ; Xiao-li RUAN ; Jian-jun ZHANG ; Zhen-jiang XIN ; Li-li TIAN
Acta Parasitologica et Medica Entomologica Sinica 2026;33(3):180-186
Objective We reviewed and analyzed the epidemiological data of 83 imported dengue fever cases reported in Fengtai District, Beijing, from 2007 to 2025, to delineate their epidemiological characteristics and guide the dengue fever prevention and control strategy in the future. Methods Data on dengue fever cases in Fengtai District from 2007 to 2025 were collected to identify the epidemic factors and characteristics using descriptive epidemiological method. Results All 83 dengue fever cases reported in this region over the past two decades have been imported from abroad or other domestic areas, with Southeast Asian countries being identified as the primary source of imported infections, accounting for 42 cases (50.60%), followed by 15 cases (18.07%) from Chinese provinces other than Beijing. The remaining import sources included 13 cases from South Asia,8 from African countries, and each from Oceania, South America, and Europe. Disease onset was found concentrated between May and November. The sex ratio (male-to-female) is 1.59:1. The age of onset ranged from 14 to 61 years old, with a median age of 36. The largest proportion of cases was observed among cadres and office workers (31 cases, 37.35%), followed by businessmen (13 cases, 15.67%), and householders or the unemployed (10 cases,12.05%). Travel visit was identified as the primary reason for their exposure history. Conclusions All dengue fever cases reported in Fengtai from 2007 to 2025 were imported, with an increasing trend of imported cases in Beijing originating from other Chinese provinces. It is essential to strengthen health education for foreign travelers and returning residents, enhance clinical diagnosis and treatment training for medical personnel, eliminate mosquito breeding sites, and reduce mosquito density through active patriotic health campaigns.
7.Risk factors for postoperative cognitive dysfunction in elderly patients undergoing hip fracture surgery
Hongxia TAO ; Zhen WU ; Tao JIANG ; Zhabing LI ; Aihong GU ; Yiqiao WANG
Chinese Journal of Anesthesiology 2025;45(3):286-290
Objective:To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip fracture surgery.Methods:In this case-control study, 6 differentially expressed genes were screened through gene expression database analysis and protein-protein interaction network analysis: cytochrome c oxidase subunit 7C (COX7C), ubiquinol-cytochrome c reductase complex III subunit VII (UQCRQ), cytochrome c oxidase subunit 7A2 (COX7A2), translocase of outer mitochondrial membrane 7, ubiquinone oxidoreductase subunit S5, and ribosomal protein L31. Elderly patients who underwent hip fracture surgery at Anhui No. 2 Provincial People′s Hospital from April 2022 to April 2024 were recruited. Based on the results of the Mini-Mental State Examination, the patients were divided into POCD group ( n=51) and non-POCD (NPOCD) group ( n=53). The expression of differentially expressed genes in the peripheral blood was detected using the fluorescent quantitative real-time polymerase chain reaction. The 6 differentially expressed genes were subjected to a difference test, and genes with P<0.05 were included in the binary logistic regression analysis to screen for risk factors for POCD. Results:The expression of COX7C, UQCRQ and COX7A2 was significantly down-regulated in POCD group compared with non-POCD group ( P<0.05). The results of logistic regression showed that the low-expression COX7C ( OR=1.926, 95% confidence interval [ CI] 1.604-5.264, P=0.022), UQCRQ ( OR=3.023, 95% CI 1.966-7.156, P=0.001), and COX7A2 ( OR=1.744, 95% CI 1.479-6.127, P=0.013) in peripheral blood were independent risk factors for the occurrence of POCD in elderly patients. Conclusions:Low-expression COX7C, UQCRQ and COX7A2 are risk factors for POCD in elderly patients undergoing hip fracture surgery.
8.Guideline for Adult Weight Management in China
Weiqing WANG ; Qin WAN ; Jianhua MA ; Guang WANG ; Yufan WANG ; Guixia WANG ; Yongquan SHI ; Tingjun YE ; Xiaoguang SHI ; Jian KUANG ; Bo FENG ; Xiuyan FENG ; Guang NING ; Yiming MU ; Hongyu KUANG ; Xiaoping XING ; Chunli PIAO ; Xingbo CHENG ; Zhifeng CHENG ; Yufang BI ; Yan BI ; Wenshan LYU ; Dalong ZHU ; Cuiyan ZHU ; Wei ZHU ; Fei HUA ; Fei XIANG ; Shuang YAN ; Zilin SUN ; Yadong SUN ; Liqin SUN ; Luying SUN ; Li YAN ; Yanbing LI ; Hong LI ; Shu LI ; Ling LI ; Yiming LI ; Chenzhong LI ; Hua YANG ; Jinkui YANG ; Ling YANG ; Ying YANG ; Tao YANG ; Xiao YANG ; Xinhua XIAO ; Dan WU ; Jinsong KUANG ; Lanjie HE ; Wei GU ; Jie SHEN ; Yongfeng SONG ; Qiao ZHANG ; Hong ZHANG ; Yuwei ZHANG ; Junqing ZHANG ; Xianfeng ZHANG ; Miao ZHANG ; Yifei ZHANG ; Yingli LU ; Hong CHEN ; Li CHEN ; Bing CHEN ; Shihong CHEN ; Guiyan CHEN ; Haibing CHEN ; Lei CHEN ; Yanyan CHEN ; Genben CHEN ; Yikun ZHOU ; Xianghai ZHOU ; Qiang ZHOU ; Jiaqiang ZHOU ; Hongting ZHENG ; Zhongyan SHAN ; Jiajun ZHAO ; Dong ZHAO ; Ji HU ; Jiang HU ; Xinguo HOU ; Bimin SHI ; Tianpei HONG ; Mingxia YUAN ; Weibo XIA ; Xuejiang GU ; Yong XU ; Shuguang PANG ; Tianshu GAO ; Zuhua GAO ; Xiaohui GUO ; Hongyi CAO ; Mingfeng CAO ; Xiaopei CAO ; Jing MA ; Bin LU ; Zhen LIANG ; Jun LIANG ; Min LONG ; Yongde PENG ; Jin LU ; Hongyun LU ; Yan LU ; Chunping ZENG ; Binhong WEN ; Xueyong LOU ; Qingbo GUAN ; Lin LIAO ; Xin LIAO ; Ping XIONG ; Yaoming XUE
Chinese Journal of Endocrinology and Metabolism 2025;41(11):891-907
Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.
9.Clinical management of lipoatrophic diabetes
Tianyuan JIANG ; Qin ZHEN ; Yanyun HU ; Muyu YU ; Na LI ; Yufan WANG ; Fang LIU ; Yongde PENG
Chinese Journal of Endocrinology and Metabolism 2025;41(5):417-423
Lipoatrophic diabetes(LD) is a rare and distinct form of diabetes characterized by notable clinical heterogeneity. It is often considered one of the manifestations of lipodystrophy syndrome(LDS). In clinical practice, LD is frequently misdiagnosed as type 2 diabetes; however, its management protocols and prognostic outcomes differ significantly from those of other diabetes subtypes. Therefore, timely and accurate diagnosis is of great clinical importance. This paper presents two detailed case reports of female patients with LD. Through an in-depth analysis of their clinical features, it also provides an comprehensive review of the key clinical manifestations of LDS, potential pathogenic mechanisms, and current approaches to genetic diagnosis. The aim is to enhance clinicans′ awareness of LDS and improve corresponding diagnostic and therapeutic strategies.
10.ACTH-independent Cushing′s syndrome caused by a GNAS hotspot mutation: Case reports of two rare patients with McCune-Albright syndrome complicated by Cushing′s syndrome and literature review
Ziwei CHEN ; Congcong XIA ; Ning PAN ; Zhuozhou CUI ; Li JIANG ; Ni ZHEN ; Yuan XIAO ; Zhiya DONG ; Xiaoyu MA ; Wenli LU
Chinese Journal of Endocrinology and Metabolism 2025;41(6):497-504
McCune-Albright syndrome(MAS) is a postzygotic somatic mutation disorder caused by activating mutations in the GNAS gene, which encodes the α subunit of the stimulatory G protein. Its clinical features typically include polyostotic fibrous dysplasia, cafe-au-lait skin pigmentation, and endocrine hyperactivity, such as Cushing′s syndrome, hyperthyroidism, and growth hormone excess. Here, we report two rare cases of MAS complicated with adrenocorticotropic hormone(ACTH)-independent Cushing syndrome, and provide a review and analysis of previously reported MAS cases associated with Cushing′s syndrome.


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