1.Construction of the clinical diagnosis and treatment model during the “pre-disease to disease” window period in traditional Chinese medicine: integration of objective multimodal data from the perspective of traditional Chinese medicine stateology
Danyang Li ; Min Ai ; Pai Zhou ; Ying Deng ; Chaoyang Yang ; Qinghua Peng
Digital Chinese Medicine 2026;9(2):173-183
The philosophy of “treating disease before its onset” is a fundamental concept of traditional Chinese medicine (TCM), permeating its diagnostic and therapeutic framework, and is central to clinical practice. However, current TCM diagnostic and treatment models for the “pre-disease to disease” window period face several limitations, including the lack of comprehensive clinical parameters, difficulties in characterizing and integrating heterogeneous multimodal data, and insufficient dynamic precision in interventions and efficacy evaluations. To address these issues, guided by Professor Candong Li’s theory of TCM stateology, this study focuses on integrating objective multimodal data. It proposes a new model for personalized TCM diagnosis and treatment targeting the “pre-disease to disease” window period. This approach first proposes the idea of restructuring the conceptual framework of “symptom” and integrating multi-source heterogeneous data at macroscopic, mesoscopic, and microscopic levels to form a three-dimensional assessment indicator system. By integrating graph neural networks, convolutional neural networks, attention mechanisms, and knowledge graph-guided weight allocation, this approach enables collaborative representation, alignment, and fusion of multi-source data. Subsequently, it plans to construct a multimodal fusion model at both feature and decision levels, in order to establish mappings between indicators and TCM state elements, and to screen key indicators characterizing pathological evolution during the window period. Furthermore, it proposes a technical path for enhancing model interpretability using methods such as SHapley Additive exPlanations (SHAP) and Ablation-CAM++. Finally, with state assessment as the core, it proposes the concept of constructing a dynamic evaluation method for individualized diagnosis and treatment based on time-series data analysis using algorithms such as long short-term memory (LSTM) networks and gated recurrent units (GRUs). Moreover, a causal inference framework and semi-supervised learning strategies are introduced to enable quantitative evaluation of individual intervention effects and to provide interpretable therapeutic feedback, forming a complete technical path from data representation and fusion, weight adjustment, and interpretability analysis, to dynamic diagnosis feedback. This study aims to address deficiencies in the current TCM diagnosis and treatment model during the “pre-disease to disease” window period and to provide an operational framework for the clinical practice of TCM’s “treating disease before its onset”.
2.Attenuation of oxidative injury in retinal photoreceptor cells by Gouqizi (Lycii Fructus) and Danshen (Salviae Miltiorrhizae Radix et Rhizoma) through modulation of ANGPTL4
Jun Peng ; Junjiang Jiang ; Junnan Zhong ; Siyi Zhou ; Tingyan Hu ; Xuyu Chen ; Qinghua Peng ; Yasha Zhou
Digital Chinese Medicine 2026;9(2):290-301
Objective:
To investigate the protective effects of Gouqizi (Lycii Fructus, GQZ)-Danshen (Salviae Miltiorrhizae Radix et Rhizoma, DS) against hydrogen peroxide (H2O2)-induced oxidative injury in 661W retinal photoreceptor cells and to explore whether these effects involve angiopoietin-like 4 (ANGPTL4).
Methods:
Liquid chromatography-mass spectrometry (LC-MS) was used to identify the major components of GQZ-DS aqueous extract. An H2O2-induced oxidative injury model was established in 661W cells. Working concentrations of H2O2 and GQZ-DS were determined using the cell counting kit-8 (CCK-8) assay. Cells were subjected to GQZ-DS, ANGPTL4 knockdown, or ANGPTL4 overexpression as indicated. Flow cytometry was used to analyze cell cycle distribution, apoptotic rate, and intracellular reactive oxygen species (ROS). Colorimetric determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity using the thiobarbituric acid (TBA) method was performed. The protein expression level of ANGPTL4 was assessed by immunofluorescence. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to quantify the mRNA level of ANGPTL4. Western blot was used to detect the protein levels of ANGPTL4 and cleaved caspase-3.
Results:
LC-MS identified five major constituents in the GQZ-DS aqueous extract: 2-O-β-D-glucopyranosyl-L-ascorbic acid, rutin, D-galactose, salvianolic acid A, and tanshinone IIA. The CCK-8 method selected 300 μmol/L H2O2 as the oxidative stress condition for experiments, and 0.05 and 0.1 g/mL were selected as the low and high doses of GQZ-DS, respectively, for subsequent experiments. The intervention with H2O2 resulted in reduced cell viability, elevated ROS and MDA levels, decreased SOD activity, increased apoptotic rate, upregulated cleaved caspase-3 expression, and G0/G1 phase cell cycle arrest of 661W cells. Both low and high doses of GQZ-DS alleviated these alterations, with high dose exhibiting stronger protective effects (P < 0.05 or P < 0.01). GQZ-DS also downregulated ANGPTL4 expression at both the mRNA and protein levels. Following plasmid transfection of cells, the study further revealed that ANGPTL4 knockdown mitigated oxidative stress and apoptosis-related injury, whereas ANGPTL4 overexpression exacerbated these pathological changes. Moreover, GQZ-DS partially reversed the degree of cellular oxidative damage induced by ANGPTL4 overexpression.
Conclusion
GQZ-DS can alleviate the H2O2-induced oxidative injury of 661W retinal photoreceptor cells, and the effects are related to the down-regulation of ANGPTL4 expression.
3.Current Understanding of Retinitis Pigmentosa in Traditional Chinese and Western Medicine
Qing LI ; Ying DENG ; Li XIAO ; Jing LU ; Min AI ; Yasha ZHOU ; Yuhui QIN ; Qinghua PENG ; Yijing YANG
Journal of Traditional Chinese Medicine 2026;67(14):1567-1573
This paper has summarized current studies on retinitis pigmentosa (RP) from two perspectives, which were disease mechanism insights from western medicine, and etiology, pathogenesis and therapeutic principles in traditional Chinese medicine (TCM). From the perspective of western medicine, the understanding of RP has evolved from an early single-factor explanation focusing on pathogenic gene mutations to a more comprehensive, multifactorial model involving genetic abnormalities, photoreceptor cell degeneration, retinal pigment epithelium dysfunction, oxidative stress, inflammatory responses, microenvironmental imbalance, and vascular insufficiency. In TCM, RP is considered to be a disorder manifested in the eyes but rooted in dysfunction of the zang-fu (脏腑) organs. Its pathogenesis is primarily associated with congenital insufficiency, liver-kidney depletion, impaired spleen function of transportation and transformation, and stasis obstructing the meridians. The core pathological mechanism can be summarized as "deficiency complicated by stasis", emphasizing holistic imbalance, dynamic disease progression, and syndrome differentiation and treatment. The differences and complementarities between the two medical systems in understanding disease progression are further discussed. RP is proposed to be more appropriately regarded as a complex disease characterized by long-term progression, stage-dependent evolution, and persistent decompensation. Western medicine contributes to elucidating the molecular mechanisms underlying RP and provides the foundation for targeted therapeutic interventions, whereas TCM offers a holistic perspective for understanding disease evolution through the assessment of overall functional status, disease-stage stratification, and long-term syndrome-based regulation.
4.Current Understanding of Retinitis Pigmentosa in Traditional Chinese and Western Medicine
Qing LI ; Ying DENG ; Li XIAO ; Jing LU ; Min AI ; Yasha ZHOU ; Yuhui QIN ; Qinghua PENG ; Yijing YANG
Journal of Traditional Chinese Medicine 2026;67(14):1567-1573
This paper has summarized current studies on retinitis pigmentosa (RP) from two perspectives, which were disease mechanism insights from western medicine, and etiology, pathogenesis and therapeutic principles in traditional Chinese medicine (TCM). From the perspective of western medicine, the understanding of RP has evolved from an early single-factor explanation focusing on pathogenic gene mutations to a more comprehensive, multifactorial model involving genetic abnormalities, photoreceptor cell degeneration, retinal pigment epithelium dysfunction, oxidative stress, inflammatory responses, microenvironmental imbalance, and vascular insufficiency. In TCM, RP is considered to be a disorder manifested in the eyes but rooted in dysfunction of the zang-fu (脏腑) organs. Its pathogenesis is primarily associated with congenital insufficiency, liver-kidney depletion, impaired spleen function of transportation and transformation, and stasis obstructing the meridians. The core pathological mechanism can be summarized as "deficiency complicated by stasis", emphasizing holistic imbalance, dynamic disease progression, and syndrome differentiation and treatment. The differences and complementarities between the two medical systems in understanding disease progression are further discussed. RP is proposed to be more appropriately regarded as a complex disease characterized by long-term progression, stage-dependent evolution, and persistent decompensation. Western medicine contributes to elucidating the molecular mechanisms underlying RP and provides the foundation for targeted therapeutic interventions, whereas TCM offers a holistic perspective for understanding disease evolution through the assessment of overall functional status, disease-stage stratification, and long-term syndrome-based regulation.
5.Self-Supervised Multi-Organ Segmentation in Pediatric Abdominal CT Based on Vision Foundation Models
Qinghua ZHANG ; Ming LI ; Zhedian ZHOU ; Jian ZHENG ; Huadan XUE ; Qiuxia WANG ; Yu DU ; Zhen LI
Medical Journal of Peking Union Medical College Hospital 2026;17(4):954-962
To address the scarcity of annotated data for pediatric abdominal CT imaging and the insufficient generalization capability of existing models, we constructed a self-supervised pretraining architecture tailored for pediatric CT domain adaptation based on the visual foundation model DINOv3, and validated its performance in the task of pediatric abdominal multi-organ segmentation. We built a general-purpose radiological visual representation using the large-scale adult CT dataset CT-3M, and introduced a Gram-anchoring mechanism that employs a frozen adult pretrained model as a structural teacher to guide domain alignment of local topological structures on unlabeled pediatric CT data. Combined with a multi-scale feature aggregation strategy and a lightweight Primus decoder, downstream segmentation tasks were evaluated on a public pediatric CT dataset. Based on case-wise paired results, we compared the mean Dice similarity coefficient (DSC) and mean intersection over union (IoU) between our model and the baseline nnU-Net using the Wilcoxon signed-rank test, and computed the relative performance improvements. A total of 867 abdominal CT imaging cases were collected, constituting a pretraining dataset comprising 367 588 two-dimensional CT slices. On the public Pediatric-CT-SEG dataset (359 cases), our model achieved a mean DSC of (71.38±1.08)% and a mean IoU of (63.73±1.01)%, representing improvements of 3.22% and 3.59% over the baseline nnU-Net, respectively, with statistically significant differences ( The self-supervised pretraining framework proposed in this study effectively alleviates the domain shift between adult and pediatric abdominal CT images, significantly enhances segmentation accuracy for pediatric abdominal multi-organs-particularly small organs and structures with complex boundaries-and provides a reliable technical solution for intelligent pediatric imaging analysis in scenarios with limited annotated data.
6.Mechanisms of Chinese herbal medicine in modulating gut microbiota on primary open-angle glaucoma: a study based on data mining, network pharmacology, and Mendelian randomization
Yu TANG ; Bingyao ZHU ; Qianhong LIU ; Kai WU ; Pai ZHOU ; Xiaolei YAO ; Qinghua PENG
Digital Chinese Medicine 2025;8(4):491-503
Objective:
To elucidate the potential mechanisms by which Chinese herbal medicine (CHM) regulates gut microbiota (GM) to influence the development of primary open-angle glaucoma (POAG).
Methods:
Data mining, network pharmacology, and Mendelian randomization (MR) analyses (two-sample design) were conducted in integration to systematically explore the CHM-GM-POAG axis. Literature-based data mining method was applied to identify frequently used herbs and herb pairs for POAG, and the properties and meridian tropism of the herbs were analyzed as well. Target prediction and pathway enrichment analyses were performed to identify shared molecular pathways among CHM components, GM, and POAG. MR analysis was performed to assess the genetically predicted causal associations between specific microbial taxa and POAG risk.
Results:
Our data mining work indicated that commonly used CHMs were mainly bitter and sweet in flavors and cold in property, with meridian tropism toward the liver, lung, and kidney. The predominant therapeutic effects of the CHMs included soothing the liver and regulating Qi, promoting blood circulation, and reducing fluid retention. Representative herb pairs were Shudihuang (Rehmanniae Radix Praeparata)-Gouqi (Lycii Fructus) with Zexie (Alismatis Rhizoma), Gouqi (Lycii Fructus)-Fuling (Poria) with Shudihuang (Rehmanniae Radix), and Juhua (Chrysanthemi Flos)-Gouqi (Lycii Fructus) with Zexie (Alismatis Rhizoma). Network pharmacology revealed overlapping targets involving antioxidative, anti-inflammatory, and metabolic regulation pathways. MR analysis demonstrated that higher abundances of Ruminiclostridium 6 [odds ratio (OR) = 0.73, 95% confidence interval (CI): 0.58 – 0.92, P = 0.007], Ruminococcaceae UCG-002 (OR = 0.77, 95% CI: 0.63 – 0.96, P = 0.018), Ruminococcus torques group (OR = 0.71, 95% CI: 0.57 – 0.90, P = 0.004), and Victivallis (OR = 0.82, 95% CI: 0.70 – 0.96, P = 0.016) were causally associated with reduced POAG risk, whereas Actinomyces (OR = 1.34, 95% CI: 1.06 – 1.68, P = 0.013) and Blautia (OR = 1.39, 95% CI: 1.01 – 1.90, P = 0.042) showed positive associations.
Conclusion
This study revealed potential causal links between GM and POAG and provided integrative evidence that CHM may modulate the microbiota to exert neuroprotective effects. These findings offer new integrative insights into the gut-eye axis and a theoretical basis for developing microbiota-targeted CHM strategies in glaucoma management.
7.Objective Data Analysis of Tongue Manifestations and Complexions in the Population with Yang Deficiency Constitution
Xuan TENG ; Tianfeng PENG ; Yuxuan ZHOU ; Xinying YI ; Jingyi YANG ; Meiyan ZENG ; Qinghua PENG ; Houpan SONG
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(4):797-802
Objective To conduct an analysis on objective data of tongue manifestations and complexions among college students with yang deficiency constitution and balanced constitution,thus to explore the correlation between yang deficiency constitution and the objective data of tongue manifestations and complexions among college students.Methods From August 2023 to January 2024,data collection was carried out in 325 cases of yang deficiency constitution(yang deficiency group)and 175 cases of balanced constitution(balanced group)from college students of Hunan University of Chinese Medicine,Central South University,Hunan Normal University,Hunan University and Changsha University of Science and Technology in Hunan Province.YM-MA-Ⅰ digital detection system for tongue manifestations and complexions of traditional Chinese medicine(TCM)was utilized for data collection and image analysis,and the differences in the Lab parameters of tongue color,tongue shape,tongue coating color,complexions,and lip color were compared between yang deficiency group and balanced group.Of the Lab parameters,letter"L"stands for luminance,which expresses the luminance from absolute black to absolute white,and takes the value of 0-100;letter"a"and letter"b"stand for two color channels,letter"a"represents the color from dark green to grey then to bright pink,and takes a value from-128 to 127,and letter"b"represents the color from bright blue to grey then to yellow,and also takes a value from-128 to 127.Results(1)The analysis of tongue manifestations showed that in comparison with the balanced group,enlarged tongue(72.62%),tooth-marked tongue(83.69%),and greasy coating(59.38%)were frequently seen in the yang deficiency group,and the differences were all statistically significant(P<0.05 or P<0.01).(2)The analysis of complexions showed that in comparison with the balanced group,lusterless complexion(79.08%)and pale lip(42.15%)were frequently seen in the yang deficiency group,with statistically significant differences(P<0.01).(3)The yang deficiency group had higher L value of tongue color,L value of tongue coating color,L value of complexions,and L and b values of lip color than the balanced group,and the differences were all statistically significant(P<0.05),indicating that the tongue color,complexions,and lip color of the yang deficiency group were all pale.Conclusion The objective data and image analysis of tongue manifestations and complexions can accurately identify the population of yang deficiency constitution from college students,and the results will provide approaches and references for the identification of other TCM constitutions from the population.
8.Androgen receptor inhibitors in treating prostate cancer.
Ryan N COLE ; Qinghua FANG ; Kanako MATSUOKA ; Zhou WANG
Asian Journal of Andrology 2025;27(2):144-155
Androgens play an important role in prostate cancer development and progression. Androgen action is mediated through the androgen receptor (AR), a ligand-dependent DNA-binding transcription factor. AR is arguably the most important target for prostate cancer treatment. Current USA Food and Drug Administration (FDA)-approved AR inhibitors target the ligand-binding domain (LBD) and have exhibited efficacy in prostate cancer patients, particularly when used in combination with androgen deprivation therapy. Unfortunately, patients treated with the currently approved AR-targeting agents develop resistance and relapse with castration-resistant prostate cancer (CRPC). The major mechanism leading to CRPC involves reactivation of AR signaling mainly through AR gene amplification, mutation, and/or splice variants. To effectively inhibit the reactivated AR signaling, new approaches to target AR are being actively explored. These new approaches include novel small molecule inhibitors targeting various domains of AR and agents that can degrade AR. The present review provides a summary of the existing FDA-approved AR antagonists and the current development of some of the AR targeting agents.
Humans
;
Male
;
Androgen Receptor Antagonists/therapeutic use*
;
Receptors, Androgen/metabolism*
;
Prostatic Neoplasms/drug therapy*
;
Prostatic Neoplasms, Castration-Resistant/drug therapy*
;
Signal Transduction/drug effects*
9.P2Y14R activation facilitates liver regeneration via CREB/DNMT3b/Dact-2/β-Catenin signals in acute liver failure.
Mengze ZHOU ; Yehong LI ; Jialong QIAN ; Xinli DONG ; Yanshuo GUO ; Li YIN ; Chunxiao LIU ; Kun HAO ; Qinghua HU
Acta Pharmaceutica Sinica B 2025;15(2):919-933
Acute liver failure (ALF) is lack of broadly approved therapeutic strategy except liver transplantation. As a glycogen metabolic intermediate, UDP-glucose (UDP-G) has been considered to accelerate liver repairment. Nevertheless, the role of UDP-G and its receptor P2Y purinoceptor 14 (P2Y14R) in ALF remains unknown. The present study aims to investigate the role and underlying mechanisms of UDP-G/P2Y14R axis in ALF. In this study, hepatic P2Y14R is significantly increased in TAA-induced and partial hepatectomy-induced ALF, while knockout of whole-body P2Y14R aggravates liver failure, manifested by inhibiting β-Catenin-mediated liver regeneration. Consistently, P2Y14R deficiency exhibits impaired liver regeneration in mice suffer partial hepatectomy. Importantly, only hepatocellular specific deletion of P2Y14R (P2Y14R flox/flox Alb cre/+ ) mice shows a similar phenomenon, rather than stellate cell specific deletion of P2Y14R (P2Y14R flox/flox Lrat cre/+ ) mice. Mechanistically, P2Y14R induction regulates methylation of Dact-2 through CREB/DNMT3b signals in hepatocytes, subsequently inhibiting the expression of Dact-2 which is a stabilizer of β-Catenin degradation complex, leading to the activation of β-Catenin -mediated liver regeneration. Interestingly, the administration of exogenous UDP-G can accelerate liver regeneration and liver function recovery after partial hepatectomy in hepatocellular carcinoma mice. Together, the findings propose an unrecognized role of P2Y14R in ALF and provide an effective adjuvant strategy for treatment of ALF.
10.RNA G-quadruplex (rG4) exacerbates cellular senescence by mediating ribosome pausing.
Haoxian ZHOU ; Shu WU ; Bin LI ; Rongjinlei ZHANG ; Ying ZOU ; Mibu CAO ; Anhua XU ; Kewei ZHENG ; Qinghua ZHOU ; Jia WANG ; Jinping ZHENG ; Jianhua YANG ; Yuanlong GE ; Zhanyi LIN ; Zhenyu JU
Protein & Cell 2025;16(11):953-967
Loss of protein homeostasis is a hallmark of cellular senescence, and ribosome pausing plays a crucial role in the collapse of proteostasis. However, our understanding of ribosome pausing in senescent cells remains limited. In this study, we utilized ribosome profiling and G-quadruplex RNA immunoprecipitation sequencing techniques to explore the impact of RNA G-quadruplex (rG4) on the translation efficiency in senescent cells. Our results revealed a reduction in the translation efficiency of rG4-rich genes in senescent cells and demonstrated that rG4 structures within coding sequence can impede translation both in vivo and in vitro. Moreover, we observed a significant increase in the abundance of rG4 structures in senescent cells, and the stabilization of the rG4 structures further exacerbated cellular senescence. Mechanistically, the RNA helicase DHX9 functions as a key regulator of rG4 abundance, and its reduced expression in senescent cells contributing to increased ribosome pausing. Additionally, we also observed an increased abundance of rG4, an imbalance in protein homeostasis, and reduced DHX9 expression in aged mice. In summary, our findings reveal a novel biological role for rG4 and DHX9 in the regulation of translation and proteostasis, which may have implications for delaying cellular senescence and the aging process.
G-Quadruplexes
;
Cellular Senescence
;
Ribosomes/genetics*
;
Humans
;
Animals
;
Mice
;
DEAD-box RNA Helicases/genetics*
;
Protein Biosynthesis
;
RNA/chemistry*
;
Neoplasm Proteins

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