1.Natural products modulate pyroptosis for treatment of spinal cord injury
Xuesan ZHANG ; Zheng ZHANG ; Le SHEN ; Qingqing GENG ; Shusen TAN ; Chunbiao LOU ; Kang HAN
Chinese Journal of Tissue Engineering Research 2025;29(30):6520-6528
BACKGROUND:Neuroinflammation is a major cause of exacerbation after spinal cord injury.In recent years,pyroptosis has received much attention due to its remarkable pro-inflammatory features.Some of these natural products can significantly inhibit the inflammatory response and improve the damaged nerve function by regulating the level of pyroptosis after spinal cord injury,which provides a new therapeutic idea for spinal cord injury.OBJECTIVE:To summarize the mechanism of action of natural products in regulating pyroptosis for the treatment of spinal cord injury,with a view to providing lessons and references for future research on the treatment of spinal cord injury.METHODS:The search terms"spinal cord injury,pyroptosis,inflammasome,natural products,natural compounds,traditional Chinese medicine"in Chinese and English were used to search for relevant literature since the establishment of the database up to September 2024 in the databases of PubMed,Web of Science,WanFang,and CNKI.According to the inclusion and exclusion criteria,75 relevant articles were finally obtained.RESULTS AND CONCLUSION:(1)Pyroptosis is an important pro-inflammatory pathway in spinal cord injury,and controlling pyroptosis is an effective way to improve damaged nerve function.(2)Some natural products can regulate pyroptosis via the NLRP3/Caspase-1 classical pyroptosis pathway,the NF-κB-related pathway,other upstream pathways such as Nrf2/HO-1,and autophagy,thereby affecting the level of tissue inflammation and accelerating neurological recovery after spinal cord injury.(3)The anti-pyroptosis effects of these natural products are mostly dependent on the NLRP3 classical pyroptosis pathway,and there is a lack of studies on other pyroptosis pathways.(4)There are still many problems in this field,such as the fact that these natural products are not currently supported by evidence from appropriate clinical studies.(5)The natural product has great potential in regulating pyroptosis and is expected to be a powerful weapon in the treatment of spinal cord injury.
2.Study on the applied value of combined clinical and ultrasound multiparameter constructed nomogram for predicting HER-2-positive breast cancer
Xinran ZHANG ; Yan SHEN ; Jiaojiao HU ; Qingqing CHEN ; Yangjie XIAO ; Feng LU ; Shasha YUAN ; Xiaohong FU
The Journal of Practical Medicine 2025;41(18):2812-2819
Objective To evaluate the predictive value of a nomogram model developed by integrating clinical and ultrasound multiparameters for HER-2-positive breast cancer.Methods This study retrospectively enrolled 343 patients with pathologically confirmed breast cancer from three medical centers and randomly divided them into training and validation cohorts.Univariate analysis,LASSO regression,and multivariate logistic regres-sion were conducted on the training set to identify independent prognostic factors and construct a nomogram model.Bootstrap resampling with 1000 iterations was performed to evaluate the model's robustness.Model calibration was assessed using calibration curves and the Hosmer-Lemeshow goodness-of-fit test.Receiver operating characteristic(ROC)curves were generated to evaluate model discrimination,and the area under the curve(AUC)along with other performance metrics were calculated.Decision curve analysis was employed to assess the clinical utility of the model,and the validation cohort was used for external validation.Results Univariate,LASSO,and multivariate regression analyses demonstrated that age,TTP(time to peak),and the presence of a filling defect sign were independent predictors of HER-2-positive breast cancer(all P<0.05).Based on these independent predictors,a nomogram model was constructed.Bootstrap validation with 1,000 resamples indicated that the model's predictive performance was stable.The Hosmer-Lemeshow test confirmed satisfactory model calibration,while the calibration curve illustrated accurate prediction probabilities.The area under the curve(AUC)for the training set was 0.863(95%CI:0.806~0.920),and for the validation set,it was 0.846(95%CI:0.764~0.929),indicating strong discriminative and generalization capabilities.Additionally,the clinical decision curve analysis demonstrated favor-able clinical utility.Conclusion A nomogram model integrating clinical and multimodal ultrasound parameters demonstrates potential utility in predicting HER-2-positive breast cancer.
3.Exploring the scientific connotation of"spleen qi disperses essence"based on apolipoproteins
Tao WANG ; Gai GAO ; Qingqing SONG ; Yanyan SHEN ; Daiyu XU ; Xiaowei ZHANG ; Jiangyan XU ; Zhenqiang ZHANG ; Zhishen XIE
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1501-1506
As one of the core theories of spleen governing transportation and transformation in the traditional Chinese medicine visceral manifestation theory,the modern biological basis of"spleen qi disperses essence"has not been fully elucidated.Lipids are one of the three major nutrients in the body,which are derived from exogenous absorption or endogenous transformation,and belong to the category of"grease"and"essence"substances in traditional Chinese medicine.Because of their hydrophobic nature,lipids require apolipoproteins to be transported in the bloodstream and used by the body;similarly,essence also needs spleen qi transformation to be distributed throughout the body and exert their nourishing effects,revealing a certain degree of inherent unity between the two.When the spleen qi functions properly,essence dispersal is orderly and lipid metabolism remains in homeostatic balance;if spleen deficient leads to impaired transportation,the essence will not be distributed,and the lipid turbidity will accumulate,causing disease.Classic strengthening spleen prescriptions such as Zexie Decoction,can reshape lipid homeostasis by regulating apolipoproteins.Based on apolipoprotein-mediated lipid metabolism,this paper explores the modern molecular biology basis of the theory of"spleen qi disperses essence,"which provides novel insights for enriching the modern research of traditional Chinese medicine visceral manifestation theory,and lays the foundation for clinical practice and theoretical innovation in the treatment of metabolic diseases from the spleen.
4.Recent advances in the pathogenesis and preventive strategies of abdominal aortic an-eurysm
Qingqing LEI ; Ziwen SHEN ; Mengxian SUN ; Tingting ZHANG
Chinese Journal of Arteriosclerosis 2025;33(7):579-586
Abdominal aortic aneurysm(AAA)is characterized by a localized and irreversible enlargement of the abdominal aorta,which poses a significant risk to life in the event of rupture.Currently,the primary treatment for AAA is surgical intervention,as there are no effective pharmacological therapies available to prevent or slow postoperative vascular dilation.Therefore,understanding the detailed pathogenesis of AAA and identifying effective prevention and treatment strategies is essential.This review begins by examining the pathological and molecular mechanisms involved in AAA,fo-cusing on key research areas such as the phenotypic switching of vascular smooth muscle cells,inflammation and metabolic reprogramming.Based on a large of animal and clinical studies,this review then explores therapeutic strategies and prom-ising drugs for AAA,including mesenchymal stem cell therapy,nanomaterial applications,and immunomodulatory inter-ventions.The review aims to provide researchers with new ideas and directions for the prevention and treatment of AAA.
5.Relationship between levels of novel inflammatory indicators and aggressivity in patients with first-episode and recurrent schizophrenia
Ying'ao CUI ; Cheng YANG ; Yinghan TIAN ; Qingqing SHEN ; Huanzhong LIU
Sichuan Mental Health 2025;38(1):28-33
BackgroundAggressive behavior in schizophrenic patients could result in legal disputes and public safety concerns. In patients with illness episodes of different numbers, there may exist differences in the association between levels of novel inflammatory indicators and aggressivity. ObjectiveTo investigate the differences in the correlation between levels of novel inflammatory indicators and aggressivity in patients with first-episode and recurrent schizophrenia, in order to search for inflammatory biomarkers to assess aggression level in schizophrenic patients. MethodsA total of 168 schizophrenic patients were selected as subjects, who were hospitalized for acute disease onset in Chaohu Hospital of Anhui Medical University from October 2022 to April 2024 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Patients were divided into first-episode group (n=58) and recurrent group (n=110). Meanwhile, 110 healthy controls from community who matched in age and gender with the patient group were recruited. All patients were evaluated with Modified Overt Aggression Scale (MOAS) and Positive and Negative Syndrome Scale (PANSS). All subjects went through examination of the levels of novel inflammatory indicators, including neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), neutrophil/high-density lipoprotein ratio (NHR), monocyte/high-density lipoprotein ratio (MHR) and platelet/high-density lipoprotein ratio (PHR). Spearman correlation analysis was adopted to investigate the correlation between levels of novel inflammatory indicators and the total score of MOAS in patients with first-episode and recurrent schizophrenia. ResultsThe levels of NLR, MLR, PLR, NHR, MHR and PHR in first-episode group were higher than those in control group (adjusted P<0.01). The levels of NLR, MLR, NHR, MHR and PHR in recurrent group were higher than those in control group (adjusted P<0.01). No significant difference was observed in the comparison in the levels of six novel inflammatory indicators between first-episode group and recurrent group (adjusted P>0.05). Spearman correlation analysis showed, the MOAS total score of recurrent group was positively correlated with the levels of NLR, MLR and PLR (r=0.234, 0.192, 0.243, P<0.05). There was no statistical significance in the correlation between MOAS total score and levels of six novel inflammatory indicators in first-episode group (P>0.05). ConclusionAmong patients with first-episode and recurrent schizophrenia, the correlation between levels of novel inflammatory indicators and aggressivity could differ. NLR, MLR and PLR might be the biomarkers for assessing aggression level in recurrent schizophrenic patients. [Funded by Anhui Provincial Natural Science Foundation (number, 2108085MH275)]
6.Optimization of immunotherapy combination strategies for microsatellite-stable advanced colorectal cancer:a real-world study
Yue GOU ; Erya HU ; Ping LIU ; Mengsi ZENG ; Qingqing LUO ; Xiangyang ZHANG ; Changjing CAI ; Hong SHEN ; Feng ZHAO ; Shan ZENG
Chinese Journal of General Surgery 2025;34(10):2106-2118
Background and Aims:Microsatellite-stable(MSS)colorectal cancer(CRC)generally exhibits poor responsiveness to immune checkpoint inhibitors(ICIs),and effective immunotherapy strategies remain lacking.Anti-angiogenic agents such as bevacizumab(BEV)can improve the tumor immune microenvironment and act synergistically with ICIs.This multicenter real-world study compared the efficacy of different immunotherapy-based combination regimens in patients with MSS/MSI-L/pMMR advanced CRC,aiming to identify the optimal treatment strategy.Methods:A total of 100 patients with MSS/MSI-L/pMMR advanced CRC who received systemic treatment between November 2019 and February 2025 at four tertiary hospitals in Hunan,China,were retrospectively enrolled.Patients were classified into six treatment groups:chemotherapy alone,chemotherapy+targeted therapy,immunotherapy alone,immunotherapy+chemotherapy,immunotherapy+targeted therapy,and immunotherapy+chemotherapy+targeted therapy.The primary endpoints were overall survival(OS)and progression-free survival(PFS),while secondary endpoints were objective response rate(ORR)and disease control rate(DCR).Additionally,among patients receiving immunotherapy,subgroup analysis was performed according to BEV administration.Results:Among all 100 patients,the immunotherapy+chemotherapy+targeted therapy group achieved the highest ORR(32.0%)and DCR(76.0%)and was the only regimen yielding a complete response(CR).Compared with chemotherapy or immunotherapy alone,the triplet regimen significantly improved OS(P<0.05);although PFS improvement did not reach statistical significance,a clear late-stage separation of survival curves was observed.In the immunotherapy subgroup,BEV-containing regimens achieved markedly better outcomes than non-BEV regimens,with DCR of 75.0%vs.48.8%,median OS of 18.9 vs.11.5 months,and median PFS of 13.8 vs.7.2 months(all P<0.001).Cox regression analysis showed that compared with chemotherapy alone,the triplet regimen significantly reduced the risk of death(HR=0.11)and disease progression(HR=0.25)(both P=0.002).Vascular invasion was identified as an adverse prognostic factor for PFS(HR=3.0,P=0.007).Conclusion:This multicenter real-world study demonstrated that combining immunotherapy with chemotherapy and targeted therapy significantly improves DCR and survival outcomes in patients with MSS/MSI-L/pMMR advanced CRC,with BEV-containing triplet regimens providing the most pronounced benefit.BEV may enhance immune responsiveness by modulating the tumor microenvironment and promoting effector T-cell infiltration,offering a promising therapeutic direction for"immune-cold"CRC.Prospective randomized studies are warranted to further validate its clinical value and define appropriate patient populations.
7.Recent advances in the pathogenesis and preventive strategies of abdominal aortic an-eurysm
Qingqing LEI ; Ziwen SHEN ; Mengxian SUN ; Tingting ZHANG
Chinese Journal of Arteriosclerosis 2025;33(7):579-586
Abdominal aortic aneurysm(AAA)is characterized by a localized and irreversible enlargement of the abdominal aorta,which poses a significant risk to life in the event of rupture.Currently,the primary treatment for AAA is surgical intervention,as there are no effective pharmacological therapies available to prevent or slow postoperative vascular dilation.Therefore,understanding the detailed pathogenesis of AAA and identifying effective prevention and treatment strategies is essential.This review begins by examining the pathological and molecular mechanisms involved in AAA,fo-cusing on key research areas such as the phenotypic switching of vascular smooth muscle cells,inflammation and metabolic reprogramming.Based on a large of animal and clinical studies,this review then explores therapeutic strategies and prom-ising drugs for AAA,including mesenchymal stem cell therapy,nanomaterial applications,and immunomodulatory inter-ventions.The review aims to provide researchers with new ideas and directions for the prevention and treatment of AAA.
8.Exploring the scientific connotation of"spleen qi disperses essence"based on apolipoproteins
Tao WANG ; Gai GAO ; Qingqing SONG ; Yanyan SHEN ; Daiyu XU ; Xiaowei ZHANG ; Jiangyan XU ; Zhenqiang ZHANG ; Zhishen XIE
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1501-1506
As one of the core theories of spleen governing transportation and transformation in the traditional Chinese medicine visceral manifestation theory,the modern biological basis of"spleen qi disperses essence"has not been fully elucidated.Lipids are one of the three major nutrients in the body,which are derived from exogenous absorption or endogenous transformation,and belong to the category of"grease"and"essence"substances in traditional Chinese medicine.Because of their hydrophobic nature,lipids require apolipoproteins to be transported in the bloodstream and used by the body;similarly,essence also needs spleen qi transformation to be distributed throughout the body and exert their nourishing effects,revealing a certain degree of inherent unity between the two.When the spleen qi functions properly,essence dispersal is orderly and lipid metabolism remains in homeostatic balance;if spleen deficient leads to impaired transportation,the essence will not be distributed,and the lipid turbidity will accumulate,causing disease.Classic strengthening spleen prescriptions such as Zexie Decoction,can reshape lipid homeostasis by regulating apolipoproteins.Based on apolipoprotein-mediated lipid metabolism,this paper explores the modern molecular biology basis of the theory of"spleen qi disperses essence,"which provides novel insights for enriching the modern research of traditional Chinese medicine visceral manifestation theory,and lays the foundation for clinical practice and theoretical innovation in the treatment of metabolic diseases from the spleen.
9.Natural products modulate pyroptosis for treatment of spinal cord injury
Xuesan ZHANG ; Zheng ZHANG ; Le SHEN ; Qingqing GENG ; Shusen TAN ; Chunbiao LOU ; Kang HAN
Chinese Journal of Tissue Engineering Research 2025;29(30):6520-6528
BACKGROUND:Neuroinflammation is a major cause of exacerbation after spinal cord injury.In recent years,pyroptosis has received much attention due to its remarkable pro-inflammatory features.Some of these natural products can significantly inhibit the inflammatory response and improve the damaged nerve function by regulating the level of pyroptosis after spinal cord injury,which provides a new therapeutic idea for spinal cord injury.OBJECTIVE:To summarize the mechanism of action of natural products in regulating pyroptosis for the treatment of spinal cord injury,with a view to providing lessons and references for future research on the treatment of spinal cord injury.METHODS:The search terms"spinal cord injury,pyroptosis,inflammasome,natural products,natural compounds,traditional Chinese medicine"in Chinese and English were used to search for relevant literature since the establishment of the database up to September 2024 in the databases of PubMed,Web of Science,WanFang,and CNKI.According to the inclusion and exclusion criteria,75 relevant articles were finally obtained.RESULTS AND CONCLUSION:(1)Pyroptosis is an important pro-inflammatory pathway in spinal cord injury,and controlling pyroptosis is an effective way to improve damaged nerve function.(2)Some natural products can regulate pyroptosis via the NLRP3/Caspase-1 classical pyroptosis pathway,the NF-κB-related pathway,other upstream pathways such as Nrf2/HO-1,and autophagy,thereby affecting the level of tissue inflammation and accelerating neurological recovery after spinal cord injury.(3)The anti-pyroptosis effects of these natural products are mostly dependent on the NLRP3 classical pyroptosis pathway,and there is a lack of studies on other pyroptosis pathways.(4)There are still many problems in this field,such as the fact that these natural products are not currently supported by evidence from appropriate clinical studies.(5)The natural product has great potential in regulating pyroptosis and is expected to be a powerful weapon in the treatment of spinal cord injury.
10.Optimization of immunotherapy combination strategies for microsatellite-stable advanced colorectal cancer:a real-world study
Yue GOU ; Erya HU ; Ping LIU ; Mengsi ZENG ; Qingqing LUO ; Xiangyang ZHANG ; Changjing CAI ; Hong SHEN ; Feng ZHAO ; Shan ZENG
Chinese Journal of General Surgery 2025;34(10):2106-2118
Background and Aims:Microsatellite-stable(MSS)colorectal cancer(CRC)generally exhibits poor responsiveness to immune checkpoint inhibitors(ICIs),and effective immunotherapy strategies remain lacking.Anti-angiogenic agents such as bevacizumab(BEV)can improve the tumor immune microenvironment and act synergistically with ICIs.This multicenter real-world study compared the efficacy of different immunotherapy-based combination regimens in patients with MSS/MSI-L/pMMR advanced CRC,aiming to identify the optimal treatment strategy.Methods:A total of 100 patients with MSS/MSI-L/pMMR advanced CRC who received systemic treatment between November 2019 and February 2025 at four tertiary hospitals in Hunan,China,were retrospectively enrolled.Patients were classified into six treatment groups:chemotherapy alone,chemotherapy+targeted therapy,immunotherapy alone,immunotherapy+chemotherapy,immunotherapy+targeted therapy,and immunotherapy+chemotherapy+targeted therapy.The primary endpoints were overall survival(OS)and progression-free survival(PFS),while secondary endpoints were objective response rate(ORR)and disease control rate(DCR).Additionally,among patients receiving immunotherapy,subgroup analysis was performed according to BEV administration.Results:Among all 100 patients,the immunotherapy+chemotherapy+targeted therapy group achieved the highest ORR(32.0%)and DCR(76.0%)and was the only regimen yielding a complete response(CR).Compared with chemotherapy or immunotherapy alone,the triplet regimen significantly improved OS(P<0.05);although PFS improvement did not reach statistical significance,a clear late-stage separation of survival curves was observed.In the immunotherapy subgroup,BEV-containing regimens achieved markedly better outcomes than non-BEV regimens,with DCR of 75.0%vs.48.8%,median OS of 18.9 vs.11.5 months,and median PFS of 13.8 vs.7.2 months(all P<0.001).Cox regression analysis showed that compared with chemotherapy alone,the triplet regimen significantly reduced the risk of death(HR=0.11)and disease progression(HR=0.25)(both P=0.002).Vascular invasion was identified as an adverse prognostic factor for PFS(HR=3.0,P=0.007).Conclusion:This multicenter real-world study demonstrated that combining immunotherapy with chemotherapy and targeted therapy significantly improves DCR and survival outcomes in patients with MSS/MSI-L/pMMR advanced CRC,with BEV-containing triplet regimens providing the most pronounced benefit.BEV may enhance immune responsiveness by modulating the tumor microenvironment and promoting effector T-cell infiltration,offering a promising therapeutic direction for"immune-cold"CRC.Prospective randomized studies are warranted to further validate its clinical value and define appropriate patient populations.

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