1.Research progress on the chemical constituents,pharmacological mechanisms and clinical application of Jiegeng decoction
Yun HUANG ; Shunwang HUANG ; Jinwei QIAO ; Qian XU ; Xiaoming GAO ; Xuemei BAO ; Manqin YANG ; Ruonan XIE ; Ming CAI
China Pharmacy 2025;36(18):2348-2352
Jiegeng decoction is a classic prescription composed of two Chinese medicinal herbs: Platycodon grandiflorum and Glycyrrhiza uralensis. It has the efficacy of diffusing lung qi, resolving phlegm, relieving sore throat and discharging pus, and is commonly used in the treatment of respiratory diseases such as cough and pharyngodynia. This article reviews the chemical components, pharmacological mechanisms and clinical applications of Jiegeng decoction. It was found that Jiegeng decoction contains triterpenoid saponins, flavonoids, glycosides, acids, and other components, with platycodin D, platycodin D2, glycyrrhizic acid, glycyrrhetinic acid, liquiritin, etc., serving as the main active pharmaceutical ingredients. Jiegeng decoction and its chemical constituents exert anti-inflammatory effects by inhibiting signaling pathways such as nuclear factor-κB and mitogen- activated protein kinases, and demonstrate anti-tumor activities through mechanisms like modulating the tumor immune microenvironment and promoting cancer cell apoptosis. Additionally, it exhibits various pharmacological actions including antibacterial, antiviral, and antioxidant effects. Clinically, Jiegeng decoction, its modified prescription and compound combinations are widely used in the treatment of respiratory diseases such as cough, pneumonia, and pharyngitis, as well as digestive system disorders like constipation.
2.Investigation on the management and nurses' cognitive level of iodinated contrast media extravasation in Henan Province
Yuanyuan SONG ; Yu WANG ; Ruonan HAO ; Fangfang DONG ; Linlin HUANG ; Qiao-fang YANG ; Xiaohui JIA ; Shan BAI
Chinese Journal of Nursing 2025;60(11):1351-1358
Objective To investigate the status of management of iodinated contrast media(ICM)extravasation in Henan Province,as well as nurses' knowledge and influencing factors,in order to provide a basis for optimizing management strategies.Methods A self-designed questionnaire was applied,employing convenience sampling,to survey nursing administrators and nurses in the radiology departments of 55 tertiary hospitals across 16 regions of Henan Province,from December 2024 to January 2025.Multiple linear regression analysis was conducted to explore the factors influencing nurses' knowledge.Results A total of 55 nursing administrators and 64 nurses participated,with a valid questionnaire response rate of 100%.The survey results reveal that only 5.45%of radiology depart-ments utilized high-pressure central venous catheters,and 32.73%employed vascular visualization techniques.When setting the high-pressure injection speed for ICM,only 54.55%of radiology departments required an assessment of the type and model of intravenous access.Additionally,only 9.09%of radiology departments mandated an observa-tion for 2 to 4 hours following ICM extravasation.Furthermore,only 50.91%of radiology departments had estab-lished an information system for ICM use.The nurses' knowledge score regarding the prevention and management of ICM extravasation was(90.00±17.59),influenced by years of experience in radiology and professional titles(P<0.05).Conclusion The prevention and management measures for ICM in radiology departments in Henan Province need further improvement.Nursing administrators should optimize management strategies,improve relevant training systems,and continuously enhance nurses' knowledge and practical abilities.
3.Correct the Mistake of the Drugs"Qianren"and"Quanpi"in TANG Rongchuan's Xuezheng Lun(Treatise on Blood Syndromes)Identified as Other Herbs or Missing
Yuanye GU ; Ruonan QIANG ; Sheng HUANG
Journal of Zhejiang Chinese Medical University 2025;49(4):518-524
[Objective]To sort out and correct the situations where TANG Rongchuan's Xuezheng Lun(Treatise on Blood Syndromes)mistakenly identified"Qianren"and"Quanpi"as other herbs or losing.[Methods]By searching the Airusheng Chinese Basic Classics Library,the Beijing University of Chinese Medicine Library's ancient books and Republican-era thread-bound book digitization platform,and the Ancient Books Database of Shanghai University of Traditional Chinese Medicine Library,the publication status of"Qianren"and"Quanpi"in Xuezheng Lun was statistically analyzed.By searching the China National Knowledge Infrastructure(CNKI)and Duxiu databases for papers and monographs that cited relevant paragraphs and contained errors,the errors of"Qianren"and"Quanpi"being mistaken for other medicines or omitted were analyzed.By searching local county annals and medical works,and combining this with the analysis of inferring the names of medicines based on their effects,the medicines referred to by"Qianren"and"Quanpi"were identified.[Results]At least 22 academic papers and 39 monographs contain errors such as"Louren""Yiren""Taoren"or missing for"Qianren",and"Danpi""Chenpi"or missing for"Quanpi".This error first appeared in the process of compiling the single edition of Xuezheng Lun from the Five Kinds of Chinese and Western Medical Books by Shanghai Health Publishing House in 1958,and the lead-printed edition by Shanghai Science and Technology Publishing House in 1959,which was derived from this version,had been widely circulated after becoming a popular edition of Xuezheng Lun,resulting in this error being passed down for more than sixty years.The spread of errors takes two forms:vertical direct quotation and horizontal transfer citation,with phenomena such as"correct and incorrect mixtures"and"error modification"during the transmission process.In the book Xuezheng Lun,"Qianren"refers to"Cheqianren"in short,and"Quanpi"is another name for"Digupi".[Conclusion]Negligence and arbitrary changes in the citation of literature are the deep reasons for TANG Rongchuan's Xuezheng Lun mistakenly identifying the drugs"Qianren"and"Quanpi"as other drugs or missing,making the original errors to be perpetuated,even passed down through annotations.Scholars should verify multiple sources when citing literature to avoid misquotation.
4.Single-cell analysis of immune-lineage features in T-cell large granular lymphocytic leukemia
Ke HUANG ; Lele ZHANG ; Chen QIU ; Ruonan LI ; Yucan SHEN ; Weiwang LI ; Hong PAN ; Zhen GAO ; Liwei FANG ; Yajing CHU ; Weiping YUAN ; Jun SHI
Chinese Journal of Hematology 2025;46(5):453-459
Objective:To investigate alterations in the immune lineage of T-cell large granular lymphocytic leukemia (T-LGLL) at the single-cell transcriptome level and to elucidate its pathogenic mechanisms.Methods:Peripheral blood samples were collected from 5 T-LGLL patients before and after treatment (from June 2019 to December 2020) and 3 healthy controls at the Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC. Single-cell transcriptome sequencing libraries were prepared and sequenced using 10× Genomics technology. Differentially expressed genes in immune cells were compared between patients and healthy donors, followed by pathway enrichment analyses.Results:Profiling 67,237 immune cells revealed that, in T-LGLL: 1) Effector CD8+ T cells exhibited increased numbers, enhanced cytotoxicity, and greater proliferative capacity. Following effective immunosuppressive therapy, both the proliferative capacity and effector functions of these cells significantly decreased ( P<0.05). 2) The proportion of regulatory T (Treg) cells was reduced, accompanied by increased apoptosis. After effective immunosuppressive therapy leading to remission, Treg cell proportions increased, and apoptotic pathways were downregulated ( P<0.05). 3) Antigen-presenting cells (APCs) showed enhanced functionality. Monocytes and dendritic cells were enriched in antigen synthesis and presentation pathways, while B cells displayed increased antigen-binding capacity and were enriched in pathways related to T-cell activation ( P<0.05). 4) Natural killer (NK) cells exhibited attenuated cytotoxic function but demonstrated an enhanced regulatory capacity over T cells ( P<0.05) . Conclusions:T-LGLL patients present a characteristic immunological profile marked by an imbalance in immune homeostasis. This profile includes abnormal activation and expansion of effector CD8 + T cells, and a reduction in Treg cell numbers accompanied by functional impairment. Furthermore, APCs and NK cells were found to positively regulate T-lymphocyte activation, differentiation, and proliferation.
5.Analysis of treatment response and post-discontinuation efficacy maintenance of cyclophosphamide monotherapy in T-cell large granular lymphocytic leukemia
Lele ZHANG ; Linzhu TIAN ; Hong PAN ; Zhen GAO ; Weiwang LI ; Ruonan LI ; Jingyu ZHAO ; Jinbo HUANG ; Xin ZHAO ; Jianping LI ; Neng NIE ; Xiao YU ; Liyun LI ; Zhexiang KUANG ; Liwei FANG ; Jun SHI
Chinese Journal of Hematology 2025;46(7):631-635
Objective:To evaluate the efficacy of cyclophosphamide in patients with T-cell large granular lymphocytic leukemia (T-LGLL) and the maintenance of treatment-free remission (TFR) following drug discontinuation.Methods:Clinical data were collected from 37 patients with T-LGLL who received oral cyclophosphamide at the Regenerative Medicine Clinic of the Institute of Hematology and Blood Diseases Hospital between June 2019 and March 2024. Patient clinical characteristics, treatment efficacy, and long-term TFR were analyzed.Results:The median age of the 37 patients was 60 years (range: 37-86), and 22 (59.5%) were male. Anemia was observed in 30 patients (81.1%), and 28 (75.7%) met the diagnostic criteria for secondary pure red cell aplasia. Neutropenia occurred in 15 patients (40.5%), lymphocytosis in 11 (29.7%), and thrombocytopenia in three (8.1%). Sixteen patients (43.2%) had not received prior immunosuppressive therapy (treatment-naive group), while 21 patients (56.8%) were refractory to or had relapsed after immunosuppressive treatment (refractory/relapsed group). All patients met the treatment criteria and received oral cyclophosphamide at doses of 50-100 mg/day. Among the 36 evaluable patients, hematologic remission was achieved in 25 (69.4%), with a median time of 2.0 months (range: 0.7-7.0). There was no statistically significant difference in remission rates between the treatment-naive and refractory/relapsed groups (68.5% vs. 66.7%, P=0.589). Among the 25 patients who achieved hematologic remission, 24 discontinued cyclophosphamide. With a median follow-up of 39.0 months (range: 8.0-56.0), the median TFR duration was not reached. The estimated TFR rates were (90.87± 6.16) % at 12 months and (75.72±11.04) % at 36 months. No significant difference in TFR was observed between the treatment-naive and refractory/relapsed groups ( P=0.451) . Conclusion:Oral cyclophosphamide is effective in the treatment of T-LGLL, and patients may maintain long-term TFR following drug discontinuation.
6.Analysis of the clinical efficacy and safety of dupilumab in the treatment of patients with moderate to severe atopic dermatitis complicated with asthma
Hongmei ZOU ; Yumeng ZHAO ; Hehua HUANG ; Chong XU ; Xinzhuo WANG ; Wenchao GUAN ; Ruonan CHAI
Chinese Journal of Preventive Medicine 2025;59(6):825-833
Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) complicated with asthma.Methods:A self-controlled study before and after treatment was conducted to retrospectively analyze 45 patients with moderate to severe atopic dermatitis combined with asthma who received dupilumab in the respiratory allergy clinic of North Theater Command General Hospital from January 2021 to May 2024, which age ≥12 years, including 27 males, 18 females. The treatment period was 4 to 12 months. All patients were treated with dupilumab combined with inhaled glucocorticoids and long-acting beta2-receptor agonists, as well as symptomatic drugs for atopic dermatitis. Analyze the clinical data of the patients before and after treatment, including lung function, asthma and AD-related assessment scales. Generalized estimation equation was used to analyze the simple effect of time on the repeated measurement data following non-normal distribution, and Wilcoxon signed rank test was used to compare the differences of each observation index before and after treatment.Results:Among 45 patients with moderate to severe atopic dermatitis complicated with asthma, after treatment with dupilumab, the FEV 1 increased from 2.39 (1.87, 2.83) L at baseline to 2.50 (1.84, 2.97) L 3 months after treatment ( Z=2.417, P=0.016), 2.60 (1.95, 3.14) L 6 months after treatment ( Z=2.896, P=0.004); the FEV 1pred% increased from 74.10% (67.70%, 78.75%) at baseline to 77.09% (68.40%, 80.24%) at 3 months after treatment ( Z=2.574, P=0.010), and 77.20% (71.10%, 80.72%) at 6 months after treatment ( Z=2.861, P=0.004). Meanwhile, there were statistically significant differences in the ACT and Mini-AQLQ scales at 3, 6, and 12 months after treatment compared with those before treatment (ACT score Z=3.170, 4.216, 5.723; Mini-AQLQ score Z=3.231, 4.133, 5.826; all P<0.05). The EASI scale decreased from baseline 25.90 (18.95, 33.45) to 6.20 (1.15, 8.35) at 4 months after treatment ( Z=5.842, P<0.05) and 4.90 (2.75, 8.35) at 6 months after treatment ( Z=5.841, P<0.05), 4.00 (3.15, 5.05) at 12 months after treatment ( Z=5.841, P<0.05); The scores of each scale of IGA, NRS and DLQI decreased significantly compared with the baseline after 4 months, 6 months and 12 months of treatment, and this trend became more obvious with the extension of treatment time. The differences were statistically significant (IGA score Z=6.247, 6.070, 5.946; NRS score Z=5.960, 5.893, 5.879; DLQI score Z=5.880, 5.850, 5.848; all P<0.05). During treatment, 1 patient had local adverse reactions at the injection site and 1 patient had conjunctivitis. Conclusion:Dupilumab may have a positive effect on improving the clinical efficacy of patients with moderate to severe atopic dermatitis complicated with asthma. During the 12-month observation period, this biological agent generally demonstrated good safety characteristics.
7.Research progress of γδ T cells in head and neck squamous cell carcinoma
Lu RUONAN ; Mao XINHUI ; Xue JIYAO ; Zheng YIJING ; Huang LIANG ; Dou YUTING ; Gui YUN ; Shi YI
Chinese Journal of Clinical Oncology 2025;52(4):193-197
Head and neck squamous cell carcinoma(HNSCC)is a highly prevalent malignancy with poor prognosis.Treatment strategies to date have achieved limited success in significantly improving overall survival rates.γδ T cells,a unique subset of immune cells in the tumor microenvironment,can link adaptive and innate immune functions.While γδ T cells can effectively recognize and eliminate HNSCC tumor cells,certain subsets of these cells can secrete interleukin-17,contributing to tumor progression.Nevertheless,due to their remarkable cyto-toxic activity,γδ T cells have been identified as promising candidates for antitumor immunotherapy.This article reviews the biological back-ground of γδ T cells,their role in tumor immunity in HNSCC,and recent advances in γδ T cell immunotherapy,aiming to provide new in-sights into HNSCC diagnosis and treatment.
8.Multimodal MRI-based neurophenotype correlated to structural bowel damage in Crohn's disease
Zhuangnian FANG ; Ruonan ZHANG ; Lili HUANG ; Xiaodi SHEN ; Qingzhu ZHENG ; Yangdi WANG ; Xuehua LI ; Zhoulei LI ; Shaochun LIN
The Journal of Practical Medicine 2025;41(15):2398-2405
Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn's disease(CD)through radiomics-assisted neurophenotyping,utilizing multiparametric brain MRI.Methods This prospective study enrolled patients with CD who underwent brain MRI,MR enterography,and ileocolonoscopy within one week.The Lémann Index was used to quantitatively assess cumulative structural bowel damage.CD patients were stratified into two groups based on a cutoff value of 4.8:those with bowel damage(LI>4.8)and those without bowel damage(LI≤4.8).A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD.Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort.Results The final study population comprised 109 patients,including 51 individuals with bowel damage and 58 without bowel damage.The neurophenotype model scores were 0.785(95%CI:0.506~0.945)in the bowel damage group and 0.155(95%CI:0.093~0.394)in the non-bowel damage group,showing a statistically significant difference between the two groups(P<0.001).The developed model exhibited strong discriminative performance,with area under the receiver operating characteristic curve(AUC)values ranging from 0.824 to 0.918 across the training,vali-dation,and test cohorts(all P<0.05).Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage,which may indicate extraintestinal manifestations associated with cumulative intestinal injury.
9.Multimodal MRI-based neurophenotype correlated to structural bowel damage in Crohn's disease
Zhuangnian FANG ; Ruonan ZHANG ; Lili HUANG ; Xiaodi SHEN ; Qingzhu ZHENG ; Yangdi WANG ; Xuehua LI ; Zhoulei LI ; Shaochun LIN
The Journal of Practical Medicine 2025;41(15):2398-2405
Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn's disease(CD)through radiomics-assisted neurophenotyping,utilizing multiparametric brain MRI.Methods This prospective study enrolled patients with CD who underwent brain MRI,MR enterography,and ileocolonoscopy within one week.The Lémann Index was used to quantitatively assess cumulative structural bowel damage.CD patients were stratified into two groups based on a cutoff value of 4.8:those with bowel damage(LI>4.8)and those without bowel damage(LI≤4.8).A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD.Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort.Results The final study population comprised 109 patients,including 51 individuals with bowel damage and 58 without bowel damage.The neurophenotype model scores were 0.785(95%CI:0.506~0.945)in the bowel damage group and 0.155(95%CI:0.093~0.394)in the non-bowel damage group,showing a statistically significant difference between the two groups(P<0.001).The developed model exhibited strong discriminative performance,with area under the receiver operating characteristic curve(AUC)values ranging from 0.824 to 0.918 across the training,vali-dation,and test cohorts(all P<0.05).Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage,which may indicate extraintestinal manifestations associated with cumulative intestinal injury.
10.Analysis of the clinical efficacy and safety of dupilumab in the treatment of patients with moderate to severe atopic dermatitis complicated with asthma
Hongmei ZOU ; Yumeng ZHAO ; Hehua HUANG ; Chong XU ; Xinzhuo WANG ; Wenchao GUAN ; Ruonan CHAI
Chinese Journal of Preventive Medicine 2025;59(6):825-833
Objective:To investigate clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) complicated with asthma.Methods:A self-controlled study before and after treatment was conducted to retrospectively analyze 45 patients with moderate to severe atopic dermatitis combined with asthma who received dupilumab in the respiratory allergy clinic of North Theater Command General Hospital from January 2021 to May 2024, which age ≥12 years, including 27 males, 18 females. The treatment period was 4 to 12 months. All patients were treated with dupilumab combined with inhaled glucocorticoids and long-acting beta2-receptor agonists, as well as symptomatic drugs for atopic dermatitis. Analyze the clinical data of the patients before and after treatment, including lung function, asthma and AD-related assessment scales. Generalized estimation equation was used to analyze the simple effect of time on the repeated measurement data following non-normal distribution, and Wilcoxon signed rank test was used to compare the differences of each observation index before and after treatment.Results:Among 45 patients with moderate to severe atopic dermatitis complicated with asthma, after treatment with dupilumab, the FEV 1 increased from 2.39 (1.87, 2.83) L at baseline to 2.50 (1.84, 2.97) L 3 months after treatment ( Z=2.417, P=0.016), 2.60 (1.95, 3.14) L 6 months after treatment ( Z=2.896, P=0.004); the FEV 1pred% increased from 74.10% (67.70%, 78.75%) at baseline to 77.09% (68.40%, 80.24%) at 3 months after treatment ( Z=2.574, P=0.010), and 77.20% (71.10%, 80.72%) at 6 months after treatment ( Z=2.861, P=0.004). Meanwhile, there were statistically significant differences in the ACT and Mini-AQLQ scales at 3, 6, and 12 months after treatment compared with those before treatment (ACT score Z=3.170, 4.216, 5.723; Mini-AQLQ score Z=3.231, 4.133, 5.826; all P<0.05). The EASI scale decreased from baseline 25.90 (18.95, 33.45) to 6.20 (1.15, 8.35) at 4 months after treatment ( Z=5.842, P<0.05) and 4.90 (2.75, 8.35) at 6 months after treatment ( Z=5.841, P<0.05), 4.00 (3.15, 5.05) at 12 months after treatment ( Z=5.841, P<0.05); The scores of each scale of IGA, NRS and DLQI decreased significantly compared with the baseline after 4 months, 6 months and 12 months of treatment, and this trend became more obvious with the extension of treatment time. The differences were statistically significant (IGA score Z=6.247, 6.070, 5.946; NRS score Z=5.960, 5.893, 5.879; DLQI score Z=5.880, 5.850, 5.848; all P<0.05). During treatment, 1 patient had local adverse reactions at the injection site and 1 patient had conjunctivitis. Conclusion:Dupilumab may have a positive effect on improving the clinical efficacy of patients with moderate to severe atopic dermatitis complicated with asthma. During the 12-month observation period, this biological agent generally demonstrated good safety characteristics.

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