1.Construction and validation of a medication deviation prediction model for hospital-to-home transition period in coronary heart disease patients with initial treatment
Yushuang LI ; Shu LI ; Qianying ZHANG ; Yan HUANG ; Kun LIU ; Xiulin GU ; Huanhuan JIANG
China Pharmacy 2026;37(4):491-496
OBJECTIVE To develope a predictive model for medication deviation risks during the hospital-to-home transition period in coronary heart disease (CHD) patients with initial treatment, aiming to assist medical staff in rapidly identifying high-risk groups for medication deviation. METHODS A total of 462 CHD patients with initial treatment from the Affiliated Hospital of North China University of Science and Technology (hereinafter referred to as “our hospital”) between January and July 2024 were enrolled. The patients were randomly divided into a modeling group and an internal validation group. The modeling group was further categorized into a medication deviation group and a non-medication deviation group based on whether medication deviations occurred. Similarly, 57 CHD patients with initial treatment from the cardiology department of our hospital between June and September 2025 were collected as an external validation group. Univariate analysis was used to screen predictive factors, followed by multivariate Logistic regression to construct the predictive model. Internal validation methods were employed to evaluate model performance, while external validation methods were used to test the model’s generalizability. RESULTS The 462 patients were divided into a modeling group (319 cases) and an internal validation group (143 cases). In the modeling group, the medication deviation group (192 cases, 60.19%) and the non-medication deviation group (127 cases, 39.81%) were identified. Multivariate Logistic regression analysis revealed that age, medication type, medication adherence, and self-efficacy in rational medication use were predictive factors for medication deviations in CHD patients with initial treatment ( P <0.05). The predictive model equation was logit P =ln[ P /(1- P ) ] =1.321+1.732×age+4.091×medication type -4.360×medication adherence -3.081×self-efficacy in rational medication use. The model demonstrated good discrimination, with a Hosmer-Lemeshow goodness-of-fit test P -value of 0.439, an area under the receiver operating characteristic curve (AUC) of 0.870, sensitivity of 0.970, and specificity of 0.607. A risk nomogram with a total score of 350 points and a cutoff value of 110 points was plotted. The internal validation group showed an AUC o f 0.787 and a prediction accuracy of 77.6%, while the external validation group exhibited an AUC of 0.802 and a prediction accuracy of 73.7%. CONCLUSIONS This study successfully developed a predictive model for medication deviation risks during the hospital-to-home transition period in CHD patients with initial treatment. The model demonstrates excellent discrimination and predictive accuracy, effectively identifying high-risk populations for medication deviations. Age (>70 years), number of drug types≥5, poor medication adherence, and poor self-efficacy in rational medication use are independent risk factors for medication deviations.
2.Mechanism of Taishan Panshisan in Inhibiting Oxidative Stress Injury of Trophoblast Cells by Regulating KEAP1/Nrf2/FoxO3 Signaling Pathway
Yangyang DUAN ; Xianglun JI ; Jiahong CHEN ; Jinghang YANG ; Xinyu XIAO ; Shutao CHEN ; Chaorui LIN ; Fan LIN ; Shu JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):12-22
ObjectiveTo explore the effect and mechanism of Taishan Panshi powder (TSPSP) on inhibiting oxidative stress injury in human chorionic trophoblast cells (HTR-8/SVneo), and to uelucidate the underlying mechanism of TSPSP in the treatment of spontaneous abortion (SA). MethodsGene differential analysis of SA was performed using the Gene Expression Omnibus (GEO) database and correlated with oxidative stress. Network pharmacology was employed to screen the active components of TSPSP, and a "Chinese medicine-component-target-disease" network was constructed to predict the mechanism of action of TSPSP. For in vitro validation experiments, HTR-8/SVneo cells were divided into blank group, model group, TSPSP-containing serum 2.5%, 5%, 10% groups, and nuclear factor E2-related factor 2 (Nrf2) inhibitor group (ML385, 30 μmol·L-1). Except for the blank group, other groups were stimulated with 150 μmol·L-1 H2O2 for 3 h to establish a cell oxidative stress injury model. After successful modeling, the blank group and model group were given 10% blank serum, each TSPSP-containing serum group was treated with the corresponding concentration of drug-containing serum, and the Nrf2 inhibitor group was additionally given 30 μmol·L-1 ML385 on the basis of 10% TSPSP-containing serum. All groups of cells were continuously cultured under the above conditions for 24 h, and then samples were collected for subsequent detection. Cell viability in each group was detected by CCK-8 assay. Cell migration rate was detected by scratch test. The contents of malondialdehyde (MDA), Fe2+, and Glutathione (GSH) were detected by enzyme-linked immunosorbent assay (ELISA). Intracellular reactive oxygen species (ROS) level was detected by a fluorescent probe (DCF-DA). The protein and mRNA expression levels of Kelch-like ECH-associated protein 1 (KEAP1), Nrf2, and forkhead box protein O3 (FoxO3) in cells were detected by immunofluorescence (IF) and real-time quantitative polymerase chain reaction (Real-time PCR). The protein expression levels of KEAP1, Nrf2, FoxO3, Glutathione peroxidase 4 (GPX4), and superoxide dismutase (SOD) in cells were detected by Western blot. ResultsThe GSE76862 and GSE22490 datasets were obtained from the GEO database. Differential gene analyses showed that the KEAP1, Nrf2, and FoxO3 genes were all associated with the disease. After matching with the oxidative stress pathway, nine significantly differential pathways were identified (P<0.05), among which three contained the target genes Nrf2 and FoxO3. A total of 246 active ingredient targets of TSPSP and 2 804 SA-related targets were obtained through network pharmacology, and 154 potential action targets were obtained after taking the intersection. Topological analysis showed that targets such as KEAP1 and Nrf2 exhibited high degree values. GO and KEGG enrichment analyses indicated that the intersection targets were mainly involved in oxidative stress response, FOXO and MAPK signaling pathways, etc. In in vitro experiments, compared with the blank group, the cell viability in the model group was significantly decreased (P<0.01). Compared with the model group, the cell viability in each TSPSP-containing serum group was significantly increased (P<0.01). Compared with the 10% TSPSP-containing serum group, the cell viability in the ML385 group decreased to approximately 70% (P<0.01). Compared with the blank group, the model group showed significantly increased contents of MDA, Fe2+, and ROS, decreased GSH expression (P<0.01), significantly reduced cell migration rate (P<0.01), and increased protein and mRNA expression levels of KEAP1 and FoxO3 (P<0.01), while decreased protein and mRNA expression levels of Nrf2, GPX4, and SOD (P<0.01). Compared with the model group, each TSPSP-containing serum group showed significantly decreased contents of MDA, Fe²⁺, and ROS, increased GSH expression (P<0.01), significantly increased migration rate (P<0.01), significantly decreased protein and mRNA expression levels of KEAP1 and FoxO3 (P<0.05, P<0.01), and significantly increased protein and mRNA expression levels of Nrf2, GPX4, and SOD (P<0.05, P<0.01). Compared with the 10% TSPSP-containing serum group, the ML385 group showed reversed trends in all indicators (P<0.05, P<0.01). ConclusionTSPSP can inhibit H2O2-induced oxidative stress injury of trophoblast cells, and its mechanism of action may be related to the drug activating the KEAP1/Nrf2/FoxO3 signaling pathway.
3.Mechanism of Taishan Panshisan in Inhibiting Oxidative Stress Injury of Trophoblast Cells by Regulating KEAP1/Nrf2/FoxO3 Signaling Pathway
Yangyang DUAN ; Xianglun JI ; Jiahong CHEN ; Jinghang YANG ; Xinyu XIAO ; Shutao CHEN ; Chaorui LIN ; Fan LIN ; Shu JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):12-22
ObjectiveTo explore the effect and mechanism of Taishan Panshi powder (TSPSP) on inhibiting oxidative stress injury in human chorionic trophoblast cells (HTR-8/SVneo), and to uelucidate the underlying mechanism of TSPSP in the treatment of spontaneous abortion (SA). MethodsGene differential analysis of SA was performed using the Gene Expression Omnibus (GEO) database and correlated with oxidative stress. Network pharmacology was employed to screen the active components of TSPSP, and a "Chinese medicine-component-target-disease" network was constructed to predict the mechanism of action of TSPSP. For in vitro validation experiments, HTR-8/SVneo cells were divided into blank group, model group, TSPSP-containing serum 2.5%, 5%, 10% groups, and nuclear factor E2-related factor 2 (Nrf2) inhibitor group (ML385, 30 μmol·L-1). Except for the blank group, other groups were stimulated with 150 μmol·L-1 H2O2 for 3 h to establish a cell oxidative stress injury model. After successful modeling, the blank group and model group were given 10% blank serum, each TSPSP-containing serum group was treated with the corresponding concentration of drug-containing serum, and the Nrf2 inhibitor group was additionally given 30 μmol·L-1 ML385 on the basis of 10% TSPSP-containing serum. All groups of cells were continuously cultured under the above conditions for 24 h, and then samples were collected for subsequent detection. Cell viability in each group was detected by CCK-8 assay. Cell migration rate was detected by scratch test. The contents of malondialdehyde (MDA), Fe2+, and Glutathione (GSH) were detected by enzyme-linked immunosorbent assay (ELISA). Intracellular reactive oxygen species (ROS) level was detected by a fluorescent probe (DCF-DA). The protein and mRNA expression levels of Kelch-like ECH-associated protein 1 (KEAP1), Nrf2, and forkhead box protein O3 (FoxO3) in cells were detected by immunofluorescence (IF) and real-time quantitative polymerase chain reaction (Real-time PCR). The protein expression levels of KEAP1, Nrf2, FoxO3, Glutathione peroxidase 4 (GPX4), and superoxide dismutase (SOD) in cells were detected by Western blot. ResultsThe GSE76862 and GSE22490 datasets were obtained from the GEO database. Differential gene analyses showed that the KEAP1, Nrf2, and FoxO3 genes were all associated with the disease. After matching with the oxidative stress pathway, nine significantly differential pathways were identified (P<0.05), among which three contained the target genes Nrf2 and FoxO3. A total of 246 active ingredient targets of TSPSP and 2 804 SA-related targets were obtained through network pharmacology, and 154 potential action targets were obtained after taking the intersection. Topological analysis showed that targets such as KEAP1 and Nrf2 exhibited high degree values. GO and KEGG enrichment analyses indicated that the intersection targets were mainly involved in oxidative stress response, FOXO and MAPK signaling pathways, etc. In in vitro experiments, compared with the blank group, the cell viability in the model group was significantly decreased (P<0.01). Compared with the model group, the cell viability in each TSPSP-containing serum group was significantly increased (P<0.01). Compared with the 10% TSPSP-containing serum group, the cell viability in the ML385 group decreased to approximately 70% (P<0.01). Compared with the blank group, the model group showed significantly increased contents of MDA, Fe2+, and ROS, decreased GSH expression (P<0.01), significantly reduced cell migration rate (P<0.01), and increased protein and mRNA expression levels of KEAP1 and FoxO3 (P<0.01), while decreased protein and mRNA expression levels of Nrf2, GPX4, and SOD (P<0.01). Compared with the model group, each TSPSP-containing serum group showed significantly decreased contents of MDA, Fe²⁺, and ROS, increased GSH expression (P<0.01), significantly increased migration rate (P<0.01), significantly decreased protein and mRNA expression levels of KEAP1 and FoxO3 (P<0.05, P<0.01), and significantly increased protein and mRNA expression levels of Nrf2, GPX4, and SOD (P<0.05, P<0.01). Compared with the 10% TSPSP-containing serum group, the ML385 group showed reversed trends in all indicators (P<0.05, P<0.01). ConclusionTSPSP can inhibit H2O2-induced oxidative stress injury of trophoblast cells, and its mechanism of action may be related to the drug activating the KEAP1/Nrf2/FoxO3 signaling pathway.
4.Exploring the Correlation between Pyroptosis and Immune Microenvironment Dysregulation in Rheumatoid Arthritis from the Perspective of "Ying Decline and Wei Attack"
Yancun LI ; Shu ZHU ; Yuhan WANG ; Yuan QU ; Yuan LIU ; Ping JIANG
Journal of Traditional Chinese Medicine 2025;66(5):464-467
As a complex autoimmune disease, rheumatoid arthritis (RA) involves immune microenvironment dysregulation resulting from excessive activation of pyroptosis, which is a crucial factor in disease progression. Based on the theory of ying-wei in traditional Chinese medicine, "ying decline and wei attack" is considered the fundamental pathogenesis of RA. Pyroptosis serves as a microscopic manifestation of this concept, suggesting a potential correlation between "ying decline and wei attack" and pyroptosis nd immune microenvironment dysregulation in RA. Accordingly, treatment principles based on this theory are proposed: in the early stage of the disease, boosting wei to consolidate the exterior, and regulating ying to dispel pathogens; in the middle and late stages, harmonizing ying to remove stagnation, and nourishing its transformational source.
5.Therapeutic effect of anti-PD-L1&CXCR4 bispecific nanobody combined with gemcitabine in synergy with PBMC on pancreatic cancer treatment
Hai HU ; Shu-yi XU ; Yue-jiang ZHENG ; Jian-wei ZHU ; Ming-yuan WU
Acta Pharmaceutica Sinica 2025;60(2):388-396
Pancreatic cancer is a kind of highly malignant tumor with a low survival rate and poor prognosis. The effectiveness of gemcitabine as a first-line chemotherapy drug is limited; however, it can activate dendritic cells and improve antigen presentation which increase the sensitivity of tumor cell to immunotherapy. Although immunotherapy has made some advancements in cancer treatment, the therapeutic benefit of programmed cell death receptor 1/programmed death receptor-ligand 1 (PD-1/PD-L1) blockade therapy remains relatively low. The chemokine C-X-C chemokine ligand 12 (CXCL12) contributes to an immunosuppressive tumor microenvironment by recruiting immunosuppressive cells. The receptor C-X-C motif chemokine receptor 4 (CXCR4), highly expressed in various tumors including pancreatic cancer, plays a crucial role in tumor development and progression. In this study, the anti-tumor immune response of human peripheral blood mononuclear cell (hPBMC) was enhanced using the combination of BsNb PX4 (anti-PD-L1&CXCR4 bispecific nanobody) and gemcitabine. In a co-culture system of gemcitabine-pretreated hPBMCs with tumor cells, the BsNb PX4 synergized gemcitabine to improve the cytotoxic activity of hPBMCs against tumor cells. Flow cytometry analysis confirmed increased ratio of CD8+ to CD4+ T cells in combination treatment. In NOD/SCID mice bearing pancreatic cancer, the combination treatment exhibited more infiltration of CD8+ T cells into tumor tissues, contributing to an effective anti-tumor response. This study presents potential new therapies for the treatment of pancreatic cancer. Ethical approval was obtained for collection of hPBMC samples from the Local Ethics Committee of Shanghai Jiao Tong University. All animal experiments were approved by the Animal Ethic Committee of Shanghai Jiao Tong University (authorizing number: A2024246).
6.The effect of rutaecarpine on improving fatty liver and osteoporosis in MAFLD mice
Yu-hao ZHANG ; Yi-ning LI ; Xin-hai JIANG ; Wei-zhi WANG ; Shun-wang LI ; Ren SHENG ; Li-juan LEI ; Yu-yan ZHANG ; Jing-rui WANG ; Xin-wei WEI ; Yan-ni XU ; Yan LIN ; Lin TANG ; Shu-yi SI
Acta Pharmaceutica Sinica 2025;60(1):141-149
Metabolic-associated fatty liver disease (MAFLD) and osteoporosis (OP) are two very common metabolic diseases. A growing body of experimental evidence supports a pathophysiological link between MAFLD and OP. MAFLD is often associated with the development of OP. Rutaecarpine (RUT) is one of the main active components of Chinese medicine Euodiae Fructus. Our previous studies have demonstrated that RUT has lipid-lowering, anti-inflammatory and anti-atherosclerotic effects, and can improve the OP of rats. However, whether RUT can improve both fatty liver and OP symptoms of MAFLD mice at the same time remains to be investigated. In this study, we used C57BL/6 mice fed a high-fat diet (HFD) for 4 months to construct a MAFLD model, and gave the mice a low dose (5 mg·kg-1) and a high dose (15 mg·kg-1) of RUT by gavage for 4 weeks. The effects of RUT on liver steatosis and bone metabolism were then evaluated at the end of the experiment [this experiment was approved by the Experimental Animal Ethics Committee of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences (approval number: IMB-20190124D303)]. The results showed that RUT treatment significantly reduced hepatic steatosis and lipid accumulation, and significantly reduced bone loss and promoted bone formation. In summary, this study shows that RUT has an effect of improving fatty liver and OP in MAFLD mice.
7.Clinical manifestations and risk factor profiling of particle therapy-induced acute radiation dermatitis in patients with nasopharyngeal carcinoma
Yuan-yuan WANG ; Yan HU ; Shu-qi YUAN ; Feng JING ; Ling-yun JIANG
Fudan University Journal of Medical Sciences 2025;52(3):372-384
Objective To investigate the longitudinal clinical manifestations of acute radiation dermatitis(ARD)induced by particle therapy in nasopharyngeal carcinoma patients and to analyze associated risk factors.Methods A longitudinal study design was employed,encompassing nasopharyngeal carcinoma patients who underwent particle therapy at the Shanghai Proton and Heavy Ion Center from Mar to Sept 2023.Participants were assessed weekly(1-12 weeks)following the commencement of radiotherapy and at baseline,prior to the start of treatment.Data collection included the patient demographic questionnaire,the Radiation Therapy Oncology Group(RTOG)grading criteria for acute radiation injury,and the radiation-induced skin reaction assessment scale(RISRAS).Photographic documentation was utilized to capture changes in the irradiated skin area.The enrolled patients with nasopharyngeal carcinoma were grouped according to different particle therapy regimens.Survival data were analyzed by Log-rank and Cox regression methods,while a linear mixed-effects model was applied to repeated measures data.Results A total of 119 patients with nasopharyngeal carcinoma were enrolled.The overall incidence of ARD was 89.1%,which included 39.5%of grade 1,45.4%of grade 2 and 4.2%of grade 3.With the extension of time,the severity of ARD peaked at week 7(RISRAS=13.26±4.512),then began to decrease,ultimately reaching a lower level.Multiple Cox proportional hazards models were constructed,revealing that proton/heavy ion radiotherapy was associated with a lower risk of ARD compared to photon/proton plus heavy ion radiotherapy(HR=0.19,95%CI:0.04-0.92,P=0.039).Additionally,concurrent cisplatin/nedaplatin chemotherapy was identified as a risk factor for the development of ARD.Least squares(LS)mean differences were calculated at different time points,and the results demonstrated that the RISRAS scores of the photon/proton plus heavy ion group were consistently and significantly higher from week 5 to week 7 compared with the proton plus heavy ion group,and despite a decrease by week 8,statistical differences remained(week 5:LS mean difference 3.35,95%CI:0.94-5.76,P=0.007;week 6:LS mean difference 5.23,95%CI:2.20-8.26,P=0.001;week 7:LS mean difference 7.13,95%CI:3.67-10.59,P<0.001;week 8:LS mean difference 4.04,95%CI:0.74-7.34,P=0.017).Patients undergoing concurrent cisplatin chemotherapy had higher RISRAS scores from week 7 to week 8 of radiotherapy compared with those not receiving chemotherapy[week 7:adjusted mean difference(Adj.MD)4.20,95%CI:1.96-6.57,P=0.006;week 8:Adj.MD 2.79,95%CI 0.55-5.03,P=0.015].Similarly,patients on concurrent nedaplatin chemotherapy had higher RISRAS scores from weeks 6 to 7 compared with those not on chemotherapy(week 6:Adj.MD 3.75,95%CI:1.54-5.96,P=0.001;week 7:Adj.MD 4.41,95%CI:2.12-6.70,P<0.001).Skin care measures during treatment and accompanying symptoms such as weight loss were not statistically associated with the development of ARD.Conclusion Proton/heavy ion radiotherapy has a lower risk of ARD,while concurrent cisplatin/nedaplatin chemotherapy is a risk factor for ARD.
8.Patient experience of robot-assisted percutaneous kyphoplasty with bone cement injection into injured vertebrae under local anesthesia
Jiahong LI ; Shu LIN ; Liuyi TANG ; Jiang HU ; Yang YU ; Wei ZHANG
Chinese Journal of Tissue Engineering Research 2025;29(22):4647-4652
BACKGROUND:Percutaneous kyphoplasty assisted by C-arm under local anesthesia requires continuous adjustment of the puncture direction under multiple C-arm fluoroscopy.The establishment time of the working channel is longer,and the intraoperative pain stimulation of patients is larger.With the help of the robot,the puncture can be successfully performed at one time,which can significantly improve the experience of patients and reduce the risk of bone cement leakage.OBJECTIVE:To compare the patient experience and other outcomes of percutaneous kyphoplasty using robot-assisted and conventional C-arm fluoroscopy under local anesthesia.METHODS:A total of 241 patients with single-stage osteoporotic vertebral compression fracture were selected from Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital,University of Electronic Science and Technology of China).132 patients underwent robot-assisted percutaneous kyphoplasty under local anesthesia(robot-assisted group).109 cases of conventional C-arm assisted percutaneous kyphoplasty under local anesthesia(conventional fluoroscopy group).Patients'intraoperative experience evaluation,bone cement injection amount,operation time,working channel establishment time,hospitalization cost and complications were recorded.Puncture deviation and bone cement leakage were evaluated by imaging on the first day after surgery.RESULTS AND CONCLUSION:(1)The intraoperative experience of 59 patients in the robot-assisted group was rated as"very good",43 as"good",16 as"average",10 as"poor",and 4 as"very poor,"while that of 30 patients in the conventional fluoroscopy group was rated as"very good",44 cases were"good",21"average",9"poor",and 5"very poor."There was a significant difference between the two groups in intraoperative experience evaluation(Z=-2.546,P=0.011).Intraoperative pain visual analog scale score was lower in the robot-assisted group than that in the conventional fluoroscopy group(t=-9.513,P=0.000).Totally 84 patients in the robot-assisted group and 47 patients in the conventional fluoroscopy group were willing to undergo percutaneous kyphoplasty again when necessary,and there was a significant difference between the two groups(Z=-2.730,P=0.006).(2)The operation time and hospitalization cost of the robot-assisted group were more than those of the conventional fluoroscopy group(t=2.860,P=0.003;t=36.522,P=0.000).The working channel establishment time of robot-assisted group was shorter than that of conventional fluoroscopy group(t=-27.066,P=0.000).The puncture deviation of robot-assisted group was better than that of conventional fluoroscopy group(Z=-3.656,P=0.000).The cement leakage of robot-assisted group was lower than that of conventional fluoroscopy group(χ2=7.284,P=0.007).(3)It is concluded that under local anesthesia,patients with robot-assisted percutaneous kyphoplasty have good surgical experience,with advantages of accurate puncture,short time to establish working channel,and low leakage rate of bone cement.
9.Clinical Characteristics of Adult Acute Myeloid Leukemia Patients with NUP98::HOXA9 Fusion Gene.
Hai-Xia CAO ; Ya-Min WU ; Shu-Juan WANG ; Zhi-Dan CHEN ; Jing-Han HU ; Xiao-Qian GENG ; Fang WANG ; Ling SUN ; Zhong-Xing JIANG ; Zhi-Lei BIAN
Journal of Experimental Hematology 2025;33(5):1241-1247
OBJECTIVE:
To investigate the clinical characteristics, treatment and prognosis of adult AML patients with NUP98::HOXA9 fusion gene.
METHODS:
From May 2017 to October 2023, among 2 113 AML patients who visited the Hematology Department of our hospital, patients with NUP98 rearrangements were screened. The clinical characteristics, chromosome karyotypes, immunophenotypes, gene mutations, treatment efficacy and prognosis of the patients with NUP98::HOXA9 positive were analyzed.
RESULTS:
Among the 2 113 AML patients, there were 18 cases with NUP98 rearrangement, including 14 NUP98::HOXA9 positive cases, with a detection rate of 0.66% (14/2 113). The median age of the NUP98::HOXA9 positive patients was 42.5 (23-64) years old. The most common chromosome karyotype was t(7; 11)(p15; p15). The immunophenotypes of all patients expressed CD13, CD33, CD117 and CD38, and most patients expressed CD34 and cMPO, while only a few expressed HLA-DR. Second-generation sequencing (NGS) was performed to detect genetic mutations associated with leukemia in all 14 patients, and the genes exhibiting a high frequency of mutation were WT1 (10/14), TET2 (7/14), and FLT3-ITD (6/14). Additionally, mutations were also observed in KRAS/NRAS, IDH1, and KIT. Of the 13 patients who received treatment, 9 achieved complete remission (CR), and all 3 patients who received azacytidine(AZA)+ venetoclax (VEN) regimen achieved CR after the first course of treatment. Within this cohort, 6 patients were classified as relapsed/refractory (6/13). 4 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), of which two achieved long-term survival. The median follow-up time was 12 (2.1-65.0) months, while the median overall survival (OS) and relapse-free survival (RFS) were recorded as 11.4 months and 9.6 months, respectively.
CONCLUSION
The most common type of NUP98 rearrangement in adults AML patients is NUP98::HOXA9 , which is often accompanied by somatic mutations in WT1, TET2, and FLT3-ITD. These patients are prone to relapse, have short survival time, and generally face poor prognoses. Hopefully, utilization of the AZA+VEN regimen is anticipated to enhance the rate of induced remission in the patients, and some patients may prolong their survival through allo-HSCT. However, more effective treatment methods are still needed to improve the overall prognosis of these patients.
Humans
;
Adult
;
Leukemia, Myeloid, Acute/genetics*
;
Middle Aged
;
Prognosis
;
Nuclear Pore Complex Proteins/genetics*
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Oncogene Proteins, Fusion/genetics*
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Mutation
;
Male
;
Female
;
Young Adult
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Homeodomain Proteins/genetics*
10.Pseudolaric Acid B Alleviates Non-alcoholic Fatty Liver Disease by Targeting PPARα to Regulate Lipid Metabolism and Promote Mitochondrial Biogenesis.
Shu-Yan LIU ; Xiao-Wei ZHANG ; Gai GAO ; Chang-Xin LIU ; Hui CHEN ; Zhong-Xue FU ; Jiang-Yan XU ; Zhen-Zhen WANG ; Zhen-Qiang ZHANG ; Zhi-Shen XIE
Chinese journal of integrative medicine 2025;31(10):877-888
OBJECTIVE:
To investigate the therapeutic potential of pseudolaric acid B (PAB) on non-alcoholic fatty liver disease (NAFLD) and its underlying molecular mechanism in vitro and in vivo.
METHODS:
Eight-week-old male C57BL/6J mice (n=32) were fed either a normal chow diet (NCD) or a high-fat diet (HFD) for 8 weeks. The HFD mice were divided into 3 groups according to a simple random method, including HFD, PAB low-dose [10 mg/(kg·d), PAB-L], and PAB high-dose [20 mg/(kg·d), PAB-H] groups. After 8 weeks of treatment, glucose metabolism and insulin resistance were assessed by oral glucose tolerance test (OGTT) and insulin tolerance test (ITT). Biochemical assays were used to measure the serum and cellular levels of total cholesterol (TC), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). White adipose tissue (WAT), brown adipose tissue (BAT) and liver tissue were subjected to hematoxylin and eosin (H&E) staining or Oil Red O staining to observe the alterations in adipose tissue and liver injury. PharmMapper and DisGeNet were used to predict the NAFLD-related PAB targets. Peroxisome proliferator-activated receptor alpha (PPARα) pathway involvement was suggested by Kyoto Encyclopedia of Genes and Genomes (KEGG) and search tool Retrieval of Interacting Genes (STRING) analyses. Luciferase reporter assay, cellular thermal shift assay (CETSA), and drug affinity responsive target stability assay (DARTS) were conducted to confirm direct binding of PAB with PPARα. Molecular dynamics simulations were applied to further validate target engagement. RT-qPCR and Western blot were performed to assess the downstream genes and proteins expression, and validated by PPARα inhibitor MK886.
RESULTS:
PAB significantly reduced serum TC, TG, LDL-C, AST, and ALT levels, and increased HDL-C level in HFD mice (P<0.01). Target prediction analysis indicated a significant correlation between PAB and PPARα pathway. PAB direct target binding with PPARα was confirmed through luciferase reporter assay, CETSA, and DARTS (P<0.05 or P<0.01). The target engagement between PAB and PPARα protein was further confirmed by molecular dynamics simulations and the top 3 amino acid residues, LEU321, MET355, and PHE273 showed the most significant changes in mutational energy. Subsequently, PAB upregulated the genes expressions involved in lipid metabolism and mitochondrial biogenesis downstream of PPARα (P<0.05 or P<0.01). Significantly, the PPARα inhibitor MK886 effectively reversed the lipid-lowering and PPARα activation properties of PAB (P<0.05 or P<0.01).
CONCLUSION
PAB mitigates lipid accumulation, ameliorates liver damage, and improves mitochondrial biogenesis by binding with PPARα, thus presenting a potential candidate for pharmaceutical development in the treatment of NAFLD.
Animals
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PPAR alpha/metabolism*
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Non-alcoholic Fatty Liver Disease/pathology*
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Male
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Mice, Inbred C57BL
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Lipid Metabolism/drug effects*
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Diterpenes/therapeutic use*
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Organelle Biogenesis
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Diet, High-Fat
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Humans
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Mice
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Liver/metabolism*
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Insulin Resistance
;
Mitochondria/metabolism*
;
Molecular Docking Simulation

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