1.Compilation Instruction for Expert Consensus on Clinical Application of Binghuang Fule Ointment
Xin CUI ; Yanping BAI ; Ping SONG ; Yuanyuan LI ; Yanming XIE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):267-273
Compilation instruction for Expert Consensus on Clinical Application of Binghuang Fule Ointment elaborates on the formulation methods and evidence-based basis of the consensus. To address the problems of insufficient evidence on efficacy, vague indications, and a lack of uniform standard for Binghuang Fule Ointment in clinical application, 34 experts from 29 medical institutions across China participated in the compilation under the lead of the Institute of Basic Research in Clinical Medicine and Xiyuan Hospital, China Academy of Chinese Medical Sciences, as well as China-Japan Friendship Hospital. The compilation strictly adhered to the WHO Handbook for Guideline Development (GB/T 1.1—2020), and the Guidance of Instructions for Compiling Expert Consensus on Clinical Practice of Chinese Patent Medicine. Through multidisciplinary collaboration, the compilation was completed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) evidence grading system. The detailed workflow included various key links. In clinical question construction, 15 items were screened by the nominal group method. In evidence retrieval, Chinese and English databases, along with gray literature, were covered to obtain 116 clinical and 33 pharmaceutical studies. In safety assessment, drug monitoring data and clinical research results were integrated, clarifying local adverse skin reactions and contraindications. Ultimately, 8 recommendations were formed by the GRADE grid method, while 16 consensus suggestions were reached via the majority vote rule. The results showed that the Binghuang Fule Ointment was applicable to eczema, psoriasis, neurodermatitis, tinea pedis, and other diseases. The Consensus also elucidated the syndrome differentiation points, usage and dosage for different diseases (such as adjustment of course and application frequency), as well as the indications of combination medication. Additionally, safety assessment suggested that the Ointment should be used with caution in individuals with skin ulceration or hypersensitivity. To ensure methodological rigor, the compilation process went through three rounds of internal and external expert reviews, while a comprehensive analysis was conducted by literature analysis, the Delphi method, and other methods. This compilation instruction provided methodological support for the clinical transformation of the Consensus through key links, including project initiation, international registration, informed consent, conflict-of-interest statements, evidence evaluation, and popularization. The Consensus will be continuously improved through a dynamic revision mechanism in the future.
2.Compilation Instruction for Expert Consensus on Clinical Application of Binghuang Fule Ointment
Xin CUI ; Yanping BAI ; Ping SONG ; Yuanyuan LI ; Yanming XIE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):267-273
Compilation instruction for Expert Consensus on Clinical Application of Binghuang Fule Ointment elaborates on the formulation methods and evidence-based basis of the consensus. To address the problems of insufficient evidence on efficacy, vague indications, and a lack of uniform standard for Binghuang Fule Ointment in clinical application, 34 experts from 29 medical institutions across China participated in the compilation under the lead of the Institute of Basic Research in Clinical Medicine and Xiyuan Hospital, China Academy of Chinese Medical Sciences, as well as China-Japan Friendship Hospital. The compilation strictly adhered to the WHO Handbook for Guideline Development (GB/T 1.1—2020), and the Guidance of Instructions for Compiling Expert Consensus on Clinical Practice of Chinese Patent Medicine. Through multidisciplinary collaboration, the compilation was completed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) evidence grading system. The detailed workflow included various key links. In clinical question construction, 15 items were screened by the nominal group method. In evidence retrieval, Chinese and English databases, along with gray literature, were covered to obtain 116 clinical and 33 pharmaceutical studies. In safety assessment, drug monitoring data and clinical research results were integrated, clarifying local adverse skin reactions and contraindications. Ultimately, 8 recommendations were formed by the GRADE grid method, while 16 consensus suggestions were reached via the majority vote rule. The results showed that the Binghuang Fule Ointment was applicable to eczema, psoriasis, neurodermatitis, tinea pedis, and other diseases. The Consensus also elucidated the syndrome differentiation points, usage and dosage for different diseases (such as adjustment of course and application frequency), as well as the indications of combination medication. Additionally, safety assessment suggested that the Ointment should be used with caution in individuals with skin ulceration or hypersensitivity. To ensure methodological rigor, the compilation process went through three rounds of internal and external expert reviews, while a comprehensive analysis was conducted by literature analysis, the Delphi method, and other methods. This compilation instruction provided methodological support for the clinical transformation of the Consensus through key links, including project initiation, international registration, informed consent, conflict-of-interest statements, evidence evaluation, and popularization. The Consensus will be continuously improved through a dynamic revision mechanism in the future.
3.Expert Consensus on Clinical Application of SkinPro Ointment
Xin CUI ; Ping SONG ; Yuanyuan LI ; Yanping BAI ; Yanming XIE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):163-170
SkinPro Ointment is an emulsion-based preparation derived from a traditional Tibetan medical empirical formula and developed using modern pharmaceutical technology. It is an exclusive patented product of Tibet Hairong Tangguo Pharmaceutical Co. Ltd. and has been listed as a National Protected Traditional Chinese Medicine Variety, the Pharmacopoeia of the People's Republic of China, and classified as a Category B product in the National Basic Medical Insurance Catalog. The ointment possesses the functions of clearing heat and drying dampness, activating blood circulation and dispelling wind, relieving itching and reducing inflammation. Clinically, it is used for skin pruritus caused by dampness-heat accumulation or blood-heat with wind-dryness, as well as pruritic skin diseases such as neurodermatitis, eczema, tinea pedis, and psoriasis. To clarify the standards for its clinical application and promote rational drug use, a consensus working group comprising 34 national experts in dermatology, evidence-based medicine, and pharmacy was established. Through expert interviews, the nominal group technique, and questionnaire surveys, 15 clinical issues were identified. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence grading system was employed to assess the quality of evidence, leading to the formulation of the Expert Consensus on the Clinical Application of SkinPro Ointment. This consensus specifies that the intended users are physicians and pharmacists in medical institutions at all levels. It standardizes the clinical application of the ointment, including syndrome characteristics, dosage and course of treatment, combination therapy, precautions, and contraindications. Recommendations and consensus suggestions were formed addressing the 15 clinical issues, covering the following key areas: ①Indications and TCM syndromes: In TCM, the ointment mainly treats conditions such as "damp sores" (Shichuang), "white scaling" (Baibi), "collar sores" (Shelingchuang), and "damp foot Qi" (Jiaoshiqi), corresponding to eczema, psoriasis, neurodermatitis, and tinea pedis in Western medicine. The relevant TCM syndromes are identified as dampness-heat accumulation or blood-heat with wind-dryness. ②Usage and dosage: For external use, apply to the affected area 3 times daily. The dosage should follow the fingertip unit (FTU) principle. A treatment course of 1-2 weeks is recommended for mild to moderate cases; for serious cases, the course should be followed as prescribed by a physician. ③Combined therapy: The ointment can be used as monotherapy for mild cases. For moderate to severe cases, combination therapy is recommended, with reference to relevant clinical guidelines. ④Safety: Common adverse reactions include skin rashes, pruritus, and erythema. The ointment is contraindicated in patients with broken skin or obvious exudation at the affected area, as well as in patients with known hypersensitivity to any of its components. Contact with sensitive areas such as the eyes and oral mucosa should be avoided. Modern research shows that the ointment also has potential efficacy in other dermatological conditions, such as adult atopic dermatitis, tinea cruris, exfoliative keratolysis, acne vulgaris, and Malassezia folliculitis. This consensus provides a scientific basis for promoting the rational clinical use of SkinPro Ointment, improving its therapeutic efficacy, and reducing medication risks. Future updates will be dynamically revised according to emerging clinical issues and new evidence.
4.Effect of different exercise interventions on patients with metabolic dysfunction-associated fatty liver disease: A systematic review and network Meta-analysis
Guodong MA ; Zhuojing SUN ; Song HU ; Zijun YE ; Mingchen MA ; Fei CUI ; Jiaju ZHU
Journal of Clinical Hepatology 2026;42(2):326-344
ObjectiveTo investigate the effect of different exercise interventions on metabolism and liver parameters in patients with metabolic dysfunction-associated fatty liver disease (MAFLD), and to provide evidence-based recommendations for clinical exercise rehabilitation. MethodsThis study was conducted according to the PRISMA guidelines, and the protocol was registered on the PROSPERO platform, with a registration number of CRD42025641717. PubMed, Web of Science, Scopus, Wiley Online Library, CNKI, Wanfang Data, and VIP were searched for related articles published up to September 2024. The Cochrane tool for assessing risk of bias was used to assess the quality of articles, and Stata MP 17.0 was used to perform the network meta-analysis. ResultsA total of 57 articles were included, involving 2 648 patients. The results showed that aerobic exercise combined with resistance exercise had the best effect in improving body mass index (mean difference [WMD]=-0.97, 95% confidence interval [CI]: -1.66 to -0.28], P<0.05, surface under the cumulative ranking curve [SUCRA]=85.4) and triglycerides (WMD=-29.6, 95%CI: -46.66 to 12.54, P<0.05, SUCRA=87.3); resistance exercise was the optimal intervention method for improving total cholesterol (WMD=-15.99, 95%CI: -24.19 to -7.79, P<0.05, SUCRA=79.9) and glutamine transaminase (WMD=-8.08, 95%CI: -12.13 to -4.02, P<0.05, SUCRA=87.3); low-intensity aerobic exercise had the best effect in improving aspartate aminotransferase (WMD=-4.3, 95%CI: -8.45 to -0.15, P<0.05, SUCRA=73.5), gamma-glutamyl transpeptidase (GGT) (WMD=-3.26, 95%CI: -7.79 to 1.27, P>0.05, SUCRA=82.3), and glycated hemoglobin (HbA1c) (WMD=-0.6, 95%CI: -2.02 to 0.82, P>0.05, SUCRA=78.8); moderate-intensity aerobic exercise was the optimal intervention modality to improve Homeostasis Model Assessment of Insulin Resistance (WMD=-0.92, 95%CI: -1.51 to -0.33, P<0.05, SUCRA=69.4). It should be noted that there were no significant differences in HbA1c and GGT across different exercise interventions (all P>0.05), suggesting that there was currently no sufficient statistical evidence to support that exercise could improve these two indicators. ConclusionBased on the comprehensive league table and cumulative probability ranking, aerobic exercise combined with resistance exercise, resistance exercise, and low- and moderate-intensity aerobic exercise may be the best exercise modality for improving key indicators in MAFLD patients, and targeted exercise modalities should be selected for intervention against different indicators; however, due to limitations of the original studies, further studies are needed for validation and exploration.
5.Influence of pterygium thickness and area on corneal refractive status
Xiaodong CHENG ; Jie WANG ; Song GAO ; Yanhong LU ; Yanbo MA ; Xinming CUI ; Xihui CHEN
International Eye Science 2026;26(1):152-156
AIM: To investigate the influence of pterygium thickness and area on corneal refractive status.METHODS: Prospective longitudinal study. A total of 60 cases(60 eyes)of pterygium patients admitted to our hospital from January 2024 to September 2024 were randomly selected. All patients underwent pterygium excision combined with pedicle conjunctival flap transplantation for treatment. Optical coherence tomography(OCT)was used to measure the preoperative thickness of patient's pterygium, and a digital slit lamp microscope was used to measure the area of pterygium. The corneal refractive status(degree of corneal astigmatism and average curvature)and changes in uncorrected visual acuity of patients before surgery, 1 d, 1, and 3 mo after surgery were compared. The relationship between preoperative thickness and area of pterygium in patients and corneal refractive status indicators at different postoperative time points were analyzed, and Logistic regression was used to analyze the impact of pterygium thickness and area on postoperative visual improvement in patients.RESULTS: All patients completed follow-up after surgery for 3 mo. At 3 mo after surgery, visual acuity improved in 21 eyes(35%). The results of bivariate Pearson correlation analysis showed that the thickness and area of pterygium positively correlated with the degree of corneal astigmatism and uncorrected visual acuity before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05), and negatively correlated with the average corneal curvature before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05). Logistic regression analysis showed that the thickness and area of pterygium before surgery, high degree of corneal astigmatism, and low uncorrected visual acuity(large LogMAR value)were all risk factors for poor postoperative visual improvement in patients(OR>1, P<0.05). The large average corneal curvature before surgery was a protective factor for poor postoperative visual improvement in patients(OR<1, P<0.05).CONCLUSION: The increase in thickness and area of pterygium can, to some extent, improve corneal astigmatism, reduce the average curvature of the cornea, and affect postoperative visual recovery.
6.Serological characteristics of individuals with hepatitis C virus/hepatitis B virus overlapping infection
Yanfei CUI ; Xia HUANG ; Chao ZHANG ; Yingjie JI ; Song QING ; Yuanjie FU ; Jing ZHANG ; Li LIU ; Yongqian CHENG
Journal of Clinical Hepatology 2026;42(1):74-79
ObjectiveTo investigate the status of overlapping hepatitis B virus (HBV) infection in patients with chronic hepatitis C virus (HCV) infection and the serological characteristics of such patients. MethodsA total of 8 637 patients with HCV infection who were hospitalized from January 1, 2010 to December 31, 2020 and had complete data of HBV serological markers were enrolled, and the composition ratio of patients with overlapping HBV serological markers was analyzed among the patients with HCV infection. The patients were divided into groups based on age and year of birth, and serological characteristics were analyzed, and the distribution of HBV-related serological characteristics were analyzed across different HCV genotypes. ResultsThe patients with HCV/HBV overlapping infection accounted for 5.85%, and the patients with previous HBV infection accounted for 48.10%; the patients with protective immunity against HBV accounted for 14.67%, while the patients with a lack of protective immunity against HBV accounted for 31.39%. The patients were divided into groups based on age: in the 0 — 17 years group, the patients with protective immunity against HBV accounted for 61.41% (304 patients); the 18 — 44 years group was mainly composed of patients with previous HBV infection (698 patients, 37.31%), the 45 — 59 years group was predominantly composed of patients with previous HBV infection (1 945 patients, 50.38%), and the ≥60 years group was also predominantly composed of patients with previous HBV infection (1 486 patients, 61.66%). The patients were divided into groups based on the year of birth: in the pre-1992 group, the patients with previous HBV infection accounted for 51.63% (4 112 patients); in the 1992 — 2005 group, the patients with protective immunity against HBV accounted for 54.72% (168 patients); in the post-2005 group, the patients with protective immunity against HBV accounted for 64.38% (235 patients). In this study, 6 301 patients underwent HCV genotype testing: the patients with genotype 1b accounted for the highest proportion of 51.71% (3 258 patients), followed by those with genotype 2a (1 769 patients, 28.07%), genotype 3b (63 patients, 1.00%), genotype 3a (10 patients, 0.16%), genotype 4 (21 patients, 0.33%), and genotype 6a (5 patients, 0.08%). ConclusionWith the implementation of hepatitis B planned vaccination program in China, there has been a significant reduction in the proportion of patients with previous HBV infection among the patients with HCV/HBV overlapping infection, but there is still a relatively high proportion of patients with a lack of protective immunity against HBV.
7.Quantitative Chemical Exchange Saturation Transfer MRI for Diagnosing Thyroid-Associated Ophthalmopathy Activity: A Prospective Feasibility Study
YunMeng WANG ; WeiYi ZHOU ; YuanYuan CUI ; JianKun DAI ; YuXin CHENG ; QingQing WEN ; TianYi XING ; HongBiao SUN ; Song JIANG ; MeiLing XU ; ZhenHuan WANG ; Yan SONG ; Tuo LI ; Yi XIAO
Korean Journal of Radiology 2026;27(2):161-173
Objective:
This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO).
Materials and Methods:
A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTRasym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTRasym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman’s correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO.
Results:
Patients with active TAO showed lower MTR values (P < 0.001) and higher MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively;all P < 0.001). MTR and MTRasym (1 ppm) were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTRasym (1 ppm) in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTRasym (1 ppm) significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001).
Conclusion
MTR and MTRasym (1 ppm) were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.
8.Differences in deltamethrin resistance and kdr gene mutation in Culex tritaeniorhynchus population in and outside the Yellow Sea wetland
Xiao-er ZHANG ; Zhi-ming WU ; Ye TIAN ; Qian CUI ; Yu-qian JI ; Huan WANG ; Shu-juan YANG ; Yi-chao ZHAO ; Yu WANG ; Hua-yu YIN ; Yu DING ; Guo-jin YAN ; Min-sen ZHAO ; Shou-gang ZHANG ; Bing-dong SONG ; Hong-na CHEN ; Jian GAO ; Wei-fang YANG ; Yu-fu ZHANG ; Hui LIU ; Hong-liang CHU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):101-107
Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.
9.Effect and mechanism of action of 2,5-dihydroxybenzoic acid on an in vitro cell model of metabolic dysfunction-associated fatty liver disease
Junjiao XU ; Tong LIU ; Sutong LIU ; Lihui ZHANG ; Yijia SONG ; Wenjing WU ; Beilei CUI ; Yajie GUAN ; Minghao LIU
Journal of Clinical Hepatology 2026;42(7):1586-1596
ObjectiveTo investigate the potential targets of 2,5-dihydroxybenzoic acid (2,5-DHBA) in the treatment of metabolic dysfunction-associated fatty liver disease (MAFLD) and the molecular mechanism by which it regulates the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsA network pharmacology analysis was performed at first, and related databases were used to obtain the common action targets of 2,5-DHBA and MAFLD, followed by molecular docking and pathway enrichment analysis to predict the potential biological processes and signaling pathways regulated by these targets. Then mouse normal hepatocytes AML-12 were used for cell experiments, and CCK-8 assay was used to determine the three optimal intervention concentrations of 2,5-DHBA. AML-12 cells were divided into control group, model group (cells cultured in a medium containing 2 mmol/L free fatty acid [FFA] to establish a cell model of MAFLD), and three 2,5-DHBA intervention groups (cells cultured with FFA and 2,5-DHBA at the three different concentrations of 1.25, 5, and 20 μmol/L, respectively). Oil red O staining was used to observe intracellular lipid accumulation; the fluorescent probe DCFH-DA was used to measure the level of intracellular reactive oxygen species (ROS); biochemical assays were used to measure the content of triglyceride (TG) and total cholesterol (TC); quantitative real-time PCR and Western Blot were used to measure the expression levels of related genes and proteins. A one-way analysis of variance was used for comparison between multiple groups, and the Tukey’s test was used for further comparison between two groups. ResultsA total of 32 common targets were obtained for 2,5-DHBA and MAFLD. Within a concentration range of 1.25 — 20 μmol/L, 2,5-DHBA treatment, starting from the concentration of 2.5 μmol/L, increased the viability of AML-12 cells in a dose-dependent manner. The minimum effective concentration of 1.25 μmol/L, the intermediate gradient concentration of 5 μmol/L, and the maximum safe concentration within the effective range of 20 μmol/L were selected for low-, middle-, and high-dose intervention, respectively. Compared with the model group, 2,5-DHBA intervention at concentrations of 1.25, 5, and 20 μmol/L could significantly reduce lipid droplet accumulation in cells (all P<0.05), and there were significant differences in TG and TC between the model group and the three intervention groups (all P<0.05). Compared with the control group, the model group had a significant increase in ROS fluorescence intensity (P<0.05), and compared with the model group, there was a dose-dependent reduction in intracellular ROS level after treatment with 5 μmol/L or 20 μmol/L 2,5-DHBA (P<0.05). Compared with the model group, 2,5-DHBA treatment at concentrations of 5 and 20 μmol/L significantly downregulated the mRNA expression levels of the lipogenic genes SREBf1 and FASN and upregulated the mRNA expression levels of the key antioxidant gene Nrf2 and its downstream target gene HO-1 (all P<0.05). Compared with the control group, the expression of p-PI3K/PI3K and p-Akt/Akt in the model group was significantly increased (all P<0.05). Compared with the model group, the protein expression levels of p-PI3K/PI3K and p-Akt/Akt were significantly decreased after 5 μmol/L 2,5-DHBA treatment (P<0.05). Compared with the control group, the expression levels of Nrf2 and HO-1 protein in the model group were significantly decreased (all P<0.05). The protein levels of Nrf2 and HO-1 were significantly increased after treatment with 1.25 μmol/L 2,5-DHBA (P<0.05). ConclusionNetwork pharmacology and cellular experiments confirm that 2,5-DHBA can alleviate lipid deposition and oxidative stress by regulating the PI3K/Akt signaling pathway, thereby exerting a therapeutic effect on MAFLD.
10.Ameliorative effect of Weiling decoction on metabolic associated fatty liver disease based on the gut-liver axis
Beilei CUI ; Yijia SONG ; Yajie GUAN ; Qizhen ZHANG ; Wenjing WU ; Junjiao XU ; Minghao LIU
China Pharmacy 2026;37(19):2501-2508
OBJECTIVE To investigate the ameliorative effect of Weiling decoction on metabolic associated fatty liver disease (MAFLD) based on the gut-liver axis theory.METHODS Male C57BL/6J mice were divided into a blank group ( n =9) and a modeling group ( n =47). The modeling group was fed a high-fat diet for 12 weeks to establish the MAFLD model. Forty-five modeled mice were randomly divided into a model group, a positive control group [metformin, 0.2 g/(kg·d)], and Weiling decoction low-, medium-, and high-dose groups [6.17, 12.34, 24.68 g/(kg·d), calculated as crude drug], with 9 mice in each group. Mice in each group received intragastric administration of the corresponding drug solution or normal saline once daily for 4 consecutive weeks. After the last administration, the body weight, liver weight, and liver index were compared among groups; the levels of liver function indicators (alanine transaminase, aspartate transaminase), lipid indicators (total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol), inflammatory indicators [tumor necrosis factor-α, interleukin-6 (IL-6), IL-1β], oxidative stress indicators (malondialdehyde, superoxide dismutase, glutathione peroxidase), and intestinal barrier indicators [lipopolysaccharide (LPS), diamine oxidase, D-lactic acid] were measured; hepatic pathological changes were observed; the expressions of tight junction proteins [zonula occludens-1 (ZO-1), occludin] in jejunal tissue and proteins related to lipid metabolism [sterol regulatory element-binding protein-1 (SREBP-1), fatty acid synthase (FASN), peroxisome proliferator-activated receptor α (PPARα)] and inflammatory pathways [Toll-like receptor 4 (TLR4), myeloid differentiation primary response protein 88 (MyD88), nuclear factor-κB p65 (NF-κB p65)] in liver tissue were detected; and changes in gut microbiota were analyzed.RESULTS Compared with the model group, hepatic steatosis and inflammatory injury were significantly alleviated in all Weiling decoction dose groups; body weight (at week 16), liver weight, liver index, and the levels of liver function indicators, lipid indicators, inflammation indicators, oxidative stress indicators, and intestinal barrier indicators were all generally improved ( P <0.05). The expressions of SREBP-1, FASN, TLR4, and MyD88 and the phosphorylation level of NF-κB p65 in liver tissue were generally decreased or downregulated ( P <0.05), while the expressions of ZO-1 and occludin in jejunal tissue and PPARα in liver tissue were generally increased or upregulated ( P <0.05). Compared with the model group, the Observed species, Chao1, and Ace indices of gut microbiota in the Weiling decoction high-dose group were significantly increased ( P <0.05), and the relative abundances of Verrucomicrobiota, Akkermansia , etc. were significantly increased, while those of Actinomycetota, Alistipes , Faecalibaculum , etc. were significantly decreased ( P <0.05).CONCLUSIONS Weiling decoction can ameliorate MAFLD, and its effect may be associated with regulating gut microbiota, repairing the intestinal mechanical barrier, reducing LPS translocation, thereby inhibiting the TLR4/MyD88/NF-κB inflammatory pathway, alleviating oxidative stress, and regulating SREBP-1/FASN and PPARα-mediated lipid metabolism.


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