1.Effect of lower extremity exoskeleton robots on balance and walking function of patients with post-stroke cerebellar ataxia
Yuan YUE ; Tong ZHANG ; Yuanmin LIU ; Ya'nan WANG
Chinese Journal of Rehabilitation Theory and Practice 2026;32(1):23-29
ObjectiveTo investigate the effect of lower extremity exoskeleton robots on balance and walking function of patients with post-stroke cerebellar ataxia. MethodsA total of 60 patients with post-stroke cerebellar ataxia in Beijing Bo'ai Hospital from October, 2022 to October, 2024 were selected, and randomly divided into control group (n = 30) and exoskeleton group (n = 30) randomly. Both groups were given conventional exercise training, including trunk control training, rotation axis training and Frenkel training; the exoskeleton group received additional training with lower limb exoskeleton robots, for four weeks. Before and after treatment, the Gait Watch three-dimensional gait analyzer and the Holden Functional Ambulation Classification (HFAC) were used to evaluate the walking spatiotemporal parameters such as walking speed, walking frequency and step length deviation, as well as the walking ability. Berg Balance Scale (BBS) and the International Cooperative Ataxia Rating Scale (ICARS) were used to access the balance and ataxia functions, respectively. ResultsAfter treatment, the walking speed, walking frequency and step length deviation of both groups improved (|t| > 19.676, P < 0.001), the BBS score improved (|t| > 29.032, P < 0.001), and the ICARS scores decreased (t > 33.192, P < 0.001) in both groups, and they were better in the exoskeleton group than in the control group (|t| > 2.284, P < 0.05). There was no significant difference in the improvement rate of HFAC between two groups (P > 0.05). ConclusionLower extremity exoskeleton robots can effectively improve the balance and walking function of patients with post-stroke cerebellar ataxia.
2.Exploration of a new model for the construction of medical institution formulation platforms from the perspective of industry-university-research collaborative innovation theory
Kana LIN ; Anle SHEN ; Yejian WANG ; Yanqiong WANG ; Hao LI ; Yanfang GUO ; Youjun WANG ; Xinyan SUN
China Pharmacy 2026;37(2):137-141
OBJECTIVE To explore a model for constructing a platform for medical institution formulation and provide insights for promoting their development. METHODS By systematically reviewing the development status and challenges of medical institution preparations in China, and based on the theory of industry-university-research collaborative innovation, the organizational structure, collaborative processes, and safeguard mechanisms of the platform were designed. RESULTS & CONCLUSIONS Medical institution formulations in China mainly faced challenges such as weak research and development (R&D) capacity, uneven quality standards, and blocked transformation pathways. This study established a full-chain, whole- industry collaborative innovation network covering the government, medical institutions, universities/research institutes, pharmaceutical enterprises, and the market, forming a new “government-industry-university-research-application” five-in-one platform model for medical institution formulations. By establishing mechanisms such as multi-entity collaborative cooperation, full- chain intellectual property management, contribution-based benefit distribution, staged risk-sharing, and third-party evaluation, the model clarified the responsibilities and collaborative pathways of all parties. The new model highlights the whole-process transformation of clinical experience-based prescriptions, enabling precise alignment between clinical needs and technological R&D, as well as between preparation achievements and industrial transformation. While breaking down the barriers of traditional platform construction, it effectively achieves optimal resource allocation and complementary advantages, addresses problems emerging in the development of medical institution preparations, and provides reference value for the formulation of relevant systems.
3.Expert consensus on neoadjuvant PD-1 inhibitors for locally advanced oral squamous cell carcinoma (2026)
LI Jinsong ; LIAO Guiqing ; LI Longjiang ; ZHANG Chenping ; SHANG Chenping ; ZHANG Jie ; ZHONG Laiping ; LIU Bing ; CHEN Gang ; WEI Jianhua ; JI Tong ; LI Chunjie ; LIN Lisong ; REN Guoxin ; LI Yi ; SHANG Wei ; HAN Bing ; JIANG Canhua ; ZHANG Sheng ; SONG Ming ; LIU Xuekui ; WANG Anxun ; LIU Shuguang ; CHEN Zhanhong ; WANG Youyuan ; LIN Zhaoyu ; LI Haigang ; DUAN Xiaohui ; YE Ling ; ZHENG Jun ; WANG Jun ; LV Xiaozhi ; ZHU Lijun ; CAO Haotian
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(2):105-118
Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.
4.Study on the in vivo effects of 5T magnetic resonance imaging on the dental pulp and periodontal ligament in young adults
QI Zhengnan ; CAO Yiting ; WANG Yiwei ; SONG Qingbo ; ZHANG Peirong ; SUN Shuntao ; WANG Dengbin ; TANG Zisheng
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(2):139-147
Objective:
To evaluate the performance of 5T magnetic resonance imaging (MRI) in visualizing dental pulp and periodontal ligament (PDL) tissues in vivo in the young adult population, thereby providing a basis for the application of high-field MRI technology in clinical oral examinations.
Methods:
The study was approved by the Ethics Committee of the hospital. A total of 15 healthy volunteers (413 permanent teeth altogether) were recruited and underwent full-mouth 5T MRI scans. Among them, six volunteers (168 permanent teeth) also received both 3T MRI and cone-beam computed tomography (CBCT) scans. Two dental specialists independently evaluated the imaging quality of the dental pulp and PDL on the images using a 5-point Likert scale and recorded the number of detectable root canals for each tooth. Inter-rater agreement was assessed using weighted kappa statistics and intraclass correlation coefficient (ICC). Non-parametric tests were employed to compare differences in imaging performance among different tissue structures, tooth positions, and imaging modalities.
Results:
5T MRI can achieve in vivo imaging for most dental pulp tissues and partial periodontal membrane structures. There was a high level of agreement between the two raters in their imaging scores for the dental pulp and PDL (dental pulp κ = 0.934, PDL κ = 0.737). The imaging scores for dental pulp were significantly higher than those for PDL (P < 0.001), and the scores for molar dental pulp were lower than those for premolars and anterior teeth. In the multimodal comparison involving six volunteers, the raters showed good consistency in scoring dental pulp and PDL imaging across 5T MRI, 3T MRI, and CBCT, as well as in root canal counts (5T MRI for dental pulp κ = 0.971, 3T MRI for dental pulp κ = 0.933, CBCT for dental pulp κ = 0.964; 5T MRI for PDL κ = 0.625, 3T MRI for PDL κ = 0.667, CBCT for PDL κ = 0.571; ICC for root canal counts all ≥ 0.990). The imaging scores for dental pulp and PDL using 5T MRI were significantly higher than those using 3T MRI (dental pulp: P < 0.001; PDL: P = 0.022), but there was no statistically significant difference in the detection rate of the number of root canals between the two (P > 0.05). Although the imaging scores for dental pulp and PDL as well as the detection rate of the number of root canals with 5T MRI were inferior to those with CBCT (dental pulp: P < 0.001; PDL: P = 0.02; number of root canals: P < 0.05), 5T MRI can truly achieve "direct imaging" of these two soft tissues.
Conclusion
5T MRI enables effective in vivo direct imaging of dental pulp and PDL tissues in the young adult population, indicating its potential clinical application value in the diagnosis and treatment of pulp and periodontal diseases.
5.Mechanisms of Yishen Juanbi Pills-containing Bone Marrow Fluid in Improving Kidney-deficiency Rheumatoid Arthritis by Regulating CD4+ T Lymphocyte Differentiation via SDF-1/CXCR4 Signaling Pathway
Jinlin TONG ; Yuyao WANG ; Hong LIU ; Jinghua PAN ; Danping FAN ; Hongyan ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):90-99
ObjectiveTo investigate the effects of Yishen Juanbi pills (YSJB)-containing bone marrow fluid on the migration and differentiation phenotypes of CD4⁺T lymphocytes based on the stromal cell-derived factor-1/chemokine receptor 4 (SDF-1/CXCR4) signaling pathway. MethodsPrimary CD4⁺T lymphocytes were isolated from mice using magnetic bead separation and identified for purity by flow cytometry. A CD4⁺T lymphocyte culture system was then established to observe the effects of SDF-1 on CD4⁺T-cell migration and differentiation. On this basis, the experimental groups included the Sham group, the ovariectomy (OVX) group, the Sham+collagen-induced arthritis (CIA) group, the OVX+CIA group, the Sham+CIA+YSJB group (2.16 g·kg-1), the OVX+CIA+YSJB group (2.16 g·kg-1), and the OVX+CIA+methotrexate (MTX) group (1.5 mg·kg-1). Bone marrow fluid from each group was prepared according to previous methods and added to the CD4⁺ T-cell culture system at 5% (v/v). Transwell assays were used to examine CD4⁺T-cell migration in each group. Real-time PCR was used to measure the mRNA expression levels of interleukin (IL)-17, tumor necrosis factor-α (TNF-α), retinoic-acid-related orphan receptor γt (RORγt), IL-10, transforming growth factor-β (TGF-β), forkhead box P3 (FoxP3), CXCR4, phosphoinositide 3-kinase (PI3K), and protein kinase B (Akt). Western blot was used to detect the expression of helper T (Th)17/regulatory T (Treg) cell signature factors (RORγt, FoxP3), CXCR4, PI3K, phosphorylated (p)-PI3K, Akt, and p-Akt. In a separate set of experiments, cells were divided into the Sham group, OVX+CIA group, OVX+CIA+CXCR4 antagonist AMD3100 group, and OVX+CIA+YSJB+AMD3100 group to observe changes in the above indicators following AMD3100 intervention. ResultsCompared with the Sham group, the number of migrated cells in the lower chamber was significantly increased in the Sham+CIA and OVX+CIA groups (P<0.05, P<0.01). The mRNA expression of RORγt, IL-17, TNF-α, CXCR4, PI3K, and Akt was significantly upregulated, whereas FoxP3, IL-10, and TGF-β mRNA expression was significantly decreased (P<0.05, P<0.01). Protein expression of RORγt, CXCR4, p-PI3K/PI3K, and p-Akt/Akt was significantly increased, while FoxP3 protein expression was markedly decreased (P<0.05, P<0.01). Compared with the OVX+CIA group, the OVX+CIA+YSJB group and OVX+CIA+MTX group showed significantly reduced migration (P<0.05), mRNA expression of RORγt, IL-17, TNF-α, CXCR4, PI3K, and Akt was also significantly decreased, while FoxP3, IL-10, and TGF-β mRNA expression was significantly increased (P<0.05, P<0.01). RORγt protein expression was significantly downregulated, and FoxP3 protein expression markedly upregulated (P<0.05). In the OVX+CIA+YSJB group, CXCR4, p-PI3K/PI3K, and p-Akt/Akt protein expression was significantly decreased (P<0.05). Compared with the OVX+CIA group, RORγt, CXCR4, PI3K, and Akt mRNA expression in CD4⁺T cells was significantly decreased in the OVX+CIA+AMD3100 group and the OVX+CIA+YSJB+AMD3100 group, while FoxP3 mRNA and protein expression was significantly upregulated (P<0.05, P<0.01). RORγt, CXCR4, p-PI3K/PI3K, and p-Akt/Akt protein expression was also markedly decreased (P<0.05, P<0.01). Compared with the OVX+CIA+AMD3100 group, the OVX+CIA+YSJB+AMD3100 group showed significantly decreased RORγt and Akt mRNA expression (P<0.05) and significantly lower p-Akt/Akt protein expression (P<0.05). ConclusionYSJB-containing bone marrow fluid suppresses CD4⁺T-cell migration and regulates Th17/Treg balance by downregulating Th17-associated signature factors and upregulating Treg-associated signature factors through inhibition of the SDF-1/CXCR4 signaling pathway and PI3K/Akt signaling pathway. The SDF-1/CXCR4 signaling pathway is one of the targets through which YSJB inhibits CD4⁺T-cell differentiation.
6.Establishment and Multidimensional Pathological Evaluations of a Cigarette Smoke Exposure-Induced Chronic Obstructive Pulmonary Disease Mouse Model
Jiaqi HE ; Yuanyuan ZHOU ; Yongqiang NIE ; Zhaoxia WANG ; Wangjie XU
Laboratory Animal and Comparative Medicine 2026;46(1):11-19
ObjectiveTo establish a reliable chronic obstructive pulmonary disease (COPD) mouse model based on a self-developed multichannel automatic control system for long-term continuous cigarette smoke exposure in small animals using a novel continuous cigarette smoke exposure method, and to conduct phenotypic evaluation and analysis, thereby providing an animal experimental basis for investigating COPD pathogenesis and prevention strategies. MethodsTwenty male C57BL/6J mice aged 6 weeks were randomly and equally divided into a control group and a model group. The model group (n=10) underwent 6 h of continuous cigarette smoke exposure daily (6 cigarettes per day for 12 consecutive weeks), while the control group (n=10) received no intervention. Body weight was monitored biweekly. Post-exposure, in vivo micro-CT imaging was performed. After euthanasia, serum and bronchoalveolar lavage fluid (BALF) levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were quantified by ELISA. Lung tissues underwent H&E and Masson's trichrome staining to observe changes in lung morphology and inflammatory cell infiltration, and the mean linear intercept (MLI) was calculated, thereby comprehensively evaluating the clinical features of COPD in the mouse model. ResultsCompared with the control group, the model group showed significantly reduced body weight (P<0.01) from the fourth week. Compared with the control group, IL-6 level in the serum and BALF of the model group increased by 27.2% and 140.0%, respectively (P<0.01). TNF-α level in the serum and bronchoalveolar lavage fluid of the model group increased by 16.7% (P<0.01) and 19.3% (P<0.05), respectively. Histopathological examination revealed alveolar wall thinning, septal rupture, emphysematous bullae formation, reduced alveolar count, bronchial wall thickening with lumen narrowing, and inflammatory cell infiltration. MLI was significantly elevated (P<0.01). Masson's staining confirmed collagen deposition and bronchial remodeling. Micro-CT demonstrated localized high-density shadows exhibiting typical features of chronic bronchitis. Conclusion The self-developed device enables long-term continuous smoke exposure, and the successfully established COPD mouse model exhibits pathological features highly consistent with clinical manifestations, offering an efficient and reliable tool for COPD research.
7.Mechanism Study of Yinchenhao Tang Regulating Fas/Caspase-8/Caspase-3 Signaling Pathway to Improve Cholestatic Liver Injury
Zhengwang ZHU ; Linlin WANG ; Jinghan ZHAO ; Linjing SHE ; Yinpei TANG ; Qingchun CAI ; Bing WANG ; Pingsheng ZHU ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):39-46
ObjectiveTo explore the mechanism of Yinchenhao Tang regulating the tumor necrosis factor receptor superfamily member 6 (Fas)/cysteine protease-8 (Caspase-8)/cysteine protease-3 (Caspase-3) signaling pathway to inhibit hepatocyte apoptosis and improve cholestatic liver injury (CLI). MethodsAmong 48 Wistar rats,12 rats were randomly selected as the blank group,and the other rats were administered alpha-naphthalene isothiocyanate (ANIT) by gavage to induce a CLI model. The modeling rats were randomly divided into the model group, the ursodeoxycholic acid group(0.1 g·kg-1) and the Yinchenhao Tang group(9.23 g·kg-1),with 12 rats in each group. The rats in each group were given corresponding drugs by gavage for three consecutive days. The levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP),gamma-glutamyl transpeptidase (γ-GT),total bilirubin (TBil) and total bile acid (TBA) in serum were detected. The levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in liver tissue were detected. The histopathological changes of the liver were observed by hematoxylin-eosin (HE) staining. The protein and mRNA expressions of Fas,Caspase-8,Caspase-3,B-cell lymphoma-2 (Bcl-2) associated X protein (Bax) and Bcl-2 in liver tissue were detected by Western blot and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). ResultsCompared with those in the blank group,the levels of ALT,AST,ALP,γ-GT,TBA and TBil in serum of the model group were significantly increased (P<0.01). The levels and mRNA expressions of TNF-α and IL-1β in liver tissue were significantly increased (P<0.01). The arrangement of hepatocytes was disordered,and inflammatory cell infiltration and bile duct epithelial cell proliferation were observed. The protein and mRNA expressions of Fas,Caspase-8,Caspase-3 and Bax in liver tissue were significantly increased(P<0.05,P<0.01),while the protein and mRNA expressions of Bcl-2 were significantly decreased (P<0.05,P<0.01). Compared with those in the model group,the levels of ALP,γ-GT,TBA and TBil in the serum of rats in the ursodeoxycholic acid group were significantly decreased. The levels and mRNA expressions of TNF-α and IL-1β in liver tissue were significantly decreased(P<0.05,P<0.01). The protein and mRNA expressions of Fas,Caspase-8,Caspase-3 and Bax in liver tissue were significantly decreased (P<0.05,P<0.01),while the mRNA expression of Bcl-2 was significantly increased (P<0.05,). The levels of ALT,AST,γ-GT,TBA and TBil in the serum of rats in the Yinchenhao Tang group were significantly decreased (P<0.01). The levels and mRNA expressions of TNF-α and IL-1β in liver tissue were significantly decreased (P<0.05,P<0.01). The protein expression of Fas and Bax and the mRNA expression of Fas,Caspase-8,Caspase-3 and Bax in liver tissue were significantly decreased (P<0.05,P<0.01),while the protein and mRNA expression of Bcl-2 were significantly increased (P<0.05,P<0.01). Hepatocyte injury,inflammatory cell infiltration and proliferation of bile duct epithelial cells were reduced. ConclusionYinchenhao Tang can ameliorate CLI,and its mechanism may be related to inhibiting hepatocyte apoptosis mediated by the Fas/Caspase-8/Caspase-3 signaling pathway.
8.Mechanism of Yinchenhao Tang in Improving Cholestatic Liver Injury by Inhibiting TLR4/MyD88/NF-κB Signaling Pathway Through FXR
Zhengwang ZHU ; Yang YANG ; Jinghan ZHAO ; Linlin WANG ; Yinpei TANG ; Qingchun CAI ; Bing WANG ; Pingsheng ZHU ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):47-54
ObjectiveTo study the mechanism of Yinchenhao Tang on the improvement of cholestatic liver injury (CLI) by inhibiting toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear transcription factor-κB (NF-κB) pathway via regulating farnesol X receptor (FXR). MethodsA total of 40 Wistar male rats were randomly selected, with 10 as a blank group,and the remaining rats were subjected to the CLI model induced by alpha-naphthalene isothiocyanate (ANIT). After modeling,they were randomly divided into the model group, the ursodeoxycholic acid (0.1 g·kg-1) group and the Yinchenhao Tang (9.23 g·kg-1) group,with 10 animals in each group. Each administration group was given the corresponding drug by intragastric administration for three consecutive days. Alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptidase (γ-GT),total bile acid (TBA),total bilirubin (TBil) and direct bilirubin (DBil) levels in serum were detected. Tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),and interleukin-6 (IL-6) levels in liver tissue were detected. Real-time PCR was used to detect the mRNA expression of FXR,TLR4,MyD88,NF-κB,F4/80,TNF-α,IL-1β and IL-6 in liver tissue. Western blot was used to detect protein expression of FXR,TLR4,MyD88 and NF-κB in liver tissue. The histopathological changes of the liver were observed by hematoxylin-eosin (HE) staining. ResultsCompared with those in the blank group,ALT,AST,ALP,γ-GT,TBA,TBil and DBil levels in serum of rats in the model group were significantly increased (P<0.01). The levels and mRNA expression of TNF-α,IL-1β and IL-6 in liver tissue were significantly increased (P<0.01),and the mRNA and protein expressions of FXR in liver tissue were decreased (P<0.01). The mRNA and protein expressions of TLR4,MyD88 and NF-κB and the mRNA expression of F4/80 were obviously increased (P<0.05,P<0.01). Hepatic histopathology showed inflammatory cell infiltration and proliferative changes of bile duct epithelial cells. Compared with those in the model group,ALT,ALP,γ-GT,TBA,TBil and DBil levels in serum of rats in the ursodeoxycholic acid group were obviously decreased (P<0.05,P<0.01),and the levels and mRNA expression of TNF-α,IL-1β and IL-6 in liver tissue were obviously decreased (P<0.05,P<0.01). The mRNA and protein expressions of TLR4,MyD88 and NF-κB and the mRNA expression of F4/80 in liver tissue were obviously decreased (P<0.05,P<0.01). ALT,AST,ALP,γ-GT,TBA,TBil and DBil levels in the serum of rats in the Yinchenhao Tang group were obviously decreased (P<0.05,P<0.01),and the levels and mRNA expression of TNF-α,IL-1β and IL-6 in liver tissue were obviously decreased (P<0.01). The mRNA and protein expressions of FXR in liver tissue were significantly increased,and the mRNA expressions of TLR4,MyD88,NF-κB,and F4/80, as well as the protein expressions of TLR4 and NF-κB were obviously decreased (P<0.05,P<0.01). The inflammatory cell infiltration of liver tissue and the proliferation of bile duct epithelial cells decreased. ConclusionYinchenhao Tang has an obvious protective effect on CLI,and its mechanism may be related to regulating FXR to inhibit TLR4/MyD88/NF-κB pathway-mediated inflammatory response.
9.Yinchenhao Tang Regulates Pyroptosis to Intervene in Cholestatic Liver Injury
Linlin WANG ; Zhengwang ZHU ; Jinghan ZHAO ; Ruixue MA ; Bing WANG ; Pingsheng ZHU ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):55-62
ObjectiveTo explore the mechanism by which Yinchenhao Tang intervenes in α-naphthylisothiocyanate (ANIT)-induced cholestatic liver injury by regulating the Takeda G-protein-coupled receptor 5(TGR5)/NOD-like receptor protein 3(NLRP3)/cysteine aspartate-specific protease-1 (Caspase-1) pyroptosis signaling pathway. MethodsForty male Wistar rats were randomly assigned into blank, model, ursodeoxycholic acid, and Yinchenhao Tang groups. Except the blank group, other groups were treated with ANIT dissolved in olive oil for the modeling of cholestatic liver injury. Ursodeoxycholic acid (0.1 g·kg-1) and Yinchenhao Tang (9.23 g·kg-1) were administered by gavage. The blank group and the model group were administrated with the same amount of pure water, once a day for 3 days. The blood and liver tissue samples were collected, and the serum levels of liver function indicators were measured by an automatic biochemical analyzer. Hematoxylin-eosin staining was employed to observe the pathological changes of the liver. The levels of interleukin (IL)-1β and IL-18 in the liver tissue were determined by ELISA. The mRNA levels of IL-1β, IL-18, TGR5, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), Caspase-1, and GSDMD in the liver tissue were assessed by Real-time PCR. The protein levels of TGR5, NLRP3, ASC, Caspase-1, and GSDMD in the liver tissue were determined by Western blot. ResultsCompared with the blank group, the model group showed elevated levels of alanine amino-transferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), total bile acid (TBA), and total bilirubin (TBil) in the serum (P<0.01), inflammatory cell infiltration, hepatocyte swelling, and bile duct epithelial cell proliferation in the liver, raised levels of IL-1β and IL-18 in the liver tissue (P<0.01), down-regulated mRNA and protein levels of TGR5 (P<0.01), up-regulated mRNA levels of IL-18 (P<0.01), ASC (P<0.01), Caspase-1 (P<0.01), GSDMD (P<0.01), IL-1β (P<0.05), and NLRP3 (P<0.05), and up-regulated protein levels of NLRP3 (P<0.01), ASC (P<0.01), Caspase-1 (P<0.01), and GSDMD (P<0.05). Compared with the model group, the ursodeoxycholic acid group showed declined levels of AST (P<0.01), TBA (P<0.01), TBil (P<0.01), and ALT (P<0.05) in the serum, lowered levels of IL-1β and IL-18 in the liver tissue (P<0.01), down-regulated mRNA levels of NLRP3 (P<0.01), Caspase-1 (P<0.01), GSDMD (P<0.01), IL-1β (P<0.05), IL-18 (P<0.05), and ASC (P<0.05), up-regulated mRNA and protein levels of TGR5 (P<0.05), and down-regulated protein levels of NLRP3, ASC, Caspase-1, and GSDMD (P<0.05). Compared with the model group, the Yinchenhao Tang group showed lowered levels of ALT, AST, ALP, TBA, and TBil in the serum (P<0.01), declined levels of IL-1β and IL-18 in the liver tissue (P<0.01), down-regulated mRNA levels of IL-1β (P<0.01), NLRP3 (P<0.01), ASC (P<0.01), Caspase-1 (P<0.01), GSDMD (P<0.01), and IL-18 (P<0.05), up-regulated mRNA and protein levels of TGR5 (P<0.01), and down-regulated protein levels of Caspase-1 and GSDMD (P<0.05). The liver tissue of the administration groups showed reduced infiltration of inflammatory cells, reduced swelling of hepatocytes, and alleviated proliferation of bile duct epithelial cells. ConclusionYinchenhao Tang can ameliorate ANIT-induced cholestatic liver injury by regulating the hepatocyte pyroptosis mediated by the TGR5/NLRP3/Caspase-1 signaling pathway.
10.Intervention Effect and Regulation Mechanism of Yinchenhao Tang on Cholestatic Liver Injury
Linlin WANG ; Zhengwang ZHU ; Jinghan ZHAO ; Ruixue MA ; Bing WANG ; Pingsheng ZHU ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):71-80
Cholestatic liver injury refers to the bile production, secretion, and excretion disorder caused by various reasons. It induces liver injury, metabolic disorders, and dysfunction of the hepatobiliary system, which can further develop into liver fibrosis, cirrhosis, liver failure, and even death. At present, the preferred drug for clinical treatment is ursodeoxycholic acid, which, however, induces adverse reactions and is intolerant in some patients. Yinchenhao Tang is a representative prescription of traditional Chinese medicine for the treatment of jaundice due to Yang jaundice. It has the effects of clearing heat, eliminating dampness, and removing jaundice and has shown good therapeutic effect in long-term clinical application. Modern pharmacological studies have found that this prescription has anti-inflammatory, anti-oxidation, bile acid balance-regulating, hepatocyte apoptosis-inhibiting and other liver-protecting effects. This paper reviews the relevant clinical and animal experimental studies on Yinchenhao Tang in the treatment of cholestatic liver injury in recent years. Yinchenhao Tang can intervene in the progression of cholestatic liver injury by regulating bile acid metabolism and excretion, reducing inflammatory response, inhibiting oxidative stress, alleviating endoplasmic reticulum stress, inhibiting hepatocyte apoptosis, and protecting intestinal mucosal barrier. This paper systematically expounds the molecular mechanisms by which Yinchenhao Tang regulates cholestatic liver injury that are confirmed by current research, aiming to provide reference for the clinical application and in-depth study of Yinchenhao Tang.


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