1.Historical Evolution and Key Information Research on Classic Formula Puji Xiaoduyin
Lianchao ZHU ; Lyuyuan LIANG ; Jing TANG ; Jialei CAO ; Ziming XU ; Huizhen ZHANG ; Zhidan GUO ; Rongze MA ; Zhengshao ZHANG ; Bingqi WEI ; Xiubo DU ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):238-247
Puji Xiaoduyin, a specialized formula for the swollen-head epidemic, was recorded in the Catalogue of Ancient Classical Formula (the Second Batch)-Han Medicine, published in September 2023. It had been inherited and developed by medical experts of successive generations and passed down to this day. This paper sorted out the historical evolution of this formula using bibliometric methods. It also comprehensively analyzed key information on the formula name, historical origin, drug dosage, herb origin, processing methods, decocting methods, function, and clinical applications. Additionally, this paper analyzed the application of this formula in both modern and ancient times. Results showed that the formula was first recorded as "Puji Xiaodu Yinzi" in LI Dongyuan's Proven Formulas written by LI Gao from the Jin dynasty. The medicinal composition and dosage were: Scutellariae Radix and Coptidis Rhizoma (20.65 g each), Ginseng Radix et Rhizoma 12.39 g, Scrophulariae Radix, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma (8.26 g each), Forsythiae Fructus, Arctii Fructus, Isatidis Radix, and Lasiosphaera Calvatia (4.13 g each), Bombyx Batryticatus and Cimicifugae Rhizoma (2.891 g each), Bupleuri Radix and Platycodonis Radix (8.26 g each). These medicines were grounded to fine powder. One dose, including 20.65 g of the powder, was mixed with 600 mL of water and decocted to 300 mL. After abandoning slag, the medicine should be taken warm frequently. In the formula, Bombyx Batryticatus is stir-fired. With the effect of dispersing wind and clearing heat, removing stagnation and dissipating mass, the formula is specialized in swollen-head epidemic, pestilence, red and swelling head, face, and neck, dry mouth and tongue, as well as other diseases resulting from toxic heat stagnated in the upper jiao. The formula is widely used in treating diseases involving the respiratory, dermal, ophthalmologic, otolaryngologic, and nervous systems. The formula is most frequently used for respiratory diseases, with a wide range of symptoms including parotitis/mumps (66 times), followed by tonsillitis (28 times). In conclusion, the broadly applied formula has accurate efficacy and great development value.
2.Historical Evolution and Key Information Research on Classic Formula Puji Xiaoduyin
Lianchao ZHU ; Lyuyuan LIANG ; Jing TANG ; Jialei CAO ; Ziming XU ; Huizhen ZHANG ; Zhidan GUO ; Rongze MA ; Zhengshao ZHANG ; Bingqi WEI ; Xiubo DU ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):238-247
Puji Xiaoduyin, a specialized formula for the swollen-head epidemic, was recorded in the Catalogue of Ancient Classical Formula (the Second Batch)-Han Medicine, published in September 2023. It had been inherited and developed by medical experts of successive generations and passed down to this day. This paper sorted out the historical evolution of this formula using bibliometric methods. It also comprehensively analyzed key information on the formula name, historical origin, drug dosage, herb origin, processing methods, decocting methods, function, and clinical applications. Additionally, this paper analyzed the application of this formula in both modern and ancient times. Results showed that the formula was first recorded as "Puji Xiaodu Yinzi" in LI Dongyuan's Proven Formulas written by LI Gao from the Jin dynasty. The medicinal composition and dosage were: Scutellariae Radix and Coptidis Rhizoma (20.65 g each), Ginseng Radix et Rhizoma 12.39 g, Scrophulariae Radix, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma (8.26 g each), Forsythiae Fructus, Arctii Fructus, Isatidis Radix, and Lasiosphaera Calvatia (4.13 g each), Bombyx Batryticatus and Cimicifugae Rhizoma (2.891 g each), Bupleuri Radix and Platycodonis Radix (8.26 g each). These medicines were grounded to fine powder. One dose, including 20.65 g of the powder, was mixed with 600 mL of water and decocted to 300 mL. After abandoning slag, the medicine should be taken warm frequently. In the formula, Bombyx Batryticatus is stir-fired. With the effect of dispersing wind and clearing heat, removing stagnation and dissipating mass, the formula is specialized in swollen-head epidemic, pestilence, red and swelling head, face, and neck, dry mouth and tongue, as well as other diseases resulting from toxic heat stagnated in the upper jiao. The formula is widely used in treating diseases involving the respiratory, dermal, ophthalmologic, otolaryngologic, and nervous systems. The formula is most frequently used for respiratory diseases, with a wide range of symptoms including parotitis/mumps (66 times), followed by tonsillitis (28 times). In conclusion, the broadly applied formula has accurate efficacy and great development value.
3.Mechanism of Shenfukang capsule in ameliorating renal interstitial fibrosis by regulating cellular crosstalk via the STAT3/YAP pathway
Wei DU ; Yufang YANG ; Yanhong LIAO ; Xiaoqin ZOU ; Zhiwei LIANG ; Xiangqian FENG ; Xiaobin ZHONG
China Pharmacy 2026;37(12):1547-1552
OBJECTIVE To investigate the mechanism by which Shenfukang capsule (SFK) ameliorates renal interstitial fibrosis (RIF) by regulating macrophage-fibroblast crosstalk via the signal transducer and activator of transcription 3 (STAT3)/Yes-associated protein (YAP) pathway. METHODS RAW264.7 macrophages were induced to polarize with transforming growth factor-β 1 (TGF-β 1 ). Subsequently, a non-contact co-culture system of macrophages with renal fibroblasts NRK-49F, as well as a non-contact co-culture system of macrophages with YAP-knockdown renal fibroblasts, were established. Cells were treated with low, medium, and high concentrations (4, 8, 16 μg/mL) of SFK, as well as a STAT3 inhibitor (STAT3-I,1.64 μg/mL) and losartan potassium tablets (positive control, 0.28 μg/mL), for 48 h. After intervention, the protein and mRNA expression levels of CD86, CD163, and STAT3 in macrophages, as well as CD86, F4/80, and STAT3 mRNA, were detected. In co-cultured renal fibroblasts, the protein and mRNA expression levels of α -smooth muscle actin ( α -SMA), Vimentin, collagen type Ⅰ (Col-Ⅰ), matrix metalloproteinase-1 (MMP-1), and YAP were detected. In co-cultured YAP-knockdown renal fibroblasts, the protein and mRNA expression levels of α -SMA, Vimentin, and MMP-1 were also detected. RESULTS Following TGF-β 1 induction, the protein expression levels of CD86, CD163, and STAT3, as well as the mRNA expression levels of CD86, F4/80, and STAT3 in macrophages were significantly increased ( P <0.05). The conditioned medium from polarized macrophages activated renal fibroblasts, as evidenced by significantly increased protein and mRNA expression levels of α -SMA, Vimentin, Col-Ⅰ, and YAP, and significantly decreased protein and mRNA expression levels of MMP-1 in renal fibroblasts ( P <0.05). Treatment with SFK and STAT3-I reversed the changes in the above indicators, with the medium concentration SFK group showing stronge r effects on some indicators than the low and high concentration groups. In the non-contact co-culture experiment of macrophages and YAP-knockdown renal fibroblasts, there were no statistically significant differences in the protein and mRNA expression of α-SMA, Vimentin, and MMP-1 among the groups. CONCLUSIONS SFK can inhibit macrophage-renal fibroblast crosstalk by blocking the STAT3/YAP pathway, thereby delaying the progression of RIF.
4.Application of motor behavior evaluation method of zebrafish model in traditional Chinese medicine research.
Xin LI ; Qin-Qin LIANG ; Bing-Yue ZHANG ; Zhong-Shang XIA ; Gang BAI ; Zheng-Cai DU ; Er-Wei HAO ; Jia-Gang DENG ; Xiao-Tao HOU
China Journal of Chinese Materia Medica 2025;50(10):2631-2639
The zebrafish model has attracted much attention due to its strong reproductive ability, short research cycle, and ease of maintenance. It has always been an important vertebrate model system, often used to carry out human disease research. Its motor behavior features have the advantages of being simpler, more intuitive, and quantifiable. In recent years, it has received widespread attention in the study of traditional Chinese medicine(TCM)for the treatment of sleep disorders, neurodegenerative diseases, fatigue, epilepsy, and other diseases. This paper reviews the characteristics of zebrafish motor behavior and its applications in the pharmacodynamic verification and mechanism research of TCM extracts, active ingredients, and TCM compounds, as well as in active ingredient screening and safety evaluation. The paper also analyzes its advantages and disadvantages, with the aim of improving the breadth and depth of zebrafish and its motor behavior applications in the field of TCM research.
Zebrafish/physiology*
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Medicine, Chinese Traditional
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Drugs, Chinese Herbal/therapeutic use*
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Disease Models, Animal
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Drug Evaluation, Preclinical/methods*
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Animals
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Sleep Wake Disorders/physiopathology*
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Epilepsy/physiopathology*
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Neurodegenerative Diseases/physiopathology*
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Fatigue/physiopathology*
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Behavior, Animal/physiology*
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Motor Activity/physiology*
5.Potential mechanism of Yueju Pills in improving depressive symptoms of psychocardiac diseases based on metabolomics and network pharmacology.
Cheng-Yu DU ; Xue-Feng GUO ; Han-Wen ZHANG ; Jian LIANG ; Huan ZHANG ; Guo-Wei HUANG ; Ping NI ; Hai-Jun MA ; You YU ; Rui YU
China Journal of Chinese Materia Medica 2025;50(16):4564-4573
The therapeutic effects of Yueju Pills on depression and cardiovascular diseases have been widely recognized. Previous studies have shown that the drug can significantly improve depressive-like behaviors induced by chronic unpredictable mild stress(CUMS) combined with atherosclerosis(AS). Given the complex pathogenesis of psychocardiac diseases, this study integrated metabolomics and network pharmacology to systematically elucidate the mechanism of Yueju Pills in alleviating depressive symptoms in psychocardiac diseases. The results demonstrate that, after Yueju Pill intervention, the levels of 9 abnormal metabolites in the hippocampus restore to normal ranges, primarily involving key pathways or signaling pathways, including the cyclic adenosine monophosphate(cAMP), mammalian target of rapamycin(mTOR), glycine/serine/threonine metabolism, and aminoacyl-tRNA biosynthesis. In a high-fat diet-induced CUMS ApoE~(-/-) mouse model, Yueju Pills significantly increases adenosine monophosphate(AMP) levels and decreases L-alanine and D-glyceric acid levels in the hippocampus. In conclusion, Yueju Pills exert antidepressant effects by regulating multiple metabolic axes, including glycine/serine/threonine metabolism and the cAMP, mTOR signaling pathways. Network pharmacology predictions reveal that the treatment of CUMS combined with AS by its core active components may be realized through modulating pathways concerning neuroinflammation and synaptic plasticity, including serine/threonine-protein kinase 1(AKT1), mitogen-activated protein kinase 1(MAPK1), and prostaglandin-endoperoxide synthase 2(PTGS2). This study provides a theoretical reference for the clinical application of Yueju Pills in alleviating the depressive symptoms of psychocardiac diseases.
Animals
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Network Pharmacology
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Mice
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Drugs, Chinese Herbal/administration & dosage*
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Metabolomics
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Male
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Depression/genetics*
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Humans
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Hippocampus/drug effects*
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Mice, Inbred C57BL
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Signal Transduction/drug effects*
6.Human epidermal growth factor gel for pin tract infection following halo-pelvic ring traction procedure in patients with severe spinal deformity.
Yu-Liang LOU ; Feng HONG ; Can-Feng WANG ; Hui FEI ; Wei-Bin DU ; Ren-Fu QUAN
China Journal of Orthopaedics and Traumatology 2025;38(8):816-821
OBJECTIVE:
To explore the efficacy and safety of human epidermal growth factor gel in the treatment of pin tract infections after surgery in patients with severe spinal deformity.
METHODS:
A retrospective case-control study was conducted to analyze the clinical data of 26 patients with pin tract infections after skull-pelvic ring traction for severe spinal deformity admitted from February 2019 to May 2022. Among them, 11 were male and 15 were female;the age ranged from 18 to 31 years, with an average of (24.1±4.3) years;the Cobb angle ranged 80.3° to 120.7°, with an average of (88.6±10.2)°;there were 52 iliac traction pins, 104 pin tract openings, and 38 pin tract infections. According to the Checketts-Otterbum classification, there were 11 infections of gradeⅠ, 13 infections of gradeⅡ, 10 infections of grade Ⅲ, and 4 infections of grade Ⅳ. The patients were divided into the conventional dressing change group (13 cases) and the growth factor group (13 cases) by coin flipping. Clinical efficacy was evaluated by recording the visual analogue scale(VAS) score during dressing change, duration of dressing change, cost of dressing change, positive rate of bacterial culture, wound improvement rate, and wound improvement time.
RESULTS:
There were no statistically significant differences in VAS or duration of dressing change between the two groups (P>0.05). The cost of dressing change was (800.0±59.5) yuan in the conventional dressing change group and (1 179.5±80.9) yuan in the growth factor group, with a statistically significant difference (P<0.05). There was no statistically significant difference in the positive rate of bacterial culture between the two groups (P>0.05). In the conventional dressing change group, within 20 pin tract infections, 2 infections achieved wound healing, 7 infections showed improvement, and 11 infections were ineffective;in the growth factor group, within 18 pin tract infections 5 infections achieved wound healing, 8 infections showed improvement, and 5 infections were ineffective, with a statistically significant difference between the two groups (P<0.05). The wound healing time was (22.8±4.9) days in the conventional dressing change group and (14.2±2.5) days in the growth factor group, with a statistically significant difference (P<0.05). No complications occurred in either group.
CONCLUSION
The application of human epidermal growth factor gel in the treatment of pin tract infections after skull-pelvic ring surgery in patients with severe spinal deformity is easy to operate, does not increase patient pain, and has significant efficacy. It shortens wound healing time, effectively promotes wound healing, and has good safety and high cost-effectiveness.
Humans
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Male
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Female
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Adult
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Adolescent
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Retrospective Studies
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Case-Control Studies
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Young Adult
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Epidermal Growth Factor/therapeutic use*
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Traction/adverse effects*
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Gels
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Bone Nails/adverse effects*
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Surgical Wound Infection/drug therapy*
7.The construction and application of a trauma limb salvage map in Shaanxi province.
Meng WANG ; Jian-Min LIU ; Xing-Bo DANG ; Long-Yang MA ; Gong-Liang DU ; Wei HU
Chinese Journal of Traumatology 2025;28(4):235-240
Trauma is an important cause of death in young- and middle-aged people. Trauma is comprehensive and includes many surgical specialties, and the surgical techniques of these specialties have long been mature. To reduce the mortality and disability rate of trauma patients, it is necessary to improve trauma management. Trauma has attracted attention in China and trauma treatment and care developed rapidly in recent years. To decrease traumatic mortality and disability rates, our team is committed to building an efficient trauma system in Shaanxi province and has successfully developed a trauma limb salvage map to address the high rates of amputation and disability in patients with limb injuries. This article elaborates on the construction experience of a trauma limb salvage map and its application details in Shaanxi province of China.
Humans
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China
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Limb Salvage/methods*
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Wounds and Injuries/surgery*
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Male
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Extremities/injuries*
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Adult
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Amputation, Surgical
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Middle Aged
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Female
8.Erratum: Author Correction: Targeting of AUF1 to vascular endothelial cells as a novel anti-aging therapy.
Jian HE ; Ya-Feng JIANG ; Liu LIANG ; Du-Jin WANG ; Wen-Xin WEI ; Pan-Pan JI ; Yao-Chan HUANG ; Hui SONG ; Xiao-Ling LU ; Yong-Xiang ZHAO
Journal of Geriatric Cardiology 2025;22(9):834-834
[This corrects the article DOI: 10.11909/j.issn.1671-5411.2017.08.005.].
9.Comparative efficacy of laminoplasty via intermuscular approach or posterior midline approach for cervical spinal cord injury without radiographic abnormality: a multi-center retrospective study
Yunfei HUANG ; Shuai LI ; Jinpeng DU ; Baorong HE ; Yanzheng GAO ; Wei MEI ; Shibao LU ; Zhigan ZHAO ; Liang YAN ; Xiaobin YANG ; Yuan HE ; Zhen CHANG
Chinese Journal of Trauma 2025;41(7):635-644
Objective:To compare the efficacy of laminoplasty via the intermuscular approach or posterior midline approach for treating spinal cord injury without radiographic abnormality (SCIWORA).Methods:A multi-center retrospective cohort study was conducted to analyze the clinical data of 135 patients with SCIWORA admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Xi'an No.5 Hospital, Henan Provincial People's Hospital, Zhengzhou Orthopedic Hospital, Xuanwu Hospital of Capital Medical University from February 2021 to June 2023, including 75 males and 60 females, aged 35-78 years [(55.3±8.1)years]. The injury segments involved C 3-C 6. All the patients underwent posterior cervical open-door laminoplasty, among whom 70 patients were treated via the intermuscular approach (intermuscular group) and 65 via the posterior midline approach (posterior midline group). The operation duration, intraoperative blood loss, postoperative drainage volume, and length of hospital stay were recorded. The visual analogue scale (VAS) score, Japanese Orthopedic Association (JOA) score, neck disability index (NDI), Barthel index, cervical Cobb angle, and cervical range of motion (ROM) were measured preoperatively, at 3, 6, 12 months postoperatively and at the final follow-up. The American Spinal Injury Association (ASIA) scale was evaluated preoperatively, at 3, 12 months postoperatively and at the final follow-up. The postoperative complication rate was recorded as well. Results:All the patients were followed up for 15-19 months [(16.3±1.6)months]. The operation duration, intraoperative blood loss, postoperative drainage and length of hospital stay were (125.0±23.0)minutes, (210.4±34.8)ml, and (165.3±23.7)ml, and (5.3±0.1)days in the intermuscular group, which were significantly shorter or less than (168.0±27.6)minutes, (260.2±45.3)ml, (196.4±31.6)ml, and (6.4±0.2)days in the posterior midline group ( P<0.01). The preoperative VAS score, JOA score, NDI and Barthel index showed no significant differences between the two groups ( P>0.05). The VAS score and JOA score also showed no significant differences between the two groups at 3, 6, 12 months postoperatively or at the final follow-up ( P>0.05). The NDI and Barthel index also showed no significant differences between the two groups at 3 months postoperatively ( P>0.05). At 6, 12 months postoperatively and at the final follow-up, the NDI were (15.4±2.5)points, (11.8±2.1)points and (8.6±1.5)points in the intermuscular group, significantly lower than (19.1±3.4)points, (14.3±2.4)points and (11.9±1.4)points in the posterior midline group ( P<0.01). At 6, 12 months postoperatively and at the final follow-up, the Barthel index were (71.4±6.2)points, (83.4±5.8)points and (89.2±7.1)points in the intermuscular group, significantly higher than (59.6±4.7)points, (74.2±3.9)points and (78.8±6.2)points in the posterior midline group ( P<0.01). Both groups showed significant improvements in VAS score, JOA score, NDI and Barthel index at 3, 6, 12 months postoperatively and at the final follow-up when compared to those preoperatively ( P<0.05). Among them, the VAS score, NDI and Barthel index were further improved over time ( P<0.05). Simultaneously, the JOA score was significantly improved at 6, 12 months postoperatively and at the last follow-up when compared to that at 3 months postoperatively ( P<0.05), with no significant difference at later time points between the two groups ( P>0.05). The preoperative cervical Cobb angle and ROM showed no significant differences between the two groups ( P>0.05). There was no significant difference in the Cobb angle between the two groups at 3, 6 or 12 months postoperatively ( P>0.05), while it was (13.6±2.4)° in the intermuscular group at the final follow-up, significantly larger than (10.4±2.8)° in the posterior midline group ( P<0.01). At 3, 6, 12 months postoperatively and at the final follow-up, the cervical ROM were (34.1±6.4)°, (32.6±7.3)°, (31.8±9.1)° and (29.6±8.7)° in the intermuscular group, significantly larger than (23.7±8.3)°, (22.3±7.8)°, (22.5±8.1)° and (20.6±9.3)° in the posterior midline group ( P<0.01). In the intermuscular group, the cervical Cobb angle showed no significant changes at 3, 6, 12 months postoperatively and at the final follow-up when compared to those preoperatively ( P>0.05). In the posterior midline group, the Cobb angles were significantly reduced at 3, 6, 12 months postoperatively and at the final follow-up when compared to those preoperatively ( P<0.05), showing significant decrease at 12 months postoperatively and at the final follow-up from those at 3, 6 months postoperatively ( P<0.05), no significant difference at 6 months postoperatively from that at 3 months postoperatively ( P>0.05), and significant decrease at the final follow-up from that at 12 months postoperatively ( P>0.05). In the intermuscular group, the cervical ROM were significantly improved at 3, 6, 12 months postoperatively and at the final follow-up when compared to those preoperatively and showed further improvement over time ( P<0.05). In the posterior midline group, the cervical ROM were significantly improved at 3, 6, 12 months postoperatively and at the final follow-up when compared to those preoperatively ( P<0.05), showing significant decreases at 6, 12 months postoperatively and at the final follow-up from that at 3 months postoperatively ( P<0.05), significant decreases at the final follow-up from those at 6, 12 months postoperatively ( P<0.05), and no significant difference at 12 months postoperatively from that at 6 months postoperatively ( P>0.05). The ASIA grades showed no significant difference between the two groups preoperatively, at 3, 12 months postoperatively and at the final follow-up ( P>0.05) , but were gradually improved over time in both groups ( P<0.05). The postoperative complication rate was 9%(6/70) in the intermuscular group, significantly lower than 48%(31/65) in the posterior midline group ( P<0.01). Conclusion:Compared to the posterior midline approach, the intermuscular approach for laminoplasty in patients with SCIWORA possesses advantages, including shorter operative time and length of hospital stay, reduced intraoperative blood loss and postoperative drainage, less postoperative neck disability, higher daily life quality, better long-term preservation of cervical lordosis and motion, and a lower complication rate.
10.Efficacy and safety of PEMD regimen in newly diagnosed early-stage non-upper respiratory digestive tract or advanced extranodal natural killer/T-cell lymphoma
Xinyi ZHANG ; Kaixin DU ; Haorui SHEN ; Jiazhu WU ; Yue LI ; Hua YIN ; Li WANG ; Jinhua LIANG ; Jianyong LI ; Wei XU
Chinese Journal of Hematology 2025;46(2):147-151
Objective:To evaluate the efficacy and safety of the pegaspargase, etoposide, methotrexate, and dexamethasone (PEMD) regimen in patients with early-stage nonupper respiratory digestive tract or advanced extranodal natural killer/T-cell lymphoma (ENKTL) .Methods:This retrospective analysis included 38 patients with newly diagnosed early-stage non-upper respiratory digestive tract or advanced ENKTL who received PEMD regimen for induction chemotherapy at the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2022. Survival outcomes and prognostic factors were examined by Kaplan-Meier, and the Log-rank test was used to compare survival.Results:The study population had a median age of 48 years (range, 26-72 years) and included 30 males (78.9%) and 8 females (21.1%). 7 patients’ age >60 years (18.4%). The Eastern Cooperative Oncology Group (ECOG) performance score was >1 in 7 patients (18.4%) ; 20 patients (52.6%) had elevated lactate dehydrogenase levels; and 37 patients (97.4%) exhibited extranodal involvement. Using the Ann Arbor staging system, 37 patients (97.4%) were classified as stage Ⅲ-Ⅳ. The median number of treatment cycles was 5 (1-6), and the median follow-up duration was 60 months (24 - 101 months). Interim efficacy assessment revealed an overall response rate of 52.7%. At 2 and 4 years, the progression-free survival (PFS) rates were 34.2% (95% CI 22.0%-53.2%) and 25.5% (95% CI 14.7%-44.4%), respectively, and the overall survival rates were 50.0% (95% CI 36.4%-68.7%) and 45.5% (95% CI 31.4%-65.7%), respectively. The risk factors for worse PFS were ECOG performance score >1 [ HR=3.711 (95% CI 1.494-9.218), P=0.005]; bone marrow infiltration [ HR=2.251 (95% CI 1.026 - 4.938), P=0.043]; and Prognostic Index for Natural Killer/T-Cell Lymphoma score of 3 - 5 [ HR=2.350 (95% CI 1.009 - 5.476), P=0.048]. Multivariate analysis identified ECOG performance score >1 as an independent risk factor for PFS [ HR=7.971 (95% CI 2.222 - 28.591), P=0.001]. The main adverse effect was anemia in 31 patients (81.6%) . Conclusion:The PEMD regimen was safe and effective for patients with newly diagnosed early-stage non-upper respiratory digestive tract or advanced ENKTL.

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