1.Establishment of a new predictive model for esophagogastric variceal rebleeding in liver cirrhosis based on clinical features
Wen GUO ; Xuyulin YANG ; Run GAO ; Yaxin CHEN ; Kun YIN ; Qian LI ; Manli CUI ; Mingxin ZHANG
Journal of Clinical Hepatology 2026;42(1):101-110
ObjectiveTo establish a new noninvasive, simple, and convenient clinical predictive model by identifying independent predictive factors for rebleeding after endoscopic therapy in cirrhotic patients with esophagogastric variceal bleeding (EGVB), and to provide a basis for individualized risk assessment and development of clinical intervention strategies. MethodsCirrhotic patients with EGVB who were diagnosed and treated in The First Affiliated Hospital of Xi’an Medical University from September 2018 to October 2023 were enrolled as subjects, and according to whether the patient experienced rebleeding within 1 year after endoscopic therapy, they were divided into rebleeding group with 93 patients and non-rebleeding group with 84 patients. Clinical data were collected and analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A Logistic model was established based on the results of the univariate and multivariate analyses, and the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to assess the accuracy of the model. R software was used to visualize the model by plotting a nomogram, and the Bootstrap method was used for internal validation of the model. ResultsThe multivariate analysis showed that red blood cell count (RBC), cholinesterase (ChE), alkaline phosphatase (ALP), albumin (Alb), thrombin time (TT), portal vein trunk diameter, sequential therapy, and primary prevention were independent predictive factors for rebleeding. Based on the results of the multivariate analysis, a logistic model was established as logit(P)=-0.805-1.978×(RBC)+0.001×(ChE)-0.020×(ALP)-0.314×(Alb)+0.567×(TT)+0.428×(portal vein trunk diameter)-2.303×[sequential therapy (yes=1, no=0)]-2.368×[primary prevention (yes=1, no=0)]. The logistic model (AUC=0.928, 95% confidence interval [CI]: 0.893—0.964, P<0.001) had a better performance in predicting rebleeding than MELD score (AUC=0.603, 95%CI: 0.520—0.687, P=0.003), Child-Pugh class (AUC=0.650, 95%CI: 0.578—0.722, P=0.001), and FIB-4 index (AUC=0.587, 95%CI: 0.503—0.671, P=0.045). The model had an optimal cut-off value of 0.607, a sensitivity of 0.817, and a specificity of 0.817. Internal validation confirmed that the model had good predictive performance and accuracy. ConclusionSequential therapy, implementation of primary prevention, an increase in RBC, and an increase in Alb are protective factors against rebleeding, while prolonged TT and widened main portal vein diameter are risk factors. The logistic model based on these independent predictive factors can predict rebleeding and thus holds promise for clinical application.
2.Electroacupuncture Ameliorates NLRP3-mediated Pyroptosis in Spinal Cord Injury Rats by Reshaping The Gut Microbiota
Yin-Jie CUI ; Hong-Ru LI ; Jing-Yi LIU ; Hai-Lin DU ; Shu-Wen LIU ; Yuan YANG ; Chen-Guang ZHENG ; Jian-Qin XIANG ; Xiao-Juan SONG
Progress in Biochemistry and Biophysics 2026;53(5):1132-1153
ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.
3.Electroacupuncture Ameliorates NLRP3-mediated Pyroptosis in Spinal Cord Injury Rats by Reshaping The Gut Microbiota
Yin-Jie CUI ; Hong-Ru LI ; Jing-Yi LIU ; Hai-Lin DU ; Shu-Wen LIU ; Yuan YANG ; Chen-Guang ZHENG ; Jian-Qin XIANG ; Xiao-Juan SONG
Progress in Biochemistry and Biophysics 2026;53(5):1132-1153
ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.
4.Effects of Yishen Yangsui formula() on pyroptosis in the spinal cord tissue in rats with degenerative cervical myelopathy.
Guo-Liang MA ; He YIN ; Bo XU ; Min-Shan FENG ; Dan ZHANG ; Dian ZHANG ; Xiao-Kuan QIN ; Li-Guo ZHU ; Bo-Wen YANG ; Xin CHEN
China Journal of Orthopaedics and Traumatology 2025;38(5):532-539
OBJECTIVE:
To preliminarily investigate the effects and mechanism of action of Yishen Yangsui Formula (, YSYSF)on the recovery of neurological function in rats with degenerative cervical myelopathy.
METHODS:
Fifty adult SD female rats were randomly divided into control group, sham group, model group, YSYSF group and positive drug group by using randomized numerical table method. In the model group, YSYSF group and positive drug group, polyvinyl alcohol acrylamide interpenetrating network hydrogel(water-absorbent swelling material) was used to construct a rat spinal cord chronic compression model. The sham group was implanted with the water-absorbent swelling material and then removed without causing spinal cord compression. The control group, the sham group and the model group were given equal amounts of saline by gavage, the group of YSYSF was given Chinese herbal medicine soup by gavage 9.1 g·kg-1 once a day, and the positive drug group was given tetrahexylsalicylglucoside sodium monosialate ganglioside by intraperitoneal injection 4.2 mg·kg-1 once a day. The motor function of the rats was assessed by the BBB method after 1, 3, 7, and 14 d of drug administration. The spinal cord tissues were taken from rats executed 14 d after drug administration, and the morphological changes of the spinal cord compression site were observed by HE staining, and the expression levels of Caspase-1, GSDMD, NLRP3, PYCARD, IL-1β, and IL-18 were detected in the area of spinal cord injury by Western blot method.
RESULTS:
The BBB scores of the control group and the sham group were normal at all time points after modeling, which were higher than the BBB scores of the model group, the YSYSF, and the positive drug group (P<0.05). From the 3rd day after gavage, at all time points, the BBB scores of rats in the YSYSF group and the positive drug group were higher than those of rats in the model group (P<0.05). The staining pattern of HE spinal cord tissue was normal in the control group and the sham group, and the HE spinal cord in the model group was severely damaged with a large number of neuron deaths, whereas the damage to the spinal cord and neuron cells was reduced in the YSYSF group and the positive drug group. The expression levels of caspase-1, GSDMD, NLRP3, PYCARD, IL-1β and IL-18 in the spinal cord of the model group were significantly higher than those of the sham group (P<0.0001), and the expression levels of caspase-1, GSDMD, NLRP3, PYCARD, IL-1β, and IL-18 in the YSYSF group and the drug group were significantly lower than those in the model group (P<0.05).
CONCLUSION
YSYSF can improve the motor function of rats with degenerative cervical spinal cord disease, alleviate the pathological changes, and promote the recovery of spinal cord neurological function. The specific mechanism may be related to the inhibition of the activation of inflammatory vesicles NLRP3 and PYCARD, the reduction of the release of inflammatory factors IL-1β and IL-18, the reduction of the expression of caspase-1 and GSDMD, the reduction of cellular death, and the inhibition of inflammatory response.
Animals
;
Female
;
Drugs, Chinese Herbal/administration & dosage*
;
Rats
;
Rats, Sprague-Dawley
;
Pyroptosis/drug effects*
;
Spinal Cord/pathology*
;
NLR Family, Pyrin Domain-Containing 3 Protein
;
Spinal Cord Diseases/drug therapy*
;
Interleukin-1beta/metabolism*
5.Comparison of clinical efficacy between robotic-assisted total hip arthroplasty and traditional total hip arthroplasty.
Hao YANG ; Wen-Han FU ; Ming LU ; Zong-Sheng YIN
China Journal of Orthopaedics and Traumatology 2025;38(10):1001-1008
OBJECTIVE:
To explore and analyze the clinical efficacy of robotic-assisted versus traditional total hip arthroplasty.
METHODS:
A total of 186 patients with end-stage hip joint diseases treated from January 2023 to April 2025 were selected as the research subjects. Among them, 85 patients were screened out using propensity score matching and divided into two groups according to different treatment methods:manual total hip arthroplasty (mTHA) group (mTHA group) and robotic-assisted total hip arthroplasty (rTHA) group (rTHA group). In mTHA group, there were 50 patients, including 18 males and 32 females, age ranged from 37 to 78 years old with a mean of (60.12±10.93) years old;body mass index (BMI) ranged from 16.6 to 32.0 kg·m-2 with an average of (23.98±3.78) kg·m-2;27 cases involved the left hip, and 23 cases involved the right hip. In the rTHA group, there were 35 patients, including 14 males and 21 females, age ranged from 31 to 76 years old with an average of (57.14±12.18) years old;the BMI ranged from 17.1 to 33.0 kg·m-2 with a mean of (22.76±2.54) kg·m-2;13 cases involved the left hip, and 22 cases involved the right hip. The following parameters were analyzed and compared between the two groups:acetabular anteversion angle, acetabular abduction angle, difference in combined offset, difference in lower limb length, proportion of acetabula located in the Lewinnek safe zone after surgery, operation time, visual analogue scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, and Harris hip score (HHS).
RESULTS:
All patients were followed up for 3 to 9 months, with an average of (6.8±1.3) months. In rTHA group and mTHA group, the abduction angles were (40.73±4.62)° and (40.95±4.71)° respectively;the differences in combined offset were (0.42±0.28) mm and (0.60±0.23) mm respectively;the WOMAC scores were(20.9±5.4) and (20.2±4.6) respectively;and the VAS were (1.1±1.0) and (1.0±0.8) respectively. There were no statistically significant differences in the above indicators between the two groups (P>0.05). However, statistically significant differences were observed between the two groups in the following aspects(P<0.05):the differences in lower limb length were (3.17±0.15) mm and (5.28±0.47) mm respectively;the postoperative acetabular anteversion angles were(22.84±2.83)° and (25.72±3.29)° respectively;the HHS were (80.7±5.5) and (74.8±6.3) respectively;and the operation times were (148.20±46.82) minutes and (81.84±18.76) minutes respectively.
CONCLUSION
Robot-assisted total hip arthroplasty demonstrates superior implant accuracy and improved early functional recovery compared with traditional manual THA. Nevertheless, it is associated with significantly longer operation time. Long-term prosthesis survival rate requires further follow-up verification.
Humans
;
Male
;
Female
;
Arthroplasty, Replacement, Hip/methods*
;
Middle Aged
;
Aged
;
Adult
;
Robotic Surgical Procedures/methods*
;
Treatment Outcome
6.Complications among patients undergoing orthopedic surgery after infection with the SARS-CoV-2 Omicron strain and a preliminary nomogram for predicting patient outcomes.
Liang ZHANG ; Wen-Long GOU ; Ke-Yu LUO ; Jun ZHU ; Yi-Bo GAN ; Xiang YIN ; Jun-Gang PU ; Huai-Jian JIN ; Xian-Qing ZHANG ; Wan-Fei WU ; Zi-Ming WANG ; Yao-Yao LIU ; Yang LI ; Peng LIU
Chinese Journal of Traumatology 2025;28(6):445-453
PURPOSE:
The rate of complications among patients undergoing surgery has increased due to infection with SARS-CoV-2 and other variants of concern. However, Omicron has shown decreased pathogenicity, raising questions about the risk of postoperative complications among patients who are infected with this variant. This study aimed to investigate complications and related factors among patients with recent Omicron infection prior to undergoing orthopedic surgery.
METHODS:
A historical control study was conducted. Data were collected from all patients who underwent surgery during 2 distinct periods: (1) between Dec 12, 2022 and Jan 31, 2023 (COVID-19 positive group), (2) between Dec 12, 2021 and Jan 31, 2022 (COVID-19 negative control group). The patients were at least 18 years old. Patients who received conservative treatment after admission or had high-risk diseases or special circumstances (use of anticoagulants before surgery) were excluded from the study. The study outcomes were the total complication rate and related factors. Binary logistic regression analysis was used to identify related factors, and odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the impact of COVID-19 infection on complications.
RESULTS:
In the analysis, a total of 847 patients who underwent surgery were included, with 275 of these patients testing positive for COVID-19 and 572 testing negative. The COVID-19-positive group had a significantly higher rate of total complications (11.27%) than the control group (4.90%, p < 0.001). After adjusting for relevant factors, the OR was 3.08 (95% CI: 1.45-6.53). Patients who were diagnosed with COVID-19 at 3-4 weeks (OR = 0.20 (95% CI: 0.06-0.59), p = 0.005), 5-6 weeks (OR = 0.16 (95% CI: 0.04-0.59), p = 0.010), or ≥7 weeks (OR = 0.26 (95% CI: 0.06-1.02), p = 0.069) prior to surgery had a lower risk of complications than those who were diagnosed at 0-2 weeks prior to surgery. Seven factors (age, indications for surgery, time of operation, time of COVID-19 diagnosis prior to surgery, C-reactive protein levels, alanine transaminase levels, and aspartate aminotransferase levels) were found to be associated with complications; thus, these factors were used to create a nomogram.
CONCLUSION
Omicron continues to be a significant factor in the incidence of postoperative complications among patients undergoing orthopedic surgery. By identifying the factors associated with these complications, we can determine the optimal surgical timing, provide more accurate prognostic information, and offer appropriate consultation for orthopedic surgery patients who have been infected with Omicron.
Humans
;
COVID-19/complications*
;
Male
;
Female
;
Middle Aged
;
Postoperative Complications/epidemiology*
;
SARS-CoV-2
;
Orthopedic Procedures/adverse effects*
;
Aged
;
Nomograms
;
Adult
;
Retrospective Studies
;
Risk Factors
7.The Influence of COVID-19 Infection on the Mobilization and Collection of Autologous Peripheral Blood Stem Cells in Patients with Multiple Myeloma.
Guo-Rong WANG ; Guang-Zhong YANG ; Yun LENG ; Yin WU ; Ai-Jun LIU ; Wen-Ming CHEN
Journal of Experimental Hematology 2025;33(2):455-462
OBJECTIVE:
To analyze the effect of COVID-19 infection on the mobilization and collection of autologous peripheral blood stem cells in patients with multiple myeloma.
METHODS:
The general baseline data, treatment factors before mobilization collection, collection status, and treatment overview after collection of autologous peripheral blood stem cells at Beijing Chaoyang Hospital affiliated with Capital Medical University from January 1, 2020 to July 15, 2023 were analyzed.
RESULTS:
269 patients underwent mobilization and collection of autologous peripheral blood stem cells. Among them, 32 cases with COVID-19 infection history (COVID-19 group) and 237 cases without COVID-19 infection history (non-COVID-19 group). In the COVID-19 group, 17 cases were treated with chemotherapy (etoposide)+G-CSF, and 15 cases were treated with plerixafor +G-CSF. In the non-COVID-19 group, 214 cases were treated with chemotherapy +G-CSF, 17 cases were treated with plerixafor +G-CSF, and 6 cases were treated with chemotherapy + plerixafor +G-CSF. The number of CD34+ cells, collection success rate, and excellence rate in the COVID-19 group and the non-COVID-19 group were [5.52 (0.94-26.87) vs 4.80 (0.53-37.20)]×106/kg (P =0.610), (93.8% vs 85.2%) (P =0.275), (62.5% vs 49.4%) (P =0.190), respectively. Among 113 patients mobilized with etoposide +G-CSF, the number of CD34+ cells, success rate, and excellence rate collected from COVID-19 infection (17 cases) and non-COVID-19 infection (96 cases) were [7.54 (2.66-26.87) vs 7.78 (2.26-37.20)]×106/kg (P =0.847), (100.0% vs 100.0%) (no P value), (82.4% vs 86.5%) (P =0.655), respectively. Among 32 patients mobilized by plerixafor +G-CSF, the number of CD34+ cells, success rate and excellence rate of COVID-19 infection (15 cases) and non-COVID-19 infection (17 cases) were [3.82 (0.94-7.27) vs 4.11 (0.53-9.05)]×106/kg (P =0.821), (86.7% vs 88.2%) (P =0.893), (40.0% vs 35.3%) (P =0.784), respectively. In 32 patients with COVID-19 infection, the number of CD34+ cells collected by etoposide +G-CSF (17 cases) and plerixafor +G-CSF (15 cases), as well as the success rate and excellence rate were [7.54 (2.66-26.87) vs 3.82(0.94-7.27)]×106/kg (P =0.004), (100.0% vs 86.7%) (P =0.120), (82.4% vs 40.0%) (P =0.014), respectively. By 2023.7.31, 232 patients (86.2%, 232/269) had received transplantation, including 24 patients in the COVID-19 group and 208 patients in the non-COVID-19 group. The median number of CD34+ cells infused in the two groups was [3.67 (2.50-13.44) vs 3.11(1.12-19.89)]×106/kg (P =0.058), the median days of neutrophil engraftment [11(9-13) vs 11(9-17)] (P =0.674), the median days of platelet engraftment [11(0-23), 12(0-43)] (P =0.279), respectively.
CONCLUSION
The history of COVID-19 infection did not affect the PBSC mobilization, collection and transplantation of patients with myeloma. In patients with COVID-19 infection, the results of chemotherapy mobilization with etoposide seems to be better than that of plerixafor mobilization, but further research is needed to clarify.
Humans
;
COVID-19/complications*
;
Multiple Myeloma/complications*
;
Hematopoietic Stem Cell Mobilization
;
Transplantation, Autologous
;
Granulocyte Colony-Stimulating Factor/therapeutic use*
;
Peripheral Blood Stem Cell Transplantation
;
SARS-CoV-2
;
Middle Aged
;
Peripheral Blood Stem Cells
;
Male
;
Female
;
Cyclams
;
Benzylamines
8.Efficacy and Safety of Erzhu Jiedu Decoction Granules in Treating Mid-advanced Hepatitis B Virus-Associated Primary Liver Cancer Patients with Pi (Spleen)-Deficiency and Dampness-Heat Syndrome.
Yang CHENG ; Hao-Yi WANG ; Cheng-Yi WAN ; Jie-Wen SHI ; Yuan-Yuan JIN ; Sheng-Li HE ; Bao-Bing YIN ; Jian-Jie CHEN
Chinese journal of integrative medicine 2025;31(5):394-401
OBJECTIVE:
To assess the efficacy and safety of Erzhu Jiedu Decoction (EZJDD) Granules in treating mid-advanced hepatitis B virus-associated primary liver cancer (HBV-PLC) patients with Pi (Spleen)-deficiency and dampness-heat syndrome.
METHODS:
From January 2021 to June 2023, a cohort of 132 patients were enrolled and randomly assigned to a control group or a EZJDD group according to the random numbers, with 66 patients in each group. The patients in the control group received conventional treatment for 3 months, followed by a 3-month follow-up. In addition to the conventional treatment, patients in the EZJDD group were administered EZJDD Granules (10.9 g/pack, 2 packs twice per day) orally for same duration. Progression-free survival (PFS) as primary outcome was evaluated by Kaplan Meier method. Karnofsky performance status (KPS) scores were used to assess the quality of life in two groups before and after treatment, and survival rates were determined as well. The efficacy of Chinese medicine syndrome was calculated with Nimodipine method. Liver function, tumor indicators and T lymphocyte subsets were measured, respectively. Safety indicators were recorded and assessed.
RESULTS:
Of the 116 patients who completed the study, 57 were in the control group and 59 in the EZJDD group. The median PFS was 3.53 months (106 days) in the EZJDD group compared to 2.33 months (70 days) in the control group (P=0.005). Six-month survival rate was 52.63% (30/57) in the control group and 69.49% (41/59) in the EZJDD group (P=0.039). The median KPS score in the EZJDD group [70(63, 90)] was higher than that in the control group [70(60, 80)] (P=0.013). The total effective rate of CM syndrome was 52.63% (30/57) in the control group and 77.97% (46/59) in the EZJDD group (P=0.005). The levels of alpha fetoprotein, alpha fetoprotein-L3, alpha-L-fucosidase and protein induced by Vitamin K absence or antagonist- II in the EZJDD group increased less than the control group (P>0.05). CD8+ levels were decreased, while CD3+ and CD4+ levels, as well as CD4+/CD8+ ratio were significantly increased in the EZZJD group (P<0.05). No treatment-related adverse reactions were observed during the study.
CONCLUSION
EZJDD Granules significantly prolonged the median PFS and improved 6-month survival rate in patients with mid-advanced HBV-PLC (Registration No. ChiCTR2200056922).
Humans
;
Drugs, Chinese Herbal/adverse effects*
;
Male
;
Female
;
Middle Aged
;
Liver Neoplasms/complications*
;
Hepatitis B virus/physiology*
;
Hepatitis B/complications*
;
Treatment Outcome
;
Adult
;
Spleen/drug effects*
;
Quality of Life
;
Medicine, Chinese Traditional
;
Aged
;
Syndrome
9.Induction of Cyp2e1 contributes to asparaginase-induced hepatocyte sensitization to lipotoxicity.
Yin ZHU ; Yuyin WANG ; Keito HOSHITSUKI ; Da YANG ; Lauren KOKAI ; Xiaochao MA ; Wen XIE ; Christian A FERNANDEZ
Acta Pharmaceutica Sinica B 2025;15(2):963-972
One of the leading therapies for acute lymphoblastic leukemia (ALL) is the chemotherapeutic agent PEGylated E. coli-derived-l-asparaginase (PEG-ASNase). Due to the high risk of dose-limiting liver injury, characterized by clinically elevated levels of hepatic transaminases, PEG-ASNase therapy is generally avoided in adult patients. Our preclinical investigations have indicated that PEG-ASNase-induced liver injury is associated with the release of free fatty acids (FFAs) from white adipose tissue (WAT), suggesting potential lipotoxic effects. However, it remains uncertain whether PEG-ASNase directly induces hepatotoxicity or sensitizes hepatocytes to FFA-induced toxicity. Our results show that PEG-ASNase treatment results in hepatocyte apoptosis and lipid peroxidation. Ex vivo and in vitro studies in mouse and human WAT suggest that PEG-ASNase induces the expression of adipose triglyceride lipase (ATGL), activates the lipase, and stimulates adipose tissue lipolysis, suggesting that the FFAs from WAT may contribute to the observed liver injury. Moreover, treatment with PEG-ASNase sensitizes hepatocytes to FFA-induced lipotoxicity. Mechanistically, our RNA-sequencing (RNA-seq) analyses reveal that PEG-ASNase-induced sensitization to lipotoxicity is accompanied by the induction of Cyp2e1. We demonstrated that this sensitization effect is attenuated by both pharmacological and genetic inhibition of Cyp2e1. Our findings suggest that PEG-ASNase therapy induces WAT lipolysis and sensitizes hepatocytes to hepatic lipotoxicity in a Cyp2e1-dependent manner.
10.Erratum: Author correction to "SHP2 inhibition triggers anti-tumor immunity and synergizes with PD-1 blockade" Acta Pharm Sin B 9 (2019) 304-315.
Mingxia ZHAO ; Wenjie GUO ; Yuanyuan WU ; Chenxi YANG ; Liang ZHONG ; Guoliang DENG ; Yuyu ZHU ; Wen LIU ; Yanhong GU ; Yin LU ; Lingdong KONG ; Xiangbao MENG ; Qiang XU ; Yang SUN
Acta Pharmaceutica Sinica B 2025;15(5):2810-2812
[This corrects the article DOI: 10.1016/j.apsb.2018.08.009.].

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