1.Mechanism of action of organelle interactions in the progression of liver fibrosis and traditional Chinese medicine prevention and treatment strategies
Yuanyuan ZHENG ; Chenlu ZHAO ; Lihui ZHANG ; Sutong LIU ; Wenxia ZHAO
Journal of Clinical Hepatology 2026;42(3):711-717
Liver fibrosis is the core pathological stage of the progression of various chronic liver diseases to liver cirrhosis, and hepatic stellate cell (HSC) activation and the abnormal accumulation of collagen fibers are important processes for the development and progression of liver fibrosis. In recent years, studies have shown that HSC activation is regulated by the complex interactions between various organelles (including mitochondria, endoplasmic reticulum, Golgi apparatus, lysosome, and peroxisomes), and such interactions affect the key cellular processes such as energy metabolism, protein synthesis and folding, reactive oxygen species balance, and autophagy, thereby participating in the progression of liver fibrosis. Meanwhile, traditional Chinese medicine and its active ingredients with multi-target synergistic effects have attracted wide attention. From the perspective of the interaction between organelles, this article systematically elaborates on the specific mechanism of such interactions in the progression of liver fibrosis and reviews how traditional Chinese medicine inhibits HSC activation and collagen production by regulating the function of these organelle and their interaction networks, thereby exerting an anti-liver fibrosis effect, in order to provide a theoretical basis for in-depth understanding of the pathological mechanism of liver fibrosis and the development of new traditional Chinese medicine intervention strategies.
2.Metabolic dysfunction-associated fatty liver disease with different clinical phenotypes: Pathogenesis and strategies for integrated traditional Chinese and Western medicine treatment
Wenxia ZHAO ; Lei GAO ; Xinju CHEN ; Yuanyuan ZHENG ; Sutong LIU ; Lihui ZHANG ; Qing ZHAO ; Chenlu ZHAO
Journal of Clinical Hepatology 2026;42(4):930-937
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a chronic metabolic liver disorder with complex etiologies. Different clinical phenotypes of MAFLD (such as obesity, hyperlipidemia, type 2 diabetes mellitus, the postmenopausal state, and chronic hepatitis B) have different mechanisms of action in the development and progression of MAFLD, leading to high heterogeneity in its clinical progression and prognosis. This article systematically reviews the pathogeneses and clinical features of the above five clinical phenotypes of MAFLD and elaborates on the corresponding individualized diagnosis and treatment regimens integrating traditional Chinese medicine and Western medicine, in order to provide a reference for clinical practice and improve clinical diagnosis and treatment.
3.Association of menopausal time and menopausal age with nonalcoholic fatty liver disease: An analysis based on a restricted cubic spline model
Chenlu ZHAO ; Suping MA ; Dongfang SHANG ; Sutong LIU ; Xiaoyan LIU ; Yuanyuan ZHENG ; Wenxia ZHAO
Journal of Clinical Hepatology 2025;41(2):247-253
ObjectiveTo investigate the association of menopausal time and menopausal age with the risk of nonalcoholic fatty liver disease (NAFLD), and to provide a basis for the early prevention and treatment of NAFLD in clinical practice. MethodsRelated data were collected from 373 postmenopausal women who attended the outpatient service of Department of Spleen, Stomach, Liver and Gallbladder Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, from January 2017 to December 2021, including general information, menopausal age, menopausal time, and presence or absence of NAFLD. The chi-square test was used for comparison of categorical data; the independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups. A Logistic regression analysis was used to calculate the association intensity and 95% confidence interval (95%CI) of menopausal time and menopausal age for the risk of NAFLD, and the restricted cubic spline (RCS) method was used to investigate the dose-response relationship between menopausal time/age and the risk of NAFLD. ResultsCompared with the women with normal menopause or late menopause, the women with early menopause had a higher prevalence rate of NAFLD and a higher degree of steatosis and fibrosis (all P<0.05). After adjustment for the confounding factors such as age and age of menarche, the risk of NAFLD in women with a menopausal time of >3 years was 4.80 (95%CI: 1.93 — 11.95, P=0.001) times that in women with a menopausal time of ≤3 years, and the risk of NAFLD in women with early or late menopause was 8.14 times (95%CI: 1.77 — 37.58, P=0.007) and 0.09 times (95%CI: 0.03 — 0.32, P<0.001), respectively, that in those with a normal menopausal age. There is a dose-response relationship between menopausal time/age and the risk of NAFLD. Menopausal time is positively correlated with the association intensity of NAFLD, while menopausal age is negatively correlated with the association intensity of NAFLD. ConclusionThe longer the menopause time and the earlier the menopause age, the ligher the risk of NAFLD.
4.Impacts of sports games on prosocial behavior of children with intellectual and developmental disabilities attending regular classes
DUAN Guanting, SHANG Xiaoxia, HOU Huisheng, ZHENG Shicheng, SHI Wenxia
Chinese Journal of School Health 2025;46(2):177-180
Objective:
To explore impacts of sports games designed based on the information-motivation-behavioral skills model (IMB) on prosocial behavior in children with intellectual and developmental disabilities (IDD) attending regular classes, so as to provide a theoretical basis for promoting the development of prosocial behavior in school age IDD children.
Methods:
From February to March 2023, 40 children with intellectual disabilities aged 8-9 who were enrolled in ordinary schools in Beijing were recruited by using WeChat parents to send messages. They were randomly divided into an experimental group (19 before intervention, 17 after intervention) and a control group (19 before intervention, 19 after intervention) by lottery method. During the study period, children in both groups received the same frequency and quality of regular physical activities. The experimental group, in addition, underwent a 13 week sports game intervention based on the IMB model, 4 times a week, each session lasting 50 minutes. The sports game intervention scheme based on IMB model was divided into two modules,including basic training and development training:low difficulty sports game intervention based on emotion recognition, and medium low difficulty and medium difficulty sports game intervention based on social training such as "prosocial". The Griffith Empathy Measure (GEM) and the Prosocial Behavior Scale for Adolescents (PBSA) were used to assess empathy ability and prosocial behavior levels of children in both groups before and after the intervention.
Results:
After intervention, the cognitive empathy dimension, emotional empathy dimension and total score of GEM in the experimental group (39.15±2.85, 38.54±1.94, 77.69±3.95) were higher than control group (32.18±4.18, 32.28± 4.28, 64.56±6.48) and before intervention (33.92±4.94, 31.30±4.61, 65.23±8.47), and the differences were statistically significant ( F =12.06, 6.99, 14.90; 8.95, 7.36, 13.22, P <0.05). After intervention, compliance with public welfare factors, trait factors and total score (31.33±1.97, 16.67±1.03, 71.83±2.93) were higher than control group (22.65±1.58, 12.59±0.71, 59.47± 2.18 ) and before intervention (22.00±1.27, 12.17±0.75, 58.00±1.67), and the differences were statistically significant ( F = 17.00 , 36.54, 12.71; 29.87, 13.09, 13.12, P <0.05).
Conclusion
Sports game intervention based on IMB model can effectively promote the development of prosocial behavior of children with IDD attending regular classes.
5.Current status and reflections on the prevention and treatment of metabolic associated fatty liver disease through different fasting patterns
Huaxin CHEN ; Wenxia ZHAO ; Jiachen YUAN ; Yuzhu ZHENG ; Yaokun HAO ; Xiaoyan LIU
Journal of Clinical Hepatology 2025;41(8):1643-1648
The incidence rate of metabolic associated fatty liver disease(MAFLD)is gradually increasing,and it has become a common chronic liver disease globally.MAFLD is closely associated with metabolic dysfunction,with dietary and exercise interventions as the primary treatment method,among which dietary control is of particular importance.This article summarizes related articles on the prevention and treatment of MAFLD through different fasting patterns in recent years,and the analysis showed that by restricting food intake and controlling calorie consumption,fasting therapy can help to reduce body weight and improve metabolic disorders.Further studies and clinical practice are needed to explore and validate the value of different fasting patterns in the prevention and treatment of MAFLD.
6.Analysis of differences in blood routine and infection markers among elderly AIDS patients combined with other opportunistic infections
Meixue CUI ; Yuan LYU ; Xiaoli LIU ; Yuzhu ZHENG ; Wenxia MA ; Lingna LYU
Chinese Journal of Geriatrics 2025;44(7):911-916
Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.
7.Analysis of differences in blood routine and infection markers among elderly AIDS patients combined with other opportunistic infections
Meixue CUI ; Yuan LYU ; Xiaoli LIU ; Yuzhu ZHENG ; Wenxia MA ; Lingna LYU
Chinese Journal of Geriatrics 2025;44(7):911-916
Objective:To analyze the differences in routine blood tests and infection markers among elderly AIDS patients with other opportunistic infections, to explore their immune status and inflammatory responses, and to provide new molecular markers for clinical diagnosis.Methods:The study included general indicators, routine blood tests, and infection markers of older HIV patients with other opportunistic infections admitted to Beijing You'an Hospital, Capital Medical University, from January 1, 2014, to December 31, 2024.Statistical analysis was performed using SPSS 27.0 software, with a significance level set at P<0.05. Results:A total of 94 elderly AIDS patients with various opportunistic infections were included in this study.Among them, the majority were co-infected with tuberculosis, accounting for 60 cases(63.83%), followed by 23 cases(24.47%)of AIDS patients co-infected with syphilis.Additionally, there were 7 cases of AIDS co-infected with amoebiasis(7.45%)and 4 cases of AIDS co-infected with monkeypox(4.26%).Almost all cases of combined infections were male, with males comprising 91.3% of AIDS patients co-infected with syphilis and 100% in the other co-infected groups.There were 9 blood routine and infectious markers that exhibited significant differences between patients with HIV co-infected with tuberculosis and those with other opportunistic infections.These markers included lymphocytes(LYM), hemoglobin(HGB), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio( P<0.05).Specifically, the levels of LYM, HGB, T lymphocytes, CD4 + T cells, CD8 + T cells, and the CD4/CD8 ratio in elderly AIDS patients with tuberculosis were significantly lower than those in patients with other co-infections(all P<0.05).Conversely, the levels of inflammatory factors such as PCT, ESR, and CRP were notably higher in the former group(all P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that when LYM was utilized as an individual indicator for the differential diagnosis between AIDS patients with tuberculosis and those with other opportunistic infections, the area under the curve(AUC)amounted to 0.832.However, the CRP/LYM ratio demonstrated the optimal diagnostic performance in differential diagnosis, with an AUC reaching 0.866. Conclusions:The immune function of elderly AIDS patients is further compromised following co-infection with tuberculosis, which is accompanied by a severe inflammatory response.The CRP/LYM ratio shows promise as a hematological molecular marker for differentiating between AIDS patients with tuberculosis and those with other opportunistic infections.
8.Study on the Mechanism of Danhe Liuwei Dihuang Decoction in Ovariectomized NAFLD Rats Based on ERα/PGC1α/PPARα
Chenlu ZHAO ; Suping MA ; Fangdong SHANG ; Sutong LIU ; Lihui ZHANG ; Yuanyuan ZHENG ; Wenxia ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(3):792-800
Objective To explore the effect on the expression of ERα/PGC1α/PPARα pathway,the therapeutic effect of Danhe Liuwei Dihuang Decoction on ovariectomized NAFLD rats was observed.Methods 60 female non-pregnant SPF SD rats were randomly divided into sham operation group(Sham),model group(Model),estrogen group(E2),traditional Chinese medicine high,medium and low dose group(DHR-H/M/L).Sham group was given normal diet after sham operation,and the other groups were given high-fat,high-fructose and high-cholesterol diet(HF/HF/HC)after bilateral ovariectomy to prepare postmenopausal NAFLD model.The Sham group and the Model group were given normal saline by gavage,and the other groups were given corresponding doses of drugs by gavage.The intervention time was 12 weeks,and the experimental period was 14 weeks.The general condition and body weight of rats in each group were recorded.HE staining of uterus was used to observe the morphology of uterus,HE staining of liver and oil red O staining were used to observe steatosis.Serum liver function(ALT,AST)and lipid metabolism indexes(TG,TC)were measured by automatic biochemical analyzer.The levels of serum E2 and free fatty acid(FFA)and the expression of FFA and TG in liver tissue were detected by ELISA.The mRNA and protein expressions of ERα,PGC1α and PPARα in liver tissues were detected by RT-PCR and Western blot.Results Compared with the Model group,by Danhe Liuwei Dihuang Decoction,the body weight and liver weight of ovariectomized NAFLD rats significantly decreased,liver fat deposition significantly decreased,E2 level increased,ALT,AST,TG,TC,FFA and liver tissue homogenate FFA,TG content significantly decreased,liver ERα,PGC1α,PPARα mRNA and protein expression up-regulated(P<0.05 or P<0.01).Conclusion Danhe Liuwei Dihuang Decoction can improve liver steatosis in postmenopausal NAFLD model rats.The mechanism may be related to up-regulating the expression of ERα/PGC1α/PPARα signaling pathway to promote liver FFA oxidation and reduce liver TG deposition.
9.Study on the Mechanism of Danhe Liuwei Dihuang Decoction in Ovariectomized NAFLD Rats Based on ERα/PGC1α/PPARα
Chenlu ZHAO ; Suping MA ; Fangdong SHANG ; Sutong LIU ; Lihui ZHANG ; Yuanyuan ZHENG ; Wenxia ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(3):792-800
Objective To explore the effect on the expression of ERα/PGC1α/PPARα pathway,the therapeutic effect of Danhe Liuwei Dihuang Decoction on ovariectomized NAFLD rats was observed.Methods 60 female non-pregnant SPF SD rats were randomly divided into sham operation group(Sham),model group(Model),estrogen group(E2),traditional Chinese medicine high,medium and low dose group(DHR-H/M/L).Sham group was given normal diet after sham operation,and the other groups were given high-fat,high-fructose and high-cholesterol diet(HF/HF/HC)after bilateral ovariectomy to prepare postmenopausal NAFLD model.The Sham group and the Model group were given normal saline by gavage,and the other groups were given corresponding doses of drugs by gavage.The intervention time was 12 weeks,and the experimental period was 14 weeks.The general condition and body weight of rats in each group were recorded.HE staining of uterus was used to observe the morphology of uterus,HE staining of liver and oil red O staining were used to observe steatosis.Serum liver function(ALT,AST)and lipid metabolism indexes(TG,TC)were measured by automatic biochemical analyzer.The levels of serum E2 and free fatty acid(FFA)and the expression of FFA and TG in liver tissue were detected by ELISA.The mRNA and protein expressions of ERα,PGC1α and PPARα in liver tissues were detected by RT-PCR and Western blot.Results Compared with the Model group,by Danhe Liuwei Dihuang Decoction,the body weight and liver weight of ovariectomized NAFLD rats significantly decreased,liver fat deposition significantly decreased,E2 level increased,ALT,AST,TG,TC,FFA and liver tissue homogenate FFA,TG content significantly decreased,liver ERα,PGC1α,PPARα mRNA and protein expression up-regulated(P<0.05 or P<0.01).Conclusion Danhe Liuwei Dihuang Decoction can improve liver steatosis in postmenopausal NAFLD model rats.The mechanism may be related to up-regulating the expression of ERα/PGC1α/PPARα signaling pathway to promote liver FFA oxidation and reduce liver TG deposition.
10.Current status and reflections on the prevention and treatment of metabolic associated fatty liver disease through different fasting patterns
Huaxin CHEN ; Wenxia ZHAO ; Jiachen YUAN ; Yuzhu ZHENG ; Yaokun HAO ; Xiaoyan LIU
Journal of Clinical Hepatology 2025;41(8):1643-1648
The incidence rate of metabolic associated fatty liver disease(MAFLD)is gradually increasing,and it has become a common chronic liver disease globally.MAFLD is closely associated with metabolic dysfunction,with dietary and exercise interventions as the primary treatment method,among which dietary control is of particular importance.This article summarizes related articles on the prevention and treatment of MAFLD through different fasting patterns in recent years,and the analysis showed that by restricting food intake and controlling calorie consumption,fasting therapy can help to reduce body weight and improve metabolic disorders.Further studies and clinical practice are needed to explore and validate the value of different fasting patterns in the prevention and treatment of MAFLD.


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