1.Advances in pyroptosis in sepsis-associated acute kidney injury
Wenyu WU ; Xin JIAO ; Shaofeng ZHAN ; Wanning LAN ; Jingyu NIAN ; Jingnan LIN ; Kai WANG ; Lin WANG ; Ruifeng ZENG ; Rui CHEN ; Jun LI
Chinese Journal of Nosocomiology 2025;35(11):1743-1748
Sepsis is a systemic inflammatory response triggered by infection and often leads to acute kidney injury(AKI).The pathogenesis of sepsis-associated AKI is complex,involving multiple factors such as renal ischemia,inflammation and oxidative stress.In recent years,pyroptosis,a pro-inflammatory form of programmed cell death,has gradually attracted the attention of researchers.Pyroptosis is activated by inflammasomes(e.g.,the NOD-like receptor pyrin domain-related protein 3 inflammasome,NLRP3 inflammasome),accompanied by Gas-dermin D(GSDMD)-mediated formation of cell membrane pores and release of cellular contents,which leads to exacerbation of local and systemic inflammatory responses.The mechanism of pyroptosis in sepsis-associated AKI has not been fully elucidated,but AKI is directly involved in the process of renal functional impairment by indu-cing the death of renal tubular epithelial cells and exacerbating the local inflammatory response.Blockade of key molecules in the pyroptosis pathway,such as GSDMD or NLRP3 inflammasome,can significantly alleviate renal injury,suggesting that the pyroptosis pathway may be a potential therapeutic target for sepsis-associated AKI.This review summarizes the recent research progress on pyroptosis in sepsis-associated AKI,and discuss its cen-tral role in the pathogenesis,particularly focusing on the inflammasome and GSDMD pathways.Additionally,this paper analyzes the potential of focal death inhibition as a therapeutic strategy and proposes future research direc-tions with the expectation of providing references for the treatment of sepsis-related AKI.
2.Characteristics of serum immunoglobulin G N-glycans in male patients with androgenetic alopecia
Linxia SHEN ; Huijuan ZHAO ; Jinran LIN ; Qingmei LIU ; Shifang REN ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):595-602
Objective:To investigate the characteristics of serum immunoglobulin G (IgG) N-glycans in male patients with different subtypes and severity grades of androgenetic alopecia (AGA) .Methods:A cross-sectional study was conducted on male patients diagnosed with male-pattern hair loss (MPHL) or female-pattern hair loss (FPHL) who attended the Department of Dermatology, Huashan Hospital, Fudan University between June and December 2022. Clinical data were collected, and serum IgG N-glycans were quantitatively analyzed using ultra-performance liquid chromatography (UPLC) . The content of serum IgG N-glycan structures was compared between patients with different AGA subtypes and among patients with different severity grades of MPHL or FPHL, while derived traits were compared between patients with different AGA subtypes. Point-biserial correlation analysis was conducted to assess associations between serum IgG N-glycans and hair loss severity.Results:A total of 85 male patients with AGA were included, comprising 44 MPHL patients and 41 FPHL patients. No significant differences were observed between the two subgroups in terms of age, age at onset, or serum levels of testosterone, sex hormone-binding globulin, uric acid, and 25-hydroxyvitamin D (all P > 0.05) . UPLC showed 23 serum IgG glycans and 5 derived glycan traits (afucosylation, fucosylation, bisecting GlcNAc, terminal galactosylation, and terminal sialylation) . Compared with the MPHL patients, the FPHL patients exhibited significantly increased levels of N-glycans GP5, GP11, GP17, and GP20 (all P < 0.05) , significantly elevated levels of afucosylated IgG N-glycans ( P = 0.047) , but significantly reduced core fucosylated IgG N-glycans ( P = 0.047) . No significant differences in serum IgG N-glycan composition were observed among patients with varying severity grades of MPHL (all P > 0.05) . In the FPHL patients, the levels of N-glycans GP10 ( r = 0.32, P = 0.039) and GP22 ( r = -0.32, P = 0.045) were significantly positively and negatively correlated with hair loss severity respectively; receiver operating characteristic curve analysis showed that both GP10 and GP22 had moderate diagnostic value for predicting hair loss severity, with the area under the curve values being 0.69 (95% CI: 0.52 - 0.86) and 0.71 (95% CI: 0.55 - 0.86) , respectively. Conclusion:Serum IgG N-glycan profiles differed among male patients with different AGA subtypes, and N-glycans GP10 and GP22 may serve as potential biomarkers for early assessment of hair loss severity in male FPHL patients.
3.Efficacy and safety of a domestic hair follicle extraction system in extracting hair follicles from patients with androgenetic alopecia: a multicenter, prospective, randomized, self-controlled clinical trial
Kai YANG ; Jinran LIN ; Fei ZHU ; Suyun FENG ; Zheng LI ; Yue ZHANG ; Ruiming HU ; Hanxiao CHENG ; Zhentao ZHOU ; Yatong WU ; Dingquan YANG ; Jufang ZHANG ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):603-607
Objective:To compare the efficacy and safety of a domestic hair follicle extraction system versus traditional follicular unit excision (FUE) in extracting hair follicles for the treatment of androgenetic alopecia (AGA) .Methods:A multicenter, randomized, self-controlled clinical trial was conducted on AGA patients aged 18 - 59 years who were recruited from the Huashan Hospital, Fudan University, the Affiliated Hangzhou First People's Hospital, and the China-Japan Friendship Hospital between June 2023 and September 2024. Each patient's scalp was randomly divided into two sides (experimental side vs. control side) using an envelope method. The experimental side underwent robotic hair transplantation with a domestic hair follicle extraction system, and the control side underwent traditional FUE. Hair follicles were extracted from the safe donor area in the occipital region, and implanted into the ipsilateral hair loss area. The primary outcome was the hair transection rate which was calculated immediately after follicular extraction. The secondary outcomes included the hair follicle unit loss rate and the change in hair density at the recipient site on postoperative day 14. Safety was evaluated by assessing the incidence of folliculitis at the donor site on postoperative day 14 and the overall incidence of adverse events. Surgical outcomes were evaluated at 9 months after surgery. Comparisons of evaluation indicators among groups were performed by using a paired t test or Wilcoxon signed-rank test. Results:A total of 55 patients with AGA (51 males and 4 females, aged 32.71 ± 5.75 years) completed the hair follicle transplantation and postoperative follow-up. The hair transection rate ( M[ Q1, Q3]) was 6.65% (4.56%, 10.16%) in the experimental group and 5.28% (3.04%, 8.89%) in the control group (difference = 1.24%, 95% CI: -0.24%, 2.65%) . The hair follicle unit loss rate was 2.00% (1.00%, 3.50%) in the experimental group and 0.50% (0, 2.00%) in the control group, with a significant difference between the two groups ( P = 0.008) . On postoperative day 14, there was no significant difference in the hair density between the experimental group and control group (72.20 ± 25.95 per cm 2vs. 76.49 ± 30.84 per cm 2, P = 0.173) . At 9-month follow-up, both groups showed improvement in the investigator's overall score in the recipient areas. Seven adverse events occurred in 7 subjects (12.72%) in each group, and all were mild folliculitis. Conclusion:The domestic hair follicle extraction system demonstrated comparable efficacy and safety to the traditional FUE in hair transplantation.
4.Oral minoxidil in the treatment of alopecia areata
Qin WANG ; Jinran LIN ; Qingmei LIU ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):653-656
Oral minoxidil has been used to treat various hair loss disorders, including alopecia areata, though its efficacy as a monotherapy remains unclear. In recent years, oral minoxidil has increasingly been applied as an adjuvant treatment alongside other agents such as Janus kinase inhibitors for alopecia areata. This review summarizes the current application of oral minoxidil in the treatment of alopecia areata.
5.Role of stem cells in scalp aging and related therapeutic strategies
Weiyun DING ; Jinran LIN ; Qingmei LIU ; Yue ZHANG ; Kai YANG ; Chunya NI ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):671-675
Changes in hair follicle stem cells (HFSCs) can affect scalp aging and hair growth. With increasing age, HFSCs exhibit a decrease in quiescence maintenance and self-renewal capacity, as well as differentiation potential, leading to shortened hair growth cycles and even hair loss. This review summarizes recent research advances in the multifactorial interactions underlying hair loss, including the regulatory mechanisms of HFSC quiescence, the impact of aging on HFSC function, and aging of the stem cell microenvironment. Additionally, this review discusses the relationship between stem cells and hair shafts, and the mechanisms of action of stem cells in scalp aging, including alterations in signaling pathways, chromatin remodeling, and epigenetic regulation, etc. Furthermore, stem cell-based therapeutic strategies are summarized, such as the use of stem cells or their secreting exosomes, modulation of the stem cell microenvironment, and pharmacological interventions.
6.Androgenetic alopecia and metabolic syndrome: from mechanisms to treatment strategies
Jinran LIN ; Hiochon LEONG ; Qingmei LIU ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):591-594
Androgenetic alopecia (AGA) is the most common type of hair loss in humans, characterized by the patterned miniaturization of scalp hair follicles and shortened anagen phases. Recent studies have revealed a significant association between AGA and metabolic syndrome (MetS) . The hallmarks of MetS include abdominal obesity, impaired glucose metabolism, hypertension, and dyslipidemia. This commentary evaluates the epidemiological association between AGA and MetS, explores the underlying concurrent mechanisms, and discusses current and potential therapeutic strategies.
7.Advances in pyroptosis in sepsis-associated acute kidney injury
Wenyu WU ; Xin JIAO ; Shaofeng ZHAN ; Wanning LAN ; Jingyu NIAN ; Jingnan LIN ; Kai WANG ; Lin WANG ; Ruifeng ZENG ; Rui CHEN ; Jun LI
Chinese Journal of Nosocomiology 2025;35(11):1743-1748
Sepsis is a systemic inflammatory response triggered by infection and often leads to acute kidney injury(AKI).The pathogenesis of sepsis-associated AKI is complex,involving multiple factors such as renal ischemia,inflammation and oxidative stress.In recent years,pyroptosis,a pro-inflammatory form of programmed cell death,has gradually attracted the attention of researchers.Pyroptosis is activated by inflammasomes(e.g.,the NOD-like receptor pyrin domain-related protein 3 inflammasome,NLRP3 inflammasome),accompanied by Gas-dermin D(GSDMD)-mediated formation of cell membrane pores and release of cellular contents,which leads to exacerbation of local and systemic inflammatory responses.The mechanism of pyroptosis in sepsis-associated AKI has not been fully elucidated,but AKI is directly involved in the process of renal functional impairment by indu-cing the death of renal tubular epithelial cells and exacerbating the local inflammatory response.Blockade of key molecules in the pyroptosis pathway,such as GSDMD or NLRP3 inflammasome,can significantly alleviate renal injury,suggesting that the pyroptosis pathway may be a potential therapeutic target for sepsis-associated AKI.This review summarizes the recent research progress on pyroptosis in sepsis-associated AKI,and discuss its cen-tral role in the pathogenesis,particularly focusing on the inflammasome and GSDMD pathways.Additionally,this paper analyzes the potential of focal death inhibition as a therapeutic strategy and proposes future research direc-tions with the expectation of providing references for the treatment of sepsis-related AKI.
8.Impact of Mild-to-Moderate Frailty on the Long-term Prognosis of Hospitalized Elderly Patients with T2DM: A Retrospective Cohort Study
Wenyu PENG ; Yuchen ZHOU ; Lina ZHOU ; Xuan QU ; Ning ZHANG ; Lin KANG
Medical Journal of Peking Union Medical College Hospital 2025;17(1):148-155
To investigate the impact of mild-to-moderate frailty on the long-term prognosis of hospitalized elderly patients with type 2 diabetes mellitus(T2DM). A retrospective cohort study was designed, which contains T2DM patients aged ≥65 years and hospitalized in the Department of Geriatrics at Peking Union Medical College Hospital(PUMCH) from 2014 to 2022. Frailty status of those T2DM patients was assessed using the Clinical Frailty Scale(CFS), and the data of comorbidities, functional status, nutritional indices, and geriatric syndromes were collected. The primary endpoint was all-cause mortality, with secondary endpoints including rehospitalization rate and severe disability. Cox proportional hazards regression models were employed to analyze the association between mild-to-moderate frailty and outcomes. A total of 367 elderly T2DM patients were enrolled, comprising 164 males(44.7%) and 203 females(55.3%), with an age ranging from 65 to 93 years(median age 74 years). According to the CFS assessment, 115 patients(31.3%) were identified as mild-to-moderate frailty(including 56 with mild frailty and 59 with moderate frailty). During a follow-up period of 2.3-10.3 years(median 5.6 years), the frail group exhibited significantly higher rates of severe disability, unscheduled rehospitalization, and all-cause mortality compared to the non-frail group. Multivariable Cox regression analysis revealed that mild-to-moderate frailty was an independent risk factor for severe disability( The presence of mild-to-moderate frailty significantly increases the risk of long-term adverse outcomes. Clinical practice is recommended to strengthen frailty screening and comprehensive intervention for elderly T2DM patients to improve their quality of life and clinical outcomes.
9.Fibrosing alopecia in a pattern distribution
Yuou SHA ; Kelu WEI ; Jinran LIN ; Qingmei LIU ; Chunya NI ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):660-663
Fibrosing alopecia in a pattern distribution (FAPD) is a newly recognized entity of primary lymphocytic cicatricial alopecia with clinical and histopathological characteristics of both androgenetic alopecia and lichen planopilaris. Currently, there is still a lack of full understanding of and standardized treatment protocols for FAPD, which is prone to be clinically underdiagnosed and misdiagnosed. This review systematically summarizes the research progress in FAPD in terms of clinical manifestations, diagnosis, and treatment, in order to facilitate its clinical diagnosis and treatment.
10.Bendamustine combined with anti-CD20 monoclonal antibody in the first-line treatment of older patients with indolent B-cell non-Hodgkin lymphoma: a multicenter retrospective study
Shuchao QIN ; Yi MIAO ; Zhaoliang ZHANG ; Jie ZHANG ; Yuye SHI ; Yuqing MIAO ; Weiying GU ; Weicheng ZHENG ; Zhuxia JIA ; Guoqiang LIN ; Haiwen NI ; Xiaohong XU ; Min XU ; Xiaoyan XIE ; Ling WANG ; Yun ZHUANG ; Wei ZHANG ; Ping LIU ; Jianyong LI ; Wenyu SHI
Chinese Journal of Hematology 2025;46(9):820-826
Objective:To investigate the efficacy and safety of bendamustine combined with anti-CD20 monoclonal antibody in the first-line treatment of older patients with indolent B-cell non-Hodgkin lymphoma (B-iNHL) .Methods:The clinical data of 159 patients with B-iNHL enrolled in 16 hospitals from Jiangsu Cooperative Lymphoma Group from December 1, 2019, to April 20, 2024, were analyzed for regimen efficacy and safety. Bendamustine plus rituximab (BR) and bendamustine plus obinutuzumab (BG) were administered to 139 (87.4% ) and 20 (12.6% ) patients, respectively.Results:Among the 159 patients, 101 (63.5% ) were male and 58 (36.5% ) were female, with a median age of 69 years (range: 60–84). Efficacy could be assessed in 138 (86.8% ) patients. The efficacy assessment demonstrated that the overall response rate was 92.0% with complete and partial remissions in 75 (54.3% ) and 52 (37.7% ) cases, respectively. With a median follow-up of 24 months (range: 4–64), the progression-free survival rate was (87.5 ± 3.0) % and the overall survival rate was (83.2 ± 3.3) %. Of the 27 patients who died, 6 (22.2% ) died due to disease progression. The mean applied dose of bendamustine per cycle was 73.0 (50.8–89.7) mg/m 2 per day, administered on days 1 and 2. Adverse events of grade 3 or higher were reported in 53 (33.3% ) patients, with infection (30 cases,18.9% ) and neutropenia (24 cases, 15.1% ) demonstrating the highest incidence. Conclusion:Bendamustine combined with anti-CD20 monoclonal antibody demonstrated good efficacy and is well-tolerated in the first-line treatment of elderly patients with B-iNHL.

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