1.Olfactory Receptors Expressed in The Intestine and Their Functions
Pei-Wen YANG ; Meng-Meng YUAN ; Ying ZHOU ; Peng LI ; Gui-Hong QI ; Ying YANG ; Zhong-Yi MAO ; Meng-Sha ZHOU ; Xiao-Shuang MAO ; Jian-Ping XIE ; Yi-Nan YANG ; Shi-Hao SUN
Progress in Biochemistry and Biophysics 2026;53(3):534-549
Olfactory receptors (ORs) form the largest superfamily of G protein-coupled receptors (GPCRs). Traditionally recognized for their role in the nasal olfactory epithelium, where they mediate the sense of smell, accumulating evidence has firmly established their ectopic expression in non-olfactory tissues, including the intestine, lungs, and kidneys. The intestine, as the primary site for nutrient digestion and absorption, harbors a highly complex chemical environment. To adapt to this environment, the gut employs a sophisticated network of “chemosensors” to monitor luminal contents and maintain homeostasis. Among these sensors, intestinal ORs have emerged as crucial functional components, serving as a molecular bridge that connects environmental chemical signals—such as food-derived odorants—to specific physiological responses. This discovery has significantly deepened our understanding of how dietary flavors and compounds influence intestinal physiology at the molecular level. This review systematically summarizes the expression profiles, ligand classification, and biological functions of ORs within the gastrointestinal tract. Studies indicate that intestinal ORs exhibit distinct spatial distribution patterns across different gut segments and display cell-type specificity, particularly within enterocytes and enteroendocrine cells. These receptors function as versatile sensors capable of recognizing a wide variety of ligands, including exogenous dietary components, gut microbiota metabolites such as short-chain fatty acids, and endogenous small molecules like azelaic acid. Upon activation by specific ligands, intestinal ORs trigger intracellular signaling cascades, primarily involving the AC-cAMP-PKA pathway or calcium influx channels. A major focus of this review is to elucidate the molecular mechanisms by which these receptors regulate the secretion of gut hormones. Activation of specific ORs in enteroendocrine cells has been shown to stimulate the release of hormones such as glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and serotonin (5-HT), thereby modulating systemic energy metabolism, glucose homeostasis, and gastrointestinal motility. Furthermore, the review addresses the critical roles of ORs in immune regulation and pathology. Evidence suggests that specific ORs contribute to the maintenance of intestinal immune homeostasis and may offer protection against inflammation. Beyond their involvement in inflammatory responses, ORs such as Olfr78 have been shown to regulate the differentiation and function of intestinal endocrine cells. Similarly, Olfr544 has been demonstrated to alleviate intestinal inflammation by remodeling the gut microbiome and metabolome. These findings collectively suggest that specific ORs hold promise as therapeutic targets for mitigating intestinal inflammation and maintaining gut homeostasis. Additionally, the review explores the emerging role of ORs in cancer. Although OR expression is often downregulated in tumor tissues compared to normal mucosa, activation of specific ORs by certain ligands can inhibit tumor cell proliferation and migration and induce apoptosis via pathways such as MEK/ERK and p38 MAPK. Conversely, other receptors, such as OR7C1, may serve as biomarkers for cancer-initiating cells. In conclusion, intestinal ORs represent a vital component of the gut’s sensory network. The review also discusses the translational potential of these findings. By elucidating the precise pairing relationships between dietary components and specific ORs, novel therapeutic strategies could be developed. Intestinal ORs may thus emerge as promising targets for nutritional and pharmacological interventions in metabolic diseases, inflammatory bowel diseases, and malignancies.
2.Latent classes of peer victimization among junior high school students and the association with non-suicidal self-injury behavior
SHI Antai, XIE Yaofei, WU Taimin, ZHOU Yang
Chinese Journal of School Health 2026;47(2):222-226
Objective:
To explore the latent classes of peer victimization among junior high school students, and to analyze the association between the characteristics of different classes and non suicidal self injury(NSSI) behavior,so as to provide scientific basis for the prevention and intervention of NSSI behavior among junior high school students.
Methods:
A census method was used to select 19 738 students from 16 junior high schools in a central urban area of Wuhan as research subjects from November to December 2024. The Multidimensional Peer Victimization Scale and a self designed NSSI questionnaire were used to assess peer victimization and NSSI behaviors. Latent profile analysis (LPA) was used to identify latent classes of peer victimization among students by sex. Binary Logistic regression model was used to analyze the association between latent classes of peer victimization and NSSI behavior among junior high school students of different genders.
Results:
Latent patterns of peer victimization among boys were classified into 4 groups:no victimization group (85.8%, n =8 874), low victimization-verbal type group (6.6%, n =682), low victimization-mixed type group (5.7%, n =587) and high victimization group (1.9%, n =195); girls were classified into 4 groups:no victimization group (87.0%, n =8 179), low victimization group (7.5%, n =702), high victimization-social type group (3.8%, n =360) and high victimization-physical type group (1.7%, n =159). After controlling for only child status, place of residence, parenting style, and self rated family socioeconomic status, binary Logistic regression analysis showed that the risk of NSSI behavior among boys increased sequentially in the low victimization-verbal type group( OR =4.14, 95% CI =3.22-5.31), low victimization-mixed type group ( OR =4.75, 95% CI =3.68-6.13), and high victimization group ( OR =8.26, 95% CI =5.83-11.71) compared to the no victimization group; the risks of NSSI behavior among girls increased sequentially in the low victimization group ( OR =3.06, 95% CI = 2.51-3.72), high victimization-social type group ( OR =4.01, 95% CI =3.13-5.15), and high victimization-physical type group ( OR =6.18, 95% CI =4.38-8.73) compared to the no victimization group (all P <0.05).
Conclusions
There are gender differences in the latent classes of peer victimization among junior high school students and the risk of NSSI behavior varies across different victimization classes. Targeted prevention and intervention should be implemented based on the gender of junior high school students and the characteristics of peer victimization students experience.
3.Efficacy and safety of anlotinib combined with ICI as first-line treatment for advanced lung squamous cell carcinoma: a single-center retrospective cohort study of 37 patients
LIN Yong1△ ; XIAO Chunmei2△ ; XIE Qiang2 ; CHEN Qun2 ; SHI Qin2 ; LUO Yang2 ; HU Ying2 ; LIN Heng2
Chinese Journal of Cancer Biotherapy 2026;33(2):155-162
[摘 要] 目的:探讨安罗替尼联合免疫检查点抑制剂(ICI)作为一线方案治疗晚期肺鳞状细胞癌(LUSC)的有效性及安全性。方法:采用单中心回顾性队列设计,连续纳入2018年10月至2023年12月福建省福州肺科医院收治的37例初治晚期LUSC患者。所有患者接受安罗替尼(剂量为8、10或12 mg/d,用药2周/停药1周)联合ICI治疗。主要终点为无进展生存期(PFS),次要终点包括客观缓解率(ORR)、疾病控制率(DCR)及治疗相关不良事件(TRAE)。结果:全组患者中位随访15.2个月,ORR达54.1%(20/37),DCR为97.3%(36/37),中位PFS为11.8个月(95%CI:8.3~NA),12个月PFS率为48.6%。探索性亚组分析显示:安罗替尼12 mg剂量组的中位PFS(未达到 vs 7.5个月,HR = 0.09,95%CI:0.01~0.67,P < 0.01)及ORR(100% vs 42.9%,P < 0.01)均显著优于8/10 mg组。分期分层显示ⅢB/ⅢC期患者ORR显著优于Ⅳ期(84.6% vs 41.7%,P = 0.02)。安全性方面,62.2%(23/37)的患者发生TRAE,以1~2级高血压[29.7%(11/37)]、手足综合征[21.6%(8/37)]为主,3例(8.1%)因3级TRAE终止治疗。结论:安罗替尼联合ICI作为晚期LUSC一线治疗方案具有良好的疗效前景和可管理的安全性。其中,12 mg剂量组在探索性分析中显示出更优疗效的潜在信号,早期分期患者ORR更高。该结果值得开展大规模前瞻性研究进行进一步验证。
4.Pinelliae Rhizoma and Its Prescription Compatibility for Depression Treatment: A Review
Zhe XIE ; Yifan SHI ; Linzhe SU ; Ming BAI ; Yucheng LI ; Baoying WANG ; Erping XU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):284-293
Depression is a common mental disorder that falls under the category of "stagnation syndrome" in traditional Chinese medicine (TCM). Its complex pathogenesis poses challenges for the development of novel therapeutic agents. Currently, clinically used antidepressants are often accompanied by significant side effects, and statistics show that about one-third of patients do not respond to these medications. TCM demonstrates advantages in the treatment of depression through multi-target, multi-pathway and multi-mechanistic approaches. Pinelliae Rhizoma, a phlegm-resolving herb, exhibits effects such as drying dampness and resolving phlegm, as well as eliminating stuffiness and reducing masses. The characteristics of harmonizing Yin and Yang and resolving stagnation in the middle energizer align precisely with the pathogenesis of depression syndrome, demonstrating therapeutic efficacy in affected patients. Literature studies have found that the active ingredients of Pinelliae Rhizoma, such as cavidine, baicalein, β-sitosterol, as well as Pinelliae Rhizoma herb pairs, such as Pinelliae Rhizoma-Magnoliae Officinalis Cortex, Pinelliae Rhizoma-husked sorghum, Pinelliae Rhizoma-Prunellae Spica, exhibit significant antidepressant effects. Furthermore, TCM formulas containing Pinelliae Rhizoma as the principal therapeutic agent, such as Banxia Xiexin Tang, Banxia Houpo Tang, and Wendan Tang, as well as formulas incorporating Pinelliae Rhizoma like compound Xiaochaihu Tang, Chaihu Jia Longgu Muli Tang, and Erchen Tang, have also demonstrated favorable antidepressant efficacy. The antidepressant mechanism of these agents may involve modulation of 5-hydroxytryptamine (5-HT) and dopamine (DA) levels, up-regulation of brain-derived neurotrophic factor (BDNF) expression, regulation of the hypothalamus-pituitary-adrenal (HPA) axis, reduction of oxidative stress, modulation of nuclear transcription factor-κB (NF-κB) signaling pathway, and inhibition of microglia-mediated inflammatory responses. This review summarized the antidepressant mechanisms and clinical applications of the active components, herb pairs, and TCM formulas containing Pinelliae Rhizoma, aiming to provide a reference for modern research on the use of Pinelliae Rhizoma in antidepressant therapy.
5.Impact of visceral fat area on significant liver fibrosis in patients with nonalcoholic fatty liver disease and establishment of a predictive model
Jingkai YUAN ; Fengming ZHAO ; Huangqi LIN ; Meijie SHI ; Huanming XIAO ; Yubao XIE ; Xiaoling CHI
Journal of Clinical Hepatology 2026;42(2):312-318
ObjectiveTo investigate whether visceral fat area (VFA) is an independent risk factor for significant liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) based on clinical data, and to establish an effective diagnostic model. MethodsA total of 222 NAFLD patients who attended Department of Hepatology, Guangdong Provincial Hospital of Traditional Chinese Medicine, from January 2021 to April 2025 were enrolled, and according to liver stiffness measurement (≥8 kPa or not), they were divided into significant fibrosis group and non-significant fibrosis group. Propensity score matching (PSM) was performed at a ratio of 1∶1 to balance the baseline data between the two groups. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was used to determine the correlation of VFA and other indicators with significant liver fibrosis; univariate and multivariate logistic regression analyses were used to identify whether VFA was an independent risk factor for significant liver fibrosis in NAFLD patients, and the receiver operating characteristic (ROC) curve was plotted to assess the predictive performance of related indicators. ResultsA total of 45 patients with significant liver fibrosis and 177 patients without significant liver fibrosis were enrolled, and after PSM, 90 patients (45 pairs) were finally included in analysis. Compared with the non-significant fibrosis group, the significant fibrosis group had significantly higher levels of body mass index (BMI), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), uric acid (UA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), controlled attenuation parameter (CAP), and VFA, as well as a significantly higher proportion of patients with visceral fat obesity or three or more metabolic risk factors (all P<0.05). VFA, BMI, AST, and HbA1c were strongly correlated with significant liver fibrosis (all r>0.5, all P <0.05), and ALT, GGT, UA, FBG, and CAP were significantly positively correlated with significant liver fibrosis (r=0.3 — 0.5, all P<0.05). VFA (odds ratio [OR]=1.040, 95% confidence interval [CI]: 1.018 — 1.062, P<0.05), FBG (OR=2.372, 95%CI: 1.199 — 4.691, P<0.05), and AST (OR=1.032, 95%CI: 1.003 — 1.058, P<0.05) were independent risk factors for significant liver fibrosis in NAFLD patients. The new diagnostic model based on VFA, FBG, and AST (with an area under the ROC curve [AUC] of 0.907) had a significantly better performance than aspartate aminotransferase-to-platelet ratio index (AUC=0.834), fibrosis-4 (AUC=0.660), triglyceride-glucose index (AUC=0.656), and NAFLD fibrosis score (AUC=0.768) in predicting significant liver fibrosis in NAFLD patients (all P<0.05). ConclusionVFA is an independent risk factor for significant liver fibrosis in NAFLD patients, and the noninvasive diagnostic model based on VFA, FBG, and AST can effectively predict the onset of significant liver fibrosis in NAFLD patients.
6.Risk Factors Analysis and Predictive Model Construction for Acute Kidney Injury Following Amphotericin B Deoxycholate Use in Hospitalized Patients
Hao XIE ; Yixun SHI ; Zhiqing XU ; Minquan LI ; Xiaoli DU ; Gang CHEN ; Bin ZHAO
Medical Journal of Peking Union Medical College Hospital 2026;17(2):429-437
To investigate the risk factors for acute kidney injury (AKI) following the use of amphotericin B deoxycholate and to develop a predictive model to guide clinical monitoring and intervention. A retrospective analysis was conducted on hospitalized patients who received amphotericin B deoxycholate between January 2014 and September 2024. Patients were divided into a training set and a validation set. Demographic data, laboratory findings, and medication orders were collected. Based on the occurrence of AKI during treatment and within 7 days after discontinuation, patients were classified into an AKI group and a non-AKI group. Univariate analysis was used to screen for potential risk factors, multivariate logistic regression was employed to construct a predictive model, and model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow test. The training set included 473 patients, comprising 255 males (53.91%) and 218 females (46.09%), with a median age of 52(35, 62) years. The AKI group consisted of 191 cases (40.38%), and the non-AKI group consisted of 282 cases (59.62%). The validation set included 114 patients, comprising 80 males (70.18%) and 34 females (29.82%), with a median age of 43.5 (31.0, 58.5) years. The AKI group consisted of 42 cases (36.84%), and the non-AKI group consisted of 72 cases (63.16%). Univariate analysis revealed statistically significant differences between the two groups in 23 factors (all Admission to the ICU, elevated serum creatinine at admission, and comorbid cardiac insufficiency as potential risk factors for AKI, while prophylactic use of diphenhydramine/promethazine or sodium bicarbonate showed a protective association. A predictive model with good discrimina-tion and calibration was developed, which may provide a basis for early identification of high-risk patients and timely adjustment of treatment strategies in clinical practice.
7.Clinical efficacy analysis of seven pediatric patients with Acute myeloid leukemia and the t(16;21)(p11;q22) FUS::ERG fusion gene.
Lihuan SHI ; Shan HUANG ; Xing XIE ; Pengkai FAN ; Haili GAO ; Yanna MAO
Chinese Journal of Medical Genetics 2026;43(2):90-95
OBJECTIVE:
To analyze the clinical characteristics, treatment, and prognosis of seven pediatric patients with Acute myeloid leukemia (AML) positive for the t(16;21)(p11;q22) FUS::ERG fusion gene.
METHODS:
A retrospective analysis was carried out on the clinical data, treatment, and prognosis of seven AML patients with t(16;21)(p11;q22) FUS::ERG fusion gene admitted to Henan Children's Hospital between June 2015 and November 2024. Relevant literature was also reviewed. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2024-102-001).
RESULTS:
Among 297 pediatric patients with AML, 7 cases (2.36%) were positive for the t(16;21)(p11;q22) FUS::ERG fusion gene, including 3 males and 4 females, with a median age of 11 years (range: 3 ~ 12 years). According to the FAB classification, these included 1 case of M2, 3 cases of M5, and 3 cases of AML-not otherwise specified (non-M3). All 7 patients were found to harbor the t(16;21)(p11;q22) translocation, with 3 cases showing additional chromosomal abnormalities. Immunophenotyping revealed universal expression of CD13, CD33, CD34, and CD117, with partial expression of CD56, CD4, CD64, CD123, CD15, CD38, CD11b, HLA-DR, cMPO, and CD16. One patient achieved complete remission (CR) after the first course of DAE (cytarabine + daunorubicin + etoposide) induction chemotherapy but relapsed and discontinued the treatment. Six patients received DAH (cytarabine + daunorubicin + homoharringtonine) induction therapy, of whom 2 achieved CR after two courses and underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), resulting in an overall CR rate of 42.86%. Five children did not receive allo-HSCT and had a median overall survival of 9 months (range: 6 ~ 18 months). Two children who underwent transplantation achieved bone marrow morphological and molecular biological relapse at 6 and 9 months post-transplantation, respectively. After receiving combined chemotherapy and donor lymphocyte infusion, one child failed to achieve remission and died at 22 months post-transplantation, while the other has been followed up to date with positive fusion gene status. Their overall survival was 25 months and 30 months, respectively.
CONCLUSION
The t(16;21)(p11;q22) FUS::ERG fusion gene is rare in pediatric AML and associated with poor prognosis. Allo-HSCT may mitigate the adverse prognostic impact of the FUS::ERG fusion gene and contribute to prolonged survival.
Humans
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Male
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Child
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Female
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Leukemia, Myeloid, Acute/drug therapy*
;
Oncogene Proteins, Fusion/genetics*
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Translocation, Genetic
;
Retrospective Studies
;
RNA-Binding Protein FUS/genetics*
;
Chromosomes, Human, Pair 16/genetics*
;
Adolescent
;
Child, Preschool
;
Chromosomes, Human, Pair 21/genetics*
;
Prognosis
;
Treatment Outcome
8.Clinical observation of 450 nm blue laser vaporization for the treatment of benign prostatic hyperplasia in frail elderly patients
Guowei CHEN ; Zunke XIE ; Lei SHI ; Xuejing GUO ; Zhe JIN ; Lianchao JIN
Journal of Modern Urology 2025;30(6):508-512
Objective: To investigate the clinical efficacy of transurethral 450 nm blue laser vaporization of prostate (BVP) and transurethral plasmakinetic resection of the prostate (PKRP) in the treatment of frail elderly patients with benign prostatic hyperplasia (BPH). Methods: A retrospective analysis was conducted on the clinical data of 62 frail elderly BPH patients undergoing BVP (n=32) or PKRP (n=30) in our hospital during Jan.2023 and Jun.2024.The two groups were compared in terms of postoperative hemoglobin drop, operation time, hospital stay, catheter indwelling time, bladder irrigation time, preoperative and postoperative 3-month postvoid residual (PVR), maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), quality of life score (QoL), and postoperative complications. Results: The postoperative hemoglobin drop was lower in the BVP group than in the PKRP group [(1.62±1.04) g/L vs.(7.37±2.37) g/L, P<0.001].The operation time [(24.53±7.52) min vs. (47.77±11.12) min], hospital stay [(2.78±1.62) d vs. (8.13±0.82) d], catheter indwelling time [(1.84±0.99) d vs. (5.40±0.81) d], and bladder irrigation time [(7.37±2.35) h vs. (51.60±19.72) h] were significantly shorter in the BVP group than in the PKRP group (all P<0.001).At 3 months postoperatively, both groups showed significant improvements in IPSS, QoL, Qmax, and PVR compared to preoperative levels (P<0.05), but there were no significant differences between the two groups (P>0.05).The overall incidence of early postoperative complications in the BVP group was lower than that in PKRP group (18.75% vs. 43.33%, P<0.05).After 3 months of follow-up, there was no significant difference in the incidence of complications between the BVP group and PKRP group(3.13% vs. 13.33%, P=0.14). Conclusion: BVP for the treatment of frail elderly BPH patients is safe and reliable, associated with minimal bleeding, short operation time, catheterization time and hospital stay, and there is no need to discontinue anticoagulant drugs.
9.Construction and application of the "Huaxi Hongyi" large medical model
Rui SHI ; Bing ZHENG ; Xun YAO ; Hao YANG ; Xuchen YANG ; Siyuan ZHANG ; Zhenwu WANG ; Dongfeng LIU ; Jing DONG ; Jiaxi XIE ; Hu MA ; Zhiyang HE ; Cheng JIANG ; Feng QIAO ; Fengming LUO ; Jin HUANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(05):587-593
Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.
10.Traditional Chinese medicine syndrome distribution and influencing factors in 385 cases of interstitial lung disease
Jiayi MA ; Liming FAN ; Zhengyu XIE ; Xiawei SHI ; Tianyu SI ; Junchao YANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(6):751-760
Objective:
To explore the distribution of traditional Chinese medicine (TCM) syndromes in patients with interstitial lung disease (ILD) and its influencing factors.
Methods:
This cross-sectional study included 385 patients with ILD admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine) from January 2018 to June 2022. Data on sex, age, body mass index, smoking history, respiratory rate, hospitalization time, treatment cost, whether velcro rales can be heard, comorbidities with rheumatic immune diseases, TCM four examination information, and clinical examination results, including CT imaging, D-dimer level, and lung function-related indicators, were collected. The distribution pattern of TCM syndromes in patients with ILD and the association between TCM syndromes and clinical indicators were analyzed using the cluster analysis and binary Logistic regression analysis.
Results:
Among the 385 patients with ILD, sticky phlegm (59.74%) and shortness of breath (56.10%) were common symptoms, while greasy tongue coating (55.32%), red tongue (52.73%), and slippery and rapid pulse (25.71%) were common tongue and pulse manifestations. The patients were divided into five syndromes using cluster analysis: syndrome of phlegm-heat stagnation in the lung (36.62%), syndrome of turbid phlegm obstructing lung (29.35%), syndrome of deficiency of both qi and yin (12.99%), syndrome of qi deficiency of lung and kidney (11.95%), and syndrome of phlegm and blood stasis obstructing lung (9.09%). The D-dimer level was lower in patients with syndrome of phlegm-heat stagnation in the lung, syndrome of turbid phlegm obstructing lung, syndrome of deficiency of both qi and yin, and syndrome of qi deficiency of lung and kidney than in those with syndrome of phlegm and blood stasis obstructing lung (P<0.05). The percentage of predicted forced vital capacity (FVC%pred) of patients with syndrome of phlegm-heat stagnation in the lung, syndrome of turbid phlegm obstructing lung, syndrome of deficiency of both qi and yin, and syndrome of phlegm and blood stasis obstructing lung was higher than in those with syndrome of qi deficiency of lung and kidney (P<0.05). Among patients aged 60 and above, those with syndrome of phlegm-heat stagnation in the lung, syndrome of phlegm and blood stasis obstructing lung, and syndrome of deficiency of both qi and yin containing dual pathogenic syndrome elements were more likely to experience moderate to severe pulmonary diffusion impairment than those with syndrome of turbid phlegm obstructing lung and syndrome of qi deficiency of lung and kidney containing single pathogenic syndrome elements (P<0.05). The Logistic regression showed that the FVC%pred was an influential factor for syndrome of qi deficiency of lung and kidney, and the area under the receiver operating characteristic (ROC) curve (AUC) between FVC%pred and the formation of syndrome of qi deficiency of lung and kidney was 0.676 (95%CI: 0.598-0.755), P=0.002. The sensitivity was 0.431, the specificity was 0.966, and the best threshold on the ROC curve of 0.397 was 79.1%. The D-dimer level was an influential factor in the formation of syndrome of phlegm and blood stasis obstructing lung. The AUC between D-dimer level and the formation of syndrome of phlegm and blood stasis obstructing lung was 0.729 (95%CI: 0.655-0.802), P<0.001. The sensitivity was 0.914, the specificity was 0.523, and the best threshold on the ROC curve of 0.437 was 0.675 mg/L.
Conclusion
syndrome of phlegm-heat stagnation in the lung and syndrome of turbid phlegm obstructing lung are common among patients with ILD. Complex pathological syndromes are more likely to exacerbate pulmonary diffusion dysfunction. The FVC%pred can assist in differentiating syndrome of qi deficiency of lung and kidney, whereas the D-dimer level can assist in differentiating syndrome of phlegm and blood stasis obstructing lung.


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