1.Individualized treatment and pharmaceutical care for breast cancer complicated with chronic kidney disease
Lu YU ; Xudong WU ; Ming ZHANG
China Pharmacy 2025;36(7):853-857
OBJECTIVE To provide a reference for individualized treatment and pharmaceutical care for patients with breast cancer complicated with chronic kidney disease (CKD). METHODS Clinical pharmacists participated in the anti-tumor treatment and pharmaceutical care for a breast cancer patient with CKD. Clinical pharmacists reviewed guidelines and literature to assist the clinical physician in formulating the initial neoadjuvant treatment plan (docetaxel+trastuzumab+paltuzumab) and provided monitoring recommendations for potential adverse drug reactions, such as vomiting, myelosuppression, renal impairment, cardiotoxicity. In response to the patient’s acute kidney injury after treatment, clinical pharmacists assisted the physician in analyzing the cause of the adverse reaction through causality assessment. Taking into account the patient’s preferences, docetaxel was substituted with paclitaxel (which did not require dose adjustment based on renal function). The clinical pharmacists collaborated with the physician to establish a postoperative targeted therapy regimen (trastuzumab+pertuzumab). Taking into account the patient’s positive estrogen receptor status, the clinical pharmacists recommended to initiate regular anastrozole administration after the completion of radiotherapy and undergo periodic bone density assessments. RESULTS The clinical physician accepted the suggestions from the clinical pharmacists. The patient successfully completed preoperative neoadjuvant chemotherapy and postoperative targeted therapy, and was discharged with medication (anastrozole). During the treatment process, the patient did not experience adverse reactions such as myelosuppression, cardiotoxicity, or the occurrence of osteoporosis. CONCLUSIONS Clinical pharmacists analyzed and adjusted the preoperative and postoperative antitumor treatment plans based on the patient’s renal function. They promptly assessed the correlation between antitumor drugs and acute kidney injury, and actively implemented comprehensive pharmaceutical care to ensure medication safety for breast cancer patients with CKD.
2.Development and Application of the Evidence Quality Rating Scale for Ancient Classical Prescriptions in Traditional Chinese Medicine
Juwen ZHANG ; Jianping LIU ; Xiangfei SU ; Wei WEI ; Xiaolan SU ; Xue FENG ; Fanya YU ; Xudong ZHANG ; Junhong YU ; Wei CHEN
Journal of Traditional Chinese Medicine 2025;66(8):804-810
ObjectiveTo develop the Evidence Grading Scale for Ancient classical prescriptions in Traditional Chinese medicine, assess its reliability and validity, and apply it in practice to provide multi-source evidence for clinical practice guidelines development. MethodsLiterature retrieval was conducted to extract and screen existing evaluation dimensions, then the initial items were summarized using thematic analysis. Experts in the clinical medicine, medical history and literature participated in the Delphi questionnaire survey to evaluate and refine the items. An expert consensus meeting was conducted to finalize the included items, refine the method for items evaluation and evidence grading. The evidence quality rating scale for ancient classical traditional Chinese medicine (TCM) prescriptions was then established and tested for reliability and validity. ResultsThrough literature review, extraction, screening and summarization, a total of 3 dimensions and 12 initial items were formed. Questionnaires were sent to 69 experts to evaluate the initial items, with a questionnaire response rate of 100% and an expert authority coefficient of 0.92. All 12 items were retained for they had importance scores above 4. The Evidence Grading Scale on Ancient classical prescriptions in Traditional Chinese medicine includes 3 dimensions with 12 items. The 3 dimensions includes ancient evidence, inheritance status, and modern application. Each dimension contains 4 items, and each item has a full score of 5 points. The evidence was rated as high-level, moderate-level, and low-level according to the final scores. The content validity index (CVI) of the 12 items was >0.9, the average CVI of the scale was 0.98, and the intraclass correlation coefficient (ICC) was 0.90. ConclusionThe Evidence Grading Scale on Ancient classical prescriptions in Traditional Chinese medicine has good reliability and validity, which is practical for use in the development of TCM clinical guidelines and can better support clinical decision-making.
3.High-efficient discovering the potent anti-Notum agents from herbal medicines for combating glucocorticoid-induced osteoporosis.
Yuqing SONG ; Feng ZHANG ; Jia GUO ; Yufan FAN ; Hairong ZENG ; Mengru SUN ; Jun QIAN ; Shenglan QI ; Zihan CHEN ; Xudong JIN ; Yunqing SONG ; Tian TIAN ; Zhi QIAN ; Yao SUN ; Zhenhao TIAN ; Baoqing YU ; Guangbo GE
Acta Pharmaceutica Sinica B 2025;15(8):4174-4192
Notum, a negative feedback regulator of the Wnt signaling, has emerged as a promising target for treating glucocorticoid-induced osteoporosis (GIOP). This study showcases an efficient strategy for discovering the anti-Notum constituents from herbal medicines (HMs) as novel anti-GIOP agents. Firstly, a rapid-responding near-infrared fluorogenic substrate for Notum was rationally engineered for high-throughput identifying the anti-Notum HMs. The results showed that Bu-Gu-Zhi (BGZ), a known anti-osteoporosis herb, potently inhibited Notum in a competitive-inhibition manner. To uncover the key anti-Notum constituents in BGZ, an efficient strategy was adapted via integrating biochemical, phytochemical, computational, and pharmacological assays. Among all identified BGZ constituents, three furanocoumarins were validated as strong Notum inhibitors, while 5-methoxypsoralen (5-MP) showed the most potent anti-Notum activity and favorable safety profiles. Mechanistically, 5-MP acted as a competitive inhibitor of Notum via creating strong hydrophobic interactions with Trp128 and Phe268 in the catalytic cavity of Notum. Cellular assays showed that 5-MP remarkably promoted osteoblast differentiation and activated Wnt signaling in dexamethasone (DXMS)-challenged MC3T3-E1 osteoblasts. In dexamethasone-induced osteoporotic mice, 5-MP strongly elevated bone mineral density (BMD) and improved cancellous and cortical bone thickness. Collectively, this study constructs a high-efficient platform for discovering key anti-Notum constituents from HMs, while 5-MP emerges as a promising anti-GIOP agent.
4.Chemical knockdown of Keap1 and homoPROTAC-ing allergic rhinitis.
Jianyu YAN ; Tianyu WANG ; Ruizhi YU ; Lijuan XU ; Hongming SHAO ; Tengfei LI ; Zhe WANG ; Xudong CHA ; Zhenyuan MIAO ; Chengguo XING ; Ke XU ; Huanhai LIU ; Chunlin ZHUANG
Acta Pharmaceutica Sinica B 2025;15(8):4137-4155
Allergic rhinitis (AR), a globally prevalent immune-mediated inflammatory condition, is still an incurable disease. In the present study, we have validated the impact of the Kelch-like ECH associated protein 1 (Keap1)-related oxidative stress and inflammatory response in clinical AR patient peripheral blood and nasal swab samples, emphasizing the biological relevance of Keap1 and AR. Targeting Keap1 -nuclear factor erythroid 2-related factor 2 (Nrf2) related anti-oxidative stress may be effective for AR intervention. Drawing inspiration from the Keap1 homodimerization and the E3 ligase characteristics, we herein present a design of novel bivalent molecules for chemical knockdown of Keap1. For the first time, we characterized ternary complexes of Keap1 dimer and one molecule of bivalent compounds. The best bivalent molecule 8 encompasses robust capacity to degrade Keap1 as a homoPROTACKEAP1. It efficaciously suppresses inflammatory cytokines in extensively different cells, including human nasal epithelial cells. Moreover, in an AR mouse model, we confirmed that the chemical degradation induced by homoPROTACKEAP1 led to therapeutic benefits in managing AR symptoms, oxidative stress and inflammation. In summary, our findings underscore the efficacy of targeting the Keap1 system through the homoPROTAC-ing technology as an innovative and promising treatment strategy for the incurable allergic disorders.
5.Summary of the 2024 report on gastroenterology and digestive endoscopy in China.
Zheran CHEN ; Yusi XU ; Lei XIN ; Yifei SONG ; Jinfang XU ; Chu CHU ; Chuting YU ; Ye GAO ; Xudong MA ; Zhaoshen LI ; Luowei WANG
Chinese Medical Journal 2025;138(21):2693-2701
BACKGROUND:
China has made significant progress in medical accessibility and quality over the past decades, and quality improvements in gastroenterology and digestive endoscopy have been consistent. The study aimed to describe the status quo of gastroenterology and digestive endoscopy in the Chinese mainland based on the data from the National Clinical Improvement System (NCIS) and the Hospital Quality Monitoring System (HQMS).
METHODS:
Data were extracted from the NCIS and the HQMS. Data analysis included general information from the Department of Gastroenterology and Endoscopy centers, management of inpatients and outpatients, and annual volume and quality indicators of digestive endoscopy. Acute pancreatitis, gastrointestinal bleeding, inflammatory bowel disease, and cirrhosis were identified as priority diseases and were subjected to detailed analysis.
RESULTS:
Data from 4620 and 7074 hospitals were extracted from the NCIS and HQMS, respectively. In 2023, 9.6 gastroenterologists, 6.7 endoscopists, and 37.3 gastroenterology beds per hospital nationwide were observed, achieving 19,252.4 outpatient visits, 1615.2 hospitalizations (97.0 for acute pancreatitis, 146.1 for gastrointestinal bleeding, 40.2 for inflammatory bowel disease, and 111.4 for cirrhosis), and 9432.7 digestive endoscopic procedures per hospital. Overall, the quality of practice improved significantly. The proportion of early cancer among gastrointestinal cancers increased from 11.1% in 2015 to 23.4% in 2023, and the adenoma detection rate during colonoscopy increased from 19.3% in 2019 to 26.9% in 2023. Regarding priority diseases, hospitalizations increased, and 31-day unplanned readmission rates decreased between 2019 and 2023. The median hospitalization costs and median proportion of medication costs decreased for acute pancreatitis, gastrointestinal bleeding, and cirrhosis. However, it increased for inflammatory bowel disease.
CONCLUSION
This report evaluates the status quo and development of gastroenterology and digestive endoscopy in the Chinese mainland, providing guidance for future quality improvements.
Humans
;
China
;
Gastroenterology/statistics & numerical data*
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Gastrointestinal Hemorrhage
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Endoscopy, Gastrointestinal/statistics & numerical data*
;
Endoscopy, Digestive System/statistics & numerical data*
6.The application of surgical robots in head and neck tumors.
Xiaoming HUANG ; Qingqing HE ; Dan WANG ; Jiqi YAN ; Yu WANG ; Xuekui LIU ; Chuanming ZHENG ; Yan XU ; Yanxia BAI ; Chao LI ; Ronghao SUN ; Xudong WANG ; Mingliang XIANG ; Yan WANG ; Xiang LU ; Lei TAO ; Ming SONG ; Qinlong LIANG ; Xiaomeng ZHANG ; Yuan HU ; Renhui CHEN ; Zhaohui LIU ; Faya LIANG ; Ping HAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(11):1001-1008
7.Expert consensus on orthodontic treatment of protrusive facial deformities.
Jie PAN ; Yun LU ; Anqi LIU ; Xuedong WANG ; Yu WANG ; Shiqiang GONG ; Bing FANG ; Hong HE ; Yuxing BAI ; Lin WANG ; Zuolin JIN ; Weiran LI ; Lili CHEN ; Min HU ; Jinlin SONG ; Yang CAO ; Jun WANG ; Jin FANG ; Jiejun SHI ; Yuxia HOU ; Xudong WANG ; Jing MAO ; Chenchen ZHOU ; Yan LIU ; Yuehua LIU
International Journal of Oral Science 2025;17(1):5-5
Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans
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Orthodontics, Corrective/methods*
;
Consensus
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Malocclusion/therapy*
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Patient Care Planning
;
Cephalometry
8.A CYP80B enzyme from Stephania tetrandra enables the 3'-hydroxylation of N-methylcoclaurine and coclaurine in the biosynthesis of benzylisoquinoline alkaloids.
Yaoting LI ; Yuhan FENG ; Wan GUO ; Yu GAO ; Jiatao ZHANG ; Lu YANG ; Chun LEI ; Yun KANG ; Yaqin WANG ; Xudong QU ; Jianming HUANG
Chinese Journal of Natural Medicines (English Ed.) 2025;23(5):630-640
Benzylisoquinoline alkaloids (BIAs) are a structurally diverse group of plant metabolites renowned for their pharmacological properties. However, sustainable sources for these compounds remain limited. Consequently, researchers are focusing on elucidating BIA biosynthetic pathways and genes to explore alternative sources using synthetic biology approaches. CYP80B, a family of cytochrome P450 (CYP450) enzymes, plays a crucial role in BIA biosynthesis. Previously reported CYP80Bs are known to catalyze the 3'-hydroxylation of (S)-N-methylcoclaurine, with the N-methyl group essential for catalytic activity. In this study, we successfully cloned a full-length CYP80B gene (StCYP80B) from Stephania tetrandra (S. tetrandra) and identified its function using a yeast heterologous expression system. Both in vivo yeast feeding and in vitro enzyme analysis demonstrated that StCYP80B could catalyze N-methylcoclaurine and coclaurine into their respective 3'-hydroxylated products. Notably, StCYP80B exhibited an expanded substrate selectivity compared to previously reported wild-type CYP80Bs, as it did not require an N-methyl group for hydroxylase activity. Furthermore, StCYP80B displayed a clear preference for the (S)-configuration. Co-expression of StCYP80B with the CYP450 reductases (CPRs, StCPR1, and StCPR2), also cloned from S. tetrandra, significantly enhanced the catalytic activity towards (S)-coclaurine. Site-directed mutagenesis of StCYP80B revealed that the residue H205 is crucial for coclaurine catalysis. Additionally, StCYP80B exhibited tissue-specific expression in plants. This study provides new genetic resources for the biosynthesis of BIAs and further elucidates their synthetic pathway in natural plant systems.
Cytochrome P-450 Enzyme System/chemistry*
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Benzylisoquinolines/chemistry*
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Hydroxylation
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Plant Proteins/chemistry*
;
Alkaloids/metabolism*
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Stephania tetrandra/genetics*
9.Improvement mechanism study of kushenol F on ulcerative colitis mice by regulating gut microbiota and immune response
Xudong HE ; Chengzhu SONG ; Haoyu NI ; Yunkai HU ; Min LI ; Dajun CHEN ; Wentao SU ; Jie YU ; Xingxin YANG
China Pharmacy 2024;35(17):2088-2095
OBJECTIVE To explore the action mechanism of kushenol F (KSCF) in treating ulcerative colitis (UC) in mice. METHODS The potential targets of KSCF intervening in UC were predicted with network pharmacology and molecular docking. C57BL/6J mice were randomly divided by body weight into model group, positive control group (sulfasalazine, 703 mg/kg), KSCF group (100 mg/kg), and normal group, with 6 mice per group. The UC model of mice was induced by dextran sulfate sodium solution. During the modeling period, the mice were given relevant medicine intragastrically, once a day, for 7 consecutive days. After the last administration, the disease activity index (DAI) of the mice was scored; the length of the mice’s colon was measured; pathological changes in the colon tissue of mice were observed; the levels of lipopolysaccharide (LPS) in serum, myeloperoxidase (MPO), nitric oxide (NO) and superoxide dismutase (SOD) in the colon were detected in mice; the expression levels of occludin and ZO-1 in colon tissue of mice were detected; the proportions of CD3+T, CD4+T, and CD8+T lymphocytes in the spleen and the ratio of CD4+/CD8+ were detected; changes in colonic microbiota were analyzed by 16S rDNA sequencing. RESULTS Results of network pharmacology indicated that KSCF may treat UC by regulating signaling pathways such as phosphatidylinositol-3 kinase/protein kinase B (PI3K/AKT) and nuclear factor kappa B (NF- κB). Molecular docking results showed that KSCF bound most stably with NF-κB p65 protein. Animal experiment results demonstrated that, compared with the model group, the pathological characteristics of colon tissue in mice were improved in KSCF group. DAI scores, serum levels of LPS, the levels of MPO,NF-κB p65 phosphorylation and NLRP3 protein expression in the colon, and the proportion of CD8+T lymphocytes in the spleen were reduced significantly (P<0.05). Body weight, SOD levels, expression levels of occludin and ZO-1 in the colon, proportions of CD3+T and CD4+T lymphocytes, and the CD4+/CD8+ ratio in the spleen were significantly increased (P<0.05); the abundance of Firmicutes, Actinobacteria, Akkermansia, and Lactobacillus genera were increased, while Proteobacteria decreased; the microbial community structure tended towards that of the normal group. CONCLUSIONS KSCF alleviates UC by restoring intestinal microbial imbalance, enhancing immune response, and inhibiting colonic inflammatory responses, thereby improving intestinal barrier integrity.
10.Clinical effect of ascending aorta banding combined with typeⅠ hybrid aortic arch repair on aortic arch diseases
Jinhui MA ; Lanlin ZHANG ; Sheng YANG ; Songbo DONG ; Yu CHEN ; Xudong PAN ; Shangdong XU ; Jun ZHENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(09):1313-1318
Objective To assess the efficacy and safety of ascending aorta banding technique combined with typeⅠhybrid aortic arch repair for the aortic arch diseases. Methods The clinical data of patients undergoing ascending aorta banding technique combined with type Ⅰ hybrid arch repair for aortic arch diseases from March 2019 to March 2022 in Beijing Anzhen Hospital were retrospectively analyzed. The technical success, perioperative complications and follow-up results were evaluated. Results A total of 44 patients were collected, including 35 males and 9 females, with a median age of 63.0 (57.5, 64.6) years. The average EuroSCORE Ⅱ score was 8.4%±0.7%. The technical success rate was 100.0%. All patients did not have retrograde type A aortic dissection and endoleaks. One patient died of multiple organ failure 5 days after operation, the in-hospital mortality rate was 2.3%, and the remaining 43 patients survived and were discharged from hospital. The median follow-up period was 14.5 (6-42) months with a follow-up rate of 100.0%. One patient with spinal cord injury died 2 years after hospital discharge. One patient underwent thoracic endovascular aortic repair at postoperative 3 months due to new entry tears near to the distal end of the stent. Conclusion Ascending aorta banding combined with typeⅠhybrid arch repair for the aortic arch diseases does not need cardio-pulmonary bypass. Ascending aorta banding technique strengthens the proximal anchoring area of the stent to avoid risks such as retrograde type A dissection, endoleak and migration. The operation owns small trauma, rapid recovery, low mortality and a low rate of reintervention, which may be considered as a safe and effective choice in the treatment of the elderly, high-risk patients with complex complications.

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