1.Development and application of albumin-binding indocyanine green for near-infrared fluorescence imaging of lung cancer
Hongliang WU ; Ze TAO ; Hao YANG ; Hong ZHU ; LU Xiaofeng LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(07):1101-1110
Objective To develop albumin-binding indocyanine green (ICG) and assess its potential for near-infrared fluorescence imaging and intraoperative navigation in lung cancer. Methods ABD-tri was recombinantly expressed by genetic engineering. Its albumin-binding capability was determined using size-exclusion chromatography, and its albumin-dependent binding to lung cancer cells was evaluated by flow cytometry. ICG was conjugated to ABD-tri to generate the fluorescent probe ABD-tri-ICG. The potential of ABD-tri-ICG for near-infrared fluorescence imaging and imaging-guided tumor resection was evaluated in mice bearing subcutaneous tumor grafts of lung cancer. Results ABD-tri was highly expressed in Escherichia coli (E. coli) and was purified to homogeneity via a simple affinity chromatography. ABD-tri bound both human and murine serum albumin, contributing to its binding to lung cancer cells. ICG was effectively conjugated to ABD-tri to produce the fluorescence probe ABD-tri-ICG after mixing and incubation at room temperature for 1 h. In mice bearing lung cancer tumor grafts, intravenously injected ABD-tri-ICG enabled clear visualization of tumors with diameters ranging from 5 to 7 mm within 0.5-24 h post-injection. The tumor grafts were resected under the guidance of ABD-tri-ICG-mediated near-infrared fluorescence imaging. Conclusion Intravenous injection of ABD-tri-ICG allows rapid and sustained visualization of lung cancer tumor grafts and enables intraoperative navigation in mice, warranting further evaluation on the clinical translation of ABD-tri-ICG.
2.Application value of simplified diagnosis and treatment strategies for chronic hepatitis C in human immunodeficiency virus/hepatitis C virus co-infection
Ying CAI ; Zhibin YANG ; Yang LUO ; Cong WANG ; Yongfen ZHU ; Ze LI ; Rusong YANG ; Qiang WU ; Wenbin DONG ; Shifu LI
Journal of Clinical Hepatology 2026;42(6):1287-1293
ObjectiveTo investigate the efficacy and safety of simplified diagnosis and treatment strategies and regimens in the treatment of patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection. MethodsThis multicenter prospective real-world study was conducted among 198 patients with HIV/HCV co-infection who received hepatitis C treatment in 10 designated primary hospitals for hepatitis C in Yuxi, China from July 2023 to June 2024, and according to whether genotype detection was performed, they were divided into genotype detection group with 122 patients and non-genotype detection group with 76 patients. The patients were observed in terms of sustained virologic response at 12 weeks (SVR12), safety, and liver biochemical parameters. Propensity score matching was used to match the two cohorts, using caliper matching (caliper value = 0.02) at a ratio of 1∶1. The independent-samples t test or the Wilcoxon signed-rank test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAmong the 122 patients in the genotype detection group, 63.11% (77/122) had genotype 3, while the non-genotype detection group had 76 patients; both groups achieved an SVR12 rate of 100%. From baseline to 12 weeks after treatment, both groups had a significant increase in the serum level of albumin, significant reductions in the serum levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and alpha-fetoprotein, and a significant reduction in FibroScan value (all P<0.05). A total of 54 patients (27.27%) experienced at least one adverse reaction, and anemia was the most common adverse reaction (38 patients, 19.19%), with an incidence rate of 50.00% (33/66) in patients with liver cirrhosis. HIV viral load remained <50 IU/mL before and after treatment, and there was no significant change in CD4+ T lymphocyte count after treatment (Z=-0.969, P=0.202). Compared with the genotype detection group, the non-genotype detection group had a significantly shorter time from positive HCV RNA testing to treatment initiation (4±2 days vs 19±4 days, t=5.321, P<0.05) and significantly lower testing costs (618±97 yuan vs 789±129 yuan, t=3.661, P<0.05). ConclusionFor patients with HIV/HCV co-infection, the simplified diagnosis and treatment strategies can achieve a relatively high SVR12 rate, improve biochemical indicators, and effectively reduce time cost and economic burden, with a favorable safety profile.
3.Analysis of Pharmacodynamic Material Basis, Mechanisms, and Efficacy-related Quality Markers of Puerariae Lobatae Radix and Puerariae Thomsonii Radix with Different Therapeutic Effect
Xiaowei MENG ; Zhenzhen YANG ; Wenting WU ; Ronghua LIU ; Yongmei GUAN ; Hui OUYANG ; Liping HUANG ; Yaqi WANG ; Qiong LI ; Huanhuan DONG ; Jianping GONG ; Weifeng ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):269-281
Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family, respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China, the two herbs have been individually recorded. Although they share the same functions and indications, the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator, puerarin, which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production, thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents, while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis, cardiovascular and cerebrovascular protection, and central analgesia, while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation, hypoglycemia, and peripheral analgesia. Based on this, the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects, namely "relieving exterior syndrome and clearing heat", "promoting fluid production to quench thirst", and "dredging channels and activating collaterals", were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway, and their common core target is prostaglandin-endoperoxide synthase 2 (PTGS2). This review provided clinical application recommendations based on the therapeutic differences between the two herbs, elucidated the scientific connotation of their "same origin but different effects", and, grounded in the quality marker (Q-Marker), proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association, as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix, the improvement of quality standards, and the high-quality development of the industry.
4.Research progress on chemical constituents and pharmacological effects of hemp seed oil
Sinan WU ; Yaqian WANG ; Yang LIU ; Jincan XIE ; Mengxiao JIA ; Xiali ZHU
China Pharmacy 2026;37(17):2344-2348
Hemp seed oil serves as the core pharmacodynamic part of hemp seed, containing various active constituents including fatty acids and their esters (such as linoleic acid, methyl linolenate, etc.), tocopherols (such as α -tocopherol, β -tocopherol, etc.), polyphenols (such as caffeic acid, quercetin, etc.), and cannabinoids (such as cannabidiolic acid, cannabinol, etc.). Pharmacological studies demonstrate that hemp seed oil exerts anti-oxidation and anti-aging, blood-lipid-lowering and anti-atherosclerotic, neuroprotective, anti-inflammatory effects, as well as functions in regulating intestinal microecology and improving intestinal mucosal barrier function. Its mechanisms are related to scavenging free radicals, activating endogenous antioxidant enzymes, improving the function of central cholinergic system, mitigating neuroinflammatory responses, regulating the balance of inflammatory factors, interfering with inflammatory signaling pathways, and optimizing the structure of intestinal microbiota. In future studies, a correlation network of “chemical component group-multi-target pharmacodynamic effect” can be constructed according to the chemical characteristics of hemp seed oil, and its pharmacodynamic evaluation for chronic diseases can be expanded, so as to promote its in-depth development and clinical transformation.
5.Exploring Content and Distribution Patterns of 22 Ginsenosides in Stems and Leaves of Panax ginseng with Different Stem Colors by UHPLC-QqQ-MS
Tianxin ZHANG ; Yang YANG ; Jiabing ZHANG ; Lixia WANG ; Xiaoxu CHEN ; Xiaoyu ZHU ; Dade YU ; Hongwei WU ; Zhuju WANG ; Kaiyang LIU ; Liying TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):198-209
ObjectiveTo systematically elucidate the accumulation characteristics of secondary metabolites in the stems and leaves of Panax ginseng with different stem colors. MethodsUltra-high-performance liquid chromatography-triple quadrupole-tandem mass spectrometry (UHPLC-QqQ-MS) was employed to determine the of 22 ginsenosides in the stems and leaves of 2- to 5-year-old P. ginseng plants with green and purple stems. Principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), and one-way analysis of variance (ANOVA) were performed to explore the distribution patterns of ginsenosides from three dimensions: tissue distribution, growth duration, and stem color. Results① Tissue distribution: Leaves served as the primary organ for ginsenoside accumulation, exhibiting significantly higher total ginsenoside content than stems, which indicated distinct tissue-specific distribution of ginsenosides. ② Growth duration: Ginsenoside levels in stems generally peaked in the 2-year-old plants before stabilizing, while those in leaves displayed a declining-rebounding pattern, indicating that the 2-year-old plants (harvest stage) was a critical time point for the resurgence of leaf ginsenosides. ③ Stem color: A stage-specific correlation was observed between stem color and ginsenoside accumulation. In stems, the early-growth stage (2-year-old) of purple-stemmed plants exhibited higher content of specific ginsenosides (e.g., ginsenoside Rk1 and notoginsenoside R1), which may be associated with its stronger early-stage stress resistance. In leaves, the content of core ginsenosides (e.g., ginsenosides Re and Rd) in 5-year-old plants with green stems showed a surpassing trend, demonstrating higher potential of resource development. ConclusionThe accumulation of ginsenosides in P. ginseng stems and leaves is multidimensionally regulated by tissue type, growth duration, and stem color phenotypes. Purple-stemmed plants exhibit early-stage specific ginsenoside accumulation and stress resistance potential, whereas green-stemmed plants are more advantageous for core leaf ginsenoside development at the harvest stage. The findings confirm that aboveground stem color can serve as a biomarker for directed breeding and efficient resource utilization of P. ginseng.
6.Accuracy of Magnetic Resonance Spectroscopy–Detected Fumarate Peak for Diagnosing Fumarate Hydratase Deficiency in Uterine Leiomyomas: A Prospective Study
Guiqin LIU ; Wenxin YU ; Shihang PAN ; Yuansheng LUO ; Jingli CHEN ; Mengying ZHU ; Zaoyu WANG ; Yang SONG ; Jin ZHANG ; Jianrong XU ; Yan ZHOU ; Jun MA ; Guangyu WU
Korean Journal of Radiology 2026;27(5):440-451
Objective:
To evaluate the diagnostic performance of magnetic resonance spectroscopy (MRS) in discriminating fumarate hydratase-deficient (FH-d) uterine leiomyomas (ULs) from FH-preserved ULs.
Materials and Methods:
This study consisted of three stages, with independent cohorts recruited for each stage: 1) sample-size estimation was retrospectively performed on UL specimens (diameter ≥3 cm; age, 20–40 years) from our database with immunohistochemistry (IHC) for 2-succinocysteine (2-SC) as the reference, without genetic testing, 2) MRS sequence optimization in confirmed FH germline mutation participants with ultrasound-detected ULs (diameter ≥3 cm), without IHC analysis, and 3) prospective diagnostic test accuracy was evaluated in consecutive participants with ultrasound-detected ULs (diameter ≥3 cm;age, 20–40 years), using IHC for 2-SC for determining the FH status and subsequent genetic testing in those with positive 2-SC results to identify whether FH mutations were germline or somatic in origin. The choline and fumarate peaks in MRS were classified as positive, negative, or technical failure (TF). TFs were analyzed separately and excluded from the primary diagnostic accuracy calculations. T1-, T2-, and diffusion-weighted images were interpreted as hyperintense or hypointense. The enhancement rate and apparent diffusion coefficient were also acquired. Diagnostic performance was compared between MRS and various magnetic resonance imaging (MRI) features.
Results:
The optimal MRS parameters for the fumarate peak were echo time (TE) = 140 ms and an average of 256. Among the 360 prospective participants, 37 were confirmed to have FH-dULs. MRS showed positive fumarate peaks in 35 of 37 FH-dULs.After excluding six TFs, the positive fumarate peak on MRS showed 94.6% (35/37) sensitivity, 99.7% (316/317) specificity, and 99.2% (351/354) accuracy, all of which were significantly superior to those of other MRI features (P ≤ 0.002).
Conclusion
A positive fumarate peak on MRS may be a useful imaging biomarker for diagnosing FH-dULs.
7.Professor WU Rongzu's Clinical Experience in Treating Irritable Bowel Syndrome with Constipation Using Fuyang Tongmi Decoction (扶阳通秘汤)
Yihao YANG ; Junran ZHU ; Wendi WU ; Liyun JIANG ; Yueqiu DONG ; Yueqing CAI ; Ruibin ZHOU ; Yunjiao XU ;
Journal of Traditional Chinese Medicine 2026;67(10):1049-1051
This paper introduces professor WU Rongzu's clinical experience in using Fuyang Tongmi Decoction (扶阳通秘汤, FTD) to treat irritable bowel syndrome with constipation (IBS-C). It is believed that yang qi depletion, water cold, earth dampness, and wood constraint are the key pathogenesis.The treatment principle is warming water, drying the earth and venting wood, with the basic formula FTD adjusted according to the symptoms. This approach aims to transport the qi movement of the middle jiao (焦) and support the recovery of intestinal function of directing turbidity downward, providing a treatment strategy for IBS-C caused by yang deficiency.
8.Comparative Analysis of Clinical Efficacy of Traditional Chinese Medicine Manipulative Reduction Combined with Small Splint Fixation Versus Surgical Treatment for Type A Distal Radius Fracture
Yang SHAO ; Zihan WANG ; Jianwei WANG ; Guoda DAI ; Hengyan CUI ; Zhen HUA ; Tingchen ZHU ; Shaoshuo LI ; Jun MAO ; Fenghua CHEN ; Shuai TAO ; Mao WU
Journal of Traditional Chinese Medicine 2026;67(10):1078-1085
ObjectiveTo compare the clinical efficacy of traditional Chinese medicine (TCM) manipulative reduction combined with small splint fixation versus surgical treatment for type A distal radius fracture (DRF) and to explore the factors influencing the choice of treatment. MethodsA multi-center retrospective study was conducted, collecting data from 1237 type A DRF patients treated in 11 hospitals in Jiangsu province from September, 2023 to April, 2025. Among them, 851 patients in the TCM group received manipulative reduction combined with small splint fixation, and 386 patients in the surgical group underwent open reduction and internal fixation. Visual analog scale (VAS) scores for pain and radiographic indicators including palmar tilt, ulnar deviation, and radial height were compared before treatment, 5-7 days after treatment, and 4-6 weeks after treatment. The wrist joint function scores including Dienst and Gartland-Werley scores at 12 weeks after treatment were recorded. Subgroup analysis was conducted for the excellent rate of Dienst and Gartland-Werley scores, stratified by age (<50, 50-59, 60-69, ≥70 years old) and AO subtypes (A1, A2, A3). A multivariate logistic regression model was used to identify independent factors influencing treatment choice. ResultsOn 5-7 days after treatment, the surgical group had lower VAS scores than the TCM group, while 4-6 weeks after treatment, the TCM group showed lower VAS scores than the surgical group (P<0.01). In terms of radiographic indicators, except for the palmar tilt before treatment being higher in the surgical group than in the TCM group (P<0.01), there were no significant differences in palmar tilt, ulnar deviation, and radial height at other timepoints (P>0.05). Twelve weeks after treatment, the surgical group had a higher average Gartland-Werley score and the excellent rate than the TCM group (P<0.01). Subgroup analysis showed that in patients with A2 type DRF aged 50-59 and 60-69 years old, the excellent rates of Dienst and Gartland-Werley scores in the TCM group were higher than those in the surgical group (P<0.05). Multivariate logistic regression analysis revealed that age, palmar tilt, ulnar deviation, and the degree of swelling on the affected side were independent factors influencing the choice of treatment (P<0.05). ConclusionBoth TCM manipulative reduction combined with small splint fixation and surgical treatment for type A DRF can achieve good therapeutic effects. TCM manipulative reduction combined with small splint fixation has certain advantages in medium- and long-term pain relief, especially in elderly patients, where wrist joint function recovery is more stable. Age, palmar tilt, ulnar deviation, and swelling degree are the main factors influencing the treatment choice.
9.Clinical Efficacy and Radiographic Outcomes of Manipulative Reduction Combined with Small Splint Fixation for Distal Radius Fractures:A Retrospective Multicenter Study with Propensity Score Matching
Mao WU ; Guoda DAI ; Yang SHAO ; Shaoshuo LI ; Zhen HUA ; Hengyan CUI ; Tingchen ZHU ; Dipeng LI ; Jintao LIU ; Ming ZHOU ; Peimin WANG ; Liyong ZHANG ; Jianwei WANG
Journal of Traditional Chinese Medicine 2026;67(10):1086-1092
ObjectiveTo observe the clinical efficacy and radiographic outcomes of manipulative reduction combined with small splint fixation in the treatment of distal radius fractures. MethodsThe clinical data of 1051 patients with distal radius fractures were retrospectively collected from five hospitals included in the Jiangsu Diagnosis and Treatment Data Platform for Traditional Chinese Medicine(TCM) Dominant Diseases. Propensity score matching at a 1∶4 ratio was applied, resulting in 580 cases selected for final analysis, which comprised 448 patients in the TCM group(manipulative reduction plus small splint fixation) and 132 in the surgical treatment group(open reduction and internal fixation). Each group was further stratified into type A, B, and C subgroups based on AO fracture classification. Radiographic indicators including palmar tilt, radial inclination, and radial height were compared between groups before treatment and 1 day, 1 week, and 4-6 weeks after treatment, and pain visual analog scale(VAS) scores before treatment and 1 week and 4-6 weeks after treatment were also compared. Wrist joint function was assessed 12 weeks after treatment, using the Dienst wrist function score and the Gartland and Werley(G-W) wrist function score. Additionally, the radiographic indicators at different timepoints and the 12-week wrist function levels were compared between groups across different fracture types. ResultsNo statistically significant difference was observed in radiographic indicators and VAS scores at all timepoints before and after treatment, as well as wrist joint function grades assessed by the Dienst score and the G-W score at 12 weeks after treatment (P>0.05). Compared to those before treatment, both groups showed increased palmar tilt, radial inclination, and radial height 1 week and 4-6 weeks after treatment, and decreased VAS scores (P<0.05). Compared to those 1 week after treatment, both groups showed a decrease in palmar tilt, an increase in radial inclination and radial height, and a reduction in VAS score 4-6 weeks after treatment(P<0.05). In type A and B subgroups, the surgical treatment group had a higher radial inclination than the TCM group 4-6 weeks after treatment, while in the type C subgroup, a higher radial height was shown in the surgical treatment group than in the TCM group 4-6 weeks after treatment(P<0.05). In type C subgroup, there was significant difference between groups in the wrist joint function by G-W scores 12 weeks after treatment(P<0.05). ConclusionManipulative reduction combined with small splint fixation can maintain fracture alignment and alleviate pain in treating distal radius fractures, which achieves therapeutic outcomes comparable to surgical treatment. It is particularly suitable for type A and B fractures and can be considered an effective treatment option for distal radius fractures.
10.Construction and Clinical Validation of a Deep Learning-Based Automatic Measurement Model for Palmar Tilt and Radial Inclination in Distal Radius Fractures
Guoda DAI ; Jianwei WANG ; Mao WU ; Bin KANG ; Yang SHAO ; Hengyan CUI ; Shaoshuo LI ; Tingchen ZHU ; Zhen HUA ; Zhongming SHEN ; Jintao LIU ; Ming ZHOU
Journal of Traditional Chinese Medicine 2026;67(10):1093-1100
ObjectiveTo construct an automatic measurement model for palmar tilt and radial inclination suitable for traditional Chinese medicine (TCM) clinical scenarios, and to validate its accuracy and efficiency in TCM manipulative reduction settings. MethodsData on anteroposterior (AP) and lateral X-rays of distal radius fractures were collected from patients admitted to 18 TCM/ integrated TCM and western medicine hospitals in Jiangsu province between September 1st, 2023, and September 1st, 2024, via the Jiangsu Diagnosis and Treatment Big Data Platform for TCM Dominant Diseases. A medical image segmentation framework based on multi-scale feature fusion and edge-awareness was employed, combined with anatomical knowledge specific to TCM orthopedics, to optimize the feature extraction strategy of an artificial intelligence (AI) model. This framework enabled automatic segmentation of fracture regions and measurement of distal radius palmar tilt and radial inclination. The accuracy of the AI model in measuring radial inclination and volar tilt was validated, and the measurement time and average time gain rate of the AI model were compared to those of manual measurement. ResultsA total of 15,444 AP and lateral X-ray images of distal radius fractures were collected, and were divided into a training set (11,144 images, 5066 AP and 6078 lateral), a validation set (3700 images, 1840 AP and 1860 lateral), and an independent test set (600 images, 300 AP and 300 lateral) after preprocessing. In the measurement of 300 AP X-rays in the independent test set for radial inclination, when the degree error between AI measurement and manual measurement was <3° and <5°, AI measurement accuracy was 83% and 93%, respectively. In 300 lateral X-rays in the test set for palmar tilt, when AI measurements had an error of <3° and <5° compared to manual measurements, corresponding accuracy rate was 78% and 90%, respectively. For 50 X-ray images, AI measurement time was (1.37±0.05) min for radial inclination while manual measurement time was (22.57±2.52) min (P<0.001); in terms of palmar tilt, the AI measurement time was (1.33±0.14) min, shorter than (23.70±2.80) min for manual measurement time (P<0.001). Average time gain rates for manual and AI measurements were 93.93% and 94.39% respectively. ConclusionAn automatic measurement model for palmar tilt and radial inclination in distal radius fractures has been established, enabling more accurate and efficient assessment as well as providing a tool to support the quantitative evaluation of the efficacy of TCM manipulative reduction and large-sample clinical research.

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