1.Effect of Tongbian Decoction (通便汤) on the VAPB-PTPIP51 Complex and Autophagy of Interstitial Cells of Cajal in the Colon of Slow Transit Constipation Model Rats
Chuyue WANG ; Jiacheng LI ; Yingqi YANG ; Sicheng SHEN ; Zhiyang CHEN ; Zhizhong XU ; Bensheng WU ; Meiyao CHEN ; Ziwei XIONG ; Jinhui GU ; Xiaopeng WANG
Journal of Traditional Chinese Medicine 2026;67(9):985-993
ObjectiveTo explore the possible mechanism of Tongbian Decoction (通便汤, TD) in treating slow transit constipation (STC). MethodsTwenty-four SD rats were randomly divided into normal group, model group, TD group, and mosapride group, with 6 rats per group. Except for the normal group, STC models were established by intragastric administration of loperamide hydrochloride combined with normal saline. On the day following successful model establishment, rats in the TD group received 18.63 g·kg⁻¹ of TD by gavage, while those in the mosapride group received 1.605 mg·d⁻¹ of mosapride, and those in the normal group and the model group received 10 ml·kg⁻¹ of normal saline by gavage. All treatments were administered once daily for 7 consecutive days. Twenty-four hours after the last administration, fecal pellet number and fecal water content were measured. After intragastric administration of a 10% activated charcoal suspension, the small intestinal transit rate was calculated 30 minutes later. Serum levels of gastrin (GAS) and motilin (MTL) were measured by ELISA. Colonic histopathology was observed by HE staining, and mucus secretion by Alcian blue-periodic acid-Schiff (AB-PAS) staining. Ultrastructure of colon tissue was examined using transmission electron microscopy. Protein expression levels of C-kit, stem cell factor (SCF), autophagy-related protein 5 (ATG5), Beclin1, vesicle-associated membrane protein B (VAPB), and protein tyrosine phosphatase interacting protein 51 (VAPB-PTPIP51) were measured by Western Blot, and the mRNA levels were detected by real-time PCR. Immunohistochemistry was used to detect SCF, C-kit, Beclin1, and ATG5 expression. The calcium content in colon tissue was determined by ELISA. ResultsCompared to the normal group, rats in the model group showed significantly reduced fecal pellet number, fecal water content, small intestinal transit rate, and serum GAS and MTL levels (P<0.01); the number of goblet cells decreased, and the mucosal and muscular layers of the colon became thinner; mRNA and protein expression levels of ATG5 and Beclin1 in colon tissue significantly increased, while calcium content decreased (P<0.05 or P<0.01); and electron microscopy revealed vacuolar degeneration and increased autophagosomes in colonic cells. Compared to the model group, both TD group and mosapride group showed increased fecal pellet number, fecal water content, small intestinal transit rate, serum GAS and MTL levels, and colonic calcium content, along with decreased Beclin1 and ATG5 protein levels (P<0.05 or P<0.01); the mucosal thickness and goblet cell number increased significantly, and autophagosomes decreased; in the TD group, ATG5 and Beclin1 mRNA levels decreased; in the mosapride group, SCF, VAPB, and PTPIP51 mRNA levels increased, while Beclin1 mRNA decreased (P<0.05 or P<0.01). Compared to the mosapride group, the TD group showed higher fecal pellet number, fecal water content, serum GAS levels, colonic calcium content, and C-kit expression, along with lower ATG5 and Beclin1 levels (P<0.05 or P<0.01). ConclusionTD may improve constipation symptoms by upregulating the VAPB-PTPIP51 complex during mitochondria-endoplasmic reticulum interactions, reducing autophagy of interstitial cells of Cajal, and promoting intestinal motility.
2.Effect of Tongbian Decoction (通便汤) on the VAPB-PTPIP51 Complex and Autophagy of Interstitial Cells of Cajal in the Colon of Slow Transit Constipation Model Rats
Chuyue WANG ; Jiacheng LI ; Yingqi YANG ; Sicheng SHEN ; Zhiyang CHEN ; Zhizhong XU ; Bensheng WU ; Meiyao CHEN ; Ziwei XIONG ; Jinhui GU ; Xiaopeng WANG
Journal of Traditional Chinese Medicine 2026;67(9):985-993
ObjectiveTo explore the possible mechanism of Tongbian Decoction (通便汤, TD) in treating slow transit constipation (STC). MethodsTwenty-four SD rats were randomly divided into normal group, model group, TD group, and mosapride group, with 6 rats per group. Except for the normal group, STC models were established by intragastric administration of loperamide hydrochloride combined with normal saline. On the day following successful model establishment, rats in the TD group received 18.63 g·kg⁻¹ of TD by gavage, while those in the mosapride group received 1.605 mg·d⁻¹ of mosapride, and those in the normal group and the model group received 10 ml·kg⁻¹ of normal saline by gavage. All treatments were administered once daily for 7 consecutive days. Twenty-four hours after the last administration, fecal pellet number and fecal water content were measured. After intragastric administration of a 10% activated charcoal suspension, the small intestinal transit rate was calculated 30 minutes later. Serum levels of gastrin (GAS) and motilin (MTL) were measured by ELISA. Colonic histopathology was observed by HE staining, and mucus secretion by Alcian blue-periodic acid-Schiff (AB-PAS) staining. Ultrastructure of colon tissue was examined using transmission electron microscopy. Protein expression levels of C-kit, stem cell factor (SCF), autophagy-related protein 5 (ATG5), Beclin1, vesicle-associated membrane protein B (VAPB), and protein tyrosine phosphatase interacting protein 51 (VAPB-PTPIP51) were measured by Western Blot, and the mRNA levels were detected by real-time PCR. Immunohistochemistry was used to detect SCF, C-kit, Beclin1, and ATG5 expression. The calcium content in colon tissue was determined by ELISA. ResultsCompared to the normal group, rats in the model group showed significantly reduced fecal pellet number, fecal water content, small intestinal transit rate, and serum GAS and MTL levels (P<0.01); the number of goblet cells decreased, and the mucosal and muscular layers of the colon became thinner; mRNA and protein expression levels of ATG5 and Beclin1 in colon tissue significantly increased, while calcium content decreased (P<0.05 or P<0.01); and electron microscopy revealed vacuolar degeneration and increased autophagosomes in colonic cells. Compared to the model group, both TD group and mosapride group showed increased fecal pellet number, fecal water content, small intestinal transit rate, serum GAS and MTL levels, and colonic calcium content, along with decreased Beclin1 and ATG5 protein levels (P<0.05 or P<0.01); the mucosal thickness and goblet cell number increased significantly, and autophagosomes decreased; in the TD group, ATG5 and Beclin1 mRNA levels decreased; in the mosapride group, SCF, VAPB, and PTPIP51 mRNA levels increased, while Beclin1 mRNA decreased (P<0.05 or P<0.01). Compared to the mosapride group, the TD group showed higher fecal pellet number, fecal water content, serum GAS levels, colonic calcium content, and C-kit expression, along with lower ATG5 and Beclin1 levels (P<0.05 or P<0.01). ConclusionTD may improve constipation symptoms by upregulating the VAPB-PTPIP51 complex during mitochondria-endoplasmic reticulum interactions, reducing autophagy of interstitial cells of Cajal, and promoting intestinal motility.
3.Evaluation of CARIFS Score and Negative Antigen Conversion Rate of Qingxuan Daozhi Formula in Treatment of Influenza in Children (Heat Accumulation in Lung and Stomach Syndrome):A Multi-center Randomized Controlled Clinical Study
Jing WANG ; Liqun WU ; Tiegang LIU ; Yongning CAO ; Jing QIU ; Jing LI ; Huaqing TAN ; Ying ZHANG ; Xulei GOU ; Jia WANG ; Jing LI ; Haipeng CHEN ; Xueying QIN ; Yuanshuo TIAN ; Yang WANG ; Chen BAI ; Zhendong WANG ; Qianqian LI ; He YU ; Xueyan MA ; Fei DONG ; Lin JIANG ; Yingqi XU ; Jianping LIU ; Xiaohong GU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):188-196
ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children (heat accumulation in the lung and stomach syndrome). MethodsThrough a multi-center randomized controlled methodology design,confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals,such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days,and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale (CARIFS) and the incidence of complications,severe cases, and critical cases. Follow-up observation was conducted on the day of enrollment,48 hours after medication,72 hours after medication, and (6+1) d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group (90 cases) or the control group (90 cases). All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was (5.29±1.25) d,and that in the control group was (5.40±1.68) d,without a statistically significant difference. After five days of intervention,52 cases in the experimental group and 51 cases in the control group converted to negative,without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention,there were statistically significant differences between the experimental group and the control group in three dimensions, including headache,muscle soreness, and the need for extra care (P<0.05). On the (6+1) days after the intervention,the differences in both the experimental group and the control group were statistically significant in 10 dimensions, including sore throat,bad sleep,uncomfortable feeling,poor spirit and fatigue,crying more than usual,the need for extra care,symptom,function,influence on parents,and total score (P<0.05). The comparison results within the group in the dimensional scores of symptom, function, and influence on parents,as well as the CARIFS total score showed that with the delay of follow-up time,scores of both groups decreased significantly,with a statistically significant difference (P<0.01). Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention,the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up,the mean score of the experimental group was lower than that of the control group,with no statistically significant difference. In terms of the incidence of complications,severe cases, and critical cases, there were no complications,severe cases, and critical cases in the two groups,without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children (heat accumulation in the lung and stomach syndrome) are not inferior to Oseltamivir Phosphate granules, and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children (heat accumulation in the lung and stomach syndrome).
4.Study on the efficacy and safety of 3 kinds of novel biologics in the treatment of Crohn’s disease
Fei WU ; Yongwu CHEN ; Weijia WU ; Furong WU ; Yingqi WU ; Aizong SHEN
China Pharmacy 2026;37(12):1601-1606
OBJECTIVE To compare the efficacy and safety of infliximab(IFX), ustekinumab(UST) and vedolizumab(VDZ) in the treatment of active Crohn’s disease (CD). METHODS The patients with active CD who were diagnosed and initially received any of the aforementioned biologics at the First Affiliated Hospital of the USTC (Anhui Provincial Hospital) from January 2020 to December 2023 were selected as the study subjects. They were divided into the IFX group (34 cases), the UST group (37 cases), and the VDZ group (15 cases) based on their treatment regimens. Patients in all three groups received induction and maintenance therapy with IFX, UST or VDZ for at least 12 months. The CD Activity Index (CDAI) scores and their changes from baseline (ΔCDAI), clinical remission rates, clinical response rates, nutritional indicators [body mass index (BMI), albumin (ALB), hemoglobin (HGB)], and inflammatory markers [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)] of three groups after the induction phase (9th week of treatment) and during the maintenance phase (12th month of treatment) were compared. Additionally, the cumulative clinical remission rates at 1 year of treatment and the incidence of adverse events (AEs) were compared. RESULTS There were no statistically significant differences in the aforementioned baseline indicators among the three groups ( P >0.05). In all three groups, the CDAI scores were significantly lower after the induction phase and during the maintenance phase, compared to the baseline ( P <0.05). In the IFX group, CDAI scores at the above time points were significantly lower than those in the UST and VDZ groups during the same periods ( P <0.05), and the absolute value of ΔCDAI during the maintenance phase was significantly higher than that in the VDZ group ( P <0.05). The clinical remission rate in the IFX group during the maintenance phase was significantly higher than that in the UST and VDZ groups during the same period, and the clinical response rate was significantly higher than that in the VDZ group during the same period ( P <0.05). The levels of ALB, HGB, CRP and ESR in the IFX group after the induction phase and during the maintenance phase, as well as the levels of CRP and ESR in the UST group after the induction phase, all improved significantly compared to the baseline. Furthermore, the levels of ALB and HGB in the IFX group were significantly higher than those in the UST and VDZ groups during the same period ( P <0.05). The cumulative clinical remission rates among the three groups were significantly different ( P <0.05), with patients in the IFX group achieving remission more rapidly and at a higher proportion. There was no statistically significant difference in the incidence of AEs among IFX, UST and VDZ groups (14.71%, 8.11% and 20.00%, respectively; P >0.05); infusion reactions were the most common AEs in the IFX group (8.82%). CONCLUSIONS Compared with UST and VDZ, IFX demonstrates a higher clinical remission rate during the maintenance phase, more effectively improves active CD patients’ nutritional status, and continuously reduces systemic inflammatory responses. However, clinicians should be mindful of the risk of adverse events, such as infusion reactions, associated with this drug.
5.Preparation and identification of monoclonal antibodies against cat allergen Fel d 1.
Linying CAI ; Zichen ZHANG ; Zhuangli BI ; Shiqiang ZHU ; Miao ZHANG ; Yiming FAN ; Jingjie TANG ; Aoxing TANG ; Huiwen LIU ; Yingying DING ; Chen LI ; Yingqi ZHU ; Guijun WANG ; Guangqing LIU
Chinese Journal of Cellular and Molecular Immunology 2025;41(4):348-354
Objective Currently, there is no commercially available quantitative detection kit for the main Felis domestic allergen (Fel d 1) in China. To establish a rapid detection method for Fel d 1, this study aims to prepare monoclonal antibodies against Fel d 1 protein. Methods The codon preference of Escherichia coli was utilized to optimize and synthesize the Fel d 1 gene. The prokaryotic expression plasmid pET-28a-Fel d 1 was constructed and used to express and purify the recombinant Fel d 1 protein. Subsequently, the recombinant protein was immunized into BALB/c mice and monoclonal antibodies (mAbs) were prepared by the hybridoma technique. An indirect ELISA was established using the recombinant Fel d 1 as the coating antigen, and hybridoma cell lines were screened for positive clones. The specificity and antigenic epitopes of the mAbs were confirmed by Western blot analysis. Finally, the selected hybridoma cells were injected into the peritoneal cavities of BALB/c mice for large-scale monoclonal antibody production. Results The recombinant plasmid pET-28a-Fel d 1 was successfully constructed, and soluble Fel d 1 protein was obtained after optimizing the expression conditions. Western blot and antibody titer assays confirmed the successful isolation of two hybridoma cell lines, 7D11 and 5H4, which stably secreted mAbs specific to Fel d 1. Antibody characterization revealed that the 5H4 mAb was of the IgG2a subtype and could recognize the amino acid region 105-163 of Fel d 1, while the 7D11 mAb was the IgG1 subtype and could recognize the amino acid region 1-59. Conclusion The high-purity recombinant Fel d 1 protein produced in this study provides a promising alternative for clinical immunotherapy of cat allergies. Furthermore, the monoclonal antibody prepared in this experiment lays a material foundation for the in-depth study of the biological function of Fel d 1 and the development of ELISA detection.
Animals
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Antibodies, Monoclonal/biosynthesis*
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Mice, Inbred BALB C
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Cats
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Mice
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Allergens/genetics*
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Glycoproteins/genetics*
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Enzyme-Linked Immunosorbent Assay
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Hybridomas/immunology*
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Recombinant Proteins/genetics*
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Female
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Antibody Specificity
6.Biomaterials of different sizes for enhanced adoptive cell transfer therapy in solid tumors.
Jiaxin CHEN ; Rui LIU ; Yingqi TANG ; Chenggen QIAN
Journal of Zhejiang University. Medical sciences 2025;54(4):469-478
Adoptive cell transfer (ACT) shows significant efficacy against hema-tological malignancies but is limited in solid tumors due to poor homing, immunosuppre-ssion, and potential toxicity. Biomaterials spanning from nano- to macroscales-including nanoparticles, microspheres/micropatches, and hydrogels-offer unique advantages for ex vivo cell engineering, in vivo delivery, and modulation of the tumor microenvironment. Specifically, nanoparticles enable gene delivery, artificial antigen-presenting cell engi-neering, and immune microenvironment remodeling. Microspheres/micropatches improve immune cell expansion, targeted activation, and localized retention. Hydrogels enhance ACT via in situ genetic engineering, 3D culture support, and cytokine co-delivery. This review summarizes advances in biomaterial-enhanced ACT, highlighting their potential to improve delivery efficiency, amplify antitumor responses, and reduce toxicity. These insights may accelerate the clinical translation of ACT for solid tumors.
Humans
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Neoplasms/therapy*
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Biocompatible Materials/chemistry*
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Immunotherapy, Adoptive/methods*
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Nanoparticles
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Hydrogels
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Adoptive Transfer/methods*
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Animals
7.Emerging trends and frontier research in the field of plant-derived vesicles for medicinal use:bibliometric analysis
Yingqi CAO ; Yuanyuan XIA ; Qi YOU ; Zhengting WU ; Qing ZHAO ; Dongxiao LI ; Zimei CHEN ; Kewei ZHAO
International Journal of Laboratory Medicine 2025;46(21):2561-2570
Based on the core collection retrieval of the Web of Science database,researches related to the medicinal field of plant-derived vesicles(PDVs)were retrieved.The research hotspots and their changes in the pharmaceutical field of PDVs are visually analyzed by using bibliometric software VOSviewer and CiteSpace.A detailed discussion is held around the author,institution,country,key research hotspots and annual develop-ment hotspots,revealing the current research status of PDVs in the pharmaceutical field and predicting future trends,which provides valuable perspectives for researchers to understand the current research status of PDVs in the pharmaceutical field and discover possible unexplored areas in this field.
8.Mechanistic insights into “Three Methods and Three Acupoints” Tuina therapy for improving spinal microcirculation and motor function in sciatic nerve injury model rats
Hanyu Zhang ; Yingqi Zhang ; Hourong Wang ; Jiayue Liu ; Jiawei Sun ; Jinping Chen ; Zhifeng Liu ; Tianyuan Yu ; Jian Shu
Journal of Traditional Chinese Medical Sciences 2025;2025(1):125-134
Objective:
To investigate the effects of “Three Methods and Three Acupoints” (TMTP) Tuina therapy on spinal microcirculation in sciatic nerve injury (SNI).
Methods:
Thirty-six Sprague–Dawley rats were randomly assigned to four groups: normal, sham operation, model, and TMTP Tuina. Successful model induction was confirmed by observable hind limb lameness. After 20 sessions, hind limb grip strength and motor nerve conduction velocity (MNCV) were measured at baseline and following the 10th and 20th intervention. CD31 and α-SMA in the ventral horn of SNI model rats were detected using immunofluorescence. Motor neurons in the ventral horn were detected by Nissl staining. PTEN levels in the ventral horn were measured by ELISA, and PI3K, Akt, BDNF, VEGF, and HIF-1α expression was determined by RT-PCR. Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt, p-Akt, BDNF, and VEGF.
Results:
Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group (both P < .001). Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group, with increased expressions of α-SMA (P = .002) and CD31 (P = .006). Western blot analysis indicated increased expression of VEGF (P = .005), p-Akt (P < .001), and BDNF (P = .008) in the ventral horn following Tuina treatment. RT-PCR analysis revealed increased expression of PI3K, Akt, BDNF, VEGF and HIF-1α (all P < .05). In contrast, expression of PTEN decreased compared to the model group (P < .001).
Conclusion
TMTP Tuina therapy may restore motor function in rats, enhance ventral horn motor neuron morphology, and promote angiogenesis and vascular smooth muscle proliferation. The mechanism may involve the activation of the PI3K/Akt signaling pathway.
9.Trends in the prevalence and patterns of cardiometabolic multimorbidity in Beijing, 2005—2022
Aijuan MA ; Gang LI ; Jiayu WANG ; Chen XIE ; Bo JIANG ; Li NIE ; Yingqi WEI ; Kai FANG ; Jin XIE ; Zhong DONG ; Jun LYU ; Liming LI
Chinese Journal of Endocrinology and Metabolism 2025;41(7):561-569
Objective:To analyze the prevalence trends and epidemiological characteristics of cardiometabolic multimorbidity(CMM) in Beijing from 2005 to 2022.Methods:A series of representative cross-sectional surveys were conducted in Beijing between 2005 and 2022 using a stratified multistage cluster random sampling method. A total of 110 496 permanent residents aged 18-79 years participated in face-to-face interviews, physical examinations, and laboratory testing. Complex sampling logistic regression models were employed to identify factors associated with CMM, and Joinpoint regression was used to assess temporal trends in prevalence. Results:The prevalence of CMM was 22.3% in 2005 and 24.3% in 2022, with an average annual percent change of 0.1%(95% CI -1.3%-1.3%, P>0.05). In rural areas, the prevalence increased by 1.3% per year(95% CI 0.2%-2.6%, P<0.05), while among obese individuals, it decreased by 1.0% annually( P<0.05). The most common CMM patterns were hypertension combined with dyslipidemia(13.2%), hypertension combined with diabetes(7.0%), and diabetes combined with dyslipidemia(5.8%). The prevalence of hypertension and dyslipidemia comorbidity showed a long-term decline among females, those aged 60-79 and obese individuals( P<0.05). In contrast, the prevalence of hypertension and diabetes comorbidity increased over time in rural residents and individuals with normal body weight( P<0.05). Furthermore, diabetes and dyslipidemia comorbidity rates increased significantly among males, adults aged 18-59 years, those with a college education or above, rural residents and individuals with normal body weight( P<0.05). Multivariable logistic regression indicated that male, older age, overweight, obese, and lower education level were independently associated with a higher risk of CMM( P<0.05). Conclusion:From 2005 to 2022, the prevalence of CMM remained high among adults in Beijing. While prevalence decreased among obese individuals, it increased significantly in rural areas. Hypertension combined with dyslipidemia was the most common multimorbidity pattern throughout the study period.
10.Construction of etiological diagnosis model for pathogen-negative pulmonary tuberculosis using tuberculosis scores of GBP5, DUSP3, and TBP genes combined with inflammatory factors
Miaomiao ZHAO ; Yanyang ZHOU ; Qiuxiang HU ; Hui CHEN ; Tingting CHEN ; Yingqi CHEN ; Ping XU
Chinese Journal of Preventive Medicine 2025;59(11):1965-1971
To evaluate the diagnostic performance of a three-gene (GBP5, DUSP3, and TBP) tuberculosis (TB) score in bacteriologically-negative pulmonary tuberculosis, and to develop and validate a discriminative diagnostic model by integrating inflammatory cytokines (IL-2, IL-5, IL-17, and IFN-γ). A prospective cohort study was conducted, a total of 238 patients admitted to the Affiliated Infectious Disease Hospital of Soochow University from May 2023 to May 2024 were enrolled, including 119 pathogen-negative pulmonary tuberculosis patients and 119 patients with other pulmonary diseases (OPD). The GeneXpert MTB-HR kit was used to detect the three-gene TB scores from residual blood routine samples. The diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Concurrent data on 12 inflammatory cytokines were collected from patients. Potential biomarkers were screened using univariate analysis and multivariate logistic regression, and selected features were incorporated into the construction of four machine learning models: logistic regression, support vector machine (SVM), K-nearest neighbors (KNN), and adaptive boosting (AdaBoost). The samples were randomly split into a training set (85%) and a test set (15%). The models were trained on the training set, and their diagnostic performance was validated using the test set. The predictive ability of each model was evaluated based on ROC curve parameters. The results showed that the three-gene TB score alone yielded an AUC of 0.539 (sensitivity: 50.94%, specificity: 60.50%) in distinguishing pathogen-negative pulmonary tuberculosis from OPD. Four non-col-linear inflammatory factors (IL-2, IL-5, IL-17, and IFN-γ) were selected and combined with the three-gene TB score to construct machine learning models. The AdaBoost model demonstrated the best performance, achieving an AUC of 0.893 (sensitivity: 85.4%, specificity: 73.0%) in the training set and an AUC of 0.873 (sensitivity: 88.2%, specificity: 72.2%) in the test set. In conclusion,the AdaBoost diagnostic model integrating the three-gene TB score with inflammatory factors (IL-2, IL-5, IL-17, and IFN-γ) exhibits superior discriminating performance for pathogen-negative pulmonary tuberculosis compared to OPD, significantly outperforming the three-gene TB score alone.


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