1.The Clinical and Genetics Characteristics of Oculopharyngodistal Myopathy
Jiaxi YU ; Zhihao QUAN ; Yilei ZHENG ; Jing AN ; Jing LIU ; Qingqing WANG ; Lingchao MENG ; Meng YU ; Zhiying XIE ; Jianwen DENG ; He LYU ; Wei ZHANG ; Yun YUAN ; Zhaoxia WANG
JOURNAL OF RARE DISEASES 2026;5(2):164-174
To analyze the clinical and genetic features of oculopharyngodistal myopathy (OPDM) patients and compare the phenotypic differences among various causative genes. A total of 65 genetically confirmed OPDM patients from 43 unrelated families, who were admitted to the Department of Neurology, Peking University First Hospital between January 2008 and December 2025, were retrospectively included.The general demographic data, clinical manifestations, laboratory/auxiliary examinations, muscle pathology, and genetic test results were systematically collected and analyzed. The clinical and pathological characteristics among different OPDM subtypes were compared. Among the 65 patients(39 male and 26 female), the mean age of onset was (31.20±10.43) years (range: 14 to 63 years). The initial symptom was predominantly distal limb weakness (67.44%), which gradually progressed to involve the extraocular muscles, pharyngeal muscles, facial muscles and proximal limb muscles. Serum creatine kinase levels were mildly to moderately elevated. Muscle pathological examinations revealed rimmed vacuoles and intranuclear inclusions (within muscle fibers). The mean duration from onset to diagnosis was (12.33±7.88) years (range: 1 to 32 years). All probands had negative results on conventional next-generation whole-exome sequencing; pathogenic variants were identified through third-generation long-read sequencing or OPDM-targeted repeat-primed polymerase chain reaction(RP-PCR). Among the 43 families, OPDM2 subtype was the most common genetic subtype ( OPDM2 was the predominant subtype in this study. All subtypes share similar age of onset and muscular pathological changes, yet exhibit distinct disease progression patterns. Future multicenter prospective cohort studies are warranted to further elucidate the clinical characteristics, pathogenetic mechanisms, and prognostic differences among OPDM subtypes.
2.A Systematic Review and Thematic Synthesis of Core Competency Elements for Pediatric Simulation Educators
Meiying QUAN ; Yu ZHANG ; Lin WANG ; Zhenghong LI
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1272-1279
To systematically synthesize existing literature, identify the core competency elements essential for instructors to effectively deliver pediatric simulation-based teaching, and provide evidence-based references for faculty development and evaluation. A systematic review was conducted by searching PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform from database inception to January 31, 2026. Two researchers independently performed literature screening and data extraction according to predefined inclusion and exclusion criteria. Methodological quality was assessed using the mixed methods appraisal tool (MMAT). Thematic synthesis wasemployed to code, summarize, and integrate the included literature. A total of 14 studies published between 2019 and 2026 were included, comprising 7 from China, 3 from the United States, and 1 each from Turkey, Japan, India, and Canada. In terms of study design, there were 3 randomized controlled trials, 4 quasi-experimental studies, 1 qualitative study, 2 cross-sectional surveys, 3 non-randomized controlled trials, and 1 mixed-methods study. Five studies received an MMAT score of 100%, while 9 scored 80%, indicating an overall moderate-to-high methodological quality. A total of 87 initial codes were extracted, which were compared and consolidated into 25 subclusters and 8 descriptive themes, ultimately abstracted into 4 analytical themes (i.e., four core competency domains): curriculum design and development; instructional facilitation and feedback; technical proficiency and scenario management; and assessment, reflection, and continuous professional development. The four-core-competency framework identified in this study encompasses the complete teaching chain from pre-session preparation and in-session implementation to post-session evaluation and improvement, and may serve as a reference for the selection, training, assessment, and career development of pediatric simulation educators.
3.Outcomes and Influencing Factors of Extremely Low Birth Weight Infants: A Retrospective Study Based on 15 Years of Clinical Data from Peking Union Medical College Hospital
Yu ZHANG ; Meiying QUAN ; Chen WANG ; Lejia ZHANG ; Yunwei LI ; Zhenghong LI
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1348-1356
To identify clinical outcome of treatment and influencing factors of prognosis of extremely low birth weight infants(ELBWI). Clinical data of ELBWI admitted to the neonatal intensive care unit of Peking Union Medical College Hospital during the study period(from January, 2010 to December, 2024) were retrospectively collected, and their in-hospital outcomes were recorded. Infants who received active treatment were enrolled in active treatment group, while those who were given up treatment due to family reasons in the absence of severe complications were enrolled in treatment-withdrawal group. According to gestational age, the active treatment group was further subdivided into four subgroups: 23-25+6 weeks, 26-27+6 weeks, 28-29+6 weeks, and ≥30 weeks. Based on year of birth, infants were divided into 2010—2019 group and 2020—2024 group. The Aalen-Johansen competing risk model was used to estimate the cumulative incidence of severe complications. Multivariate Logistic regression analysis was performed to identify independent risk factors for mortality. Cox proportional hazards regression model was used to analyze factors associated with survival without major complications. A total of 151 ELBWI were enrolled, including 79 males(52.3%) and 72 females(47.7%). The median gestational age was 27.4(26.4, 29.0) weeks, and the median birth weight was 840(750, 930) g. There were 14 cases(9.3%, 14/151) in treatment-withdrawal group, 137 cases(90.7%, 137/151) in the active treatment group. In the active treatment group, 16 infants(11.7%, 16/137) died or were withdrawn from treatment due to severe complications, and 121 infants(88.3%, 121/137) survived at discharge. The survival rates of rescue by gestational age subgroups were as follows: 75.0%(21/28) in the 23-25+6 weeks group, 90.9%(40/44) in the 26-27+6 weeks group, 93.6%(44/47) in the 28-29+6 weeks group, and 88.9%(16/18) in the ≥30 weeks group. Among the 137 actively treated infants, the incidences of moderate-to-severe bronchopulmonary dysplasia(BPD), sepsis, severe retinopathy of prematurity, severe intraventricular hemorrhage(IVH), severe necrotizing enterocolitis, and periventricular leukomalacia were 60.6%(83/137), 30.7%(42/137), 12.4%(17/137), 13.1%(18/137), 8.8%(12/137), and 1.5%(2/137), respectively. Compared with the 2010—2019 group, the 2020—2024 group had a higher rate of survival without major complications, a shorter time to full enteral feeding, and a lower incidence of moderate-to-severe BPD( Gestational age is an independent predictor of prognosis in ELBWI. A comprehensive manage-ment strategy oriented toward "improving quality of survival" should be implemented to maximize the quality of survival while ensuring the survival rate of ELBWI.
4.Buyang Huanwu Decoction targets PPARG/SPP1/CD44 signaling pathway: mechanisms of lipid dysregulation and treatment in idiopathic pulmonary fibrosis.
Gang-Gang LI ; Xiao-Chuan PAN ; Fei WANG ; Quan-Yu DU
China Journal of Chinese Materia Medica 2025;50(14):3821-3834
Idiopathic pulmonary fibrosis(IPF) is a chronic progressive interstitial lung disease characterized by a complex pathogenesis and limited treatment options. Although studies have indicated that lipid metabolism dysregulation is associated with the progression of IPF, the core regulatory mechanisms remain unclear. By integrating RNA sequencing data from the GEO database, we identified four key genes related to lipid metabolism: peroxisome proliferator-activated receptor gamma(PPARG), secreted phosphoprotein 1(SPP1), caspase 3(CASP3), and platelet endothelial cell adhesion molecule 1(PECAM1). Further validation using single-cell RNA sequencing revealed the cell-specific expression patterns of these genes. The results found that PPARG was significantly downregulated in alveolar macrophages while SPP1 was significantly upregulated. Mechanistic studies indicated that PPARG negatively regulated SPP1 expression, and the interaction between SPP1 and cluster of differentiation 44(CD44) activated intercellular signaling pathways that promoted fibrosis. Through network pharmacology and molecular docking, it was predicted that the bioactive components of the traditional Chinese medicine formula, namely Buyang Huanwu Decoction may target PPARG to modulate lipid metabolism pathways. In a bleomycin-induced rat model with IPF, this paper randomly divided the rats into six groups(control, group, model group, pirfenidone group, and low, middle, and high-dose groups of Buyang Huanwu Decoction). The results demonstrated that Buyang Huanwu Decoction treatment significantly improved tissue pathological damage, reduced collagen deposition, and alleviated lipid metabolism dysregulation. Western blot analysis confirmed that Buyang Huanwu Decoction mediated the upregulation of PPARG and inhibited the activation of the SPP1/CD44 pathway. The multi-omics study elucidated the role of the PPARG/SPP1/CD44 pathway as a key regulatory factor in lipid metabolism in IPF, providing evidence that Buyang Huanwu Decoction exerted its antifibrotic effects through this novel mechanism and thus offering new insights into the therapeutic prospects for IPF.
Animals
;
Drugs, Chinese Herbal/administration & dosage*
;
Signal Transduction/drug effects*
;
PPAR gamma/genetics*
;
Humans
;
Osteopontin/genetics*
;
Lipid Metabolism/drug effects*
;
Idiopathic Pulmonary Fibrosis/genetics*
;
Hyaluronan Receptors/genetics*
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Rats
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Male
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Rats, Sprague-Dawley
;
Molecular Docking Simulation
5.Astragaloside IV delayed the epithelial-mesenchymal transition in peritoneal fibrosis by inhibiting the activation of EGFR and PI3K-AKT pathways.
Ying HUANG ; Chen-Ling CHU ; Wen-Hui QIU ; Jia-Yi CHEN ; Lu-Xi CAO ; Shui-Yu JI ; Bin ZHU ; Guo-Kun WANG ; Quan-Quan SHEN
Journal of Integrative Medicine 2025;23(6):694-705
OBJECTIVE:
Peritoneal fibrosis (PF) is an adverse event that occurs during long-term peritoneal dialysis, significantly impairing treatment efficiency and adversely affecting patient outcomes. Astragaloside IV (AS-IV), a principal active component derived from Astragalus membranaceus (Fisch.) Bunge, has exhibited anti-inflammatory and antifibrotic effects in various settings. This study aims to investigate the potential therapeutic efficacy and mechanism of AS-IV in the treatment of PF.
METHODS:
The PF mouse model was established by intraperitoneal injection of 4.25% peritoneal dialysis fluid (100 mL/kg). The epithelial-mesenchymal transition (EMT) of HMrSV5 cells was induced by the addition of 10 ng/mL transforming growth factor β (TGF-β). The differentially expressed genes in HMrSV5 cells treated with AS-IV were screened using transcriptome sequencing analysis. The potential targets of AS-IV were screened using network pharmacology and analyzed using molecular docking and molecular dynamics simulations.
RESULTS:
Administration of AS-IV at doses of 20, 40, or 80 mg/kg effectively mitigated the increase in peritoneal thickness and the development of fibrosis in mice with PF. The expression of the fibrosis marker α-smooth muscle actin in the peritoneum was significantly decreased in AS-IV-treated mice. The treatment of AS-IV (10, 20, and 40 μmol/L) significantly delayed the EMT of HMrSV5 cells induced by TGF-β, as demonstrated by the decreased number of 5-ethynyl-2'-deoxyuridine-positive cells, reduced migrated area, and decreased expression of fibrosis markers. A total of 460 differentially expressed genes were detected in AS-IV-treated HMrSV5 cells through transcriptome sequencing, with notable enrichment in the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)-AKT serine/threonine kinase 1 (AKT) signaling pathway. The reduced levels of phosphorylated PI3K (p-PI3K) and p-AKT were detected in HMrSV5 cells with AS-IV treatment. Epidermal growth factor receptor (EGFR) was predicted as a direct target of AS-IV, exhibiting strong hydrogen bond interactions. The activation of the PI3K-AKT pathway by the compound 740Y-P, and the activation of the EGFR pathway by NSC 228155 each partially counteracted the inhibitory effect of AS-IV on the EMT of HMrSV5 cells.
CONCLUSION
AS-IV delayed the EMT process in peritoneal mesothelial cells and slowed the progression of PF, potentially serving as a therapeutic agent for the early prevention and treatment of PF. Please cite this article as: Huang Y, Chu CL, Qiu WH, Chen JY, Cao LX, Ji SY, Zhu B, Wang GK, Shen QQ. Astragaloside IV delayed the epithelial-mesenchymal transition in peritoneal fibrosis by inhibiting the activation of EGFR and PI3K-AKT pathways. J Integr Med. 2025; 23(6):694-705.
Epithelial-Mesenchymal Transition/drug effects*
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Animals
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Saponins/pharmacology*
;
Triterpenes/pharmacology*
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Mice
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Peritoneal Fibrosis/pathology*
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Proto-Oncogene Proteins c-akt/metabolism*
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ErbB Receptors/metabolism*
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Phosphatidylinositol 3-Kinases/metabolism*
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Signal Transduction/drug effects*
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Male
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Humans
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Molecular Docking Simulation
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Cell Line
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Mice, Inbred C57BL
6.Nogo-A Protein Mediates Oxidative Stress and Synaptic Damage Induced by High-Altitude Hypoxia in the Rat Hippocampus.
Jin Yu FANG ; Huai Cun LIU ; Yan Fei ZHANG ; Quan Cheng CHENG ; Zi Yuan WANG ; Xuan FANG ; Hui Ru DING ; Wei Guang ZHANG ; Chun Hua CHEN
Biomedical and Environmental Sciences 2025;38(1):79-93
OBJECTIVE:
High-altitude hypoxia exposure often damages hippocampus-dependent learning and memory. Nogo-A is an important axonal growth inhibitory factor. However, its function in high-altitude hypoxia and its mechanism of action remain unclear.
METHODS:
In an in vivo study, a low-pressure oxygen chamber was used to simulate high-altitude hypoxia, and genetic or pharmacological intervention was used to block the Nogo-A/NgR1 signaling pathway. Contextual fear conditioning and Morris water maze behavioral tests were used to assess learning and memory in rats, and synaptic damage in the hippocampus and changes in oxidative stress levels were observed. In vitro, SH-SY5Y cells were used to assess oxidative stress and mitochondrial function with or without Nogo-A knockdown in Oxygen Glucose-Deprivation/Reperfusion (OGD/R) models.
RESULTS:
Exposure to acute high-altitude hypoxia for 3 or 7 days impaired learning and memory in rats, triggered oxidative stress in the hippocampal tissue, and reduced the dendritic spine density of hippocampal neurons. Blocking the Nogo-A/NgR1 pathway ameliorated oxidative stress, synaptic damage, and the learning and memory impairment induced by high-altitude exposure.
CONCLUSION:
Our results demonstrate the detrimental role of Nogo-A protein in mediating learning and memory impairment under high-altitude hypoxia and suggest the potential of the Nogo-A/NgR1 signaling pathway as a crucial therapeutic target for alleviating learning and memory dysfunction induced by high-altitude exposure.
GRAPHICAL ABSTRACT
available in www.besjournal.com.
Animals
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Oxidative Stress
;
Hippocampus/metabolism*
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Rats
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Nogo Proteins/genetics*
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Male
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Rats, Sprague-Dawley
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Hypoxia/metabolism*
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Altitude
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Synapses
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Humans
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Altitude Sickness/metabolism*
7.Research Advances in the Construction and Application of Intestinal Organoids.
Qing Xue MENG ; Hong Yang YI ; Peng WANG ; Shan LIU ; Wei Quan LIANG ; Cui Shan CHI ; Chen Yu MAO ; Wei Zheng LIANG ; Jun XUE ; Hong Zhou LU
Biomedical and Environmental Sciences 2025;38(2):230-247
The structure of intestinal tissue is complex. In vitro simulation of intestinal structure and function is important for studying intestinal development and diseases. Recently, organoids have been successfully constructed and they have come to play an important role in biomedical research. Organoids are miniaturized three-dimensional (3D) organs, derived from stem cells, which mimic the structure, cell types, and physiological functions of an organ, making them robust models for biomedical research. Intestinal organoids are 3D micro-organs derived from intestinal stem cells or pluripotent stem cells that can successfully simulate the complex structure and function of the intestine, thereby providing a valuable platform for intestinal development and disease research. In this article, we review the latest progress in the construction and application of intestinal organoids.
Organoids/cytology*
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Intestines/physiology*
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Humans
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Animals
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Pluripotent Stem Cells
8.Advances in Applications of Machine Learning for Colorimetric Analysis
Yu-Han YAN ; Quan-Feng WANG ; Yu-Tong LAI ; De-Min YANG ; Chang XIA
Chinese Journal of Analytical Chemistry 2025;53(11):1797-1807
Colorimetric analysis is a detection and quantification method based on observable color changes in response to analytes,which offers significant advantages including visually detectable signals,straightforward operation,rapid response,and low cost.Consequently,it plays a crucial role in a variety of fields.With increasingly diverse and complex application,colorimetric analysis requires continuous improvement in sensitivity,adaptability to diverse detection environments,and complex data handling capabilities.In recent years,the development of artificial intelligence technology,particularly within its core domain of machine learning(ML),has led to significant advancements in colorimetric analysis.The ML-assisted colorimetric analysis enables high-throughput and high-sensitivity detection,alongside automated analysis,thereby providing novel strategies to overcome the inherent limitations.This review categorized machine learning techniques and summarized their application in colorimetric analysis,introducing two fundamental categories of supervised learning,and unsupervised learning based on the division of core learning paradigms.The research progress of ML-assisted colorimetric analysis in the fields of environmental monitoring,biochemical detection,and food safety were summarized.Finally,the current challenges facing by this research area were analyzed and the research prospect of ML-assisted colorimetric analysis was outlined.
9.Study on data mining of Chinese materia medica with estrogen-activity
Yu GAO ; Wenyi WANG ; Haoqing XING ; Xiaomin QUAN ; Meihui TANG ; Chao AN
International Journal of Traditional Chinese Medicine 2025;47(3):401-406
Objective:To summarize Chinese materia medica with estrogen-activity based on data mining and analyze their characteristics.Methods:Literature was retrieved from CNKI, Wanfang Data, Chongqing VIP, CBM, PubMed and Web of Science from the establishment of the databases to June 30, 2024, and Chinese materia medica with estrogenic activity were screened. Excel 2021 and KH Coder 3.0 software were used to perform statistical and network co-occurrence analysis on the efficacy classification of Chinese materia medica, properties, tastes and meridians, screening methods for estrogen activity, and applications.Results:Totally 121 kinds of Chinese materia medica with estrogen-activity were included in total. The efficacy classifications were mostly tonic medicines, heat-clearing medicines and blood circulation promoting drugs. The properties were mainly warm and neutral, the tastes were mainly sweet and bitter, and the meridians were mainly the liver, kidney and spleen meridians. The network co-occurrence analysis of the efficacy classification, properties, tastes and tropism meridians showed that the clustering relationship of tonic medicine-neutral-sweet-liver-kidney was the most obvious. The screening methods mainly included MCF-7 cell proliferation and uterine weight gain experiments. Their applications mainly covered osteoporosis, perimenopausal syndrome, lipid metabolism disorder, and premature ovarian failure, etc.Conclusions:Chinese materia medica with estrogen-activity or their components act on estrogen target cells or organs to exert estrogen-like or antagonistic estrogenic effects. This kind of Chinese materia medica can regulate the body's qi, blood, yin and yang, the function of organs and the fullness of Tiangui, as well as the Chong meridian and Conception Vessel, thus improving human growth and development, reproduction and aging. In the future, it is suggested to explore their effective components, mechanisms, bidirectional effect and safety on the basis of guiding clinical medication with the theory of TCM, combining with modern medical research techniques and evidence-based medical research.
10.Association between neutrophil-to-lymphocyte ratio and in-hospital mortality risk in patients with acute aortic dissection:a multicenter 10-year retrospective cohort study
Zi-Xuan LIU ; Hui-Qing WANG ; Xiao-Dan ZHONG ; Xing-Wei HE ; Wen-Hua WANG ; Dan YU ; Bao-Quan ZHANG ; Chun-Wen LI ; He-Song ZENG
Medical Journal of Chinese People's Liberation Army 2025;50(8):917-924
Objective To investigate the role of the neutrophil-to-lymphocyte ratio(NLR)in predicting the in-hospital mortality risk of patients with acute aortic dissection(AAD)in multicenter hospitals.Methods A multicenter retrospective cohort study was conducted.Clinical data were collected from 2642 AAD patients who were hospitalized in five teaching hospitals:Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Henan Provincial People's Hospital,Fuwai Central China Cardiovascular Hospital,the Third Affiliated Hospital of Xinxiang Medical University,and the Second Affiliated Hospital of Chongqing Medical University between August 2010 and December 2021.According to the quartiles of serum NLRlevels,the patients were divided into four groups:first quartile(Q1,n=660),second quartile(Q2,n=661),third quartile(Q3,n=661),and fourth quartile(Q4,n=660).The clinical characteristics and biochemical indicators of each group were compared.Partial correlation analysis was used to assess the relationship between NLR and cardiovascular parameters.Restricted cubic splines,Kaplan-Meier survival analysis,and Cox regression models were employed to evaluate the association between NLR levels and in-hospital mortality risk in AAD patients.Results The median age of all patients was 54[interquartile range(IQR):46-63]years,including 2096 males and 546 females.Compared with Q1-Q3 groups,patients inQ4group had a lower incidence of smoking history and diabetes history,and were more likely to have DeBakey type Ⅰ AAD(P<0.05).Additionally,the levels of aspartate aminotransferase,high-density lipoprotein cholesterol,creatinine,and D-dimer in Q4 group were higher,while the levels of triglycerides and C-reactive protein(CRP)were lower(P<0.01).The results of partial correlation analysis showed that the plasma NLR level was positively correlated with D-dimer(r=0.43,P<0.01)and creatinine(r=0.16,P<0.01).The restricted cubic spline function in the Cox model revealed a significant non-linear relationship between the plasma NLR level and clinical outcomes in AAD patients(P<0.01).Kaplan-Meier survival analysis indicated that patients in Q4 group had the highest in-hospital mortality rate compared with Q1-Q3 groups(P<0.0001).Furthermore,multivariate Cox regression analysis demonstrated that compared with Q1 group,the hazard ratio(HR)of NLR in Q4 group was 1.77(95%CI 1.33-2.37,P<0.001),which was an independent risk factor for the primary endpoint events.Conclusion A higher plasma NLR level is significantly associated with the occurrence of cardiovascular events in AAD patients,and this association remains significant even after adjusting for potential confounding factors such as the multicenter visiting hospitals.

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