1.Effect of Modified Duhuo Jisheng Mixture Regulating PI3K/Akt/mTOR Signaling Pathway on Synoviocyte Pyroptosis in Rabbit Models of Knee Osteoarthritis
Zifeng YE ; Yiwei YUAN ; Liguo QIU ; Xuyi TAN ; Liang OU ; Gaoyan KUANG ; Min LU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):170-179
ObjectiveTo explore the potential mechanisms of action of the modified Duhuo Jisheng Mixture (JDJM) in treating synovial lesions in knee osteoarthritis (KOA). MethodsA total of 43 male New Zealand white rabbits were randomly allocated into a blank group (n=8) and a model group (n=35). The KOA model was induced by immobilizing the right hind limb with a high-molecular resin plaster bandage, with a modeling period of 6 weeks, resulting in successful modeling in 32 rabbits. These rabbits were then randomly allocated to the model group, celecoxib group, JDJM group and JDJM+740Y-P group, each consisting of 8 rabbits. The celecoxib group received celecoxib via gavage at a single dose of 0.009 3 g·kg-1, while the JDJM was administered a single dose of 6.8 mL·kg-1 (4.515 2 g·kg-1) of the herbal preparation via gavage. The phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway activator + JDJM group received 4.515 2 g·kg-1 of the herbal preparation via gavage along with an auricular vein injection of 0.15 μmol·kg-1 740Y-P. For a period of 6 weeks, the remaining groups received an equal volume of physiological saline via gavage daily. After the medication period, the knee joint pain threshold and circumference were measured, and hematoxylin-eosin (HE) staining was performed to assess the pathological changes in the synovial tissues. Enzyme-linked immunosorbent assay (ELISA) measured the levels of interleukin-1β (IL-1β), interleukin-6 (IL-18) and tumor necrosis factor-α (TNF-α) in the joint fluid. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to assess the mRNA expression of PI3K, Akt, mTOR, NOD-like receptor protein 3 (NLRP3), cysteine-requiring aspartate protease-1 (Caspase-1) and gasdermin D (GSDMD) in the synovial tissues. Immunohistochemical (IHC) assay was performed to assess the protein expression of NLRP3, Caspase-1 and GSDMD. Western blot was carried out to analyze the protein expression of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, NLRP3, Caspase-1 and GSDMD. ResultsCompared to the blank group, the model group showed a significant increase in knee joint circumference and decrease in pain threshold, the synovial tissue pathology score was higher (P<0.05), and the levels of IL-1β, IL-18, and TNF-α in the joint fluid significantly increased (P<0.01). PI3K, Akt, mTOR phosphorylation as well as mRNA and protein expression increased (P<0.01), while the mRNA and protein expression levels of NLRP3, Caspase-1 and GSDMD also significantly increased (P<0.01). Compared to the model group, the celecoxib and JDJM groups exhibited a significant reduction in knee joint circumference and increase in pain threshold, the synovial tissue pathology score was lower (P<0.05), and the levels of IL-1β, IL-18, and TNF-α in the joint fluid decreased (P<0.01). The mRNA and protein expression of p-PI3K, p-Akt, p-mTOR, NLRP3, Caspase-1 and GSDMD were reduced (P<0.01). Compared to the JDJM group, the JDJM+740Y-P group showed a decrease in the improvement of synovial lesions, an increase in knee joint circumference, and a decrease in pain threshold. The synovial tissue pathology score was lower (P<0.05), and the levels of IL-1β, IL-18, and TNF-α in the joint fluid were higher (P<0.01). The mRNA and protein expression of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, NLRP3, Caspase-1 and GSDMD increased (P<0.01). ConclusionJDJM is effective in treating KOA. Its mechanism may involve modulating the PI3K/Akt/mTOR pathway in synovial tissues, inhibiting pyroptosis, reducing inflammatory factor release, and protecting bony structures.
2.Chufeng Yisuntang Ameliorates PM2.5-induced Dry Eye via ROS/p38 MAPK Signaling Pathway
Yuan ZHONG ; Pan ZHAO ; Shi TAN ; Yu TANG ; Dongdong LI ; Lihao CHEN ; Jun PENG ; Qinghua PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):191-200
ObjectiveTo establish a mouse model of particulate matter 2.5 (PM2.5)-induced dry eye and investigate whether Chufeng Yisuntang can ameliorate the PM2.5-induced ocular surface damage by regulating the reactive oxygen species (ROS)/p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway. MethodsSixty 8-week-old male C57BL/6J mice were used. Ten were randomly selected as the control group. The remaining 50 mice received topical instillation of 1 drop (0.1 mL) of 5 g·L-1 PM2.5 suspension in both eyes, four times daily. Successfully modeled mice were randomized into four groups (n=10): Model, p38 MAPK inhibitor, Chufeng Yisuntang, and combination (Chufeng Yisuntang at 7.3 g·kg-1 + p38 MAPK inhibitor SB203580 at 5 mg·kg-1). Chufeng Yisuntang was administered via gavage, and the inhibitor group via intraperitoneal injection. The control and model groups received equal volumes of distilled water by gavage. All treatments lasted for 4 weeks. General conditions were dynamically observed. Tear secretion, tear film break-up time, and corneal fluorescein staining were assessed. After intervention for 4 weeks, hematoxylin and eosin (HE) staining was used to examine the histopathological changes. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure serum levels of ROS, malondialdehyde (MDA), superoxide dismutase (SOD) 1, and SOD2. Western blot and Real-time PCR were employed to determine the protein and gene levels, respectively, of p38 MAPK, B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), and cysteinyl aspartate-specific proteinase-3 (Caspase-3) in the corneal tissue. ResultsCompared with the control group, the model group exhibited reduced tear secretion volume and tear film breakup time, along with increased corneal fluorescein staining scores (P<0.01). Compared with the model group, the Chufeng Yisuntang group, p38 MAPK inhibitor group, and combination group demonstrated increased tear secretion volume and tear film breakup time, along with decreased corneal fluorescein staining scores (P<0.01). HE staining revealed that compared with the control group, the model group exhibited marked increases in corneal epithelial cell layers and epithelial thickness, along with reduced meibomian gland acini and intensely stained, densely packed nuclei around the acini. Compared with the model group, the Chufeng Yisuntang group, p38 MAPK inhibitor group, and combination group showed intact corneal structure, improved cell morphology, and reduced damage severity. ELISA revealed elevated ROS and MDA levels (P<0.01) and decreased SOD1 and SOD2 levels (P<0.01) in the model group compared with the control group. Compared with the model group, Chufeng Yisuntang, p38 MAPK inhibitor, and the combination lowered ROS and MDA levels (P<0.01), while raising SOD1 and SOD2 levels (P<0.05, P<0.01). Western blot revealed that compared with the control group, the model group exhibited increased protein levels of p38 MAPK, Bax, and Caspase-3 (P<0.01) and reduced protein level of Bcl-2 (P<0.01). Compared with the model group, Chufeng Yisuntang, p38 MAPK inhibitor, and the combination down-regulated the protein levels of p38 MAPK, Bax, and Caspase-3 (P<0.01), while up-regulating the protein level of Bcl-2 (P<0.01). Compared with the Chufeng Yisuntang group, the combination group exhibited decreased protein levels of p38 MAPK, Bax, and Caspase-3 (P<0.01) and increased protein level of Bcl-2 (P<0.01). Real-time PCR revealed that compared with the control group, the model group exhibited upregulated mRNA levels of p38 MAPK, Bax, and Caspase-3 (P<0.01), and downregulated mRNA level of Bcl-2 (P<0.01). Compared with the model group, Chufeng Yisuntang, p38 MAPK inhibitor, and the combination down-regulated the mRNA levels of p38 MAPK, Bax, and Caspase-3 (P<0.01), while up-regulating the mRNA level of Bcl-2 (P<0.05, P<0.01). Compared with the Chufeng Yisuntang group, the combination group exhibited decreased mRNA levels of p38 MAPK, Bax, and Caspase-3 expression (P<0.05, P<0.01) and increased mRNA level of Bcl-2 (P<0.01). ConclusionChufeng Yisuntang may partially protect against PM2.5-induced corneal injury by inhibiting the ROS/p38 MAPK pathway, enhancing antioxidant defense, and reducing epithelial apoptosis.
3.Mechanism of MEK/Ras/Raf/ERK Signaling Pathway Modulated by Mimenghua Prescription on Inflammatory Response in Dry Eye Animal Model
Shi TAN ; Pei LIU ; Yuan ZHONG ; Sainan TIAN ; Pengfei JIANG ; Genyan QIN ; Qinghua PENG ; Jun PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):211-221
ObjectiveThis paper aims to investigate the effects and mechanism of Mimenghua prescription in modulating the mitogen-activated protein kinase kinase (MEK)/rat sarcoma viral oncogene homolog (Ras)/rapidly accelerated fibrosarcoma kinase (Raf)/extracellular signal-regulated kinase (ERK) signaling pathway to inhibit inflammatory responses in a dry eye animal model. MethodsA total of 60 C57BL/6J mice (eight weeks old, half male and half female) were used in the experiment. Ten mice were randomly selected as the blank control group, while the remaining 50 were exposed to a controlled dry system and received instillation of 0.2% benzalkonium chloride (BAC) into the eyes for four weeks to establish a dry eye mouse model. After successful modeling, the mice were randomly divided into five groups: Model group, sodium hyaluronate group, and Mimenghua prescription groups with low dose (4.83 g·kg-1), medium dose (9.67 g·kg-1), and high dose (19.34 g·kg-1). The mice in the model group received an equal volume of normal saline via gavage for four weeks. The mice in the sodium hyaluronate group received instillation of sodium hyaluronate eye drops twice daily for 14 consecutive days. The tear secretion volume, tear film break-up time (TBUT), and corneal fluorescein staining were evaluated once every two weeks. After four weeks of administration, mice were euthanized, and their lacrimal gland tissues and corneas were harvested. Hematoxylin-eosin (HE) staining was used to assess histopathological morphology. Western blot was performed to detect the protein expression levels of MEK, Ras, Raf, and ERK. Enzyme-linked immunosorbent assay (ELISA) was used to measure the contents and expressions of MEK, Ras, Raf, ERK, and interleukin (IL)-1β in lacrimal gland and corneal tissues of the mice in each group. Quantitative real-time polymerase chain reaction (Real-time PCR) was employed to determine mRNA expression levels of MEK, Ras, Raf, and ERK. ResultsThe Mimenghua prescription groups and the sodium hyaluronate group exhibited significantly increased tear secretion volume (P<0.05) and prolonged TBUT (P<0.05) after treatment. Ocular surface damage of mice was visibly recovered. Western blot results indicated that protein expression levels of MEK, Ras, Raf, and ERK in the lacrimal gland and corneal tissues were significantly downregulated in the sodium hyaluronate group and Mimenghua prescription group with high dose (P<0.05). ELISA results showed that IL-1β levels were highest in the model group but significantly reduced in the sodium hyaluronate group and Mimenghua prescription groups (P<0.05). Both ELISA and Real-time PCR results demonstrated that the expression levels of MEK, Ras, Raf, and ERK in the lacrimal glands and corneal tissues were significantly elevated in the model group (P<0.05), but markedly downregulated in the sodium hyaluronate group and Mimenghua prescription groups (P<0.05), suggesting that Mimenghua prescription can decrease the expressions of MEK, Ras, Raf, and ERK in the lacrimal glands and corneal tissues. ConclusionMimenghua prescription can reduce inflammatory responses, increase tear secretion, prolong TBUT, and promote corneal recovery by inhibiting the MEK, Ras, Raf, and ERK signaling pathways in lacrimal gland and corneal tissues.
4.Effects of Qizhi Tongluo Granules on Endoplasmic Reticulum Stress and Nrf2/OASL1 Signaling Pathway in Rats with Membranous Nephropathy
Qin LU ; Fei GAO ; Xiaomeng WANG ; Zhenhua WU ; Guodong YUAN ; Fengwen YANG ; Jinchuan TAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):134-143
ObjectiveTo investigate the therapeutic efficacy of Qizhi Tongluo granules on proteinuria in membranous nephropathy (MN) and its potential protective effects and underlying mechanism against endoplasmic reticulum stress. MethodsAfter 70 Sprague-Dawley (SD) rats were adaptively fed for one week, the MN rat model was established by injecting cationic bovine serum albumin (C-BSA) into the tail vein. Rats were divided into the normal group, model group, low-dose Qizhi Tongluo granules group (2.43 g·kg-1), medium-dose group (4.86 g·kg-1), high-dose group (9.72 g·kg-1), and benazepril group (0.01 g·kg-1), with 10 rats in each group. Treatment was administered for four weeks. The 24-hour urinary total protein (UTP) content, as well as the levels of reactive oxygen species (ROS), malondialdehyde (MDA), and glutathione peroxidase (GPX) in renal tissues, were measured. Renal pathological changes were assessed using immunoglobulin G (IgG) staining, periodic acid-silver methenamine (PASM) staining, and transmission electron microscopy (TEM). The localization and expression levels of glucose-regulated protein 78 (GRP78), phosphorylated inositol-requiring enzyme 1α (p-IRE1α), phosphorylated protein kinase R-like endoplasmic reticulum kinase (p-PERK), activating transcription factor 4 (ATF4), nuclear factor erythroid 2-related factor 2 (Nrf2), and 2'-5' oligoadenylate synthetase-like protein 1 (OASL1) in rat kidneys were detected by immunohistochemistry (IHC). The mRNA and protein expression levels of Nrf2, thioredoxin 1 (Trx1), thioredoxin-interacting protein (TXNIP), and OASL1 in rat kidneys were measured using real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot analysis. ResultsCompared with the normal group, UTP levels were significantly increased in the model rats (P<0.05), with obvious renal pathological damage. GPX content levels were significantly decreased in renal tissue (P<0.05), while ROS and MDA content levels were significantly increased (P<0.05). The expression of GRP78, p-IRE1α, p-PERK, and ATF4 proteins was significantly increased in the kidneys (P<0.05), while the mRNA and protein expression levels of Trx1 and Nrf2 were significantly decreased (P<0.05). The mRNA and protein expression levels of TXNIP and OASL1 were significantly increased (P<0.05). Compared with the model group, the UTP levels of rats in the Qizhi Tongluo granules groups and the benazepril group decreased to varying degrees (P<0.05), and renal pathological damage was significantly alleviated. The GPX content in renal tissue was significantly increased (P<0.05), while the ROS and MDA levels were significantly decreased (P<0.05). The expression of GRP78, p-IRE1α, p-PERK, and ATF4 proteins in the kidney was significantly decreased (P<0.05). The mRNA and protein expression levels of Trx1 and Nrf2 were significantly increased (P<0.05), while the mRNA and protein expression levels of TXNIP and OASL1 were significantly decreased (P<0.05). ConclusionQizhi Tongluo granules alleviates proteinuria in MN rats by modulating the Nrf2/OASL1 signaling pathway in renal tissues to reduce endoplasmic reticulum stress, which represents its underlying mechanism.
5.The impact of donor reentry experience on blood donation return intention
Shangwu LI ; Yao GUAN ; Yuan YUAN ; Jing CHEN ; Minghua TAN ; Jia LUO
Chinese Journal of Blood Transfusion 2026;39(5):636-642
Objective: To explore the impact of donor reentry experience, specifically among those with a single reactive serological result who completed the reentry process, on their willingness to return for future blood donation, and to examine the mediating roles of blood donation knowledge and trait anxiety. Methods: A cross-sectional survey was conducted between November and December 2025. A total of 386 blood donors from the Changsha Blood Center were categorized into a reentry group (n=123) and a control group (n=263). Data on demographic characteristics, blood donation knowledge (BDKQ), trait anxiety (STAI-T), and blood donation return intention (BDRIS) were collected via questionnaires. SPSS 27.0 and AMOS 28.0 were used for statistical analyses, including independent-samples t-test, one-way ANOVA, multiple linear regression, and path analysis for mediating effect testing. Results: There were statistically significant differences in age, occupation, education level, monthly income and donation frequency between the reentry group and the control group (all P<0.05). The reentry group scored significantly higher in blood donation knowledge and blood donation return intention than the control group (both P<0.05). The mean BDRIS score was 11.51±3.62, indicating a relatively high intention to return. Blood donation knowledge was significantly negatively correlated with trait anxiety (r=-0.15, P<0.05) and positively correlated with blood donation return intention (r=0.19, P<0.05); trait anxiety was significantly negatively correlated with blood donation return intention (r=-0.33, P<0.05). Significant differences in BDRIS scores were found based on group (reentry vs control), age, and number of previous donations (all P<0.05). Multiple linear regression showed that BDKQ positively predicted BDRIS (β=0.11, P<0.05), while STAI-T negatively predicted BDRIS (β=-0.27, P<0.05). Path analysis further revealed that the reentry experience had no direct effect on the intention to return. However, it exerted a positive influence through two indirect pathways: 1) a simple mediating effect via increased blood donation knowledge (β=0.17, accounting for 25.0% of the total effect), and 2) a chain mediating effect through "increased blood donation knowledge → decreased trait anxiety" (β=0.05, accounting for 8.1% of the total effect). The model fit indices reached the ideal fitting criteria. Conclusion: The donor reentry experience does not directly enhance the intention to return for blood donation. Rather, it may exert an indirect positive influence by increasing blood donation knowledge and through the sequential pathway of "increased knowledge → decreased trait anxiety". Blood collection institutions should leverage the reentry process as an opportunity for education and psychological support to improve donor retention rate.
6.Mechanism of Liuwei dihuang pill promoting tendon-bone healing by regulating cell crosstalk through Wnt/β-catenin pathway
Peng ZHANG ; Honglüe TAN ; Xiaotao SHI ; Xiao WANG ; Peizhao WANG ; Yanhao YUAN ; Renkun ZHAO ; Guorui CAO
China Pharmacy 2026;37(13):1722-1727
OBJECTIVE To explore the mecha nism by which Liuwei dihuang pill promotes tendon-bone healing by regulating the interaction between bone marrow mesenchymal stem cells (BMSCs) and macrophages through Wnt/ β -catenin pathway. METHODS BMSCs were co-cultured with macrophages at a ratio of 1∶4 and divided into control group, 10% drug-containing serum group, 20% drug-containing serum group, Wnt/ β -catenin pathway inhibitor Dickkopf-related protein 1 (DKK-1) group, and 20% drug-containing serum+DKK-1 group. After 48 hours of cell co-culture and 14 days of osteogenic induction, the CD86 and CD206 positive cell rates in macrophages, the proportion of calcium nodule positive staining area in BMSCs, the levels of osteocalcin (OCN) and oncostatin M (OSM) and alkaline phosphatase (ALP) activity in cell supernatant, as well as the mRNA and protein expression levels of OCN, Runt-related transcription factor 2 (RUNX2), OSM, low-density lipoprotein receptor-related protein 5 (LRP5), β -catenin in cells were detected. Pearson correlation analysis was performed to assess the correlation between LRP5 and β -catenin protein expression with OCN, RUNX2, OSM protein expression, and CD206 positive cell rate, respectively. RESULTS Compared with the control group, the CD86 positive cell rates in the 10% drug-containing serum group and the 20% drug-containing serum group were significantly reduced, while the CD206 positive cell rate, proportion of calcium nodule positive staining area, OCN level, OSM level, ALP activity, and mRNA and protein expression levels of OCN, RUNX2, OSM, LRP5, β -catenin were significantly increased ( P <0.05). Compared with the 20% drug-containing serum group, the changes in the above indicators in the 20% drug-containing serum+DKK-1 group were significantly reversed ( P <0.05). The protein expression of LRP5 and β -catenin was positively correlated with the pro tein expression of OCN, RUNX2, OSM, and CD206 positive cell rate. CONCLUSIONS Liuwei dihuang pill can activate the Wnt/ β -catenin pathway, induce M2 polarization of macrophages and secretion of OSM, promote osteogenic differentiation and matrix mineralization of BMSCs, and synergistically promote tendon-bone healing.
7.Mechanism of Liuwei dihuang pill promoting tendon-bone healing by regulating cell crosstalk through Wnt/β-catenin pathway
Peng ZHANG ; Honglüe TAN ; Xiaotao SHI ; Xiao WANG ; Peizhao WANG ; Yanhao YUAN ; Renkun ZHAO ; Guorui CAO
China Pharmacy 2026;37(13):1722-1727
OBJECTIVE To explore the mecha nism by which Liuwei dihuang pill promotes tendon-bone healing by regulating the interaction between bone marrow mesenchymal stem cells (BMSCs) and macrophages through Wnt/ β -catenin pathway. METHODS BMSCs were co-cultured with macrophages at a ratio of 1∶4 and divided into control group, 10% drug-containing serum group, 20% drug-containing serum group, Wnt/ β -catenin pathway inhibitor Dickkopf-related protein 1 (DKK-1) group, and 20% drug-containing serum+DKK-1 group. After 48 hours of cell co-culture and 14 days of osteogenic induction, the CD86 and CD206 positive cell rates in macrophages, the proportion of calcium nodule positive staining area in BMSCs, the levels of osteocalcin (OCN) and oncostatin M (OSM) and alkaline phosphatase (ALP) activity in cell supernatant, as well as the mRNA and protein expression levels of OCN, Runt-related transcription factor 2 (RUNX2), OSM, low-density lipoprotein receptor-related protein 5 (LRP5), β -catenin in cells were detected. Pearson correlation analysis was performed to assess the correlation between LRP5 and β -catenin protein expression with OCN, RUNX2, OSM protein expression, and CD206 positive cell rate, respectively. RESULTS Compared with the control group, the CD86 positive cell rates in the 10% drug-containing serum group and the 20% drug-containing serum group were significantly reduced, while the CD206 positive cell rate, proportion of calcium nodule positive staining area, OCN level, OSM level, ALP activity, and mRNA and protein expression levels of OCN, RUNX2, OSM, LRP5, β -catenin were significantly increased ( P <0.05). Compared with the 20% drug-containing serum group, the changes in the above indicators in the 20% drug-containing serum+DKK-1 group were significantly reversed ( P <0.05). The protein expression of LRP5 and β -catenin was positively correlated with the pro tein expression of OCN, RUNX2, OSM, and CD206 positive cell rate. CONCLUSIONS Liuwei dihuang pill can activate the Wnt/ β -catenin pathway, induce M2 polarization of macrophages and secretion of OSM, promote osteogenic differentiation and matrix mineralization of BMSCs, and synergistically promote tendon-bone healing.
8.Shuhe Granules (舒和颗粒) in Treating Rheumatoid Arthritis Comorbid with Insomnia with Kidney-Heart Deficiency and Qi-Blood Disharmony Syndrome:An Exploratory Single-Arm Clinical Trial
Yonghao PAN ; Yuxi LI ; Yu GAO ; Xiangbin CHEN ; Kaixin GAO ; Runyue HUANG ; Fei TAN ; Jiamin YUAN ; Biyun XU ; Zhimin YANG
Journal of Traditional Chinese Medicine 2026;67(16):1743-1751
ObjectiveTo investigate the clinical effects and safety of Shuhe Granules (舒和颗粒) in patients with rheumatoid arthritis (RA) comorbid with insomnia. MethodsA single-arm prospective exploratory design was adopted. Thirty RA patients comorbid with insomnia and diagnosed with the traditional Chinese medicine (TCM) syndrome of kidney-heart deficiency and qi-blood disharmony were enrolled. On the basis of maintaining their original RA treatment regimens, all patients received oral Shuhe Granules, one dose per day, for 12 consecutive weeks. The outcomes were assessed before treatment and at weeks 4, 8, and 12 after treatment. Sleep and related psychosomatic function were evaluated using the insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), fatigue severity scale (FSS), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), and Montreal cognitive assessment (MoCA) scores. RA-related assessments included the 28-joint disease activity score based on C-reactive protein (DAS28-CRP), pain visual analog scale (VAS), tender joint count (TJC28), swollen joint count (SJC28), morning stiffness duration, and health assessment questionnaire (HAQ) score. Laboratory parameters included erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), anti-cyclic citrullinated peptide antibody (anti-CCP), and rheumatoid factor (RF) levels. A literature-based historical control group was established through literature retrieval and meta-analysis. The ISI, PSQI, DAS28-CRP, and pain VAS scores were compared between the treatment group in the present study and the historical control group. Safety assessments were also performed. ResultsCompared with baseline before treatment, ISI and PSQI scores decreased at weeks 4, 8, and 12, while MoCA scores increased at weeks 4, 8, and 12. FSS scores decreased at weeks 4 and 12. At weeks 8 and 12, GAD-7 scores, DAS28-CRP scores, duration of morning stiffness, TJC28, and SJC28 were reduced. At week 12, PHQ-9, pain VAS, and HAQ scores significantly decreased (P<0.05). FSS and DAS28-CRP scores at week 12 were lower than those at week 4, and CRP levels at week 8 were lower than those at week 4 (P<0.05). Compared with the historical control group, the treatment group showed superior improvement in ISI and PSQI scores (P<0.001); however, no statistically significant differences were observed between the two groups in DAS28-CRP or pain VAS scores (P>0.05). No serious adverse events occurred during the study, and the 4 reported mild adverse events were all considered unrelated to the study medication. ConclusionShuhe Granules significantly improve sleep quality, fatigue, emotional status, cognitive function, RA-related symptoms, and joint function in patients with RA comorbid insomnia, with good safety and tolerability.
9.Mechanism of action of the fat mass and obesity-associated gene in the development and progression of metabolic dysfunction-associated fatty liver disease and related targeted therapies
Zhaoquan PAN ; Xudong LIU ; Weiqiang TAN ; Xiaoke RAN ; Yuan YUAN ; Xinfeng LOU
Journal of Clinical Hepatology 2025;41(6):1167-1173
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common chronic liver disease with the pathological feature of lipid accumulation in the liver, and it is closely associated with liver metabolic disorders. The latest research has shown that the pathogenesis of MAFLD is associated with the abnormal expression of specific genes, especially the fat mass and obesity-associated (FTO) gene. The abnormal activity of the FTO gene may lead to an imbalance in liver lipid metabolism, which manifests as the increase in fatty acid synthesis and the reduction in fatty acid oxidation, thereby promoting liver fat deposition and inflammatory response. Therefore, regulating the expression or activity of the FTO gene is considered one of the potential strategies for the treatment of MAFLD. At present, drug research targeting the function of the FTO gene has achieved preliminary results, and inhibition of the activity of the FTO gene can help to regulate liver lipid metabolism and alleviate liver inflammatory injury. This article reviews the mechanism of action of the FTO gene in the development and progression of MAFLD, summarizes the advances in drug research on the FTO gene and related metabolic pathways in recent years, and analyzes their application prospect in research and treatment.
10.Application of bicuspid pulmonary valve sewn by 0.1 mm expanded polytetrafluoroethylene in right ventricle outflow tract reconstruction
Jianrui MA ; Tong TAN ; Miao TIAN ; Jiazichao TU ; Wen XIE ; Hailong QIU ; Shuai ZHANG ; Jian ZHUANG ; Jimei CHEN ; Jianzheng CEN ; Shusheng WEN ; Haiyun YUAN ; Xiaobing LIU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(08):1127-1132
Objective To introduce a modified technique of right ventricular outflow tract (RVOT) reconstruction using a handmade bicuspid pulmonary valve crafted from expanded polytetrafluoroethylene (ePTFE) and to summarize the early single-center experience. Methods Patients with complex congenital heart diseases (CHD) who underwent RVOT reconstruction with a handmade ePTFE bicuspid pulmonary valve due to pulmonary regurgitation at Guangdong Provincial People’s Hospital from April 2021 to February 2022 were selected. Postoperative artificial valve function and right heart function indicators were evaluated. Results A total of 17 patients were included, comprising 10 males and 7 females, with a mean age of (18.18±12.14) years and a mean body weight of (40.94±19.45) kg. Sixteen patients underwent reconstruction with a handmade valved conduit, with conduit sizes ranging from 18 to 24 mm. No patients required mechanical circulatory support, and no in-hospital deaths occurred. During a mean follow-up period of 12.89 months, only one patient developed valve dysfunction, and no related complications or adverse events were observed. The degree of pulmonary regurgitation was significantly improved post-RVOT reconstruction and during follow-up compared to preoperative levels (P<0.001). Postoperative right atrial diameter, right ventricular diameter, and tricuspid regurgitation area were all significantly reduced compared to preoperative values (P<0.05). Conclusion The use of a 0.1 mm ePTFE handmade bicuspid pulmonary valve for RVOT reconstruction in complex CHD is a feasible, effective, and safe technique.

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