1.Exploration and model construction of a mutual recognition mechanism for regional medical ethical review
Ze HU ; Zhaoheng YUN ; Shengqiang JIANG
Chinese Medical Ethics 2026;39(6):762-768
Against the backdrop of the rapid development of multicenter and interdisciplinary collaboration in medical research, establishing a standardized and efficient ethical collaborative review and mutual recognition system constitutes not only an urgent priority for advancing multi-institutional joint research but also a crucial measure in response to national policy orientations. Based on Jiangsu Province’s innovative practices in the field of ethical collaborative review, and through an analysis of common challenges in this field globally, this paper systematically put forward implementation strategies to ensure review quality and efficiency. These strategies encompassed establishing a regional ethics alliance to achieve resource integration and constructing supporting legal frameworks to strengthen institutional guarantees. Meanwhile, it was also crucial to enhance team professionalism, optimize multi-party collaboration models, and establish sustainable communication mechanisms, ultimately forming a scalable collaborative development framework for ethical review. The research outcomes can provide decision-making references and operational paradigms for the optimization and upgrading of the cross-institutional medical research ethics management system in China.
2.Epidemiological Characteristics of Venous Thromboembolism Among Inpatients at the People's Hospital of Xizang Autonomous Region: A Cross-Sectional Study from the Perspective of Chronic Disease Pharmaceutical Clinic in a High-Altitude Region
Xue SUN ; Wei ZUO ; Yangzom PEMA ; Li LIU ; Zekun DING ; Yang HU ; Bi ZE
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1461-1469
To investigate the epidemiological characteristics of venous thromboembolism (VTE) among inpatients at the People's Hospital of Xizang Autonomous Region, and to provide data support for the establishment of a standardized risk screening and pharmaceutical care system in the plateau chronic disease pharmaceutical clinic. This study was a retrospective cross-sectional survey. Patients discharged with a diagnosis of VTE from the People's Hospital of Xizang Autonomous Region between January 2019 and December 2024 were selected. General data, clinical outcomes, and anticoagulation regimens were collected. The Mann-Kendall trend test was used to analyze the temporal trend of VTE prevalence, and multivariate Logistic regression was used to analyze the influencing factors of VTE occurrence. A total of 939 VTE patients were included, comprising 492 females (52.40%) and 447 males (47.60%), with a mean age of (54.87±20.10) years. There were 339 elderly patients aged ≥65 years and 600 patients aged < 65 years. In terms of treatment outcomes, the clinical improvement (improvement) rate was 79.02%, and the cure rate was 10.76%. Among thrombus types, pulmonary embolism (PE) accounted for the highest proportion (58.79%), with low-risk PE being the main subtype (35.50%). The main comorbidity among VTE patients was hypertension (39.94%), followed by acute myocardial infarction or ischemic stroke (11.40%). The prevalence of VTE increased from 0.62% in 2019 to 1.07% in 2024. The Mann-Kendall trend test showed a Kendall's Tau coefficient of 0.733 ( The prevalence of VTE at the People's Hospital of Xizang Autonomous Region is on the rise. The key risk population consists of chronic disease patients with hypertension and obesity. It is necessary to further strengthen early identification of VTE, management of comorbidities, and medication monitoring for chronic disease patients, so as to improve the comprehensive management of VTE in plateau areas.
3.Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma
Weifeng ZENG ; Furong LIU ; Yachong LIU ; Ze ZHANG ; Haofan HU ; Shangwu NING ; Hongwei ZHANG ; Xiaoping CHEN ; Zhibin LIAO ; Zhanguo ZHANG
Clinical and Molecular Hepatology 2025;31(2):489-508
Background/Aims:
Transmembrane 4 L six family member 1 (TM4SF1) is highly expressed and contributes to the progression of various malignancies. However, how it modulates hepatocellular carcinoma (HCC) progression and senescence remains to be elucidated.
Methods:
TM4SF1 expression in HCC samples was evaluated using immunohistochemistry and flow cytometry. Cellular senescence was assessed through SA-β-gal activity assays and Western blot analysis. TM4SF1-related protein interactions were investigated using immunoprecipitation-mass spectrometry, co-immunoprecipitation, bimolecular fluorescence complementation, and immunofluorescence. Tumor-infiltrating immune cells were analyzed by flow cytometry. The HCC mouse model was established via hydrodynamic tail vein injection.
Results:
TM4SF1 was highly expressed in human HCC samples and murine models. Knockdown of TM4SF1 suppressed HCC proliferation both in vitro and in vivo, inducing non-secretory senescence through upregulation of p16 and p21. TM4SF1 enhanced the interaction between AKT1 and PDPK1, thereby promoting AKT phosphorylation, which subsequently downregulated p16 and p21. Meanwhile, TM4SF1-mediated AKT phosphorylation enhanced PD-L1 expression while reducing major histocompatibility complex class I level on tumor cells, leading to impaired cytotoxic function of CD8+ T cells and an increased proportion of exhausted CD8+ T cells. In clinical HCC samples, elevated TM4SF1 expression was associated with resistance to anti-PD-1 immunotherapy. Targeting TM4SF1 via adeno-associated virus induced tumor senescence, reduced tumor burden and synergistically enhanced the efficacy of anti-PD-1 therapy.
Conclusions
Our results revealed that TM4SF1 regulated tumor cell senescence and immune evasion through the AKT pathway, highlighting its potential as a therapeutic target in HCC, particularly in combination with first-line immunotherapy.
4.Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma
Weifeng ZENG ; Furong LIU ; Yachong LIU ; Ze ZHANG ; Haofan HU ; Shangwu NING ; Hongwei ZHANG ; Xiaoping CHEN ; Zhibin LIAO ; Zhanguo ZHANG
Clinical and Molecular Hepatology 2025;31(2):489-508
Background/Aims:
Transmembrane 4 L six family member 1 (TM4SF1) is highly expressed and contributes to the progression of various malignancies. However, how it modulates hepatocellular carcinoma (HCC) progression and senescence remains to be elucidated.
Methods:
TM4SF1 expression in HCC samples was evaluated using immunohistochemistry and flow cytometry. Cellular senescence was assessed through SA-β-gal activity assays and Western blot analysis. TM4SF1-related protein interactions were investigated using immunoprecipitation-mass spectrometry, co-immunoprecipitation, bimolecular fluorescence complementation, and immunofluorescence. Tumor-infiltrating immune cells were analyzed by flow cytometry. The HCC mouse model was established via hydrodynamic tail vein injection.
Results:
TM4SF1 was highly expressed in human HCC samples and murine models. Knockdown of TM4SF1 suppressed HCC proliferation both in vitro and in vivo, inducing non-secretory senescence through upregulation of p16 and p21. TM4SF1 enhanced the interaction between AKT1 and PDPK1, thereby promoting AKT phosphorylation, which subsequently downregulated p16 and p21. Meanwhile, TM4SF1-mediated AKT phosphorylation enhanced PD-L1 expression while reducing major histocompatibility complex class I level on tumor cells, leading to impaired cytotoxic function of CD8+ T cells and an increased proportion of exhausted CD8+ T cells. In clinical HCC samples, elevated TM4SF1 expression was associated with resistance to anti-PD-1 immunotherapy. Targeting TM4SF1 via adeno-associated virus induced tumor senescence, reduced tumor burden and synergistically enhanced the efficacy of anti-PD-1 therapy.
Conclusions
Our results revealed that TM4SF1 regulated tumor cell senescence and immune evasion through the AKT pathway, highlighting its potential as a therapeutic target in HCC, particularly in combination with first-line immunotherapy.
5.Association between uric acid-albumin ratio and spontaneous reperfusion in ST-segment elevation myocardial infarction patients.
Jing NAN ; Shuai MENG ; Ruo-Fei JIA ; Wei CHEN ; Xing-Sheng YANG ; Hong-Yu HU ; Ze-Ning JIN
Journal of Geriatric Cardiology 2025;22(2):229-236
BACKGROUND:
The association between uric acid-albumin ratio (UAR) with different diseases has been evaluated before. However, the association between UAR with spontaneous reperfusion (SR) in patients with ST-segment elevation myocardial infarction (STEMI) has not been explored.
METHODS:
STEMI patients admitted to our department and underwent primary coronary angiography between 1st November 2018 and 31st December 2020 were retrospectively enrolled. The patients were divided into the SR group and the non-SR group according to the index coronary angiography results. The association between UAR and SR was evaluated by uni-variable and multi-variable logistic analysis. Receiver operating characteristic curve analysis was used to determine the optimum cut-off level of UAR in predicting SR.
RESULTS:
Three hundred and fifty-seven patients were finally enrolled in our study, 55 patients were divided into the SR group and 302 patients were divided into the non-SR group. In uni-variable analysis, patients with SR were older (P = 0.032), with higher red blood cell distribution width (P < 0.001) and red blood cell distribution width-to-platelet ratio (P < 0.001), higher level of C-reactive protein (P = 0.046), higher level of uric acid (P < 0.001) compared with patients without SR. Patients with SR had a lower level of platelets (P = 0.008), lower level of on-admission B-type natriuretic peptide (P < 0.001). As for the level of UAR, STEMI patients with SR had significantly higher levels of UAR compared with STEMI patients without SR [11.1 (8.9-13.4) vs. 8.3 (6.6-10.0), P < 0.001]. Further multi-variable logistic analysis reveals that UAR was the independent risk factor of SR in different models after adjusting different variables. Receiver operating characteristic analysis showed that UAR had good predictive value in SR (AUC = 0.75, 95% CI: 0.702-0.794, P < 0.01).
CONCLUSIONS
Our study shows that UAR is an independent risk factor for predicting SR in STEMI patients.
6.Advantages of Chinese Medicines for Diabetic Retinopathy and Mechanisms: Focused on Inflammation and Oxidative Stress.
Li-Shuo DONG ; Chong-Xiang XUE ; Jia-Qi GAO ; Yue HU ; Ze-Zheng KANG ; A-Ru SUN ; Jia-Rui LI ; Xiao-Lin TONG ; Xiu-Ge WANG ; Xiu-Yang LI
Chinese journal of integrative medicine 2025;31(11):1046-1055
7.Targeting TM4SF1 promotes tumor senescence enhancing CD8+ T cell cytotoxic function in hepatocellular carcinoma
Weifeng ZENG ; Furong LIU ; Yachong LIU ; Ze ZHANG ; Haofan HU ; Shangwu NING ; Hongwei ZHANG ; Xiaoping CHEN ; Zhibin LIAO ; Zhanguo ZHANG
Clinical and Molecular Hepatology 2025;31(2):489-508
Background/Aims:
Transmembrane 4 L six family member 1 (TM4SF1) is highly expressed and contributes to the progression of various malignancies. However, how it modulates hepatocellular carcinoma (HCC) progression and senescence remains to be elucidated.
Methods:
TM4SF1 expression in HCC samples was evaluated using immunohistochemistry and flow cytometry. Cellular senescence was assessed through SA-β-gal activity assays and Western blot analysis. TM4SF1-related protein interactions were investigated using immunoprecipitation-mass spectrometry, co-immunoprecipitation, bimolecular fluorescence complementation, and immunofluorescence. Tumor-infiltrating immune cells were analyzed by flow cytometry. The HCC mouse model was established via hydrodynamic tail vein injection.
Results:
TM4SF1 was highly expressed in human HCC samples and murine models. Knockdown of TM4SF1 suppressed HCC proliferation both in vitro and in vivo, inducing non-secretory senescence through upregulation of p16 and p21. TM4SF1 enhanced the interaction between AKT1 and PDPK1, thereby promoting AKT phosphorylation, which subsequently downregulated p16 and p21. Meanwhile, TM4SF1-mediated AKT phosphorylation enhanced PD-L1 expression while reducing major histocompatibility complex class I level on tumor cells, leading to impaired cytotoxic function of CD8+ T cells and an increased proportion of exhausted CD8+ T cells. In clinical HCC samples, elevated TM4SF1 expression was associated with resistance to anti-PD-1 immunotherapy. Targeting TM4SF1 via adeno-associated virus induced tumor senescence, reduced tumor burden and synergistically enhanced the efficacy of anti-PD-1 therapy.
Conclusions
Our results revealed that TM4SF1 regulated tumor cell senescence and immune evasion through the AKT pathway, highlighting its potential as a therapeutic target in HCC, particularly in combination with first-line immunotherapy.
8.Morphology of enteric nervous system in C57BL/6 mice based on fMOST high-resolution 3D reconstruction system
Li-Ge LENG ; Guan-Xiong YANG ; Ze-En WANG ; Yi CHEN ; Zhi-Liang QIAO ; Qing-Zhong HU ; Ming-Yan WANG ; Feng TIAN
Acta Anatomica Sinica 2025;56(1):114-119
Objective To initially explore the possibility of applying the fluorescence micro-optical sectioning tomography(fMOST)high-resolution 3D reconstruction system to the morphological study of the intestinal nervous system and to preliminarily establish a method for studying the morphology of the intestinal nervous system using this system.Methods fMOST high-resolution 3D reconstruction system was used to study the intestinal nervous system of C57BL/6 mice in detail.Based on this method,a new morphological method of the visceral nervous system of small animal models was explored at the single-cell level.Results Compared with the large intestine,the small intestine lacked the typical myenteric plexus(Auerbach),deep mucosal plexus(Henley),and submucosal superficial plexus(Meissner).Conclusion The result of this paper provide a clearer and systematic display of the anatomical structure of the enteric nervous system in C57BL/6 mice,and further clarify the similarities and differences between the enteric nervous system of mice and human,and provide a theoretical basis for its rational application in the study of digestive system diseases.The morphological study of fMOST high-resolution 3D reconstruction system is not limited to the central nervous system,but can be extended to the morphological study of multiple visceral nervous systems.
9.Optimization of fermentation conditions in shake flask of JA20-1, a VOCs-producing biocontrol bacterium and evaluation of its biocontrol effect against Botrytis cinerea of ginseng.
Yu-Ze ZHANG ; Yan-Cong HU ; Xiu-Xiu WANG ; Cong ZHANG ; Zhong-Hua QU ; Bao-Hui LU ; Xue WANG ; Jie GAO
China Journal of Chinese Materia Medica 2025;50(7):1748-1757
Bacillus mycoides JA20-1 was screened and identified as a biocontrol bacterium with a high capacity for producing volatile organic compounds(VOCs) in the laboratory. This strain had significant inhibitory effects on various postharvest disease pathogens in crops, such as Botrytis cinerea, as well as soil-borne disease pathogens in ginseng, such as Sclerotinia ginseng. In order to accelerate its industrialization process, in this study, single-factor experiments and response surface optimization methods were used. The fermentation medium and fermentation conditions in the shake flask of strain JA20-1 were systematically optimized by using cell production volume as the response variable. Meanwhile, the biocontrol effect of JA20-1 on B. cinerea of ginseng during the storage period was evaluated by using the method of fumigation in a dry dish in vitro. The results indicated that the optimal fermentation medium formulation for strain JA20-1 was as follows: 1% yeast paste, 1% soluble starch, 0.25% K_2HPO_4·3H_2O, and 0.2% NaCl. The optimal fermentation conditions in the shake flask were vaccination size of 3%, culture volume of 50 mL in a 250 mL Erlenmeyer flask, pH of 6.2, fermentation temperature of 34 ℃, shaking speed of 180 r·min~(-1), and incubation time of 18 hours. The bacteria count in the fermentation broth under these conditions reached 2.17 × 10~8 CFU·mL~(-1), which was 6.58 times higher than before. The average control efficacy of the fermentation broth on Botrytis cinerea of ginseng under in vitro fumigation reached 61.70% and 84.04% respectively, when 20 mL and 30 mL per dish were used. The research provided theoretical support and technical foundation for the development and utilization of Bacillus mycoides JA20-1 and the biocontrol of soil-borne diseases in ginseng and postharvest diseases in crops.
Botrytis/drug effects*
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Fermentation
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Panax/microbiology*
;
Plant Diseases/prevention & control*
;
Volatile Organic Compounds/metabolism*
;
Bacillus/physiology*
;
Pest Control, Biological/methods*
;
Biological Control Agents/metabolism*
;
Culture Media/chemistry*
10.Stimulation mechanism of osteoblast proliferation and differentiation by Duzhong Decoction-containing serum through L-VGCCs.
Ze-Bin CHEN ; Lan-Lan LUO ; Xin-Yi SHI ; Rui-Tong ZHAO ; Cai-Xian HU ; Yun-Ying FU ; Su-Zhen CHAO ; Bo LIU
China Journal of Chinese Materia Medica 2025;50(12):3335-3345
This paper aimed to explore the effects of Duzhong Decoction(DZD)-containing serum on the proliferation and osteoblast differentiation of MC3T3-E1 cells through L-type voltage-gated calcium channels(L-VGCCs). L-VGCCs inhibitors, nifedipine and verapamil, were used to block L-VGCCs in osteoblasts. MC3T3-E1 cells were divided into a control group, a low-dose DZD-containing serum(L-DZD) group, a medium-dose DZD-containing serum(M-DZD) group, a high-dose DZD-containing serum(H-DZD) group, a nifedipine group, a H-DZD + nifedipine group, verapamil group, and a H-DZD + verapamil group. The CCK-8 method was used for cell proliferation analysis, alkaline phosphatase(ALP) assay kits for intracellular ALP activity measurement, Western blot for protein expression level in cells, real-time fluorescence quantitative PCR technology for intracellular mRNA expression level determination, fluorescence spectrophotometer for free Ca~(2+) concentration determination in osteoblasts, and alizarin red staining(ARS) for mineralized nodule formation in osteoblasts. The experimental results show that compared to the control group, DZD groups can promote MC3T3-E1 cell proliferation, ALP activity, and mineralized nodule formation, increase intracellular Ca~(2+) concentrations, and upregulate the protein expression of bone morphogenetic protein 2(BMP2), collagen Ⅰ(COL1), α2 subunit protein of L-VGCCs(L-VGCCα2), and the mRNA expression of Runt-related transcription factor 2(RUNX2), and BMP2. After blocking L-VGCCs with nifedipine and verapamil, the intervention effects of DZD-containing serum were inhibited to varying degrees. Both nifedipine and verapamil could inhibit ALP activity, reduce mineralized nodule areas, and downregulate the expression of bone formation-related proteins. Moreover, the effects of DZD-containing serum on increasing MC3T3-E1 cell proliferation, osteoblast differentiation, and Ca~(2+) concentrations, upregulating the mRNA expression of osteoprotegerin(OPG) and protein expression of phosphorylated protein kinase B(p-Akt) and phosphorylated forkhead box protein O1(p-FOXO1), and upregulating phosphatase and tensin homolog(PTEN) expression were reversed by nifedipine. The results indicate that DZD-containing serum can increase the Ca~(2+) concentration in MC3T3-E1 cells to promote bone formation, which may be mediated by L-VGCCs and the PTEN/Akt/FoxO1 signaling pathway, providing a new perspective on the mechanism of DZD in treating osteoporosis.
Animals
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Osteoblasts/metabolism*
;
Cell Proliferation/drug effects*
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Cell Differentiation/drug effects*
;
Mice
;
Drugs, Chinese Herbal/pharmacology*
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Calcium Channels, L-Type/genetics*
;
Alkaline Phosphatase/genetics*
;
Serum/chemistry*
;
Cell Line
;
Osteogenesis/drug effects*
;
Bone Morphogenetic Protein 2/genetics*

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