1.Diagnosis and Treatment of Epstein-Barr Virus-Positive Diffuse Large B-cell Lymphoma Complicated by Cytokine Release Syndrome
Qi KONG ; Ji MA ; Zhijun GUO
Medical Journal of Peking Union Medical College Hospital 2026;17(1):33-39
Epstein-Barr virus-positive diffuse large B-cell lymphoma, not otherwise specified(EBV+DLBCL, NOS) is a lymphoma subtype characterized by distinct biological features and a poor prognosis. This disease is frequently complicated by cytokine release syndrome(CRS), a severe condition closely linked to its intrinsic biological characteristics, which is receiving increasing clinical attention. This article systematically elaborates on the latest advances in the molecular mechanisms, diagnostic grading, and therapeutic strategies for EBV+ DLBCL, NOS complicated by CRS, aiming to provide a more comprehensive evidence-based foundation for clinical decision-making.
2.Value of bedside ultrasound monitoring of quadriceps muscle changes in mechanically ventilated children in the early treatment of ICU-acquired muscle weakness
Zhijun LAI ; Wenhai YANG ; Yan LI ; Lifen GU ; Keze MA
Chinese Journal of Radiological Health 2026;35(1):103-107
Objective To investigate the application value of bedside ultrasound monitoring of quadriceps muscle changes in mechanically ventilated children in the early treatment of ICU-acquired muscle weakness (ICU-AW). Methods Eighty-two pediatric ICU patients with mechanical ventilation for>48 hours were selected. On the day of admission (D0) and on day 7 (D7), bedside ultrasound was performed to measure the thickness and cross-sectional area of the rectus femoris and vastus intermedius muscles. Patients were classified using Medical Research Council scores into control group (n = 63) and muscle weakness group (n = 19). Muscle parameters and atrophy rates were compared between groups. Diagnostic performance was assessed using receiver operating characteristic curves. Results The incidence of ICU-AW was 23.17%. At both D0 and D7, the average thickness of the rectus femoris, the average thickness of the vastus intermedius, the average area of the rectus femoris, and the average area of the vastus intermedius were significantly different between the two groups (P<0.05). The atrophy rates of the thickness of the rectus femoris and the area of the vastus intermedius were lower in the control group than in the muscle weakness group at both D0 and D7 (P<0.05). The area under the receiver operating characteristic curve for quadriceps parameters in diagnosing ICU-AW was 0.871, with a sensitivity of 89.47% and a specificity of 79.37%. Conclusion Bedside ultrasound dynamic monitoring of quadriceps changes enables early identification of ICU-AW and provides a basis for clinical intervention.
3.Imaging Measurement of the Safe Distances of Acupuncture at Fengfu (GV 16) in Children Aged 4 to 8 Based on CT Three-Dimensional Reconstruction
Kun LI ; Tianyi WANG ; Xing WANG ; Zhijun LI ; Peng WU ; Yang YANG ; Yunteng HAO ; Hailong ZHAO ; Yuan MA ; Shaojie ZHANG
Journal of Traditional Chinese Medicine 2026;67(14):1523-1527
ObjectiveTo measure the distance from the surface of Fengfu (GV 16) to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology, thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups (4-, 5-, 6-, 7-, 8-year-old groups), 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu (GV 16) to the first underlying bony barrier (such as the lower edge of the occipital bone, the posterior arch of the atlas vertebra) were measured at intervals of 5° on both the transverse section (0° ± 35°) and the sagittal section (40° upward to 40° downward on the diagonal). The correlation between the measured distance, age, and angle was analyzed. ResultsIn the transverse and sagittal sections, the measured distance from the skin surface to the underlying bone of Fengfu (GV 16) at each angle increased with age. In the transverse section, the increase was relatively small within the 0° to 20° angle range, whereas a more pronounced increase was observed when the angle exceeded 20°; at measurement angles of 30° to 35°, the distance of the skin surface to the bone at Fengfu (GV 16) in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group (P<0.05). In the sagittal section, the measured distance from the skin surface to the bone at Fengfu (GV 16) was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group, and increased markedly at near-vertical angles of 0° to 10°; it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu (GV 16) to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling, finding that this distance has clear age and angle dependence, which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu (GV 16) in pediatric clinical practice.
4.Imaging Measurement of the Safe Distances of Acupuncture at Fengfu (GV 16) in Children Aged 4 to 8 Based on CT Three-Dimensional Reconstruction
Kun LI ; Tianyi WANG ; Xing WANG ; Zhijun LI ; Peng WU ; Yang YANG ; Yunteng HAO ; Hailong ZHAO ; Yuan MA ; Shaojie ZHANG
Journal of Traditional Chinese Medicine 2026;67(14):1523-1527
ObjectiveTo measure the distance from the surface of Fengfu (GV 16) to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology, thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups (4-, 5-, 6-, 7-, 8-year-old groups), 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu (GV 16) to the first underlying bony barrier (such as the lower edge of the occipital bone, the posterior arch of the atlas vertebra) were measured at intervals of 5° on both the transverse section (0° ± 35°) and the sagittal section (40° upward to 40° downward on the diagonal). The correlation between the measured distance, age, and angle was analyzed. ResultsIn the transverse and sagittal sections, the measured distance from the skin surface to the underlying bone of Fengfu (GV 16) at each angle increased with age. In the transverse section, the increase was relatively small within the 0° to 20° angle range, whereas a more pronounced increase was observed when the angle exceeded 20°; at measurement angles of 30° to 35°, the distance of the skin surface to the bone at Fengfu (GV 16) in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group (P<0.05). In the sagittal section, the measured distance from the skin surface to the bone at Fengfu (GV 16) was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group, and increased markedly at near-vertical angles of 0° to 10°; it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu (GV 16) to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling, finding that this distance has clear age and angle dependence, which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu (GV 16) in pediatric clinical practice.
5.Mechanisms and Clinical Research Advances of Curcumin in Modulation of Hyperlipidemia
Zhijun ZENG ; Wenjie LU ; Xiaoxue MA ; Yanhua JI ; Yun TONG ; Siyu LING ; Yue ZENG ; Chao LE ; Shaohua WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):325-334
Hyperlipidemia is a common metabolic disorder driven by dysregulated lipid metabolism, whose pathological progression involves multifaceted interactions across various signaling pathways, including disrupted cholesterol homeostasis, insulin resistance, chronic inflammation, and oxidative stress. Although existing clinical medications such as statins can effectively reduce low-density lipoprotein cholesterol through single-target inhibition, significant limitations remain in comprehensively improving reverse cholesterol transport, metabolic inflammation, and coordinated regulation of glucose and lipid metabolism. Curcumin, the primary polyphenolic active compound derived from the traditional medicinal herb turmeric, exhibits multi-dimensional pharmacological effects including modulation of lipid metabolism, improvement of insulin sensitivity, suppression of inflammatory responses, and enhancement of antioxidant defense. This review systematically integrates the multi-target regulatory network of curcumin, elucidating its key mechanisms: Balancing the low density lipoprotein receptor/proprotein convertase subtilisin/kexin type 9 (LDLR/PCSK9) signaling pathway to promote reverse cholesterol transport, activating peroxisome proliferator-activated receptor α/γ (PPARα/γ) signaling pathways to coordinate glucolipid metabolic homeostasis, remodeling the gut microbiota-bile acid axis, inhibiting nuclear factor kappa-B (NF-κB)-mediated inflammatory responses, and activating the nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) antioxidant signaling pathway. Furthermore, supported by clinical research data, the review validates curcumin's therapeutic potential in reducing total cholesterol (TC) and triglyceride (TG) levels, increasing high-density lipoprotein cholesterol (HDL-C), as well as improving vascular endothelial function and insulin sensitivity. The study highlights the multi-target regulatory properties of curcumin and discusses future clinical applications based on nano-delivery systems and personalized treatment strategies, providing a theoretical basis and novel insights for the prevention and treatment of hyperlipidemia and related metabolic disorders.
6.Chinese expert consensus on the application of jejunal interposition for esophageal reconstruction in complex esophageal cancer surgery (2026 edition)
Wenshu CHEN ; Lilan ZHAO ; Zhaoxian LIN ; Debin OU ; Zhigang LI ; Chengchu ZHU ; Longqi CHEN ; Shuoyan LIU ; Xiangnan LI ; Chao CHENG ; Ni ZHANG ; Songping XIE ; Xufeng GUO ; Xu LI ; Xinyu MEI ; Xuefeng LENG ; Jianqun MA ; Zhijun HUANG ; Guojun GENG ; Lin ZHANG ; Hongyan WANG ; Yi ZHANG ; Weijie WANG ; Jiangbo LIN ; Jinbiao XIE ; Jun GUAN ; Rongqi HE ; Xing LIN ; Xiuhua TU ; Yong LI ; Lijie TAN ; Xiaojie PAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(10):1527-1543
Objective Jejunal interposition is an important option for restoring gastrointestinal continuity in patients with complex esophageal cancer in whom the stomach is unavailable for reconstruction due to previous gastrectomy, tumor involvement, failed gastric conduit, or other constraints. Although the jejunum offers a caliber similar to the esophagus, a rich blood supply, and preserved peristaltic function, anatomical variations in mesenteric length and vascular arcades render long-segment and high-level reconstruction susceptible to excessive tension, mesenteric torsion, venous congestion, and inadequate distal perfusion. This consensus aims to provide standardized recommendations for the application of jejunal interposition in this specific patient population. Methods This consensus was developed in accordance with the WHO Handbook for Guideline Development and Chinese national guideline development standards, with reference to the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), Reporting Items for Practice Guidelines in Healthcare (RIGHT), and Scientific, Transparent and Applicable Rankings (STAR) checklists. The project was registered on the international practice guidelines registry platform (PREPARE-2026CN1384). The working group systematically searched Chinese and English evidence addressing 12 clinical questions. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 system, with structured appraisal of risk of bias, inconsistency, indirectness, and imprecision. Recommendations were formulated through two rounds of Delphi surveys and a face-to-face consensus meeting, with an agreement threshold of ≥75%. Results The consensus generated 12 recommendations covering indications, selection between jejunum and colon, preoperative assessment, surgical approach and reconstruction route, pedicled jejunal interposition (PJI), supercharged pedicled jejunal interposition (SPJ), indocyanine green (ICG) perfusion assessment, perioperative nutrition, management of anastomotic leakage, long-term follow-up, and special treatment scenarios. Given that the available direct evidence is predominantly derived from single-center retrospective cohorts and case series, recommendations extrapolated from general esophagectomy or other gastrointestinal surgical evidence are deliberately phrased with caution. Conclusion Jejunal interposition is a safe and effective approach for digestive tract reconstruction in patients with complex esophageal cancer in whom the stomach is unavailable. This consensus emphasizes that clinical decision-making should be individualized based on the patient's prior treatment history, reconstruction height, vascular anatomy, technical availability, and institutional experience in the Chinese context.
7.Introduction of the main addition and revision of the Chinese Pharmacopoeia 2025 Edition(Volume Ⅱ)
ZHOU Yi ; WANG Zhijun ; YUE Zhihua ; CHENG Qilei ; YUE Ruiqi ; YANG Xi ; GUO Wei ; MA Shuangcheng
Drug Standards of China 2025;26(1):023-027
The Pharmacopeia of the People’s Republic of China 2025 Edition (referred to as the Chinese Pharmacopoeia 2025 Edition, ChP 2025) will be promulgated and implemented. This article introduces the process of development of ChP 2025 Edition (Volume Ⅱ), including the selection, the revision of general notices,the addition and revision of drug monographs, etc., and provides some analysis and examples to illustrate,which can facilitate the readers to understand and implement the ChP 2025 Edition (Volume Ⅱ).
8.Comparative study on the mechanism and efficacy of Zexie tang traditional decoction and formula granules in reducing lipid accumulation
Yuanyuan GUO ; Lina MA ; Huqin LIN ; Changhui ZHENG ; Jiayi LI ; Zhijun LI ; Junling CAO
China Pharmacy 2025;36(10):1202-1208
OBJECTIVE To explore the effect and mechanism of Zexie tang (ZXT) on reducing lipid accumulation through network pharmacology, and compare the difference of traditional decoction versus formula granules. METHODS The active components and targets of ZXT were identified using TCMSP and SwissTargetPrediction databases. GeneCards, OMIM, DisGeNET and TTD databases were used to analyze the related targets of non-alcoholic fatty liver disease (NAFLD); protein-protein interaction network model was constructed by String database;“ ZXT-NAFLD target-pathway” network diagram was constructed by using CytoScape software; target enrichment analysis was performed by using Metascape platform. Fat accumulation model of human hepatocellular carcinoma HepG2 cells was established to observe the effects of traditional decoction and formula granules of ZXT on lipid accumulation of cells. RESULTS Alisol B, alisol C, 1-monolinolein and alisol B monoacetate were the key active components of ZXT in the treatment of NAFLD. The core targets included MDM2, MAPK1, PIK3CB, PRKCQ and MAPK14, etc. The core signaling pathways included endocrine resistance, insulin resistance and Th17 cell differentiation. Compared with model group, except for the Zexie formula granules group and Baizhu formula granules group, the absorbance values in all other administration groups were significantly decreased (P<0.01); the absorbance value of Baizhu traditional decoction group was significantly higher than that of ZXT traditional decoction group (P<0.01); the absorbance values of Zexie formula granule group and Baizhu formula granule group were significantly higher than that of ZXT formula granule group (P<0.01); the absorbance value of Zexie formula granule group was significantly higher than that of Zexie traditional decoction group (P<0.01); the absorbance value of Baizhu formula granule group was significantly higher than that of Baizhu traditional decoction group (P<0.01). CONCLUSIONS ZXT reduces lipid accumulation of human hepatocellular carcinoma cells through multiple components, multiple target and multiple pathways, and its traditional decoction and formula granules exhibit slightly different lipid-lowering effects.
9.Clinical Application of Green Prescription of Traditional Chinese Medicine:Problems and Solution Strategies
Yike SONG ; Zhijun BU ; Wenxin MA ; Kai LIU ; Yuyi WANG ; Yuan SUN ; Yang SHEN ; Hongkui LIU ; Jianping LIU ; Zhaolan LIU
Journal of Traditional Chinese Medicine 2025;66(11):1094-1098
Green prescription is a written prescription aimed at improving health by promoting physical activity and improving diet, with advantages such as high cost-effectiveness, strong feasibility, and minimal harm to patients. The theory of traditional Chinese medicine (TCM) green prescription integrates the health philosophy of "following rule of yin and yang, and adjusting ways to cultivating health", the exercise philosophy of balancing yin-yang and the five elements, and the dietary philosophy of moderation and balance, which embody core TCM concepts such as treating disease before its onset and harmony between humans and nature. It has also developed traditional exercise practices like Tai Chi, Baduanjin, Wuqinxi, Yi-Gin-Ching, and Qigong, as well as dietary adjustments like medicated diet and herbal wines. However, it is believed that the TCM green prescription currently suffers from insufficient evidence-based research, low patient awareness and acceptance, and weak basic research. Based on this, it is proposed that large-sample clinical trials should be conducted in the future to improve the quality of evidence-based medicine, basic research can be carried out with the help of artificial intelligence and other methods in research design, the hospital information system (HIS) can be used for control at the implementation level, and publicity and patient education can be strengthened through the new media, so as to promote the development and application of the TCM green prescriptions in the field of global health treatment.
10.Impact of Toxoplasma gondii type I rhoptry protein 16 on programmed cell death ligand 1 expression and its binding to programmed cell death 1 in lung adenocarcinoma cells
Guangqi LI ; Yuning ZHOU ; Shaohan MA ; Mei TIAN ; Tiantian DANG ; Zhijun ZHAO
Chinese Journal of Schistosomiasis Control 2025;37(1):44-54
Objective To investigate the impact of Toxoplasma gondii type I, II and III rhoptry protein 16 (ROP16) on programmed cell death ligand 1 (PD-L1) expression in lung adenocarcinoma cells, and to examine the effects of T. gondii type I ROP16 protein on the relative PD-L1 expression, the relative PD-L1 distribution on the cell membrane surface, and the binding of programmed cell death 1 (PD-1) to PD-L1 in lung adenocarcinoma cells. Methods Lentiviral vectors overexpressing T. gondii type I, II and III ROP16 proteins were generated, and transfected into the human lung adenocarcinoma A549 cell line. A549 cells were used as a blank control group, and A549 cells transfected with an empty lentiviral expression vector were used as a negative control group, while A549 cells transfected with lentiviral vectors overexpressing T. gondii type I, II and III ROP16 proteins served as experimental groups. Stably transfected cells were selected with puromycin and verified using Western blotting, quantitative real-time PCR (RT-qPCR), and immunofluorescence assays. The PD-L1 expression was quantified at translational and transcriptional levels using Western blotting and RT-qPCR assays in A549 cells in the five groups, and the relative PD-L1 distribution was detected on the A549 cell membrane surface using flow cytometry. In addition, the effect of T. gondii type I ROP16 protein on the PD-1/PD-L1 binding was measured in A549 cells using enzyme-linked immunosorbent assay (ELISA). Results The relative ROP16 protein expression was 0, 0, 1.546 ± 0.091, 1.822 ± 0.047 and 2.334 ± 0.089 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 1 339.00,P < 0.001), and the relative ROP16 mRNA expression was 2.153 ± 0.949, 2.436 ± 1.614, 14.343 ± 0.020, 12.577 ± 0.285 and 15.090 ± 0.420 in the blank control group, negative control group and the T. gondii type I, II and III ROP16 protein overexpression groups, respectively (F = 483.50,P < 0.001). The ROP16 expression was higher in the T. gondii type I, II and III ROP16 protein overexpression groups than in the blank control group at both translational and transcriptional levels (allP values < 0.001). Immunofluorescence assay revealed that T. gondii type I, II and III ROP16 proteins were predominantly localized in A549 cell nuclei. Western blotting showed that the relative PD-L1 protein expression was 0.685 ± 0.109, 0.589 ± 0.114, 1.007 ± 0.117, 0.572 ± 0.151, and 0.426 ± 0.116 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 9.46,P < 0.05), and RT-qPCR assay quantified that the relative PD-L1 mRNA expression was 1.012 ± 0.190, 1.281 ± 0.465, 1.950 ± 0.175, 0.889 ± 0.251, and 0.230 ± 0.192 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 14.18,P < 0.05). The PD-L1 expression was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group at both translational and transcriptional levels (both P values < 0.05). Flow cytometry detected that the relative distributions of PD-L1 protein were (10.83 ± 0.60)%, (11.23 ± 0.20)%, and (14.61 ± 0.50)% on the A549 cell membrane surface (F = 28.31, P < 0.05), and the relative distribution of PD-L1 protein was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group and negative control group (both P values < 0.001). ELISA measured significant differences in the absorbance (A) value among the T. gondii type IROP16 protein overexpression group, the blank control group and the negative control group if the concentrations of the recombinant PD-1 protein were 0.04 (F = 10.45, P < 0.05), 0.08 μg/mL (F = 11.68, P < 0.05) and 0.12 μg/mL (F = 52.68, P < 0.05), and the A value was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group and the negative control group (both P values < 0.05), indicating that T. gondii type IROP16 protein promoted the PD-L1/PD-1 binding in A549 cells in a concentration-dose manner. Conclusions T. gondii type IROP16 protein overexpression may up-regulate PD-L1 expression in A549 cells at both transcriptional and translational levels and the relative PD-L1 distribution on the A549 cell membrane surface, and affect the PD-1/PD-L1 binding in a concentration-dependent manner.

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