1.Epigenetic mechanism of Diwu Yanggan Capsule in improving liver regeneration microenvironment in a rat model of liver cancer
Minggang WANG ; Jiamei DONG ; Zhihua YE ; Xiang GAO ; Qi CHEN ; Xiaoqiao YU ; Hanmin LI
Journal of Clinical Hepatology 2026;42(2):362-371
ObjectiveTo investigate the epigenetic mechanism of Diwu Yanggan Capsule in improving liver regeneration microenvironment in a rat model of liver cancer by regulating DNA methylation, and to provide a basis for scientific clinical medication. MethodsA total of 48 specific pathogen-free Sprague-Dawley rats were divided into normal group, model group, and Diwu Yanggan Capsule group using a random number table, with 16 rats in each group. The Solt-Farber two-step method was used to establish a rat model of liver cancer. The rats in the Diwu Yanggan Capsule group were given Diwu Yanggan Capsule at a dose of 750 mg/kg/d by gavage, and those in the normal group and the model group were given an equal volume of normal saline by gavage. Liver tissue samples were collected from each group of rats after 16 weeks of continuous intervention; DNA methylation chips were used to analyze the change in DNA methylation in liver tissue, and gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used for data analysis. In addition, the MeDIP-PCR technique was used to detect the changes in candidate differentially methylated genes such as YWHAB, ADCK2, ERLIN2, SEMA3B, and TPH2 in the liver tissue of rats, and Western blot and RT-qPCR were used to verify the expression of key methylated genes. The independent-samples t test was used for comparison of continuous data between two groups, and a one-way analysis of variance was used for comparison between multiple groups, while the least significant difference t-test was used for further comparison between two groups. ResultsThe DNA methylation chip analysis showed that compared with the normal group, the model group had significant methylation changes in the promoter region of 2 422 genes in liver tissue of rats. The GO functional enrichment analysis and the KEGG pathway enrichment analysis showed that these differentially methylated genes were significantly enriched in metabolic pathways such as steroid hormone biosynthesis and drug metabolism-cytochrome P450. Compared with the model group, the Diwu Yanggan Capsule group had significant reversal of promoter methylation in 1 650 genes, and the KEGG enrichment analysis showed that these genes were mainly involved in the pathways closely associated with cell proliferation, apoptosis, and microenvironment regulation, such as the calcium ion signaling pathway, the cAMP signaling pathway, and the extracellular factor signaling pathway. Compared with the model group, the Diwu Yanggan Capsule group had a significant increase in the promoter methylation level of the ADCK2 gene (P<0.05) and significant reductions in the promoter methylation levels of the ERLIN2 and TPH2 genes (all P<0.05). Compared with the model group, the Diwu Yanggan Capsule group had significant reductions in the mRNA expression levels and the protein expression levels of the ADCK2 (all P<0.05). ConclusionAbnormal DNA methylation in liver tissue participates in the development and progression of liver cancer. The effect of Diwu Yanggan Capsule on DNA methylation level is an important epigenetic mechanism for its effect in the prevention and treatment of liver cancer.
2.Pathogenesis Evolution and Treatment Strategies of Inflammation-Cancer Transformation in Helicobacter Pylori-Associated Gastritis:Based on the Theory "Latent Wind in Stomach Collaterals"
Chuanyang LIU ; Lin CHENG ; Xinqiao CHU ; Shuxuan CHEN ; Zhihua TIAN ; Shaoli WANG ; Zhen LIU
Journal of Traditional Chinese Medicine 2026;67(13):1383-1389
It is considered that "latent wind in stomach collaterals" is the core pathogenesis underlying the inflammation-caner transformation of helicobacter pylori-associated gastritis (HpAG). The concept of "latent wind in stomach collaterals" integrates stomach wind theory, latent pathogen theory, and collateral disease theory, referring to wind pathogen deeply hidden in the stomach collaterals, characterized by both external and internal wind pathogen as well as latent pathogen that remain concealed and may be triggered under certain conditions. Accordingly, the Correa cascade is reclassified into four stages including the prodromal stage, progressive stage, transitional stage and carcinogenic stage. In the prodromal stage, the fundamental pathogenesis is described as "wind toxin invading externally with collateral deficiency and stirring of wind". In the progressive stage, wind is accompanied by qi constraint, fire pathogen, and dryness pathogen, manifesting as "wind pathogen complicated by constraint" "wind-fire agitation" and "wind-dryness interaction". In the transitional stage, "wind transforming into phlegm-drool and stomach collaterals being obstructed by stasis" is identified as a critical window for disease reversal. In the carcinogenesis stage, "wind-qi hyperactivity leading to pathological transformation, and collateral damage resulting in abdominal masses" drives tumor progression and metastasis. This paper proposes the treatment principle of "wind-dispelling throughout the entire process and stage-based treatment", according to the pathological evolution of "collateral deficiency-collateral stagnation-collateral accumulation". In the prodromal stage, it is suggested to dispel wind and resolve toxin, fortify spleen and tonify collaterals; in the progressive and transitional stage, the method of dispelling wind pathogen, clearing phlegm and eliminating stasis should be used; in the carcinogenesis stage, it is suggested to expel wind and remove pathogens from collaterals, disperse concretions and eliminate tumors.
3.Expert consensus on liquid biopsy-based multi-cancer early detection(2025 edition)
Chen WANQING ; Chen KEXIN ; He YUTONG ; Jia WEIHUA ; Liu ZHIHUA ; Ma HONGXIA ; Miao XIAOPING ; Pan KAIFENG ; Wu CHEN ; Xia CHANGFA ; Xing JINLIANG ; Xu YONGJIE
Chinese Journal of Clinical Oncology 2025;52(14):727-742
Cancer stands as a significant global public health challenge,and cancer screening serves as a pivotal strategy for reducing its mortality.Presently,only a limited number of cancer types have appropriate screening methods available.Traditional single-cancer screen-ing approaches are fraught with limitations,including invasiveness,low accuracy,and poor patient compliance.Multi-cancer early detection(MCED)leveraging liquid biopsy technology enables non-invasive and efficient early detection of multiple cancers by analyzing biomarkers such as cell-free DNA,cell-free RNA,proteins,and metabolites in blood and other bodily fluids.This innovative approach substantially broadens the spectrum of detectable cancers and enhances population coverage,showcasing immense potential for improving existing can-cer screening strategies.This expert consensus comprehensively reviews the progress of liquid biopsy-based MCED,biomarker selection and detection technologies,the criteria for cancer type selection,research design and clinical utility evaluation,as well as implementation path-ways.The overarching goal of this consensus is to offer scientific guidance for further research and the widespread adoption of MCED,thereby facilitating the continuous optimization of cancer screening strategies.
4.Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
Filiz AKYÜZ ; Yoon Kyo AN ; Jakob BEGUN ; Satimai ANIWAN ; Huu Hoang BUI ; Webber CHAN ; Chang Hwan CHOI ; Nazeer CHOPDAT ; Susan J CONNOR ; Devendra DESAI ; Emma FLANAGAN ; Taku KOBAYASHI ; Allen Yu-Hung LAI ; Rupert W LEONG ; Alex Hwong-Ruey LEOW ; Wai Keung LEUNG ; Julajak LIMSRIVILAI ; Virly Nanda MUZELLINA ; Kiran PEDDI ; Zhihua RAN ; Shu Chen WEI ; Jose SOLLANO ; Michelle Mui Hian TEO ; Kaichun WU ; Byong Duk YE ; Choon Jin OOI
Intestinal Research 2025;23(1):37-55
The lack of clear definition and classification for “moderate ulcerative colitis (UC)” creates ambiguity regarding the suitability of step-up versus top-down treatment approaches. In this paper, experts address crucial gaps in assessing and managing moderate UC. The Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition comprised 24 experts who convened to share, discuss and vote electronically on management recommendations for moderate UC. Experts emphasized that the goal of treating UC is to attain clinical, biomarker, and endoscopic remission using cost-effective strategies such as 5-aminosalicylates (5-ASAs), well-tolerated therapy that can be optimized to improve outcomes. Experts agreed that 5-ASA therapy could be optimized by maximizing dosage (4 g/day for induction of remission), combining oral and topical administration, extending treatment duration beyond 8 weeks, and enhancing patient adherence through personalized counselling and reduced pill burden. Treatment escalation should ideally be reserved for patients with predictors of aggressive disease or those who do not respond to 5-ASA optimization. Premature treatment escalation to advanced therapies (including biologics and oral small molecules) may have long-term health and financial consequences. This paper provides consensus-based expert recommendations and a treatment algorithm, based on current evidence and practices, to assist decision-making in real-world settings.
5.Cervical Kyphosis Based on Cervical Rehabilitation Training System:A Biomechanical Model Study
Zhihua LIU ; Mingwen ZHANG ; Yang ZHOU ; Yankui SHEN ; Zhongzhong CHEN
Journal of Medical Biomechanics 2025;40(3):615-622
Objective A biomechanical model of cervical kyphosis under the effects of axial traction load and lateral push load was establised,so as to provide a theoretical basis for the treatment of cervical curvature abnormalities,and formulate the most appropriate treatment plan for patients.Methods Based on the CT scan data of patients,the axial data of the cervical spine was extracted to fit the cervical curvature curve.Using the Timoshenko beam theory and the cervical rehabilitation training system,a mathematical model of cervical kyphosis was established for analytical calculations to obtain the recovery curve of the cervical spine under load and the total load required to cure cervical kyphosis,and its rationality was also verified.Results The biomechanical model of cervical kyphosis was established.Under the effects of axial traction load and lateral push load,the cervical spine effectively developed in the direction of physiological bending.The total axial load and lateral load were 353 N and 5 649 N,respectively,and the total axial load increased with the increase in traction angle.The therapeutic moment of the total lateral load decreased as the Bordon value increased.The therapeutic moment of the axial load was smaller than that of the lateral load in the range of normal Bordon value,confirming the rationality of the loads.Conclusions The established biomechanical model of cervical kyphosis can accurately simulate the biomechanical characteristics of the cervical spine,and the analysis results were valid,providing a mechanical theoretical basis for the design of treatment plans for patients.
6.Establishment of Vero cell line overexpressing pAPN gene and its effect on porcine epidemic diarrhea virus replication
Qiuyong CHEN ; Zhihua SUN ; Rujing CHEN ; Xuemin WU ; Renjie WU ; Jinli QIU ; Bing HE ; Yutao LIU ; Longbai WANG ; Lunjiang ZHOU
Chinese Journal of Veterinary Science 2025;45(2):181-186
pAPN is a zinc-dependent metalloprotease,mediating the fusion between virus and host cell,and playing a role as the receptor of coronavirus.To explore the effect of pAPN on PEDV rep-lication,the full-length pAPN gene was amplified from the porcine small intestinal by PCR,and was cloned into the lentiviral vector via the homologous site digested with BamH Ⅰ and Not Ⅰ to obtain the recombinant lentiviral vector PLVX-pAPN-mCMV-ZsGreen1-puro.The recombinant lentiviral vector and helper plasmids pLP1,pLP2,pLP-VSVG were co-transfected into 293T cells for lentiviral packaging.Vero cells were infected with the packaged lentivirus and the pAPN gene overexpressing cells were screened by puromycin.The stable expression of Vero-pAPN monoclonal cell line was screened by a limited dilution method,and the effect of the cell line on the replication of PEDV was determined by qPCR for N mRNA transcription level,Western blot for N protein level,and TCID50.The results showed that the packaged lentivirus could infect Vero cells,and the monoclonal cell line Vero-pAPN(2C5)could stably expressed pAPN.The Vero-pAPN cell line can promote the replication of PEDV,the N gene mRNA transcription level was significantly different at 12-48 h(P<0.05),the N protein expression level increased,and the TCID50 was significantly different at 24 and 48 h(P<0.05).In conclusion,the Vero-pAPN cell line was constructed in this study and it can significantly promote the replication of PEDV,which provides a candidate cell line for PEDV vaccine production and isolation.
7.Mechanism of A20 in rheumatoid arthritis and progress of Chinese medicine intervention
Yiying WU ; Yujia LIU ; Lei ZHENG ; Li LIU ; Xinyi CHEN ; Zhihua GUO
Chinese Journal of Immunology 2025;41(9):2123-2130
Rheumatoid arthritis(RA)is an autoimmune disease characterized by chronic,aggressive joint inflammation,which seriously harms mental and physical health of patients.Efficacy of clinical drugs for RA is limited,so it is a hot issue to seek new therapeutic targets and drugs.Zinc finger protein A20,a cytoplasmic ubiquitin modifier,is closely related to negative regulation of nuclear factor-kappaB(NF-κB),an inflammatory signaling pathway,and has anti-inflammatory and anti-apoptotic effects.A20 is involved in pathogenesis of RA and can improve inflammatory response and bone destruction of RA.Treatment of RA by traditional Chinese medicine has unique advantages of multi-target and multi-pathway,and studies have found that traditional Chinese medicine has a regulatory effect on A20.This paper expounds mechanism of A20 in RA and research progress of traditional Chinese medicine intervention in A20,in order to provide references for treatment and drug development of RA.
8.Consensus on informed consent for orthodontic treatment
Yang CAO ; Bing FANG ; Zuolin JIN ; Hong HE ; Yuxing BAI ; Lin WANG ; Haiping LU ; Zhihe ZHAO ; Tianmin XU ; Weiran LI ; Min HU ; Jinlin SONG ; Jun WANG ; Fang JIN ; Ding BAI ; Xianglong HAN ; Yuehua LIU ; Bin YAN ; Jie GUO ; Jiejun SHI ; Yongming LI ; Zhihua LI ; Xiuping WU ; Jiangtian HU ; Linyu XU ; Lin LIU ; Yi LIU ; Yanqin LU ; Wensheng MA ; Shuixue MO ; Liling REN ; Shuxia CUI ; Yongjie FAN ; Jianguang XU ; Lulu XU ; Zhijun ZHENG ; Peijun WANG ; Rui ZOU ; Chufeng LIU ; Lunguo XIA ; Li HU ; Weicai WANG ; Liping WU ; Xiaoxing KOU ; Jiali TAN ; Yuanbo LIU ; Bowen MENG ; Yuantao HAO ; Lili CHEN
Chinese Journal of Stomatology 2025;60(12):1327-1336
This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.
9.Surgical techniques and clinical outcomes of upper urinary tract reconstruction for stone-related ureteral strictures
Xiaoteng YU ; Yixuan HUANG ; Xinfei LI ; Changfu CHEN ; Fangzhou ZHAO ; Honggang YING ; Zihao TAO ; Yiming ZHANG ; Liqing XU ; Zhihua LI ; Kunlin YANG ; Liqun ZHOU ; Xuesong LI ; Zheng ZHAO
Journal of Peking University(Health Sciences) 2025;57(4):670-675
Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7%)had strictures in the upper ureter,9(12.7%)in the middle ureter,15(21.1%)in the lower ureter,and 11(15.5%)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1%)and appendiceal flap ureteroplasty(8/36,22.2%).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1%)and ureteroureterostomy(1/9,11.1%)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3%)and ileal ureter replacement(4/9,44.4%)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7%),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2%)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.
10.Influencing factors of chronic dyslipidemia in T2DM patients with diabetes point system management in Qingpu District,Shanghai
Zhouli WU ; Sen WANG ; Jie CHEN ; Zhihua REN ; Kaiyou YE ; Yueqin JIANG ; Ya WU
Journal of Public Health and Preventive Medicine 2025;36(2):56-60
Objective To understand the influencing factors of chronic dyslipidemia in T2DM patients who signed a contract for diabetes point system management in Qingpu District, and to provide a basis for comprehensive intervention and prevention and control of dyslipidemia in T2DM patients and to optimize the management strategy of Qingpu District diabetes point system. Methods Among the T2DM patients who signed the diabetes point system from 2017 to 2023, patients with chronic dyslipidemia and normal blood lipids were selected and included in the case group and the control group, respectively. A case-control study was conducted with 1:1 matching by age and gender to analyze the factors influencing dyslipidemia. Results Multifactorial paired logistic regression analysis showed that overweight/obesity and central obesity and smoking in T2DM patients increased the risk of dyslipidemia by 1.93, 2.27, and 2.16 times, respectively. Long-term use of lipid-lowering drugs, duration of diabetes for 5 years or more, regular physical exercise, knowledge of blood lipid status, and married status could reduce the risk of dyslipidemia in T2DM patients (OR values were 0.547, 0.452, 0.685, 0.386 and 0.354, respectively). Current complications (history of stroke, coronary heart disease, and renal insufficiency) were also associated with dyslipidemia (OR=1.802, 95% CI:1.125-2.888). Conclusion The management of diabetes point system in Qingpu District should strengthen the feedback and interpretation of blood lipid monitoring results, improve patients’ health awareness of blood lipid management, and actively take comprehensive management of lifestyle intervention and drug treatment to effectively control blood lipid and reduce the occurrence of related complications.


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