1.A Case Report of Pachydermoperiostosis by Multidisciplinary Diagnosis and Treatment
Jie ZHANG ; Yan ZHANG ; Li HUO ; Ke LYU ; Tao WANG ; Ze'nan XIA ; Xiao LONG ; Kexin XU ; Nan WU ; Bo YANG ; Weibo XIA ; Rongrong HU ; Limeng CHEN ; Ji LI ; Xia HONG ; Yan ZHANG ; Yagang ZUO
JOURNAL OF RARE DISEASES 2025;4(1):75-82
A 20-year-old male patient presented to the Department of Dermatology of Peking Union Medical College Hospital with complaints of an 8-year history of facial scarring, swelling of the lower limbs, and a 4-year history of scalp thickening. Physical examination showed thickening furrowing wrinkling of the skin on the face and behind the ears, ciliary body hirsutism, blepharoptosis, and cutis verticis gyrate. Both lower limbs were swollen, especially the knees and ankles. The skin of the palms and soles of the feet was keratinized and thickened. Laboratory examination using bone and joint X-ray showed periostosis of the proximal middle phalanges and metacarpals of both hands, distal ulna and radius, tibia and fibula, distal femurs, and metatarsals.Genetic testing revealed two variants in
2.Mechanism of cGAS/STING Signaling Pathway in Regulating Lung Cancer and Traditional Chinese Medicine Treatment: A Review
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):236-244
According to the latest global cancer statistics, the incidence and mortality of lung cancer rank first in China. Classical therapies remain the most common cancer treatment options, such as surgical resection, radiotherapy, and chemotherapy, but not all cancer patients respond to classical therapies, which require new lung cancer treatment strategies. After decades of research and development, cancer immunotherapy has achieved certain curative effect, which provides new possibilities for cancer treatment. Cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS) is a cytosolic DNA sensor. It can induce protective immune defense responses against various DNA-containing pathogens and provide anti-tumor immunity by activating the interferon (IFN) gene stimulator (STING) protein. At present, relevant researchers in China and abroad have done a lot of research on the occurrence and development of lung cancer and the pathophysiological mechanism of drug intervention in the treatment of lung cancer. The results show that cGAS/STING signaling pathway plays an important role in the development of the disease, and traditional Chinese medicine monomers or compounds can intervene in lung cancer cells by regulating the cGAS/STING signaling pathway, induce their autophagy and death, regulate their cycle operation, promote senescence, inhibit their proliferation and tumor angiogenesis, promote their invasion and metastasis, and promote the immune activation of anti-lung cancer cells, so as to inhibit or delay the occurrence and development of lung cancer. In recent years, the related research results have been updated rapidly, and the previous literature has not included the latest research results in time, which causes a lot of inconvenience for many scholars to search the literature. Based on this, this paper mainly summarized the mechanism of cGAS/STING signaling pathway intervention in lung cancer in China and abroad in recent years, as well as the research progress of related traditional Chinese medicine intervention, so as to provide new ideas for the development of lung cancer in molecular biology, drug treatment research, and clinical new drug research and provide a reference for further mechanism research.
3.Oxidative Stress-related Signaling Pathways in Lung Cancer and Chinese Medicine Intervention: A Review
Anqi LYU ; Yufeng SHI ; Cheng JIANG ; Jia KE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):228-237
Lung cancer has the highest incidence and mortality rate among all cancers in China, with its complex and variable nature, long treatment duration, and often poor prognosis. Currently, the treatment of lung cancer mainly employs classical therapies such as surgery, radiotherapy, and chemotherapy, but some patients may experience a series of adverse reactions, which affect their quality of life, survival period, and treatment outcomes. As reported, oxidative stress is one of the important pathogenic factors of lung cancer, affecting its occurrence and development. Oxidative stress is a state of imbalance between oxidative products and antioxidant defense mechanisms in the body. The intervention of oxidative stress in the occurrence and development of lung cancer is related to multiple signaling pathways, including the Kelch-like ECH-associated protein 1 (Keap1)-nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, and nuclear factor-κB (NF-κB) signaling pathway. Currently, researchers in China and abroad have conducted extensive studies on the occurrence and development of lung cancer and the pathophysiological mechanisms of drug intervention. The results have shown that oxidative stress plays an important role in the occurrence and development of lung cancer. Chinese medicine monomers and compounds can regulate oxidative stress levels and intervene in related signaling pathways, thereby inhibiting or delaying the occurrence and development of lung cancer. Based on this, this article mainly summarized the relevant signaling pathways regulating oxidative stress intervention in lung cancer in recent years, and also reviewed the latest research on Chinese medicine monomers and compounds in regulating oxidative stress to treat lung cancer, aiming to provide new ideas for research on drug treatment of lung cancer and clinical drug development, as well as to provide references and guidance for further in-depth mechanistic studies in the future.
4.Investigation and analysis of the current status of transjugular intrahepatic portosystemic shunt treatment for portal hypertension in China
Haozhuo GUO ; Meng NIU ; Haibo SHAO ; Xinwei HAN ; Jianbo ZHAO ; Junhui SUN ; Zhuting FANG ; Bin XIONG ; Xiaoli ZHU ; Weixin REN ; Min YUAN ; Shiping YU ; Weifu LYU ; Xueqiang ZHANG ; Chunqing ZHANG ; Lei LI ; Xuefeng LUO ; Yusheng SONG ; Yilong MA ; Tong DANG ; Hua XIANG ; Yun JIN ; Hui XUE ; Guiyun JIN ; Xiao LI ; Jiarui LI ; Shi ZHOU ; Changlu YU ; Song HE ; Lei YU ; Hongmei ZU ; Jun MA ; Yanming LEI ; Ke XU ; Xiaolong QI
Chinese Journal of Radiology 2024;58(4):437-443
Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.
5.Application of rotational skin flap in repairing skin and soft tissue defects in the perineum
Shihui LYU ; Peifeng LI ; Jian WANG ; Hailei GUO ; Ke TAO ; Shenghu DU
Journal of Chinese Physician 2024;26(3):345-348
Objective:To explore the application effect of rotating skin flap in the repair of skin and soft tissue defects in the perineum.Methods:A retrospective analysis was conducted on the data of 9 patients with perineal soft tissue defects treated in the Department of the First Affiliated Hospital, Wenzhou Medical University from January 2022 to March 2024. Among them, 8 cases were soft tissue defects after extensive resection of Paget′s disease in the perineum, and 1 case was soft tissue defects after treatment of severe urethral stricture. The defect area ranged from 4 cm×1.5 cm to 30 cm×35 cm, and all wounds were repaired with rotating skin flaps, For patients with excessive area, rotating skin flaps were used to cover important areas, combined with autologous skin and artificial skin to cover the remaining wounds. Patients with urethral stricture were treated with free oral mucosal reconstruction of the urethra combined with rotational skin flap coverage. The donor site was directly sutured or autologous skin was transplanted.Results:After surgery, the recipient skin flaps of 9 patients survived and the donor area healed. After a follow-up of 9-15 months, the skin flap survived well, with skin color approaching normal, and the donor site wound healed well. Eight patients with Paget′s disease did not show any recurrence, among which one patient with extensive wound expansion had good recovery of the perineal skin flap coverage area, and small-scale chronic ulcers appeared in the skin graft area. The skin flap of the patient with urethral stricture had recovered well, and the shape of the penis was good, without any urethral stricture, urinary fistula, sinus tract, etc.Conclusions:The rotational skin flap has a clear therapeutic effect on perineal soft tissue defects and is suitable for repairing perineal skin and soft tissue defects.
6.An Exploratory Study on the Effects of Interatrial Shunt for Patients With Heart Failure With Reduced Ejection Fraction
Sanshuai CHANG ; Wenhui WU ; Xinmin LIU ; Zhengming JIANG ; Yutong KE ; Qiang LYU ; Xin DU ; Jianzeng DONG ; Guangyuan SONG
Chinese Circulation Journal 2024;39(10):989-996
Objectives:To explore the effects of interatrial shunt on cardiac function and clinical prognosis of patients with heart failure with reduced ejection fraction(HFrEF). Methods:This study was a prospective single-arm study.From December 2021 to December 2022,15 consecutive patients with HFrEF from Beijing Anzhen Hospital were enrolled in this study.Interatrial shunt was performed with a D-Shant atrial shunt device.Right heart catheterization was performed before and immediately after device implantation,pulmonary capillary wedge pressure(PCWP),mean right atrial pressure(RAP),interatrial gradient pressure,mean pulmonary artery pressure,total pulmonary resistance(TPR),pulmonary vascular resistance(PVR),cardiac index(CI),and pulmonary/systemic blood flow ratio(Qp/Qs)were measured.Patients were followed-up for 12 months after procedure,changes in cardiac structure and function were evaluated by echocardiography.NYHA classification,6-minute walking distance(6MWD),and Kansas City cardiomyopathy questionnaire(KCCQ)were observed.All-cause mortality and rehospitalization for heart failure served as clinical endpoints. Results:Interatrial shunt procedure was successful in all patients.Compared with preoperative value,PCWP,interatrial gradient pressure,mean pulmonary artery pressure,and TPR were significantly decreased,while Qp/Qs was significantly increased immediately after procedure(all P<0.01).There were no significant changes in RAP,PVR,and CI post procedure(all P>0.05).There were no significant differences in shunt size,shunt velocity,and shunt pressure difference between postoperative immediately and at 12-months follow-up(all P>0.05).At 12 months,left ventricular ejection fraction was significantly higher than baseline level(P<0.05),and there were no significant changes in right atrial diameter and right ventricular fractional area change(both P>0.05).Compared with preoperative status,NYHA classification was improved,KCCQ score was increased,and the number of patients with 6MWD>450 m was increased at 12 months(all P<0.05).N-terminal pro-B-type natriuretic peptide value was significantly decreased at 12 months(P<0.05).No patient died during the 12-months follow-up period,and there were no device-related adverse events.Two patients experienced hospital readmission for heart failure. Conclusions:Implantation of interatrial shunt device could effectively improve hemodynamic parameters in patients with HFrEF and is related to significantly improved cardiac function at 12-months follow-up.
7.Ginsenosides in Treatment of Lung Cancer: A Review
Anqi LYU ; Yufeng SHI ; Jia KE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):270-280
Lung cancer is the leading cause of cancer-related death, characterized by high invasiveness, early metastasis and poor prognosis. It has the highest incidence and mortality rates among cancers in China. Currently, the treatment of lung cancer is still dominated by the classic therapies such as surgery, radiotherapy, chemotherapy and targeted therapy. However, the classic therapies are not suitable for all patients with lung cancer, so new treatment strategies and methods are needed to prevent and treat lung cancer. In recent years, Ginseng Radix et Rhizoma has attracted wide attention in the field of anti-lung cancer research, and traditional Chinese medicine has a substantial theoretical and practical foundation in treating lung cancer. Ginseng Radix et Rhizoma , as a commonly used Chinese herbal medicine, has the functions of replenishing vital Qi, replenishing veins, strengthening the spleen and lung, and nourishing body and blood. The main active components of Ginseng Radix et Rhizoma , known as ginsenosides, exhibit anti-cancer and anti-inflammatory activities. Therefore, the mechanism and pharmacological activity of ginsenosides in the intervention of lung cancer have been extensively studied by researchers worldwide. The results show that ginsenosides can effectively inhibit the proliferation, invasion, migration, epithelial-mesenchymal transition and angiogenesis of lung cancer cells. Additionally, they inhibit drug resistance, enhance chemotherapy sensitivity and efficacy, and promote apoptosis and autophagy of lung cancer cells. Ginsenosides also modulate the tumor microenvironment and regulate immunity, thereby delaying the occurrence and development of lung cancer. The rapid advancements in related research have outpaced previous literature review, creating challenges for scholars seeking the latest information. Based on this, this article summarizes recent findings on the mechanism and pharmacological activities of ginsenosides in lung cancer intervention, aiming to provide new insights for the development of molecular biology, drug treatment research and clinical new drug research in lung cancer. It also provides the reference for further mechanism research.
8.TU Jinwen's Experience in the Treatment of Severe Influenza Based on the “Heat Toxin Theory”
Anqi LYU ; Yufeng SHI ; Yi YANG ; Jia KE ; Jinwen TU
Journal of Traditional Chinese Medicine 2024;65(7):674-677
To summarize Professor TU Jinwen's clinical experience in the treatment of severe influenza based on the “heat toxin theory”. He believed that “heat toxin” is the main disease mechanism of severe influenza, emphasized the pathogenesis process that toxin enters with the pathogenic qi, heat generates by the toxin, and changes initiate from the toxin, and proposed simultaneous treatment of warmth and toxin and combination of multiple methods as the treatment principles. Syndrome differentiation in clinic should combine with wei-qi-ying-blood. The disease in the early stage located in wei (defensive) and qi level, treated by clearing heat and resolving toxins, releasing the exterior and expelling pathogen, harmonizing the exterior and interior, dredging the bowels with diarrhea, and combining other methods to get rid of the heat and toxin, and modified Self-Prescribed Tuire No. 1 Formula (自拟退热1号方) is recommended; the disease in progression stage located in ying-blood, treated by relieving heat and resolving toxins, and clearing the ying level and cool the blood, with prescriptions as modified Self-Prescribed Tuire No. 1 Formula plus Qingying Decoction (清营汤), or Xijiao Dihuang Decoction (犀角地黄汤); the disease in the late stage with of yin fluid consumption, and heat toxin in the blood level, treated by eliminating heat and resolving toxins, and enriching yin and cooling the blood, with prescriptions as modified Shashen Maidong Decoction (沙参麦冬汤) and Zhuye Shigao Decoction (竹叶石膏汤). At the same time, it is emphasised that heat-clearing and fire-draining method and harmonising methods are important, and that dispelling pathogen should not injure healthy qi, and that the selection of prescriptions and medicines need consider syndrome differentiation and treatment.
9.Progress and practice of objective measurement of physical behaviors in large-scale cohort research
Yuanyuan CHEN ; Yalei KE ; Jun LYU ; Dianjianyi SUN ; Lang PAN ; Pei PEI ; Huaidong DU ; Junshi CHEN ; Zhengming CHEN ; Liming LI ; Doherty AIDEN ; Canqing YU
Chinese Journal of Epidemiology 2024;45(1):35-40
Due to the limited reliability of traditional self-completed questionnaire, the accuracy of measurement of physical behaviors (physical activity, sedentary behavior and sleep) is not high. With the development of technology, wearable devices (e.g. accelerometer) can be used for more accurate measurement of physical behaviors and have great application potential in large-scale research. However, the data of objective measurement of physical behaviors from large-scale cohort research in Asian populations is still limited. Between August 2020 and December 2021, the 3 rd resurvey of China Kadoorie Biobank (CKB) project used Axivity AX3 wrist triaxial accelerometer to collect the data of participants' daily activity and sleep status. A total of 20 370 participants from 10 study areas were included in the study, in whom 65.2% were women, and the age was (65.4±9.1) years. The participants' physical activity level varied greatly in different study areas. The objective measurement of participants' physical behaviors in CKB project has provided valuable resources for the description of 24-hour patterns of physical behaviors and evaluation of the health effect of physical activity, sedentary behavior and sleep as well as their association with diseases in the elderly in China.
10.Distribution and influencing factors of lipoprotein (a) levels in non-arteriosclerotic cardiovascular disease population in China
Yalei KE ; Lang PAN ; Jun LYU ; Dianjianyi SUN ; Pei PEI ; Yiping CHEN ; Ling YANG ; Huaidong DU ; Robert CLARKE ; Junshi CHEN ; Zhengming CHEN ; Xiao ZHANG ; Ting CHEN ; Runqin LI ; Litong QI ; Liming LI ; Canqing YU
Chinese Journal of Epidemiology 2024;45(6):779-786
Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

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