1.Interpretation of 2024 ESC guidelines for the management of peripheral arterial and aortic diseases
Kai TANG ; Mingyao LUO ; Chang SHU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):14-23
In recent years, the worldwide incidence rate of peripheral arterial and aortic diseases has increased year by year, significantly increasing the cardiovascular mortality and incidence rate of the whole population. In the past, peripheral arterial and aortic diseases were often more prone to missed diagnosis and delayed treatment compared to coronary artery disease. The 2024 ESC guidelines for the management of peripheral arterial and aortic diseases for the first time combines peripheral arterial and aortic diseases, integrating and updating the 2017 guidelines for peripheral arterial disease and the 2014 guidelines for aortic disease. The aim is to provide standardized recommendations for the management of systemic arterial diseases, ensuring that patients can receive coherent and comprehensive diagnosis and treatment, thereby improving prognosis. This article interprets the main content of the guideline in order to provide reference and assistance for the clinical diagnosis and treatment of peripheral arterial and aortic diseases in China at the current stage.
2.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.
3.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.
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.Changes of parameters associated with anemia of inflammation in patients with stage Ⅲ periodontitis before and after periodontal initial therapy
Chang SHU ; Ye HAN ; Yuzhe SUN ; Zaimu YANG ; Jianxia HOU
Journal of Peking University(Health Sciences) 2024;56(1):45-50
Objective:To investigate the differences and similarities of parameters associated with ane-mia of inflammation between patients with stage Ⅲ periodontitis and periodontally healthy volunteers,and to explore the influence of periodontal initial therapy on those indicators.Methods:Patients with stageⅢ periodontitis and periodontally healthy volunteers seeking periodontal treatment or prophylaxis at De-partment of Periodontology,Peking University School and Hospital of Stomatology from February 2020 to February 2023 were enrolled.Their demographic characteristics,periodontal parameters(including pro-bing depth,clinical attachment loss,bleeding index),and fasting blood were gathered before periodontal initial therapy.Three months after periodontal initial therapy,the periodontal parameters of the patients with stage Ⅲ periodontitis were re-evaluated and their fasting blood was collected again.Blood routine examinations(including white blood cells,red blood cells,hemoglobin,packed cell volume,mean cor-puscular volume of erythrocytes,and mean corpuscular hemoglobin concentration)were performed.And ferritin,hepcidin,erythropoietin(EPO)were detected with enzyme-linked immunosorbent assay(ELISA).All data analysis was done with SPSS 21.0,independent sample t test,paired t test,and analysis of co-variance were used for comparison between the groups.Results:A total of 25 patients with stage Ⅲperiodontitis and 25 periodontally healthy volunteers were included in this study.The patients with stageⅢ periodontitis were significantly older than those in periodontally healthy status[(36.72±7.64)years vs.(31.44±7.52)years,P=0.017].The patients with stage Ⅲ periodontitis showed lower serum he-moglobin[(134.92±12.71)g/L vs.(146.52±12.51)g/L,P=0.002]and higher serum ferritin[(225.08±103.36)μg/L vs.(155.19±115.38)μg/L,P=0.029],EPO[(41.28±12.58)IU/L vs.(28.38±10.52)IU/L,P<0.001],and hepcidin[(48.03±34.44)μg/L vs.(27.42±15.00)μg/L,P=0.009]compared with periodontally healthy volunteers.After adjusting the age with the co-variance analysis,these parameters(hemoglobin,ferritin,EPO,and hepcidin)showed the same trends as independent-sample t test with statistical significance.Three months after periodontal initial therapy,all the periodontal parameters showed statistically significant improvement.The serum hemoglobin raised[(146.05±15.48)g/L vs.(133.77±13.15)g/L,P<0.001],while the serum ferritin[(128.52± 90.95)μg/Lvs.(221.22±102.15)μg/L,P<0.001],EPO[(27.66±19.67)IU/L vs.(39.63± 12.48)IU/L,P=0.004],and hepcidin[(32.54±18.67)μg/L vs.(48.18±36.74)μg/L,P=0.033]decreased compared with baseline.Conclusion:Tendency of iron metabolism disorder and ane-mia of inflammation was observed in patients with stage Ⅲ periodontitis,which can be attenuated by periodontal initial therapy.
6.Discussion on the Pathogenesis of Osteonecrosis of the Femoral Head Under the System of Non-uniform Settlement During Bone Resorption and Multidimensional Composite Bowstring Working in Coordination with the Theory of Liver-Kidney and Muscle-Bone Based on the Concept of Liver and Kidney Sharing the Common Source
Gui-Xin ZHANG ; Feng YANG ; Le ZHANG ; Jie LIU ; Zhi-Jian CHEN ; Lei PENG ; En-Long FU ; Shu-Hua LIU ; Chang-De WANG ; Chun-Zhu GONG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(1):239-246
From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.
7.Mechanism of Mitochondrial Quality Control in Ovarian Aging and Intervention of Traditional Chinese Medicine: A Review
Fei YAN ; Yanfeng LIU ; Qi ZHAO ; Xingtong LIU ; Ying LI ; Chang SHU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):291-298
Ovarian aging is a reproductive endocrine disease caused by a variety of factors leading to a gradual decline in ovarian function until ovarian failure, which seriously affects women's physical and reproductive health and is a major factor leading to female infertility. Mitochondria, the energy metabolism centers of cells, are critical for ovarian functions. Their structural and functional abnormalities are key pathological factors leading to the declined ovarian function. Mitochondrial quality control is an important endogenous regulatory mechanism for the maintenance of mitochondrial homeostasis and the improvement of mitochondrial functions. Abundant studies have shown that the dysregulation of mitochondrial quality control, characterized by mitochondrial oxidative damage, abnormal mitochondrial biogenesis, abnormal mitochondrial dynamics, abnormal mitochondrial autophagy, and dysregulated calcium homeostasis, is closely associated with the occurrence of ovarian hypofunction. Traditional Chinese medicine (TCM) is a treasure of China's medicine, demonstrating remarkable efficacy in the clinical treatment of ovarian aging-related diseases. In recent years, research progress has been achieved in the TCM treatment of ovarian aging by regulating mitochondrial quality control disorders in a multi-target and multi-pathway manner. However, systematic research remains to be carried out regarding the research progress in this field. Therefore, this article reviews the research progress in the TCM treatment of ovarian aging based on mitochondrial quality control, with a view to providing a theoretical basis for studying the clinical efficacy of TCM in the treatment of ovarian aging and a new strategy for the in-depth research on the prevention and treatment of ovarian aging by TCM.
8.The Preclinical Models of Glioma Dependent on Alternative Lenthening of Telomeres (ALT) and Current Applications
Jin-Kai TONG ; Si-Xiang YAN ; Yan-Duo ZHANG ; Kai-Long HOU ; Ke ZHANG ; Hao-Nan ZHANG ; Shun CHANG ; Shu-Ting JIA
Progress in Biochemistry and Biophysics 2024;51(2):269-275
Glioma is the most common malignancy of the central nervous system, originating mainly from glial cells. Because of its highly aggressive nature, glioma has one of the highest rates of death among all types of cancer. Therefore, it is very important to develop new therapeutic approaches and drugs for glioma treatment. Instead of activate the telomerase, approximately 30% of glioma use alternative lenthening of telomere (ALT) to maintain telomere length. The mechanism of ALT development is poorly understood, however, some genetic mutations have been reported to induce the development of ALT glioma, such as ATRX, IDH1, p53, etc. The lack of ALT glioma cell lines and preclinical ALT glioma models has limited the mechanistic studies of ALT glioma. Therefore, this review listed ALT glioma cell lines that derived from primary culture or gene editing in the last decade, as well as the xenografted animal models established by ALT glioma cell lines, and discussed the role and significance these cell and animal models play in preclinical studies.
9.Clinical trial of Morinda officinalis oligosaccharides in the continuation treatment of adults with mild and moderate depression
Shu-Zhe ZHOU ; Zu-Cheng HAN ; Xiu-Zhen WANG ; Yan-Qing CHEN ; Ya-Ling HU ; Xue-Qin YU ; Bin-Hong WANG ; Guo-Zhen FAN ; Hong SANG ; Ying HAI ; Zhi-Jie JIA ; Zhan-Min WANG ; Yan WEI ; Jian-Guo ZHU ; Xue-Qin SONG ; Zhi-Dong LIU ; Li KUANG ; Hong-Ming WANG ; Feng TIAN ; Yu-Xin LI ; Ling ZHANG ; Hai LIN ; Bin WU ; Chao-Ying WANG ; Chang LIU ; Jia-Fan SUN ; Shao-Xiao YAN ; Jun LIU ; Shou-Fu XIE ; Mao-Sheng FANG ; Wei-Feng MI ; Hong-Yan ZHANG
The Chinese Journal of Clinical Pharmacology 2024;40(6):815-819
Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P<0.05).After continuation treatment,the remission rate was 54.59%(202 cases/370 cases),and the recurrence rate was 6.49%(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35%(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.
10.Relationship between Phenotypic Changes of Dendritic Cell Subsets and the Onset of Plateau Phase during Intermittent Interferon Therapy in Patients with CHB
Liu YANG ; Yu Shi WANG ; Ting Ting JIANG ; Wen DENG ; Min CHANG ; Ling Shu WU ; Hua Wei CAO ; Yao LU ; Ge SHEN ; Yu Ru LIU ; Jiao Yuan GAO ; Jiao Meng XU ; Ping Lei HU ; Lu ZHANG ; Yao XIE ; Hui Ming LI
Biomedical and Environmental Sciences 2024;37(3):303-314
Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to the frequency of dendritic cell subsets and expression of the costimulatory molecules CD40,CD80,CD83,and CD86. Method This was a cross-sectional study in which patients were divided into a natural history group(namely NH group),a long-term oral nucleoside analogs treatment group(namely NA group),and a plateau-arriving group(namely P group).The percentage of plasmacytoid dendritic cell and myeloid dendritic cell subsets in peripheral blood lymphocytes and monocytes and the mean fluorescence intensity of their surface costimulatory molecules were detected using a flow cytometer. Results In total,143 patients were enrolled(NH group,n = 49;NA group,n = 47;P group,n = 47).The results demonstrated that CD141/CD1c double negative myeloid dendritic cell(DNmDC)/lymphocytes and monocytes(%)in P group(0.041[0.024,0.069])was significantly lower than that in NH group(0.270[0.135,0.407])and NA group(0.273[0.150,0.443]),and CD86 mean fluorescence intensity of DNmDCs in P group(1832.0[1484.0,2793.0])was significantly lower than that in NH group(4316.0[2958.0,5169.0])and NA group(3299.0[2534.0,4371.0]),Adjusted P all<0.001. Conclusion Reduced DNmDCs and impaired maturation may be associated with the onset of the plateau phase during intermittent interferon therapy in patients with chronic hepatitis B.

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