1.Association between non-alcoholic fatty liver disease and depression: A systematic review and Meta-analysis
Shudi LI ; Shuaibing CAO ; Mingyu BA ; Suling LI ; Fei DUAN ; Baoping LU
Journal of Clinical Hepatology 2025;41(9):1795-1801
		                        		
		                        			
		                        			ObjectiveTo systematically review the association between non-alcoholic fatty liver disease (NAFLD) and depression, and to provide a basis for synergistic management in clinical practice. MethodsThis study was conducted according to the PRISMA guidelines, with the PROSPERO registration number of CRD42023482013. PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM were searched for articles on the association between NAFLD and depression published up to November 1, 2024. The articles were screened according to the inclusion and exclusion criteria, and related data were extracted. RevMan 5.3 was used to perform the Meta-analysis. ResultsA total of 18 studies were included, involving 396 793 participants. Among these studies, 12 discussed the influence of NAFLD on depression, involving 224 269 participants, among whom there were 75 574 patients with NAFLD. The Meta-analysis showed that NAFLD was significantly associated with the risk of depression (odds ratio [OR]=1.21, 95% confidence interval [CI]: 1.12 — 1.30, P0.001). Six studies examined the influence of depression on NAFLD, involving 172 524 participants, among whom there were 29 368 patients with depression. The meta-analysis showed that depression caused a significant increase in the risk of NAFLD (OR=1.13, 95%CI: 1.05 — 1.22, P=0.001). ConclusionThere is a significant bidirectional association between NAFLD and depression. It is recommended to perform the screening for depression and enhance mental health monitoring in patients with NAFLD, and metabolic function assessment and exercise intervention should be performed for patients with depression. 
		                        		
		                        		
		                        		
		                        	
2.Single-arm, Multi-center, Prospective Clinical Study of Recombinant Human Endostatin Combined with Afatinib and Teggio in Second-line Treatment of Advanced Lung Squamous Cell Carcinoma
Yang CHEN ; Guodong FAN ; Annan JIAO ; Zegeng LI ; Jiabing TONG ; Biao FANG ; Suling YAO ; Mingqi WANG ; Mei ZHANG ; Ping LI
Chinese Journal of Modern Applied Pharmacy 2024;41(10):1388-1393
		                        		
		                        			OBJECTIVE 
		                        			To evaluate the effictiveness and safety of recombinant human endostatin combined with afatinib and teggio in the treatment of advanced lung squamous cell carcinoma.
METHODS 
A total of 25 patients with driver-negative advanced lung squamous cell carcinoma were included in this single-arm prospective study, and the enrolled patients were treated with recombinant human endostatin combined with afatinib and teggio as scheduled. Progression-free survival(PFS), overall survival(OS), disease control rate(DCR), objective response rate(ORR), and adverse reactions(AR) were observed and analyzed.
RESULTS 
The 25 enrolled patients received at least 2 cycles of second-line treatment, and were followed up as of March 31, 2023. Among them, 4 patients had partial remission, 17 patients had stable disease, and 4 patients experienced progressive disease. The ORR confirmed by the researchers was 16%(95%CI, 4.5%−36.1%), DCR was 84%(95%CI, 63.9%−95.5%), and median PFS was 5.3 months(95%CI, 3.5−6.9 months). The median OS had not yet been achieved. The entire group of patients had good treatment tolerance, and the most common level Ⅲ or Ⅳ adverse events related to treatment were leukopenia(20%) and rash(12%), with no reported treatment-related deaths.
CONCLUSION 
Recombinant human endostatin combined with afatinib and teggio in the second line treatment of advanced lung squamous cell carcinoma can prolong the progression free survival period of patients and is relatively safe, which is worth further exploration and promotion.
		                        		
		                        		
		                        		
		                        	
3.Application of mind map in self-management mode of elderly patients after mitral valve transcatheter edge-to-edge repair
Meili JI ; Suling DI ; Qi WU ; Ruoya JIA ; Xiaoxian WU ; Juan ZHANG ; Yan LI
Journal of Interventional Radiology 2024;33(10):1131-1137
		                        		
		                        			
		                        			Objective To discuss the application of mind map in self-management of elderly patients after receiving mitral valve transcatheter edge-to-edge repair(M-TEER).Methods A total of 66 patients,who underwent M-TEER at Nanjing Hospital of Nanjing Medical University from August 2021 to October 2022,were enrolled in this study.Using the envelope concealment method,a total of 66 data analysis samples were included in the analysis.There were 33 patients each in the study group and control group.Routine health education was adopted for the patients of the control group,while the responsible nurse conducted health education for the patients of the study group under the guidance of the mind map that was designed by a multidisciplinary specialized nurses.Results There was a significant difference in postoperative medication compliance between the study group and the control group(P<0.05),i.e.the degree of compliance,including taking medicine on time,insisting on taking medicine and taking medicine as prescribed,in the study group was obviously higher than that in the control group.The postoperative 6-min walking test,which was regarded as one of the indicators of cardiac functions,in the study group was remarkably better than that in the control group,the difference was statistically significant(P<0.05).The postoperative quality of life(including daily activity ability,frailty degree,social support,and incidence of hospitalization for heart failure within one year after treatment)in the study group was strikingly better than that in the control group(P<0.05).Conclusion The use of mind map in self-management of elderly patients after receiving M-TEER can effectively improve the medication compliance of the patients after discharge,improve the quality of life of patients,and reduce the incidence of hospitalization due to heart failure.
		                        		
		                        		
		                        		
		                        	
4.Research advances in the mechanism of action of traditional Chinese medicine in inhibiting angiogenesis in hepatocellular carcinoma
Xiangxiang LI ; Zhen WANG ; Xing YANG ; Suling LI
Journal of Clinical Hepatology 2024;40(7):1477-1485
		                        		
		                        			
		                        			Angiogenesis is a key process in the development and progression of hepatocellular carcinoma(HCC)and can provide essential material conditions for the proliferation,invasion,and metastasis of HCC cells.Inhibition of angiogenesis has become a research hotspot in the field of HCC therapy.Traditional Chinese medicine has become a potential drug for HCC therapy due to its characteristics of multiple targets and pathways,enhancing efficacy and reducing toxicity,improving tumor prognosis,and prolonging survival time.Modern studies have confirmed that traditional Chinese medicine can inhibit tumor angiogenesis by inhibiting the expression of angiogenic factors,upregulating the levels of anti-angiogenic factors,inhibiting endothelial cell proliferation,reducing the microvascular density of HCC tissue,and regulating related signaling pathways,and therefore,traditional Chinese medicine has unique advantages in the treatment of HCC.By summarizing related articles in China and globally in recent years,this article analyzes the mechanism of action of traditional Chinese medicine on inhibiting HCC angiogenesis,in order to provide certain theoretical basis and reference for the optimization of HCC treatment strategies in clinical practice.
		                        		
		                        		
		                        		
		                        	
5.Active Components of Chinese Medicine Against Liver Fibrosis Based on PI3K/Akt Signaling Pathway: A Review
Xing YANG ; Zhen WANG ; Shudi LI ; Jiangkai LIU ; Suling LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(13):230-240
		                        		
		                        			
		                        			Hepatic fibrosis is a pathological reparative response of the liver to chronic injury and a crucial step in the progression of chronic liver disease, characterized mainly by the activation of hepatic stellate cells and diffuse deposition of extracellular matrix. Currently, there is no ideal specific drug for the treatment of liver fibrosis in clinical practice. In recent years, with the development and progress of traditional Chinese medicine (TCM) in the treatment of liver fibrosis, TCM has been widely recognized for its significant therapeutic effect and fewer adverse reactions. The phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway is an important pathway that affects the formation and development of liver fibrosis. It mainly plays a role in liver fibrosis by inhibiting the activation and proliferation of hepatic stellate cells, promoting their apoptosis, reducing oxidative stress in liver cells, decreasing the deposition of extracellular matrix, and enhancing liver cell autophagy. This article summarized the mechanisms by which Chinese medicinal monomers regulated the PI3K/Akt pathway to exert their effects on liver fibrosis and their synergistic effects with other signaling pathways, providing a theoretical basis and references for the development of new drugs for the treatment of liver fibrosis with TCM. 
		                        		
		                        		
		                        		
		                        	
6.Current research status of traditional Chinese medicine in the prevention and treatment of hepatocellular carcinoma by regulating the JAK/STAT signaling pathway
Xing YANG ; Shudi LI ; Jiangkai LIU ; Zhen WANG ; Suling LI
Journal of Clinical Hepatology 2023;39(11):2718-2729
		                        		
		                        			
		                        			Hepatocellular carcinoma (HCC) is one of the common malignant tumors of the digestive tract and seriously threatens the life of patients due to a high incidence rate, a high degree of malignancy, strong invasion and metastasis, and poor prognosis. At present, the main methods for the prevention and treatment of HCC include drugs, surgery, and interventional treatment, but all of these methods have certain adverse reactions and side effects. As an important intracellular signal transduction pathway in the human body, the JAK/STAT signaling pathway mainly exerts an anti-HCC effect by regulating cell invasion, metastasis, proliferation, growth, apoptosis, autophagy, angiogenesis, inflammation/immune response, iron metabolism, and drug resistance. Therefore, targeting the JAK/STAT signaling pathway plays an important role in the prevention and treatment of the development and progression of HCC. Traditional Chinese medicine has attracted wide attention due to its advantages of multiple targets, pathways, components, and levels in the treatment of HCC, and many cell or animal experiments on traditional Chinese medicine in the treatment of HCC have shown that the JAK/STAT signaling pathway is an important target for the prevention and treatment of HCC, with the effects of improving liver function, reducing HCC recurrence, and improving immunity. Based on this, this article analyzes the mechanism of action of the JAK/STAT signaling pathway in HCC, as well as the intervention effect of traditional Chinese medicine monomers, traditional Chinese medicine extracts, and traditional Chinese medicine compounds on the JAK/STAT signaling pathway, in order to provide theoretical basis and reference for the prevention and treatment of HCC and the research and development of new traditional Chinese medicine drugs. 
		                        		
		                        		
		                        		
		                        	
7.CD103 +CD8 +T cells combined with neutrophil-to-lymphocyte ratio predict response to neoadjuvant chemoimmunotherapy in advanced oral squamous cell carcinoma
Bowen LI ; Siqi REN ; Suling CHEN ; Tianjun LAN ; Fan WU ; Jinsong LI
Chinese Journal of Stomatology 2023;58(12):1257-1264
		                        		
		                        			
		                        			Objective:To investigate the relationship between the expression of CD103 +CD8 +T cells in locally advanced oral squamous cell carcinoma (LA-OSCC), and the response to neoadjuvant chemoimmunotherapy (NACI). Methods:Thirty LA-OSCC patients from the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, who underwent NACI from June 2020 to December 2022 were analyzed, including 16 responders and 14 non-responders. Using multiple immunofluorescence technique to stain sections of patients to verify the correlation between the expression of CD103 +CD8 +T cells and the efficacy of NACI. CD103 +CD8 +T cell density was counted using Inform and HALO software. The Spearman correlation coefficient in rank correlation is used to describe the correlation between CD103 +CD8 +T cell and neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII) It′s effectiveness as a predictive marker to NACI was analyzed by receiver operator characteristic (ROC) curve analysis and decision curve analysis (DCA). Two-tailed t-test or Mann-Whitney U-test was used to compare data between two groups, and one-way ANOVA was used to compare data between multiple groups. SPSS 22.0 and GraphPad prism 9.0 software were used for statistical analysis and plotting of relevant statistical graphs such as histograms. P<0.05 was considered a statistically significant difference. Results:The density of CD103 +CD8 +T cells has expanded in advanced OSCC patients who are responsive to NACI. The CD103 +CD8 +T cell densities in the responsive and nonresponsive groups were 118.30(41.92, 197.80) pcs/mm 2 and 21.63(4.91, 71.92) pcs/mm 2 respectively, with statistically significant differences( U=52.00, P=0.012). CD103 +CD8 +T cell abundance was negatively correlated with NLR, dNLR, PLR, and SII ( P<0.05). ROC curve analysis showed that the AUC for predicting efficacy of NLR, dNLR, PLR, and SII were 0.781 ( P=0.009, 95% CI: 0.5715-0.9910), 0.671 ( P=0.105, 95% CI: 0.467-0.881), 0.679 ( P=0.020 95% CI: 0.549-0.951), 0.750 ( P=0.096, 95% CI: 0.461-0.896), respectively. The AUC for CD103 +CD8 +T cells alone was 0.861 ( P=0.013, 95% CI: 0.585-0.950), and the AUC of combining CD103 +CD8 +T cells with NLR was 0.896 ( P=0.025, 95% CI: 0.454-0.938). Conclusions:The density of CD103 +CD8 +T cells is expanded in advanced OSCC patients who are responsive to NACI. CD103 +CD8 +T cells positively predict favorable responses as a strong indicator to NACI in advanced OSCC patients. Co-interpretation of CD103 +CD8 +T cells and NLR value enhances the predictive accuracy of NACI in advanced OSCC patients.
		                        		
		                        		
		                        		
		                        	
8.Advances in the mechanism of action of silent information regulator 1 in alcoholic liver disease and related pharmaceutical studies
Tiantian LIU ; Jiangkai LIU ; Suling LI ; Liang LIU ; Yaru ZHANG ; Jianwen ZHANG ; Bingqian LI
Journal of Clinical Hepatology 2022;38(12):2841-2845
		                        		
		                        			
		                        			 Alcoholic liver disease (ALD) is one of the main chronic liver diseases in the world, and the prevalence rate of ALD is increasing year by year in China, with a trend of earlier age of onset. Silent information regulator 1 (SIRT1) is a nicotinamide adenine dinucleotide-dependent deacetylase and plays a significant role in cell metabolism, oxidative stress, and inflammation, and it is expected to become a new therapeutic target for ALD. This article reviews the mechanism of action of SIRT1 in ALD and related pharmaceutical studies, in order to provide a reference and strategies for further research on the pathogenesis of ALD and its potential therapeutic targets. 
		                        		
		                        		
		                        		
		                        	
9.Effect of Jiedu Huayu Tongfu prescription on intestinal flora in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome
Jiangkai LIU ; Yameng NIU ; Suling LI ; Qingliang MA ; Jiangwen ZHANG ; Yaru ZHANG ; Bingqian LI
Journal of Clinical Hepatology 2022;38(4):821-827
		                        		
		                        			
		                        			 Objective To investigate the regulatory effect of Jiedu Huayu Tongfu prescription on intestinal homeostasis in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome, as well as its effect on endotoxin, inflammatory factors, and cellular immune function. Methods A total of 72 patients who attended The First Affiliated Hospital of Henan University of Chinese Medicine from June 2019 to January 2021 and met the diagnostic and inclusion criteria were enrolled as subjects and then randomly divided into observation group and control group, with 36 patients in each group. In the treatment group, 2 patients were lost to follow-up, 2 patients were excluded, and 32 patients completed the study; in the control group, 2 patients were lost to follow-up, 1 patient was excluded, and 33 patients completed the study. In addition to the basic treatment including antiviral therapy and liver-protecting treatment, the patients in the observation group were given Jiedu Huayu Tongfu granules, and those in the control group were given oral administration of Bifidobacterium tetravaccine tablets; the course of treatment was 4 weeks for both groups. The 16S rDNA sequencing technique was used for sequencing of fecal flora, and the two groups were measured in terms of the changes in liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and albumin (Alb)], endotoxin (ET), levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and T lymphocyte subsets (CD3 + T, CD4 + T, CD8 + T, and CD4 + /CD8 + ) after treatment. For normally distributed continuous data with homogeneity of variance, the paired t -test was used for comparison within each group, and the independent samples t -test was used for comparison between two groups; the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data. The chi-square test was used for comparison of categorical data. Results The observation group had a significantly higher overall response rate than the control group (87.5% vs 60.6%, χ 2 =-2.299, P =0.022). After treatment, both groups had significant reductions in ALT, AST, and TBil and a significant increase in Alb (all P < 0.05), and compared with the control group, the observation group had a significantly greater reduction in TBil ( Z =-2.165, P =0.030). After treatment, both groups had significant improvements in the levels of CD3 + T, CD4 + T, and CD4 + /CD8 + , and the observation group had significantly greater improvements than the control group ( Z =-2.146, -2.940, and 3.157, P =0.032, 0.003, and 0.002). After treatment, both groups had significant reductions in the levels of TNF-α, IL-6, and ET, and the observation group had significantly greater reductions than the control group ( Z =-2.139, -1.982, and -2.062, P =0.032, 0.048, and 0.043). Both groups had an increase in the number of operational taxonomic units after treatment. As for the abundance of intestinal flora at the phylum level, the observation group had a significant increase in the abundance of Firmicutes and a significant reduction in the abundance of Bacteroidetes after treatment ( Z =-3.181 and -2.215, P =0.001 and 0.027); compared with the control group, the observation group had significantly greater increases in the abundance of Firmicutes and Cyanobacteria and significantly greater reductions in the abundance of Bacteroidetes, Cercozoa, and ε-Proteobacteria (all P < 0.05). At the genus level, the observation group had a significant increase in the abundance of Bifidobacterium after treatment ( Z =-2.045, P =0.041). The alpha-diversity analysis showed that the observation group had significant increases in Chao1 and Ace indices after treatment ( t =-4.263 and -3.328, P =0.001 and 0.005) and a significantly greater increase in Ace index than the control group ( t =2.292, P =0.030). The beta-diversity analysis showed that the two groups had a similar composition of flora without significant difference (all P > 0.05). Conclusion Jiedu Huayu Tongfu prescription, in combination with etiological and basic treatments, can alleviate clinical symptoms, reduce liver injury, and improve cellular immune function in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome. Jiedu Huayu Tongfu prescription can improve the imbalance of intestinal flora by increasing the abundance of the probiotic bacteria such as Firmicutes, Lactobacillus, and Bifidobacterium and the pathogenic bacteria such as Bacteroidetes and Cercozoa, and its effect in further improving liver and immune function may be associated with the regulation of intestinal microecology. 
		                        		
		                        		
		                        		
		                        	
10.Signaling pathways involved in the active components of Polygonum cuspidatum in treatment of nonalcoholic fatty liver disease and their interaction
Shudi LI ; Xinju CHEN ; Jiangkai LIU ; Zhen WANG ; Fei DUAN ; Zhuoya YUAN ; Lei LIANG ; Suling LI
Journal of Clinical Hepatology 2022;38(4):902-907
		                        		
		                        			
		                        			 The pathogenesis of nonalcoholic fatty liver disease (NAFLD) remains unclear, and currently no effective drugs have been approved for the treatment of NAFLD. Polygonum cuspidatum is a natural traditional Chinese medicine with a long history of application, and studies have shown that it plays an important role in the treatment of NAFLD. This article summarizes related research findings in the active components of Polygonum cuspidatum applied in the treatment of NAFLD, and it is found that the active components of Polygonum cuspidatum can improve insulin resistance, exert an anti-oxidative stress effect, regulate lipid metabolism, improve endoplasmic reticulum stress, and alleviate inflammatory infiltration by regulating the signaling pathways including Nrf2, AMPK, NF-κB, SIRT1, and PPARα, thereby exerting a preventive and therapeutic effect on NAFLD, so as to provide a basis and ideas for developing drugs for NAFLD and exploring related mechanisms. 
		                        		
		                        		
		                        		
		                        	
            

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