1.Current Research on Modulation of NF-κB Signaling Network by Traditional Chinese Medicine to Intervene in Rheumatoid Arthritis
Xuejuan LI ; Ping YANG ; Ting CHEN ; Xixiang LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):286-294
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease with complex pathogenesis, poor cure rate, long course of disease, and high disability rate, which seriously affects patients' quality of life. Western medicine treatment of RA mainly includes non-steroidal anti-inflammatory drugs, rheumatic drugs, glucocorticoids, biologics, and targeted small-molecule drugs, which have large side effects and many adverse reactions. Traditional Chinese medicine (TCM) has systematic, comprehensive, multi-target, and multi-mechanism advantages in the treatment of RA. Through the overall syndrome pattern identification, it is effective in relieving symptoms, delaying onset, and relieving pain in RA patients by dispelling wind and removing dampness, dissipating cold and dredging collaterals, clearing heat and removing toxin, resolving phlegm and removing blood stasis, and relaxing sinew and activating collaterals. In recent years, TCM has made remarkable progress in the intervention of RA by regulating the nuclear transcription factor-κB (NF-κB) signaling network. They include Toll-like receptor 4 (TLR4), phosphoinositol 3 kinase (PI3K)/protein kinase B (Akt), mitogen-activated protein kinase (MAPK), Nod-like receptor protein 3 (NLRP3), nuclear factor E2 associated factor 2 (Nrf2), Janus kinase 2 (JAK2)/signaling and transcriptional activator 3 (STAT3), and Toll-like receptor 2 (TLR2). The regulatory mechanism of NF-κB signaling network is complex: TLR4 is the upstream receptor of NF-κB, PI3K/Akt and MAPK pathways can not only regulate the activity of NF-κB, but also serve as its downstream effect pathway, Nrf2 and NF-κB often have antagonistic effects in the regulation of inflammatory response. Therefore, the research progress of regulating NF-κB signaling network by traditional Chinese medicine in the intervention of RA was summarized to provide a reference for the treatment of RA disease and the development of new drugs.
2.Clinical value of abdominal adipose volume in predicting early tumor recurrence after resec-tion of hepatocellular carcinoma
Guojiao ZUO ; Mi PEI ; Zongqian WU ; Fengxi CHEN ; Jie CHENG ; Yiman LI ; Chen LIU ; Xingtian WANG ; Xuejuan KONG ; Lin CHEN ; Xiaoqin YIN ; Hongyun RAO ; Wei CHEN ; Ping CAI ; Xiaoming LI
Chinese Journal of Digestive Surgery 2024;23(1):140-146
Objective:To investigate the clinical value of abdominal adipose volume in predicting early tumor recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 132 HCC patients with tumor diameter ≤5 cm who were admitted to The First Affiliated Hospital of Army Medical University from December 2017 to October 2019 were collected. There were 110 males and 22 females, aged (51±4)years. All patients underwent resection of HCC. Preoperative computer tomography scanning was performed and the visceral and subcutaneous fats of patients were quantified using the Mimics Research 21.0 software. Based on time to postoperative tumor recurrence patients were divided to two categories: early recurrence and non-early recurrence. Observation indicators: (1) consistency analy-sis; (2) analysis of factors influencing early tumor recurrence after resection of HCC and construction of prediction model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribu-tion were represented as M( Q1,Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Consistency analysis was conducted using the intragroup correlation coefficient (ICC) test. Multivariate analysis was performed using the binary Logistic regression model forward method. Independent risk factors influencing early tumor recurrence after resection of HCC were screened. The area under curve (AUC) of receiver operating characteristic (ROC) curve was applied to select the optimal cut-off value to classify high and low risks of recurrence. The Kaplan-Meier method was used to draw survival curve and calculate survival time. The Log-Rank test was used for survival analysis. Results:(1) Consistency analysis. The consistency ICC of abdominal fat parameters of visceral fat volume (VFV), subcutaneous fat volume, visceral fat area, and subcutaneous fat area measured by 2 radiologists were 0.84, 1.00, 0.86, and 0.94, respectively. (2) Analysis of factors influencing early tumor recurr-ence after resection of HCC and construction of prediction model. All 132 patients were followed up after surgery for 662(range, 292-1 111)days. During the follow-up, there were 52 patients with non-early recurrence and 80 patients with early recurrence. Results of multivariate analysis showed that VFV was an independent factor influencing early tumor recurrence after resection of HCC ( odds ratio=4.07, 95% confidence interval as 2.27-7.27, P<0.05). The AUC of ROC curve based on VFV was 0.78 (95% confidence interval as 0.70-0.85), and the sensitivity and specificity were 72.2 % and 77.4 %, respectively. The optimal cut-off value of VFV was 1.255 dm 3, and all 132 patients were divided into the high-risk early postoperative recurrence group of 69 cases with VFV >1.255 dm 3, and the low-risk early postoperative recurrence group of 63 cases with VFV ≤1.255 dm 3. The disease-free survival time of the high-risk early postoperative recurrence group and the low-risk early post-operative recurrence group were 414(193,702)days and 1 047(620,1 219)days, showing a significant difference between them ( χ2=31.17, P<0.05). Conclusions:VFV is an independent factor influen-cing early tumor recurrence of HCC after resection. As a quantitative indicator of abdominal fat, it can predict the prognosis of HCC patients.
3.Characteristics of Oral Breath Odor Map of Chronic Atrophic Gastritis Patients with Dampness-Heat Syndrome: A Cross-Sectional Study
Xuejuan LIN ; Yanyu HUANG ; Long ZHU ; Donglin CAO ; Shanshan DING ; Xinghui LI ; Yingying HU ; Meng LAN ; Weirong HUANG
Journal of Traditional Chinese Medicine 2024;65(16):1687-1694
ObjectiveTo explore the recognition of oral breath odor map of chronic atrophic gastritis (CAG) patients with dampness-heat syndrome by electronic nose technique. MethodsPatients with chronic gastritis were recruited, including 60 cases in CAG group of dampness-heat syndrome, 50 cases in CAG group of non-dampness-heat syndrome, 60 cases in chronic non-atrophic gastritis (CNAG) group of dampness-heat syndrome, 50 cases in CNAG group of non-dampness-heat syndrome, and 30 cases of healthy volunteers were selected to set up the health control group. Ten cases in the CAG dampness-heat group and 50 cases in the CAG non-dampness-heat group were selected to form the CAG group, and 10 cases in CNAG dampness-heat group and 50 cases in CNAG non-dampness-heat group were selected to form the CNAG group. In addition to the health control group, the remaining patients were tested for Helicobacter pylori (Hp); the electronic nose (GISXM-MQWA01) was used to collect the oral breath odor of all the participants to draw the mapping, and amplitudes and slopes of each curve (including curves A, B, C, D, E, F, G, H, I, J) of the oral odor mapping of health control group, CAG group, CNAG group, CAG dampness-heat group, CAG non-dampness-heat group, and CNAG dampness-heat group was compared. The modified transformer model was used to classify the odor mapping characteristics, and the confusion matrix method was used to evaluate the classification model, with metrics including accuracy and area under ROC curve (AUC). ResultsThe Hp positivity rate in CAG dampness-heat group was 80.00% (48/60), CAG non-dampness-heat group was 62.00% (31/50), CNAG dampness-heat group was 46.67% (28/60), and CNAG non-dampness-heat group was 42.00% (21/50); the difference in Hp positivity rate between CAG dampness-heat group and CAG non-dampness-heat group was statistically significant (P<0.05). The amplitudes of response curves A, B, C, D, F, G, and I, and slopes of A and F in the odor mapping of the CAG group were lower than those in health control group, while the amplitude and slope of curve E were higher than those in the health control group and CNAG group (P<0.05 or P<0.01); The amplitude of the response curves A, B, C, D, F, G, and I, and slopes of A, D, and F in the CNAG group were lower than those in the health control group (P<0.05 or P<0.01). The amplitude of response curve D and slope of response curve J in the odor mapping of the CAG dampness-heat group were higher than those in CNAG dampness-heat group, the amplitude of curve F was lower than that in CAG non-dampness-heat group, and the amplitude of curve H and slopes of curve A, H, and J were higher than those in CAG non-dampness-heat group (P<0.05). The recognition accuracy of CAG group and health control group reached 77.78%, AUC = 0.88; the recognition accuracy of CAG group and CNAG group was 69.44%, AUC = 0.61; the recognition accuracy of CAG dampness-heat group and CAG non-dampness-heat group reached 75.8%, AUC=0.70. ConclusionElectronic nose technology can make a more accurate identification of the oral breath odor in CAG patients with dampness-heat syndrome, with a decrease in the amplitude of the curve F and an increase in the amplitude of the curve H and in the slopes of the curves A, H, and J may as the characteristics of their odor mapping.
4.Effect of psychological intervention on postpartum depression
Hui LU ; Xuejuan TANG ; Yanxia LI ; Jinlong ZHAO
Chinese Journal of Primary Medicine and Pharmacy 2024;31(3):381-385
Objective:To investigate the effect of psychological intervention on postpartum depression.Methods:A total of 250 pregnant women who were hospitalized for delivery in the obstetrics ward of Jiaxing Maternity and Child Health Care Hospital from January 2021 to January 2022 were included in this randomized controlled study. The patients were randomly assigned to an observation group ( n = 125) and a control group ( n = 125) using a random number table. The observation group received psychological intervention, while the control group underwent routine ward rounds. Prior to and after intervention, the levels of depression [assessed by Edinburgh Postnatal Depression Scale (EPDS) score and Self-rating Depression scale (SDS) score] and anxiety [measured by Self-rating Anxiety Scale (SAS) score] were compared between the two groups. Results:Before intervention, the EPDS, SDS, and SAS scores in the observation group were (16.95 ± 4.20) points, (65.83 ± 7.52) points, and (61.12 ± 7.59) points, respectively. In the control group, these scores were (16.62 ± 4.03) points, (64.49 ± 7.98) points, and (60.88 ± 7.85) points, respectively. At 7 days post-discharge, the EPDS, SDS, and SAS scores in the observation group were (11.54 ± 2.39) points, (51.12 ± 4.62) points, and (49.71 ± 4.22) points, respectively. In the control group, these scores were (15.93 ± 3.87) points, (63.21 ± 6.95) points, and (59.65 ± 6.43) points, respectively. At 7 days post-discharge, the EPDS, SDS, and SAS scores in the observation group were significantly decreased compared with those before intervention ( t = 18.35, 27.09, 21.60, all P < 0.001). At 7 days post-discharge, the EPDS, SDS, and SAS scores in the observation group were significantly lower than those in the control group ( t = -10.79, -16.19, -14.44, all P < 0.001). There were no significant differences in EPDS, SDS, and SAS scores in the control group between before intervention and 7 days post-discharge ( t = 1.95, 1.91, 1.92, P = 0.051, 0.056, 0.055). Conclusion:Psychological intervention can effectively alleviate postpartum depression and anxiety in postpartum women and deserves clinical promotion.
5.Establishment and Evaluation of A High-Speed Fragment-Induced Penetrating Liver Injury Model Assisted by Portable Ultrasound
Zhaoming ZHONG ; Jianxin GAO ; Yi SHAN ; Xuan ZHANG ; Xuejuan WANG ; Yang ZHAO ; Chengcheng LI ; Faqin LV
Chinese Journal of Medical Imaging 2024;32(2):113-118
Purpose To establish and evaluate a high-speed fragment-induced penetrating liver injury model in pigs assisted by portable ultrasound.Materials and Methods With the aid of portable ultrasound,the lower edge of the liver at the end of expiration and the lower edge of the right chest at the end of inspiration of 10 Landrace pigs were positioned on the body surface.Then the sighting line was traced to determine the direction of projection and the sighting point.High-speed(about 627 m/s)fragments were projected through an experimental ballistic gun to induce penetrating liver injury.Blood pressure,heart rate,respiratory rate,pulse oxygen saturation and other physiological indexes were measured 15 minutes before shooting and 20 minutes after shooting.20 minutes after injury,the liver injury and the degree of injury were examined by ultrasound.After injury,the liver injury and abdominal fluid accumulation were observed by on-site portable ultrasound,and the size of liver trauma,liver injury grade,abdominal fluid accumulation location and maximum depth were recorded.The degree of liver injury was evaluated by comparison with the gross pathological results.Results Nine out of ten pigs were successfully modeled.The success rate of penetrating liver injury induced by fragments was 90%(9/10),other organ injury in abdominal cavity was 22.22%(2/9),and diaphragm penetrating injury was 22.22%(2/9),which did not occur obvious hemopneumothorax.After injury,the systolic blood pressure,diastolic blood pressure,and pulse oxygen saturation of the pigs decreased[(132.44±12.65)mmHg vs.(103.33±33.43)mmHg,(96.44±12.27)mmHg vs.(70.89±24.21)mmHg,(89.44±8.49)%vs.(76.00±13.41)%;t=2.440,2.651,4.084,all P<0.05],and the heart rate increased[(94.00±17.39)times/min vs.(139.89±37.21)times/min;t=3.534,P<0.05].Within 20 minutes after modeling,portable ultrasound images showed that the liver injury was a patchy,heterogeneous,slightly strong echo area with clear and irregular boundary,and the continuity of the local liver capsule was interrupted.The ascites appeared in the abdominal cavity with the maximum depth of(4.16±1.35)cm.The American association for the surgery of trauma(AAST)liver injury grading of gross pathology after the animals were killed showed that there were 6 cases of grade Ⅱ and 3 cases of grade Ⅲ.Along the fragment projection direction,the short diameter measured by ultrasound was positively correlated with the depth of gross pathological laceration(r=0.945,P<0.001).Compared with the gross specimen,the accuracy rate of ultrasonic AAST grading of liver injury was 88.89%(8/9).Conclusion The model of high-speed fragment-induced liver injury in pigs assisted by portable ultrasound is accurate and stable,and portable ultrasound can effectively evaluate the penetrating liver injury,which provides a basis for the treatment of liver firearm injury.
6.Effect of early liraglutide administration on cardiometabolic risk factors in T2DM patients with coronary microvascular disease
Hongxu ZHANG ; Tong CHEN ; Lifang ZHANG ; Fanqi GENG ; Zhao LI ; Xuejuan ZHANG
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(8):892-897
Objective To investigate the effect of early combined use of liraglutide on cardiometa-bolic risk factors and prognosis in patients with T2DM and CMVD.Methods A total of 124 T2DM patients with concomitant CMVD admitted in our hospital from May 2021 to June 2023 were enrolled,and divided into the liraglutide group(n=59)and the non-liraglutide group(n=65)according to taking liraglutide or not.The main observation indicators were compared between the two groups,including cardiometabolic risk factors,such as Hcy,UA,FPG,eGFR,HbA1c,hs-CRP,WC,BMI,WWI,and echocardiographic indicators,such as LAD,LVEDD,LVPWT,IVST,E/e',e',LVEF,LAVI,LVMI,and RWT.And the incidence of adverse reactions and read-mission rates were recorded during follow-up.Results After treatment,in the liraglutide group,Hcy,UA,FPG,HbA1c,hs-CRP,WC,BMI,WWI,E/e',LAVI,LVMI,RWT,IVST and LVPWT values,and anteroposterior,transverse and long diameters of left atrium were all lower than before treatment,and eGFR and e'value were increased(P<0.05,P<0.01),and no significant difference was seen in LVEF and LVEDD(P>0.05).The non-liraglutide group obtained lower HbA1c,FPG,BMI,E/e'and LAVI values,and transverse diameter of left atrium,elevated LVPWT and e'value(P<0.05,P<0.01),and no obvious changes in Hcy,UA,eGFR,hs-CRP,WC,WWI,BMI,LVEF,LVMI,RWT,LVEDD,IVST,and anteroposterior and long diameters of left atrium when compared with the indicators before treatment(P>0.05).At the end of the fol-low-up,when compared with the non-liraglutide group,the liraglutide group had more significant decreases in E/e',LAVI,LVMI and RWT values and increase in e'value(P<0.05,P<0.01),and higher total effective rates(94.92%vs 72.31%,P<0.01).What's more,the readmission rate due to adverse cardiovascular events was notably lower in the liraglutide group and the non-liraglutide group(3.39%vs 15.38%,P<0.05).Conclusion Compared with BMI,WWI may be more sensi-tive in reflecting changes in cardiometabolic risk factors in T2DM patients with CMVD;Early combined application of liraglutide has good efficacy and safety,and exerts multiple cardiovascular protective effects,including reducing cardiometabolic risk factors,improving cardiac diastolic function and renal function,inhibiting chronic inflammation and decreasing the occurrence of ad-verse cardiovascular events in the patients.
7.Impact of 177Lu-DOTATATE therapy on radiation exposure of ward healthcare staff and accompanying persons
Xuesong SU ; Jinming ZHANG ; Jianhua GENG ; Yingmao CHEN ; Gaofeng LI ; Xuejuan WANG
Chinese Journal of Radiological Health 2024;33(5):510-516
Objective To investigate air radioactivity contamination, surface contamination, ambient dose equivalent rates, and radiation doses to individuals in the treatment room during 177Lu-DOTATATE therapy. Methods A ward for 177Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital. Air and surface radioactivity samples were collected before and after therapy for four patients. Ambient dose equivalent rates were measured around the four patients following the initiation of 177Lu-DOTATATE therapy. Measurements were taken at distances of 0.1, 0.3, 0.5, and 1−4 m (with 0.5 m intervals) from the right lateral midsection of the patient’s torso. The measurement time points included 5, 15, and 30 min after initiation of administration, as well as 0−4 h (with 1 h intervals), 24 h, and 48 h post-administration. Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval. Results The results of radioactive aerosol detection for all four patients during and after the administration of 177Lu-DOTATATE were similar to those before administration. Surface contamination was not detected at the measurement locations except for patient number 2. The ambient dose equivalent rates increased with increasing injection dose during the administration. However, the ambient dose equivalent rates decreased significantly within one hour after administration. At the end of the administration, the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931 μSv/h. From the start of administration to four hours post-administration, personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64 μSv. Conclusion Air radioactivity contamination does not occur during 177Lu-DOTATATE therapy. However, measures should be taken before the commencement of therapy to address potential surface contamination. Both accompanying persons and healthcare staff receive radiation doses below the stipulated dose constraints throughout the treatment process. Therefore, it is necessary to implement appropriate measures to minimize the radiation exposure of healthcare staff.
8.Application and Thinking on Multimodal Fusion Technology of Traditional Chinese Medicine Inspection
Wendi XIAO ; Long ZHU ; Yang WANG ; Xuejuan LIN ; Candong LI
Journal of Traditional Chinese Medicine 2024;65(17):1741-1746
Multimodal fusion research in traditional Chinese medicine (TCM) inspection has greatly improved the accuracy of identification results with the help of emerging technologies in science and technology. At present, multimodal fusion technology is used in the integration of the parameters collected by the inspection instruments and the analysis of the parameters, which is represented by the development and application of the tongue inspection instrument, the face inspection instrument and the eye inspection instrument. However, the multimodal fusion research of TCM inspection has problems such as insufficient comprehensiveness and accuracy of parameter acquisition, difficulty in parameter integration for fusion analysis, and low clinical practicability of identification results. It is believed that, while keeping up with the cutting-edge science and technology, research on multimodal fusion of TCM inspection should be guided by the holism concept of TCM, and should focus on the enhancement of comprehensiveness and accuracy of multimodal parameter acquisition, standardisation of parameter fusion, and fusion of identification results, so as to gradually promote the objectivity, intelligence and modernisation of the four diagnostic methods of TCM.
9.Impact of 177Lu-DOTATATE therapy on radiation exposure of ward healthcare staff and accompanying persons
Xuesong SU ; Jinming ZHANG ; Jianhua GENG ; Yingmao CHEN ; Gaofeng LI ; Xuejuan WANG
Chinese Journal of Radiological Health 2024;33(5):510-516
Objective To investigate air radioactivity contamination, surface contamination, ambient dose equivalent rates, and radiation doses to individuals in the treatment room during 177Lu-DOTATATE therapy. Methods A ward for 177Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital. Air and surface radioactivity samples were collected before and after therapy for four patients. Ambient dose equivalent rates were measured around the four patients following the initiation of 177Lu-DOTATATE therapy. Measurements were taken at distances of 0.1, 0.3, 0.5, and 1−4 m (with 0.5 m intervals) from the right lateral midsection of the patient’s torso. The measurement time points included 5, 15, and 30 min after initiation of administration, as well as 0−4 h (with 1 h intervals), 24 h, and 48 h post-administration. Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval. Results The results of radioactive aerosol detection for all four patients during and after the administration of 177Lu-DOTATATE were similar to those before administration. Surface contamination was not detected at the measurement locations except for patient number 2. The ambient dose equivalent rates increased with increasing injection dose during the administration. However, the ambient dose equivalent rates decreased significantly within one hour after administration. At the end of the administration, the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931 μSv/h. From the start of administration to four hours post-administration, personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64 μSv. Conclusion Air radioactivity contamination does not occur during 177Lu-DOTATATE therapy. However, measures should be taken before the commencement of therapy to address potential surface contamination. Both accompanying persons and healthcare staff receive radiation doses below the stipulated dose constraints throughout the treatment process. Therefore, it is necessary to implement appropriate measures to minimize the radiation exposure of healthcare staff.
10.Curative effect of percutaneous microwave ablation therapy on hepatocellular carcinoma survival: a 15-year real-world study
Yanchun LUO ; Manlin LANG ; Wenjia CAI ; Zhiyu HAN ; Fangyi LIU ; Zhigang CHENG ; Xiaoling YU ; Jianping DOU ; Xin LI ; Shuilian TAN ; Xuejuan DONG ; Ping LIANG ; Jie YU
Chinese Journal of Hepatology 2024;32(4):332-339
Objective:To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma.Methods:2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival.Results:A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P ?0.001, especially for liver cancer 3.1~5.0 cm ( P ?0.001). Conclusion:Microwave ablation therapy is a safe and effective method for BCLC stage 0-B, with significantly enhanced technical efficacy and survival rate over time.

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