1.Association between intestinal barrier disruption in liver failure and the cGAS-STING signaling pathway
Qiao TANG ; Chao ZHOU ; Ning ZHANG ; Man GONG
Journal of Clinical Hepatology 2025;41(3):574-579
Liver failure is a common severe syndrome of liver diseases with high mortality. The function and structural integrity of the intestinal barrier as an entity are closely associated with the development and progression of liver failure. The cGAS-STING signaling pathway can participate in innate immune response by recognizing DNA produced by pathogen invasion and host cell damage and inducing the production of type I interferon. Numerous studies have shown that activation of the cGAS-STING pathway can significantly impact the cellular structure, mucosal components, and commensal bacteria of the intestinal barrier. This article reviews the interplay between the cGAS-STING signaling pathway and intestinal barrier disruption in liver failure, in order to provide novel insights for the clinical management of liver failure.
2.Practice innovation in pharmaceutical management for infusion safety in hospitalized patients
Jie CHEN ; Man YOU ; Pengfei CAO ; Wenfeng TAI ; Lu MENG ; Hong ZHANG ; Guanghong HE
China Pharmacy 2025;36(10):1238-1242
OBJECTIVE To establish a pharmaceutical management model for infusion safety in hospitalized inpatients and ensure the safety of drug use. METHODS Our hospital established the standardized management process for infusion scheme, formulated rules for compatibility contraindications in drug combinations. In the form of embedded hospital official account, the infusion scheme and medication guidance WeChat developed by pharmacists are pushed to the mobile phone of inpatients, providing electronic medication guidance services for patients, and forming a pharmaceutical management model for infusion safety of inpatients. RESULTS Our hospital provided a total of 45 291 inpatients with pharmaceutical services including the formulation of individualized infusion scheme and WeChat push infusion scheme and medication guidance as of December 2023. After the implementation of the management model, the intervention rate of pharmacists on the compatibility contraindications in drug combination of long-term medical orders for inpatients increased from 18.25% before implementation to 90.58% (P<0.01), and the satisfaction rate of inpatients increased from 87.50% to 94.50% (P<0.05). CONCLUSIONS The pharmaceutical management model for infusion safety of hospitalized patients integrates pharmaceutical services throughout the entire process of intravenous medication treatment. Pharmacists can participate in the management of infusion usage while providing qualified finished infusion products, achieving closed-loop management of pharmaceutical services, improving the hospital’s pharmaceutical service capabilities and patient satisfaction, and providing guarantees for the safety and effectiveness of patient medication.
3.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
4.Mechanisms of hepatocellular carcinoma and cirrhosis development in concurrent steatotic liver disease and chronic hepatitis B
Saisai ZHANG ; Lung-Yi MAK ; Man-Fung YUEN ; Wai-Kay SETO
Clinical and Molecular Hepatology 2025;31(Suppl):S182-S195
Chronic hepatitis B (CHB) poses a major global public health challenge and is a leading cause of cirrhosis and liver cancer. Hepatic steatosis is common in individuals with CHB compared to the non-CHB population and is particularly prevalent in hepatitis B virus (HBV)-endemic regions, affecting about one-third of CHB patients. The interaction between hepatic steatosis and CHB-related disease progression is complex and still under debate. Evidence demonstrates that co-existing steatosis may worsen liver fibrosis while paradoxically increasing the likelihood of achieving better HBV control. In particular, despite the association of steatotic liver disease (SLD) with lower HBV viral loads and higher rates of HBsAg seroclearance, the coexistence of CHB and SLD can potentially accelerate liver disease progression. Factors such as fat deposition, lipotoxicity, oxidative stress, and chronic inflammation in SLD may foster a pro-fibrotic and pro-carcinogenic environment, accelerating the disease progression. Additionally, loss of global DNA methylation, changes in the immune microenvironment, and genetic susceptibility further contribute to the development of CHB-related cirrhosis and hepatocellular carcinoma (HCC). This review examines the mechanisms driving liver disease progression and the heightened risk of cirrhosis and HCC in patients with concurrent CHB and steatotic liver disease, underscoring the importance of prioritizing antiviral therapy for CHB in addition to addressing SLD.
5.Traditional Chinese Medicine Intervention in Depression Based on Signaling Pathway Regulation: A Review
Jinjiang XU ; Li WU ; Qi ZHANG ; Yasheng DENG ; Jingjing XIE ; Haobin CHEN ; En ZHAO ; Man ZHANG ; Jianye DAI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):319-328
Depression is a common psychiatric disorder characterized by persistent low mood or mental disorders. Current treatments primarily focus on regulating neurotransmitter levels, but their effectiveness is limited. The mechanisms underlying its onset are complex, and there is no unified consensus. Abnormal signaling pathway transmission plays a crucial role in the development of depression, involving multiple pathways, including Toll-like receptor 4/nucleotide-binding oligomerization domain-like receptor protein 3 (TLR4/NLRP3), nuclear factor-κB (NF-κB), Janus kinase/signal transducer and activator of transcription (JAK/STAT), mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK), brain-derived neurotrophic factor/tyrosine kinase receptor B (BDNF/TrkB), cyclic AMP/protein kinase A/cAMP response element-binding protein (cAMP/PKA/CREB), and others. Traditional Chinese medicine(TCM) is based on a holistic approach and the principle of treatment based on the differentiation of syndromes, regulating the balance of multiple systems and organ functions from a macroscopic perspective. This approach has shown unique advantages in the treatment of depression. TCM attributes the onset of depression to dysfunction of the organ systems, involving liver Qi stagnation, heart spirit deficiency, kidney essence depletion, and spleen dysfunction. TCM compound treatments focus on soothing the liver, strengthening the spleen, calming the heart, and replenishing essence, with formulas such as Xiaoyaosan, Zishui Qinggan Yin, and Chahu Jia Guizhi Longgu Muli Tang. The active components of Chinese herbs mainly aim to tonify and regulate Qi, such as salidroside, ginsenoside Rb1, astragaloside, and muscone. External TCM treatments, primarily acupuncture, aim to open the orifices and invigorate the spirit. Acupoints such as Baihui, Shenting, and Yintang are commonly used. Additionally, massage and moxibustion therapy can intervene in depression by regulating signaling pathways. This article reviews the core role of signaling pathways in the development of depression and the mechanism of TCM regulation of signaling pathways to intervene in depression, aiming to discover new therapeutic approaches that can improve the symptoms of depressed patients.
6.Source, Structure, Biological Activity and Application of Natural Arabinogalactan: A Review
Peng ZHAO ; Man ZHANG ; Dan MU ; Wenming BAI ; Rina SU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):353-362
Natural arabinogalactan, an important polysaccharide, has a wide range of sources, a complex structure, various biological activities, and great application potential. Natural arabinogalactan is mainly rich in plants and microorganisms, and its structure varies due to different sources, including types Ⅰ, type Ⅱ, type Ⅱ-related types, and new configurations. Natural arabinogalactan has shown a variety of biological activities, such as anti-tumor, anti-oxidation, anti-coagulation, anti-aging, blood glucose-lowering, intestinal health-maintaining, anti-inflammatory, and immunomodulatory activities. In addition, natural arabinogalactan shows good biocompatibility and low toxicity, serving as a potential material in the biomedical field. Natural arabinogalactan has been designed as a carrier in the drug delivery system to effectively improve drug stability and targeting. Natural arabinogalactan is often added to skin care products to help delay skin aging and enhance skin barrier function because of their moisturizing and antioxidant properties. Additionally, natural arabinogalactan acts as a thickener, stabilizer, and emulsifier to improve the texture and taste while enhancing the nutritional value of food products. The review of latest research reports is helpful to further understand the relationship between the structure, biological activity, and functional application of natural arabinogalactan and provides an important reference for future research and development.
7.Association between unhealthy lifestyle and risk of heart disease and diabetes in the elderly in Xi'an
Ning CUI ; Jun LIU ; Rui WANG ; Nini MA ; Man ZHANG ; Aiping SUN ; Xiaomin RAN ; Aiqing PAN
Journal of Public Health and Preventive Medicine 2025;36(5):163-167
Objective To investigate the association between lifestyle and risk of heart disease and diabetes in the elderly population in Xi'an City. Methods From January 2021 to January 2024, a staged cluster sampling method was used to investigate the lifestyle and the occurrence of heart disease and diabetes in elderly population aged 60 years and above in the communities of Xi'an. Multivariate logistic regression was used to analyze the relationship between lifestyle and the risk of heart disease and diabetes. Results A total of 413 elderly people were investigated, of which 31.96% had heart disease, 27.12% had diabetes, and 10.90% had diabetes with heart disease. Multivariate logistic regression analysis revealed that age, BMI, family history, sweet food preference, smoking, and sitting and lying for a long time were risk factors for diabetes in the elderly population (P<0.05). Age, BMI, family history, history of diabetes, preference for salted products, smoking, drinking, and sitting and lying for a long time were risk factors for heart disease in the elderly population (P<0.05). Conclusion The incidence rates of heart disease and diabetes are high in the elderly population in Xi'an City. The risk of diabetes is related to unhealthy lifestyles such as sweet food preference, smoking, and sitting and lying for a long time, while heart disease is related to unhealthy lifestyles such as preference for salted products, smoking, drinking, and sitting and lying for a long time.
8.Study on the regulatory effects of Buqi tongqiao formula on intestinal flora and immune balance in IgA nephropathy rats
Jinjiang XU ; Man ZHANG ; Qiuye WU ; Xiongbin GUI
China Pharmacy 2025;36(20):2512-2518
OBJECTIVE To explore the regulatory effects of Buqi tongqiao formula on intestinal flora and immune balance in immunoglobulin A nephropathy (IgAN) rats based on the theory of “treating different diseases with the same therapy”. METHODS Male SD rats were randomly assigned to the Normal group and the modeling group. IgAN rat models were established in the modeling group by intragastric administration of bovine serum albumin, subcutaneous injection of carbon tetrachloride and castor oil mixture, and tail vein injection of lipopolysaccharide. Successfully modeled rats were then randomly divided into the model group (Model group), Buqi tongqiao formula low-dose group (BQTQ-L group), Buqi tongqiao formula high-dose group (BQTQ- H group), and positive control group (BZP group), with 15 rats in each group. BZP group received intragastric administration of benazepril hydrochloride (10 mg/kg), while BQTQ-L and BQTQ-H groups were given Buqi tongqiao formula at doses of 9.81 and 19.62 g/kg (calculated as raw herb weight), respectively. The Normal group and the Model group received an equal volume of normal saline intragastrically, once a day, for 8 consecutive weeks. The 24-hour urinary total protein (24 h UTP) contents were measured at weeks 8, 10, 12, 14 and 16 of the experiment. After the last administration, serum creatinine (Scr) and blood urea nitrogen (BUN) contents were detected. Renal histopathological changes and glomerular IgA immune complex deposition were examined. Additionally, alterations in gut microbiota composition, the proportions of peripheral T helper cell 17 (Th17) and regulatory T cell (Treg), as well as the ratio of Th17 and Treg (Th17/Treg), were analyzed across all groups. RESULTS Compared with the Model group, rats in both BQTQ-L and BQTQ-H groups showed alleviated mesangial cell hyperplasia, reduced matrix expansion, and decreased IgA immune complex deposition in the glomeruli. The 24 h UTP contents (at weeks 14 and 16 in the BQTQ-L group; at weeks 12, 14 and 16 in the BQTQ-H group), Scr and BUN contents, IgA-positive area fluorescence intensities, relative abundances of Firmicutes, Th17 cell proportions, and Th17/Treg were significantly decreased in both BQTQ-L and BQTQ-H groups (P<0.05); while the Chao1, Observed species, Shannon, and Simpson (except for BQTQ-H group) indexes, the relative abundances of Bacteroidota, and the proportions of Treg were significantly increased (P<0.05). Differential microbiota included c_Clostridia (BQTQ-L group vs. Model group) and g_Ruminococcus (BQTQ-H group vs. Model group), etc. CONCLUSIONS Buqi tongqiao formula may alleviate renal injury and exert a renal protective effect in IgAN rats by modulating intestinal flora homeostasis and Th17/Treg immune balance.
9.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
10.Mechanisms of hepatocellular carcinoma and cirrhosis development in concurrent steatotic liver disease and chronic hepatitis B
Saisai ZHANG ; Lung-Yi MAK ; Man-Fung YUEN ; Wai-Kay SETO
Clinical and Molecular Hepatology 2025;31(Suppl):S182-S195
Chronic hepatitis B (CHB) poses a major global public health challenge and is a leading cause of cirrhosis and liver cancer. Hepatic steatosis is common in individuals with CHB compared to the non-CHB population and is particularly prevalent in hepatitis B virus (HBV)-endemic regions, affecting about one-third of CHB patients. The interaction between hepatic steatosis and CHB-related disease progression is complex and still under debate. Evidence demonstrates that co-existing steatosis may worsen liver fibrosis while paradoxically increasing the likelihood of achieving better HBV control. In particular, despite the association of steatotic liver disease (SLD) with lower HBV viral loads and higher rates of HBsAg seroclearance, the coexistence of CHB and SLD can potentially accelerate liver disease progression. Factors such as fat deposition, lipotoxicity, oxidative stress, and chronic inflammation in SLD may foster a pro-fibrotic and pro-carcinogenic environment, accelerating the disease progression. Additionally, loss of global DNA methylation, changes in the immune microenvironment, and genetic susceptibility further contribute to the development of CHB-related cirrhosis and hepatocellular carcinoma (HCC). This review examines the mechanisms driving liver disease progression and the heightened risk of cirrhosis and HCC in patients with concurrent CHB and steatotic liver disease, underscoring the importance of prioritizing antiviral therapy for CHB in addition to addressing SLD.


Result Analysis
Print
Save
E-mail