1.The distribution pattern of traditional Chinese medicine syndromes and influencing factors for primary liver cancer: An analysis of 415 cases
Zhiyao SHI ; Xiaofei FAN ; Yu GAO ; Shaojian REN ; Shiyu WU ; Xixing WANG
Journal of Clinical Hepatology 2025;41(1):84-91
ObjectiveTo investigate the influencing factors for traditional Chinese medicine (TCM) syndromes of primary liver cancer, and to provide a theoretical basis for the TCM syndrome differentiation and standardized treatment of liver cancer. MethodsTCM syndrome differentiation was performed for 415 patients who were admitted to Shanxi Institute of Traditional Chinese Medicine and were diagnosed with primary liver cancer based on pathological or clinical examinations from January 2019 to December 2023. The chi-square test was used for comparison of categorical data between groups, and the unordered polytomous logistic regression model was used to investigate the influencing factors for TCM syndromes of liver cancer. ResultsThe common initial symptoms of the 415 patients with primary liver cancer included pain in the liver area (31.81%), abdominal distension (25.30%), abdominal pain (15.18%), and weakness (13.98%), and the main clinical symptoms included poor appetite (70.84%), fatigue (69.16%), pain in the liver area (67.47%), poor sleep (59.04%), abdominal distension (53.01%), and constipation (52.53%). There were significant differences in TCM syndromes between patients with different sexes, courses of the disease, clinical stages, Child-Pugh classes, presence or absence of intrahepatic and extrahepatic metastasis, and presence or absence of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (all P<0.05). The logistic regression analysis showed that male sex was a risk factor for damp-heat accumulation (odds ratio [OR]=2.036, P=0.048) and the syndrome of spleen-kidney Yang deficiency (OR=5.240, P<0.001); a course of disease of<1 year was a risk factor for damp-heat accumulation (OR=2.837, P=0.004) and syndrome of Qi stagnation and blood stasis (OR=2.317, P=0.021), but it was a protective factor against syndrome of spleen-kidney Yang deficiency (OR=0.385, P=0.005); Child-Pugh class A/B was a protective factor against liver-kidney Yin deficiency (OR=0.079, P<0.001); intrahepatic metastasis was a risk factor for liver-kidney Yin deficiency (OR=5.117, P=0.003) and syndrome of spleen-kidney Yang deficiency (OR=3.303, P=0.010); TACE was a protective factor against liver-kidney Yin deficiency (OR=0.171, P<0.001) and syndrome of spleen-kidney Yang deficiency (OR=0.138, P<0.001); radiofrequency ablation was a risk factor for damp-heat accumulation (OR=4.408, P<0.001) and liver-kidney Yin deficiency (OR=32.036, P<0.001). ConclusionSex, course of disease, Child-Pugh class, intrahepatic metastasis, TACE, and radiofrequency ablation are the main influencing factors for TCM syndromes of liver cancer.
2.Advances in research on fine motion control of prosthesis fingers with brain-computer interface
Di GAN ; Hui HUANG ; Chengzhi LI ; Shiyu ZHANG ; Shiyuan WANG ; Tao WANG
Chinese Journal of Clinical Medicine 2025;32(1):114-119
The deficiency of fingers due to various reasons leads to a certain degree of loss of full or part hand functions. Physical and mental health of patients are seriously affected, and patients have varying degrees of reduced quality of life. Prosthesis fingers play an important role in completing the body shape and enhancing patients’ self-confidence and self-esteem. However, how to make prosthesis fingers perform coordinated movements and restore complete functions is a crucial problem that urgently needs to be solved. This paper reviews the methods of brain-computer interface controlled fine finger movements and elaborates on the origin, current situation, and advancements of the development of this technology, laying a foundation for subsequent research, with the expectation of helping patients solve the problems arising from the insufficiency or absence of finger functions.
3.Distribution pattern of traditional Chinese medicine syndromes and analysis of influencing factors in pancreatic cancer
Zhiyao SHI ; Shiyu WU ; Shaojian REN ; Yichan LIU ; Yijie YIN ; Yu GAO ; Xixing WANG
Journal of Clinical Hepatology 2025;41(3):528-535
ObjectiveTo investigate the influencing factors for traditional Chinese medicine (TCM) syndromes in pancreatic cancer by analyzing 608 cases, and to provide a theoretical reference for TCM syndrome differentiation and standardized treatment of pancreatic cancer. MethodsA total of 608 patients with a pathological or clinical diagnosis of pancreatic cancer who were admitted to Shanxi Institute of Traditional Chinese Medicine, The Affiliated Hospital of Shanxi University of Chinese Medicine, and Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to December 2023 were enrolled, and TCM syndrome differentiation was performed. The chi-square test was used for comparison of categorical data between groups. The clinical data with statistical significance between groups were included in the regression analysis, and the unordered polytomous logistic regression model was used to investigate the influencing factors for the TCM syndrome of pancreatic cancer. ResultsFor the 608 patients with pancreatic cancer, common initial symptoms included abdominal pain (32.40%), abdominal distension (23.85%), fatigue (16.12%), and emaciation (10.03%), and the main clinical symptoms included poor appetite (75.97%), abdominal pain (67.27%), fatigue (61.84%), abdominal distension (57.40%), and emaciation (53.62%). There were significant differences between the patients with different TCM syndromes of pancreatic cancer in sex (χ2=62.823, P<0.001), disease duration (χ2=14.868, P=0.011), clinical stage (χ2=21.006, P<0.001), lymph node metastasis (χ2=2.205, P=0.032), surgery (χ2=38.008, P<0.001), chemotherapy (χ2=21.384, P<0.001), radiotherapy (χ2=17.510, P=0.004), and immunotherapy (χ2=18.573, P=0.002). The logistic regression analysis showed that male sex was a protective factor against Qi and blood deficiency syndrome (odds ratio [OR]=0.081, 95% confidence interval [CI]: 0.031 — 0.213, P<0.001), Qi stagnation and blood stasis syndrome (OR=0.100, 95%CI: 0.041 — 0.247, P<0.001), and syndrome of Yin deficiency with internal heat (OR=0.158, 95%CI: 0.057 — 0.444, P<0.001), while it was a risk factor for the syndrome of damp-heat accumulation (OR=2.378, 95%CI: 1.074 — 5.266, P=0.033); the course of the disease of<1 year was a protective factor against Qi and blood deficiency syndrome (OR=0.167, 95%CI: 0.073 — 0.383, P<0.001), syndrome of spleen-kidney Yang deficiency (OR=0.183, 95%CI: 0.089 — 0.378, P<0.001), and syndrome of Yin deficiency and internal heat (OR=0.164, 95%CI: 0.070 — 0.385, P<0.001); clinical stage Ⅰ/Ⅱ/Ⅲ was a risk factor for damp-heat accumulation (OR=2.793, 95%CI: 1.259 — 6.196, P=0.012) and Qi stagnation and blood stasis syndrome (OR=7.863, 95%CI: 2.808 — 22.020, P<0.001); lymph node metastasis was a risk factor for Qi and blood deficiency syndrome (OR=4.005, 95%CI: 1.477 — 10.861, P=0.006); surgical treatment was a risk factor for Qi and blood deficiency syndrome (OR=4.151, 95%CI: 1.916 — 8.995, P<0.001), syndrome of spleen-kidney yang deficiency (OR=5.352, 95%CI: 2.436 — 11.759, P<0.001), Qi stagnation and blood stasis syndrome (OR=2.334, 95%CI: 1.071 — 5.088, P=0.033), and syndrome of Yin deficiency and internal heat (OR=4.167, 95%CI: 1.789 — 9.707, P<0.001); chemotherapy was a protective factor against damp-heat accumulation (OR=0.188, 95%CI: 0.082 — 0.428, P<0.001); radiotherapy was a risk factor for damp-heat accumulation (OR=2.571, 95%CI: 1.151 — 5.746, P=0.021) and syndrome of Yin deficiency with internal heat (OR=8.384, 95%CI: 3.348 — 20.997, P<0.001); immunotherapy was a risk factor for Qi and blood deficiency syndrome (OR=2.114, 95%CI: 1.021 — 4.379, P=0.044). ConclusionSex, course of the disease, clinical stage, presence or absence of lymph node metastasis, surgery, chemotherapy, radiotherapy, and immunotherapy are the main influencing factors for the TCM syndrome of pancreatic cancer.
4.Revision and enlightenment of the 2024 version of the Declaration of Helsinki
Shiyu LIU ; Jingru MA ; Mingxu WANG
Chinese Medical Ethics 2025;38(4):412-419
In October 2024, the 75th World Medical Association General Assembly adopted the tenth revised version of the Declaration of Helsinki. Using textual analysis, this paper systematically compared the changes between the 2024 version and the 2013 version of the Declaration of Helsinki. This study found that, while maintaining the original framework, the new version incorporated the common achievements of the values and civilizational development of human society in recent years, mainly presenting changes in three aspects. First, the core terms were updated, and new concepts such as vulnerability, structural inequality, and environmental sustainability were introduced to further emphasize human dignity, rights and interests, and autonomy in terms of values. Second, the contents of the provisions were refined, especially focusing on the vulnerability of research subjects, free and full informed consent, ethical principles in public health emergencies, and the responsibilities of the ethics committee, as well as the standardization of implementation continued to be improved in the research process. Third, mandatory expressions were strengthened, and the justice of value pursuit was further reinforced in terms of research responsibilities. The revised contents reflected the “human-oriented” fundamental principle in medical research ethics, indicating the direction for future ethical development in medical research. In the future, China should strengthen the construction of ethics committees, actively build a protection system for research participants, and continuously promote international cooperation in medical ethics, to contribute Chinese wisdom to global medical research.
5.Setup Error and Its Influencing Factors in Radiotherapy for Spinal Metastasis
Wenhua QIN ; Xin FENG ; Zengzhou WANG ; Shangnan CHU ; Hong WANG ; Shiyu WU ; Cheng CHEN ; Fukui HUAN ; Bin LIANG ; Tao ZHANG
Cancer Research on Prevention and Treatment 2025;52(5):400-404
Objective To investigate the setup error in patients with spinal bone metastasis who underwent radiotherapy under the guidance of kilovoltage cone-beam CT (KV-CBCT). Methods A total of 118 patients with spinal metastasis who underwent radiotherapy, including 17 cases of cervical spine, 62 cases of thoracic spine, and 39 cases of lumbar spine, were collected. KV-CBCT scans were performed using the linear accelerators from Elekta and Varian’s EDGE system. CBCT images were registered with reference CT images in the bone window mode. A total of 973 data were collected, and 3D linear errors were recorded. Results The patients with spinal bone metastasis were grouped by site, height, weight, and BMI. The P value of the patients grouped only by site was P<0.05, which was statistically significant. Conclusion When grouped by site in the 3D direction, the positioning effect of cervical spine is better than that of thoracic and lumbar spine. The positioning effect of the thoracic spine is better in the head and foot direction but worse in the left and right direction compared with that of the lumbar spine. Instead of extending or narrowing the margin according to the BMI of patients with spinal metastasis, the margin must be changed according to the site of spinal bone metastasis.
6.Application of blood conservation measures with different red blood cell transfusion volumes in obstetrics and their impact on postpartum outcomes
Huimin DENG ; Fengcheng XU ; Meiting LI ; Lan HU ; Xiao WANG ; Shiyu WANG ; Xiaofei YUAN ; Jun ZHENG ; Zehua DONG ; Yuanshan LU ; Shaoheng CHEN
Chinese Journal of Blood Transfusion 2025;38(5):691-698
Objective: To evaluate the application of blood conservation measures in obstetric patients with different red blood cell transfusion volumes and to assess the impact of different transfusion volumes on postpartum outcomes. Methods: A retrospective investigation was conducted on 448 obstetric patients who received blood transfusions at the Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2016 to December 2022. Patients were divided into four groups (1-2 units group, 3-4 units group, 5-6 units group, and >6 units group) based on the volumes of red blood cells (RBCs) transfused during and within 7 days after delivery. The maternal physiological indicators, pre- and postpartum laboratory test indicators, obstetric complications, application of blood conservation measures, use of blood products, and postpartum outcomes were reviewed. The clinical characteristics, application of blood conservation measures, and their impact on postpartum outcomes were compared among different transfusion groups. Results: There were statistically significant differences in the multivariate logistic analysis of history of previous cesarean section (OR=1.781), eclampsia/pre-eclampsia/(OR=1.972) and postpartum blood loss>1 000 mL(OR=1.699)(P<0.05) among different transfusion groups. In terms of blood conservation measures, the more RBCs transfused, the higher the rate of mothers receiving blood conservation measures such as balloon occlusion, arterial ligation, autologous blood transfusion with a cell saver, and hysterectomy. With the increase in the volume of RBCs transfusion, the demand for fresh frozen plasma(FFP), cryoprecipitate, and platelet transfusions also increased. The hospitalization days for the four groups of parturients were 6.0 (4.0-9.0), 7.5 (5.0-14.8), 7.0 (4.5-13.0) and 11.0 (9.0-20.5), respectively (P<0.05) and the rates of ICU transfer were 2.0% (5/250), 9.4% (12/128),18.2% (6/33) and 51.4% (19/37), respectively (P<0.05). Both increased significantly with the increase in the volume of RBCs transfusion, and the differences between groups were statistically significant. Conclusion: Parturients who received higher volume of RBCs had multiple risks factors for bleeding before childbirth, had higher postpartum blood loss, and had a higher rate of application of various blood conservation measures. In addition, an increase in the volume of RBCs transfusion may have adverse effects on postpartum recovery.
7.LC-MS-based phosphoproteomic profiling of the acute phase of myocardial infarction in mice
Yang GAO ; Jian ZHANG ; Shiyu HU ; Jingpu WANG ; Yiwen WANG ; Jiatian CAO ; Feng ZHANG
Chinese Journal of Clinical Medicine 2025;32(3):392-402
Objective To investigate dynamic changes in myocardial protein phosphorylation during the acute phase of myocardial infarction (MI) in mice. Methods Six 8-week-old C57BL/6J mice were randomly assigned to MI model (n=3) or sham-operated control (n=3) groups. Cardiac tissues were harvested 72 hours post-intervention for proteomic analysis. Phosphorylation modifications were systematically characterized using liquid chromatography-mass spectrometry (LC-MS). Bioinformatics analyses included differential phosphorylation screening, functional enrichment, hierarchical clustering, and protein-protein interaction network. Results LC-MS identified 1 921 differentially phosphorylated sites (20 tyrosine and 1 901 serine/threonine sites) across 851 proteins. Compared with controls, MI hearts exhibited significant phosphorylation upregulation at 1 545 sites and downregulation at 376 sites (P<0.05). Conclusions This study delineates MI-associated phosphorylation dynamics, providing mechanistic insights and potential therapeutic targets for acute MI intervention.
8.Huangqi Baijiang Yiren Decoction Restores Intestinal Mucosa Barrier in Rat Model of Ulcerative Colitis via miR-21/SOCS1/JAK1/STAT6 Signaling Pathway
Ruiping LI ; Shiyu WANG ; Xiunan WEI ; Ermei WU ; Dajuan SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):96-104
ObjectiveTo explore the potential mechanism by which Huangqi Baijiang Yiren decoction (HBY) repairs the intestinal mucosal injury in the rat model of ulcerative colitis (UC) via the miR-21/suppressor of cytokine signaling 1 (SOCS1)/Janus kinase 1 (JAK1)/signal transducer and activator of transcription 6 (STAT6) signaling pathway. MethodsSixty SPF-grade male SD rats were randomly assigned into six groups: blank, model, low-dose (3.68 g·kg-1) HBY, medium-dose (7.35 g·kg-1) HBY, high-dose (14.5 g·kg-1) HBY, and mesalazine (0.035 g·kg-1), with 10 rats in each group. The rat model of UC was established in other groups except the blank group by 3% dextran sulfate sodium solution. The rats were administrated with corresponding drugs once a day for 7 consecutive days since the 3th day after modeling. The histopathological changes of the colon were observed by hematoxylin-eosin staining, and the Robarts histopathology index (RHI) was scored. Enzyme-linked immunosorbent assay was employed to measure the levels of pro-inflammatory cytokines [interleukin (IL)-6, IL-18, IL-1β, and tumor necrosis factor-α (TNF-α)] in the serum. Real-time PCR was employed to determine the mRNA levels of miR-21, SOCS1, JAK1, and STAT6 in the colon tissue. Western blot was employed to determine the protein levels of SOCS1, JAK1, phosphorylated (p)-JAK1, STAT6, p-STAT6, Occludin, and Claudin-1 in the colon tissue. ResultsCompared with the blank group, the model group showed an increase in disease activity index (DAI) (P<0.01), shortening of colon length (P<0.01), severe histopathological damage in the colon tissue, and an increase in RHI, rises in serum levels of IL-6, IL-1β, IL-18, and TNF-α (P<0.01), up-regulation in mRNA levels of miR-21, JAK1, and STAT6 and protein levels of p-JAK1 and p-STAT6 (P<0.01), and down-regulation in mRNA and protein levels of SOCS1 and protein levels of Occludin and Claudin-1 (P<0.01). The treatment with HBY reduced the DAI (P<0.01), alleviated colon shortening and histopathological damage in the colon tissue, decreased the RHI (P<0.01), lowered the serum levels of IL-6, IL-1β, IL-18, and TNF-α (P<0.01), down-regulated the mRNA levels of miR-21, JAK1, and STAT6 (P<0.05, P<0.01), up-regulated the mRNA level of SOCS1 (P<0.05), up-regulated the protein levels of SOCS1, Occludin, and Claudin-1 (P<0.05, P<0.01), and down-regulated the protein levels of p-JAK1 and p-STAT6 (P<0.05, P<0.01). ConclusionHBY may modulate the miR-21/SOCS1/JAK1/STAT6 signaling pathway to suppress inflammatory responses and restore the intestinal mucosal barrier in UC rats.
9.Chaihu and Longgu Mulitang Regulates ERK/CREB Signaling Pathway to Ameliorate Hippocampal Nerve Injury in Mouse Model of Depression
Shiyu JI ; Li WANG ; Zhuo ZHANG ; Yingzhe GAO ; Zefeng ZHANG ; Siyu CHEN ; Guangjing XIE ; Ping WANG ; Panpan HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):1-9
ObjectiveTo investigate the effects of Chaihu and Longgu Mulitang (CLMT) on hippocampal neural damage in the mouse model of depression via the extracellular signal-regulated protein kinase (ERK)/cAMP-response element-binding protein (CREB) signaling pathway. MethodsSeventy-eight male C57BL/6 mice were randomly allocated into normal control, model, low/medium/high-dose (2.89, 5.78, and 11.56 g·kg-1, respectively) CLMT, and paroxetine (10 mg·kg-1) groups. A depression model was established by chronic unpredictable mild stress (CUMS) combined with social isolation. Behavioral tests were carried out to evaluate depressive-like behaviors. Hematoxylin-eosin staining and Nissl staining were performed to assess hippocampal morphology and neuronal damage. Immunofluorescence was employed to detect glial fibrillary acidic protein (GFAP) and ionized calcium-binding adapter molecule 1 (Iba1). Real-time PCR was employed to measure the mRNA levels of ERK and CREB. Western blot was employed to determine the expression of ERK/CREB pathway proteins and brain-derived neurotrophic factor (BDNF) in the hippocampal tissue. Molecular Operating Environment (MOE) software was used for molecular docking to evaluate the interactions between CLMT components and target proteins. ResultsCompared with the normal control group, the model group showed decreased sucrose preference (P0.01), increased tail-suspension immobility time (P0.01), decreased activity in the central region of the open field test (P0.01), and decreased activity in the middle and open-arm region of the elevated plus maze test (P0.01). The hippocampal area in the model group showed wrinkled cells and a reduction in the number of cells, neurons with reduced sizes and Nissl bodies, enhanced fluorescence intensity of GFAP and Iba1 (P0.01), and down-regulated expression of phosphorylated (p)-ERK, p-CREB, and BDNF (P0.05, P0.01) and mRNA levels of ERK and CREB (P0.01). Compared with the model group, the CLMT group showed increased body weight (P0.05, P0.01), restored cell morphology, with only a small number of ruptured cells, normal neuronal structure and morphology with obvious nuclei and abundant Nissl bodies, weakened fluorescence intensity of GFAP and Iba1 (P0.05, P0.01), up-regulated mRNA levels of ERK and CREB (P0.05, P0.01) and protein levels of phosphorylated (p)-ERK, p-CREB, and BDNF in the hippocampal tissue (P0.05, P0.01). The results of molecular docking indicated that nine active ingredients in CLMT had good binding affinity with ERK and CREB. ConclusionCLMT may ameliorate the hippocampal nerve injury in the mouse model of depression by regulating the ERK/CREB pathway.
10.Study on the Mechanism of Hepatotoxicity Induced by Rhubarb Based on Network Pharmacology and Experimental Verification
Hongxin WANG ; Shiyu ZHANG ; Yang JIN ; Taotao CAO ; Qin QIN ; Wen LIU
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(1):167-178
Objective The potential mechanism of hepatotoxicity induced by rhubarb was preliminarily explored by network pharmacology and verified by cell experiments.Methods Based on network pharmacology,component collection and target prediction are carried out through multiple databases.PPI network construction,GO enrichment analysis and KEGG pathway analysis were combined with software to systematically predict the mechanism of hepatotoxicity induced by rhubarb.The pathway information predicted by network pharmacology was verified by primary hepatocyte experiments and Western blot experiments.Results The results of network pharmacology showed that RH was the main component of hepatotoxicity induced by rhubarb.Seventeen core targets of hepatotoxicity induced by rhubarb were obtained.KEGG results suggested that DNA damage and apoptosis were one of the key mechanisms of hepatotoxicity induced by rhubarb.The results of primary hepatocytes and Western blot showed that RH could inhibit the viability of primary hepatocytes in a time-dose dependent manner.ABT and SFP can significantly reduce the toxicity of RH on primary liver cells in mice,and RFP can increase the toxicity of RH to mouse primary liver cells.Upregulation of γ-H2AX and PARP-1 protein in primary liver cells of mice after treatment with different concentrations of RH.Conclusion RH in rhubarb can significantly inhibit the viability of mouse primary hepatocytes,and its toxicity to mouse primary hepatocytes is mainly caused by the metabolic activation of RH by CYP 2C9.RH can activate PARP-1 protein,phosphorylate H2AX,induce DNA damage and apoptosis in mouse primary hepatocytes.

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