1.Effect of extract of Schisandra chinensis on expression of matrix metalloproteinase in kidney tissue of diabetic rats and its protective effect on kidney tissue
Jianghui YANG ; Chengbo SUN ; Jianan GENG ; Jiujie LI ; Yao ZHU ; Xingxing CHEN ; Antian CHEN ; Xiaoyan YU
Journal of Jilin University(Medicine Edition) 2017;43(3):512-517
Objective:To investigate the effect of the extract of Schisandra chinensis on the matrix metalloproteinases(MMPs) system in kidney tissue of the diabetic rats,and to explore its protective effect on the kidney tissue from the matrix degradation perspective.Methods:STZ was used to establish rat models of diabetes mellitus.A total of 45 diabetic rats were randomly divided into model group,extract of Schisandra chinensis group and Benazepril group,and there were 15 rats in each group.Another 15 rats were selected and used as normal control group.12 weeks after administration,the routine blood and urine biochemical indexes,the histological changes,blood glucose (BG),blood urea nitrogen(BUN),serum creatinine(Scr),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),total cholesterol(T-CHO),and triglyceride(TG) levels,excretion rates of albuminuria and proteinuria of the rats in various groups were detected;the expression amounts of fibronectin (FN),type Ⅳ collagen (Col Ⅳ),and matrix metalloproteinase inhibitor metalloproteinase-2 (TIMP-2) in kidney tissue of the rats were detected by immunohistochemical method;the activity of matrix metalloproteinase-2 (MMP-2) was detected by zymography.Results:Compared with model group,the glomeruli matrix accumulation of the rats in extract of Schisandra chinensis group was significantly improved,the excretion rate of albuminuria,LDL-C level and serum MDA level were decreased(P<0.05),the activities of CAT(P<0.01)and SOD(P<0.05)in kidney tissue were increased,and the level of MDA in kidney tissue was decreased(P<0.05).The immunohistochemistry results showed that compared with model group,the expression amounts of FN,Col Ⅳ,and TIMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group were significantly decreased.The zymography results showed that compared with model group,the activity of MMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group was significantly increased(P<0.05).Conclusion:Extract of Schisandra chinensis has protective effect on the kidney tissue of the diabetic rats induced by STZ,and the mechanism may be related to the inhibition of oxidative stress and the improvement of MMP-2 activity as well as the inhibition of TIMP-2 expression which could improve the matrix degradation.
2.Exploration on the Shared Decision-making Framework in Cardiovascular Disease
Antian CHEN ; Xinqing ZHANG ; Fengxing ZHONG
Chinese Medical Ethics 2023;36(9):976-980
The burden of cardiovascular disease is heavy, the condition is complex, and the clinical decision-making methods are diverse. Taking coronary heart disease and implantable cardioverter defibrillator implantation as examples, this paper illustrated the shared decision-making framework in cardiovascular disease. Patient participation in diagnosis and treatment decision-making will enhance their sense of control and gain. Strategies to improve the quality of shared decision-making include developing effective decision-making aids, enhancing patients’ risk perception abilities, and empowering patients to enhance their decision-making abilities.
3.Exploration of the impact mechanisms of generative artificial intelligence on doctor-patient shared decision-making
Antian CHEN ; Jun LU ; Xinqing ZHANG
Chinese Medical Ethics 2024;37(9):1087-1092
As large-scale language models become increasingly mature, generative artificial intelligence (GenAI), represented by ChatGPT/GPT-4, is anticipated to be deeply embedded in clinical decision-making. However, the clinical application of GenAI also has potential issues, such as the Moravec paradox. The Ethics and Governance of Artificial Intelligence for Health: Guidance on Large Multi-Modal Models released by the World Health Organization proposed six principles that should be followed when large models are applied in the medical field. The participation of GenAI in clinical decision-making requires the joint engagement of both doctors and patients. Clinical doctors are involved in the research and development, promotion, and application of GenAI, as well as in controlling the direction of technological development. GenAI empowers patients to participate in decision-making, aligning with actual medical scenario and meeting the value selection preferences of patients. Deepen GenAI’s explainability and responsibility allocation system, empower doctor-patient shared decision-making, properly handle the challenges brought by GenAI to traditional information and understanding, and achieve maximum clinical benefits.