1.Research on interview outline design and quality control methods based on grounded theory for physician prescribing behavior
Liyuan TAO ; Li WANG ; Xinli XIANG ; Lu YANG ; Songleng DUAN ; Dechun JIANG
China Pharmacy 2025;36(5):524-528
OBJECTIVE To establish a interview outline design process and quality control evaluation method based on grounded theory, providing ideas for qualitative research interview outline design in medical fields. METHODS A literature review was conducted to understand the current research status; a preliminary interview outline was developed around the research content. The triangulation method, group evaluation, expert review and pre-interview were adopted to execute the interview outline and conduct quality control. The evaluation indicators and target values were formulated (an average score for the overall quality evaluation of all indicators ≥4.5, and an average score for individual indicators ≥4.00) to evaluate the effect of the interview outline. Taking the research on the mechanism of physicians’ prescribing behavior under the background of Diagnosis Related Groups (DRGs) payment as an example, the methodological contents of above interview outline were applied in practical research. RESULTS The interview outline included basic information and interview questions. The interview questions were divided into three parts:influencing factors survey, promoting and hindering factors of standardizing physician prescription behavior, and communication, with a total of 12 questions. After being reviewed by members of the research group, experts review and pre- interview, a total of 9 people participated in the quality control evaluation of the interview outline. The overall evaluation score was 4.94 (>4.50), and the average score of each indicator was greater than 4.00, indicating that the quality of the outline met the requirements for the interview and could be used for the formal interview. CONCLUSIONS The established interview outline design and quality control method based on grounded theory provides ideas for the qualitative research interview outline design in the medical field, and lays the foundation for further using grounded theory to study the influencing factors and mechanisms of physician prescription behavior under the DRG background.
2.Mechanism of imperatorin in ameliorating doxorubicin resistance of breast cancer based on transcriptomics
Yiting LI ; Wei DONG ; Xinli LIANG ; Hu WANG ; Yumei QIU ; Xiaoyun DING ; Hao ZHANG ; Huiyun BAO ; Xianxi LI ; Xilan TANG
China Pharmacy 2025;36(5):529-534
OBJECTIVE To investigate the ameliorative effect and potential mechanism of imperatorin (IMP) on doxorubicin (DOX) resistance in breast cancer. METHODS The effects of maximum non-toxic concentration (100 μg/mL) of IMP combined with different concentrations of DOX (12.5, 25, 50, 75, 100 μg/mL) on the proliferation of MCF-7/DOX cells were determined by MTT method. MCF-7/DOX cells were divided into blank control group (1‰ dimethyl sulfoxide), DOX group (50 μg/mL), IMP+DOX group (100 μg/mL IMP+50 μg/mL DOX) and IMP group (100 μg/mL). mRNA and protein expressions of multidrug resistance protein 1 (MDR1) and multidrug resistance-associated protein 1 in each group were measured. The relevant pathways and targets involved in the improvement of DOX resistance in breast cancer cells by IMP were screened and validated by using transcriptome sequencing technology, along with gene ontology (GO) enrichment analyses and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. RESULTS Compared with DOX alone, the combination of IMP and DOX reduced the half inhibitory concentration of DOX on MCF-7/DOX cells from 81.965 μg/mL to 43.170 μg/mL, the reverse fold was 1.90, and the mRNA expression of MDR1 was significantly down-regulated (P<0.05). The results of GO enrichment analyses and KEGG pathway enrichment analyses indicated that the reversal of DOX resistance in breast cancer by IMP was mainly associated with the regulation of biological processes such as detoxification, multiple biological processes, and cell killing. The main pathway involved was the p53 signaling pathway, and the key targets mainly included constitutively photomorphogenic protein 1 (COP1), cyclin E1 (CCNE1), growth arrest and DNA damage-inducible protein 45A E-mail:tangxilan1983@163.com (GADD45A) and GADD45B. The results of the verification experiments showed that compared with DOX group, there was a trend of up-regulation of COP1 mRNA, and significant down- regulation of CCNE1, GADD45A, and GADD45B mRNA expression in IMP+DOX group (P<0.05). CONCLUSIONS The effect of IMP in ameliorating DOX resistance in breast cancer is related to its regulation of COP1, CCNE1, GADD45A and GADD45B targets in the p53 signaling pathway.
3.Detoxification Strategies of Triptolide: A Review
Wenchen WANG ; Ming CHEN ; Shuangjie WU ; Zhenggen LIAO ; Wei DONG ; Xinli LIANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):278-287
Tripterygium wilfordii is a traditional Chinese medicinal herb belonging to the genus Tripterygium in the Celastraceae family, which has the effects of clearing heat and detoxifying, dispelling wind and dampness, and invigorating blood circulation to relieve pain, and is used to treat diseases such as rheumatoid arthritis, glomerulonephritis, nephrotic syndrome, lupus erythematosus, scabies, and stubborn tinea. Its chemical composition is diverse. Among them, triptolide(TP) is one of the main active and toxic components of T. wilfordii. It has significant biological activities such as anti-inflammation, anti-tumor, and immunosuppression. However, it causes serious adverse reactions such as liver and kidney function damage and reproductive system disorders. At the same time, TP has poor water solubility and low bioavailability, and the enhancement of bioavailability by increasing the dosage undoubtedly improves the exposure of the drug in non-target organs, leading to the occurrence of adverse reactions, and these largely limit the clinical application of TP. Based on this, this article extracted relevant data from the Web of Science, PubMed, and China National Knowledge Infrastructure(CNKI) databases, summarized the research on the adverse reactions of TP in recent years, and reviewed the progress of toxicity reduction research from the perspectives of structural modification, novel drug delivery systems, and compatibility. Structural modification can precisely alter the chemical structure of TP, reduce the activity of its toxic groups, and retain its biological activity while fundamentally reducing the occurrence of adverse reactions. New drug delivery systems can achieve targeted delivery of TP, increase its concentration in target organs, and reduce its exposure in non-target organs, thereby enhancing therapeutic efficacy and reducing adverse effects. In addition, the combination of TP with Chinese medicine compound, single-flavored Chinese medicine or monomer can reduce the adverse effects of TP and enhance the efficacy to different degrees, which is of clinical value. This paper systematically explains attenuation research from the above three perspectives, aiming to provide a theoretical basis for the full utilization of biological activity and drug development of TP.
4.Spherical measurement-based analysis of gradient nonlinearity in magnetic resonance imaging.
Xiaoli YANG ; Zhaolian WANG ; Qian WANG ; Yiting ZHANG ; Zixuan SONG ; Yuchang ZHANG ; Yafei QI ; Xiaopeng MA
Journal of Biomedical Engineering 2025;42(1):174-180
The gradient field, one of the core magnetic fields in magnetic resonance imaging (MRI) systems, is generated by gradient coils and plays a critical role in spatial encoding and the generation of echo signals. The uniformity or linearity of the gradient field directly impacts the quality and distortion level of MRI images. However, traditional point measurement methods lack accuracy in assessing the linearity of gradient fields, making it difficult to provide effective parameters for image distortion correction. This paper introduced a spherical measurement-based method that involved measuring the magnetic field distribution on a sphere, followed by detailed magnetic field calculations and linearity analysis. This study, applied to assess the nonlinearity of asymmetric head gradient coils, demonstrated more comprehensive and precise results compared to point measurement methods. This advancement not only strengthens the scientific basis for the design of gradient coils but also provides more reliable parameters and methods for the accurate correction of MRI image distortions.
Magnetic Resonance Imaging/instrumentation*
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Humans
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Image Processing, Computer-Assisted/methods*
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Nonlinear Dynamics
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Magnetic Fields
;
Algorithms
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Phantoms, Imaging
5.Overexpression of multimerin-2 promotes cutaneous melanoma cell invasion and migration and is associated with poor prognosis.
Jinlong PANG ; Xinli ZHAO ; Zhen ZHANG ; Haojie WANG ; Xingqi ZHOU ; Yumei YANG ; Shanshan LI ; Xiaoqiang CHANG ; Feng LI ; Xian LI
Journal of Southern Medical University 2025;45(7):1479-1489
OBJECTIVES:
To investigate the inhibitory effect of multimerin-2 (MMRN2) overexpression on growth and metastasis of cutaneous melanoma cells.
METHODS:
Clinical data of patients with cutaneous melanoma were obtained from the GEO database to compare MMRN2 expressions between normal and tumor tissues. A protein-protein interaction network was constructed using the STRING database, and the intersecting genes from GEPIA2.0 were subjected to GO and KEGG enrichment analysis. The prognostic relevance of MMRN2 expression level was assessed using Cox regression and "timeROC". The correlations of MMRN2 expression level with immune infiltration and angiogenesis-related genes were analyzed using GSCA database and the ssGSEA algorithm. Colony-forming assay, Transwell assay, and wound healing assay were used to examine the changes in proliferation and migration of cultured cutaneous melanoma cells following MMRN2 knockdown. In a mouse model bearing cutaneous melanoma xenograft, the effect of MMRN2 knockdown on vital organ pathologies, survival of the mice and GM-CSF, CXCL9, and TGF‑β1 protein expressions were analyzed.
RESULTS:
MMRN2 was significantly upregulated in metastatic cutaneous melanoma (P<0.001). Protein interaction network analysis identified 15 intersecting genes, which were enriched in endothelium development and cell-cell junctions. In patients with cutaneous melanoma, a high MMRN2 expression was correlated with a poor prognosis, an advanced T stage, a greater Breslow depth, and ulceration (P<0.05). MMRN2 expression level was strongly correlated with 24 immune cell types (P<0.001), fibroblasts, endothelial cells, and expressions of the pro-angiogenic genes (KCNJ8, SLCO2A1, NRP1, and COL3A1; P<0.001). In cultured B16F10 cells, MMRN2 knockdown significantly suppressed cell proliferation, migration and invasion and caused remo-deling of the immunosuppressive microenvironment.
CONCLUSIONS
MMRN2 overexpression drives progression of cutaneous melanoma by enhancing tumor metastasis, angiogenesis and immune evasion, highlighting its potential as a therapeutic target for melanomas.
Humans
;
Melanoma/metabolism*
;
Animals
;
Cell Movement
;
Prognosis
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Skin Neoplasms/metabolism*
;
Mice
;
Cell Proliferation
;
Neoplasm Invasiveness
;
Cell Line, Tumor
;
Protein Interaction Maps
6.Qingre Lidan Jiedu Recipe improves high copper load-induced cognitive dysfunction in rats by regulating mitophagy.
Yulan WANG ; Xiang FANG ; Zeming CHEN ; Bingkun RUAN ; Xinli HAN ; Yujie TANG ; Luyao ZHU
Journal of Southern Medical University 2025;45(11):2437-2443
OBJECTIVES:
To explore the mechanisms of Qingre Lidan Jiedu Recipe (QLJR) for improving cognitive dysfunction in rats with high copper load.
METHODS:
Seventy-five male SD rats were randomized into normal control group, model group, QLJR group, penicillamine (PCA) group, and QLJR+ PCA group. Except for those in the control group, all the rats were fed a high-copper diet for 12 weeks. The effects of the treatments on cognitive function of the rats were assessed using the Barnes maze and passive avoidance tests. Hippocampal expressions of NIX, FUNDC1 and LC3 of the rats were detected using Western blotting and immunofluorescence staining, and changes in mitochondrial morphology were observed with transmission electron microscopy.
RESULTS:
Behavioral tests showed prolonged target hole latency, shortened latency to enter the dark chamber, and increased error counts of the rats in the model group, which were significantly improved in QLJR+PCA group; the error counts were significantly lower in QLJR+PCA group than in either QLJR or PCA group. Among all the groups, the hippocampal expressions of NIX and FUNDC1 were the lowest and LC3 I/II expression the highest in the model group; NIX and FUNDC1 expressions were significantly higher and LC3 I expression was lower in QLJR+PCA group than in QLJR group and PCA group. Immunofluorescence staining revealed weakened NIX and FUNDC1 expressions and enhanced LC3 expression in the hippocampus of the rats in the model group as compared with those in the normal control and QLJR+PCA groups, but their expressions did not differ significantly between QLJR and PCA groups. The rats in the model group showed obvious structural disarray of the mitochondria, which were improved in all the treatment groups.
CONCLUSIONS
QLJR improves cognitive dysfunction in rats with high copper load possibly by regulating mitophagy.
Animals
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Male
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Rats, Sprague-Dawley
;
Rats
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Drugs, Chinese Herbal/therapeutic use*
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Copper/toxicity*
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Mitophagy/drug effects*
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Hippocampus/drug effects*
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Cognition Disorders/drug therapy*
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Cognitive Dysfunction/chemically induced*
7.Application value of antegrade splenic superior region dissection first in laparoscopic total gastrectomy of obesity gastric cancer
Danhua XU ; Jiayi GU ; Xinli MA ; Chunchao ZHU ; Ming WANG ; Enhao ZHAO ; Zizhen ZHANG ; Jiangfeng QIU ; Hui CAO
Chinese Journal of Digestive Surgery 2024;23(4):609-612
Objective:To investigate the application value of antegrade splenic superior region dissection first in laparoscopic total gastrectomy of obesity gastric cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 21 obesity patients with gastric cancer who underwent laparoscopic total gastrectomy in Renji Hospital of Shanghai Jiaotong University School of Medicine from July 2018 to October 2023 were collected. There were 16 males and 5 females, aged (58±13)years. All 21 patients underwent laparoscopic total gastrec-tomy with antegrade splenic superior region dissection first. Observation indicators: operation time, volume of intraoperative blood loss, laparotomy conversion, intraoperative splenic hemorrhage or gastric hemorrhage, lymph node dissection, time to postoperative first flatus, time to postoperative initial liquid food intake, duration of postoperative hospital stay, postoperative complication. Measure-ment data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:All 21 patients underwent laparoscopic total gastrectomy success-fully, with the operation time of (283±47)minutes, time for splenogastric ligament and vascular manage-ment of (34±12)minutes, volume of intraoperative blood loss of (143±86)mL, and no laparotomy conversion. There was no intraoperative splenic hemorrhage or gastric haemorrhage. The total number of lymph node dissected in 21 patients was 375, with the number of lymph node dissected as (21±9)per case. Time to postoperative first flatus, time to postoperative initial liquid food intake and duration of postoperative hospital stay in 21 patients were (3.1±0.7)days, (4.0±0.8)days and (10.1±3.0)days, respectively. There were 2 patients with postoperative complications, including 1 case of incision infection and 1 case of lung infection. The 2 patients with postoperative com-plications were recovered and discharged after conservative treatment. There was no death during the postoperative 30 days.Conclusion:The application of antegrade splenic superior region dissec-tion first in laparoscopic total gastrectomy is safe and feasible, which can reduce surgical difficulty.
8.Effects of multidisciplinary management combined with 60-second high-risk diabetic foot screening in patients with diabetic foot
Li LIU ; Xiaoxia FANG ; Kun ZHANG ; Xinli WANG ; Qingling SUN ; Yalin WANG ; Baoping CUI ; Jun CAO
Chinese Journal of Modern Nursing 2024;30(27):3673-3677
Objective:To explore the effect of multidisciplinary management combined with 60-second high-risk diabetic foot screening in diabetic foot.Methods:From January to December 2022, 138 patients with diabetic foot were selected from Xinxiang Central Hospital by convenience sampling. The patients were randomly divided into a control group and an observation group, with 69 cases in each group. Control group implemented routine follow-up management of diabetic foot, and observation group carried out multidisciplinary management combined with 60-second high-risk diabetic foot screening on the basis of control group, and the intervention lasted for six months. The progress of Wagner grading of diabetic foot and foot self-care were compared between the two groups.Results:After intervention, the number of Wagner grading progression patients in observation group and control group was four cases (5.80%) and 10 cases (14.49%), respectively. The number of progression patients in observation group was less than that in control group, and the difference was statistically significant (χ 2=4.161, P=0.041). The total score and dimension scores of diabetic foot self-management in the two groups after the intervention were higher than those before the intervention, but only the scores of observation group before and after the intervention were statistically significant ( P<0.05). After intervention, the total score and dimension scores of diabetic foot self-management in observation group were higher than those in control group, with a statistically significant difference ( P<0.05) . Conclusions:Multidisciplinary management combined with 60-second high-risk diabetic foot screening can effectively delay the progress of diabetic foot and improve patients' foot self-care.
9.GPR120 mediates mechanism of protective effect of NF-κB and MAPK in regula-ting LTA-induced Mac-T cells
Siqi WANG ; Peiyao ZHOU ; Quanzhou MOU ; Lin WAN ; Xinli LI ; Yang LI ; Xingli HE ; Zhaoyuan WANG ; Zi WANG ; Ziqiang GAO ; Zhihui ZHAO ; Binglei SHEN
Chinese Journal of Veterinary Science 2024;44(10):2165-2171
Lipophosphatidic acid(LTA)was used to stimulate Mac-T cells,and the expression lev-els and phosphorylation levels of key proteins of nuclear factor-κB(NF-κB)and mitogen-activated protein kinase(MAPK)signaling pathway and the expression levels of upstream key action factors TLR4 and MyD88 proteins were detected by Western blot,and EDU assay was used to detect cell proliferation levels and flow cytometry was used to detect apoptosis.The results showed that acti-vation of GPR120 significantly decreased the phosphorylation levels of LTA-induced NF-κB(P65 and IκBα)(P<0.01)and MAPK(JNK,ERK,p38)(P<0.01)in Mac-T cells;inhibition of GPR120 was able to upregulate LTA-induced NF-κB(p65 and IκBα)in Mac-T cells(P<0.01)and MAPK(JNK,ERK,p38)phosphorylation levels(P<0.01);and activation of GPR120 significantly allevia-ted LTA-induced upregulation of TLR4 and MyD88(P<0.01);inhibition of GPR120 significantly exacerbated LTA-induced upregulation of TLR4 and MyD88(P<0.05);LTA stimulation led to a trend of diminished Mac-T cell proliferation and significantly increased apoptosis,whereas activa-tion of the GPR120 gene significantly increased cell activity(P<0.01),promoted cell proliferation and significantly reduced apoptosis(P<0.05)thereby alleviating the damage to Mac-T cells by LTA;LTA stimulation led to a highly significant increase in apoptosis(P<0.01).In contrast,acti-vation of the GPR120 gene significantly reversed the increase in the apoptosis rate of Mac-T cells induced by LTA(P<0.01),while inhibition of the GPR120 gene enhanced the apoptosis-promo-ting effect of LTA(P<0.05),indicating that activation of the GPR120 gene attenuated the in-crease of apoptosis rate caused by LTA-induced inflammatory Mac-T cells.The results suggest that GPR120 can regulate inflammation by mediating TLR4 and MyD88 expression to inhibit NF-κB/MAPK inflammatory pathway activation and can promote cell proliferation.
10.Factors influencing acute kidney injury following abdominal surgery and development of a predictive model in elderly patients: based on LASSO regression
Lingzi YIN ; Wanli ZHAO ; Chunsheng WANG ; Xinli NI
Chinese Journal of Anesthesiology 2024;44(11):1300-1306
Objective:To identify the factors influencing acute kidney injury (AKI) following abdominal surgery in elderly patients and develop a predictive model based on the LASSO regression.Methods:The medical records of American Society of Anesthesiologists (ASA) Physical Status classificationⅠ-Ⅳ patients, aged ≥60 yr, with operation time ≥ 2 h, undergoing elective abdominal surgery under anesthesia in the General Hospital of Ningxia Medical University from May 2021 to May 2023, were retrospectively collected. AKI was diagnosed based on the Kidney Disease: Improving Global Outcomes organization guidelines. The patients were divided into 2 groups based on whether AKI occurred within 7 days after surgery: AKI group and non-AKI group. The least absolute shrinkage and selection operator algorithm was performed to reduce the dimension of unbalanced factors between AKI group and non-AKI group and the known risk factors for AKI. A nomogram prediction model was developed by integrating the optimized features derived from the LASSO regression model into multivariate logistic regression analysis. Internal validation was performed using the Bootstrap method, and the predictive ability and accuracy of the prediction model were assessed through the calibration curve, area under the receiver operating characteristic curve, Brier index and decision curve analysis.Results:Five hundred and ninety patients were finally included in this study, with 62 cases (10.5%) suffered postoperative AKI. The results of multivariate logistic regression analysis showed that increased age ( OR=1.06, 95% confidence interval [ CI] 1.01-1.11, P=0.048), higher ASA classification ( OR=2.32, 95% CI 1.21-4.45, P=0.011), preoperative coronary heart disease ( OR=1.89, 95% CI 1.01-3.61, P=0.049), and longer surgical duration ( OR=1.01, 95% CI 1.01-1.02, P=0.004) were risk factors for AKI after abdominal surgery, and the intraoperative use of dexmedetomidine ( OR=0.22, 95% CI 0.08-0.59, P=0.003) and increased postoperative albumin concentrations ( OR=0.91, 95% CI 0.85-0.98, P=0.017) were protective factors for postoperative AKI in elderly patients ( P<0.05). A risk prediction model was constructed based on the 9 identified factors of age, ASA classification, Charlson Comorbidity Index, preoperative coronary heart disease, preoperative hemoglobin concentration, preoperative estimated glomerular filtration rate, surgical duration, intraoperative use of dexmedetomidine and postoperative albumin concentration. A nomogram was plotted to visualize the model and verify it, showing that the Brier score of the model was 0.079, with a discrimination of 0.844, sensitivity of 84.4%, and specificity of 70.2%. Two hundred bootstrap resamples were used for internal validation, yielding a receiver operating characteristic curve of 0.821 with a 95% confidence interval of 0.79 to 0.90. The clinical decision curve indicated significant net benefits when the threshold probability of the model was between 0.03 and 0.45. Conclusions:Increased age, higher ASA classification, preoperative coronary heart disease, and longer surgical duration are risk factors, and the intraoperative use of dexmedetomidine and increased postoperative albumin concentrations are protective factors for postoperative AKI in elderly patients. The AKI prediction model following abdominal surgery developed based on age, ASA classification, Charlson Comorbidity Index, preoperative coronary heart disease, preoperative hemoglobin concentration, preoperative estimated glomerular filtration rate, surgical duration, intraoperative use of dexmedetomidine and postoperative albumin concentration has good predictive value in elderly patients.

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