1.Discussion on Construction of a Multi-Agent "Cross-scale" Collective Decision-making Model for Superior Disease Entities in Sichuan-style Traditional Chinese Medicine
Qiuping CHEN ; Hang ZHOU ; Dan ZHENG ; Baixue LI ; Chenhao LIU ; Ju CHEN ; Jibin LIU ; Quansheng FENG ; JIANGYUMING ; Cen JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):1-13
At present, the systematic excavation of the clinical experience and academic thought of the Sichuan school of Chinese medicine vis-à-vis its dominant disease entities remains fragmentary, and replicable paradigms are scarce. Confronted with empirical fragmentation, data heterogeneity and decision-making subjectivity, the standardised distillation, inheritance and clinical translation of these distinctive experiences has become a critical bottleneck constraining the development of the Sichuan school. The integration of artificial-intelligence technologies in data processing, pattern recognition and intelligent decision-making has rendered deep mining of traditional Chinese medicine(TCM) clinical knowledge and patterns imperative. Constructing an intelligent modern TCM diagnostic-therapeutic-evaluative system is now the obligatory route for inheritance and innovation in Chinese medicine, and simultaneously provides a technological breakthrough for intelligent decision paradigms in the dominant diseases of the Sichuan school. Accordingly, this study adopts the regional academic school as its point of entry, focuses on the dominant diseases of the Sichuan school, and proposes an innovative pathway of "four-dimensional data-multi-modal fusion-multi-agent decision-making". Specifically, four data dimensions are defined and instantiated: (Ⅰ) knowledge from classical medical literature and historical case records. (Ⅱ) objective four-diagnosis phenotypic data. (Ⅲ) master physicians' prescribing regularities. (Ⅳ) characteristic mechanisms of renowned formulae. Leveraging multi-modal data fusion and generative artificial intelligence, the entire causal chain of Famous Physicians and Renowned Formulas is explicated to reconstruct the diagnostic-therapeutic cognitive logic of the regional school. Finally, a multi-agent collective-decision model is established and refined for the dominant diseases of the Sichuan school, capable of generating precise, individualised treatment regimens and thereby advancing an intelligent diagnostic-therapeutic paradigm that delivers more efficient and accurate clinical decision support.
2.ManNAc improves glucose and lipid metabolic disorders in high-fat diet-induced obese mice
Xiangxue KONG ; Dan LI ; Jiangwei XU ; Ju YANG ; Yingyu WANG ; Jiai YAN ; Jing SUN ; Hong CAO
Chinese Journal of Endocrinology and Metabolism 2025;41(5):401-410
Objective:To investigate the ameliorative effects of N-acetyl-D-mannosamine(ManNAc) on glucose and lipid metabolic disorders in obese mice.Methods:In vivo experiments were conducted using 21 four-week-old C57BL/6JGpt mice, randomly divided into three groups( n=7 per group): a normal control group, a high-fat diet(HFD) control grooup, and a ManNAc treatment group(400 mg·kg -1·d -1). The intervention lasted for 20 weeks. Body weight, food intake, and fasting blood glucose levels were monitored weekly. Glucose tolerance tests(GTT), insulin sensitivity tests(ITT), and respiratory metabolism monitoring were performed in the 17th, 18th, and 19th weeks, respectively. At the end of the experiment, whole-body fat distribution was assessed, and serum lipid profiles were measured. Liver and adipose tissue weights were recorded, and histological analyses including HE staining of liver, adipose and pancreatic tissues were performed. Liver transcriptome sequencing and quantitative real-time PCR(qPCR) were conducted to evaluate hepatic gene expression. In vitro, a hepatic steatosis model was established by inducing HepG2 cell with 0.4 mmol/L oleic acid, followed by treatment with 500 μg/mL ManNAc. Lipid accumulation was assessed using BODIPY staining, and the expression of lipid metabolism-related genes was quantified by qPCR. Results:ManNAc administration attenuated HFD-induced weight gain, reduced total body fat volume, and decreased liver and adipose tissue weights as well as intracellular lipid accumulation. Pancreatic islet numbers increased, while fasting blood glucose levels, glucose tolerance, and insulin sensitivity significantly improved. Serum levels of triglycerides, total cholesterol, and low-density lipoprotein levels were decreased, accompanied by enhanced energy expenditure. Additionally, hepatic expression of Cd36, Fabp3, and Scd1 was downregulated. In vitro, ManNAc significantly reduced lipid accumulation in HepG2 cells and downregulated the expression of Cd36, Fabp3, and Scd1 genes.Conclusion:ManNAc may improve glucose and lipid metabolism by modulating the PPARs-mediated fatty acid metabolic pathway, reducing lipogenesis, promoting fatty acid oxidation and energy expenditure, and enhancing insulin sensitivity, ultimately ameliorating disorders in obese mice.
3.The Effect of Serum Ferritin before Transplantation on Implanta-tion in MDS and AML Patients after Unrelated Cord Blood Trans-plantation
Dan-Dan HAN ; Hui-Ru WANG ; Xiao-Ju WAN ; Juan LI ; Hui-Lan LIU
Journal of Experimental Hematology 2025;33(6):1797-1802
Objective:To analyze the effect of high serum ferritin(SF)before transplantation on erythrocyte,granulocyte and platelet implantation in unrelated cord blood transplantation(UCBT)patients with myelodysplastic syndrome(MDS)and acute myeloid leukemia(AML).Methods:The medical records of 60 patients with MDS and AML who underwent UCBT in the First Affiliated Hospital of University of Science and Technology of China from January 2020 to December 2022 were retrospectively collected.According to the SF level before transplantation,they were divided into high SF group(SF ≥ 1 000 μg/L,n=20)and non-high SF group(SF<1 000 μg/L,n=40).The red blood cell(RBC)infusion volume before transplantation,implantation time of RBC,granulocyte and platelet,implantation risk and prognosis were analyzed and compared between the two groups.Results:There was no correlation between the level of SF before transplantation and RBC infusion.After transplantation,the median implantation time of RBC in the high SF group was 28.5(14-149)d,which was longer than 21(10-83)d in the non-high SF group(P<0.05).The median time of granulocyte engraftment in the high SF group was 16.5(12-63)d,while that in the non-high SF group was 16(12-49)d,with no statistical difference between the two groups(P>0.05).The median platelet engraftment time in the high SF group was 45(12-206)d,while that in the non-high SF group was 35.5(14-149)d,with no statistical difference between the two groups(P>0.05).Kaplan-Meier cumulative implantation probability analysis showed that the rate of erythroid implantation in the non-high SF group was higher than that in the high SF group(P<0.05),while there was no significant difference in the rates of granulocyte and platelet implantation between the two groups(P>0.05).The 1-year overall survival rates of the non-high SF group and high SF group were 95%and 90%,respectively,with no statistical difference between the two groups(P>0.05).Conclusion:SF levels before cord blood transplantation in MDS and AML patients have an impact on post transplant erythroid implantation.Detecting and intervening of iron load in patients before transplant may be beneficial for improving implantation and prognosis.
4.Construction and investigation of work capability evaluation indicator system for different positions of offshore workers
Dan QU ; Xiaobei JU ; Jian GAO
Journal of Navy Medicine 2025;46(8):821-825
Objective To investigate the work capability need of offshore workers,and then to construct the evaluation indicator system of work capability for different positions of offshore workers.Methods Literature search,cluster analysis,key events,weight calculation and expert assessment were applied in this study.Results After the indicator screening,weight calculation and expert verification,the work capability evaluation indicator system was established,which contained 5 dimensions and 24 items.The indicators were sequenced according to the weight calculation,and the coefficient of variation of each indicator was less than 20%.Conclusion The construction of the work capability evaluation indicator system for different positions of offshore workers not only improves the content of the offshore job performance evaluation system,but also meets the demand for enhancing offshore operation support.It has greatly practical significance and promotion value.
5.ManNAc improves glucose and lipid metabolic disorders in high-fat diet-induced obese mice
Xiangxue KONG ; Dan LI ; Jiangwei XU ; Ju YANG ; Yingyu WANG ; Jiai YAN ; Jing SUN ; Hong CAO
Chinese Journal of Endocrinology and Metabolism 2025;41(5):401-410
Objective:To investigate the ameliorative effects of N-acetyl-D-mannosamine(ManNAc) on glucose and lipid metabolic disorders in obese mice.Methods:In vivo experiments were conducted using 21 four-week-old C57BL/6JGpt mice, randomly divided into three groups( n=7 per group): a normal control group, a high-fat diet(HFD) control grooup, and a ManNAc treatment group(400 mg·kg -1·d -1). The intervention lasted for 20 weeks. Body weight, food intake, and fasting blood glucose levels were monitored weekly. Glucose tolerance tests(GTT), insulin sensitivity tests(ITT), and respiratory metabolism monitoring were performed in the 17th, 18th, and 19th weeks, respectively. At the end of the experiment, whole-body fat distribution was assessed, and serum lipid profiles were measured. Liver and adipose tissue weights were recorded, and histological analyses including HE staining of liver, adipose and pancreatic tissues were performed. Liver transcriptome sequencing and quantitative real-time PCR(qPCR) were conducted to evaluate hepatic gene expression. In vitro, a hepatic steatosis model was established by inducing HepG2 cell with 0.4 mmol/L oleic acid, followed by treatment with 500 μg/mL ManNAc. Lipid accumulation was assessed using BODIPY staining, and the expression of lipid metabolism-related genes was quantified by qPCR. Results:ManNAc administration attenuated HFD-induced weight gain, reduced total body fat volume, and decreased liver and adipose tissue weights as well as intracellular lipid accumulation. Pancreatic islet numbers increased, while fasting blood glucose levels, glucose tolerance, and insulin sensitivity significantly improved. Serum levels of triglycerides, total cholesterol, and low-density lipoprotein levels were decreased, accompanied by enhanced energy expenditure. Additionally, hepatic expression of Cd36, Fabp3, and Scd1 was downregulated. In vitro, ManNAc significantly reduced lipid accumulation in HepG2 cells and downregulated the expression of Cd36, Fabp3, and Scd1 genes.Conclusion:ManNAc may improve glucose and lipid metabolism by modulating the PPARs-mediated fatty acid metabolic pathway, reducing lipogenesis, promoting fatty acid oxidation and energy expenditure, and enhancing insulin sensitivity, ultimately ameliorating disorders in obese mice.
6.Value of lung ultrasound monitoring in the clinical diagnosis and treatment of mycoplasma pneumoniae pneumonia in children
Lei ZUO ; Yi HUANG ; Lian XUE ; Meng JU ; Wenqi CUI ; Sihan WANG ; Dan SU ; Xin ZHANG
Chinese Journal of Ultrasonography 2025;34(3):203-209
Objective:To evaluate the lung ultrasound characteristics of mycoplasma pneumoniae pneumonia in children and to investigate the value of lung ultrasound monitoring in clinical diagnosis and treatment.Methods:A retrospective analysis of 62 children with mycoplasma pneumoniae pneumonia admitted to Xi'an Chest Hospital from 7 November to 30 November 2023 was performed,and the characteristic parameters of bedside lung ultrasound and their related clinical data were collected. Pathological lung ultrasound features such as interrupted pleural line,well-spaced B-lines,coalescent B-lines,small subpleural patchy pulmonary consolidation,large pulmonary consolidation and pleural effusion in 12 scan areas of both lungs were observed. The maximum upper and lower diameters,right and left diameters,and anterior and posterior diameters of the large pulmonary consolidations were measured,and the changes in the above signs before and after treatment were measured and compared.Results:In sixty-two children with mycoplasma pneumoniae pneumonia,including 32 males and 30 females,with a mean age of(8.18 ± 2.05)years old and a mean hospital stay of(8.79 ± 2.93)days,lung ultrasound showed interrupted pleural line,well-spaced B-lines,coalescent B-lines,small subpleural patchy pulmonary consolidation,large pulmonary consolidation and pleural effusion,with the incidence of 93.5%(58 /62),33.9%(21/62),32.3%(20/62),59.7%(37/62),66.1%(41/62)and 17.7%(11/62),respectively,in which the large pulmonary consolidations presented rich blood supply were more common in the L6 and L4 areas,while the pleural effusions were more common in the L6 area.The signs of interrupted pleural line,coalescent B-lines,large pulmonary consolidation and pleural effusion were significantly improved after treatment compared with before treatment(all P<0.05). The upper and lower diameters,left and right diameters,and anterior and posterior diameters of large pulmonary consolidations were significantly reduced after treatment compared with before treatment[(4.19 ± 2.42)cm vs.(2.84 ± 2.31)cm, t=2.613, P=0.011;(2.80 ± 1.82)cm vs.(1.96 ± 1.62)cm, t=2.226, P=0.029;(3.41 ± 2.11)cm vs.(2.12 ± 1.82)cm, t=2.972, P=0.004].With the process of treatment,the dynamic observation of lung ultrasound showed that the well-spaced B-lines/coalescent B-lines gradually decreased until they completely disappeared or a small number of B-lines remained,and the area of the large pulmonary consolidation showed a dynamic downward trend(all P<0.001),and the area of large pulmonary consolidations gradually decreased until they completely disappeared or only small subpleural patchy pulmonary consolidations and well-spaced/coalescent B-lines remained,and at the same time,the pleural effusion gradually absorbed until it disappeared. Conclusions:Lung ultrasound can detect the distribution area of lung lesions,morphology and blood supply characteristics of children with mycoplasma pneumoniae pneumonia,as well as the dynamic changes after treatment,and lung ultrasound can dynamically monitor and evaluate the progression and regression of the disease in real time,providing a reliable imaging evidence for clinical practice.
7.Home-based phototherapy implementation and management needs in patients with vitiligo: a questionnaire survey analysis
Yu LI ; Ziwei WANG ; Rongjia YE ; Rong LI ; Yan ZHU ; Xiaohua ZHANG ; Dan HUANG ; Mei JU
Chinese Journal of Dermatology 2025;58(7):608-612
Objective:To investigate the current status of the implementation of home-based phototherapy (HBPT) in patients with vitiligo, and to analyze management needs among patients receiving HBPT.Methods:A questionnaire survey was conducted on the application of HBPT among patients with vitiligo who visited the outpatient clinic of the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from December 2021 to November 2022. Additionally, the popularization and usage of HBPT as well as needs of patient management were investigated and analyzed in these vitiligo patients.Results:A total of 496 valid questionnaires were collected from 496 patients with vitiligo (241 males [48.5%] and 255 females [51.5%]) . Their ages at visit ranged from 2 to 67 (30.87 ± 12.36) years. The most commonly affected sites were the head and face (52.2%) , followed by hair (32.1%) , hands and feet (31.4%) , trunk (30.2%) , limbs (24.3%) , neck (19.5%) , and perineum (9.9%) . Among the participants, 320 (64.5%) were currently using or had used HBPT, and 352 (70.8%) expressed a willingness to learn more about HBPT usage guidelines and health education. Regarding the repigmentation outcomes after HBPT: among 312 patients, 54 (17.3%) reported complete recovery, 64 (20.5%) were markedly improved, 142 (45.5%) experienced improvement, and 52 (16.7%) showed no response. Adverse reactions occurred in 223 patients (71.5%) , of whom 28 (9.0%) experienced severe adverse reactions. The most desired guiding information was the adjustment method for phototherapy dosage and treatment duration (184/352, 52.3%) ; the most effective way to receive health education information was through verbal education by medical staff (177/352, 50.3%) .Conclusion:For vitiligo patients who were willing to accept and use HBPT, the most desired guiding information was the adjustment method for phototherapy dosage and treatment duration, and verbal health education by medical staff appeared to be the main way to obtain health education information.
8.Home-based phototherapy implementation and management needs in patients with vitiligo: a questionnaire survey analysis
Yu LI ; Ziwei WANG ; Rongjia YE ; Rong LI ; Yan ZHU ; Xiaohua ZHANG ; Dan HUANG ; Mei JU
Chinese Journal of Dermatology 2025;58(7):608-612
Objective:To investigate the current status of the implementation of home-based phototherapy (HBPT) in patients with vitiligo, and to analyze management needs among patients receiving HBPT.Methods:A questionnaire survey was conducted on the application of HBPT among patients with vitiligo who visited the outpatient clinic of the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from December 2021 to November 2022. Additionally, the popularization and usage of HBPT as well as needs of patient management were investigated and analyzed in these vitiligo patients.Results:A total of 496 valid questionnaires were collected from 496 patients with vitiligo (241 males [48.5%] and 255 females [51.5%]) . Their ages at visit ranged from 2 to 67 (30.87 ± 12.36) years. The most commonly affected sites were the head and face (52.2%) , followed by hair (32.1%) , hands and feet (31.4%) , trunk (30.2%) , limbs (24.3%) , neck (19.5%) , and perineum (9.9%) . Among the participants, 320 (64.5%) were currently using or had used HBPT, and 352 (70.8%) expressed a willingness to learn more about HBPT usage guidelines and health education. Regarding the repigmentation outcomes after HBPT: among 312 patients, 54 (17.3%) reported complete recovery, 64 (20.5%) were markedly improved, 142 (45.5%) experienced improvement, and 52 (16.7%) showed no response. Adverse reactions occurred in 223 patients (71.5%) , of whom 28 (9.0%) experienced severe adverse reactions. The most desired guiding information was the adjustment method for phototherapy dosage and treatment duration (184/352, 52.3%) ; the most effective way to receive health education information was through verbal education by medical staff (177/352, 50.3%) .Conclusion:For vitiligo patients who were willing to accept and use HBPT, the most desired guiding information was the adjustment method for phototherapy dosage and treatment duration, and verbal health education by medical staff appeared to be the main way to obtain health education information.
9.Qualitative and quantitative analysis of chemical components of different processed products of Corni Fructus by UPLC-Q-TOF-MS and UPLC-QqQ-MS/MS.
Li-Qiang ZHANG ; Guo-Shun SHAN ; Yi-Dan HONG ; Si-Han LIU ; Guo-Wei XU ; Hui GAO ; Wei WANG ; Cheng-Guo JU
China Journal of Chinese Materia Medica 2025;50(8):2145-2158
Qualitative and quantitative analysis methods for chemical components of different processed products of Corni Fructus were established to systematically characterize and identify these components, and the content of the main differential components was determined. The chemical components of different processed products of Corni Fructus were collected using ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS). Through analysis of self-built databases, literature, and reference standards, a total of 93 components were obtained, including 19 iridoids, 15 flavonoids, 16 organic acids, eight triterpenoids, eight tannins, four amino acids, two polysaccharides, five olefins, and 16 other compounds. Additionally, by using multivariate statistical methods, the differential components between different processed products of Corni Fructus were screened under the conditions of VIP>1.0 and FC<0.5 or FC>2.0 and P<0.05. The PCA and OPLS-DA results showed differences in the chemical components between different processed products of Corni Fructus. A total of 21 differential components were screened, including tartaric acid, morroniside, and rutin. On this basis, ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS) was used to determine the content of 10 main common differential components, including gallic acid, morroniside, ursolic acid, loganin, swertiamarin, rutin, 5-hydroxymethylfurfural, cornuside Ⅰ, quercetin, and oleanolic acid. The above 10 components showed a good linear relationship within the determined concentration range, with the precision, stability, repeatability, and sample recovery rate all meeting the requirements. Compared with that in Corni Fructus, the content of iridoid glycosides in wine-prepared Corni Fructus and wine-and honey-prepared Corni Fructus decreased, while the content of gallic acid, rutin, quercetin, 5-hydroxymethylfurfural, ursolic acid, and oleanolic acid increased. Compared with wine-prepared Corni Fructus, wine-and honey-prepared Corni Fructus showed varying degrees of increase in all other components, except for a slight decrease in gallic acid content. In summary, this study clarified the influence of different processing methods on the chemical components of Corni Fructus, providing a theoretical basis for the scientific connotation, overall quality evaluation, and clinically rational application of Corni Fructus processing in the future.
Tandem Mass Spectrometry/methods*
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Chromatography, High Pressure Liquid/methods*
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Cornus/chemistry*
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Drugs, Chinese Herbal/chemistry*
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Fruit/chemistry*
10.Targeting PPARα for The Treatment of Cardiovascular Diseases
Tong-Tong ZHANG ; Hao-Zhuo ZHANG ; Li HE ; Jia-Wei LIU ; Jia-Zhen WU ; Wen-Hua SU ; Ju-Hua DAN
Progress in Biochemistry and Biophysics 2025;52(9):2295-2313
Cardiovascular disease (CVD) remains one of the leading causes of mortality among adults globally, with continuously rising morbidity and mortality rates. Metabolic disorders are closely linked to various cardiovascular diseases and play a critical role in their pathogenesis and progression, involving multifaceted mechanisms such as altered substrate utilization, mitochondrial structural and functional dysfunction, and impaired ATP synthesis and transport. In recent years, the potential role of peroxisome proliferator-activated receptors (PPARs) in cardiovascular diseases has garnered significant attention, particularly peroxisome proliferator-activated receptor alpha (PPARα), which is recognized as a highly promising therapeutic target for CVD. PPARα regulates cardiovascular physiological and pathological processes through fatty acid metabolism. As a ligand-activated receptor within the nuclear hormone receptor family, PPARα is highly expressed in multiple organs, including skeletal muscle, liver, intestine, kidney, and heart, where it governs the metabolism of diverse substrates. Functioning as a key transcription factor in maintaining metabolic homeostasis and catalyzing or regulating biochemical reactions, PPARα exerts its cardioprotective effects through multiple pathways: modulating lipid metabolism, participating in cardiac energy metabolism, enhancing insulin sensitivity, suppressing inflammatory responses, improving vascular endothelial function, and inhibiting smooth muscle cell proliferation and migration. These mechanisms collectively reduce the risk of cardiovascular disease development. Thus, PPARα plays a pivotal role in various pathological processes via mechanisms such as lipid metabolism regulation, anti-inflammatory actions, and anti-apoptotic effects. PPARα is activated by binding to natural or synthetic lipophilic ligands, including endogenous fatty acids and their derivatives (e.g., linoleic acid, oleic acid, and arachidonic acid) as well as synthetic peroxisome proliferators. Upon ligand binding, PPARα activates the nuclear receptor retinoid X receptor (RXR), forming a PPARα-RXR heterodimer. This heterodimer, in conjunction with coactivators, undergoes further activation and subsequently binds to peroxisome proliferator response elements (PPREs), thereby regulating the transcription of target genes critical for lipid and glucose homeostasis. Key genes include fatty acid translocase (FAT/CD36), diacylglycerol acyltransferase (DGAT), carnitine palmitoyltransferase I (CPT1), and glucose transporter (GLUT), which are primarily involved in fatty acid uptake, storage, oxidation, and glucose utilization processes. Advancing research on PPARα as a therapeutic target for cardiovascular diseases has underscored its growing clinical significance. Currently, PPARα activators/agonists, such as fibrates (e.g., fenofibrate and bezafibrate) and thiazolidinediones, have been extensively studied in clinical trials for CVD prevention. Traditional PPARα agonists, including fenofibrate and bezafibrate, are widely used in clinical practice to treat hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C) levels. These fibrates enhance fatty acid metabolism in the liver and skeletal muscle by activating PPARα, and their cardioprotective effects have been validated in numerous clinical studies. Recent research highlights that fibrates improve insulin resistance, regulate lipid metabolism, correct energy metabolism imbalances, and inhibit the proliferation and migration of vascular smooth muscle and endothelial cells, thereby ameliorating pathological remodeling of the cardiovascular system and reducing blood pressure. Given the substantial attention to PPARα-targeted interventions in both basic research and clinical applications, activating PPARα may serve as a key therapeutic strategy for managing cardiovascular conditions such as myocardial hypertrophy, atherosclerosis, ischemic cardiomyopathy, myocardial infarction, diabetic cardiomyopathy, and heart failure. This review comprehensively examines the regulatory roles of PPARα in cardiovascular diseases and evaluates its clinical application value, aiming to provide a theoretical foundation for further development and utilization of PPARα-related therapies in CVD treatment.

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