1.Effects of apolipoprotein (a) on vascular smooth muscle cells proliferation and cell signal transduction pathway
Chunying WEI ; Menghong WANG ; Yunfeng WEI ; Zeqi ZHENG ; Jingtian PENG ; Jun HUANG ; Yuan WEN ; Zhiyong WU
Chinese Journal of Pathophysiology 2009;25(11):2122-2125
AIM: To investigate the effect and the mechanism of apolipoprotein (a) [apo (a) ] on proliferation of vascular smooth muscle cells ( VSMCs). METHODS: All VSMCs used in experiments were serial subcultured from primary cells and were identified by immunohistochemistry staining of a - actin. Cell growth assay was observed as cell counting and MTT assay. Western blotting was also employed to detect the related mechanism. RESULTS: All cells used in experiments were confirmed as VSMCs. Although apo (a) enhanced VSMCs proliferation, this effect was attenuated by anti -integrin α_vβ_3, LM609.Use these reagents alone had no effect on VSMCs growth. The results of Western blotting demonstrated that focal adhesion kinase (FAK) was activated by apo (a) and the expression of total or phosphorylated transforming growth factor β_1 (TGF -β_1) was also decreased. However, these effects described above were all blocked by LM609.CONCLUSION: Apolipoprotein (a) enhances VSMCs proliferation and this effect is mediated by integrin α_vβ_3, which activates FAK and attenuates TGF - β_1 and phospho -TGF - β_1 expression.
2.Effect of devated plasma lipoprotein (a) on restenosis after stent implantation
Chunying WEI ; Yunfeng WEI ; Menghong WANG ; Zeqi ZHENG ; Jingtian PENG ; Jun HUANG ; Bingong LI ; Yuan WEN ; Zhiyong WU
Clinical Medicine of China 2009;25(10):1027-1029
Objective To investigate the association between plasma lipoprotein (a) [LP (a)] concentra-tion and in-stent restenosis after coronary stent implantation. Methods 152 patients with successful elective coro-nary stont implantation and percutancous transluminal coronary angioplasty (PICA) undergoing foUow-up angiogra-phy were retrospectively analyzed. These patients were divided into restenosis group( n = 29) and no-restenosis group (n = 123 ). The serum LP (a) levels of all patients were also investigated. The general clinical data were analyzed. Multivariate logistic regression was used for statistical analysis. Results We compared the serum Lap (a) levels, smoking and diabet in the two groups, and there was a statisticaLly significant difference between the restenosis group and no-restenosis group(P<0.05). Multivariate logistic regression showed that the elevation of Lap (a) level re-mained as an independent predictor of restenosis (RR =2. 648,95% CI 1. 066-6. 575,P <0. 05). Other risk fac-tors,such as smoking(P =0.023) ,diabet(P =0. 036) and the type of stent(P = 0.011 ) were also correlated with restenosis. Conclusions High plasma LP (a) concentration is an independent predictor of stent restenosis after stent implantation.
3.Oral Chinese Patent Medicines for Adult Functional Dyspepsia:A Scoping Review of Clinical Evidence and Drug Package Inserts
Miaomiao LI ; Hui ZHAO ; Yue WU ; Zeqi DAI ; Simin XU ; Xudong TANG ; Xing LIAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(8):2840-2850
Objective To systematically review the present status of oral Chinese patent medicines(CPMs)for treating functional dyspepsia(FD),explore the formation rules of CPMs,and reveal the potential problems by referring to the methods and procedures of Scoping review.Methods First,we screened all CPMs from the domestic-related drug catalogs which are generally accepted and own the force of law,then we sorted the CPMs based on the drug instructions while carrying out Chinese and English database document retrieval to review the clinical studies.Descriptive analysis of the basic feature and clinical research evidence of CPMs was performed combined with visual charts.Results This study included 42 CPMs for treating FD.Among the formulas of CPMs,Tangerine peel,Radices saussureae,Poria cocos,Glycyrrhiza,Atractylodes macrocephala,and Six Divine Qu appeared frequently.In addition,96 studies involving 21 CPMs were included,among which Zhizhu Kuanzhong Capsule,Liuwei Anxiao capsule,and Dalitong granules had more clinical literature.By analyzing the included 96 clinical studies,we found that the combination of Chinese and Western medicine was the main intervention,and the effective rate,clinical symptom score,and adverse reactions were the main outcomes that were concerned.In addition,8 studies had off-label use of diseases,involving the Wuling capsule to treat the FD whether the disease was accompanied by depression and anxiety symptoms or not,and Zhizhu Kuanzhong Capsule to treat the FD with anxiety and depression.Although the Wuling capsule and Zhizhu Kuanzhong capsule were off-label used in clinical practice,there was no beyond the scope of the guideline.Conclusion The qi-regulating drug,spleen-strengthening drug and digestant drugs are the usual Chinese medicines used for treating adult FD.In recent years,research on CPMs for treating adult FD has increased rapidly.But there is insufficient reflection of CPMs treatment characteristics,ambiguous differences from the primary and secondary outcomes,multiple composite outcomes,and not explicit information on FD or its symptoms in drug package insert,which needs to be improved in the future.
4.Health Technology Assessment Institutions and Organizations: A Scoping Review
Xue WU ; Simin XU ; Zeqi DAI ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(20):178-185
To understand the development status and provide the basis for the construction and development of health technology assessment (HTA) institutions/organizations in China, this paper systematically reviewed the status of international HTA institutions/organizations and the HTA institutions/organizations in western developed countries and some Asian countries. This study was based on the results of the second round of global survey on HTA conducted by the World Health Organization (WHO) in 2020/2021. The websites of WHO, International HTA Database (INAHTA), international HTA institutions/organizations, and the HTA institutions/organizations in different countries were searched. After data extraction and classification, we summarized the status of 9 international HTA institutions/organizations (including Decide: Health Decision Hub, Health Technology Assessment International, HTAsiaLink, International Network of Agencies for Health Technology Assessment, European Network for Health Technology Assessment, Health Technology Assessment Network of the Americas, International Society for Pharmacoeconomics and Outcomes Research, Southern African Health Technology Assessment Society, International Information Network on New and Emerging Health Technologies), 11 HTA institutions/organizations in western developed countries and Asian countries (including Canada, France, Germany, the United Kingdom, Australia, the United States, Japan, Malaysia, South Korea, Singapore, and Thailand), and 6 HTA organizations/teams in China. The use of HTA varies greatly because of different medical and health systems among different countries, and thus the role of HTA in health decision-making varies among different countries. The international HTA institutions/organizations have greatly strengthened the communication between HTA institutions/organizations and the pharmaceutical industry and facilitated the promotion and practice of evidence-based health decision-making.
5.Construction and Interpretation of Clinical Comprehensive Evaluation Index System for Chinese Patent Medicine Based on EVIDEM Framework
Zeqi DAI ; Chengyang JING ; Xue WU ; Le ZHANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):134-143
ObjectiveTo establish the clinical comprehensive evaluation index system for Chinese patent medicine(CPM) based on Evidence and Value:Impact on DEcisionMaking(EVIDEM) framework, so as to promote the scientific, systematic and standardized implementation of clinical comprehensive evaluation of CPM. MethodThe clinical comprehensive evaluation index system was determined through literature review, semi-structured interview and Delphi method, and the weights of each index were clarified by analytic hierarchy process(AHP). ResultThe recovery rates of both rounds of expert consultation were 100%, and the authority coefficient of experts was 0.90 and 0.905, respectively. Kendall's coordination coefficients(W) of the second- and third-level indicators in the first-round consultation were 0.320 and 0.283(P<0.001), and in the second round were 0.411 and 0.351, respectively(P<0.001). The finally constructed clinical comprehensive evaluation index system for CPM included 6 first-level indicators, 13 second-level indicators and 28 third-level indicators. Among the first-level indicators, the weights of effectiveness, safety, economy, innovation, suitability and accessibility were 37.34%, 32.68%, 11.85%, 5.87%, 5.79% and 6.47%, respectively. ConclusionThis study has constructed a universal clinical comprehensive evaluation index system for CPM, and the domain and criteria are introduced and interpreted in detail, which can provide reference and information for carrying out the clinical comprehensive evaluation of CPM, but it needs to be refined and improved in combination with the clinical practice of CPM for specialized diseases.
6.Clinical Evidence of Treatment of Constipation with Oral Chinese Patent Medicine: A Scoping Review
Simin XU ; Zeqi DAI ; Miaomiao LI ; Xue WU ; Xudong TANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(20):144-153
This study systematically and comprehensively sorted out the application status of Chinese patent medicines for the treatment of constipation in the clinic, to provide scientific evidence for future research directions and clinical drug use in this field. Based on the method of scoping review, the Chinese patent medicines for the treatment of constipation were retrieved from three drug lists to obtain the medicines that needed to be evaluated. A comprehensive and systematic search was carried out on the included studies on the treatment of constipation by Chinese patent medicines through eight Chinese and English databases, and the included studies were integrated and analyzed. The results were displayed in combination with charts. Thirty-four Chinese patent medicines and 118 studies were included in this study. According to the efficacies, Chinese patent medicines were divided into 4 categories, namely eliminating accumulation, purging fire, promoting Qi, and moistening bowels, involving 125 Chinese medicines. The overall attention of constipation research is on the rise. Marenwan (granules or soft capsules) gained the highest attention, with 42 studies, followed by Qirong Runchang oral liquid, with 21 studies, and Biantong tablets (capsules), with 19 studies. There are 10 studies on Congrong Tongbian oral liquid. Seventeen Chinese patent medicines had no corresponding clinical research. There were 8 study design types, and all drugs were mainly randomized controlled trials except Danggui Longhui pill. Among the intervention types, the comparison between Chinese patent medicines and western medicines was the most. The highest outcome indicators were efficacy, safety evaluation, and main symptoms or scores, and there was a lack of a unified core outcome indicator set. There were few studies on adverse reactions and the economy. Only 11.86% of the studies were funded. Clinically, Chinese patent medicines are widely used in the treatment of constipation, and the amount of related research shows an increasing trend. However, some Chinese patent medicines lack corresponding clinical evidence, and the published research has problems such as unrigorous design, ununified criteria for efficacy evaluation, lack of comprehensive evidence studies, and insufficient funds. It is hoped that more investment will be made in this field in the future, and more attention will be paid to drugs with relatively blank research and constipation syndromes with few treatments. Comprehensive evidence studies such as systematic reviews should be carried out actively. And the study design should be standardized to provide reliable evidence for the treatment of constipation with Chinese patent medicines.
7.Clinical Evidence on Treatment of Otorhinolaryngologic Diseases with Oral Chinese Patent Medicine: A Scoping Review
Zeqi DAI ; Xue WU ; Le ZHANG ; Miaomiao LI ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(20):170-177
This paper aims to systematically retrieve and summarize the clinical evidence on oral Chinese patent medicine in otorhinolaryngology by scoping review and analyze the distribution of the evidence, which is expected to serve as a reference for clinical practice and healthcare decision-making. Seven databases were searched (from inception to March 2022) for the clinical evidence of oral Chinese patent medicine in the prevention and treatment of otorhinolaryngologic diseases, and the distribution of the evidence was discussed. A total of 248 papers from core journals/SCI were included: 238 clinical studies (185 randomized controlled trials, 46 semi-/non-randomized controlled trials, 7 case series studies), 5 systematic reviews, 4 guidelines/expert consensuses, and 1 pharmacoeconomic study. The papers covered 26 oral Chinese patent medicines and 40 otorhinolaryngological diseases (5 ear diseases, 22 nose diseases, and 13 throat diseases). The majority of the clinical studies included 100-300 cases. The combination of Chinese patent medicine and western medicine is the common intervention in the experimental group. The outcomes were mainly “cure rate” and improvement of clinical symptoms. Common adverse events were nausea, vomiting, rash, headache, gastrointestinal discomfort, fatigue, etc. In summary, there is a lack of high-quality clinical evidence on oral Chinese patent medicine in otorhinolaryngology. In addition, the available studies have such problems as seldom use of recognized outcomes, low quality of clinical studies, and lack of pharmacoeconomic study. In future, efforts should be made to carry out more rigorous primary and secondary research and enhance the pharmacoeconomic evaluation, in a bid to explore the advantages of Chinese patent medicine in the treatment of otorhinolaryngologic diseases and promote the more rational allocation and application of health resources.
8.Clinical Evidence of Chinese Patent Medicines in Treatment of Respiratory Diseases in Children: A Scoping Review
Xue WU ; Zeqi DAI ; Miaomiao LI ; Le ZHANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(6):147-156
ObjectiveThis study performed a scoping review to comprehensively analyze and report the information on the instructions of Chinese patent medicines and clinical research evidence for the treatment of respiratory diseases in children. MethodChinese patent medicines against respiratory diseases in children were obtained by searching the three major drug catalogues. The Chinese and English databases were searched for relevant literature,followed by data statistics and visualized analysis. ResultAfter screening and analysis,52 Chinese patent medicines were included,involving nine dosage forms. The main drugs were Scutellariae Radix,Armeniacae Semen Amarum,Forsythiae Fructus,etc. The main functions included clearing heat and releasing exterior syndrome,and relieving cough and dissipating phlegm. The indications mainly included common cold with wind-heat syndrome and cough in children. Adverse drug reactions and contraindications were only specified in 19.23% (10/52) of Chinese patent medicines,and the rest only displayed "unclear". A total of 279 articles were included,including 277 articles from Chinese Core Periodicals and two articles from SCIE. In terms of research type,those articles included 253 randomized controlled trials (RCTs,with six dosage form/dose comparisons involved),11 retrospective analyses based on Hospital Information System (HIS) data,one case series,13 systematic reviews/Meta-analyses (with two network Meta-analyses involved),and one economic evaluation article. Among them,72.76% (203/279) of the articles were published in the Core Journals of Chinese Science and Technology. Only 33 Chinese patent medicines were involved,and Xiaoer Feire Kechuan Oral Liquid was the top 1 under investigation,accounting for 15.71% (44/280). The indicated diseases were mainly infantile pneumonia,bronchitis,respiratory tract infection,cough,asthma,and other western medicine diseases. Xiaoer Chiqiao Qingre Granules and Xiaoer Dingchuan Oral Liquid were used off-label. The sample size was concentrated in 51-150 cases,accounting for 67.17% (178/265). The interventions in the experimental group were mainly Chinese patent medicine + western medicine + basic treatment or Chinese patent medicine + western medicine. The main outcomes were the effective rate and the improvement of clinical symptoms. The adverse reactions were mainly gastrointestinal reactions,drug-induced skin symptoms,etc.,and two studies have shown that drug doses were associated with adverse reactions. ConclusionIn research years,the research on Chinese patent medicines in the treatment of respiratory diseases in children has advanced rapidly. However,there are still some problems that need to be resolved in the future,such as incomplete information on drug content in the instruction,concentrated drugs to be studied,limited indications,failure to highlight the characteristics of traditional Chinese medicine (TCM) syndromes,unstandardized research design,and an incomplete reflection of Chinese patent medicine.
9.Research on Syndrome and Treatment Rules of Famous Doctors in Treating Ulcerative Colitis Based on Data Mining
Yujie WU ; Ting WANG ; Peixuan ZHU ; Yonghuang YAN ; Han YANG ; Wenting ZHANG ; Fang YAN ; Shiqing QIAO ; Cai ZHANG ; Zeqi SU
Journal of Traditional Chinese Medicine 2023;64(21):2241-2247
ObjectiveTo systematically review the clinical experience of four sessions of Masters of Traditional Chinese Medicine and two sessions of National Famous Chinese Medicine Practitioners in treating ulcerative colitis (UC). Data mining and analysis were conducted to clarify the diagnosis and treatment ideas and characteristics of prescription used by these famous doctors in treating UC. MethodsRelevant literature on the treatment of UC by renowned doctors was retrieved from the establishment of the database until March 31, 2023. The literature was collected from databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, Chinese Science and Technology Periodicals Database, and China Biomedical Literature Database. The data mining techniques including frequency analysis, association rules, and cluster analysis were conducted using the Ancient and Modern Medical Case Cloud Platform V2.3.5. ResultsA total of 157 literatures were included in this study, including 115 clinical case data. The study found that UC can be categorized into 14 types of syndrome patterns for treatment, including large intestine dampness-heat syndrome (75,65.22%), syndrome of dampness stagnancy due to spleen deficiency (23, 20.00%), spleen-kidney yang deficiency syndrome (21, 18.26%). The main affected organs were the spleen (85, 73.91%) and large intestine (75, 65.22%), and they were closely related to liver (24, 20.87%) and the kidney (21, 18.26%). The predominant pathogenic factors were dampness (83, 72.17%) , heat (80, 69.57%) and qi deficiency (65, 56.52%). The treatment involved 30 kinds of treatment methods, including heat-clearing and dampness-draining method (75, 65.22%), pleen-tonifying and qi-boosting method (25,21.74%) and spleen-invigorating and dampness-transforming method (23, 20.00%). The medication involved 187 ingredients, with the most commonly used being heat-clearing herbs (37, 19.79%) and tonifying herbs (27, 14.44%). The tastes of the herbs were mostly sweet (85, 45.45%) , bitter (80, 42.78%) , and pungent (71, 37.97%). The association rules revealed 16 high-frequency combinations mainly composed of Huanglian (黄连), Baishao (白芍) and Gancao (甘草) along with Baizhu (白术), Fuling (茯苓), Muxiang (木香) and Danggui (当归). ConclusionFamous doctors are skilled in diagnosing and treating UC based on the differentiation of the zang-fu organs and qi-blood. The key pathological mechanism is “spleen deficiency as the root, and large intestine damp-heat as the manifestation”. The core treatment approach is “heat-clearing, spleen-tonifying, and dampness-draining”, with the inclusion of “regulating qi and blood, and balancing cold and heat”.
10.Visualization Analysis of Studies on Prediction Models in Field of Traditional Chinese Medicine
Chengyang JING ; Zeqi DAI ; Xue WU ; Le ZHANG ; Lirong LIANG ; Xing LIAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):209-217
ObjectiveBased on knowledge mapping, the studies on prediction models in the field of traditional Chinese medicine (TCM) were visually analyzed, which provided a reference basis for the excavation and evolution of the future research direction by combing the development process and summarizing the research hotspots and dynamic trends. MethodChina National Knowledge Infrastructure and Web of Science Core Collection databases were searched to obtain studies on prediction models in the field of TCM from inception to February 28, 2023. Endnote X20 software was used for document management. Knowledge mapping generated by CiteSpace software and VOSviewer software was used to visually analyze the characteristics of publication, institutional cooperation relationship, author cooperation network, co-citation, and keywords. ResultA total of 264 pieces of Chinese literature and 266 pieces of English literature were included, and the overall number of research publications showed an increasing trend year by year. The cooperation relationship between the issuing institutions showed obvious regional characteristics, with the closest cooperation relationship between the universities of TCM and their affiliated hospitals, as well as secondary units subordinate to scientific research institutions. The number of research teams and team members publishing papers in English was higher, and cooperation between different teams was more frequent. Groundbreaking and/or referential studies were widely cited and referred to. The highly cited literature was mainly published in complementary and alternative medicine journals and pharmaceutical journals. Research hotspots mainly focused on clinical prediction models of TCM, quantitative models of TCM, and specific modeling methods. The application of artificial intelligence technologies such as machine learning and deep learning in the field of TCM will be the most cutting-edge research direction in the future. ConclusionThe field of TCM is paying more and more attention to the studies on prediction models, while the research cooperation mode involving multiple organizations and teams has increasingly become the mainstream. With the continuous development of multi-disciplinary integration, studies on prediction models are closely related to the development and rise of innovative techniques and methods, and any breakthrough in theory or application will induce and guide a new round of research upsurge. Systematic reviews of topic-specific prediction models should be carried out in the future to provide evidence-based evidence.