1.Efficacy Connotation and Mechanisms of Shudi Qiangjin Pills Against Steroid-induced Osteonecrosis of Femoral Head Based on "Disease-Syndrome-Formula" Association Network
Zhijian CHEN ; Suya ZHANG ; Longlong DING ; Guixin ZHANG ; Bo LIU ; Baohong MI ; Yanqiong ZHANG ; Na LIN ; Weiheng CHEN ; Chunzhu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):88-99
ObjectiveTo elucidate the efficacy connotation of Shudi Qiangjin pills (SQP) against liver and kidney deficiency in steroid-induced osteonecrosis of femoral head (SONFH) from the perspective of the "disease-syndrome-formula" association and to clarify the underlying mechanisms based on in vivo and in vitro experiment validation. MethodsThe chemical components and the corresponding putative targets of SQP were collected from the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP) v2.0, the Encyclopedia of Traditional Chinese Medicine (ETCM) v2.0, and HERB databases. The SONFH-related genes were identified based on the differential expression profiles of peripheral blood of patients with SONFH compared to the healthy volunteers, and the disease phenotype-related targets were collected from the TCMIP v2.0 database. Then, the interaction network of "SONFH-related genes and candidate targets of SQP" was constructed based on "gene-gene interaction information", and the major network targets were screened by calculating the topological characteristic values of the network followed by the functional mining according to the Kyoto Encyclopedia of Genes and Genomes (KEGG) database and the SoFDA database. After that, the SONFH rat model was prepared by lipopolysaccharide combined with methylprednisolone injection, and 2.5, 5, 7.5 g·kg-1 SQP (once per day, equivalent to 1, 2, and 3 times the clinical equivalent dose, respectively) or 7.3×10-3 g·kg-1 of alendronate sodium (ALS, once per week, equivalent to the clinical equivalent dose) was given for 8 weeks. The effect characteristics of SQP and ALS in the treatment of SONFH were evaluated by micro-computed tomography scanning, hematoxylin and eosin staining, alkaline phosphatase (ALP) staining, immunohistochemical staining, enzyme-linked immunosorbent assay, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)staining, and a comparative efficacy analysis was conducted with ALS. In addition, SONFH cell models were prepared by dexamethasone stimulation of osteoblasts, and the intervention was carried out with the medicated serum of SQP at the aforementioned three doses. Cell counting kit-8, ALP staining, ALP activity assay, alizarin red staining, and flow cytometry were employed to investigate the regulatory effect of SQP on osteoblasts. The expression levels of osteogenesis-related proteins and key factors of the target signaling axis were detected by quantitative real-time polymerase chain reaction and Western blot. ResultsThe network analysis results demonstrated that the candidate targets of SQP primarily exerted their therapeutic effects through key signaling pathways, including phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt), lipid metabolism and atherosclerosis, prolactin, chemokines, and neurotrophic factors pathways. These pathways were significantly involved in critical biological processes such as muscle and bone metabolism and the regulation of the "neuro-endocrine-immune" network, thereby addressing both modern medical symptoms (e.g., delayed skeletal maturation and recurrent fractures) and traditional Chinese medicine (TCM) symptoms (e.g., fatigue, aversion to cold, cold limbs, and pain in the limbs and joints in patients with SONFH characterized by liver and kidney deficiency syndrome. Among these pathways, the PI3K/Akt signaling pathway exhibited the highest degree of enrichment. The in vivo experimental results demonstrated that starting from the 4th week after modeling, the modeling group exhibited a significant reduction in body weight compared to the control group (P<0.05). After six weeks of treatment, all dosage groups of SQP showed significantly higher body weights compared to the model group (P<0.01). Compared with the normal group, the model group exhibited significant decreases in bone mineral density (BMD), bone volume fraction (BV/TV), trabecular number (Tb.N), osteocalcin (OCN), alkaline phosphatase (ALP) levels in femoral head tissue, and serum bone-specific alkaline phosphatase (BALP) (P<0.01), along with significant increases in trabecular separation (Tb.Sp), empty lacunae rate in tissue, and apoptosis rate (P<0.01). In comparison to the model group, the SQP intervention groups showed significant improvements in BMD, BV/TV and Tb.N (P<0.01), significant reductions in Tb.Sp, empty lacunae rate and apoptosis rate (P<0.05), and significant increases in protein levels of OCN and ALP as well as BALP content (P<0.05). The in vitro experimental results revealed that all dosage groups of SQP medicated serum showed no toxic effects on osteoblast. Compared with the normal group, the model group displayed significant suppression of osteoblast proliferation activity, ALP activity, and calcified nodule formation rate (P<0.01), significant decreases in mRNA transcription levels of OCN and Runt-related transcription factor 2 (RUNX2) (P<0.01), significant reductions in protein content of osteopontin (OPN), typeⅠ collagen (ColⅠ)A1, B-cell lymphoma-2 (Bcl-2), PI3K, and phosphorylated (p)-Akt (P<0.01), and a significant increase in apoptosis rate (P<0.01). Compared with the model group, the SQP medicated serum intervention groups exhibited significant increases in proliferation activity, ALP activity, calcified nodule formation rate, mRNA transcription levels of OCN and RUNX2, and protein content of OPN, ColⅠA1, Bcl-2, PI3K, and p-Akt (P<0.05), along with a significant decrease in apoptosis rate (P<0.01). ConclusionSQP can effectively reduce the disease severity of SONFH with liver and kidney deficiency syndrome and improve bone microstructure, with the therapeutic effects exhibiting a dose-dependent manner. The mechanism may be related to its regulation of key processes such as muscle and bone metabolism and the correction of imbalances in the "neuro-endocrine-immune" network, thereby promoting osteoblast differentiation and inhibiting osteoblast apoptosis. The PI3K/Akt signaling axis is likely one of the key pathways through which this formula exerts its effects.
2.Expression and biological characterization of anti-CD63 single-chain variable fragment antibody in Pichia pastoris.
Chinese Journal of Biotechnology 2025;41(4):1440-1454
To prepare antibodies that specifically recognize the conserved domain in the large extracellular loop of the CD63 protein, we expressed anti-CD63 single-chain variable fragment (scFv) antibody in Pichia pastoris in a secreted form. The purified expression product was found to bind specifically with CD63 protein and recognize CD63 on the surface of SK-MEL-28 cells. The variable region of the anti-CD63 monoclonal antibody in an anti-CD63-positive cell line was sequenced. The anti-CD63 scFv consisted of a variable heavy chain and a variable light chain linked by a flexible peptide was then designed. After codon optimization, the gene was synthesized and cloned into the expression plasmid pPICZα-A. The SacI-linearized plasmid was electroporated into P. pastoris X33, and 1% methanol were used to induce the expression of scFv. The fermentation supernatant was purified by Ni column. Anti-CD63 scFv was identified by SDS-PAGE and Western blotting, and its biological activities were analyzed by immunoblotting, immunofluorescence, cell-based ELISA, and flow cytometry. A P. pastoris strain capable of expressing and secreting anti-CD63 scFv was successfully obtained. The antibody had a molecular weight of approximately 30 kDa and specifically recognized CD63 protein. The expression of anti-CD63 scFv in P. pastoris paves the way for the production of anti-CD63 antibodies on a large-scale, which is undoubtedly an economical and effective way of antibody acquisition.
Single-Chain Antibodies/immunology*
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Humans
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Tetraspanin 30/immunology*
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Recombinant Proteins/immunology*
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Pichia/genetics*
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Saccharomycetales/metabolism*
3.Multidisciplinary expert consensus on weight management for overweight and obese children and adolescents based on healthy lifestyle
HONG Ping, MA Yuguo, TAO Fangbiao, XU Yajun, ZHANG Qian, HU Liang, WEI Gaoxia, YANG Yuexin, QIAN Junwei, HOU Xiao, ZHANG Yimin, SUN Tingting, XI Bo, DONG Xiaosheng, MA Jun, SONG Yi, WANG Haijun, HE Gang, CHEN Runsen, LIU Jingmin, HUANG Zhijian, HU Guopeng, QIAN Jinghua, BAO Ke, LI Xuemei, ZHU Dan, FENG Junpeng, SHA Mo, Chinese Association for Student Nutrition & ; Health Promotion, Key Laboratory of Sports and Physical Fitness of the Ministry of Education,〖JZ〗 Engineering Research Center of Ministry of Education for Key Core Technical Integration System and Equipment,〖JZ〗 Key Laboratory of Exercise Rehabilitation Science of the Ministry of Education
Chinese Journal of School Health 2025;46(12):1673-1680
Abstract
In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.
4.Food-derived bioactive peptides: health benefits, structure‒activity relationships, and translational prospects.
Hongda CHEN ; Jiabei SUN ; Haolie FANG ; Yuanyuan LIN ; Han WU ; Dongqiang LIN ; Zhijian YANG ; Quan ZHOU ; Bingxiang ZHAO ; Tianhua ZHOU ; Jianping WU ; Shanshan LI ; Xiangrui LIU
Journal of Zhejiang University. Science. B 2025;26(11):1037-1058
Food-derived bioactive peptides (FBPs), particularly those with ten or fewer amino acid residues and a molecular weight below 1300 Da, have gained increasing attention for their safe, diverse structures and specific biological activities. The development of FBP-based functional foods and potential medications depends on understanding their structure‒activity relationships (SARs), stability, and bioavailability properties. In this review, we provide an in-depth overview of the roles of FBPs in treating various diseases, including Alzheimer's disease, hypertension, type 2 diabetes mellitus, liver diseases, and inflammatory bowel diseases, based on the literature from July 2017 to Mar. 2023. Subsequently, attention is directed toward elucidating the associations between the bioactivities and structural characteristics (e.g., molecular weight and the presence of specific amino acids within sequences and compositions) of FBPs. We also discuss in silico approaches for FBP screening and their limitations. Finally, we summarize recent advancements in formulation techniques to improve the bioavailability of FBPs in the food industry, thereby contributing to healthcare applications.
Humans
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Peptides/therapeutic use*
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Structure-Activity Relationship
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Functional Food
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Diabetes Mellitus, Type 2/drug therapy*
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Biological Availability
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Alzheimer Disease/drug therapy*
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Inflammatory Bowel Diseases/drug therapy*
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Hypertension/drug therapy*
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Liver Diseases/drug therapy*
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Bioactive Peptides, Dietary
5.In vitro studies of the anti-inflammatory activity of micheliolide on myeloproliferative neoplasm cell lines
Meng CHEN ; Jinqin LIU ; Ying ZHANG ; Zhexin SHI ; Zhijian XIAO
Journal of Beijing University of Traditional Chinese Medicine 2025;48(1):68-79
Objective:
The effects and molecular mechanisms of micheliolide on cytokine expression in myeloproliferative neoplasm cell lines were explored based on the signal transducer and activator of transcription 3 (STAT3)/nuclear factor-kappa B (NF-κB) signaling pathways.
Methods:
The UKE-1 and SET-2 cell lines were investigated, and micheliolide concentrations were screened using the CCK-8 assay. The UKE-1 and SET-2 cells were divided into the control and micheliolide-treated groups at concentrations of 2.5, 5.0, and 10.0 μmol/L. Each group received 1 mL of micheliolide solution at final concentrations of 2.5, 5.0, and 10.0 μmol/L, respectively, whereas the control group only received an equal volume of culture medium. The inhibition rates of interleukin-1β(IL-1β), tumor necrosis factor-α (TNF-α), and chemokine ligand 2 (CCL2) mRNA expression in cells from each group were detected using real-time fluorescent PCR (RT-PCR). Western blotting was used to measure STAT3 and phosphorylated STAT3 (p-STAT3) protein expression levels in cells from each group. Reversal experiments with reduced glutathione and dithiothreitol were performed using UKE-1 cells, which were divided into the control group, micheliolide, micheliolide + glutathione, micheliolide + dithiothreitol, and glutathione + dithiothreitol groups. Western blotting was used to detect the STAT3 and p-STAT3 protein expression levels in the cells of each group. UKE-1 cells were stimulated with TNF-α (5 μg/L) to replicate a pathological model of excessive cytokine secretion. Subsequently, UKE-1 cells were divided into the control, model, and three micheliolide-treated groups at concentrations of 2.5, 5.0, and 10.0 μmol/L. RT-PCR was used to measure the indicators above. An enzyme-linked immunosorbent assay (ELISA) was used to detect the CCL2 content in the cell culture media of each group. Western blotting was performed to assess the protein expression levels of STAT3, p-STAT3, and proteins related to the NF-κB signaling pathway.
Results:
Compared with the control group, the proliferation inhibition rates of UKE-1 cells at 24, 48, and 72 h increased in the micheliolide-treated groups at concentrations of 2.5, 5.0, 10.0, and 20.0 μmol/L. Similarly, the proliferation inhibition rates of SET-2 at 48 and 72 h increased in the micheliolide-treated groups at concentrations of 5.0, 10.0, and 20.0 μmol/L (P<0.05). Concentrations of 2.5, 5.0, and 10.0 μmol/L were selected for further studies to exclude the potential influence of high micheliolide concentrations on subsequent result owing to reduced cell numbers. Compared with the control group, the inhibition rates of TNF-α mRNA expression in UKE-1 and SET-2 cells increased in the micheliolide-treated groups at concentrations of 2.5, 5.0, and 10.0 μmol/L. Similarly, the inhibition rates of IL-1β mRNA expression in UKE-1 and SET-2 cells also increased in the micheliolide-treated groups at concentrations of 5.0 and 10.0 μmol/L. Additionally, the inhibition rate of CCL2 mRNA expression in UKE-1 and SET-2 cells increased in the micheliolide-treated group at a concentration of 10 μmol/L (P<0.05). Compared with the model group, the inhibition rates of TNF-α, IL-1β, and CCL2 mRNA expression in UKE-1 cells increased in the micheliolide-treated groups at concentrations of 2.5, 5.0, and 10.0 μmol/L after stimulation with TNF-α (P<0.05). ELISA showed that compared with the control group, the CCL2 content in UKE-1 cells increased in the model group. Compared with the model group, the CCL2 content in UKE-1 cells decreased in the micheliolide-treated groups at concentrations of 2.5, 5.0, and 10.0 μmol/L (P<0.05). Western blotting showed that compared with the control group, the p-STAT3 protein expression levels in UKE-1 and SET-2 cells were downregulated in the micheliolide-treated groups at concentrations of 5.0 and 10.0 μmol/L, and the protein expression level of STAT3 in SET-2 was also downregulated (P<0.05). Compared with the control group, the p-STAT3 expression level in UKE-1 cells decreased in the micheliolide group in the reductive glutathione and dithiothreitol reversal experiments. Compared with the micheliolide group, the p-STAT3 protein expression levels in UKE-1 cells increased in the micheliolide + dithiothreitol and micheliolide + glutathione groups (P<0.05). Compared with the control group, the model group showed increased p-STAT3, p-IκKα/β, p-IκBα, and p-NF-κB p65 protein expression and decreased IκBα protein expression after stimulation with TNF-α. Compared with the model group, the micheliolide-treated groups showed decreased p-IκKα/β, p-IκBα, p-STAT3, and p-NF-κB p65 protein expression at concentrations of 2.5, 5.0, and 10.0 μmol/L, whereas the micheliolide-treated groups showed increased IκBα protein expression at concentrations of 5.0 and 10.0 μmol/L (P<0.05).
Conclusion
Micheliolide potently suppresses IL-1β, TNF-α, and CCL2 mRNA expression in UKE-1 and SET-2 cells, as well as CCL2 secretion by UKE-1 cells, which may be associated with STAT3 phosphorylation suppression and NF-κB signaling pathway activation.
6.Effect of laparoscopic surgery on incarcerated inguinal hernia in children
Zhijian ZHOU ; Donglai HU ; Xuan FANG ; Baoyuan JIN ; Rui XIANG ; Junjie CHEN ; Xiaodong GUO
China Modern Doctor 2025;63(26):21-23,40
Objective To evaluate the effect of laparoscopic surgery on incarcerated inguinal hernia(IIH)in children.Methods A total of 81 IIH children treated at Jinhua Maternal & Child Health Hospital from September 2018 to December 2023 were selected as subjects.The children were divided into laparoscopic surgery group(n=45)and open surgery group(n=36).Comparative analysis was conducted on admission age,gender,duration of incarceration,surgical timing,intraoperative hernia contents,and postoperative complications between two groups.Results Operative duration,intraoperative blood loss,postoperative bowel function recovery time,number of occult hernias,and hospitalization duration in laparoscopic surgery group were statistically better than those in open surgery group(P<0.05).There were fewer postoperative complications in laparoscopic group compared to open surgery group,there was significant difference between two groups(P<0.05).Conclusion Compared with traditional open surgery,laparoscopic surgery for IIH in children has the advantages of less trauma,shorter operation time and hospitalization time,and less intraoperative bleeding.
7.Development of a smartphone-integrated handheld automated biochemical analyzer for point-of-care testing of urinary albumin.
Ze WU ; Peng ZHANG ; Wei XIAO ; Qian CHEN ; Wangrun LIN ; Peipei CHEN ; Kangwei CHEN ; Qiangqiang FU ; Zhijian WANG ; Lei ZHENG
Journal of Pharmaceutical Analysis 2025;15(3):101041-101041
The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease (CKD). However, existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes. This study presents a smartphone-integrated handheld automated biochemical analyzer (sHABA) designed for point-of-care testing of urinary albumin. The sHABA features a pre-loaded, disposable reagent cassette with reagents for the albumin assay arranged in the order of their addition within a hose. The smartphone-integrated analyzer can drive the reagents following a preset program, to enable automatic sequential addition. The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L. The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity (95.78%) and specificity (90.16%). This research advances the field by providing an automated detection method for albumin in a portable device, allowing even untrained individuals to monitor CKD in real time at the patient's bedside. In the context of promoting tiered diagnosis and treatment, the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.
8.The characteristics in risky decision-making feedback of depressed patients with suicidal ideation: an ERP study
Ciqing BAO ; Qiaoyang ZHANG ; Haowen ZOU ; Chen HE ; Rui YAN ; Qing LU ; Zhijian YAO
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(5):405-411
Objective:To explore behavioral and electrophysiological differences in risky decision-making between depressed patients with and without suicidal ideation.Methods:A total of 61 patients with first-episode untreated depression were enrolled in the depression clinic of Nanjing Brain Hospital from September 2023 to January 2024, which were divided into the suicidal ideation group( n=32) and the non-suicidal ideation group ( n=29).At the same time, healthy controls matched with sex, age and years of education were recruited from the community( n=36).The event-related potentials (ERP) of the participants were detected, and the amplitude and latency of feedback related negative waves (FRN) and P300 during the feedback phase under Iowa gambling task (IGT) were recorded. Statistical analysis was performed using SPSS 26.0 software.The inter-and intra-group differences of ERP indexes were compared using two-way ANOVA, and Spearman correlation analysis was conducted to examine the relationship between ERP indexes and scores of the Beck scale for suicidal ideation. Results:(1)Compared with healthy controls, depressed patients with and without suicidal ideation had both lower net scores in IGT (both P<0.05).(2)When comparing the mean FRN amplitude under different feedback types among the three groups, the main effect of feedback type ( F=8.799, P=0.004), the main effect of group ( F=6.396, P=0.002) and the interaction effect ( F=4.200, P=0.018)were all significant. Under gain feedback conditions, the mean FRN amplitude was lower in both depressed groups compared with healthy controls (both P<0.05). (3)The comparison of the mean P300 amplitude under different feedback types among the three groups showed that the main effect of group ( F=15.719, P<0.001) and the main effect of feedback type ( F=15.949, P=0.001) were both significant, while the interaction effect between group and feedback type was not significant ( F=1.573, P=0.213). The group with suicidal ideation ((0.85±0.21) μV) had a smaller amplitude than both the non-suicidal ideation group ((1.61±0.22) μV) and healthy controls ((2.46±0.20) μV) (both P<0.05). (4)In depressed patients, P300 mean amplitude under both loss and gain feedback conditions were both negatively correlated with suicidal ideation (loss: r=-0.435, P=0.001; gain: r=-0.318, P=0.013). Conclusion:Depressed patients with and without suicidal ideation both exhibit impaired risk decision-making. The decrease of P300 mean amplitude is more significant in depressed patients with suicidal ideation than those without suicidal ideation.P300 mean amplitude may serve as an electrophysiological marker to differentiate depressed patients with suicidal ideation and those without suicidal ideation.
9.The microstate characteristics of electroencephalogram in first-episode drug-naive patients with major depressive disorder
Wubin CHEN ; Ciqing BAO ; Qiaoyang ZHANG ; Haowen ZOU ; Rui YAN ; Qing LU ; Zhijian YAO
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(9):798-803
Objective:To analyze the characteristics of electroencephalogram microstate parameters in first-episode drug-naive patients with major depressive disorder (MDD), so as to provide electrophysiological evidence for the pathogenesis and early diagnosis of MDD.Methods:Eighty-four first-episode, drug-naive outpatients diagnosed with MDD(MDD group) and 82 healthy controls(healthy group) participated in this study. Resting-state EEG data (5-6 min, with eyes closed) were recorded for all participants. Data preprocessing and microstate analysis were performed using MATLAB and EEGLAB software. Temporal parameters of resting-state brain network microstates were compared using SPSS 26.0.Results:This study identified four typical microstates: Class A microstate(auditory network), Class B microstate(visual network), Class C microstate(salient network), and Class D microstate(attention and control network). The coverage rate (0.16±0.06, 0.21±0.06), duration (67.72±7.07, 72.28±8.59), and incidence rate (2.38±0.68, 2.82±0.67) of microstate A in MDD group were significantly lower than those in healthy group ( F=22.115, 13.368, 18.779, all P<0.001), while the above indexes of microstate B in MDD group were significantly higher than those in healthy group(coverage rate: 0.24±0.07 vs 0.18±0.06, duration: 76.35±11.28 vs 69.46±8.52, incidence rat: 3.16±0.52 vs 2.52±0.57) ( F=41.287, 18.999, 52.245, all P<0.001). Additionally, the microstate D in MDD group showed significantly lower coverage rate(0.33±0.08, 0.36±0.08) and duration (89.66±15.38, 95.46±16.79)compared with healthy group( F=3.932, 4.215, both P<0.05). Notably, significant differences were observed in the transition probabilities between the following microstates: A→B, A→D, B→A, C→A, C→B, D→A and D→B (all P<0.05). Conclusion:First-episode drug-naive depressive patients are characterized by alterations in microstate A, microstate B, and microstate D, which may be the potential pathogenesis of MDD and may serve as electrophysiological indicators for early diagnosis of MDD.
10.Analysis of differences between subjective and objective refraction results in myopic children and adolescents under different ciliary muscle functional states
Xinhui HUANG ; Haotian WU ; Bo ZHANG ; Zhijian AI ; Jun CHEN ; Xiangui HE
Chinese Journal of Experimental Ophthalmology 2025;43(2):138-143
Objective:To analyze the differences between subjective refraction and autorefraction in myopic children and adolescents under different ciliary muscle functional states.Methods:A cohort study was conducted.A total of 98 myopic children and adolescents (196 eyes) aged 7-15 years who visited the Shanghai Eye Disease Prevention and Treatment Center from November 2023 to February 2024 were included by random sampling.All participants underwent cycloplegia with 1.0% cyclopentolate and completed both subjective refraction and autorefraction before cycloplegia, after cycloplegia and after recovery from cycloplegia.The spherical equivalent (SE) differences and differences in SE(ΔSE) between different conditions were compared.Proportion of ΔSE, differences in spherical power (ΔS), and differences in cylindrical power (ΔC) of objective and subjective refraction between different conditions within the clinically acceptable error range (-0.25 to 0.25 D) was calculated and compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Eye Diseases Prevention & Treatment Center (No.2021SQ021).Written informed consent was obtained from guardian of each subject before any medical examination.Results:The SE values obtained from autorefraction before cycloplegia, after cycloplegia, and after recovery from cycloplegia were -2.44(-3.47, -1.63), -2.13(-3.25, -1.50), and -2.38(-3.50, -1.66)D, respectively, with a statistically significant overall difference ( χ2=148.36, P<0.001) and statistically significant differences in pairwise comparisons at different time points (all P<0.001); for subjective refraction, the SE values were -2.25(-3.50, -1.50), -2.19(-3.47, -1.45), and -2.28(-3.50, -1.50)D, respectively, with a statistically significant overall difference ( χ2=43.48, P<0.001) and statistically significant differences in pairwise comparisons at different time points (all P<0.001).Subjective refraction ΔSE between before and after cycloplegia, after cycloplegia and after recovery from cycloplegia were significantly smaller than those of autorefraction ( t=2.84, 1.82; both P<0.001).There was no significant difference in ΔSE between subjective refraction and autorefraction between before cycloplegia and after recovery from cycloplegia ( t=-0.43, P=0.070).The proportions of subjective refraction ΔSE within the acceptable error range between before and after cycloplegia, before cycloplegia and after recovery from cycloplegia, and after cycloplegia and after recovery from cycloplegia were significantly higher than those of autorefraction ( χ2=28.32, 11.82, 25.55; all P<0.001).The proportion of subjective refraction ΔS and ΔC both within the acceptable error range between before cycloplegia and after recovery from cycloplegia was 81.63%(160/196) and 79.59%(156/196) between after cycloplegia and after recovery from cycloplegia. Conclusions:Subjective refraction is less affected by different ciliary muscle functional states.The differences in subjective refraction results under different ciliary muscle functional states are mostly within the acceptable error range.The subjective refraction results before or after cycloplegia can be used to better predict the subjective refraction results after recovery from cycloplegia.


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