1.Construction and Evaluation of "Constitution-disease-syndrome" Trinity Model for Rodents with Qi Deficiency
Yasheng DENG ; Jiang LIN ; Yujiang XI ; Qian ZHOU ; Yanping FAN ; Wenyue LI ; Yonghui LIU ; Zhaobing NI ; Qiu CHEN ; Xi MING
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):274-284
The theory of constitution in traditional Chinese medicine (TCM) has emerged as a new discipline in recent years. Constitution plays a vital role in the onset,progression,transformation,and prognosis of diseases. At present,some clinical scholars have adopted a novel diagnostic and treatment model of "constitution differentiation-disease identification-syndrome differentiation",in which constitution is regarded as a core element throughout the diagnostic and therapeutic process. Constitution is closely associated with etiology,onset,pathogenesis,syndrome differentiation,and treatment. Against this background,the construction of animal models based on constitution holds far-reaching significance for advancing clinical research. This paper focuses on the construction and evaluation of rodent models with Qi-deficiency constitution,aiming to explore how to further induce Qi-deficiency syndromes and related disease states on the basis of Qi-deficiency constitution models,thereby developing an integrated animal model that embodies the trinity of "constitution-disease-syndrome". The establishment of this model not only provides a solid experimental foundation for the development of new therapies and drugs in TCM targeting specific constitutions,diseases,and syndromes,but also greatly promotes the modernization and scientific advancement of TCM theory. By comprehensively applying multidisciplinary technologies and methods,the study evaluates the model's validity,reliability,and practicality,with the aim of opening new avenues for future research in TCM and promoting the development of the field.
2.Construction and Evaluation of "Constitution-disease-syndrome" Trinity Model for Rodents with Qi Deficiency
Yasheng DENG ; Jiang LIN ; Yujiang XI ; Qian ZHOU ; Yanping FAN ; Wenyue LI ; Yonghui LIU ; Zhaobing NI ; Qiu CHEN ; Xi MING
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):274-284
The theory of constitution in traditional Chinese medicine (TCM) has emerged as a new discipline in recent years. Constitution plays a vital role in the onset,progression,transformation,and prognosis of diseases. At present,some clinical scholars have adopted a novel diagnostic and treatment model of "constitution differentiation-disease identification-syndrome differentiation",in which constitution is regarded as a core element throughout the diagnostic and therapeutic process. Constitution is closely associated with etiology,onset,pathogenesis,syndrome differentiation,and treatment. Against this background,the construction of animal models based on constitution holds far-reaching significance for advancing clinical research. This paper focuses on the construction and evaluation of rodent models with Qi-deficiency constitution,aiming to explore how to further induce Qi-deficiency syndromes and related disease states on the basis of Qi-deficiency constitution models,thereby developing an integrated animal model that embodies the trinity of "constitution-disease-syndrome". The establishment of this model not only provides a solid experimental foundation for the development of new therapies and drugs in TCM targeting specific constitutions,diseases,and syndromes,but also greatly promotes the modernization and scientific advancement of TCM theory. By comprehensively applying multidisciplinary technologies and methods,the study evaluates the model's validity,reliability,and practicality,with the aim of opening new avenues for future research in TCM and promoting the development of the field.
3.Expert Consensus on Clinical Application of Qidong Yixin Oral Liquid
Changkuan FU ; Xiaochang MA ; Mingjun ZHU ; Yue DENG ; Hongxu LIU ; Mingxue ZHANG ; Ying CHEN ; Yan ZHOU ; Ling ZHANG ; Jianhua FU ; Wei YANG ; Yu'er HU ; Ming CHEN ; Yanming XIE ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):147-158
The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis (VMC). It has the functions of tonifying Qi, nourishing the heart,calming the mind, and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However,the understanding of its efficacy evidence, advantageous aspects, dosage and administration, and medication safety remains insufficient in clinical practice. Therefore,the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid (hereinafter referred to as consensus) was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine,successively completing multiple tasks such as the consensus project initiation,determination of clinical problems,evidence search and evaluation,formation of recommendation opinions and consensus suggestions,solicitation of opinions,peer review, submission for review and release, and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions,clarifying the clinical positioning,efficacy advantages,syndrome differentiation,dosage and administration,combination therapy,timing of medication,adverse reactions,contraindications, and precautions of Qidong Yixin oral liquid,indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease,providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23, 2024. Standard number:GSCACM-376-2024.
4.Molecular Crosstalk Mechanisms of Shoutai Wan and Juyuan Jian on Maternal-fetal Interface Subcellular Clusters in CBA/J×DBA/2 Recurrent Pregnancy Loss Model
Jingxin GAO ; Qiuping CHEN ; Xiaoyan ZHENG ; Pengfei ZENG ; Rui ZHOU ; Yancai TANG ; Qian ZENG ; Wenli GUO ; Jinzhu HUANG ; Weijun DING ; Linwen DENG ; Hang ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):70-87
ObjectiveTo systematically compare the differential regulation of the maternal-fetal interface cell lineages and communication networks in the CBA/J×DBA/2 mouse model of recurrent pregnancy loss (RPL) by the two classic therapeutic methods-tonifying the kidney to stabilize the fetus and invigorating the spleen to stabilize the fetus (Shoutai Wan, Juyuan Jian)-of traditional Chinese medicine (TCM) at the single-cell resolution and clarify their modern scientific connotations. MethodsFemale non-pregnant CBA/J mice were caged with male BALB/c (blank group) and DBA/2 (modeling group) mice separately. Pregnant mice in the modeling group were randomly grouped as follows: high/low-dose Shoutai Wan, high/low-dose Juyuan Jian, model (RPL), and positive control (dydrogesterone), with 10 mice in each group. Starting from the day after the detection of the vaginal plug, mice were administrated with drugs or an equal volume of normal saline by gavage for 10 consecutive days. After the intervention, the following indicators were measured. ① Macroscopic evaluation: general conditions, uterine wet weight, embryo loss rate, four coagulation parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and thrombin time (TT)], and peripheral blood estradiol (E2) and progesterone (Pg) levels. The decidua with embryos was stained with hematoxylin-eosin (HE) and evaluated by transmission electron microscopy (TEM). The expression of B-cell lymphoma-2 (Bcl-2), vascular endothelial growth factor (VEGF), angiotensin Ⅱ (AngⅡ), matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6), leukemia inhibitory factor (LIF), CXC chemokine ligand 12 (CXCL12), and microtubule-associated protein 1 light chain 3 homolog (LC3)Ⅰ/Ⅱ was quantified by Western blot. ② Mechanism analysis at the single-cell level: The decidua with embryos from the blank, model, high-dose Shoutai Wan, and high-dose Juyuan Jian groups (6 mice per group, with 3 single-cell samples per group, totaling 24 mice) were analyzed by the BD Rhapsody™ platform, and the whole-cell atlas was drawn by uniform manifold approximation and projection (UMAP) dimensionality reduction clustering combined with the single-cell mouse cell atlas (scMCA). The differentially expressed genes (DEGs) and cell interaction networks were analyzed via Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and CellChat, and the protein-protein interaction (PPI) map of subtype cells was constructed. The CytoTRACE pseudo-temporal analysis was performed to explore the developmental trajectories of core immune cells (natural killer cells, NK cells) from maternal and fetal sources. Results① Pathological and Western blot results indicated that compared with the blank group, the RPL group showed an increase in the embryo loss rate (P<0.01), down-regulated expression of Bcl-2, LIF, MMP-2, and Vegf in the decidua with embryos (P<0.05), up-regulated protein levels of CXCL-12, AngⅡ, and IL-6 (P<0.05), blocked angiogenesis, apoptosis-inflammation imbalance, and coagulation dysfunction. Both prescriptions dose-dependently reduced the abortion rate and restored the angiogenesis-inflammation balance, and Shoutai pill showed superior performance in restoring the E2 level to the Pg level (P<0.05). ② Single-cell transcriptome analysis indicated that compared with the blank group, the RPL group showed differences in multiple key cell populations such as decidual cells, trophoblast cells, endothelial cells, erythroblasts, NK cells, and macrophages at the maternal-fetal interface. Immunity and angiogenesis were the key links in RPL. Compared with the RPL group, high-dose Shoutai Wan reversed the changes of NK cells in the embryonic layer (upregulating the mRNA levels of 17 genes and downregulating the mRNA levels of 29 genes) and macrophages (upregulating the mRNA levels of 117 genes and downregulating the mRNA levels of 53 genes) through the regulation of gene expression. High-dose Shoutai pill regulated the immune cells to affect unfolded proteins, cell adhesion, and programmed cell death, thereby promoting decidualization and angiogenesis and modulating embryo-membrane development. High-dose Juyuan Jian regulated the key subgroups of NK cells (up-regulating the mRNA levels of 9 genes and down-regulating the mRNA levels of 17 genes) and macrophages (up-regulating the mRNA levels of 110 genes and down-regulating the mRNA levels of 81 genes), which affected decidual inflammation and apoptosis and intervened in glycolysis. ③ The pseudo-temporal analysis and communication network indicated that the communication frequency of the RPL group decreased. High-dose Shoutai Wan restored maternal-fetal tolerance through pathways such as NKG2D, CDH5, GDF, and FASLG. High-dose Juyuan Jian enhanced the IL-6/LIFR/JAK/signal transducer and activator of transcription 3 (STAT3) and desmosome/SEMA6/tumor necrosis factor-like weak inducer of apoptosis (TWEAK) signaling to improve endometrial receptivity. The RPL group showed an increased proportion of toxic dNK7, a decreased proportion of reparative dNK4, and blocked embryo fNK1. High-dose Shoutai Wan down-regulated dNK7 and up-regulated dNK4. High-dose Juyuan Jian inhibited the terminal differentiation of dNK7 and up-regulated LILRB1, thus restoring the balance of cytotoxicity and repair. ConclusionBoth the kidney-tonifying and spleen-invigorating methods are effective in treating RPL. NK and macrophages are the key immune cells in the interaction between the embryo and the membrane. The kidney-tonifying method (Shoutai Wan) has an advantage in regulating the phenotypes of unfolded protein, cell adhesion, and programmed cell death, and shows expression characteristics closer to the physiological state in the regulation of NKG2D and CDH5 signals. The spleen-invigorating method (Juyuan Jian) has an advantage in regulating epithelial-mesenchymal transition (EMT), angiogenesis, and glycolysis and shows higher communication intensity in the IL-6 and LIFR pathways.
5.A New Perspective on Mental Health Assessment in Laboratory Animals: Stress Response Monitoring Based on Hair Characteristics
Hongman LI ; Yutong CHEN ; Yingpei SHI ; Yijing WANG ; Yan PAN ; Tong XU ; Yi ZHOU ; Qiyue DENG ; Xue LIU
Laboratory Animal and Comparative Medicine 2026;46(4):553-563
The mental health management of laboratory animals is a critical factor in ensuring the reliability of scientific research data. However, due to the subtle nature of mental state alterations and the limitations of current assessment methods, the mental health of laboratory animals is often overlooked by researchers. Therefore, there is an urgent need to explore a new, objective, simple, and practical method for evaluating mental health. Stress, as a primary factor inducing alterations in the mental state of animals, can influence experimental results across multiple research fields through the neuroendocrine-immune network. This paper first elucidates the necessity of mental health management in laboratory animals from three perspectives: factors contributing to stress, neural mechanisms of stress, and research areas affected by stress. It highlights that excluding animals with abnormal mental states before experiments can enhance the efficiency and reproducibility of biomedical studies. Second, this paper briefly summarizes existing methods for assessing the health of laboratory animals, pointing out that approaches such as behavioral tests and metabolomics have many limitations in evaluating stress responses. Existing methods struggle to meet the demand for simple, objective, and non-invasive assessment methods in animal management. Therefore, this paper focuses on hair, a biological sample with the advantages of cumulative information and non-invasive collection, and systematically describes the theoretical basis and technological advances in using hair characteristics as indicators of stress responses from three perspectives: hair traits, the levels of substances in hair, and artificial intelligence (AI). It proposes and supports an innovative technical pathway that combines hair traits with AI-based image analysis, with the aim of offering an improved solution for non-invasive and objective stress assessment, while providing theoretical support for improving the health management system of laboratory animals.
6.Exploring Mechanism of Luoshi Neiyi Prescription in Treating Endometriosis Based on Ferroptosis and Serum Metabolomics
Haixia PAN ; Yingqiao ZHONG ; Ting MAO ; Ziyi DENG ; Meilin WU ; Lei HUANG ; Siyang CHEN ; Yong GUO ; Ying ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):201-212
ObjectiveThis study aimed to investigate the mechanism by which Luoshi Neiyi prescription treats endometriosis (EMs) through regulating ferroptosis, and to screen key metabolites and analyze their association with ferroptosis. MethodsClinical samples of normal endometrium from patients without EMs and eutopic and ectopic endometrium from EMs patients (10 cases each) were collected and divided into control group, eutopic group, and EMs group. Hematoxylin-eosin (HE) staining was performed to observe ectopic lesions of EMs. Immunohistochemistry was used to detect the expression of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4). Enzyme-linked immunosorbent assay (ELISA) was adopted to determine the levels of malondialdehyde (MDA), ferrous ion (Fe2+), GPX4 and glutathione (GSH) in endometrial tissues, as well as serum levels of Fe2+, GPX4 and GSH. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of SLC7A11, GPX4, transferrin receptor (TFR) and ferritin heavy chain 1 (FTH1). In the in vitro experiment, primary stromal cells were isolated from ectopic lesions of EMs patients. Cell counting kit-8 (CCK-8) was used to determine the optimal concentration of drug-containing serum for intervention. The level of reactive oxygen species (ROS) was measured, and Real-time PCR was applied to detect ferroptosis-related indicators. In the animal experiments, an EM rat model was established, and the rats were randomly assigned to the sham operation group, EMs group, low-dose Luoshi Neiyi Formula group (7.87 g·kg-1), high-dose Luoshi Neiyi prescription group (15.74 g·kg-1), and danazol group (42 mg·kg-1). Untargeted metabolomics detection and pathway enrichment analysis were conducted on serum samples from patients and rats. Spearman correlation analysis was performed to assess the relationship between differential metabolites and ferroptosis indicators. The correlations between differential metabolites in patient endometrium and serum and key ferroptosis indicators (GPX4, Fe2+, MDA, GSH) as well as ferroptosis-related mRNAs (GPX4, SLC7A11, FTH1) were analyzed, and correlation heatmaps were generated accordingly. ResultsCompared with normal eutopic endometrium, ectopic lesions in EMs patients showed glandular disorganization and stromal fibrosis. In ectopic endometrium, the contents of MDA, ROS, and Fe2+ decreased, while GPX4 level increased, and the mRNA expression of SLC7A11 and GPX4 was upregulated (P<0.05, P<0.01). In serum, the levels of GPX4 and Fe2+ were elevated, whereas the GSH level declined, suggesting abnormalities in ferroptosis-related pathways in ectopic lesions (P<0.05, P<0.01). After intervention with Luoshi Neiyi prescription-containing serum, the intracellular ROS level in ectopic endometrial stromal cells was elevated, the mRNA expression of SLC7A11 and GPX4 was downregulated, and TFR mRNA expression was upregulated (P<0.05, P<0.01). Metabolomics analysis revealed 1104 and 198 differential metabolites in EMs patients and EMs rats, respectively, compared with their corresponding control groups, and both low-dose and high-dose Luoshi Neiyi prescription were found to regulate this metabolic disturbance, with the core regulatory pathways mainly involving arginine and proline metabolism. Correlation analysis showed that the glycerophospholipids including PI(16∶0/17∶0) and PI[18∶2(9Z,12Z)] were negatively correlated with GPX4 and positively correlated with MDA, while 17α-hydroxyprogesterone was positively correlated with GPX4, SLC7A11, and FTH1 q<0.05). ConclusionLuoshi Neiyi prescription may systematically ameliorate disease-associated metabolic dysregulation via modulation of the serum arginine and proline metabolism pathway, and may regulate ferroptosis in ectopic lesions through a mechanism potentially linked to the serum glycerophospholipid and steroid metabolism pathways. Collectively, these findings provide experimental evidence for the clinical application of Luoshi Neiyi prescription.
7.Exploring Mechanism of Luoshi Neiyi Prescription in Treating Endometriosis Based on Ferroptosis and Serum Metabolomics
Haixia PAN ; Yingqiao ZHONG ; Ting MAO ; Ziyi DENG ; Meilin WU ; Lei HUANG ; Siyang CHEN ; Yong GUO ; Ying ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):201-212
ObjectiveThis study aimed to investigate the mechanism by which Luoshi Neiyi prescription treats endometriosis (EMs) through regulating ferroptosis, and to screen key metabolites and analyze their association with ferroptosis. MethodsClinical samples of normal endometrium from patients without EMs and eutopic and ectopic endometrium from EMs patients (10 cases each) were collected and divided into control group, eutopic group, and EMs group. Hematoxylin-eosin (HE) staining was performed to observe ectopic lesions of EMs. Immunohistochemistry was used to detect the expression of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4). Enzyme-linked immunosorbent assay (ELISA) was adopted to determine the levels of malondialdehyde (MDA), ferrous ion (Fe2+), GPX4 and glutathione (GSH) in endometrial tissues, as well as serum levels of Fe2+, GPX4 and GSH. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of SLC7A11, GPX4, transferrin receptor (TFR) and ferritin heavy chain 1 (FTH1). In the in vitro experiment, primary stromal cells were isolated from ectopic lesions of EMs patients. Cell counting kit-8 (CCK-8) was used to determine the optimal concentration of drug-containing serum for intervention. The level of reactive oxygen species (ROS) was measured, and Real-time PCR was applied to detect ferroptosis-related indicators. In the animal experiments, an EM rat model was established, and the rats were randomly assigned to the sham operation group, EMs group, low-dose Luoshi Neiyi Formula group (7.87 g·kg-1), high-dose Luoshi Neiyi prescription group (15.74 g·kg-1), and danazol group (42 mg·kg-1). Untargeted metabolomics detection and pathway enrichment analysis were conducted on serum samples from patients and rats. Spearman correlation analysis was performed to assess the relationship between differential metabolites and ferroptosis indicators. The correlations between differential metabolites in patient endometrium and serum and key ferroptosis indicators (GPX4, Fe2+, MDA, GSH) as well as ferroptosis-related mRNAs (GPX4, SLC7A11, FTH1) were analyzed, and correlation heatmaps were generated accordingly. ResultsCompared with normal eutopic endometrium, ectopic lesions in EMs patients showed glandular disorganization and stromal fibrosis. In ectopic endometrium, the contents of MDA, ROS, and Fe2+ decreased, while GPX4 level increased, and the mRNA expression of SLC7A11 and GPX4 was upregulated (P<0.05, P<0.01). In serum, the levels of GPX4 and Fe2+ were elevated, whereas the GSH level declined, suggesting abnormalities in ferroptosis-related pathways in ectopic lesions (P<0.05, P<0.01). After intervention with Luoshi Neiyi prescription-containing serum, the intracellular ROS level in ectopic endometrial stromal cells was elevated, the mRNA expression of SLC7A11 and GPX4 was downregulated, and TFR mRNA expression was upregulated (P<0.05, P<0.01). Metabolomics analysis revealed 1104 and 198 differential metabolites in EMs patients and EMs rats, respectively, compared with their corresponding control groups, and both low-dose and high-dose Luoshi Neiyi prescription were found to regulate this metabolic disturbance, with the core regulatory pathways mainly involving arginine and proline metabolism. Correlation analysis showed that the glycerophospholipids including PI(16∶0/17∶0) and PI[18∶2(9Z,12Z)] were negatively correlated with GPX4 and positively correlated with MDA, while 17α-hydroxyprogesterone was positively correlated with GPX4, SLC7A11, and FTH1 q<0.05). ConclusionLuoshi Neiyi prescription may systematically ameliorate disease-associated metabolic dysregulation via modulation of the serum arginine and proline metabolism pathway, and may regulate ferroptosis in ectopic lesions through a mechanism potentially linked to the serum glycerophospholipid and steroid metabolism pathways. Collectively, these findings provide experimental evidence for the clinical application of Luoshi Neiyi prescription.
8.Cost and Medical Efficiency Analysis of Indocyanine Green Fluorescence-Guided Thoracoscopic Resection of Lung Lesions under the DRG Payment System
Qian CHEN ; Chao GUO ; Shuchang WANG ; Wenhao DENG ; Tianan YANG ; Jiong ZHOU ; Xiaojun MA
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1380-1389
To investigate the clinical application value of indocyanine green(ICG) fluorescence-guided thoracoscopic lung lesion resection under the diagnosis related group(DRG) payment system, and to provide reference for the management of new medical technologies in healthcare institutions. Discharged patients who underwent thoracoscopic segmentectomy and/or wedge resection at Peking Union Medical College Hospital from January 1, 2016 to May 31, 2024 were enrolled. Patients who received ICG fluorescence guidance were assigned to new technology group, while those who did not receive ICG fluorescence guidance were assigned to control group. Operative time, length of stay, cost consumption index, time consumption index, duration of ventilator use, total hospitalization cost, and 10 representative cost items were compared between the two groups. Propensity score matching(PSM) was further used to analyze the changes in these indicators after controlling for confounding factors including age, sex, DRG code, and surgical type. A total of 7999 patients who met the inclusion and exclusion criteria were enrolled, including 1392 patients(17.4%) in the new technology group and 6607 patients(82.6%) in the control group. Compared with the control group, the new technology group showed significantly shorter operative time and length of stay, and significant reductions in time consumption index, consultation and diagnostic fees, nursing fees, therapeutic medical material fees, bed fees, oxygen therapy fees, antibiotic fees, and albumin product fees, while the cost consumption index, total hospitalization cost, surgical fees, and surgical medical material fees were significantly increased(all ICG fluorescence-guided thoracoscopic lung lesion resection can significantly improve medical efficiency, optimize cost structure, and reduce perioperative supportive resource consumption. However, its clinical benefits vary significantly among patients with different surgical types or different DRG groups, so clinicians are advised to strengthen preoperative precise evaluation.
9.Construction of pharmaceutical service quality evaluation system for Chongqing’s compact urban medical groups and empirical investigation
Yan CHEN ; Zheng DENG ; Binbin LIAO ; Yongwei ZHOU ; Guangxian WANG ; Liu YANG
China Pharmacy 2026;37(20):2654-2659
OBJECTIVE To construct a pharmacy service quality evaluation system, identify weaknesses in the integrated development of pharmacy services, and provide a reference for the homogenized and high-quality development of pharmacy services in compact urban medical groups.METHODS Guided by the five core dimensions of the Servperf model, the Delphi method was used to screen and optimize items, and a tripartite pharmacy service quality evaluation system, covering clinicians, pharmacists, and patients, adapted to the characteristics of compact urban medical groups was constructed. A multicenter cross-sectional empirical investigation was conducted in six compact urban medical groups in Chongqing using the evaluation system.RESULTS Through two rounds of Delphi consultation with 12 experts, a tripartite pharmacy service quality evaluation system was successfully constructed, comprising 5 dimensions and 78 items (24 for clinical pharmacists, 23 for clinical medical staff, and 31 for patients and family members). The Cronbach’s α coefficients for all dimensions exceeded 0.81, and the KMO values all exceeded 0.7. A total of 1 339 valid questionnaires were collected, including 279 from clinical pharmacists, 727 from clinical medical staff, and 333 from patients and family members. The empirical investigation showed that the overall quality of regional basic pharmacy services was good, but significant inter-group differences existed in service perceptions among the three groups. The score differences across the five dimensions were all statistically significant among the three groups (all P <0.001). Except for the tangibles dimension, in which clinical medical staff scored significantly lower than clinical pharmacists and patients/family members, patients/family members scored significantly higher than clinical medical staff and clinical pharmacists in the other four dimensions ( P <0.05). For the 78 items, expert expectations largely matched the perceptions of the three groups, with a mean difference of 0.08 points; only 13 items showed a difference exceeding 0.5 points, representing marked gap,with “participating in multidisciplinary team consultation and making effective recommendations” showing the largest difference of 0.94 points.CONCLUSIONS The physician‑ pharmacist‑patient tripartite evaluation system constructed in this study is scientific and reliable. Empirical investigation confirms that the basic pharmaceutical support services of the medical groups are well established, whereas the development of high‑level collaborative services has notable weaknesses, and marked heterogeneity exists in service perception among the three groups.
10.Preliminary study on the quantitative assessment model of mitral regurgitation in echocardiography based on fully convolutional networks: automatic identification and measurement of regurgitant radius
Lu ZHONG ; Hongning SONG ; Bo HU ; Qing DENG ; Jinling CHEN ; Qing ZHOU ; Fengxia JIANG ; Sheng CAO
Chinese Journal of Ultrasonography 2025;34(2):98-106
Objective:To develop an artificial intelligence system using fully convolutional neural networks(FCN)to assist echocardiographers in the quantitative assessment of mitral regurgitation(MR)severity.Methods:From August 2021 to June 2024,echocardiographic images of 441 patients with MR were prospectively collected from Renmin Hospital of Wuhan University and the Central Hospital of Wuhan. After screening,a total of 269 patients(4 917 frames)were included in the study. Of these,3 644 frames(128 patients)of apical four-chamber color Doppler MR flow convergence images from Renmin Hospital of Wuhan University were selected as the training/validation set,while images from 121 patients(813 frames)were used as the internal test set. Additionally,images from 20 patients(460 frames)from the Central Hospital of Wuhan were selected as the external test set. The FCN algorithm was employed to capture features and segment the MR color region on the left atrial side,simultaneously outputting the regurgitant radius(r)for the calculation of the effective regurgitant orifice area and regurgitant volume. The severity of MR was then classified according to the 2017 guidelines of the American Society of Echocardiography. The segmentation and classification performance of the model was evaluated,and the measurement results of the AI system was compared with that of both senior and junior physicians.Results:In the internal test set,the accuracy of r identification for cases classified as Grade Ⅰ to Ⅳ was 0.48,0.81,0.86,and 0.87,respectively. In the external test set,the accuracy of r identification for cases classified as Grade Ⅰ to Ⅳ was 0.60,0.77,0.64,and 0.77,respectively. The average accuracy of MR classification in the internal and external test sets was 0.91 and 0.88,respectively.Conclusions:The FCN model is capable of segmenting the left atrial side regurgitant areas in apical four-chamber heart color Doppler images,aiding physicians in obtaining quantitative assessment parameters for MR,and assisting junior physicians in accurately assessing the severity of MR.

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