1.Multicenter machine learning-based construction of a model for predicting potential organ donors and validation with decision curve analysis
Xu WANG ; Wenxiu LI ; Fenghua WANG ; Shuli WU ; Dong JIA ; Xin GE ; Zhihua SHAN ; Tongzuo LI
Organ Transplantation 2026;17(1):106-115
Objective To evaluate the predictive value of different machine learning models constructed in a multicenter environment for potential organ donors and verify their clinical application feasibility. Methods The study included 2 000 inpatients admitted to five domestic tertiary hospitals from January 2020 to December 2023, who met the criteria for potential organ donation assessment. They were randomly divided into a training set and an internal validation set (7∶3). Another 300 similar patients admitted to the First Affiliated Hospital of Harbin Medical University from January 2024 to April 2025 were included as an external validation set. The area under the curve (AUC), sensitivity, specificity, accuracy and F1-score of three models were compared, and the consistency of the potential organ donor determination process was tested. Multivariate logistic regression analysis was used to identify predictive factors of potential organ donors. Decision curve analysis (DCA) was employed to verify the resource efficiency of each model, and the threshold interval and intervention balance point were assessed. Results Apart from age, there were no significant differences in other basic characteristics among the centers (all P>0.05). The consistency of the potential organ donor determination process among researchers in each center was good [all 95% confidence interval (CI) lower limits >0]. In the internal validation set, the XGBoost model had the best predictive performance (AUC=0.92, 95% CI 0.89-0.94) and the best calibration (P=0.441, Brier score 0.099). In the external validation set, the XGBoost model also had the best predictive performance (AUC=0.91, 95% CI 0.88-0.94), outperforming logistic regression and random forest models. Multivariate logistic regression showed that mechanical ventilation had the greatest impact (odds ratio=2.06, 95% CI 1.54-2.76, P<0.001). DCA indicated that the XGBoost model had the highest net benefit in the threshold interval of 0.2-0.6. The “treat all” strategy only had a slight advantage at extremely low thresholds. The recommended threshold interval, which balances intervention costs and clinical benefits, considers ≥50% positive predictive value (PPV) and ≤50 referrals per 100 high-risk patients. Conclusions The XGBoost model established in a multicenter environment is accurate and well-calibrated in predicting potential organ donors. Combined with DCA, it may effectively guide the timing of clinical interventions and resource allocation, providing new ideas for the assessment and management of organ donation after brain death.
2.Treatment Principles and Paradigm of Diabetic Microvascular Complications Responding Specifically to Traditional Chinese Medicine
Anzhu WANG ; Xing HANG ; Lili ZHANG ; Xiaorong ZHU ; Dantao PENG ; Ying FAN ; Min ZHANG ; Wenliang LYU ; Guoliang ZHANG ; Xiai WU ; Jia MI ; Jiaxing TIAN ; Wei ZHANG ; Han WANG ; Yuan XU ; .LI PINGPING ; Zhenyu WANG ; Ying ZHANG ; Dongmei SUN ; Yi HE ; Mei MO ; Xiaoxiao ZHANG ; Linhua ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):272-279
To explore the advantages of traditional Chinese medicine (TCM) and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications (DMC), refine key pathophysiological insights and treatment principles, and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine, hosted by the China Association of Chinese Medicine, was held in Beijing, 2024. Experts in TCM, Western medicine, and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis, diagnostic and treatment challenges, and mechanism research related to DMC, ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development, research prioritization, and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM, strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.
3.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine
Ziyi WANG ; Xingyu FAN ; Yuzhi JIA ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):230-236
Type 2 diabetes mellitus (T2DM) and hypertension are common and frequent chronic non-communicable diseases, which often coexist in clinical practice, resulting in a large number of cardiovascular events and deaths, and their case fatality rate far exceeds that of other factors such as dyslipidemia and obesity. Based on the diagnostic standards, guidelines, and animal model evaluation methods of T2DM with hypertension at home and abroad, this study summarized, evaluated, and analyzed the characteristics of the existing animal models of T2DM with hypertension based on the clinical symptoms in traditional Chinese and Western medicine. The animal models showing high fitting degrees with the clinical symptoms in Western medicine are mainly established by injection of streptozocin (STZ) in SHR rats in the surgical induction and chemical induction methods and feeding a high-fat and high-salt diet combined with STZ injection in SD rats in the dietary induction methods. The models showcasing high fitting degrees with the clinical symptoms in traditional Chinese medicine (TCM) are mainly established by the surgical induction method. Considering the fitting degrees and the advantages and disadvantages, the ideal modeling method for T2DM with hypertension is the two-kidney, one clip (2K1C) method (a surgical induction method) combined with feeding a high-fat and high-sugar diet and STZ injection. However, the available models lack the characteristics of TCM and the evaluation indicators have poor specificity. This study found that there are few animal models of T2DM with hypertension considering the characteristics of both disease and syndrome, which may be related to the identification and attribution of TCM syndromes in animal macroscopic information. In view of this problem, it is suggested that the evaluation criteria should be established and improved for the animal models combining disease and syndrome, which can help to evaluate the fitting degree of the pathological characteristics of different syndromes in the animal models of T2DM with hypertension. In this way, ideal animal models of T2DM with hypertension can be established to simulate the disease occurrence and development in the human body. The animal models are expected to provide an ideal approach for the further research on the pathogenesis of T2DM and its prevention and treatment with TCM, which is of great significance for the treatment and prevention of T2DM with hypertension and the prognosis of its complications. At the same time, breakthroughs in the basic syndrome models of comorbidities are expected to lay a foundation for the leapfrog development of TCM research.
4.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine
Ziyi WANG ; Xingyu FAN ; Yuzhi JIA ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):230-236
Type 2 diabetes mellitus (T2DM) and hypertension are common and frequent chronic non-communicable diseases, which often coexist in clinical practice, resulting in a large number of cardiovascular events and deaths, and their case fatality rate far exceeds that of other factors such as dyslipidemia and obesity. Based on the diagnostic standards, guidelines, and animal model evaluation methods of T2DM with hypertension at home and abroad, this study summarized, evaluated, and analyzed the characteristics of the existing animal models of T2DM with hypertension based on the clinical symptoms in traditional Chinese and Western medicine. The animal models showing high fitting degrees with the clinical symptoms in Western medicine are mainly established by injection of streptozocin (STZ) in SHR rats in the surgical induction and chemical induction methods and feeding a high-fat and high-salt diet combined with STZ injection in SD rats in the dietary induction methods. The models showcasing high fitting degrees with the clinical symptoms in traditional Chinese medicine (TCM) are mainly established by the surgical induction method. Considering the fitting degrees and the advantages and disadvantages, the ideal modeling method for T2DM with hypertension is the two-kidney, one clip (2K1C) method (a surgical induction method) combined with feeding a high-fat and high-sugar diet and STZ injection. However, the available models lack the characteristics of TCM and the evaluation indicators have poor specificity. This study found that there are few animal models of T2DM with hypertension considering the characteristics of both disease and syndrome, which may be related to the identification and attribution of TCM syndromes in animal macroscopic information. In view of this problem, it is suggested that the evaluation criteria should be established and improved for the animal models combining disease and syndrome, which can help to evaluate the fitting degree of the pathological characteristics of different syndromes in the animal models of T2DM with hypertension. In this way, ideal animal models of T2DM with hypertension can be established to simulate the disease occurrence and development in the human body. The animal models are expected to provide an ideal approach for the further research on the pathogenesis of T2DM and its prevention and treatment with TCM, which is of great significance for the treatment and prevention of T2DM with hypertension and the prognosis of its complications. At the same time, breakthroughs in the basic syndrome models of comorbidities are expected to lay a foundation for the leapfrog development of TCM research.
5.Safety analysis of Yttrium-90 resin microsphere selective internal radiation therapy on malignant liver tumors
Jia CAI ; Shiwei TANG ; Rongli LI ; Mingxin KONG ; Hongyan DING ; Xiaofeng YUAN ; Yuying HU ; Ruimei LIU ; Xiaoyan ZHU ; Wenjun LI ; Haibin ZHANG ; Guanwu WANG
Chinese Journal of Clinical Medicine 2025;32(1):24-29
Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (90Y-SIRT) on malignant liver tumors. Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent 90Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of 90Y-SIRT. Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (99mTc-MAA) perfusion test and received the 90Y-SIRT; one patient received 90Y-SIRT after the second 99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%). Conclusion The adverse reactions of 90Y-SIRT for treating malignant liver tumors are mild, indicating good safety.
6.Research advances in the disease burden of viral hepatitis in China
Jian LI ; Fuzhen WANG ; Zhongdan CHEN ; Jinlei QI ; Ailing WANG ; Fanghui ZHAO ; Yuanyuan KONG ; Jing SUN ; Jiaqi KANG ; Zundong YIN ; Zhongfu LIU ; Jidong JIA ; Yu WANG
Journal of Clinical Hepatology 2025;41(2):221-227
Over the past three decades, China has made significant progress in the prevention and control of viral hepatitis, and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level; however, there is still a heavy disease burden of chronic viral hepatitis in China, which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China, analyzes existing problems and challenges, and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China, in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.
7.Identification of tortoiseshell glue and antler glue in Qixiong zuogui granules and content determination of 12 chemical components
Mengxiao JIA ; Chunhui CHANG ; Yang LIU ; Yaqian WANG ; Yunke ZHANG ; Yongyan JIA
China Pharmacy 2025;36(5):540-545
OBJECTIVE To identify tortoiseshell glue and antler glue in Qichong zuogui granules, and determine the contents of 12 chemical components. METHODS Identification and content determination were performed by using liquid chromatography- tandem mass spectrometry (LC-MS/MS) method. The identification was performed on Hypersil GOLD column with a mobile phase consisted of acetonitrile-0.1% formic acid solution (gradient elution); the electrospray ion source was used to scan in the positive ion multi-reaction detection mode. The mass charge ratio (m/z) 631.3→546.4, 631.3→921.4 was the detection ion pair for tortoiseshell glue, and the m/z 765.4→554.0, 765.4→733.0 was the detection ion pair for antler glue. The determination method for 12 chemical components was as follows: Accucore C18 column, methanol-0.1% formic acid as mobile phase (gradient elution); scanning range of positive and negative ions was m/z 100→1 000 with the electric spray ion source and single ion detection scanning mode. RESULTS Average retention times of the molecular ion peaks for characteristic peptide segments of tortoiseshell glue and antler glue were 6.28 and 6.77 min, respectively; the linear relationship of 12 chemical components was good within their respective concentration ranges, such as astragaloside Ⅳ, calycosin-7-O-β-D-glucoside, calycosin, chlorogenic acid, ferulic acid, betaine, amygdalin, rutin, hydroxysafflor yellow A, hyperoside, loganin, cyasterone (r>0.999); RSDs for precision, stability (24 h) and reproducibility tests were all less than 5%. The average sample recovery rates ranged from 98.04% to 101.08%. The average contents of 12 components were 1.83, 25.73, 13.76,56.71, 23.80, 49.82, 807.49, 15.01, 317.02, 60.21, 202.71 and 17.70 μg/g, respectively. CONCLUSIONS In this study, tortoiseshell glue and antler glue in Qixiong zuogui granules are identified, and the contents of 12 chemical components therein are determined. This provides a reference for the quality control of this granule.
8.Study on population pharmacokinetics of levetiracetam in post-stroke epilepsy patients
Chenxi LIU ; Yin WU ; Caiyun JIA ; Sai CUI ; Huizhen WU ; Suxing WANG
China Pharmacy 2025;36(5):594-599
OBJECTIVE To establish population pharmacokinetic model of levetiracetam (Lev) for Chinese patients with post- stroke epilepsy (PSE), and provide reference for formulating individualized dosing regimens for Lev therapy in this specific population. METHODS Blood concentration data and clinical diagnosis and treatment information of PSE patients meeting the inclusion criteria were retrospectively collected and divided into model group and validation group at an 8∶2 ratio using a random number method. Based on the model group data, a population pharmacokinetic model was developed using nonlinear mixed-effects modeling. Internal evaluation was performed through goodness-of-fit tests and bootstrap analysis, while external validation was conducted using the validation group data. RESULTS A total of 75 blood concentration measurements from 70 PSE patients were collected, with 60 measurements from 55 patients used for model development and 15 measurements from 15 patients reserved for external validation. The final model estimated a population typical value of clearance at 2.98 L/h. Estimated glomerular filtration rate, daily dose, and homocysteine level significantly influenced clearance of Lev (P<0.01). The model demonstrated satisfactory predictive performance, as evidenced by goodness-of-fit tests, bootstrap analysis, and external validation results. CONCLUSIONS Daily dose, estimated glomerular filtration rate, and homocysteine level are identified as significant covariates influencing Lev clearance in Chinese PSE patients. When making clinical decisions, comprehensive consideration should be given to the patient’s treatment response, physiological and pathological conditions, and the occurrence of adverse reactions, etc. The dosage of Lev should be adjusted based on the results of population pharmacokinetic model.
9.Cloning and Functional Characterization of Farnesyl Diphosphate Synthase Gene in Biosynthesis of Terpenoid Components in Chinese Materia Medica
Yue ZHANG ; Feng ZHANG ; Yue ZHANG ; Chaoyue LIU ; Bolin ZHANG ; Jia LIU ; Caixia WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):175-183
ObjectiveThis study aims to enhance of the farnesyl pyrophosphate(FPP) pool in Saccharomyces cerevisiae by heterologously expressing different farnesyl diphosphate synthases(FPSs) from various plants, thereby increasing the production of terpenoid compounds by the engineered yeast. MethodsRNA from mixed samples of roots, stems, and leaves of seven plants including Arabidopsis thaliana, Rosa rugosa, Artemisia annua, Centella asiatica, Humulus lupulus, Medicago sativa, and Panax ginseng was extracted by column chromatography and reverse transcribed into the first strand of complementary DNA(cDNA), and based on the transcriptome data of the seven species of plants, sequence-specific primers were designed for CaFPS, RrFPS, MsFPS, HiFPS, PgFPS, AtFPS, and AaFPS, the full-length of the genes was cloned, and the genes were analyzed for bioinformatics in order to construct a pESC yeast shuttle vector. These seven plant-derived FPSs were further heterologously expressed in the previous constructed β-elemene-producing yeast, and the yield of β-elemene was indicated for their catalytic acivities. ResultsThe coding sequences of CaFPS, RrFPS, MsFPS, HiFPS, PgFPS, AtFPS, and AaFPS were all of 1 021 bp in length and encoding 301 amino acids, all of which were similarly related to the endogenous FPS-encoding gene(ERG20) in S. cerevisiae. After heterologous expression, RrFPS was identified as the most effective in catalyzing the synthesis of FPP from isopentenyl pyrophosphate(IPP) and dimethylallyl pyrophosphate(DMAPP). Compared to the control strains, the RrFPS overexpressed yeast strains YB-1-Rr and YB-3-Rr increased the production of β-elemene by 231.25% and 189.3%, respectively. ConclusionBy comparing the functions of FPS-encoding genes from seven different plant sources, it is determined that the protein encoded by the RrFPS from R. rugosa has the best catalytic ability, which can provide key genetic elements for the construction of engineered yeast strain constructs with high terpenoid production.
10.Autophagy Abnormalities in PCOS and Targeted Treatment with Traditional Chinese Medicine: A Review
Xinxin YANG ; Zhicheng JIA ; Mengyu SHI ; Yongqian LI ; Peixuan WANG ; Ying GUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):313-322
Polycystic ovary syndrome (PCOS) is a common gynecological endocrine and reproductive disorder,with the main clinical manifestations including ovulation failure,insulin resistance,hyperandrogenism,and obesity. Its occurrence and development are closely related to cellular regulatory mechanisms such as apoptosis,autophagy,oxidative stress,and inflammatory response. Autophagy,as a clearance mechanism that maintains cellular homeostasis,plays a crucial role in maintaining the growth,development,and maturation of oocytes. Exploring the mechanism of autophagy during the occurrence and development of diseases can help develop treatment methods for PCOS by regulating autophagy. Studies have shown that autophagy plays an important role in the pathogenesis of PCOS,and it can affect the occurrence and development of PCOS through multiple pathways,levels,and targets. Traditional Chinese medicine (TCM) regulates autophagy in ovarian granulosa cells or endometrium of patients with PCOS by targeting the expression of autophagy signaling pathways,regulatory factors,and non-coding single-stranded RNA molecules,thereby alleviating inflammation,regulating metabolism disorders,and balancing hormone levels in PCOS. Accordingly,TCM can ameliorate pathological conditions such as insulin resistance,hyperandrogenism,and ovulation failure in PCOS. This article summarizes the TCM formulas and extracts for the treatment of PCOS,as well as the main autophagy pathways and regulatory factors involved,aiming to provide reference and suggestions for the future treatment of PCOS with TCM by regulating autophagy.

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