1.Effect of Optimized New Shengmai Powder (优化新生脉散方) on Exercise Tolerance in Patients with Chronic Heart Failure of Qi Deficiency,Blood Stasis and Fluid Retention Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial
Xianliang WANG ; Jingyi ZHANG ; Zhao GE ; Tongzuo LIU ; Maozhe ZHANG ; Shuai WANG ; Zhiqiang ZHAO ; Yingfei BI ; Ruijuan ZHOU ; Ying ZHENG ; Jingyuan MAO
Journal of Traditional Chinese Medicine 2026;67(4):425-431
ObjectiveTo evaluate the effects and safety of the optimized new Shengmai Powder (优化新生脉散方) on exercise tolerance in patients with chronic heart failure (CHF) of qi deficiency, blood stasis, and fluid retention syndrome. MethodsA randomized, double-blind, placebo-controlled trial was conducted. A total of 78 CHF patients with qi deficiency, blood stasis, and fluid retention syndrome were recruited and randomly assigned to a treatment group (39 cases) and a control group (39 cases). On the basis of conventional western medical therapy, patients in the treatment group additionally received the optimized new Shengmai Powder granules, while the control group was given an oral placebo of optimized new Shengmai Powder granules. Patients in both groups took 30.6 g each time, twice a day, mixed with water for administration, with a total treatment course of 4 weeks. The primary outcomes were 6-minute walk distance (6MWD) and peak oxygen uptake (Peak VO2) measured by cardiopulmonary exercise testing. Secondary outcomes included New York Heart Association (NYHA) functional classification, B-type natriuretic peptide (BNP) levels, cardiac function indexes including left ventricular ejection fraction (LVEF), left ventri-cular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD), Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, and scores of four diagnostic information of traditional Chinese medicine (TCM). All indicators were assessed once before and after treatment respectively. Safety indicators were evaluated, and adverse events during the trial were recorded. ResultsAll patients in both groups were included in the full ana-lysis set (FAS) and safety set (SS). Compared with baseline, the 6MWD and Peak VO₂ of cardiopulmonary exercise test in the treatment group significantly increased after treatment, while the MLHFQ scores, serum BNP levels and scores of TCM four diagnostic information significantly decreased, and the NYHA cardiac function grade significantly improved (P<0.01). After treatment, the 6MWD and Peak VO₂ of cardiopulmonary exercise test, as well as their changes from baseline in the treatment group were higher than those in the control group; the MLHFQ scores, serum BNP levels and scores of TCM four diagnostic information in the treatment group were lower than those in the control group; and the improvement of NYHA cardiac function grade in the treatment group was superior to that in the control group (P<0.01). There was no statistically significant differences in all indicators after treatment in the control group (P>0.05). The incidence of adverse events was 5.1% (2/39) in the treatment group and 2.6% (1/39) in the control group, with no statistically significant difference between groups (P>0.05). ConclusionOn the basis of conventional western medicine treatment, the addition of the optimized new Shengmai Powder can further improve exercise tolerance, cardiac function and quality of life in patients with CHF of qi deficiency, blood stasis and fluid retention syndrome, and show good safety.
2.Differences in scapular kinematics between healthy individuals and rotator cuff tear patients based on biplane X-ray
Zicheng GUO ; Jingyuan MENG ; Jiechao ZHANG ; Li DING ; Xiaoye TANG ; Lichao TIAN ; Yilin WANG ; Yong HE
Chinese Journal of Tissue Engineering Research 2026;30(3):652-660
BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P<0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P<0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P<0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P<0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P>0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.
3.Differences in scapular kinematics between healthy individuals and rotator cuff tear patients based on biplane X-ray
Zicheng GUO ; Jingyuan MENG ; Jiechao ZHANG ; Li DING ; Xiaoye TANG ; Lichao TIAN ; Yilin WANG ; Yong HE
Chinese Journal of Tissue Engineering Research 2026;30(3):652-660
BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P<0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P<0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P<0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P<0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P>0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.
4.Scleromitrion diffusum reverses epithelial-mesenchymal transi-tion of gastric mucosa in rats with gastric precancerous lesions.
Luping MA ; Xin ZUO ; Weikai ZHU ; Jiyan LI ; Yanyan ZHAO ; Jingyuan ZHANG ; Hui SHEN
Journal of Zhejiang University. Medical sciences 2025;54(3):342-349
OBJECTIVES:
To investigate the effect of Scleromitrion diffusum on gastric mucosal epithelial-mesenchymal transition (EMT) in rats with gastric precancerous lesion.
METHODS:
Fifty SD rats were randomly divided into blank control group (n=11), model control group (n=13), Scleromitrion diffusum (SD) group (n=13) and vitase group (n=13). Gastric precancerous lesion animal model was prepared by 1-methyl-3-nitro-1-nitrosoguanidine complex polyfactor method, and the drugs were administrated by gavage once a day for 6 weeks. The pathological changes of gastric mucosa were observed with hematoxylin and eosin staining, the expression of EMT marker proteins were detected with immunohistochemical staining and Western blotting.
RESULTS:
Compared with the model control group, the gastric mucosal injury was significantly attenuated in the Scleromitrion diffusum group, the mucosal tissue structure gradually recovered, the saccular expansion area was reduced, and the inflammatory infiltration was ameliorated. The expression of epithelial cadherin was higher, and the expression of neural cadherin and vimentin in the Scleromitrion diffusum group were lower than those of model control group (all P<0.05).
CONCLUSIONS
Scleromitrion diffusum can ameliorate gastric mucosal injury in rats with gastric precancerous lesion by reversing the EMT.
Animals
;
Rats
;
Rats, Sprague-Dawley
;
Epithelial-Mesenchymal Transition/drug effects*
;
Precancerous Conditions/metabolism*
;
Gastric Mucosa/metabolism*
;
Stomach Neoplasms/drug therapy*
;
Male
;
Cadherins/metabolism*
5.Adaptability study on hydrogen and methane breath test for small intestinal bacterial overgrowth in Chinese population
Yuqing ZHANG ; Mengwei LOU ; Linna FU ; Jingyuan FANG ; Yingxuan CHEN
Chinese Journal of Digestion 2025;45(2):100-106
Objective:To explore the data distribution characteristics of hydrogen and methane breath test (HMBT) in Chinese population and to evaluate its applicability for diagnosing small intestinal bacterial overgrowth (SIBO) in Chinese population.Methods:HMBT data of 18 634 individuals who underwent health check-up nationwide from March 2019 to september 2022 were retrospectively collected, which included the levels of hydrogen and methane at 0, 30, 60, and 90 min. After quality control and data cleaning, the final valid sample size was 12 654 cases, comprising 7 146 SIBO-negative cases and 5 508 SIBO-positive cases. In order to exclude confounding factors such as oral hygiene, the 12 654 cases were divided into D0 and D1 dataset, when the 0 min-value of hydrogen and methane were both lower than the 30 min-value, the 0 min-value was taken as the baseline, and induded into the D0 dataset (5 556 cases), and other situations were induded into the D1 dataset (7 098 cases). There were 2 879 SIBO-negative cases and 2 659 SIBO-positive cases in D0 dataset, and 4 249 SIBO-negative cases and 2 849 SIBO-positive cases in D1 dataset. The hydrogen and methane level at each testing time point in the SIBO-negative and SIBO-positive individuals, the difference between the peak gas level at 90 min and the baseline, and the distribution of time points at which peak level occurred were analyzed. Independent-sample t test and Mann-Whitney U test were used for statistical analysis. Results:The overall SIBO positive rate was 43.53% (5 508/12 654). In SIBO-positive cases the hydrogen level at 0, 30, 60, and 90 min were 9.41×10 -6 (5.01×10 -6, 21.90×10 -6), 11.34×10 -6 (6.13×10 -6, 22.94×10 -6), 18.16×10 -6 (11.03×10 -6, 29.37×10 -6) and 29.59×10 -6 (20.12×10 -6, 43.36×10 -6), respectively, and methane level were 9.13×10 -6 (7.12×10 -6, 12.03×10 -6), 9.23×10 -6 (8.07×10 -6, 12.03×10 -6), 10.21×10 -6 (9.02×10 -6, 13.01×10 -6), and 12.03×10 -6 (10.01×10 -6, 14.11×10 -6), respectively, which were higher than those of SIBO-negative cases (6.04×10 -6 (3.10×10 -6, 11.08×10 -6), 6.04×10 -6 (3.21×10 -6, 10.06×10 -6), 6.95×10 -6 (4.03×10 -6, 11.01×10 -6), 8.96×10 -6 (5.01×10 -6, 13.91×10 -6); 8.04×10 -6 (7.02×10 -6, 10.00×10 -6), 8.03×10 -6 (7.03×10 -6, 9.95×10 -6), 8.04×10 -6 (7.03×10 -6, 10.00×10 -6) 8.98×10 -6 (7.12×10 -6, 10.03×10 -6)], and the differences were statistically significant ( U=1.41×10 7, 1.09×10 7, 6.66×10 6, 4.14×10 6, 1.51×10 7, 1.23×10 7, 1.02×10 7, 8.86×10 6; all P<0.001). In both D0 and D1 datasets, the increase in hydrogen and methane of SIBO positive subgroup were higher than those of SIBO negative subgroup (22.39×10 -6(14.82×10 -6, 33.37×10 -6) vs. 4.82×10 -6(1.96×10 -6, 7.85×10 -6), 20.61×10 -6(7.87×10 -6, 31.44×10 -6) vs. 3.25×10 -6(0.79×10 -6, 7.88×10 -6); 3.98×10 -6(2.87×10 -6, 6.87×10 -6) vs. 1.95×10 -6(0.98×10 -6, 2.99×10 -6), 2.95×10 -6(0.98×10 -6, 4.93×10 -6) vs. 0.98×10 -6(0.00×10 -6, 1.99×10 -6)), and the differences were statistically significant( U=7.24×10 6, 9.72×10 6, 5.74×10 6, 8.27×10 6; all P<0.001). In both D0 and D1 datasets, hydrogen and methane concentrations peaked at 90 min. Conclusion:HMBT can be used for non-invasive diagnosis of SIBO in Chinese population, and the differences in hydrogen and methane concentrations at 90 min of the test have critical value for SIBO diagnosis.
6.Analysis of the efficacy of lamb′s tripe extract and vitamin B 12 capsule on chronic atrophic gastritis at different sites
Dongdong XIA ; Huahong XIE ; Bo JIANG ; Hong XU ; Zhanguo NIE ; Chengwei TANG ; Qiang GUO ; Xiaoping ZOU ; Shuisheng SHI ; Tao SUN ; Shourong SHEN ; Guoqing LI ; Xiaozhong GUO ; Xiaoyan ZHAO ; Jiaming QIAN ; Weixing CHEN ; Guiying ZHANG ; Aijun LIAO ; Jingyuan FANG ; Daiming FAN ; Kaichun WU
Chinese Journal of Digestion 2025;45(3):162-168
Objective:To evaluate the efficacy of lamb′s tripe extract and vitamin B 12 capsule (LTEVB 12C) on chronic atrophic gastritis (CAG) at different locations (antrum lesser curvature, antrum greater curvature, gastric angle, corpus lesser curvature, and corpus greater curvature). Methods:From August 2011 to January 2013, 715 patients with CAG in a multicenter, randomized, double-blind, placebo-controlled trial were enrolled from 16 tertiary first-class hospitals across the country, including the First Affiliated Hospital of Air Force Medical University, Nanfang Hospital of Southern Medical University, the First Hospital of Jilin University, West China Hospital of Sichuan University, etc., there were 476 cases in the LTEVB 12C group and 239 cases in the placebo group. The patients of the LTEVB 12C group received LTEVB 12C, and the patients of placebo group received LTEVB 12C mimetic, all the medications were taken 3 capsules each time and 3 times a day after meals, and the treatment course of 2 groups were both 6 months. The efficacy evaluation criteria included the effective rate (a decrease of ≥1 in histopathological score compared with baseline after 6 months of treatment) and the reversal rate (a decrease of ≥ 2 in histopathological score compared with baseline after 6 months of treatment in the patients with moderate to severe CAG). The impact of lesion sites on the therapeutic effects of LTEVB 12C was analyzed by logistic regression analysis. The two-way unordered Cochran-Mantel-Haenszel chi-square test considering the center effect and Pearson chi-square test were used for statistical analysis. Results:The effective rates of chronic inflammation at the antrum greater curvature and corpus greater curvature (23.3%, 110/473 vs. 13.0%, 31/239; 20.3%, 96/472 vs. 12.6%, 30/239), the effective rates of atrophy at the antrum lesser curvature, antrum greater curvature, gastric angle, corpus lesser curvature, and the corpus greater curvature (27.0%, 118/437 vs. 15.7%, 34/216; 29.2%, 126/432 vs. 18.5%, 38/205; 27.8%, 121/435 vs. 16.7%, 36/216; 32.5%, 127/391 vs. 19.8%, 37/187; 33.0%, 119/361 vs. 21.8%, 39/179), and the effective rates of intestinal metaplasia at the antrum lesser curvature, antrum greater curvature, gastric angle, and the corpus lesser curvature (45.0%, 112/249 vs. 29.8%, 31/104; 53.8%, 86/160 vs. 33.9%, 21/62; 45.8%, 103/225 vs. 24.0%, 25/104; 51.9%, 83/160 vs. 28.3%, 17/60) of the LTEVB 12C group were all higher than those of the placebo group, and the differences were statistically significant ( χ2=10.76, 6.39, 9.69, 7.91, 11.05, 9.62, 8.57, 5.20, 7.11, 12.45, and 6.73; all P<0.05). The reversal rates of chronic inflammation at the corpus lesser curvature and corpus greater curvature (5.2%, 12/231 vs. 0, 0/123; 4.7%, 8/170 vs. 0, 0/88), the reversal rates of atrophy at the antrum lesser curvature, antrum greater curvature, corpus lesser curvature, and the corpus greater curvature (6.8%, 22/323 vs. 1.3%, 2/151; 9.2%, 29/315 vs. 1.4%, 2/144; 14.2%, 38/267 vs. 2.5%, 3/121; 20.8%, 35/168 vs. 5.8%, 4/69), and the reversal rates of intestinal metaplasia at the antrum lesser curvature, antrum greater curvature, gastric angle, and the corpus lesser curvature (29.8%, 39/131 vs. 9.1%, 4/44; 41.0%, 32/78 vs. 12.5%, 3/24; 33.3%, 44/132 vs. 4.8%, 3/63; 50.0%, 37/74 vs. 8.7%, 2/23) of the LTEVB 12C group were all higher than those of the placebo group, and the differences were statistically significant ( χ2=6.58, 5.12, 5.60, 8.61, 11.43, 6.59, 7.30, 4.95, 15.92, 7.62; all P<0.05). There were no statistically significant differences in the effective rates and reversal rates of active inflammation at different locations between the LTEVB 12C group and the placebo group (all P>0.05). The results of logistic regression analysis (taking the antrum lesser curvature as the reference) further confirmed that the reversal rates of chronic inflammation ( OR=0.22, 95% confidence interval (95% CI): 0.07 to 0.67; OR=0.24, 95% CI: 0.07 to 0.80), atrophy ( OR=0.28, 95% CI: 0.16 to 0.49; OR=0.28, 95% CI: 0.16 to 0.49), and intestinal metaplasia ( OR=0.42, 95% CI: 0.24 to 0.77; OR=0.20, 95% CI: 0.08 to 0.52) at the corpus lesser curvature and corpus greater curvature were all higher than those at the antrum lesser curvature, and the differences were statistically significant (all P<0.05). There were no statistically siginificant differences in the reversal rates of the aforementioned pathological features between the antrum greater curvature, gastric angle, and the antrum lesser curvature (all P>0.05). Conclusion:LTEVB 12C can achieve good efficacy in the treatment of CAG, and the chronic inflammation, atrophy, and intestinal metaplasia at multiple locations are improved, especially at the corpus lesser curvature and the corpus greater curvature.
7.Direction and clinical practice of traditional Chinese medicine in the prevention and treatment of cancer
Xinyi MA ; Bowen XU ; Jie LI ; Ying ZHANG ; Luchang CAO ; Yuansha GE ; Guanghui ZHU ; Xiaoyu ZHU ; Jingyuan WU ; Xinmiao WANG
Chinese Journal of Oncology 2025;47(2):121-128
Cancer is a major chronic disease that threatens human health, while traditional Chinese medicine (TCM) is a unique method for cancer prevention and treatment in China. After about 70 years of innovation and development, TCM has made constant progress in areas such as the clinical diagnosis, treatment, evidence-based researches, and mechanism exploration of cancer. It has special advantages in aspects such as reducing toxicity, enhancing treatment efficacy, managing symptoms, accelerating recovery, preventing recurrence and metastasis, and prolonging advanced-stage survival. However, there are still bottlenecks for TCM in cancer care. This paper cuts in the key links between TCM and western medicine in their combined application in cancer prevention and treatment, and take the original TCM theories on cancer as the lead, high-quality evidence-based researches as the drive, and analysis on the dynamic mechanism as the core, to show the advantages and effects of TCM in cancer treatment in an all-round way. It also aims to provide novel strategies for sustainable and innovative development and for formulation of comprehensive schemes that integrate TCM and western medicine for cancer prevention and treatment.
8.Epidemiological characteristics and treatment outcome of pulmonary tu-berculosis patients combined with diabetes mellitus in Bijie City from 2017 to 2022
Mai ZHANG ; Jingyuan YANG ; Qin YU ; Miao YU ; Jinlan LI ; Yong LIU
Chinese Journal of Infection Control 2025;24(3):402-409
Objective To analyze the epidemiological distribution characteristics and influencing factors of treat-ment outcome of pulmonary tuberculosis(PTB)patients complicated with diabetes mellitus(DM)in Bijie City from 2017 to 2022,and provide reference for formulating prevention and control measures of PTB-DM.Methods The registered management cases of PTB patients combined with DM from the tuberculosis surveillance report informa-tion management system in Bijie City in 2017-2022 were collected.Changing trends in annual registration rates and successful treatment rates were analyzed with Joint-point regression models.Different characteristics between pa-tients with PTB-DM and PTB alone were conducted comparative analysis;the influencing factors of treatment out-come were analyzed by x2 test and binary logistic regression analysis.Results A total of 679 PTB-DM patients were registered in Bijie City from 2017 to 2022,accounting for 1.53%of total PTB patients,the annual registration rate increased from 1.11/100 000 in 2017 to 3.08/100 000 in 2022,with an increasing trend in the annual percentage change(APC=26.67%,95%CI:5.36%-52.29%,t=3.564,P=0.024).In the analysis on characteristics,the proportion of PTB-DM male patients,age ≥45 years and farmers,the ratio of direct consultation to transfer treat-ment,the pathogenicity positive rate,the proportion re-treatment,and rate of delay in consultation were all higher than those of PTB alone;successful treatment rate and proportion of floating population were all lower than PTB alone,difference were all statistically significant(all P<0.05).The successful treatment rate of PTB-DM patients in Bijie City from 2017 to 2022 was 87.80%.Age,occupation,pathogenicity diagnosis results were influencing fac-tors for treatment outcome in patients with PTB-DM,with farmers(OR=3.68,95%CI:1.22-11.09),with pathogenicity positivity(OR=2.84,95%CI:1.24-6.50),and without pathogenic detection result+tuberculous pleurisy(OR=11.35,95%CI:2.16-59.74)being risk factors for successful treatment.Conclusion Although the proportion of PTB-DM in the total PTB patients in Bijie City from 2017 to 2022 was not high,it showed an up-ward trend;it is necessary to attach great importance to male,re-treated,farmer,and pathogenicity positivity co-morbid patients in Bijie City,and strengthen the two-way screening of PTB-DM in high-risk populations.
9.Mechanism of tigecycline resistance induced in vitro in Citrobacter freundii
Hang MU ; Hao FU ; Jie ZHOU ; Shubo WANG ; Jingyuan ZHANG ; Ledi MA ; Jin ZHANG ; Shuyong WEI
Chinese Journal of Veterinary Science 2025;45(10):2222-2230
Tigecycline(TGC)is a recently developed broad-spectrum and highly effective glycylcy-cline antibiotic that overcomes traditional tetracycline resistance mechanisms.It is widely used in the treatment of complex skin and intra-abdominal infections.However,the emergence of TGC re-sistance in recent years poses a significant challenge,and its underlying resistance mechanisms re-main incompletely understood,warranting further investigation.This study induced TGC resistance in Klebsiella aerogenes(ATCC-43864)under in vitro conditions and evaluated phenotypic chan-ges,including growth curves,motility,multidrug susceptibility,and ultrastructural alterations,be-fore and after induction.Whole-genome sequencing(WGS)and transcriptome sequencing(RNA-seq)were employed to analyze resistance-related genetic changes,which were further validated.Ef-flux pump inhibition assays and Red homologous recombination were used to investigate the roles of efflux pumps,lon deletion,and rpsM mutation in TGC resistance.A stable resistant strain,CF-T-32,was obtained,with a 32-fold increase in TGC minimum inhibitory concentration(MIC).CF-T-32 exhibited an enlarged periplasmic space between the cell wall and membrane,reduced growth and motility,and no significant changes in susceptibility to 28 antimicrobial agents,including doxy-cycline,gentamicin,and ciprofloxacin.Genomic analysis revealed no significant differences in ge-nome composition or interference from exogenous plasmids between the parental and induced strains.However,two missense mutations were identified in rpsM and lon.Transcriptomic analysis and qPCR validation showed significant upregulation of efflux pump genes(acrA and acrB)in the AcrAB-TolC system and downregulation of ribosomal protein genes(rpsM,rpsJ,and rpsC).Ef-flux pump inhibition and Red homologous recombination experiments demonstrated that the rpsM C287T missense mutation,leading to a Pro96Leu substitution and reduced expression,is likely the primary factor contributing to TGC resistance in the induced strain.
10.Bibliometric analysis and reflections on the current status of traditional Chinese medicine systematic reviews and Meta-analysis in the past decade
Jiaying WANG ; Yi ZHAO ; Ru DUAN ; Jingting LIU ; Yun WU ; Jisheng ZHANG ; Xuemei XIANG ; Yifei GU ; Yu TIAN ; Yawen CAO ; Bin LI ; Xianliang WANG ; Jingyuan MAO
Chinese Journal of Pharmacoepidemiology 2025;34(1):57-68
Objective To understand the current status of traditional Chinese medicine(TCM)systematic reviews/Meta-analysis over the past 10 years.Methods Cochrane Database of Systematic Reviews,PubMed,Web of Knowledge,CNKI,SinoMed,WanFang Data,VIP databases,as well as the Cochrane Register and PROSPERO registration platform were searched to collect TCM-related systematic reviews/Meta-analysis published between January 2015 and December 2024.Literature was screened,and standardization of institutions,countries,and journals was performed.Data cleaning was conducted,and trends in publication years,high-frequency diseases,journals,institutions,and highly cited papers were analyzed.Results A total of 11,174 papers were included,involving approximately 56,656 authors from 1,422 institutions across 44 countries,covering 1,300 journals and 1,070 diseases.The top five institutions in terms of publications were Beijing University of Chinese Medicine(954 papers),Guangzhou University of Chinese Medicine(928 papers),China Academy of Chinese Medical Sciences(537 papers),Tianjin University of Chinese Medicine(460 papers),and Chengdu University of Chinese Medicine(393 papers).Foreign institutions with the highest publication volumes were concentrated in South Korea,Iran,and Australia.The most frequently published Chinese journal was Zhongyi Clinical Research with 332 papers,while the most published English journal was Evidence-Based Complementary and Alternative Medicine with 311 papers.There were 282 single-author papers involving 271 authors,and the most cited paper was referenced 323 times,The three most frequently studied diseases were diabetes(267 papers,2.39%),angina pectoris(214 papers,1.92%),and osteoarthritis(210 papers,1.88%).Non-pharmacological interventions such as acupuncture(1,265 papers,11.32%),auricular therapy(101 papers,0.90%),and Tai Chi(98 papers,0.88%)were most frequently reported.In pharmacological interventions,studies on Tripterygium wilfordii tablets(76 papers,0.68%)and Danhong injection(54 papers,0.48%)were more common.Conclusion The systematic reviews/Meta-analysis method is widely used in the field of TCM,and the field continues to grow.Active academic teams,institutions,and journals have emerged.Over the past decade,there has been a considerable body of evidence in Chinese systematic reviews on TCM for chronic diseases such as diabetes,angina pectoris,and osteoarthritis.In English-language studies,non-pharmacological therapies like acupuncture have been more widely reported,and some high-impact studies have emerged.However,challenges remain,such as issues with research transparency and methodological standardization.Future efforts should focus on establishing transparent systems and quality control mechanisms to further enhance the reliability,accuracy,and dissemination of TCM evidence-based research.

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