1.Effect of Modified Tuoli Xiaodusan on Patients After Perianal Abscess Surgery on STAT3/VEGF Pathway
Haoyang DU ; Yuan GAO ; Haiqi FU ; Jinling HE ; Jing ZHANG ; Yangyang YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):187-195
ObjectiveTo explore the clinical efficacy of oral administration of modified Tuoli Xiaodusan on postoperative patients with perianal abscess, and its effects on related inflammatory factors and signal transducers and activators of transcription protein 3 (STAT3)/vascular endothelial growth factor (VEGF) signaling pathways. MethodsFrom January 2023 to December 2023 in Inner Mongolia hospital of traditional Chinese medicine, 60 postoperative patients with perianal abscess who met the inclusion criteria were selected. They were divided into a treatment group and a control group using the random number table method, with 30 cases in each group. The control group received conventional treatment, while the treatment group received additional treatment with modified Tuoli Xiaodusan on the basis of the control group. The course of treatment in both groups was three weeks. On the day of operation and on the 7th, 14th and 21st day after operation, enzyme-linked immunosorbent assay (ELISA) was used to measure the expression levels of serum interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Hematoxylin eosin (HE) staining was used to observe the pathological morphology of pathological tissue. Western blot was used to measure the levels of phosphorylated STAT3 (p-STAT3) and vascular endothelial growth factor (VEGF) proteins, and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to determine the expression level of VEGF mRNA. The clinical efficacy of the two groups was compared according to the wound pain, secretion volume score, and healing rate of patients on the 3rd, 7th, 14th, and 21st day after operation. ResultsThe total effective rate of the treatment group was higher than that of the control group (P<0.05). For intra-group comparison, the pain score of the control group decreased at each time period (P<0.05), and the healing rate increased (P<0.05). The secretion volume score decreased on the 14th and 21st days after operation (P<0.05). The pain score and secretion volume score of the treatment group decreased at each time period (P<0.05), and the healing rate increased (P<0.05). The levels of various inflammatory factors decreased in both groups (P<0.05). Compared with those on the surgical day, the levels of p-STAT3 and VEGF proteins in the wound tissue of the two groups were different on the 7th and 21st days after operation (P<0.05). There were significant differences in VEGF mRNA levels in wound tissue between the two groups at each time period (P<0.01). For inter-group comparison, on the 7th and 14th days after operation, the pain score in the treatment group was lower than that in the control group. On the 7th, 14th and 21st days after operation, the secretion volume scores and healing rate of the treatment group were better than those of the control group (P<0.05). The levels of various inflammatory factors in the treatment group were lower than those in the control group (P<0.05), and the decline rate was faster (P<0.05). On the 7th day after operation, the levels of p-STAT3, VEGF protein, and VEGF mRNA in the wound tissue of the treatment group were higher than those in the control group (P<0.05). HE staining showed that the inflammatory cell infiltration in the treatment group decreased faster. The cell arrangement was more orderly, and new blood vessel lumens were visible. There were no abnormalities in the safety observation indexes of all patients during the study period. ConclusionModified Tuoli Xiaodusan can relieve wound pain after perianal abscess surgery, reduce secretions, and improve wound healing rate. The mechanism may be reducing the levels of serum IL-1β, IL-6, and TNF-α, reducing the inflammatory response of the wound, upregulating the expression of p-STAT3 and VEGF proteins, and stimulating the STAT3/VEGF signaling pathway, thereby accelerating angiogenesis and promoting wound healing.
2.Study on the Change Law of Tongue Images in Postoperative Patients with Anorectal Disease
Jinling HE ; Yuan GAO ; Jianguo LIANG ; Yangyang YU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(5):168-172
Objective To summarize the change law of tongue images in postoperative patients with anorectal disease by observing the postoperative tongue image changes in 400 patients with anorectal disease;To investigate the relationship between the severity of postoperative symptoms in anorectal disease and tongue symptoms.Methods Totally 400 patients meeting the inclusion criteria were selected from the first Department of Anorectal Medicine of Inner Mongolia Hospital of Traditional Chinese Medicine during January 2023 to December 2023.Tongue texture and tongue coating,postoperative wound pain degree,duration of pain,defecation situation and degree of wound edema of patients were observed and recorded before surgery,on the 1st,3rd,5th,7th and 10th days after surgery,respectively.Results The data recorded for 6 time spots of before surgery and 1,3,4,5,10 d after surgery showed significant differences in the tongue coating results of patients,indicating that the postoperative tongue image of patients with anorectal disease presented dynamic changes,with the general law being light red tongue or red tongue before surgery,thin white tongue or little fur,gradually changing into red tongue,blue tongue,thin white dry tongue or thin yellow tongue 1-3 days after operation,red tongue or purple tongue 3-7 days,white greasy tongue or yellow thick greasy tongue,and tongue coating subside after 10 days.Tongue quality gradually recovered,and tongue image changes were closely related to clinical symptoms.Conclusion The tongue image of anorectal patients after operation has obvious characteristic expression,and its change is regular,and it is related to the symptoms,degree and outcome of the disease.
3.Construction of a combined disease-syndrome animal model of dilated cardiomyopathy with heart failure toxin syndrome and study on potential biomarkers
Feng JIANG ; Jiayang TANG ; Xiangyi QIAN ; Hai PAN ; Aolong HE ; Xiaoqi WEI ; Jinling XIAO ; Wei WANG ; Shuzhen GUO
Journal of Beijing University of Traditional Chinese Medicine 2025;48(5):613-624
Objective To construct an animal model of dilated cardiomyopathy(DCM)with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine(TCM)syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.Methods Fifteen male SD rats were divided into a blank control,doxorubicin,or DCM with heart failure toxin syndrome group using a random number table method,with five rats per group.The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg,administered on the first and fourth days of each week,along with a standard diet.The DCM with heart failure toxin syndrome group,in addition to the doxorubicin treatment,was given 42%white liquor(10 mL/kg)via gavage every other day,along with a 45%high-fat feed and 10%fructose water.The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group,along with a standard diet.The model was established for 10 weeks.At the fourth and tenth weeks of modeling,echocardiography was performed to measure left ventricular ejection fraction(LVEF),fractional shortening(FS),systolic left ventricular posterior wall thickness(LVPWs),diastolic left ventricular posterior wall thickness,systolic left ventricular internal diameter(LVIDs),and diastolic left ventricular internal diameter(LVIDd);macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method.After modeling,the open field test was conducted to evaluate the exercise tolerance of the rats,and the grip strength test was performed to assess changes in forelimb grip strength.Hematoxylin-eosin,Masson,and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue.Bulk RNA sequencing analysis was performed to identify differentially expressed genes(DEGs)in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups.Using DCM,the Blue value of rat fur color,and forelimb grip strength as phenotypic traits,weighted gene co-expression network analysis(WGCNA)was performed to screen for characteristic module gene sets(MEs)associated with DCM with heart failure toxin syndrome.Overlapping analysis was performed on DEGs,immune-related gene sets,and MEs,and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.The sensitivity and specificity of these targets were evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the blank control group,at the tenth week of modeling,the LVEF,FS,and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased,whereas LVIDs and LVIDd increased,and the movement distance of the open field test and forelimb grip strength were reduced(P<0.05).At the 10th week of modeling,the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups(P<0.05).Compared with the blank control group,rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue,accompanied by collagen deposition and cardiomyocyte hypertrophy.Bulk RNA sequencing identified 2,003 DEGs,including 1,082 downregulated genes and 921 upregulated genes.WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength.The overlapping analysis identified four intersecting genes:bone morphogenetic protein 6(Bmp6),serine-threonine-protein kinase 1(Pak1),proto-oncogene JunD(JunD),and S100 calcium-binding protein A3(S100A3).ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.Conclusion The rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed,fructose water,and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome.Bmp6,JunD,Pak1,and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.
4.Research progress on Astragali Radix for promoting healing of chronic refractory wound
Yangyang YU ; Yuan GAO ; Jinling HE ; Hao WU ; Keyu CHEN ; Yuxing ZHAO
China Pharmacy 2025;36(19):2473-2478
Chronic refractory wound (CRW) presents significant clinical treatment challenges due to pathological characteristics such as persistent inflammation, bacterial infection, oxidative stress and inadequate angiogenesis. Astragali Radix, a traditional Chinese medicinal herb, exerts multi-target pharmacological effects on CRW through its active components, including Astragalus polysaccharides, flavonoids, and astragaloside Ⅳ, etc. Fundamental studies indicate that these components promote CRW healing by modulating inflammatory responses, inhibiting pathogen growth, improving antioxidant capacity and stimulating neovascularization. Network pharmacology and bioinformatics studies have revealed that active components of Astragali Radix target and modulate key signaling nodes such as nuclear factor-κB, phosphatidylinositol 3-kinase/Akt, AMP-activated protein kinase, and vascular endothelial growth factor receptor, as well as inflammation-angiogenesis-related pathways, thereby synergistically exerting anti-inflammatory and pro-angiogenic effect. Clinical applications have demonstrated that oral formulations (e.g., Huangqi guizhi decoction, Danggui huangqi decoction, etc.) reduce healing time of CRW and lower inflammatory marker levels, while topical preparations (e.g., Zizhu ointment, Huangqi shengji ointment, electrostatically spun Astragalus polysaccharide composite nanofibre dressings, etc.) significantly improve healing rates of CRW and minimize complications.
5.Study on the Change Law of Tongue Images in Postoperative Patients with Anorectal Disease
Jinling HE ; Yuan GAO ; Jianguo LIANG ; Yangyang YU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(5):168-172
Objective To summarize the change law of tongue images in postoperative patients with anorectal disease by observing the postoperative tongue image changes in 400 patients with anorectal disease;To investigate the relationship between the severity of postoperative symptoms in anorectal disease and tongue symptoms.Methods Totally 400 patients meeting the inclusion criteria were selected from the first Department of Anorectal Medicine of Inner Mongolia Hospital of Traditional Chinese Medicine during January 2023 to December 2023.Tongue texture and tongue coating,postoperative wound pain degree,duration of pain,defecation situation and degree of wound edema of patients were observed and recorded before surgery,on the 1st,3rd,5th,7th and 10th days after surgery,respectively.Results The data recorded for 6 time spots of before surgery and 1,3,4,5,10 d after surgery showed significant differences in the tongue coating results of patients,indicating that the postoperative tongue image of patients with anorectal disease presented dynamic changes,with the general law being light red tongue or red tongue before surgery,thin white tongue or little fur,gradually changing into red tongue,blue tongue,thin white dry tongue or thin yellow tongue 1-3 days after operation,red tongue or purple tongue 3-7 days,white greasy tongue or yellow thick greasy tongue,and tongue coating subside after 10 days.Tongue quality gradually recovered,and tongue image changes were closely related to clinical symptoms.Conclusion The tongue image of anorectal patients after operation has obvious characteristic expression,and its change is regular,and it is related to the symptoms,degree and outcome of the disease.
6.Immunomodulatory effects of lycorine on mice infected with Toxoplasma gondii
Danruo LI ; Rongqi DU ; Jinling HE ; Hui WANG ; Aili FAN ; Dongchao ZHANG
Chinese Journal of Veterinary Science 2025;45(6):1233-1242
To study the immunoregulatory effects of lycorine on mice infected with Toxoplasma gondii(T.gondii),BALB/c mice were treated with 20 mg/kg lycorine solution after peritoneal in-fection with T.gondii RH strain.The serum and spleen of mice were collected at the 1st,3rd,5th and 7th day,respectively,and the spleen index of mice was calculated.The proportion of T lympho-cyte subtypes and NK cells were detected in mice by flow cytometry,and the changes of cytokine levels in mice were measured using ELISA kit,so as to evaluate the immunomodulatory effect of lycorine on mice infected with T.gondii.At the same time,the heart,liver,spleen,lungs,and kid-neys of mice were collected at the 7th day,and the pathological changes of the mouse organs were observed through pathological tissue sections,and the amount of the parasite in the liver,lung,kid-ney,and brain of the mice was detected by fluorescence quantitative PCR.The results showed that the survival time of the mice treated with lycorine was significantly extended,and the survival rate reached 80%.The spleen index of mice treated with lycorine was lower than that of the control group.Lycorine up-regulates the ratio of the CD4+T lymphocytes and NK cells in the spleen of mice infected with T.gondii,and helps to improve the ability of mice to resist T.gondii infection.Lycorine can up-regulate the levels of anti-inflammatory cytokine IL-4 and down-regulate the lev-els of pro-inflammatory factors IFN-γ,IL-1β,and IL-9 in serum of mice infected with T.gondii,which is conducive to reducing the damage of inflammatory response and enhancing the ability of anti-T.gondii infection.In addition,lycorine can alleviate the pathological damage of T.gondii to the liver,lungs,spleen,and kidneys of mice,and significantly reduce the amount of the parasite in the lung of mice.The results showed that lycorine could up-regulate the proportion of immune cells CD4+T lymphocytes and NK cells,inhibit the inflammatory response of mice infected with T.gondii,reduce the pathological damage of mice organs,and enhance the ability of mice to resist T.gondii infection,which is expected to become a novel anti-T.gondii drug.
7.Immunomodulatory effects of lycorine on mice infected with Toxoplasma gondii
Danruo LI ; Rongqi DU ; Jinling HE ; Hui WANG ; Aili FAN ; Dongchao ZHANG
Chinese Journal of Veterinary Science 2025;45(6):1233-1242
To study the immunoregulatory effects of lycorine on mice infected with Toxoplasma gondii(T.gondii),BALB/c mice were treated with 20 mg/kg lycorine solution after peritoneal in-fection with T.gondii RH strain.The serum and spleen of mice were collected at the 1st,3rd,5th and 7th day,respectively,and the spleen index of mice was calculated.The proportion of T lympho-cyte subtypes and NK cells were detected in mice by flow cytometry,and the changes of cytokine levels in mice were measured using ELISA kit,so as to evaluate the immunomodulatory effect of lycorine on mice infected with T.gondii.At the same time,the heart,liver,spleen,lungs,and kid-neys of mice were collected at the 7th day,and the pathological changes of the mouse organs were observed through pathological tissue sections,and the amount of the parasite in the liver,lung,kid-ney,and brain of the mice was detected by fluorescence quantitative PCR.The results showed that the survival time of the mice treated with lycorine was significantly extended,and the survival rate reached 80%.The spleen index of mice treated with lycorine was lower than that of the control group.Lycorine up-regulates the ratio of the CD4+T lymphocytes and NK cells in the spleen of mice infected with T.gondii,and helps to improve the ability of mice to resist T.gondii infection.Lycorine can up-regulate the levels of anti-inflammatory cytokine IL-4 and down-regulate the lev-els of pro-inflammatory factors IFN-γ,IL-1β,and IL-9 in serum of mice infected with T.gondii,which is conducive to reducing the damage of inflammatory response and enhancing the ability of anti-T.gondii infection.In addition,lycorine can alleviate the pathological damage of T.gondii to the liver,lungs,spleen,and kidneys of mice,and significantly reduce the amount of the parasite in the lung of mice.The results showed that lycorine could up-regulate the proportion of immune cells CD4+T lymphocytes and NK cells,inhibit the inflammatory response of mice infected with T.gondii,reduce the pathological damage of mice organs,and enhance the ability of mice to resist T.gondii infection,which is expected to become a novel anti-T.gondii drug.
8.Construction of a combined disease-syndrome animal model of dilated cardiomyopathy with heart failure toxin syndrome and study on potential biomarkers
Feng JIANG ; Jiayang TANG ; Xiangyi QIAN ; Hai PAN ; Aolong HE ; Xiaoqi WEI ; Jinling XIAO ; Wei WANG ; Shuzhen GUO
Journal of Beijing University of Traditional Chinese Medicine 2025;48(5):613-624
Objective To construct an animal model of dilated cardiomyopathy(DCM)with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine(TCM)syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.Methods Fifteen male SD rats were divided into a blank control,doxorubicin,or DCM with heart failure toxin syndrome group using a random number table method,with five rats per group.The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg,administered on the first and fourth days of each week,along with a standard diet.The DCM with heart failure toxin syndrome group,in addition to the doxorubicin treatment,was given 42%white liquor(10 mL/kg)via gavage every other day,along with a 45%high-fat feed and 10%fructose water.The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group,along with a standard diet.The model was established for 10 weeks.At the fourth and tenth weeks of modeling,echocardiography was performed to measure left ventricular ejection fraction(LVEF),fractional shortening(FS),systolic left ventricular posterior wall thickness(LVPWs),diastolic left ventricular posterior wall thickness,systolic left ventricular internal diameter(LVIDs),and diastolic left ventricular internal diameter(LVIDd);macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method.After modeling,the open field test was conducted to evaluate the exercise tolerance of the rats,and the grip strength test was performed to assess changes in forelimb grip strength.Hematoxylin-eosin,Masson,and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue.Bulk RNA sequencing analysis was performed to identify differentially expressed genes(DEGs)in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups.Using DCM,the Blue value of rat fur color,and forelimb grip strength as phenotypic traits,weighted gene co-expression network analysis(WGCNA)was performed to screen for characteristic module gene sets(MEs)associated with DCM with heart failure toxin syndrome.Overlapping analysis was performed on DEGs,immune-related gene sets,and MEs,and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.The sensitivity and specificity of these targets were evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the blank control group,at the tenth week of modeling,the LVEF,FS,and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased,whereas LVIDs and LVIDd increased,and the movement distance of the open field test and forelimb grip strength were reduced(P<0.05).At the 10th week of modeling,the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups(P<0.05).Compared with the blank control group,rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue,accompanied by collagen deposition and cardiomyocyte hypertrophy.Bulk RNA sequencing identified 2,003 DEGs,including 1,082 downregulated genes and 921 upregulated genes.WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength.The overlapping analysis identified four intersecting genes:bone morphogenetic protein 6(Bmp6),serine-threonine-protein kinase 1(Pak1),proto-oncogene JunD(JunD),and S100 calcium-binding protein A3(S100A3).ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.Conclusion The rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed,fructose water,and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome.Bmp6,JunD,Pak1,and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.
9.Intervention effect of kushenol F on ulcerative colitis mice
Xudong HE ; Haoyu NI ; Jinbiao HE ; Min LI ; Yunkai HU ; Dihong GONG ; Jinling YAO ; Jie YU ; Xingxin YANG
China Pharmacy 2024;35(4):419-424
OBJECTIVE To investigate the intervention effect of kushenol F (KSC-F) on ulcerative colitis (UC) mice. METHODS Totally 30 male C57BL/6J mice were randomly divided into the normal group, model group, positive drug group (sulfasalazine, 703 mg/kg), KSC-F 50 mg/kg group (KSC-F50 group), and KSC-F 100 mg/kg group (KSC-F100 group), with 6 mice in each group. Except for the normal group, the mice in the remaining groups were given 3% dextran sulfate sodium solution continuously for 7 days to induce UC model. Concurrently, administration groups received corresponding drug solution intragastrically, once a day, for 10 consecutive days. During the experiment, the changes in body weight and bowel movements of the mice were observed. Disease activity index scoring was performed after the last administration. The histopathological morphology of colonic tissue was examined. The levels of inflammatory factors in the serum and colon tissue were measured. Additionally, the mRNA expression of inflammatory factors, and the protein expressions of inflammation-related proteins [interleukin-1β (IL-1β), forkhead box O1(FOXO1), phosphoinositide 3-kinase(PI3K), phosphorylated PI3K(p-PI3K), p38 mitogen-activated protein kinase(p38 MAPK), phosphorylated p38 MAPK(p-p38 MPAK) and phosphorylated protein kinase B(p- Akt)] were determined in colonic tissue. RESULTS KSC-F could alleviate weight loss and colonic tissue damage in UC mice. KSC- F reduced the levels of IL-1β, IL-6, IL-8 and tumor necrosis factor-α (TNF-α) in serum, as well as IL-1β, IL-6, IL-17 and TNF- α in colonic tissue to varying degrees and increased the levels of IL-10 in both serum and colonic tissue (P<0.05 or P<0.01). Moreover, KSC-F decreased the expression levels of IL-1β, IL-17 and TNF-α mRNA, as well as p-PI3K, p-p38 MAPK, and p- Akt proteins in colonic tissue to varying degrees, and increased the expression levels of IL-10 mRNA and FOXO1 protein in colonic tissue (P<0.05 or P<0.01). CONCLUSIONS KSC-F effectively alleviates UC symptoms in mice by inhibiting PI3K, Akt and p38 MAPK activation, mitigating the release of pro-inflammatory factors such as IL-1β, IL-6, TNF- α,promoting the anti-inflammatory factor IL-10 secretion, and reducing inflammation-induced colonic tissue damage.
10.Birth cohorts and their current status and prospects in China
Ying JIANG ; Wei HE ; Fei YANG ; Yuwei SHI ; Wenjie WANG ; Qiang SHU ; Jinling TANG ; Shankuan ZHU
Chinese Journal of Epidemiology 2024;45(12):1745-1750
In the context of delayed marriage and parenthood, decreased willingness in having children, and population aging in China, maternal and child health has become an important and urgent issue. Being essential platforms for research in maternal and child health, the importance of birth cohorts has been widely recognized. In the past 20 years, tens of birth cohorts have been established in major cities and regions of China, with cohorts ranging from thousands to hundreds of thousands. These cohorts, particularly those large ones launched in recent years, have collected a wide spectrum of data and biological samples from mothers and children. Although they have made considerable preliminary achievements, there remain difficulties and challenges. The significant challenges include small and medium-sized cohorts' lacking of clear research themes; insufficient recognition of and emphasis on behavioral and social determinants of health while emphasizing biological determinants of health; variations in types of variables and quality of data collected, which make it difficult for cohorts to be merged and shared; lack of and difficulties in long-term follow-up; significant uncertainties in resources for long-term sustention of the cohorts, and so on. So, we argue that birth cohorts should focus on essential and urgent issues in maternal and child health in the country and seek recognition and support from the government and the entire society. Last but not least, the overall success of birth cohorts in the country requires scientists to be not only academically capable, but also realistic, persistent, altruistic, and collaborative.

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