1.Chinese Materia Medica by Regulating Nrf2 Signaling Pathway in Prevention and Treatment of Ulcerative Colitis: A Review
Yasheng DENG ; Lanhua XI ; Yanping FAN ; Wenyue LI ; Tianwei LIANG ; Hui HUANG ; Shan LI ; Xian HUANG ; Chun YAO ; Guochu HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):321-330
Ulcerative colitis(UC) is a chronic non-specific inflammatory bowel disease characterized by inflammation and ulceration of the colonic mucosa and submucosa, and its complex pathogenesis involves immune abnormality, oxidative stress and other factors. The nuclear transcription factor E2-related factor 2(Nrf2), encoded by the Nfe212 gene, plays a central role in antioxidant responses. It not only activates various antioxidant response elements such as heme oxygenase-1(HO-1) and quinone oxidoreductase 1(NQO1), but also enhances the activity of glutathione-S-transferase(GST) and superoxide dismutase 1(SOD1), effectively eliminating reactive oxygen species(ROS) accumulated in the body, and mitigating oxidative stress-induced damage to intestinal mucosa. In addition, Nrf2 can reduce the release of inflammatory factors and infiltration of immune cells by regulating immune response, cell apoptosis and autophagy pathways, thereby alleviating intestinal inflammation and promoting the repair and regeneration of damaged mucosa. Based on this, this paper reviews the research progress of Chinese materia medica in the prevention and treatment of UC by modulating the Nrf2 signaling pathway. It deeply explores the physiological role of Nrf2, the molecular mechanism of activation, the protective effect in the pathological process of UC, and how active ingredients in Chinese materia medica regulate the Nrf2 signaling pathway through multiple pathways to exert their potential mechanisms. These studies have revealed in depth that Chinese materia medica can effectively combat oxidative stress by regulating the Nrf2 signaling pathway. It can also play a role in anti-inflammatory, promoting autophagy, inhibiting apoptosis, protecting the intestinal mucosal barrier, and promoting intestinal mucosal repair, providing new ideas and methods for the multi-faceted treatment of UC.
2.Comparision of aripiprazole and risperidone in improving psychiatric symptoms among chronic schizophrenia patients
Jianfeng WANG ; Bangwen LIU ; Yanyan ZHANG ; Yanping XUE ; Liang GUO ; Yanhai WU
Sichuan Mental Health 2025;38(2):108-114
BackgroundAtypical antipsychotics have been widely used in patients with chronic schizophrenia, and aripiprazole and risperidone are the most commonly used drugs. The mechanism of action of the two is different, while previous studies have provided insufficient credible evidence from multiple perspectives to support the comparative efficacy of the two drugs in improving symptoms in patients with chronic schizophrenia. ObjectiveTo compare the efficacy of aripiprazole and risperidone on the improvement of symptoms, prepulse inhibition (PPI), cognitive functioning and neurotrophic factors in patients with chronic schizophrenia, so as to provide effective treatment regimens for these patients. MethodsA total of 86 patients with chronic schizophrenia attending the psychiatry department of the Third People's Hospital of Fuyang from March 2021 to March 2023 and fulfilling the diagnostic criteria of International Classification of Diseases, tenth edition (ICD-10) were enrolled and grouped using random number table method, each with 43 cases. Aripiprazole group was given oral aripiprazole once daily at an initial dose of 5 mg for one week and then gradually increased to a maximum dose of 25 mg. Risperidone group received oral risperidone twice daily at an initial dose of 0.5 mg for one week and then gradually increased to a maximum dose of 3 mg. Treatment in both groups lasted 3 months. Before treatment and 3 months after treatment, Patients were required to complete Positive and Negative Symptom Scale (PANSS), detection of both strong and weak PPIs in a startle modification passive attention paradigm, Wisconsin Card Sorting Test (WCST) and the measurement of neurotrophic factors at baseline and after treatment. The adverse reactions were recorded. Analysis of covariance was used to test the difference between the PANSS score, PPI, WCST and neurotrophic factor levels of the groups, with the pretest used as the covariate. Results3 months after treatment, no statistical difference was found in the scores of PANSS general psychopathology subscale, positive symptom subscale, negative symptom subscale and total score between two groups after treatment (F=0.621, 0.815, 0.743, 0.752, P>0.05). There were no statistically significant differences between the two groups in PPI inhibition rate, single intense stimulus amplitude, single intense stimulus latency, prepulse inhibition amplitude, or prepulse inhibition latency (F=0.174, 0.001, 0.183, 0.171, 0.001, P>0.05). There was no statistically significant difference in the total number of WCST tests between two groups (F=0.512, P>0.05), whereas aripiprazole group reported significantly larger total numbers of categories completed and correct responses as well as smaller total numbers of random errors and perseverative errors compared to risperidone group (F=3.737, 4.621, 4.892, 5.130, P<0.05). A significant increase in brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) along with a reduction in glial fibrillary acidic protein (GFAP) were documented in risperidone group when compared to risperidone group (F=4.414, 3.781, 6.319, P<0.05). No significant difference was demonstrated in the incidence of adverse reactions between the two groups (χ2=0.261, P>0.05). ConclusionAripiprazole may be more beneficial than risperidone in improving cognitive functioning and neurotrophic factor levels in patients with chronic schizophrenia. [Funded by Scientific Research Project of Fuyang Municipal Health Commission in 2021 (number, FY2021-147)]
3.Liquiritin improves macrophage degradation of engulfed tumour cells by promoting the formation of phagolysosomes via NOX2/gp91phox.
Caiyi YANG ; Kehan CHEN ; Yunliang CHEN ; Xuting XIE ; Pengcheng LI ; Meng ZHAO ; Junjie LIANG ; Xueqian XIE ; Xiaoyun CHEN ; Yanping CAI ; Bo XU ; Qing WANG ; Lian ZHOU ; Xia LUO
Journal of Pharmaceutical Analysis 2025;15(5):101093-101093
The incomplete degradation of tumour cells by macrophages (Mϕ) is a contributing factor to tumour progression and metastasis, and the degradation function of Mϕ is mediated through phagosomes and lysosomes. In our preliminary experiments, we found that overactivation of NADPH oxidase 2 (NOX2) reduced the ability of Mϕ to degrade engulfed tumour cells. Above this, we screened out liquiritin from Glycyrrhiza uralensis Fisch, which can significantly inhibit NOX2 activity and inhibit tumours, to elucidate that suppressing NOX2 can enhance the ability of Mϕ to degrade tumour cells. We found that the tumour environment could activate the NOX2 activity in Mϕ phagosomes, causing Mϕ to produce excessive reactive oxygen species (ROS), thus prohibiting the formation of phagolysosomes before degradation. Conversely, inhibiting NOX2 in Mϕ by liquiritin can reduce ROS and promote phagosome-lysosome fusion, therefore improving the enzymatic degradation of tumour cells after phagocytosis, and subsequently promote T cell activity by presenting antigens. We further confirmed that liquiritin down-regulated the expression of the NOX2 specific membrane component protein gp91 phox, blocking its binding to the NOX2 cytoplasmic component proteins p67 phox and p47 phox, thereby inhibiting the activity of NOX2. This study elucidates the specific mechanism by which Mϕ cannot degrade tumour cells after phagocytosis, and indicates that liquiritin can promote the ability of Mϕ to degrade tumour cells by suppressing NOX2.
4.Interpretation of the Guideline for Multi-dimensional and Multi-criteria Comprehensive Evaluation of Chinese Patent Medicine:weighting of evaluation indicators
Haili ZHANG ; Bin LIU ; Weili WANG ; Wenjie CAO ; Yijiu YANG ; Ziteng HU ; Yaxin CHEN ; Ning LIANG ; Huizhen LI ; Qianzi CHE ; Xingyu ZONG ; Zhao CHEN ; Yanping WANG ; Nannan SHI
China Pharmacy 2024;35(7):773-777
OBJECTIVE To provide a detailed report and interpretation of the method and results for determining the weights of the technical indicators from the “multi-dimensional and multi-criteria comprehensive evaluation index system (first edition)” stated in Guideline for Multi-dimensional and Multi-criteria Comprehensive Evaluation of Chinese Patent Medicine. METHODS Normalization calculations were performed on the comprehensive weight values calculated by the analytic hierarchy process and expert weighting method to obtain the objective weights of the indicators. RESULTS The weight results of the six primary dimensions in the current comprehensive evaluation indicator system of Chinese patent medicine showed effectiveness dimension> safety dimension>standard dimension>application dimension>scientific dimension>economic dimension, with weight values of 0.281 0, 0.268 5, 0.195 8, 0.107 3, 0.096 1 and 0.051 3 respectively, consistent with the results of most researches currently. CONCLUSIONS The process of weight determination in this indicator system is scientifically reasonable, with clear methods and clear interpretations, and is worthy of further optimization and widespread application.
5.Prevalence and associated risk factors of retinopathy of prematurity in preterm infants with gestational age ≤34 weeks
Xiaokang WANG ; Yifei LIANG ; Yanping ZHU
Chinese Journal of Child Health Care 2024;32(2):187-190
【Objective】 To understand the prevalence of retinopathy (ROP) in preterm infants with gestational age ≤34 weeks in the First Affiliated Hospital of Xinjiang Medical University, and to analyze the associated risk factors, so as to provide a basis for early screening of high-risk premature infants. 【Methods】 A retrospective analysis was conducted on the relevant case data of hospitalized premature infants with gestational age ≤34 weeks in neonatal intensive care unit (NICU) of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to June 2020. Infants were divided into ROP group and non-ROP group based on the results of fundus screening. Relevant data were collected to analyze the relevant risk factors for ROP in premature infants. 【Result】 A total of 1 738 premature infants with gestational age ≤34 weeks were included, with 292 cases (16.8%) in ROP group and 1 446 cases in non-ROP group. Logistic regression analysis revealed that bronchopulmonary dysplasia(BPD) (OR=3.379, 95%CI:1.835 - 6.221), anemia (OR=7.388, 95%CI: 4.262 - 12.806), receiving blood transfusion treatment (OR=2.129, 95%CI: 1.278 - 3.547), oxygen requirement time >7 days (OR=3.429, 95%CI: 2.309 - 5.094), and the fraction of inspired oxygen greater than 40% (OR=2.541, 95%CI: 1.540 - 4.193) were independent risk factors for the occurrence of ROP. Among these patients, 167 eyes (103 patients) received treatment of ROP, including 108 eyes treated with intraocular injection of Rizumab, 35 eyes treated with fundus laser, and 24 eyes treated with combination of both. All patients had acceptable outcomes during the follow-up. 【Conclusions】 Premature infants with anemia, BPD, receiving blood transfusion treatment, oxygen requirement time >7 days, and the fraction of inspired oxygen >40% are at high risk of developing ROP. Standardized fundus screening and timely treatment measures are essential to reduce the risk of visual impairment in premature infants.
6.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 1):Concept and Current Practice
Lijiao YAN ; Ning LIANG ; Ziteng HU ; Yujing ZHANG ; Yaxin CHEN ; Fuqiang ZHANG ; Xiaoling LI ; Wenjie CAO ; Chen ZHAO ; Cheng LYU ; Nannan SHI ; Yanping WANG
Journal of Traditional Chinese Medicine 2024;65(3):269-274
Rapid and living guidelines are those developed in response to public health emergencies in a short period of time using a scientific and standardized approach. Subsequently, they provide timely and credible recommendations for decision makers through regular and frequent updates of clinical evidence and recommendations. In this paper, we introduced the definition of rapid and living guideline as well as analyzed the basic characteristics of eight rapid and living guidelines in the field of traditional Chinese medicine (TCM) published till 2023 June, summarizing three core methodological issues in relation to how to rapidly develop guidelines, how to formulate recommendations when there is lack of evidence, and how to ensure the timeliness of guidelines. Based on the analysis of current rapid and living guidelines, it is implicated that there is necessity to carry out rapid and living guideline in the field of TCM, and the methodology of rapid integration of multivariate evidence in the field of TCM needs to be further explored; furthermore, it is necessary to further explore the obstacles of implementation of guidelines and promote timely updating, all of which provide certain theoretical references for relevant guideline developers and researchers.
7.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 2): Development Process and Key Steps during Preparation Stage
Yujing ZHANG ; Lijiao YAN ; Ziteng HU ; Yaxin CHEN ; Xiaoling LI ; Qianzi CHE ; Jingya WANG ; An LI ; Nannan SHI ; Yanping WANG ; Ning LIANG
Journal of Traditional Chinese Medicine 2024;65(3):275-280
It is necessary to develop rapid and living guidelines in order to improve the evidence translation and guidance for clinical practice in emergency situations, and to enhance the participation of traditional Chinese medicine (TCM) in management of emergencies. This paper introduced the process of developing rapid and living guidelines of TCM and divided it into three stages, that is preparation, rapid development and dynamic updating, which highlights the features of rapid development, high quality, and dynamic updating and the integration with the predominance of TCM. By comparing with general guidelines on composition, personnel number, timing to formulate and communication patterns of the guideline working groups, as well as the content and number of clinical questions, this paper mainly gave suggestions on how to formulate a concise but authoritative team during the preparation stage, how to efficiently manage the guideline team and promote the development process from conflict of interest management, working and communication mode adjustment, and how to formulate and update the important and prioritized clinical questions, all of which may provide reference for the development of TCM rapid and living guidelines.
8.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 3): Rapid Evidence Collection, Integration and Recommendation Formation
Ziteng HU ; Lijiao YAN ; Yujing ZHANG ; Yaxin CHEN ; Xiaoling LI ; Haili ZHANG ; Huizhen LI ; Jingya WANG ; An LI ; Zhao CHEN ; Ning LIANG ; Nannan SHI ; Yanping WANG
Journal of Traditional Chinese Medicine 2024;65(3):281-286
The lack of direct evidence is an important problem faced in the formation of recommendations in rapid living guidelines of traditional Chinese medicine under public health emergencies, and the supplementation of indirect evidence can be a key method to solve this problem. For the collection of evidence, the type of evidence required, including direct and indirect evidence, should be clarified, and ‘direct first’ principle for selecting evidence can be set to standardize and accelerate the guideline development. When integrating evidence, recommendations can be formed directly if there is sufficient direct evidence, while regarding insufficient direct evidence, recommendations need to be supplemented and improved by integrating indirect evidence. In addition, when the body of evidence contains evidence from multiple sources, it is suggested to rate the evidence according to “higher rather than lower” principle. Finally, when forming recommendations, the level of evidence, safety and economic efficiency should be taken into consideration to determine the strength of the recommendation.
9.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 4): Evidence Monitoring and Dynamic Updates
Lijiao YAN ; Ning LIANG ; Yujing ZHANG ; Ziteng HU ; Yaxin CHEN ; Xiaoling LI ; Wenjie CAO ; Huizhen LI ; Xingyu ZONG ; Chen ZHAO ; Cheng LYU ; Nannan SHI ; Yanping WANG
Journal of Traditional Chinese Medicine 2024;65(3):287-291
In developing rapid and living guidelines of traditional Chinese medicine (TCM) in response to public health emergencies, it is important that evidence continue to be reviewed, and clinical questions and recommendations updated if necessary, due to the rapid changes in disease progression and the continuous generation of relevant research evidence. This paper proposed that the updating scope in dynamic mode should first be identified; then evidence monitoring should be carried out in four aspects, including clinical research, related guidelines or laws and regulations, disease progression, as well as clinical use of recommendations and clinical needs; finally, based on the results of the evidence monitoring, different options should be made, including revising the clinical questions, updating the evidence and recommendations, and withdrawing the guideline.
10.Methodological Consideration on Combination Model of TCM Clinical Practice Guidelines and Real-world Study
Guozhen ZHAO ; Huizhen LI ; Ning LIANG ; Haili ZHANG ; Bin LIU ; Qianzi CHE ; Feng ZHOU ; He LI ; Xiaowen CHEN ; Long YE ; Jiahao LIN ; Xingyu ZONG ; Dingyi WANG ; Nannan SHI ; Yanping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):87-93
The clinical practice guidelines of traditional Chinese medicine (TCM) have problems such as limited clinical application and unclear implementation effects, which may be related to the lack of clinical practice evidence. To provide reliable and precise evidence for clinical practice, this article proposes a model of combining TCM guidelines with real-world study, which includes 4 steps. Firstly, during the implementation process of the guidelines, a high-quality research database is established. Secondly, the recommendations in the guidelines are evaluated based on the established database in multiple dimensions, including applicability, effectiveness, safety, and cost-effectiveness, and thus their effectiveness in practical applications can be determined. Thirdly, based on the established database, core prescriptions are identified, and the targeted populations and medication plans are determined. That is, the best treatment regimen is established based on the analysis of abundant clinical data regarding the effects of different medication frequencies, dosages, and duration on efficacy. Fourthly, the guidelines are updated according to the real-world evidence. The research based on this model can provide real-world evidence for ancient and empirical prescriptions, improving their application in clinical practice. Moreover, this model can reduce research costs and improve research efficiency. When applying this model, researchers need to pay attention to the quality of real-world evidence, ensuring that it can truly reflect the situation in clinical practice. In addition, importance should be attached to the clinical application of guideline recommendations, ensuring that doctors can conduct standardized diagnosis and treatment according to the guidelines. Finally, full-process participation of multidisciplinary experts is encouraged to ensure the comprehensiveness and scientificity of the study. In conclusion, the application of this model will contribute to the development of TCM guidelines responsive to the needs of clinical practice and achieve the goal of promoting the homogenization of TCM clinical diagnosis and treatment.

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