1.Data analysis of resolution discrepancies in minipool nucleic acid testing: A 2024 national study of Chinese blood stations
Ying YAN ; Qing HE ; Wei ZHENG ; Jie MA ; Le CHANG ; Huimin JI ; Huizhen SUN ; Lunan WANG
Chinese Journal of Blood Transfusion 2026;39(4):423-429
Objective: To investigate the incidence, characteristics, and influencing factors of resolution discrepancies within the minipool (MP) testing model across Chinese blood station laboratories in 2024. Methods: A nationwide, multicenter, cross-sectional study was conducted, including 334 blood station laboratories that reported nucleic acid reactive data among enzyme immunoassay non-reactive samples. Of these, 296 laboratories adopted the pool resolution model, with a total of 12 536 273 samples tested. Systematic analysis was performed on resolution data, focusing on the MP-NAT reactivity rate, the pool resolution concordance rate, and the resolution discrepancy rate. Subgroup analyses were conducted based on reagent types, viral targets, and Ct values. Potential causes were further explored through laboratory surveys and re-examination of raw amplification curves. Results: In 2024, the national average MP-NAT reactivity rate was 0.15%. The overall pool resolution concordance rate was 57.86%, which showed a gradual decline as Ct values increased across all reagents. The national average resolution discrepancy rate was 0.081‱(102/12 536 273), with 17.91%(53/296) of laboratories reporting at least one discrepancy. Nine reagent types were associated with these events, exhibiting reagent-specific patterns. For Reagent A2, the predominant discrepancy was HBV reactive pools resolving as HIV (36.36%); for Reagent D1, HBV pools frequently resolved as HCV (38.89%); and for Reagent E, the most common pattern was HIV pools resolving as HBV (48.00%). These resolution discrepancies were strongly associated with high Ct values: the median pool Ct for HBV exceeded 38, while those for HCV and HIV both exceeded 40. Investigations across 16 laboratories revealed that most discrepant samples exhibited “tailing” amplification curves, with some cases linked to cross-contamination or reagent batch-specific issues. Conclusion: While the incidence of resolution discrepancies in the MP-NAT model remains low in China, variations exist across different reagents and laboratories. These discrepancies are closely associated with low viral load, reagent performance, and laboratory operational practices.
2.Analysis of HPV Infection Characteristics and Influencing Factors for Lesion Grade in Patients with Cervical Squamous Intraepithelial Lesion and Cervical Cancer
Jingjing HAN ; Lijie ZHANG ; Ruyu CAI ; Haili LI ; He WANG ; Le DANG ; Hongda CHEN ; Ming'e LI ; Lan ZHU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):156-165
To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions. Clinical data of women attending the gynecological colposcopy clinic of Shenzhen People's Hospital from January 2020 to December 2023 were retrospectively collected. Patients with HPV genotyping records and histopathologically diagnosed SIL or CC were included and divided into three groups based on pathological results: low-grade squamous intraepithelial lesion(LSIL) group, high-grade squamous intraepithelial lesion(HSIL) group, and CC group. The distribution of high-risk HPV subtypes was analyzed among the three groups, and multivariate Logistic regression was used to identify influencing factors for high-grade cervical lesions. A total of 4162 patients were included, comprising 4057 cervical SIL patients(3317 LSIL and 740 HSIL) and 105 CC patients. The overall mean age was(39.9±11.2) years. The HPV infection rate was 95.1%(3959/4162), and 25.0%(1040/4162) of patients had received HPV vaccination. Among high-risk HPV infections, HPV 52, HPV 16, HPV 58, and HPV 18 were the most common subtypes. HPV 52 had the highest infection rate in the LSIL group(27.6%), while HPV 16 was the most prevalent in the HSIL group(45.3%) and CC group(64.9%). Multivariate Logistic regression analysis showed that HPV vaccination( HPV infection is common in patients with SIL and CC, but the distribution of high-risk HPV subtypes varies among different grades of cervical lesions. It is recommended to strengthen cervical cancer screening and monitoring of key high-risk HPV infections in older and multiparous women in Shenzhen, and to continue promoting HPV vaccination.
3.Preliminary study on an improved method for constructing internal quality control framework of ELISA
Youbin DUAN ; Rui WANG ; Le CHANG ; Changwen QIU ; Zhiqiang LI ; Gengrui CHEN ; Jingjuan YANG ; Qing HE ; Lunan WANG
Chinese Journal of Blood Transfusion 2026;39(1):103-108
Objective: To propose an improved method for constructing the internal quality control (IQC) framework for ELISA assays and validate its efficacy by statistically analyzing IQC data from nine blood center laboratories. Methods: 1) IQC data was collected from nine blood centers and analyzed using a domestic HBsAg ELISA detection kit as an example. 2) Differences between IQC values across batches within Blood Center 1 were assessed. 3) Statistical analyses were performed on batch usage, number of batches used, days of use, number of QC points, batch-specific means, and coefficients of variation (CV) across all nine centers. 4) Using the improved construction method for IQC framework, provisional and permanent frames were established for batches within Blood Center 1 and Blood Center 9, followed by outlier determination. Results: 1) Statistically significant differences were observed in IQC data between batches within Blood Center 1 (P<0.01). It is recommended that both the control material/reagents and the control chart framework be replaced simultaneously. 2) There were substantial differences among 9 blood centers regarding the control material/reagent lot numbers used, the number of QC runs per batch, and the QC values for identical lots. Therefore, individual laboratories should establish their own IQC chart frameworks. 3) The improved IQC framework construction method for ELISA assays is as follows: provisional frames are established via frame-shifting, using the pre-experimental mean and cumulative coefficient of variation (CV) from the preceding batch. For batches used >20 days with >20 QC points, permanent frames are constructed by aggregating in-control data accumulated over ≥20 days with ≥20 points to calculate cumulative mean and standard deviation. The provisional and permanent frames constructed by this method identified all 26 extreme outliers across Blood Centers 1 and 9 as out-of-control. Among the 218 general outliers, 10 were classified as normal by the provisional frames, while the remainder were designated as warnings or out-of-control. This method effectively monitors assay stability. Conclusion: Based on the statistical analysis of IQC practices across blood centers of varying scales, combined with the inherent characteristics of ELISA assays and the batch-to-batch instability of reagents/QC materials, it is recommended to reconstruct QC charts upon lot changes. The proposed method—utilizing frame-shifting for provisional frames and establishing permanent frames based on cumulative data—is applicable to blood center laboratories of differing sizes and effectively monitors the stability of the ELISA assay process.
4.Relationship between dyslipidemia and onset risk of cardiovascular disease in 340 patients with diabetes mellitus
Journal of Public Health and Preventive Medicine 2026;37(1):179-182
Objective To explore the relationship between dyslipidemia and cardiovascular disease risk in 340 patients with diabetes mellitus (DM). Methods A retrospective analysis was conducted on the clinical data of 340 DM patients who visited the West China Hospital of Sichuan University from January 2020 to January 2024 and were followed up for at least one year. According to the occurrence of cardiovascular disease in DM patients within 1 year of follow-up after treatment, the patients were divided into occurrence group and non-occurrence group. The demographic and related disease indicators in the two groups were statistically analyzed, and univariate analysis was performed. Binary logistic regression analysis was used to analyze the independent risk factors affecting the risk of cardiovascular disease in DM patients. Results The survey results showed that 38 out of 340 DM patients developed cardiovascular disease within 1 year of follow-up after treatment, accounting for 11.18%, and 302 cases did not develop cardiovascular disease, accounting for 88.82%. There were no statistical differences in gender, age, education level, family history of DM, smoking history and alcohol drinking history between the two groups (P>0.05). The proportions of DM course (>10 years), hypertension history and abnormal blood lipid-related indicators in the occurrence group were higher than those in the non-occurrence group (P<0.05). Binary logistics regression analysis showed that DM course>10 years, history of hypertension and abnormal blood lipid-related indicators were independent risk factors affecting the risk of cardiovascular disease in DM patients (P<0.05). Conclusion The course of DM, history of hypertension, and abnormal blood lipid-related indicators in DM patients significantly increase the risk of cardiovascular disease. It is necessary to actively monitor and manage blood lipid levels to reduce the risk of cardiovascular disease.
5.Analysis of depressive symptoms and predictive factors in children and adolescents in Inner Mongolia Autonomous Region
Guiwei CHEN ; Lu TONG ; Ziyu LI ; Xiaojuan GAO ; Ruiqi WANG ; Xiaolu ZHANG ; Le LIU ; Yinxia BAI
Sichuan Mental Health 2026;39(1):83-88
BackgroundIn recent years, the incidence of depression among adolescents has been increasing steadily, posing a serious threat to their physical and mental health and even leading to severe consequences such as self-harm and suicide. At the same time, the detection rate of subclinical depression symptoms among adolescents is even higher. Although these symptoms do not meet the clinical diagnostic criteria, they have significantly affected their quality of life, and their persistence over time may further develop into depression. Therefore, in-depth exploration of adolescent depression symptoms and the predictive factors holds significant practical significance and research value. However, up to now, no large-scale investigation and research on depression symptoms among children and adolescents has been conducted in Inner Mongolia Autonomous Region. ObjectiveTo understand the prevalence of depressive symptoms among children and adolescents in Inner Mongolia Autonomous Region, in order to provide references for formulating scientific and effective prevention strategies and intervention measures. MethodsBy using the cluster stratified random sampling method, 6 281 students from the third grade of primary school to the second grade of high school in 12 leagues and cities of Inner Mongolia Autonomous Region were selected in March 2024. A self-designed questionnaire and the Self-rating Depression Scale (SDS) were used for on-site investigation. ResultsA total of 6 058 (96.45%) children and adolescents completed the valid questionnaire survey, and 2 728 cases (45.03%) were found to have depressive symptoms. There were statistically significant differences in the detection rates of depressive symptoms among children and adolescents of different genders, ages, whether they were only children, different family types, family monthly income, parents' educational levels, and whether the mother was employed (χ2=33.769, 40.618, 48.593, 29.972, 142.648, 195.999, 168.190, 5.445, P<0.05 or 0.01).The results of the Logistic regression analysis showed that for children and adolescents, being female, aged between 12 and 16, over 16 years old, not being an only child, living in a reconstituted family, having a monthly family income of less than 5 000 yuan, and having parents with an education level of primary school or below were predictors of depressive symptoms (OR=1.241, 1.427, 1.273, 1.177, 1.549, 1.278, 1.462, 1.417, 1.514, 1.929, 1.660, 1.528, P<0.05 or 0.01). ConclusionThe detection rate of depressive symptoms among children and adolescents in Inner Mongolia Autonomous Region is relatively high. Factors that may predict depressive symptoms in children and adolescents include female gender, ages between 12 and 16, ages over 16 years old, non-only children, families with a restructured structure, monthly family income of less than 5 000 yuan, and parents with an education level of primary school or below. [Funded by Science and Technology Planning Project of the Inner Mongolia Autonomous Region (number, 2022YFSH0119)]
6.Pathogenic Mechanisms of Spleen Deficiency-Phlegm Dampness in Obesity and Traditional Chinese Medicine Prevention and Treatment Strategies:from the Perspective of Immune Inflammation
Yumei LI ; Peng XU ; Xiaowan WANG ; Shudong CHEN ; Le YANG ; Lihua HUANG ; Chuang LI ; Qinchi HE ; Xiangxi ZENG ; Juanjuan WANG ; Wei MAO ; Ruimin TIAN
Journal of Traditional Chinese Medicine 2026;67(1):31-37
Based on spleen deficiency-phlegm dampness as the core pathogenesis of obesity, and integrating recent advances in modern medicine regarding the key role of immune inflammation in obesity, this paper proposes a multidimensional pathogenic network of "obesity-spleen deficiency-phlegm dampness-immune imbalance". Various traditional Chinese medicine (TCM) herbs that strengthen the spleen, regulate qi, and resolve phlegm and dampness can treat obesity by improving spleen-stomach transport and transformation, promoting water-damp metabolism, and regulating immune homeostasis. This highlights immune inflammation as an important entry point to elucidate the TCM concepts of "spleen deficiency-phlegm dampness" and the therapeutic principle of "strengthening the spleen and eliminating dampness to treat obesity". By systematically analyzing the intrinsic connection between "spleen deficiency generating dampness, internal accumulation of phlegm dampness" and immune dysregulation in obesity, this paper aims to provide theoretical support for TCM treatment of obesity based on dampness.
7.Effect and Mechanisms of Ermiao Formula Analogs and Their Active Components in Treating Dampness-heat Type Gouty Arthritis: A Review
Xueping ZHAO ; Xinya ZHANG ; Le YANG ; Ye SUN ; Xin SUN ; Hui SUN ; Qimeng ZHANG ; Guangli YAN ; Xijun WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):276-285
Gouty arthritis (GA) is caused by monosodium urate(MSU) deposition due to purine metabolism disorders. In traditional Chinese medicine (TCM), it falls under the category of "dampness-heat Bi syndrome", with core pathogenesis involving dampness-heat accumulation and dysfunction of the spleen and kidney. The dampness-heat syndrome is the most common and the primary syndrome type during acute attacks. In Western medicine, GA is associated with purine metabolism imbalance and inflammation triggered by MSU crystals, involving pathways such as NOD-like receptor protein 3 (NLRP3) inflammasome activation and Toll-like receptor 2/4 (TLR2/4) signaling. Clinically, colchicine and similar drugs are commonly used to treat GA, although long-term use carries potential side effects. Ermiao Formula analogs originate from ancient prescriptions, including Ermiao, Sanmiao, and Simiao compound formulas. All contain Atractylodis Rhizoma and Phellodendri Chinensis Cortex. Ermiaowan follow a 1∶1 formulation ratio. Sanmiaowan add Cyathulae Radix. Simiaowan further incorporate Coicis Semen. These formulas are rich in active ingredients, including alkaloids, terpenoids, flavonoids, and sterols, and treat GA through multi-component, multi-pathway, and multi-target mechanisms. Ermiaosan primarily exerts anti-inflammatory effects by inhibiting pathways such as TLR4/nuclear factor kappa-B (NF-κB) or regulating immune responses to reduce the release of inflammatory mediators, while also suppressing xanthine dehydrogenase (XDH) and xanthine oxidase (XO) activity to decrease uric acid production. Sanmiaowan enhance uric acid-lowering and anti-inflammatory effects through the guiding herb Cyathulae Radix, while also protecting cartilage from damage. Simiaowan utilizes Coicis Semen to regulate intestinal flora, alleviate dampness-heat symptoms, and exert multi-pathway anti-inflammatory and uric acid-lowering effects. The active ingredients contribute differently to uric acid metabolism regulation, anti-inflammation, antioxidant activity, and bone repair, resulting in varying therapeutic effects due to differences in formula composition. In summary, formulas derived from Ermiaosan demonstrate significant efficacy in treating dampness-heat type GA. This review summarizes their research progress and mechanisms, providing a reference for clinical application, new drug development, and further studies.
8.The Role and Regulatory Mechanisms of FOXO1 in Hepatic Lipid Deposition
Meng JIA ; Fang-Hui LI ; Shi-Zhan YAN ; Ai-Ju LI ; Yi-Le WANG ; Pin-Shi NI ; Jia-Han HE ; Yin-Lu LI
Progress in Biochemistry and Biophysics 2026;53(4):905-919
Metabolic associated fatty liver disease (MAFLD) is fundamentally driven by an imbalance in hepatic fatty-acid flux: the influx of fatty acids exceeds the liver’s capacity for disposal, resulting in excessive hepatic lipid accumulation, predominantly in the form of triglycerides (TGs). The occurrence and progression of MAFLD depend on disordered regulation across multiple metabolic steps, including fatty-acid uptake, de novo lipogenesis (DNL), fatty-acid oxidation (FAO), and very low-density lipoprotein (VLDL) export. Forkhead box protein O1 (FOXO1) is a key transcriptional regulator within the hepatic network coordinating glucose and lipid metabolism. Under metabolic stress and insulin resistance (IR), FOXO1 expression is frequently increased, whereas its inhibitory phosphorylation is reduced. These changes enhance FOXO1 nuclear localization and transcriptional activity, thereby reprogramming the expression of genes related to metabolism in the liver. Because hepatic lipid deposition is the central pathological feature of MAFLD, the functional status of FOXO1 directly influences hepatic lipid homeostasis. Growing evidence suggests that FOXO1 can exert bidirectional, environment-dependent effects on hepatic lipid accumulation; however, the molecular basis for this functional switch remains incompletely understood. This review systematically summarizes the biological functions and regulatory mechanisms of FOXO1 and its roles in hepatic lipid metabolism, with a particular focus on its crosstalk with insulin signaling. FOXO1 expression is shaped by RNA modifications and epigenetic regulation mediated by non-coding RNAs. Its transcriptional output is precisely governed by post-translational modifications—such as phosphorylation and acetylation—as well as by coordinated nucleocytoplasmic shuttling. Notably, these regulatory patterns vary markedly across nutritional states, degrees of insulin resistance, and stages of disease. In the fed state, insulin/IGF-1 signaling activates the PI3K-AKT pathway, promoting the inhibitory phosphorylation of FOXO1 and facilitating additional modifications, including acetylation, methylation, and ubiquitination. Together, these events drive FOXO1 export from the nucleus and dampen its transcriptional activity, suppressing gluconeogenesis and constraining lipogenic programs. Conversely, during fasting or when insulin signaling is weakened, FOXO1 inhibition is relieved. FOXO1 accumulates in the nucleus, binds to DNA, and regulates the transcription of downstream target genes. Mechanistically, FOXO1 can aggravate hepatic lipid accumulation by activating genes involved in TG synthesis while repressing FAO-related pathways, thereby favoring storage over oxidation. However, under specific conditions, FOXO1 may also alleviate the hepatic lipid burden by promoting TG hydrolysis and enhancing VLDL secretion, thereby reducing the net hepatic lipid load. In addition, lipotoxic signals mediated by ceramides and diacylglycerols (Cer/DAG) activate atypical protein kinase C (aPKC), further exacerbating the disruption of the AKT-FOXO1 axis. This vicious cycle ultimately produces a metabolic paradox in which increased hepatic glucose output coexists with persistent, insulin-independent lipogenesis, accelerating MAFLD progression. Importantly, FOXO1 regulation is not uniform: during early metabolic overload, insulin-mediated suppression may remain effective, whereas in advanced insulin resistance, the loss of AKT control permits sustained FOXO1 activity. Such stage-dependent dynamics may help explain why FOXO1 can either promote steatosis or, in certain contexts, support programs that facilitate lipid turnover. Accordingly, interventions should be liver-specific and tuned to the disease stage, aiming to curb maladaptive FOXO1 signaling while preserving its capacity to promote triglyceride hydrolysis and VLDL secretion when advantageous. Overall, this review offers an important perspective on MAFLD pathogenesis, emphasizing FOXO1 as a potential therapeutic target and providing a theoretical basis for developing liver-specific, disease-course-dependent precision interventions.
9.Differential expression and molecular genetic characteristics of CD36 antigen in platelet donor database in Shaanxi province, China
Tianju WANG ; Jun QI ; Manni WANG ; Yuhui LI ; Lixia SHANG ; Le CHEN ; Xiaofang WANG
Chinese Journal of Blood Transfusion 2025;38(5):621-628
Objective: To screen the frequency of CD36 antigen expression in platelet donor database in Shaanxi province and analyze the molecular genetic characteristics of samples with CD36 antigen deficiency and low expression. Methods: A total of 525 platelet donors samples were randomly collected during May 2023. CD36-FITC monoclonal antibody was used for immunofluorescence labeling, and flow cytometry was applied to detect the expression of CD36 antigen on platelets. For samples with CD36 antigen deficiency on platelets, the expression of CD36 on monocytes was further detected. Samples with CD36 antigen deficiency and low expression were sequenced and analyzed. Results: Among the 525 blood samples, 99.24% (521/525) showed positive expression of CD36 antigen. There were differences in the expression intensity of CD36 antigen, with low expression accounting for 3.43% (18/525) and CD36 antigen deficiency accounting for 0.76% (4/525), all of which were type Ⅱ deficiency. The exon mutation frequency of CD36 type Ⅱ deficiency and low expression samples was 31.82% (7/22), and the exon mutation types were 121-1_126delGCAAGTT, 329-330delAC, 1142T>G, 1204-1246dupl 43bp, 1221G>A, and 1228-1239delATTGTGCCTATT. All four cases of CD36 type Ⅱ deficiency had a 121-6 T>C mutation in intron 3. All CD36 low expression samples had a mutation of 282-10A>G, and 121-6T>C mutation rate was 61.1%(11/18). Conclusion: There were differences in the expression of CD36 antigen in the platelet donor database in Shaanxi province, which may be caused by multiple molecular genetic variations. The frequency of CD36 antigen deficiency in Shaanxi was lower than that of Han, Zhuang and Yao populations in southern China. This study provides references for solving the CD36 antibody mediated transfusion reaction and auxiliary treatment of diseases caused by CD36 antigen deficiency in the future. It also provides a basis for investigating the molecular mechanisms of CD36 deficiency and low expression.
10.Zuoguiwan Regulates Pdx1 Pathway to Improve Pancreas Development in Offspring of Gestational Diabetes Mellitus Model Rats
Wanqiu LIANG ; Rang CHEN ; Le ZHAO ; Xiaoyi REN ; Qianhui SU ; Yonghui WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):10-19
ObjectiveTo explore the mechanism by which Zuoguiwan improves the pancreas development in the gestational diabetes mellitus (GDM) model by observing the effects of Zuoguiwan on the expression of key regulatory factors in different stages of pancreas development. MethodsPregnant Wistar rats were randomly assigned into blank, model, insulin detemir (20 U·kg-1) and Zuoguiwan (1.89 g·kg-1) groups (n=18). GDM was induced by peritoneal injection of streptozotocin on day 6.5 (E6.5d) in the embryonic stage, and the blank group was given an equal volume of sodium citrate buffer. The modeling performance was assessed by measuring the blood glucose of pregnant rats. Except the blank group and model group, pregnant rats in other groups were administrated with corresponding drugs from E9.5d to delivery. The random blood glucose of pregnant rats was monitored, and the embryos and offspring rats were measured for the length and weighed on E12.5d, E18.5d and day 21 after birth (B21d). The Lee's index of rats on B21d was calculated. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the fasting insulin (FINS) levels of B22d rats and the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) was calculated. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), total cholesterol (CHO), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) in E18.5d pregnant rats and B22d offspring were determined. The pathological changes in the pancreas of E12.5d, E18.5d and B22d rats were observed by hematoxylin-eosin (HE) staining. Western blot was used to determine the protein levels of pancreatic duodenal homeobox 1 (Pdx1), pancreas-specific transcription factor 1a (Ptf1a), and sex-determining region Y-box protein 9 (Sox9) in the pancreas of E12.5d embryos, Pdx1, Nkx2 homeobox 2 (Nkx2.2), and hairy and enhancer of split-1 (Hes1) in the pancreas of E18.5d embryos, and Pdx1, v-maf musculoaponeurotic fibrosarcoma oncogene homolog A (Mafa), and NK transcription factor-related homeobox gene family 6 locus 1 (Nkx6.1) in the pancreas of B22d rats. ResultsCompared with the blank group, the model group showed elevated blood glucose levels in pregnant rats on B0d, E9.5d, E12.5d, E15.5d, and E18.5d (P<0.05, P<0.01), decreased body weight and body length (P<0.01) and increased Lee's index in the offspring. In addition, the B22d offspring showed rising levels of FBG, FINS, HOMA-IR, AST, and TG (P<0.01), a declined level of HDL (P<0.01), and pancreatic acinous cells with edema and loose arrangement. The pregnant rats on E18.5d exhibited raised levels of ALT, AST, and TG (P<0.05, P<0.01) in the pancreas and a declined level of HDL (P<0.05). The E12.5d embryos showed up-regulated protein levels of Pdx1, Sox9, and Ptf1a in the pancreas (P<0.01) and the E18.5d embryos exhibited down-regulated protein levels of Pdx1, Nkx2.2, and Hes1 in the pancreas (P<0.01). The protein levels of Pdx1, Nkx6.1, and Mafa in the pancreas of B22d offspring were down-regulated (P<0.01). Compared with the model group, the insulin group exhibited lowered blood glucose in pregnant rats on B0d, E15.5d, and E18.5d (P<0.05, P<0.01). The offspring in all treatment groups showcased increased body weight and body length (P<0.01) and decreased Lee's index. The B22d offspring exhibited declined levels of FBG, FINS, and HOMA-IR in the insulin group (P<0.01) and lowered levels of FBG and HOMA-IR in the Zuoguiwan group (P<0.01). The B22d offspring in all the treatment groups showed reduced levels of ALT, AST, TBIL, CHO, TG, and LDL, a raised level of HDL, and alleviated edema of pancreatic acinous cells. The pregnant rats on E18.5d demonstrated declined levels of TG and ALT (P<0.05, P<0.01) and an elevated level of HDL (P<0.05). The pancreas of E12.5d embryos presented down-regulated protein levels of Pdx1 and Sox9 and an up-regulated protein level of Ptf1a in the insulin group (P<0.05). The pancreas of E12.5d embryos in the Zuoguiwan group presented down-regulated protein levels of Pdx1, Sox9, and Ptf1a (P<0.01). All the treatment groups showed up-regulated protein levels of Pdx1, Nkx2.2, and Hes1 in the pancreas of E18.5d embryos (P<0.01) and Pdx1, Nkx6.1, and Mafa in the pancreas of B22d embryos (P<0.05, P<0.01). ConclusionZuoguiwan can promote the growth and development and ameliorate the pathological changes in the pancreas of the offspring of GDM model by regulating the expression of Pdx1 pathway-related regulatory factors in different stages of pancreas development.


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