1.Regulatory Pathways of Cell Apoptosis in Diabetic Kidney Disease and Intervention by Traditional Chinese Medicine: A Review
Yunjie YANG ; Mingqian JIANG ; Chen QIU ; Yaqing RUAN ; Senlin CHEN ; Wenxin HUANG ; Hangbin ZHENG ; Yi WEI ; Pengfei LI ; Xueqin LIN ; Jing WU ; Shiwei RUAN ; Jianting WANG ; Yuliang QIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):294-306
Diabetic kidney disease(DKD) is a chronic kidney structural and functional disorder caused by diabetes. With the global prevalence of diabetes continuing to rise, DKD has gradually become a major cause of chronic kidney disease and end-stage renal disease(ESRD), posing a serious threat to patients' quality of life and long-term health outcomes. Studies have shown that apoptosis plays a pivotal role in the development and progression of DKD, with its mechanisms involving abnormal activation of multiple signaling pathways such as Toll-like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)/B-cell lymphoma-2(Bcl-2)/cysteinyl aspartate-specific proteinase(Caspase)-3, protein kinase R-like endoplasmic reticulum kinase(PERK)/eukaryotic initiation factor 2α(eIF2α)/activating transcript factor 4(ATF4)/CCAAT enhancer-binding protein homologous protein(CHOP), phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/glycogen synthase kinase-3β(GSK-3β), Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3), adenosine monophosphate-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) and silent information regulator 1(SIRT1)/tumor suppressor protein 53(p53), thereby accelerating renal pathological damage in DKD. Extensive evidence-based medical studies have confirmed that traditional Chinese medicine(TCM), leveraging its unique therapeutic advantages of multi-target, multi-component and multi-pathway approaches, has demonstrated remarkable efficacy and favorable safety profiles in treating DKD. Recent studies have demonstrated that active components of TCM can specifically target and modulate key effectors in apoptotic signaling pathways. Meanwhile, traditional compound formulations exert synergistic effects through multiple approaches such as replenishing deficiency and activating blood circulation, detoxifying and dredging collaterals, tonifying kidney essence, and removing stasis and purging turbidity, thereby comprehensively regulating critical pathological processes including endoplasmic reticulum stress and mitochondrial apoptosis pathways. This combined therapeutic approach of molecular targeting and holistic regulation provides novel strategies for delaying the progression of DKD. Based on this, this paper provides an in-depth analysis of key apoptotic signaling pathways and their regulatory mechanisms, while systematically summarizing recent research advances regarding the therapeutic effects of TCM active components, compound formulations, and proprietary Chinese medicines on DKD through modulation of these pathways, with particular emphasis on their underlying molecular mechanisms. These findings not only elucidate the modern scientific connotation and theoretical basis of TCM in treating DKD but also establish a solid theoretical and practical foundation for promoting the wider clinical application and further research of TCM in the field of DKD treatment.
2.Luoshi Neiyi Prescription Treats Endometriosis Through TLR4/NF-κB Signaling Pathway
Yuanyuan RUAN ; Sai XU ; Jiangyue TANG ; Xiang LI ; You ZOU ; Fangli PEI ; Lizheng WU ; Kaidi ZHENG ; Shuhong LIN ; Weilan ZHONG ; Cheng ZENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):185-196
ObjectiveTo investigate the mechanism by which Luoshi Neiyi prescription treats endometriosis (EMs) through the Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway. MethodsAnimal experiments were conducted with 50 female SD rats, which were randomized into a sham operation group (10 rats) and a modeling group (40 rats). An autologous endometrial transplantation method was used for the modeling of EMs. The 36 successfully modeled rats were randomly allocated into four groups (n=9 each): The model group, the low-dose (7.87 g·kg-1) Luoshi Neiyi prescription group, the high-dose (15.74 g·kg-1) Luoshi Neiyi prescription group, and the dienogest (0.20 mg·kg-1) group. The physiological status and ectopic lesion volumes of rats in each group were observed. Hematoxylin-eosin (HE) staining was used to observe the morphology of the eutopic endometrial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of inflammatory factors including interleukin-1β (IL-1β) and prostaglandin E2 (PGE2) in the serum of EMs rats. Immunohistochemistry was used to detect the expression of matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor A (VEGFA) in the eutopic endometrial tissue. Western blot was adopted to determine the protein levels of TLR4, myeloid differentiation factor 88 (MyD88), phosphorylated nuclear factor-κB (p-NF-κB)/NF-κB, MMP-9, and VEGFA in the eutopic endometrial tissue. In the cell experiments, the cell-counting kit-8 (CCK-8) assay was employed to screen the optimal concentration of Luoshi Neiyi prescription-containing serum, and a scratch assay was performed to assess the migration ability of iheESCs cells. Interventions with Luoshi Neiyi prescription-containing serum, resatorvid (TAK-242, a TLR4 inhibitor), and lipopolysaccharides (LPS, a TLR4 agonist) were conducted, and Western blot was used to detect the expression of proteins related to the TLR4/NF-κB signaling pathway. ResultsThis experiment successfully replicated 36 EMs rat models. Compared with the sham operation group, the model group exhibited visible ectopic lesions on the abdominal wall and an increase in the writhing response score (P<0.01). Furthermore, HE staining revealed the model group exhibited a thickened eutopic epithelium, stromal cell disarrangement, and evident infiltration of inflammatory cells. In addition, the model group showed elevated serum levels of IL-1β and PGE2 (P<0.05, P<0.01), increased positive expression of MMP-9 and VEGFA in the ectopic endometrial tissue (P<0.01), and up-regulated protein levels of TLR4, MyD88, p-NF-κB/NF-κB, MMP-9, and VEGFA in the ectopic endometrial tissue (P<0.05, P<0.01). Compared with the model group, all treatment groups exhibited a reduction in the ectopic lesion volume (P<0.01). Furthermore, the writhing response scores were decreased in the high-dose Luoshi Neiyi prescription group and the dienogest group (P<0.05, P<0.01). The pathological state of the ectopic endometrial tissue was alleviated to varying degrees in the treatment groups. Low-dose Luoshi Neiyi prescription reduced serum PGE2 levels, and high-dose Luoshi Neiyi prescription and dienogest decreased serum IL-1β and PGE2 levels in EMs rats (P<0.05, P<0.01). The treatment groups showed decreased positive expression of MMP-9 and VEGFA in the ectopic endometrial tissue (P<0.05, P<0.01) and down-regulated protein levels of TLR4, MyD88, p-NF-κB/NF-κB, MMP-9, and VEGFA in the ectopic endometrial tissue (P<0.05, P<0.01). The cell experiments showed that 5%, 10%, and 20% Luoshi Neiyi prescription-containing sera significantly reduced the viability and inhibited the migration of iheESCs. Compared with the control group, 5%, 10%, and 20% Luoshi Neiyi prescription-containing serum groups and the TAK-242 group showed reduced protein levels of TLR4, MyD88, p-NF-κB/NF-κB, MMP-9, and VEGFA (P<0.01). Compared with the control group, the LPS group showed increased expression of the above proteins (P<0.01). Compared with the LPS group, the LPS+5%, 10%, and 20% Luoshi Neiyi prescription-containing serum groups showed reduced expression of the above proteins (P<0.05, P<0.01). ConclusionLuoshi Neiyi prescription may modulate the TLR4/NF-κB signaling pathway to reduce the inflammatory response and histopathological damage in the eutopic endometrium and suppress the adhesive, invasive, and angiogenic biological processes in the ectopic endometrial tissue, thereby exerting its therapeutic effect on EMs.
3.Effects of Shujin Jiannao Formula (舒筋健脑方) on Neural Repair and PI3K-Akt-mTOR Pathway of Brain Tissue in Cerebral Palsy Model Rats
Ruiqin YU ; Yanjun MO ; Houjun ZHANG ; Gang LIU ; Zhuoluo ZHOU ; Zechen RUAN ; Lin XU ; Xiaohong MU
Journal of Traditional Chinese Medicine 2025;66(10):1038-1045
ObjectiveTo explore the possible mechanisms of Shujin Jiannao Formula (舒筋健脑方) for cerebral palsy. MethodsThirty 7-day-old SD rats were randomly divided into normal group, model group, and Shujin Jiannao Formula group, with 10 rats in each group. The model group and Shujin Jiannao Formula group established a cerebral palsy model by the classic Rice-Vannucci method. After successful modeling, rats in Shujin Jiannao Formula group were given Shujin Jiannao Formula 16 g/(kg·d) by gavage, while the normal group and model group were given normal saline 10 ml/(kg·d) by gavage once a day. After one week of intervention, the rats' body weight was measured, and Zea-Longa scores, the righting reflex test, and the hindlimb suspension test were conducted for assessment; hematoxylin-eosin (HE) staining and Nissl staining were used to observe pathological changes in brain tissue, and the number of Nissl-positive neurons was counted; enzyme-linked immunosorbent assay (ELISA) was employed to measure levels of inflammatory cytokines in the brain tissue, specifically interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α); immunofluorescence was used to detect the expression levels of neurofilament protein 200 (NF200) and myelin basic protein (MBP) in brain tissue; Western Blot analysis was conducted to determine the protein levels of phosphoinositide 3-kinase (PI3K), protein kinase B (Akt/PKB/Rac), and mammalian target of rapamycin (mTOR) in brain tissue. ResultsCompared with the normal group, rats in the model group showed significantly higher Zea-Longa scores and lower scores in the hindlimb suspension test (P<0.01); pathological findings revealed loose structure in the cerebral cortex, hippocampal atrophy, and neuronal damage in brain tissue. Levels of IL-1β and TNF-α elevated, and the number of Nissl-stained positive neurons in the cortex and hippocampal CA1 region reduced, and immunofluorescence intensity of NF200 and MBP, as well as protein expression levels of PI3K and mTOR, significantly decreased (P<0.05 or P<0.01). Compared with the model group, rats in Shujin Jiannao Formula group showed decreased Zea-Longa scores and increased hindlimb suspension test scores (P<0.05); pathological damage in brain tissue alleviated, levels of IL-1β and TNF-α reduced, the number of Nissl-stained positive neurons in the cortex and hippocampal CA1 region increased, and the immunofluorescence intensity of NF200 and MBP, as well as the protein levels of PI3K and mTOR, significantly elevated (P<0.05 or P<0.01). There were no statistically significant differences among the groups in body weight, body-turning time, or AKT protein levels in brain tissue (P>0.05). ConclusionShujin Jiannao Formula can improve the neurological function of rats with cerebral palsy, exert neurorestorative effects, and its mechanism of action may be related to the reduction of inflammatory response in brain tissue and the activation of the PI3K/AKT/mTOR signaling pathway.
4.Regulatory effects of Dangua Humai Oral Liquid on gut microbiota and mucosal barrier in mice with glucolipid metabolism disorder.
Zhuang HAN ; Lin-Xi JIN ; Zhi-Ta WANG ; Liu-Qing YANG ; Liang LI ; Yi RUAN ; Qi-Wei CHEN ; Shu-Hong YAO ; Xian-Pei HENG
China Journal of Chinese Materia Medica 2025;50(15):4315-4324
The gut microbiota regulates intestinal nutrient absorption, participates in modulating host glucolipid metabolism, and contributes to ameliorating glucolipid metabolism disorder. Dysbiosis of the gut microbiota can compromise the integrity of the intestinal mucosal barrier, induce inflammatory responses, and exacerbate insulin resistance and abnormal lipid metabolism in the host. Dangua Humai Oral Liquid, a hospital-developed formulation for regulating glucolipid metabolism, has been granted a national invention patent and demonstrates significant clinical efficacy. This study aimed to investigate the effects of Dangua Humai Oral Liquid on gut microbiota and the intestinal mucosal barrier in a mouse model with glucolipid metabolism disorder. A glucolipid metabolism disorder model was established by feeding mice a high-glucose and high-fat diet. The mice were divided into a normal group, a model group, and a treatment group, with eight mice in each group. The treatment group received a daily gavage of Dangua Humai Oral Liquid(20 g·kg~(-1)), while the normal group and model group were given an equivalent volume of sterile water. After 15 weeks of intervention, glucolipid metabolism, intestinal mucosal barrier function, and inflammatory responses were evaluated. Metagenomics and untargeted metabolomics were employed to analyze changes in gut microbiota and associated metabolic pathways. Significant differences were observed between the indicators of the normal group and the model group. Compared with the model group, the treatment group exhibited marked improvements in glucolipid metabolism disorder, alleviated pathological damage in the liver and small intestine tissue, elevated expression of recombinant claudin 1(CLDN1), occluding(OCLN), and zonula occludens 1(ZO-1) in the small intestine tissue, and reduced serum levels of inflammatory factors lipopolysaccharides(LPS), lipopolysaccharide-binding protein(LBP), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α). At the phylum level, the relative abundance of Bacteroidota decreased, while that of Firmicutes increased. Lipid-related metabolic pathways were significantly altered. In conclusion, based on the successful establishment of the mouse model of glucolipid metabolism disorder, this study confirmed that Dangua Humai Oral Liquid effectively modulates gut microbiota and mucosal barrier function, reduces serum inflammatory factor levels, and regulates lipid-related metabolic pathways, thereby ameliorating glucolipid metabolism disorder.
Animals
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Gastrointestinal Microbiome/drug effects*
;
Mice
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Intestinal Mucosa/microbiology*
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Male
;
Drugs, Chinese Herbal/administration & dosage*
;
Mice, Inbred C57BL
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Humans
;
Glycolipids/metabolism*
;
Lipid Metabolism/drug effects*
;
Administration, Oral
;
Disease Models, Animal
5.Analysis on trend of hearing changes in infants with p.V37I mutation in GJB2 gene at different months of age.
Shan GAO ; Cheng WEN ; Yiding YU ; Yue LI ; Lin DENG ; Yu RUAN ; Jinge XIE ; Lihui HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(1):10-18
Objective:To explore the trend of hearing changes in infants with GJB2 gene p.V37I mutation at different months. Methods:The subjects were 54 children(108 ears) with p.V37I homozygous or compound heterozygous mutation in GJB2 gene. All the subjects underwent auditory brainstem response, auditory steady-state response, acoustic immittance and other audiological tests. Children were divided into three groups according to their age, 26 cases in group A were ≤3 months old, 17 cases in group B were>3~≤6 months old, and 11 cases in group C were>6 months old. Statistical analysis was performed on the three groups of ABR response threshold, hearing degree, the ASSR average response threshold of four frequencies and the ASSR response thresholds for each frequency of 500, 1 000, 2 000 and 4 000 Hz. Results:Among the 54 cases, 35 were male and 19 were female, with an age rang of 2-27 months and a median age of 4 months. The ABR response threshold of the three groups were ranked from low to high as group A, group B and group C, and the difference was statistically significant(P<0.05). The ABR response thresholds of the three groups were ranked from low to high as group A, group B, and group C. The comparison between groups showed that the ABR response thresholds of group C was higher than that of group A(P=0.006). The proportion of confirmed hearing loss in the three groups was 34.61%, 50.00% and 63.64%, respectively, and the difference of hearing level among the three groups was statistically significant(P<0.05). The comparison between groups showed that the difference between group A and group C was statistically significant(P=0.012), normal hearing accounted for the highest proportion in group A(65.39%), while mild hearing loss accounted for the highest proportion in group C(45.46%). The ASSR average response thresholds of the four frequencies in the three groups were ranked from low to high as group A, group B and group C, and the difference is statistically significant(P<0.05). The comparison between groups showed that response ASSR thresholds of group C was higher than that of group A(P=0.002). Response thresholds of ASSR in each frequency in the three groups were all ranked from low to high as in group A, group B and group C, and the differences were statistically significant(P<0.05). Compared with each other between groups, response ASSR thresholds of group C was higher than those of group A(P=0.003) and group B(P=0.015) at 500 Hz, while response ASSR thresholds of group C was higher than group A at 1 000 Hz(P=0.010) and 2 000 Hz(P<0.001), and there was no statistical difference at 4 000 Hz. Conclusion:The incidence of hearing loss in GJB2 gene p.V37I mutation increased with age, and the degree of hearing loss increased, the hearing progression was mainly 500, 1 000 and 2 000 Hz suggesting regular follow-up and alert to hearing changes.
Humans
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Connexin 26
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Male
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Female
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Infant
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Child, Preschool
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Mutation
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Evoked Potentials, Auditory, Brain Stem
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Connexins/genetics*
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Auditory Threshold
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Hearing/genetics*
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Hearing Loss/genetics*
6.Prediction of hearing change in children with enlarged vestibular aqueduct with different genotypes by linear mixed-effects model.
Lin DENG ; Lihui HUANG ; Xiaohua CHENG ; Yiding YU ; Yue LI ; Shan GAO ; Yu RUAN ; Jinge XIE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(8):717-723
Objective:To explore the hearing changes of children with different genotypes of SLC26A4 with enlarged vestibular aqueduct(EVA) using the linear mixed effect model(LMM), providing evidence for the risk prediction of progressive hearing loss. Methods:A total of 48 children with EVA diagnosed in our hospital from January 2017 to January 2024. All subjects underwent two or more auditory tests. According to the results of deafness gene screening and sequencing, the genotypes are divided into: type A: homozygous mutation of c. 919-2A>G, type B: compound heterozygous or heterozygous mutation containing c. 919-2A>G, and type C: no mutation site of c. 919-2A>G of SLC26A4 gene. LMM was used to analyze the hearing thresholds change of 500 Hz, 1 000 Hz, 2 000 Hz, 4 000 Hz and the average in children with different genotypes with age. Results:A total of 92 ears, 314 audiograms of 48 children were included, the median number of audiograms was 3, the median age of initial diagnosis was 4 months, and the median follow-up time was 13 months. According to LMM, the standard deviation of random effects between patients and ears was large. There was no significant difference in hearing thresholds of different frequencies and the average in genotype A, genotype B, and genotype C, indicating that genotype had no effect on hearing threshold. There is an interaction between age and genotype. Taking genotype C as the reference, children with genotype B had the lowest increase in 500 Hz, 1000 Hz, and the average hearing threshold, followed by type A. Conclusion:EVA children exhibit substantial inter-individual/ear hearing threshold variability. Low-frequency thresholds progress slower than high frequencies. Genotype modulates progression rates, with wild-type(Type C) demonstrating fastest deterioration, supporting personalized auditory monitoring strategies.
Humans
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Vestibular Aqueduct/abnormalities*
;
Genotype
;
Sulfate Transporters
;
Mutation
;
Auditory Threshold
;
Hearing Loss, Sensorineural/genetics*
;
Male
;
Female
;
Child
;
Child, Preschool
;
Hearing Loss/genetics*
;
Hearing Tests
;
Linear Models
;
Infant
7.Base on the"One Qi Circulation"Theory to Treat Heart Failure with Reduced Ejection Fraction
Ruyi LIN ; Hui CHEN ; Lili RUAN
Journal of Zhejiang Chinese Medical University 2025;49(10):1332-1335
[Objective]To analyze the etiology and pathogenesis of heart failure with reduced ejection fraction(HFrEF)by using the"One Qi Circulation"theory,and explore the corresponding therapeutic strategies in traditional Chinese medicine.[Methods]Based on the"One Qi Circulation"theory,the causes of HFrEF fraction are analyzed in conjunction with the clinical manifestations of patients.The treatment principles and the selection of formulas and drugs are specifically discussed in combination with the characteristics of drug use in the"One Qi Circulation"theory,and the application of the method of benefiting the heart,strengthening the spleen and promoting diuresis is elaborated.Finally,a clinical case was listed for verification.[Results]The"One Qi Circulation"theory considers that water-cold and earth-dampness are the basic pathogenesis of heart failure,and Yang-decline and fire-defeat are the keys to the exacerbation of the condition.The ultimate goal is to restore the state of"One Qi Circulation".The method of benefiting the heart,strengthening the spleen and promoting diuresis is refined from this,which takes drying the earth,warming the water and protecting the middle Qi as the basic principles.The cited case involved an HFrEF patient exhibiting water-cold and earth-dampness with Yang deficiency and water overflow,treated by invigorating the spleen and promoting diuresis,warming Yang and benefiting the heart,and the symptoms of the patients were relieved.[Conclusion]The application of the method of benefiting the heart,strengthening the spleen and promoting diuresis based on the"One Qi Circulation"theory on treating HFrEF fraction is practical and effective,and it provides much inspiration for improving the prognosis and reducing the recurrence rate of the disease,providing new ideas and methods for the clinical diagnosis and treatment of HFrEF fraction.
8.Mechanism of sacubitril/valsartan intervention in myocardial fibrosis induced by doxorubicin in rabbits with heart failure
Jinlong ZHUANG ; Hua CHEN ; Genghai LIN ; Fahui RUAN ; Wangdong ZHANG ; Qigan ZHU ; Li LIU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(11):1552-1557
Objective To investigate the intervention effect of sacubitril/valsartan(Sac/Val)on doxorubicin-induced heart failure(HF)in rabbits and its regulative effect on the transforming growth factor β1(TGF-β1)/SMAD family member 3(Smad3)/connective tissue growth factor(CTGF)signaling pathway.Methods Thirty-eight male New Zealand rabbits were subjected,and 8 of them were randomly assigned into a control group.The other 30 rabbits were injected with doxorubicin to establish a rabbit HF model,and finally,there were 6 rabbits in a model group,7 in a valsartan group,and 7 in a Sac/Val group.After 8 weeks of intervention,echocardiography[left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],and myocardial histopathologic observation(HE staining,Masson staining)were performed,and collogen volume fraction(CVF)was calculated.The levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),soluble growth stimulation expressed gene 2(sST2),galectin-3(Gal-3)were detected.Activities of renin-angiotensin-aldosterone system(RAAS)and levels of atrial natriuretic peptide,B-type brain natriuretic peptide(BNP),cyclic guanosine monophosphate(cGMP)and protein kinase G(PKG)were measured.The expression of α-smooth muscle actin(α-SMA),typeⅠ collagen,TGF-β1,Smad3,recombinant SMAD family member 7(Smad7)and CTGF in the myocardial tissues were detected.Results Compared with the control group,the model group exhibited significantly lower LVEF and LVFS and decreased expression of Smad7,higher LVEDD and LVESD(P<0.01).The CVF of each group was(7.15±0.82)%、(43.20±5.09)%、(29.53±4.05)%、(22.48±2.93)%.Valsartan and Sac/Val treatment resulted in obvious increases in LVEF and LVFS,up-regulation of Smad7,decreased in LVEDD,LVESD and CVF,reduced levels of NT-proBNP,sST2,Gal-3,AngⅡ,aldosterone,atrial natriuretic peptide,BNP,cGMP and PKG,and down-regulation of α-SMA,collagen I,TGF-β1,Smad3 and CTGF when compared with the model group(P<0.01).Sac/Val treatment showed better effects in above indicators than simple valsartan treatment(P<0.01).Conclusion Sac/Val can reduce myocardial fibrosis and improve cardiac function in doxorubicin-induced HF rabbits,which may be related to the dual inhibition of TGF-β1/Smad3/CTGF signaling pathway by upregulating atrial natriuretic peptide and BNP levels and blocking RAAS activation.
9.Research Hotspots and Trends of Growth Mindset in Medical Education: A Bibliometric Analysis
Ning ZHANG ; Gechong RUAN ; Yang JIAO ; Xiaoqing LIU ; Jonathan LIO ; Lin KANG
Medical Journal of Peking Union Medical College Hospital 2025;16(6):1501-1510
This study aims to analyze the international research trends and frontier hotspots related to the application of growth mindset in medical education from 2016 to 2024. The objective is to provide insights and references for the development of relevant research in China. The Web of Science Core Collection and Scopus databases were searched for English-language literature on the application of growth mindset in medical education, published between January 1, 2016, and December 15, 2024. VOSviewer (v.1.6.18) software was utilized to extract bibliographic information and generate diagrams that illustrate cooperation networks among countries, regions, and authors. Additionally, CiteSpace (v.6.1.R6) software was employed to perform co-occurrence and cluster analyses on various datasets, including those pertaining to document authors and countries/regions. From 2016 to 2024, a total of 109 articles, comprising 92 research papers and 17 review articles, were published on the application of growth mindset in medical education. The annual publication volume exhibited a significant upward trend overall. The United States emerged as the country with the highest number of publications, totaling 77 (70.6%), as well as the highest citation frequency, with 1191 citations (57.5%) in this domain. The Uniformed Services University of the Health Sciences and Mayo Clinic ranked as the two institutions with the highest citation frequency, recording 423 and 417 citations, respectively. Professor Carol S.Dweck of Stanford University holds the title for the highest total citation frequency in this field, with 128 citations, while Anthony R.Artino from the Uniformed Services University of the Health Sciences has the highest citation frequency for individual publications, totaling 383 citations. High-frequency keywords primarily encompass " academic success ""academic performance ""resilience ""professional development", and "faculty develop-ment", all of which underscore the outcomes of medical education. Additionally, the terms "undergraduate medical education" and "graduate medical education" delineate the target groups within this field. Furthermore, "coaching""feedback", and "competency-based education" emphasize the pedagogical approaches employed in this educational context. Since 2016, the application of the growth mindset in medical education-related research has garnered significant disciplinary attention. Developed countries, particularly the United States, are at the forefront of this field. Currently, the research focus encompasses teaching methods, educational goals, and the educational psychology associated with the application of the growth mindset in medical education, as well as its role in enhancing the well-being and mental health of medical students. Practically, the experiences of the Pritzker School of Medicine at the University of Chicago in implementing the growth mindset serve as a valuable reference for domestic medical institutions engaging in related research.
10.Ameliorative effect of ACE2/Ang(1-7)/Mas axis on high-turover bone disease in uremic rats
Yang XUE ; Yingxin RUAN ; Tiekun YAN ; Junya JIA ; Shan LIN
Journal of Jilin University(Medicine Edition) 2025;51(1):26-33
Objective:To discuss the effect of angiotensin(1-7)[Ang(1-7)]on high-turnover bone disease in the uremic rats,and to clarify its possible mechanism.Methods:Thirty SD rats were randomly divided into sham operation group(n=6)and experimental group(n=24).The rats in experimental group underwent 5/6 nephrectomy(Platt method)+high-phosphorus(P)diet[1.2%P,1.0%calcium(Ca)]to establish the model of uremic high-turnover bone disease.The successfully modeled rats were then randomly divided into model group,Ang(1-7)group,angiotensin-converting enzyme 2(ACE2)activator dimethylacetamide amidoxime(DIZE)group,and Mas receptor antagonist group(A779 group),with 6 rats in each group.The levels of Ca,P,blood creatinine(Scr),blood urea nitrogen(BUN),and 24 h urinary protein(UP)in serum of the rats in various groups were detected by automatic biochemical analyzer at 12 and 18 weeks after operation;immunofluorescence staining was used to detect the levels of intact parathyroid hormone(iPTH)in the rats in various groups;ELISA method was used to detect the levels of osteocalcin(OC),type Ⅰ collagen N-terminal peptide(NTX),and tartrate-resistant acid phosphatase(TRAP)-5b in serum of the rats in various groups;high-resolution micro-CT scan was used to detect the bone density(BMD),tissue mineral density(TMD),trabecular thickness(Tb.Th),and trabecular separation(Tb.Sp)in femur tissue of the rats in various groups;Von Kossa staining and Giemsa staining were used to observe the pathomorphology of cortical bone and trabecular bone of the rats in various groups,and the trabecular bone volume(TBV)was calculated;fluorescence microscope was used to detect the mineral apposition rates(MAR)of the rats in vanious groups,and the osteoblast index(OBI)and osteoclast index(OCI)of the rats in various groups were calculated.Results:At 12 and 18 weeks after operation,compared with sham operation group,the weights of the rats in model group,Ang(1-7)group,DIZE group,and A779 group were decreased(P<0.05).At 12 and 18 weeks after operation,compared with sham operation group,the levels of 24 h UP,Scr,and BUN in serum of the rats in model group,Ang(1-7)group,DIZE group,and A779 group were increased(P<0.05);at 18 weeks after operation,compared with model group,the levels of 24 h UP and Scr in serum of the rats in Ang(1-7)group and DIZZ group were decreased(P<0.05),and the levels of 24 h UP,Scr and BUN in serum of the rats in A779 group were increased(P<0.05).The successful establishment of the uremic high-turnover bone disease model was confirmed.At 12 and 18 weeks after operation,compared with sham operation group,the serum iPTH,P,OC,NTX,and TRAP-5b levels ofthe rats in model group,Ang(1-7)group,DIZE group,and A779 group were all significantly increased(P<0.05);at 18 weeks after operation,compared with model group,the serum NTX and TRAP-5b levels of the rats in Ang(1-7)group and DIZE group were decreased(P<0.05),while the serum iPTH,P,NTX and TRAP-5b levels in A779 group were increased(P<0.05).The high-resolution micro-CT scan results showed that compared with sham operation group,the values of femur BMD and TMD of the rats in model group,Ang(1-7)group,DIZE group,and A779 group were all significantly decreased(P<0.05);compared with model group,the values of femur BMD and TMD of the rats in Ang(1-7)group and DIZE group were increased(P<0.05),while the values of BMD and TMD of the rats in A779 group were decreased(P<0.05).Compared with sham operation group,the femur Tb.Th of the rats in model group was decreased(P<0.05),and the Tb.Sp was increased(P<0.05);the femur Tb.Th of the rats in Ang(1-7)group and DIZE group were increased(P<0.05),and the Tb.Sp was decreased(P<0.05).Compared with model group,the femur Tb.Th of the rats in A779 group was decreased(P<0.05),and the Tb.Sp was increased(P<0.05).The bone pathological examination results showed that compared with sham operation group,the femur TBV of the rats in model group,Ang(1-7)group,DIZZ group and A779 group were decreased(P<0.05),and MAR,OBI and OCI were increased(P<0.05);compared with model group,the OBI and OCI of the rats in Ang(1-7)group and DIZE group were decreased(P<0.05),and TBV was increased(P<0.05),while the OBI and OCI of the rats in A779 group were increased(P<0.05),and TBV was decreased(P<0.05).Conclusion:The ACE2/Ang(1-7)/Mas axis improves high-turnover bone disease in the uremic rats.

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