1.Ameliorative Effect of Wendantang Combined with Danshenyin and Dushentang on Ischemic Heart Disease with Phlegm-stasis Syndrome in Mice Based on Circulating Monocytes
Fenghe YANG ; Ziqi TIAN ; Zhiqian SONG ; Shitao PENG ; Wenjie LU ; Tao LIN ; Chun WANG ; Zhangchi NING
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):22-32
ObjectiveTo investigate the ameliorative effect of Wendantang combined with Danshenyin and Dushentang (WDD) on mice with ischemic heart disease (IHD) presenting phlegm-stasis syndrome based on the inflammatory phenotype and differentiation of circulating monocytes. MethodsA model of IHD with phlegm-stasis syndrome was established using left anterior descending coronary artery ligation supplemented with a high-fat diet. Eighty model mice were randomly assigned to the model group, WDD low-dose group (WDD-L), WDD medium-dose group (WDD-M), WDD high-dose group (WDD-H), and atorvastatin calcium tablet group, with 16 mice in each group. An additional 16 C57BL/6J mice were designated as the sham-operation group. The WDD groups received intragastric administration at doses of 8.91, 17.81, 35.62 g·kg-1, and the atorvastatin calcium tablet group received the corresponding drug at 1.3 mg·kg-1, twice daily. The sham-operation and model groups were given the same volume of pure water by gavage each day. After 5 consecutive weeks of administration, the cardiac index was calculated. Cardiac function was assessed by echocardiography. Myocardial histopathology was examined by hematoxylin-eosin (HE) staining. Serum N-terminal pro-B-type natriuretic peptide (pro-BNP) content was measured by enzyme-linked immunosorbent assay (ELISA). Hemorheological parameters were analyzed using an automated hemorheology analyzer. Serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were determined using an automated biochemical analyzer. Changes in circulating monocytes were detected by flow cytometry. Mouse bone marrow mononuclear cells were isolated in vitro and divided into blank group, model serum group, WDD-L drug-containing serum group, WDD-M drug-containing serum group, and WDD-H drug-containing serum group. CD36 expression and macrophage differentiation in each group were assessed by flow cytometry. The mechanism by which WDD mediates circulating monocyte differentiation was further explored using CD36 knockdown/overexpression RAW264.7 cell lines. ResultsCompared with the sham-operation group, the model group showed a significantly increased cardiac index (P0.01), significantly decreased fractional shortening (FS) (P0.01), and significantly increased left ventricular end-diastolic internal diameter (LVDD) and left ventricular end-systolic internal diameter (LVDS) (P0.01). Cardiomyocytes exhibited marked deformation and necrosis with inflammatory cell infiltration. Serum pro-BNP levels were significantly elevated (P0.01), and whole-blood viscosity (BV) at high, medium, and low shear rates was significantly increased (P0.01). Compared with the model group, the WDD groups showed significantly reduced cardiac index (P0.05, P0.01), significantly increased FS (P0.05, P0.01), significantly decreased LVDD and LVDS (P0.01), markedly improved cardiomyocyte morphology, significantly reduced inflammatory infiltration, significantly decreased serum pro-BNP levels (P0.01), and significantly decreased BV at high, medium, and low shear rates (P0.01), with the most pronounced improvement observed in the WDD-M group. Compared with the sham-operation group, TC, TG, and LDL levels were significantly increased in the model group (P0.05, P0.01), while HDL levels were significantly decreased (P0.05). After WDD-H treatment, TC, TG, and LDL levels were significantly reduced and HDL levels were significantly increased in mice (P0.05, P0.01). Compared with the sham-operation group, classical monocytes in blood and bone marrow and intermediate monocytes in blood were significantly increased in the model group (P0.01), whereas intermediate monocytes in bone marrow and non-classical monocytes in blood were significantly decreased (P0.01). After WDD administration, all circulating monocyte subsets in blood and bone marrow were significantly alleviated (P0.05, P0.01), with the WDD-M group showing the optimal effect. In vitro, compared with the blank group, CD36 expression on bone marrow monocytes and the proportion of differentiated macrophages were significantly increased in the model serum group (P0.01), and CD36 expression was significantly upregulated on RAW264.7 cells (P0.01). Compared with the model serum group, all drug-containing serum groups exhibited significantly reduced CD36 expression on bone marrow monocytes and significantly reduced macrophage differentiation (P0.01). WDD downregulated CD36 expression in both CD36 knockdown and overexpression RAW264.7 cell lines (P0.05, P0.01), with the strongest regulatory effect observed in the WDD-M drug-containing serum group. ConclusionWDD can significantly improve the manifestations of phlegm-stasis syndrome in IHD mice and reduce the proportion of classical circulating monocytes. Its mechanism may be related to the inhibition of CD36 expression on classical circulating monocytes.
2.Ameliorative Effect of Wendantang Combined with Danshenyin and Dushentang on Ischemic Heart Disease with Phlegm-stasis Syndrome in Mice Based on Circulating Monocytes
Fenghe YANG ; Ziqi TIAN ; Zhiqian SONG ; Shitao PENG ; Wenjie LU ; Tao LIN ; Chun WANG ; Zhangchi NING
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):22-32
ObjectiveTo investigate the ameliorative effect of Wendantang combined with Danshenyin and Dushentang (WDD) on mice with ischemic heart disease (IHD) presenting phlegm-stasis syndrome based on the inflammatory phenotype and differentiation of circulating monocytes. MethodsA model of IHD with phlegm-stasis syndrome was established using left anterior descending coronary artery ligation supplemented with a high-fat diet. Eighty model mice were randomly assigned to the model group, WDD low-dose group (WDD-L), WDD medium-dose group (WDD-M), WDD high-dose group (WDD-H), and atorvastatin calcium tablet group, with 16 mice in each group. An additional 16 C57BL/6J mice were designated as the sham-operation group. The WDD groups received intragastric administration at doses of 8.91, 17.81, 35.62 g·kg-1, and the atorvastatin calcium tablet group received the corresponding drug at 1.3 mg·kg-1, twice daily. The sham-operation and model groups were given the same volume of pure water by gavage each day. After 5 consecutive weeks of administration, the cardiac index was calculated. Cardiac function was assessed by echocardiography. Myocardial histopathology was examined by hematoxylin-eosin (HE) staining. Serum N-terminal pro-B-type natriuretic peptide (pro-BNP) content was measured by enzyme-linked immunosorbent assay (ELISA). Hemorheological parameters were analyzed using an automated hemorheology analyzer. Serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were determined using an automated biochemical analyzer. Changes in circulating monocytes were detected by flow cytometry. Mouse bone marrow mononuclear cells were isolated in vitro and divided into blank group, model serum group, WDD-L drug-containing serum group, WDD-M drug-containing serum group, and WDD-H drug-containing serum group. CD36 expression and macrophage differentiation in each group were assessed by flow cytometry. The mechanism by which WDD mediates circulating monocyte differentiation was further explored using CD36 knockdown/overexpression RAW264.7 cell lines. ResultsCompared with the sham-operation group, the model group showed a significantly increased cardiac index (P<0.01), significantly decreased fractional shortening (FS) (P<0.01), and significantly increased left ventricular end-diastolic internal diameter (LVDD) and left ventricular end-systolic internal diameter (LVDS) (P<0.01). Cardiomyocytes exhibited marked deformation and necrosis with inflammatory cell infiltration. Serum pro-BNP levels were significantly elevated (P<0.01), and whole-blood viscosity (BV) at high, medium, and low shear rates was significantly increased (P<0.01). Compared with the model group, the WDD groups showed significantly reduced cardiac index (P<0.05, P<0.01), significantly increased FS (P<0.05, P<0.01), significantly decreased LVDD and LVDS (P<0.01), markedly improved cardiomyocyte morphology, significantly reduced inflammatory infiltration, significantly decreased serum pro-BNP levels (P<0.01), and significantly decreased BV at high, medium, and low shear rates (P<0.01), with the most pronounced improvement observed in the WDD-M group. Compared with the sham-operation group, TC, TG, and LDL levels were significantly increased in the model group (P<0.05, P<0.01), while HDL levels were significantly decreased (P<0.05). After WDD-H treatment, TC, TG, and LDL levels were significantly reduced and HDL levels were significantly increased in mice (P<0.05, P<0.01). Compared with the sham-operation group, classical monocytes in blood and bone marrow and intermediate monocytes in blood were significantly increased in the model group (P<0.01), whereas intermediate monocytes in bone marrow and non-classical monocytes in blood were significantly decreased (P<0.01). After WDD administration, all circulating monocyte subsets in blood and bone marrow were significantly alleviated (P<0.05, P<0.01), with the WDD-M group showing the optimal effect. In vitro, compared with the blank group, CD36 expression on bone marrow monocytes and the proportion of differentiated macrophages were significantly increased in the model serum group (P<0.01), and CD36 expression was significantly upregulated on RAW264.7 cells (P<0.01). Compared with the model serum group, all drug-containing serum groups exhibited significantly reduced CD36 expression on bone marrow monocytes and significantly reduced macrophage differentiation (P<0.01). WDD downregulated CD36 expression in both CD36 knockdown and overexpression RAW264.7 cell lines (P<0.05, P<0.01), with the strongest regulatory effect observed in the WDD-M drug-containing serum group. ConclusionWDD can significantly improve the manifestations of phlegm-stasis syndrome in IHD mice and reduce the proportion of classical circulating monocytes. Its mechanism may be related to the inhibition of CD36 expression on classical circulating monocytes.
3.Mechanism of Fresh Cutting of Traditional Chinese Medicine: Discussion on Integration of Traditional Wisdom and Modern Technology
Wenjie BAO ; Lingyun ZHONG ; Wenhua WU ; Congmin LIU ; Zixin CHEN ; Xingmei LU ; Hengli TONG ; Yi HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):282-290
Fresh-cut processing constitutes a pivotal technique in the origin processing of Chinese medicinal materials, with a long history documented in multiple materia medica. In recent years, it has garnered national policy support for its ability to prevent component loss and low processing efficiency associated with traditional drying-before-cutting methods. As of August 2025, 26 provinces and municipalities nationwide have cumulatively published 789 species for fresh-cut processing. Among these, 78 were included in the 2025 edition of the Pharmacopoeia of the People's Republic of China. However, the practice continues to face common challenges and difficulties, including ambiguous scientific understanding, fragmented standards, limited quality control approaches, and poor process stability. Based on this, this paper synthesises years of research findings to systematically elucidate the core mechanisms of fresh-cut processing. These encompass alterations to herbal tissue structure during cutting, post-processing changes in constituents, and physiological-biochemical processes such as plant stress responses and shifts in endogenous enzyme activity. It also summarises influencing factors, including inherent herbal properties, cutting timing and methods, and environmental conditions like temperature, humidity, and microbial presence. Based on this overview of fresh-cutting mechanisms, subsequent research should advance in four directions:Clarifying the scientific principles of fresh-cutting, overcoming technical bottlenecks, upgrading intelligent equipment, and establishing quality standards and evaluation systems. This study provides a theoretical foundation and scientific basis for future research on fresh-cutting in traditional Chinese medicine(TCM), promoting its deeper practical application within the industry and contributing to the high-quality development of TCM industry and the modernization of TCM.
4.Mechanism and Clinical Research Progress of Puerarin in Treatment of Chronic Heart Failure
Wenjie LU ; Siqi ZHONG ; Lu ZHANG ; Wenting LIN ; Zhijun ZENG ; Shaohua WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):327-336
Chronic heart failure (CHF) is an end-stage cardiac syndrome driven by multiple factors. Its pathological process involves interactions of multiple pathways such as energy metabolism dysfunction, neuroendocrine dysregulation, and myocardial fibrosis. Although current clinical medicine can alleviate symptoms through single-target approaches, significant limitations in reversing cardiac remodeling and disease progression remain. Puerarin, a major bioactive isoflavone constituent derived from Pueraria lobata, exhibits multidimensional pharmacological effects, such as vasodilatory effects, regulation of neuroendocrine balance, enhancement of metabolic homeostasis, and suppression of myocardial apoptosis. This review systematically integrated puerarin's multi-target regulatory network, elucidating its mechanisms such as improving energy metabolism by AMP-activated protein kinase/mechanistic target of rapamycin (AMPK/mTOR) pathway, inhibiting fibrosis mediated by transforming growth factor-β (TGF-β)/Smad signals, and attenuating oxidative-inflammatory cascades by regulating nuclear factor erythroid 2 (E2)-related factor 2/nuclear transcription factor-κB(Nrf2/NF-κB) axis. Clinical research data was used to validate its efficacy in improving the left ventricular ejection function and reducing the therapeutic potential of cardiovascular events' risks. The study proposed that puerarin's "systemic regulation" characteristic breaks through the limitations of traditional single-target drugs and prospected its clinical translation pathway based on metabolomics and nano-delivery technology, offering an integrative perspective from molecular mechanisms to precise therapy for the research on modernization of traditional Chinese medicine.
5.Mechanism and Clinical Research Progress of Puerarin in Treatment of Chronic Heart Failure
Wenjie LU ; Siqi ZHONG ; Lu ZHANG ; Wenting LIN ; Zhijun ZENG ; Shaohua WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):327-336
Chronic heart failure (CHF) is an end-stage cardiac syndrome driven by multiple factors. Its pathological process involves interactions of multiple pathways such as energy metabolism dysfunction, neuroendocrine dysregulation, and myocardial fibrosis. Although current clinical medicine can alleviate symptoms through single-target approaches, significant limitations in reversing cardiac remodeling and disease progression remain. Puerarin, a major bioactive isoflavone constituent derived from Pueraria lobata, exhibits multidimensional pharmacological effects, such as vasodilatory effects, regulation of neuroendocrine balance, enhancement of metabolic homeostasis, and suppression of myocardial apoptosis. This review systematically integrated puerarin's multi-target regulatory network, elucidating its mechanisms such as improving energy metabolism by AMP-activated protein kinase/mechanistic target of rapamycin (AMPK/mTOR) pathway, inhibiting fibrosis mediated by transforming growth factor-β (TGF-β)/Smad signals, and attenuating oxidative-inflammatory cascades by regulating nuclear factor erythroid 2 (E2)-related factor 2/nuclear transcription factor-κB(Nrf2/NF-κB) axis. Clinical research data was used to validate its efficacy in improving the left ventricular ejection function and reducing the therapeutic potential of cardiovascular events' risks. The study proposed that puerarin's "systemic regulation" characteristic breaks through the limitations of traditional single-target drugs and prospected its clinical translation pathway based on metabolomics and nano-delivery technology, offering an integrative perspective from molecular mechanisms to precise therapy for the research on modernization of traditional Chinese medicine.
6.Regulatory effects of G3BP2 on activation, proliferation, and migratory capacity in hepatic stellate cells
Qiqi DONG ; Wenjie SUN ; Minghui LI ; Jingjing YANG ; Renpeng ZHOU ; Wei HU ; Chao LU
Acta Universitatis Medicinalis Anhui 2026;61(3):501-508
ObjectiveTo investigate the role of Ras-GTPase-activating protein SH3 domain-binding protein 2 (G3BP2) in regulating the activation, proliferation, and migration of hepatic stellate cells (HSCs). MethodsThe mouse HSCs (JS-1 cell line) were treated with 5 μg/L transforming growth factor-beta 1(TGF-β1) for 24 hours to establish an HSC activation and proliferation model. A G3BP2 knockdown system was constructed using siRNA interference technology. The experiment was divided into four groups: Control, TGF-β1 treatment, TGF-β1+si-NC, and TGF-β1+ G3BP2-siRNA. The expression levels of key fibrosis indicators, including type I collagen (Collagen I), α-smooth muscle actin (α-SMA), and G3BP2, were detected by Western blot and RT-qPCR. Cell proliferation activity was assessed using the CCK-8 proliferation assay kit and EdU fluorescence labeling technology. Cell migration ability was analyzed by scratch wound healing assay and Transwell migration assay. The formation level of stress granules was quantified by immunofluorescence microscopy to investigate the effects of G3BP2 on stress granule formation in activated HSCs. ResultsStimulation with TGF-β1 upregulated the expression of G3BP2 in JS-1 cells (RT-qPCR: P0.000 1; Western blot: P0.000 1), while a downward trend in its expression was observed in the G3BP2‑silenced group (RT-qPCR: P0.01; Western blot: P0.000 1). Compared with the control group, the TGF-β1 group exhibited increased protein expression levels of α-SMA and Collagen I (RT-qPCR: both P0.01; Western blot: P0.01 and P0.05, respectively), concomitant with an increased number of stress granules and enhanced cell proliferation and migration capacity (all P0.001). The experimental results demonstrated that G3BP2 knockout effectively reversed the aforementioned phenotypes, with the G3BP2-silenced group showing reduced expression of fibrotic markers (all P0.01), decreased stress granule formation (P0.01), and reduced cell proliferation and migration capacity (all P0.05), compared to the negative control group. ConclusionG3BP2 enhances the activation, proliferation, and migration of HSCs by promoting the formation of stress granules, thereby accelerating the pathological progression of liver fibrosis. This suggests that stress granules may serve as important regulators in controlling the activation, proliferation, and migration of HSCs.
7.Changes in health status and management strategies for workers in a chemical enterprise under low-level multiple occupational exposure
Xueting WANG ; Jiming ZHANG ; Yulai TIAN ; Zhiping DUAN ; Wenjie LI ; Chaoye SHEN ; Dasheng LU ; Zhijun ZHOU
Journal of Environmental and Occupational Medicine 2026;43(6):693-701
Background Long-term occupational health surveillance facilitates the identification of chronic health risks arising from occupational hazard exposures. However, under low-level exposure conditions in chemical enterprises, traditional workplace-centered risk assessment models are insufficient to fully explain the observed health effects among workers, highlighting the need for individual-focused health management strategies that focus on the worker. Objective To characterize long-term health trends among workers in a chemical enterprise and examine the limitations of workplace hazard monitoring and health surveillance under low-level multiple exposure scenarios, thereby providing a scientific basis for more comprehensive worker health protection measures. Methods We analyzed 972 occupational health examination records collected over a 15-year period (2010–2024) from a chemical enterprise, integrating these with enterprise hazard monitoring reports and workshop air monitoring of volatile organic compounds (VOCs). The annual counts and prevalences of abnormalities in liver function tests, metabolic syndrome-related indicators, and liver imaging were summarized. Temporal trends were evaluated using the Cochran-Armitage trend test. Time-related changes in abnormal health indicators among active workers were evaluated by generalized linear mixed-effects models (GLMMs), adjusting for age and sex. Individual longitudinal profiles were described for nine workers with continuous 15-year records. In addition, paired comparisons of health outcomes were conducted for 81 workers with both pre-employment and periodic examinations. Results Workplace hazard monitoring indicated that airborne concentrations of major occupational contaminants including VOCs, acids and bases, dust, and physical factors were below national occupational exposure limits. However, 62 VOC species—including chlorobenzene, chloromethane, and cyclohexane—were detected in workshop air, suggesting complex mixed organic solvent exposure. From 2010 to 2015, occupational health examination records were primarily based on physicians’ qualitative assessment, yielding generally low abnormality detection rates. During 2016–2024, data collection was complete, and the prevalences of abnormalities in liver function, metabolic syndrome-related indicators, and liver imaging among active workers remained relatively high. Trend analysis indicated that only the abnormality rates of total bilirubin (TBIL) and hypertension showed statistically significant temporal trends; other indicators exhibited no significant linear changes despite high prevalences. After adjusting for age and sex, the GLMMs showed that the abnormality rates of aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), TBIL, and hypertension decreased over time, whereas those of total cholesterol, triglycerides, and fatty liver increased. In a subgroup of 9 workers with continuous 15-year follow-up data, the cumulative number of abnormal health indicators increased in several individuals after 2016. Among the 81 workers with both pre-employment and periodic records, abnormalities in total cholesterol, triglycerides, body mass index, and fatty liver were significantly more prevalent after employment over time, whereas changes in liver function enzymes were not statistically significant. Conclusion With increasing age, workers exhibit a gradual deterioration in liver function and metabolic-related health indicators, reaching abnormality rates comparable to those reported in the general population. These findings suggest that both workplace-related and non-occupational factors jointly contribute to the observed health changes. Consequently, occupational health management should shift towards an "individual-centered" approach. Enhancing workers' health literacy, strengthening workplace health promotion, and extending occupational health services beyond the workplace are essential to comprehensively protect workers' health.
8.Mechanisms and Clinical Research Advances of Curcumin in Modulation of Hyperlipidemia
Zhijun ZENG ; Wenjie LU ; Xiaoxue MA ; Yanhua JI ; Yun TONG ; Siyu LING ; Yue ZENG ; Chao LE ; Shaohua WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):325-334
Hyperlipidemia is a common metabolic disorder driven by dysregulated lipid metabolism, whose pathological progression involves multifaceted interactions across various signaling pathways, including disrupted cholesterol homeostasis, insulin resistance, chronic inflammation, and oxidative stress. Although existing clinical medications such as statins can effectively reduce low-density lipoprotein cholesterol through single-target inhibition, significant limitations remain in comprehensively improving reverse cholesterol transport, metabolic inflammation, and coordinated regulation of glucose and lipid metabolism. Curcumin, the primary polyphenolic active compound derived from the traditional medicinal herb turmeric, exhibits multi-dimensional pharmacological effects including modulation of lipid metabolism, improvement of insulin sensitivity, suppression of inflammatory responses, and enhancement of antioxidant defense. This review systematically integrates the multi-target regulatory network of curcumin, elucidating its key mechanisms: Balancing the low density lipoprotein receptor/proprotein convertase subtilisin/kexin type 9 (LDLR/PCSK9) signaling pathway to promote reverse cholesterol transport, activating peroxisome proliferator-activated receptor α/γ (PPARα/γ) signaling pathways to coordinate glucolipid metabolic homeostasis, remodeling the gut microbiota-bile acid axis, inhibiting nuclear factor kappa-B (NF-κB)-mediated inflammatory responses, and activating the nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) antioxidant signaling pathway. Furthermore, supported by clinical research data, the review validates curcumin's therapeutic potential in reducing total cholesterol (TC) and triglyceride (TG) levels, increasing high-density lipoprotein cholesterol (HDL-C), as well as improving vascular endothelial function and insulin sensitivity. The study highlights the multi-target regulatory properties of curcumin and discusses future clinical applications based on nano-delivery systems and personalized treatment strategies, providing a theoretical basis and novel insights for the prevention and treatment of hyperlipidemia and related metabolic disorders.
9.Latent Profile Analysis and Influencing Factors of Fear of Progression in Patients with Behçet′s Disease
Lu LI ; Yiyuan AO ; Yeling LIU ; Jingwen WU ; Jinjing LIU ; Wenjie ZHENG
JOURNAL OF RARE DISEASES 2026;5(3):283-291
To explore the latent profile characteristics of fear of progression (FoP) in patients with Behçet′s disease (BD) and analyze its influencing factors. This was a cross-sectional study. By convenience sampling, BD patients attending Peking Union Medical College Hospital from May 2025 to March 2026 were included as study subjects. Data were collected using sociodemographic and disease status questionnaires, the Fear of Progression Questionnaire-Short Form, the Connor-Davidson Resilience Scale, the Perceived Social Support Scale, the Ruminative Response Scale, the Medical Coping Modes Questionnaire, and the Hospital Anxiety and Depression Scale. Latent profile analysis was used to identify FoP profiles, and univariate analysis and multivariate Logistic regression were employed to explore associated influencing factors, and sensitivity analyses were conducted. A total of 221 patients with BD were included in the study. Heterogeneity was observed in their FoP. Latent profile analysis identified three latent classes: the low-fear group-good-adaptation type (68 cases, 30.77%), the moderate-fear group-situational-fluctuation type (110 cases, 49.77%), and the high-fear group-prevalent-worry type (43 cases, 19.46%). The univariate analysis revealed differences among the three patient groups in terms of age, Behçet′s Disease Current Activity Form (BDCAF) score, psychological resilience, perceived social support, rumination, and medical coping styles (including confrontation, avoidance, and resignation)(all FoP in patients with BD exhibits significant population heterogeneity, indicating that individualized and differentiated psychological interventions are warranted in clinical settings to substantially improve patients' overall prognosis and quality of life.
10.Quality Appraisal of Clinical Practice Guidelines and Expert Consensus Statements for Knee Osteoarthritis Based on AGREE Ⅱ (2019—2025)
Yifan LU ; Zhuo YANG ; Hui XIONG ; Gonghui JIAN ; Xiaolong LU ; Pei CHEN ; Wenjie SU ; Zebing MA ; Tianxiao CHEN ; Simin TANG ; Tao WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):186-195
ObjectiveTo evaluate the quality of clinical practice guidelines and expert consensus statements on knee osteoarthritis (KOA) based on the Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ), thus providing a new perspective for clinical selection as well as guideline development and updating. MethodsA systematic search was conducted for KOA-related guidelines and consensus statements published from November 1, 2019 to December 31, 2025. The databases and platforms searched included CNKI, VIP, Wanfang Data, PubMed, Web of Science, the National Institute for Health and Care Excellence (NICE), SinoMed, Yimaitong, and relevant official websites. Two researchers independently screened the literature, and four researchers used AGREE Ⅱ to score the included documents and completed the quality appraisal after reaching a unified understanding. Subgroup analyses were further performed according to developing organization, document type, medical approach, funding status, and region of development, and longitudinal comparisons were conducted by year of publication. ResultsA total of 23 guidelines and consensus statements were included. The standardized scores of the six AGREE Ⅱ domains, from the highest to the lowest, were clarity of presentation [(70.36±8.13)%], scope and purpose [(67.46 ± 11.44)%], editorial independence [(64.50±20.01)%], rigor of development [(62.24±15.26)%], stakeholder involvement [(55.73±10.29)%], and applicability [(53.89±13.17)%]. In terms of overall recommendation, 6 documents were rated as grade A and 17 as grade B. Stratified analyses showed that professional organizations scored higher than comprehensive organizations. The overall scores of traditional Chinese medicine/integrative medicine and Western medicine guidelines (or consensus statements) were similar. Guidelines scored higher than consensus statements. The overall scores were similar between documents with reported funding and those without reported funding. International guidelines scored higher than domestic guidelines. Longitudinal comparisons showed that the largest number of documents was published in 2021. The overall scores were higher in 2021—2022, and some domain scores declined in 2023—2024. Overall, the quality of recent guidelines and consensus statements for KOA showed slight fluctuations, without a clear linear trend. ConclusionThe included guidelines and consensus statements for KOA can generally serve as references for clinical practice. However, the quality across domains remains uneven, and stakeholder involvement and applicability are still weak domains. Future guideline development and updating should further improve methodological standardization and transparency in reporting.

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