1.Distribution of Traditional Chinese Medicine Syndrome Elements in Different Risk Populations of Heart Failure Complicated with Type 2 Diabetes: A Retrospective Study Based on Nomogram Model and Factor Analysis
Tingting LI ; Zhipeng YAN ; Yajie FAN ; Wenxiu LI ; Wenyu SHANG ; Yongchun LIANG ; Yiming ZUO ; Yuxin KANG ; Boyu ZHU ; Junping ZHANG
Journal of Traditional Chinese Medicine 2025;66(11):1140-1146
ObjectiveTo analyze the distribution characteristics of traditional Chinese medicine (TCM) syndrome elements in different risk populations of heart failure complicated with type 2 diabetes. MethodsClinical data of 675 type 2 diabetes patients were retrospectively collected. Lasso-multivariate Logistic regression was used to construct a clinical prediction nomogram model. Based on this, 441 non-heart failure patients were divided into a low-risk group (325 cases) and a high-risk group (116 cases) according to the median risk score of heart failure complicated with type 2 diabetes. TCM diagnostic information (four diagnostic methods) was collected for both groups, and factor analysis was applied to summarize the distribution of TCM syndrome elements in different risk populations. ResultsLasso-multivariate Logistic regression analysis identified age, disease duration, coronary heart disease, old myocardial infarction, arrhythmia, absolute neutrophil count, activated partial thromboplastin time, and α-hydroxybutyrate dehydrogenase as independent risk factors for heart failure complicated with type 2 diabetes. These were used as final predictive factors to construct the nomogram model. Model validation results showed that the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the modeling group and validation group were 0.934 and 0.935, respectively. The Hosmer-Lemeshow test (modeling group P = 0.996, validation group P = 0.121) indicated good model discrimination. Decision curve analysis showed that the curves for All and None crossed in the upper right corner, indicating high clinical utility. The low-risk and high-risk groups each obtained 14 common factors. Preliminary analysis revealed that the main disease elements in the low-risk group were qi deficiency (175 cases, 53.85%), dampness (118 cases, 36.31%), and heat (118 cases, 36.31%), with the primary locations in the spleen (125 cases, 38.46%) and lungs (99 cases, 30.46%). In the high-risk group, the main disease elements were yang deficiency (73 cases, 62.93%), blood stasis (68 cases, 58.62%), and heat (49 cases, 42.24%), with the primary locations in the kidney (84 cases, 72.41%) and heart (70 cases, 60.34%). ConclusionThe overall disease characteristics in different risk populations of type 2 diabetes patients with heart failure are a combination of deficiency and excess, with deficiency being predominant. Deficiency and heat are present throughout. The low-risk population mainly shows qi deficiency with dampness and heat, related to the spleen and lungs. The high-risk population shows yang deficiency with blood stasis and heat, related to the kidneys and heart.
2.A Review of the Current Status and Progress Scope of Defensive Medical Research in China
Huanyu ZHANG ; Xinle YIN ; Yue ZHOU ; Yaping LIU ; Lin WU ; Yajie FENG ; Libo LIANG
Chinese Hospital Management 2024;44(7):1-5
Objective Summarizes the current research status of defensive medicine in China and provides references for future research.Methods The search period spans from the inception of the database to March 2024.CNKI,Wan-fang Data,Web of Science,PubMed databases were queried,followed by literature screening based on predeter-mined inclusion and exclusion criteria.The current landscape of defensive medicine research in China was synthe-sized and categorized based on fundamental research characteristics,measurement methodologies,influencing fac-tors,and other relevant aspects.Results A total of 24 Chinese literature sources and 4 foreign literature sources were incorporated,indicating a prevalent occurrence of defensive medicine in China.Measurement tools for defen-sive medicine exhibit variability across different studies.Key influencing factors encompass doctor's demographic vari-ables such as gender,age,and professional status,institutional factors like legal frameworks and medical in-surance,and sociol-cultural factors such as doctor-patient relationships and adverse public perceptions.Conclusion Defensive medicine is relatively widespread and influenced by various factors in China.It's urgent to explore the for-mation mechanism of defensive medicine from multiple perspectives and provide evidence for passive defen-sive medicine governance.
3.Analysis of Influencing Factors and Mechanism Model of Defensive Medicine based on Grounded Theory
Xinle YIN ; Huanyu ZHANG ; Juan ZHAO ; Chen WANG ; Yajie FENG ; Xinru LIU ; Yue ZHOU ; Libo LIANG
Chinese Hospital Management 2024;44(7):6-10,15
Objective To clarify the influencing factors of defensive medicine and provide ideas for preventing and re-solving defensive medicine.Methods Literature related to defensive medicine was searched,personnel related to de-fensive medicine were interviewed,and literature and interview data were coded with the method of grounded theo-ry,and related concepts and categories were summarized.Results After three levels of coding,52 initial concepts,23 initial categories,7 sub-categories and 3 main categories were sorted out,and the correlation among influencing factors was analyzed to build a three-dimensional model of"doctor-patient relationship-institutional system-social environment"influencing factors and their mechanism of action.Conclusion The influencing factors of defensive medi-cine mainly include doctor-patient relationship,institutional system and social environment.The three factors have an impact on defensive medicine through different mechanisms of action,which provides qualitative evidence for comprehensive analysis of factors in related studies of defensive medicine.
4.A Review of the Current Status and Progress Scope of Defensive Medical Research in China
Huanyu ZHANG ; Xinle YIN ; Yue ZHOU ; Yaping LIU ; Lin WU ; Yajie FENG ; Libo LIANG
Chinese Hospital Management 2024;44(7):1-5
Objective Summarizes the current research status of defensive medicine in China and provides references for future research.Methods The search period spans from the inception of the database to March 2024.CNKI,Wan-fang Data,Web of Science,PubMed databases were queried,followed by literature screening based on predeter-mined inclusion and exclusion criteria.The current landscape of defensive medicine research in China was synthe-sized and categorized based on fundamental research characteristics,measurement methodologies,influencing fac-tors,and other relevant aspects.Results A total of 24 Chinese literature sources and 4 foreign literature sources were incorporated,indicating a prevalent occurrence of defensive medicine in China.Measurement tools for defen-sive medicine exhibit variability across different studies.Key influencing factors encompass doctor's demographic vari-ables such as gender,age,and professional status,institutional factors like legal frameworks and medical in-surance,and sociol-cultural factors such as doctor-patient relationships and adverse public perceptions.Conclusion Defensive medicine is relatively widespread and influenced by various factors in China.It's urgent to explore the for-mation mechanism of defensive medicine from multiple perspectives and provide evidence for passive defen-sive medicine governance.
5.Analysis of Influencing Factors and Mechanism Model of Defensive Medicine based on Grounded Theory
Xinle YIN ; Huanyu ZHANG ; Juan ZHAO ; Chen WANG ; Yajie FENG ; Xinru LIU ; Yue ZHOU ; Libo LIANG
Chinese Hospital Management 2024;44(7):6-10,15
Objective To clarify the influencing factors of defensive medicine and provide ideas for preventing and re-solving defensive medicine.Methods Literature related to defensive medicine was searched,personnel related to de-fensive medicine were interviewed,and literature and interview data were coded with the method of grounded theo-ry,and related concepts and categories were summarized.Results After three levels of coding,52 initial concepts,23 initial categories,7 sub-categories and 3 main categories were sorted out,and the correlation among influencing factors was analyzed to build a three-dimensional model of"doctor-patient relationship-institutional system-social environment"influencing factors and their mechanism of action.Conclusion The influencing factors of defensive medi-cine mainly include doctor-patient relationship,institutional system and social environment.The three factors have an impact on defensive medicine through different mechanisms of action,which provides qualitative evidence for comprehensive analysis of factors in related studies of defensive medicine.
6.Strategies and advances in laboratory tests for primary liver cancer
Yuan CHEN ; Jing LIANG ; Yunhui LI ; Yajie WANG
Chinese Journal of Preventive Medicine 2024;58(1):128-135
Primary liver cancer is one of the leading causes of cancer-related deaths worldwide, its early diagnosis and early treatment are of great clinical importance. The main detection tools for liver cancer include serological indicators, imaging tests and risk assessment models. With the advancement of technology and research, the sensitivity and specificity of laboratory tests for liver cancer have been substantially improved, but there are still false negatives and low rates of early diagnosis. For different causes and prevalence regions, each country has developed its clinical practice guidelines to guide risk groups for effective prevention, early diagnosis and standardized treatment. It is important to establish a liver cancer diagnosis strategy that is suitable for China′s national conditions, concerning the guidelines for the vigilance and prevention of liver cancer. In this article, the advantages and disadvantages of liver cancer-related tests and the impact of future development trends on laboratory strategies are explained from the perspective of laboratory testing strategies, to provide theoretical support for the practical application of liver cancer diagnostic strategies.
7.Protective Effect and Mechanism of Proanthocyanidin B2 Against H2O2-induced Oxidative Damage and Apoptosis of Astrocytes
Shuwen YUAN ; Yiwei DONG ; Jian LIU ; Yajie LIANG ; Jianjun HUANG ; Baoguo XIAO ; Qing WANG ; Cungen MA
Chinese Journal of Modern Applied Pharmacy 2024;41(6):727-735
OBJECTIVE
To investigate the protective effect proanthocyanidin B2(PC-B2) on oxidative damage and apoptosis of mouse astrocytes(AS) induced by hydrogen peroxide(H2O2) and its mechanism.
METHODS
AS were isolated and cultured from neonatal C57BL/6 mice(1−3 d). The optimal concentration of H2O2 and PC-B2 was divided into four groups: normal group, normal+PC-B2 group(100 μg·mL‒1 PC-B2 treated for 24 h), H2O2 model group(200 μmol·L‒1 H2O2 treated for 24 h), PC-B2 group(200 μmol·L‒1 H2O2 and 100 μg·mL‒1 PC-B2 treated for 24 h). The cell viability of each group was detected by CCK-8 method. Cytotoxicity was detected by LDH method. The antioxidant capacity was detected by ABTS and DPPH. The content of MDA and the activity of SOD, CAT and GSH-Px were detected by ELISA kit. Detection of apoptosis in each group was done by TUNEL staining. The mRNA and protein expression levels of Bax, Bcl-2, Caspase-3, Akt/Stat3, p-Akt, p-Stat3 and Nrf2/HO-1 in AS were detected by RT-PCR and Western blotting, respectively.
RESULTS
PC-B2 could significantly enhance cell viability and inhibit AS apoptosis. Compared with the H2O2 model group, PC-B2 intervention could significantly reduce the content of LDH and MDA in AS, and increase the activity of SOD, CAT and GSH-Px. PC-B2 intervention could inhibit the mRNA and protein expression of Bax and Caspase-3, and up-regulate the mRNA and protein expression of Akt/Stat3, Bcl-2, Nrf2/HO-1.
CONCLUSION
PC-B2 can enhance the antioxidant capacity of AS through Akt/Stat3 and Nrf2/HO-1 pathways, therefore reduce H2O2-induced AS oxidative damage and apoptosis.
8.A Review of the Current Status and Progress Scope of Defensive Medical Research in China
Huanyu ZHANG ; Xinle YIN ; Yue ZHOU ; Yaping LIU ; Lin WU ; Yajie FENG ; Libo LIANG
Chinese Hospital Management 2024;44(7):1-5
Objective Summarizes the current research status of defensive medicine in China and provides references for future research.Methods The search period spans from the inception of the database to March 2024.CNKI,Wan-fang Data,Web of Science,PubMed databases were queried,followed by literature screening based on predeter-mined inclusion and exclusion criteria.The current landscape of defensive medicine research in China was synthe-sized and categorized based on fundamental research characteristics,measurement methodologies,influencing fac-tors,and other relevant aspects.Results A total of 24 Chinese literature sources and 4 foreign literature sources were incorporated,indicating a prevalent occurrence of defensive medicine in China.Measurement tools for defen-sive medicine exhibit variability across different studies.Key influencing factors encompass doctor's demographic vari-ables such as gender,age,and professional status,institutional factors like legal frameworks and medical in-surance,and sociol-cultural factors such as doctor-patient relationships and adverse public perceptions.Conclusion Defensive medicine is relatively widespread and influenced by various factors in China.It's urgent to explore the for-mation mechanism of defensive medicine from multiple perspectives and provide evidence for passive defen-sive medicine governance.
9.Analysis of Influencing Factors and Mechanism Model of Defensive Medicine based on Grounded Theory
Xinle YIN ; Huanyu ZHANG ; Juan ZHAO ; Chen WANG ; Yajie FENG ; Xinru LIU ; Yue ZHOU ; Libo LIANG
Chinese Hospital Management 2024;44(7):6-10,15
Objective To clarify the influencing factors of defensive medicine and provide ideas for preventing and re-solving defensive medicine.Methods Literature related to defensive medicine was searched,personnel related to de-fensive medicine were interviewed,and literature and interview data were coded with the method of grounded theo-ry,and related concepts and categories were summarized.Results After three levels of coding,52 initial concepts,23 initial categories,7 sub-categories and 3 main categories were sorted out,and the correlation among influencing factors was analyzed to build a three-dimensional model of"doctor-patient relationship-institutional system-social environment"influencing factors and their mechanism of action.Conclusion The influencing factors of defensive medi-cine mainly include doctor-patient relationship,institutional system and social environment.The three factors have an impact on defensive medicine through different mechanisms of action,which provides qualitative evidence for comprehensive analysis of factors in related studies of defensive medicine.
10.A Review of the Current Status and Progress Scope of Defensive Medical Research in China
Huanyu ZHANG ; Xinle YIN ; Yue ZHOU ; Yaping LIU ; Lin WU ; Yajie FENG ; Libo LIANG
Chinese Hospital Management 2024;44(7):1-5
Objective Summarizes the current research status of defensive medicine in China and provides references for future research.Methods The search period spans from the inception of the database to March 2024.CNKI,Wan-fang Data,Web of Science,PubMed databases were queried,followed by literature screening based on predeter-mined inclusion and exclusion criteria.The current landscape of defensive medicine research in China was synthe-sized and categorized based on fundamental research characteristics,measurement methodologies,influencing fac-tors,and other relevant aspects.Results A total of 24 Chinese literature sources and 4 foreign literature sources were incorporated,indicating a prevalent occurrence of defensive medicine in China.Measurement tools for defen-sive medicine exhibit variability across different studies.Key influencing factors encompass doctor's demographic vari-ables such as gender,age,and professional status,institutional factors like legal frameworks and medical in-surance,and sociol-cultural factors such as doctor-patient relationships and adverse public perceptions.Conclusion Defensive medicine is relatively widespread and influenced by various factors in China.It's urgent to explore the for-mation mechanism of defensive medicine from multiple perspectives and provide evidence for passive defen-sive medicine governance.


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