1.Improving the Certainty of Evidence in Animal Experiment Systematic Review/Meta-Analysis: An Empirical Study of the GRADE Method
Tengfei LI ; Qingyong ZHENG ; Jianguo XU ; Yiyi LI ; Yongjia ZHOU ; Caihua XU ; Mingyue ZHANG ; Jiexiang TIAN ; Gang WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(1):101-111
Animal experiments are essential tools in biomedical research, serving as a bridge between basic research and clinical trials. Systematic reviews and meta-analyses (SRs/MAs) of animal experiments are crucial methods for integrating evidence from animal experiment, which can facilitate the translation of findings into clinical research, reduce translational risks, and promote resource integration in basic research. With the continuous development of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, its application in SRs/MAs of animal experiments has gained increasing attention. This article first outlines the principles and specific applications of the GRADE methodology in SRs/MAs of animal experiments, including qualitative descriptive systematic reviews, meta-analyses, and network meta-analyses. It then deeply analyzes the misuse of the GRADE methodology in practice, including incorrect evidence grading, improper classification of evidence, misapplication in qualitative systematic reviews, inconsistencies between the documentation of the upgrading and downgrading process and results, and inappropriate use for making recommendations. Furthermore, this article comprehensively discusses the factors influencing the grading of evidence certainty in SRs/MAs of animal experiments, including the impact of bias risk, indirectness, inconsistency, imprecision, and publication bias on evidence downgrading, as well as the role of large effect sizes and cross-species consistency in evidence upgrading. Finally, in response to the issues discussed, improvement strategies are proposed, including further research and optimization of the GRADE methodology for SRs/MAs of animal experiments, the development of reporting guidelines tailored to the characteristics of SRs/MAs in animal experiment research, and enhanced professional training for researchers in the GRADE methodology. This article aims to improve the quality of evidence in SRs/MAs of animal experiments, strengthen their reliability in clinical decision-making, and promote the more efficient translation of findings from animal experiment research into clinical practice.
2.Re-examination of Atractylodis Rhizoma and Dosage of Whole Formula in Yuejiuwan
Yanping HAN ; Yiyi ZHANG ; Huimin GAO ; Raorao LI ; Li YAO ; Zhaoxiang SUN ; Zhuo MA ; Huamin ZHANG ; Wei ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):223-233
Yuejuwan is a classic formula widely used by doctors to relieve liver and depression, with precise clinical efficacy in traditional Chinese medicine (TCM). The authors used bibliometric methods to collect and collate 495 ancient data related to Yuejuwan, and 105 valid data were screened out, involving 68 ancient Chinese medical books. After systematic verification of the origin of the formula of Yuejuwan, the main treatment symptoms, the principle of the formula, the composition of the drug, the dosage, the preparation method, the decoction method, and other information, the results showed that Yuejuwan originated from the Danxi Xinfa (《丹溪心法》) of the Yuan Dynasty by ZHU Zhenheng, and it is composed of five medicines, namely Atractylodis Rhizoma, Cyperi Rhizom, Chuanxiong Rhizoma, Massa Medicata Fermentata, and Gardeniae Fructus. In terms of drug base, Atractylodis Rhizoma, Cyperi Rhizom, Chuanxiong Rhizoma, and Gardeniae Fructus are in line with the records in the 2020 edition of Chinese Pharmacopoeia, and Massa Medicata Fermentata is used. The preparation method is as follows: Massa Medicata Fermentata and Gardeniae Fructus are fried, and Cyperi Rhizoma is roasted in vinegar. Chuanxiong Rhizoma is used in the raw form, and Atractylodis Rhizoma is prepared with rice swill. The formula can regulate Qi and relieve depression and broaden the middle and remove fullness. It is clinically used for the treatment of six types of depression syndromes, chest and diaphragm plumpness, abdominal distension and leg acid, acid swallowing and vomiting, eating and drinking disharmony, toothache, mouth and tongue sores, and other diseases. The most used dosage of the formula in the ancient records through the ages is converted into the modern dosage, namely 3.05 g Atractylodis Rhizoma, 3.05 g Cyperi Rhizoma, 3.05 g Chuanxiong Rhizoma, 3.05 g Massa Medicata Fermentata, and 3.05 g Gardeniae Fructus, and the daily dosage is 15.25 g. The converted dosage is similar to that recorded in the 2020 edition of the Chinese Pharmacopoeia. The formula is in pill form, and medicine should be taken with lukewarm boiled water after the meal. Through the excavation of the ancient literature related to Yuejuwan, the key information of the formula is identified, with a view to providing a more accurate reference for the clinical application of Yuejuwan and subsequent in-depth investigation.
3.Re-examination of Atractylodis Rhizoma and Dosage of Whole Formula in Yuejiuwan
Yanping HAN ; Yiyi ZHANG ; Huimin GAO ; Raorao LI ; Li YAO ; Zhaoxiang SUN ; Zhuo MA ; Huamin ZHANG ; Wei ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):223-233
Yuejuwan is a classic formula widely used by doctors to relieve liver and depression, with precise clinical efficacy in traditional Chinese medicine (TCM). The authors used bibliometric methods to collect and collate 495 ancient data related to Yuejuwan, and 105 valid data were screened out, involving 68 ancient Chinese medical books. After systematic verification of the origin of the formula of Yuejuwan, the main treatment symptoms, the principle of the formula, the composition of the drug, the dosage, the preparation method, the decoction method, and other information, the results showed that Yuejuwan originated from the Danxi Xinfa (《丹溪心法》) of the Yuan Dynasty by ZHU Zhenheng, and it is composed of five medicines, namely Atractylodis Rhizoma, Cyperi Rhizom, Chuanxiong Rhizoma, Massa Medicata Fermentata, and Gardeniae Fructus. In terms of drug base, Atractylodis Rhizoma, Cyperi Rhizom, Chuanxiong Rhizoma, and Gardeniae Fructus are in line with the records in the 2020 edition of Chinese Pharmacopoeia, and Massa Medicata Fermentata is used. The preparation method is as follows: Massa Medicata Fermentata and Gardeniae Fructus are fried, and Cyperi Rhizoma is roasted in vinegar. Chuanxiong Rhizoma is used in the raw form, and Atractylodis Rhizoma is prepared with rice swill. The formula can regulate Qi and relieve depression and broaden the middle and remove fullness. It is clinically used for the treatment of six types of depression syndromes, chest and diaphragm plumpness, abdominal distension and leg acid, acid swallowing and vomiting, eating and drinking disharmony, toothache, mouth and tongue sores, and other diseases. The most used dosage of the formula in the ancient records through the ages is converted into the modern dosage, namely 3.05 g Atractylodis Rhizoma, 3.05 g Cyperi Rhizoma, 3.05 g Chuanxiong Rhizoma, 3.05 g Massa Medicata Fermentata, and 3.05 g Gardeniae Fructus, and the daily dosage is 15.25 g. The converted dosage is similar to that recorded in the 2020 edition of the Chinese Pharmacopoeia. The formula is in pill form, and medicine should be taken with lukewarm boiled water after the meal. Through the excavation of the ancient literature related to Yuejuwan, the key information of the formula is identified, with a view to providing a more accurate reference for the clinical application of Yuejuwan and subsequent in-depth investigation.
4.Recreational use of electronic products among high school students in Shanxi Province
WANG Wenwen ; CHEN Hailong ; CHEN Mengli ; XING Yiyi ; ZHANG Xuejuan
Journal of Preventive Medicine 2025;37(4):425-428
Objective:
To investigate the recreational use status of electronic products among high school students in Shanxi Province and the influencing factors for excessive use, so as to provide insights into the promotion of rational use of electronic products among high school students.
Methods:
The high school students from 117 schools in Shanxi Province were selected using the stratified random sampling method, and basic information, lifestyle behaviors and recreational use of electronic products were collected using questionnaire surveys. The prevalence of excessive recreational use of electronic products was analyzed, and the factors affecting excessive recreational use of electronic products among high school students were analyzed using a multivariable logistic regression model.
Results:
A total of 13 804 valid questionnaires were recoverd, with an effective rate of 98.32%. There were 6 634 males (48.06%) and 7 170 females (51.94%), with a median age of 17.00 (interquartile range, 1.00) years. There were 7 024 students in Grade One (50.88%) and 6 780 students in Grade Two (49.12%). The prevalence of recreational use of electronic products was 14.18% (1 958 cases). Multivariable logistic regression analysis showed that males (OR=1.461, 95%CI: 1.325-1.611), students in Grade Two (OR=1.720, 95%CI: 1.559-1.897), students whose parents had below high school education (OR=1.391, 95%CI: 1.156-1.674), students without parental support (OR=1.281, 95%CI: 1.078-1.523), students not living on campus (OR=1.142, 95%CI: 1.026-1.271), students without myopia (OR=1.121, 95%CI: 1.008-1.248), and students with sufficient sleep (OR=1.162, 95%CI: 1.054-1.281) had a higher risk of excessive recreational use of electronic products.
Conclusion
The prevalence of excessive recreational use of electronic products among high school students in Shanxi Province was relatively high, which was related to gender, grade, parental education, parental attitudes, boarding status, myopia and sleep quality.
5.Research Advances in Targeting the YAP/TAZ Signaling Pathway to Improve Cancer Immunotherapy.
Chinese Journal of Lung Cancer 2025;28(3):221-229
Despite the groundbreaking advances in cancer immunotherapy achieved by immune checkpoint inhibitors (ICIs), their efficacy remains limited by the immunosuppressive tumor microenvironment (TME). Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), key effectors of the Hippo signaling pathway, play pivotal roles in tumor immune evasion. They directly regulate the expression of immune checkpoints, mediate the formation of an immunosuppressive microenvironment, inhibit T cell function, and interact with other signaling pathways to promote immune escape. Diverse strategies targeting YAP/TAZ have been developed, including direct inhibition, modulation of upstream regulators, and suppression of downstream target genes. Preclinical studies have demonstrated that combining YAP/TAZ inhibition with ICIs significantly enhances therapeutic efficacy across various tumor models. This review summarizes recent advances in understanding the role of YAP/TAZ in immune evasion within the TME and explores the potential of targeting this pathway to improve immunotherapy outcomes. Furthermore, it discusses the translational value of combination therapies based on YAP/TAZ inhibition, providing a theoretical framework and practical guidance for the development of innovative immunotherapeutic strategies and precision medicine approaches.
.
Humans
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Immunotherapy/methods*
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Neoplasms/metabolism*
;
Signal Transduction/drug effects*
;
Adaptor Proteins, Signal Transducing/immunology*
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Animals
;
Transcriptional Coactivator with PDZ-Binding Motif Proteins
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Transcription Factors/immunology*
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YAP-Signaling Proteins
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Tumor Microenvironment
6.The toxic components, toxicological mechanism and effective antidote for Gelsemium elegans poisoning.
Niping LI ; Yaorong YANG ; Shengyuan ZHANG ; Bin JIANG ; Wei ZHANG ; Haibo WANG ; Lixin CHEN ; Liwei WANG ; Yiyi LI ; Lei SHI ; Wencai YE ; Lei WANG
Acta Pharmaceutica Sinica B 2025;15(9):4872-4885
Gelsemium elegans (G. elegans) is an extremely poisonous plant that is widely distributed in southern China and southeastern Asia. G. elegans poisoning events occur frequently in southern China, and are therefore an urgent public health problem requiring multidisciplinary action. However, the toxic components and toxicological mechanisms remain unclear. Here, we describe a systematic investigation on the toxic components of G. elegans, resulting in the isolation and identification of 120 alkaloids. Based on acute toxicity screening, the structure-toxicity relationship of Gelsemium alkaloids was proposed for the first time. Moreover, gelsedine- and humantenine-type alkaloids were detected in the clinical blood sample, and were confirmed to be causative in the poisoning. The most toxic compound, gelsenicine (1), had selective inhibitory effects toward ventral respiratory group (VRG) neurons in the medulla, which is the main brain region controlling respiration in the central nervous system. Gelsenicine (1) strongly inhibited the firing of action potentials in VRG neurons through its ability to stimulate GABAA receptors, the main receptors involved in inhibitory neurotransmission. Application of GABAA receptor antagonists successively reversed action potential firing in gelsenicine (1)-treated VRG neurons. Importantly, the GABAA receptor antagonists securinine and flumazenil significantly increased the survival of poisoned animals. Our findings provide insight into the components and mechanisms of G. elegans toxicity, and should assist the development of effective emergency treatments for G. elegans poisoning.
7.Lipidome atlas of human myometrium reveals distinctive lipid signatures associated with adenomyosis: Combination of high-coverage lipidomics and mass spectrometry imaging.
Shuo LIANG ; Jialin LIU ; Maokun LIAO ; Dandan LIANG ; Yiyi GONG ; Bo ZHANG ; Nan ZHAO ; Wei SONG ; Honghui SHI
Journal of Pharmaceutical Analysis 2025;15(9):101197-101197
Adenomyosis is a common gynecological disease characterized by the invasion of endometrial glands and stroma into the myometrium of uterus, the pathological mechanism of which remains unclear yet. Disturbed lipid metabolism extensively affects abnormal cell proliferation and invasion in various diseases. However, the lipidome signature of human myometrium, which could be crucial in the development of adenomyosis, remains unknown. In this study, we generated the first lipidome profiling of human myometrium using a high-coverage and quantitative lipidomics approach based on ultra-performance liquid chromatography (UPLC) coupled with triple quadrupole (QqQ)-mass spectrometry (MS). A total of 317 lipid species were successfully quantified in the myometrial tissues from women with (n = 38) or without (n = 65) adenomyosis who underwent hysterectomy at Peking Union Medical College Hospital (Bejing, China). Up to 83 lipid species showed significant alternations in content between the two groups. These lipid aberrations involved multiple metabolic pathways, and emphasized inflammation, cell migration, and immune dysregulation upon adenomyosis. Moreover, receiver operating characteristic (ROC) curve analysis found that the combination of five lipid species could accurately distinguished the myometrial samples from women with and without adenomyosis with an area under the curve (AUC) of 0.906. Desorption electrospray ionization MS imaging (MSI) further underscored the heterogeneous distributions of these lipid markers in the adenomyosis lesion and adjacent myometrial tissue. Collectively, these results extremely improved our understanding on the molecular basis of adenomyosis, and could shed light on developing potential biomarkers and new therapeutic directions for adenomyosis.
8.Developmental trajectory and interaction between loneliness and social support among middle school students
Chinese Journal of School Health 2024;45(11):1604-1608
Objective:
To analyze the developmental trajectories of middle school students loneliness and social support, as well as to explore the interaction between loneliness and social support, so as to provide the evidence based support for the mental health development of adolescents.
Methods:
A total of 989 first year students from four public middle schools in Xiangxi Tujia and Miao Autonomous Prefecture, Hunan Province were selected for three follow up surveys by a cluster random sampling method (T1:March 2023, T2:June 2023, T3:December 2023). The UCLA Loneliness Scale-20 (ULS-20) and Social Support Scale for University Students (SSSUS) were employed for questionnaire data collection. The growth mixture modeling was utilized to test the developmental trajectories of loneliness and social support among middle school students, while the cross lagged analysis was performed to investigate their mutual influence.
Results:
The scores for loneliness and social support in T1, T2 and T3 were (43.1±5.8, 42.5± 6.8 , 42.0±6.9; 55.9±12.0, 60.7±15.7, 60.4±16.7), respectively. Correlational analysis revealed a significant negative correlation between loneliness levels (T1, T2, T3) and social support (T1, T2, T3) ( r =-0.47 to -0.36, P <0.01). Growth mixture modeling indicated a linear declining trend of middle school students loneliness, and the developmental trajectory of social support showed a linear increasing trend, with significant individual differences in initial levels and rates of change ( P <0.05). Cross lagged analyses revealed that loneliness levels at T1 negatively predicted social support scores at T2 ( β =-0.16), and loneliness levels at T2 negatively predicted social support scores at T3 ( β =-0.12) ( P <0.05). Additionally, prior loneliness positively predicted its subsequent levels, with path coefficients of 0.58 and 0.47, respectively ( P <0.05). Social support scores at T1 negatively predicted loneliness levels at T2 ( β =-0.10), while scores at T2 negatively predicted loneliness levels at T3 ( β =-0.15) ( P <0.05). Prior loneliness also positively predicted its subsequent levels, with path coefficients of 0.43 and 0.44, respectively ( P <0.05).
Conclusion
The developmental trajectory of middle school students loneliness demonstrates a decreasing trend, while that of social support exhibits a linear increasing trend, indicating a longitudinal causal relationship between loneliness and social support.
9.Textual Research on Key Information of Classic Formula Gualou Niubangtang
Yanping HAN ; Yiyi ZHANG ; Mengyuan YANG ; Raorao LI ; Li YAO ; Zhaoxiang SUN ; Zhuo MA ; Huimin GAO ; Wei ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):224-232
Gualou Niubangtang is a classic formula for eliminating swelling and dispersing lumps, commonly used in the clinical treatment of breast diseases in traditional Chinese medicine (TCM). This paper employed bibliometric methods to collect and organize 12 pieces of data from ancient texts related to Gualou Niubangtang, ultimately screening 10 valid references from 10 ancient Chinese medical books. Information regarding the prescription origin, main indications, formulation principles, drug composition, dosages, preparation methods, and decoction techniques was systematically verified. The results indicate that Gualou Niubangtang originates from the Orthodox Manual of External Medicine (Wai Ke Zheng Zong) by Chen Shigong in the Ming Dynasty. The formula consists of 12 Chinese medicines, including Citri Reticulatae Pericarpium, Arctii Fructus, Gardeniae Fructus, Lonicerae Japonicae Flos, Glycyrrhizae Radix et Rhizoma, Trichosanthis Semen, Scutellariae Radix, Trichosanthis Radix, Forsythiae Fructus, Gleditsiae Spina, Bupleuri Radix, and Citri Reticulatae Pericarpium Viridm. In terms of drug origins, the dominant radical for Trichosanthis Semen and Trichosanthis Radix is Trichosanthes kirilowii, and the historical dominant radical for Glycyrrhizae Radix et Rhizoma is Glycyrrhiza uralensis. The nine medicines, Citri Reticulatae Pericarpium, Arctii Fructus, Gardeniae Fructus, Lonicerae Japonicae Flos, Scutellariae Radix, Forsythiae Fructus, Gleditsiae Spina, Bupleuri Radix, and Citri Reticulatae Pericarpium Viridm, are consistent with the 2020 edition of the Chinese Pharmacopoeia. The preparation methods involve frying Arctii Fructus, removing the heart from Forsythiae Fructus, while the remaining 10 medicines are used raw. The efficacy includes clearing heat, removing toxins, reducing swelling, and dispersing lumps. Clinically, it is used to treat conditions such as breast carbuncles, breast gangrene, and knot-like swellings and pain. The dosage, converted to modern standards, includes 3.73 g of Trichosanthis Semen, 3.73 g of Trichosanthis Radix, 3.73 g of Arctii Fructus, 3.73 g of Scutellariae Radix, 3.73 g of Gardeniae Fructus, 3.73 g of Forsythiae Fructus, 3.73 g of Gleditsiae Spina, 3.73 g of Lonicerae Japonicae Flos, 3.73 g of Glycyrrhizae Radix et Rhizoma, 3.73 g of Citri Reticulatae Pericarpium, 1.85 g of Citri Reticulatae Pericarpium Viridm, and 1.85 g of Bupleuri Radix. The preparation is in the form of a decoction, with the 12 medicines added to 400 mL of water and decocted until 160 mL. The liquid is then mixed with 200 mL of yellow wine and taken before meals three times a day. Through the excavation and organization of ancient literature regarding Gualou Niubangtang, key information has been identified to provide a scientific basis for its clinical application and further development.
10.The effect of magnetic stimulation of the sacral nerve on detrusor weakness after spinal cord injury/
Yiyi ZHENG ; Shufang CHEN ; Haojie ZHANG
Chinese Journal of Rehabilitation Medicine 2024;39(1):82-86
Objective:To investigate the effect of the magnetic stimulation of the sacral nerve on detrusor weakness after spinal cord injury. Method:36 individuals with detrusor weakness after spinal cord injury were divided into experimental group and control group after randomization.Both groups received conventional rehabilitation treatment,besides,the experimental group received repetitive functional magnetic stimulation(rFMS)on S3 nerve roots.Before treat-ment and after 4-weeks treatment,the simple bladder capacity,bladder ultrasound,self-rating anxiety scale were observed. Result:The maximum automatic micturition volume,average automatic micturition volume,residual urine vol-ume,initial uriesthesis,and anxiety self-evaluation score of the two groups were improved after intervention.And the improvements are more in experimental group(P<0.05). Conclusion:The effect of the rFMS on individuals with detrusor weakness after spinal cord injury is signifi-cantly better than conventional intervention,which provides a new idea for the clinical treatment of neurogenic bladder with detrusor weakness.


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