1.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
2.Comparison of cumulative live birth rate per oocyte retrieval cycle between GnRH-agonist long and GnRH-antagonist protocols in overweight and obese women: a propensity score-matched study
Chunxiang WU ; Nan LU ; Jing WANG ; Jiayin LIU ; Xiang MA
Chinese Journal of Reproduction and Contraception 2025;45(7):679-686
Objective:To compare the cumulative live birth rate (CLBR) per oocyte retrieval cycle between gonadotropin-releasing hormone agonist (GnRH-a) long protocol and GnRH antagonist (GnRH-A) protocol in overweight and obese women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:A retrospective cohort study was conducted to analyze the clinical characteristics of overweight and obese patients who underwent IVF/ICSI at the Center of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2019. A total of 3 707 cycles were executed in overweight and obese patients who fulfilled the prescribed inclusion criteria, comprising 1 555 GnRH-a long protocol cycles and 2 152 GnRH-A protocol cycles. To mitigate confounding factors, post hoc randomization and propensity score matching (PSM) at a 1∶1 ratio were applied to match female age, anti-Müllerian hormone levels, and antral follicle count. The primary outcome observation indicator was the CLBR of the oocyte retrieval cycle. Analysis of subgroups of the population was conducted by the women's body mass index, age, and polycystic ovarian syndrome (PCOS) status.Results:After PSM, a total of 2 496 cycles were included comprising 1 248 GnRH-a long protocol cycles and 1 248 GnRH-A protocol cycles. GnRH-a long protocol had a higher CLBR [71.88% (897/1 248)] than that in GnRH-A protocol [62.98% (786/1 248), P<0.001]. No statistically significant difference was observed in the interval from gonadotropin initiation to live birth delivery day between the GnRH-a long protocol and GnRH-A protocol ( P>0.05). Subgroup analysis revealed that after PSM, the CLBR of GnRH-a long protocol in the patients with a body mass index of 25.0-29.9 kg/m 2 [71.36% (856/1 195)] and ≥30.0 kg/m 2 [77.36% (41/53)] were higher than those of the GnRH-A protocol patients [63.30% (759/1 199), P<0.001; 55.10% (27/49), P=0.017]. The CLBR of GnRH-a long protocol in women aged 20-34 [73.32% (805/1 098)] and ≥35 years [61.33% (92/150)] were higher than those of the GnRH-A protocol patients [67.18% (696/1 036), P=0.002; 42.45% (90/212), P<0.001]; among patients without PCOS, the CLBR with the GnRH-a long protocol [71.55% (850/1 188)] was significantly higher than that with GnRH-A protocol [60.95% (654/1 073), P<0.001]. However, in overweight and obese patients with PCOS, there was no statistically significant difference in CLBR between the two protocols ( P>0.05). The incidence of moderate-severe ovarian hyperstimulation syndrome (OHSS) was significantly lower in the overweight and obese population using GnRH-A protocol [0.64% (8/1 248)] compared with GnRH-a long protocol [1.76% (22/1 248), P=0.016]. Conclusion:For overweight and obese patients, GnRH-a long protocol demonstrates higher CLBR compared with GnRH-A protocol, indicating superior efficacy. For those with PCOS, both protocols show comparable CLBR, while the incidence of severe OHSS is lower in the GnRH-A.
3.Influencing factors of pulmonary dysfunction among community-based population at high-risk for chronic obstructive pulmonary disease in Putuo District, Shanghai
Rongwei SONG ; Chunxiang WU ; Jie YU ; Yuqing LU ; Fengying ZHANG
Shanghai Journal of Preventive Medicine 2025;37(5):397-402
ObjectiveTo analyze the influencing factors of pulmonary dysfunction among community-based population at high-risk for chronic obstructive pulmonary disease (COPD), and to establish a risk assessment model to provide a reference basis for accelerating the beforehand prevention and control of COPD and promoting the respiratory health of community-based residents. MethodsIndividuals aged >35 years old, with at least one risk factor except age illustrated in the Guidelines for Primary Diagnosis and Treatment of Chronic Obstructive Lung Disease (2018), and participated in the early screening for COPD from July 2022 to December 2023 were selected as the research subjects, and their lung function was assessed by the forceful expiratory volume in the first second after inhalation of bronchodilator (FEV1)/ forced vital capacity (FVC) <70% and/or the ratio of FEV1 to predicted value (FEV1%Pred) <80% as the diagnostic criteria. In addition, risk factors related to pulmonary dysfunction were analyzed for the establishment of risk assessment model. ResultsA total of 823 individuals aged between 35‒76 years were included, among which 298 (36.21%) were diagnosed with pulmonary dysfunction, 167 (20.29%) with COPD, and 131 (15.92%) with preserved ratio but impaired spirometry. Logistic regression analysis revealed that male gender, increasing age, more frequent smoking, insufficient physical activity, recurrent wheezing, the presence of post-exercise wheezing or coughing, insensitive to airborne allergens, and history of chronic bronchitis or bronchial asthma were correlated with pulmonary dysfunction. The incidence rate of pulmonary dysfunction was 1.99 times higher in males than that in females, 1.81 times more common in those aged between 70‒76 years than those aged <60 years, 2.42 times more common in those who smoked 50‒200 pack-years than in those who smoked 0‒14 pack-years, 1.78 times higher in those who underwent physical activity <600 MET‑min·week-1 than in those who underwent physical activity ≥600 MET‑min·week-1, 2.61 times higher in those suffered recurrent wheezing than in those did not, 1.53 times higher in those with symptoms of post-exercise wheezing or coughing than in those without, 1.61 times higher in those insensitive to airborne allergens than those sensitive, 2.02 times higher in patients with chronic bronchitis than in those without, and 2.41 times higher in patients with bronchial asthma than in those without. The risk assessment model for pulmonary dysfunction constructed on this basis had a total score of 28 points, and the area under the subject operating characteristic (ROC) curve was 0.72, reaching the cut-off point of ROC curve while taking scores ≥10 points as the cut-off value for pulmonary dysfunction. ConclusionIn community-based high-risk COPD population, the incidence rate of pulmonary dysfunction is higher in males than that in females, in addition, which increases with the advancement of age. Smoking,insufficient physical activity,recurrent wheezing,post-exercise wheezing or coughing,insensitive to airborne allergens,and history of chronic bronchitis or bronchial asthma are high risk factors for pulmonary dysfunction. The risk assessment model constructed based on these factors has a good predictive effect in screening high-risk population of COPD, but its effectiveness in screening people at general risk needs to be further validated.
4.Comparison of cumulative live birth rate per oocyte retrieval cycle between GnRH-agonist long and GnRH-antagonist protocols in overweight and obese women: a propensity score-matched study
Chunxiang WU ; Nan LU ; Jing WANG ; Jiayin LIU ; Xiang MA
Chinese Journal of Reproduction and Contraception 2025;45(7):679-686
Objective:To compare the cumulative live birth rate (CLBR) per oocyte retrieval cycle between gonadotropin-releasing hormone agonist (GnRH-a) long protocol and GnRH antagonist (GnRH-A) protocol in overweight and obese women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:A retrospective cohort study was conducted to analyze the clinical characteristics of overweight and obese patients who underwent IVF/ICSI at the Center of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2019. A total of 3 707 cycles were executed in overweight and obese patients who fulfilled the prescribed inclusion criteria, comprising 1 555 GnRH-a long protocol cycles and 2 152 GnRH-A protocol cycles. To mitigate confounding factors, post hoc randomization and propensity score matching (PSM) at a 1∶1 ratio were applied to match female age, anti-Müllerian hormone levels, and antral follicle count. The primary outcome observation indicator was the CLBR of the oocyte retrieval cycle. Analysis of subgroups of the population was conducted by the women's body mass index, age, and polycystic ovarian syndrome (PCOS) status.Results:After PSM, a total of 2 496 cycles were included comprising 1 248 GnRH-a long protocol cycles and 1 248 GnRH-A protocol cycles. GnRH-a long protocol had a higher CLBR [71.88% (897/1 248)] than that in GnRH-A protocol [62.98% (786/1 248), P<0.001]. No statistically significant difference was observed in the interval from gonadotropin initiation to live birth delivery day between the GnRH-a long protocol and GnRH-A protocol ( P>0.05). Subgroup analysis revealed that after PSM, the CLBR of GnRH-a long protocol in the patients with a body mass index of 25.0-29.9 kg/m 2 [71.36% (856/1 195)] and ≥30.0 kg/m 2 [77.36% (41/53)] were higher than those of the GnRH-A protocol patients [63.30% (759/1 199), P<0.001; 55.10% (27/49), P=0.017]. The CLBR of GnRH-a long protocol in women aged 20-34 [73.32% (805/1 098)] and ≥35 years [61.33% (92/150)] were higher than those of the GnRH-A protocol patients [67.18% (696/1 036), P=0.002; 42.45% (90/212), P<0.001]; among patients without PCOS, the CLBR with the GnRH-a long protocol [71.55% (850/1 188)] was significantly higher than that with GnRH-A protocol [60.95% (654/1 073), P<0.001]. However, in overweight and obese patients with PCOS, there was no statistically significant difference in CLBR between the two protocols ( P>0.05). The incidence of moderate-severe ovarian hyperstimulation syndrome (OHSS) was significantly lower in the overweight and obese population using GnRH-A protocol [0.64% (8/1 248)] compared with GnRH-a long protocol [1.76% (22/1 248), P=0.016]. Conclusion:For overweight and obese patients, GnRH-a long protocol demonstrates higher CLBR compared with GnRH-A protocol, indicating superior efficacy. For those with PCOS, both protocols show comparable CLBR, while the incidence of severe OHSS is lower in the GnRH-A.
5.Low-dose risperidone for bipolar disorder in a child onset at age 5: a case report and 4-year follow-up
Yaru ZHANG ; Yanmei SHEN ; Xingyue JIN ; Xueping GAO ; Chunxiang HUANG ; Xuerong LUO ; Jianping LU
Chinese Journal of Psychiatry 2025;58(5):373-376
Bipolar disorder in children, a serious mental illness, often leads to significant functional impairment. Bipolar disorder onset in children is rare and is difficult to diagnose correctly due to the atypical clinical manifestations. Risperidone, as a second-generation antipsychotic, shows satisfied efficacy in children with bipolar disorder with dual effects on mood stabilization and psychotic symptom control. However, the long-term efficacy and safety of risperidone for the treatment of children with bipolar disorder remains unknown. This paper reports a 5-year-old child with bipolar disorder who was treated with low-dose risperidone and followed up for 4 years. The child showed significant emotional stabilization and behavioral improvement at the beginning of treatment. No serious side effects occurred during long-term follow-up. This paper detailly describes the clinical manifestations and diagnostic process of bipolar disorder onset in children in aspects of detailed clinical observation and evaluation. It summarizes the efficacy and safety of risperidone in the treatment of pediatric bipolar disorder to provide valuable experience for clinicians.
6.Low-dose risperidone for bipolar disorder in a child onset at age 5: a case report and 4-year follow-up
Yaru ZHANG ; Yanmei SHEN ; Xingyue JIN ; Xueping GAO ; Chunxiang HUANG ; Xuerong LUO ; Jianping LU
Chinese Journal of Psychiatry 2025;58(5):373-376
Bipolar disorder in children, a serious mental illness, often leads to significant functional impairment. Bipolar disorder onset in children is rare and is difficult to diagnose correctly due to the atypical clinical manifestations. Risperidone, as a second-generation antipsychotic, shows satisfied efficacy in children with bipolar disorder with dual effects on mood stabilization and psychotic symptom control. However, the long-term efficacy and safety of risperidone for the treatment of children with bipolar disorder remains unknown. This paper reports a 5-year-old child with bipolar disorder who was treated with low-dose risperidone and followed up for 4 years. The child showed significant emotional stabilization and behavioral improvement at the beginning of treatment. No serious side effects occurred during long-term follow-up. This paper detailly describes the clinical manifestations and diagnostic process of bipolar disorder onset in children in aspects of detailed clinical observation and evaluation. It summarizes the efficacy and safety of risperidone in the treatment of pediatric bipolar disorder to provide valuable experience for clinicians.
7.Study on mechanism of Chanbao zhichuang suppository in treating hemorrhoids based on network pharmacology and metabolomics
Chunfeng GUO ; Xin JIANG ; Ruyang CHENG ; Shumin LIU ; Chunxiang XIE ; Fang LU
China Pharmacy 2025;36(13):1622-1628
OBJECTIVE To explore the mechanism of improvement effect of Chanbao zhichuang suppository(CBZCS)on hemorrhoids in rats through network pharmacology and metabolomics.METHODS A hemorrhoid model was established by subcutaneous injection of rhododendron oil to induce anal swelling.SD rats were divided into blank group(NC group,0.32 g/kg vaseline),model group(Model group,0.32 g/kg vaseline),CBZCS low-,medium-,and high-dose groups(CBZCS-L,CBZCS-M,CBZCS-H groups,with dosages of 0.16,0.32,and 0.64 g/kg respectively),and Mayinglong musk hemorrhoids suppository group(Positive group,0.32 g/kg),with 9 rats in each group.Anal administration was performed at 6,12,24,48,and 72 hours after modeling.After the last administration,the pathological changes of the anal tissues in rats were observed,and the serum levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in rats were detected.Differential metabolite analysis and enrichment analysis were conducted by metabolomics methods,and the target proteins of CBZCS in treating hemorrhoids were obtained by network pharmacology.The core metabolic pathways were screened by interaction and enrichment analysis of differential metabolites and proteins,and the core proteins were experimentally verified.RESULTS Compared with the NC group,the anal tissues of the Model group showed obvious lesions,and the levels of IL-6 and TNF-α in the serum were significantly increased(P<0.05);compared with the Model group,the pathological damage of the anal tissues in the treatment groups was alleviated to varying degrees,and serum levels of IL-6 in CBZCS-H group,CBZCS-M group,and Positive group as well as serum levels of TNF-α in CBZCS-H group were significantly reduced(P<0.05).The metabolomics results showed that 34 differential metabolites were screened from the anal tissues of rats,and 22 of them showed a return after CBZCS administration.The differential metabolites mainly enriched in arachidonic acid metabolism,histidine metabolism,and glycerophospholipid metabolism.Through the network pharmacology,138 intersection genes of CBZCS against hemorrhoids were determined.The analysis results showed that differential metabolites and target proteins were mainly enriched in the arachidonic acid metabolism pathway,and the regulation of this pathway might be related to cyclooxygenase-2(COX-2),Myc proto-oncogene protein(c-MYC),cytochrome P450 1B1(CYP1B1),interleukin-1β(IL-1β),and IL-6 protein expression.The experimental verification results showed that the expression levels of key proteins(COX-2,c-MYC,CYP1B1,IL-6,IL-1β)in the anal tissues of the Model group were significantly higher than those in the NC group(P<0.05),and the levels of the above proteins in the anal tissues of CBZCS-H group and Positive group were significantly lower than those in the Model group(P<0.05).CONCLUSIONS The mechanism of CBZCS in treating hemorrhoids may be to inhibit the expression of COX-2,c-MYC and CYP1B1 proteins,thereby inhibiting arachidonic acid metabolism and reducing the release of inflammatory factors IL-6 and IL-1β.
8.Research advances on in-situ cell electrospinning and its application in wound repair
Huazhen LIU ; Yi ZHANG ; Chuang GAO ; Chunxiang LU ; Zilong GUO ; Wenbin SUN ; Shichu XIAO ; Yuanyuan LIU
Chinese Journal of Burns 2024;40(7):694-698
Currently, there are limited strategies for convenient and rapid wound repair in clinical practice. In recent years, in-situ cell electrospinning (IS-CE) technology, developed from in-situ electrospinning (IS-E) technology, has emerged. IS-CE technology involves encapsulating living cells within micro-nanofibers to construct living fibrous tissue scaffolds in situ, making some progress in wound repair applications. However, this technology still faces limitations such as low cell survival rate and poor fiber stability. This article provides a comprehensive review on the current status of both IS-E and IS-CE technologies, as well as the application of IS-CE technology in wound repair. In addition, the advantages, limitations, and improvement methods of IS-CE technology applied in wound treatment are emphatically discussed, aiming to provide insights for its application in tissue engineering and wound repair.
9.Stereotactic body radiotherapy versus radiofrequency ablation for hepatocellular carcinoma:a meta-analysis
Wenting DU ; Yu HE ; Yue WU ; Bingxin YU ; Yang LU ; Yuanqiang LIN ; Cuiping ZHAN ; Chunxiang JIN
Journal of Interventional Radiology 2023;32(12):1233-1241
Objective Stereotactic body radiotherapy(SBRT)and radiofrequency ablation(RFA)are primary treatments for hepatocellular carcinoma(HCC)at present.However,the effect of these treatments in clinical trails are rather controversial.The purpose of this paper is to conduct a meta-analysis on the clinical effect and related complications of SBRT and RFA for HCC.Methods A computerized retrieval of academic papers concerning the treatment effect of SBRT and RFA for HCC from the databases of PubMed,Embase,Cochrane Library,Scopus,Web of Science,CBM,CNKI,Wanfang database,VIP was conducted.The retrieval time period was from the establishment of the database to June 2022.Stata14.0 software was used to make meta-analysis.Results A total of 14 retrospective studies including 6 806 patients were included in this analysis.The results of combined hazard ratio(HR)based on overall survival(OS)showed that the OS rate of SBRT was lower than that of RFA(HR=1.25,95%CI=1.10-1.43,12=0%,P=0.000 9),while the results of combined HR of local control(LC)rate indicated that SBRT had a better therapeutic effect(HR=0.61,95%CI=0.47-0.78,I2=0%,P=0.000 1).Subgroup analysis revealed that the combined HR of LC rate favored the performance of SBRT for patients with tumor diameter larger than 2 cm(HR=2.64,95%CI=1.56-4.48,I=0%,P=0.000 3).No statistically significant difference in the incidence of late serious adverse reactions existed between SBRTgroup and RFA group(OR=1.01,95%CI=0.59-1.73,I2=30%,P=0.97).Conclusion SBRT is superior to RFA in controlling local HCC lesions,especially in patients whose tumor diameter is larger than 2 cm,although it does not show certain advantages in the survival benefit.(J Intervent Radiol,2023,32:1233-1241)
10.Bioinformatics analysis of primary biliary cholangitis key genes and molecular mechanisms
Qinlei CHEN ; Fei QIAO ; Weiting LU ; Huilian SHI ; Chunxiang ZHOU
Chinese Journal of Hepatology 2023;31(11):1209-1216
Objective:To extract the differentially expressed key genes of primary biliary cholangitis (PBC) using bioinformatics methods, so as to provide information for further study into the mechanism.Methods:The GSE119600 dataset was downloaded from the GEO database to obtain differentially expressed genes. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed for differentially expressed genes. Protein-protein interaction (PPI) network reconstruction, Cytoscape software visualization, and core gene screening were performed. The area under the receiver operating characteristic curve (ROC AUC) was used to assess the diagnostic effectiveness of genes and plot the pROC software package. The x-Cell software was used to calculate the enrichment score of 34 immune cells in each sample. Finally, four key genes (PSMA4, PSMA1, PSMB1, and PSMA3) were selected. Blood samples were analyzed using the qPCR method.Results::A total of 373 immune-related differentially expressed genes were identified. Eight genes (PSMC6, PSMB2, PSMB1, PSMA3, PSMA4, PSMA1, PSMD7, and PSMB5) were screened from the 178 nodes and 596 edges as hub genes of the PPI network, which were significantly related to amino acid metabolism, hematopoietic stem cell differentiation, cell cycle, and immune processes. PSMA4, PSMA1, PSMB1, and PSMA3 were defined as immunological biomarkers for PBC with an AUC value of the ROC curve > 0.7. Immunoinfiltrating cell analysis showed that the proportion of eosinophils was significantly higher in PBC patients compared to the control group, whereas the proportion of CD4+ memory T cells, plasma cells, Th2 cells, and cDC cells was significantly lower in PBC patients than the control group. Plasma cells were associated with all four immunological biomarkers. Seven PBC patients and seven healthy subjects were selected for peripheral blood qPCR validation, which demonstrates that PSMB1, PSMA3, PSMA1, and PSMA4 levels were significantly lower in PBC patients than healthy subjects, with a statistically significant difference.Conclusion::Bioinformatics screened eight key genes, of which four were key immunological markers and may serve as a basis for clinical diagnosis and mechanism exploration.

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