1.Staged Efficacy of Qijia Rougan Prescription Combined with Entecavir for Chronic Hepatitis B-related Hepatic Fibrosis with Qi Deficiency and Collateral Stasis Syndrome Based on "Zhu Ke Jiao" Theory
Baixue LI ; Xin WANG ; Jibin LIU ; Li WEN ; Cen JIANG ; Wenjun WU ; Dong WANG ; Shuwan LIU ; Huabao LIU ; Yongli ZHENG ; Liang HUANG ; Yue SU ; Song ZHANG ; Yanan SHANG ; Hang ZHOU ; Quansheng FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):180-188
ObjectiveThis paper aims to investigate and evaluate the staged efficacy and safety of the representative empirical prescription of the “Zhu Ke Jiao” theory, Qijia Rougan prescription, combined with entecavir in the treatment of hepatic fibrosis in chronic hepatitis B. MethodsA multicenter randomized controlled clinical study was conducted, and 101 patients diagnosed with chronic hepatitis B-related hepatic fibrosis (CHB-HF) who met the diagnosis and inclusion criteria were randomly assigned to an observation group (Qijia Rougan prescription + entecavir) and a control group (entecavir). The treatment duration was 24 weeks. Liver stiffness measurement (LSM), fibrosis-4 index (FIB-4), portal vein diameter, hepatitis B serology, biochemical indicators, hepatic fibrosis markers in serum [hyaluronic acid (HA), laminin (LN), procollagen Ⅲ peptide (PⅢP), and type Ⅳ collagen (Ⅳ-C)], and traditional Chinese medicine syndrome scores were used as efficacy evaluation indicators. Efficacy assessments and explorations of different staged subgroups of Qijia Rougan prescription were conducted according to LSM values based on the Metavir pathological staging standard. ResultsA total of 98 cases were included for statistical analysis, with 49 cases in the observation group and 49 in the control group. The general data of the patients in both groups were comparable. Compared with the same group before treatment, the observation group showed a significant reduction in LSM and FIB-4 (P<0.01), as well as notable improvements in LN, Ⅳ-C, and various TCM syndrome scores (P<0.05, P<0.01). When compared to the control group after treatment, the observation group demonstrated significant improvements in LSM, FIB-4, and various TCM syndrome score indicators (P<0.05, P<0.01), indicating that the observation group performed better than the control group. Subgroup analysis of the regression of hepatic fibrosis stages showed that compared to the same group before treatment, the observation group had better improvement in regression of stages F2 and F3 (P<0.05). When compared to the control group after treatment, the observation group exhibited superior improvement in regression of stage F3 (P<0.05). No adverse events occurred in either group during the treatment period. ConclusionCompared with entecavir alone, the combination of Qijia Rougan prescription and entecavir significantly improves the degree of hepatic fibrosis and clinical TCM symptoms in patients. The optimal intervention period is primarily during stage F3, which is a potential “interception” point of the “Zhu Ke Jiao” theory.
2.Mechanism of Electroacupuncture Alleviating Inflammatory Pain in Rats by Regulating ErbB Subtypes in the Spinal Dorsal Horn
Yuxin WU ; Shuxin TIAN ; Zhengyi LYU ; Dingru JI ; Xingzhen LI ; Yue DONG ; Binyu ZHAO ; Yi LIANG ; Jianqiao FANG
Journal of Traditional Chinese Medicine 2026;67(1):69-78
ObjectiveTo observe the changes in the levels of different subtypes of epidermal growth factor receptor (ErbB), namely ErbB1, ErbB2, ErbB3, and ErbB4, in the spinal dorsal horn of inflammatory pain model rats, and to explore their mechanism of mediating hyperalgesia as well as the intervention mechanism of electroacupuncture at "Zusanli (ST 36)" and "Kunlun (BL 60)". MethodsThe study was divided into five parts. In experiment 1, 14 Sprague Dawley (SD) rats were randomly divided into control and inflammatory pain group (7 rats each group) to observe the pain behavior and the protein expression of different ErbB receptor subtypes in the spinal dorsal horn. In experiment 2, 30 rats were randomly divided into control group 1, inflammatory pain group 1, and low-, medium-, and high-concentration TX1-85-1 groups, with 6 rats in each group, to observe the effect of inhibiting spinal ErbB3 on inflammatory pain. In experiment 3, 12 rats were randomly divided into control virus group and ErbB3 knockdown virus group, with 6 rats in each group, to observe the effect of knocking down ErbB3 in the spinal dorsal horn on inflammatory pain. In experiment 4, 44 rats were randomly divided into control group 2, inflammatory pain group 2, electroacupuncture group, and sham electroacupuncture group, with 11 rats in each group, to observe the effect of electroacupuncture. In experiment 5, 40 rats were randomly divided into control group 3, inflammatory pain group 3, electroacupuncture group 1, and electroacupuncture + NRG1 group, with 10 rats in each group, to observe the effect of activating ErbB3 on electroacupuncture. A rat model of inflammatory pain was established by subcutaneous injection of 100 μl of complete Freund's adjuvant into the sole of the unilateral hind foot of SD rats. Rats in the low-, medium-, and high-concentration TX1-85-1 groups were intrathecally injected with ErbB3 inhibitor TX1-85-1 on day 5 to day 7 after modeling. Rats in the ErbB3 knockdown virus group were injected with ErbB3 knockdown virus packaged with adenovirus vector-based short hairpin RNA (shRNA) into the spinal dorsal horn in situ 3 weeks before modeling. Rats in each electroacupuncture group received electroacupuncture at bilateral "Zusanli (ST 36)" and "Kunlun (BL 60)" from day 1 to day 7 after modeling, with dense-sparse waves at a frequency of 2 Hz/100 Hz and a current of 0.5-1.5 mA for 30 minutes once a day. Rats in the electroacupuncture + NRG1 group were intrathecally injected with ErbB3 ligand recombinant human neuregulin-1 (NRG1) after electroacupuncture intervention from day 5 to day 7 after modeling. The mechanical withdrawal threshold and thermal withdrawal latency of rats were measured on day 1, 3, 5, and 7 after modeling to evaluate behavior, and Western Blot was used to detect the protein and phosphorylation levels of each ErbB subtype in the spinal dorsal horn. ResultsCompared with the control group, rats in the inflammatory pain group showed decreased mechanical withdrawal threshold and thermal withdrawal latency of rats, and increased expression of phosphorylated ErbB3 (p-ErbB3) protein in the spinal dorsal horn on days 1, 3, 5, and 7 after modeling (P<0.01). On day 5 and day 7 after modeling, compared with the inflammatory pain group 1, the mecha-nical withdrawal threshold and thermal withdrawal latency of rats in the medium- and high-concentration TX1-85-1 groups increased, and the expression of p-ErbB3 protein decreased (P<0.05). On day 1, 3, 5, and 7 after modeling, compared with the control virus group, the mechanical withdrawal threshold and thermal withdrawal latency of rats in the ErbB3 knockdown virus group increased (P<0.05). On day 5 and day 7 after modeling, compared with the inflammatory pain group 2 and the sham electroacupuncture group, the mechanical withdrawal threshold and thermal withdrawal latency of rats in the electroacupuncture group increased, and the expression of p-ErbB3 protein decreased (P<0.05). On day 5 and day 7 after modeling, compared with the electroacupuncture + NRG1 group, the mechanical withdrawal threshold and thermal withdrawal latency of rats in the electroacupuncture group 1 increased (P<0.05). ConclusionThe p-ErbB3 in the spinal dorsal horn involved in hyperalgesia in rats with inflammatory pain, and electroacupuncture at "Zusanli (ST 36)" and "Kunlun (BL 60)" can alleviate inflammatory pain by inhibiting the expression of p-ErbB3 protein in the spinal dorsal horn of rats.
3.450nm semiconductor blue laser vaporization prostatectomy in the treatment of high-risk benign prostatic hyperplasia patients without discontinuing anticoagulant drugs
Yongdi WU ; Jiaqing SUN ; Liang CHAO ; Chen ZHOU ; Dong QIU ; Pengfei SHI
Journal of Modern Urology 2026;31(2):131-134
Objective To evaluate the efficacy and safety of 450nm semiconductor blue laser vaporization prostatectomy in high-risk benign prostatic hyperplasia (BPH) patients without discontinuing anticoagulant drugs, so as to provide a safe and effectiveminimally invasive treatment option for such patients. Methods A total of 40 high-risk BPH patients who underwent 450nm semiconductor blue laser vaporization prostatectomy in our hospital during Sep. 2023 and Dec. 2024 were selected as the research subjects. The patients were divided into two groups: the oral medication group took oral anticoagulants during the perioperative period, while the discontinuation group discontinued anticoagulants, with 20 cases in either group. The perioperative indicators and changes including international prostate symptom score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax) and post-void residual (PVR) were compared between the two groups.Results There were no statistically significant differences between the oral medication group and discontinuation group in operation time [(28.83±15.52)min vs. (26.43±14.02)min], postoperative catheter indwelling time [(3.04±0.89) d vs. (3.23±1.01) d], bladder irrigation time [(27.36±7.54) h vs. (25.46±7.10) h], and decrease in hemoglobin [(8.08±1.82)g/L vs. (7.56±1.68)g/L] (all P>0.05). Three month after surgery, Qmax in both groups was higher, while IPSS, QoL and PVR were significantly lower (P<0.05), but there were no statistically significant differences between the two groups (P>0.05). No serious complications such as urinary incontinence or massive hemorrhage occurred.Conclusion 450nm semiconductor blue laser vaporization prostatectomy for high-risk BPH patients is characterized by high vaporization efficiency and good hemostatic effects. It can significantly improve the clinical symptoms with high safety, especially for high-risk patients who cannot discontinue anticoagulants.
4.Differences in deltamethrin resistance and kdr gene mutation in Culex tritaeniorhynchus population in and outside the Yellow Sea wetland
Xiao-er ZHANG ; Zhi-ming WU ; Ye TIAN ; Qian CUI ; Yu-qian JI ; Huan WANG ; Shu-juan YANG ; Yi-chao ZHAO ; Yu WANG ; Hua-yu YIN ; Yu DING ; Guo-jin YAN ; Min-sen ZHAO ; Shou-gang ZHANG ; Bing-dong SONG ; Hong-na CHEN ; Jian GAO ; Wei-fang YANG ; Yu-fu ZHANG ; Hui LIU ; Hong-liang CHU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):101-107
Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.
5.Burden and Trends of Ulcerative Colitis in China and Worldwide
Weiqing ZHANG ; Yizhong LIANG ; Meilan MO ; Zhulin WU ; Weijun LUO ; Dong ZHANG ; Derong LIN
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):857-867
ObjectiveTo assess changes in the incidence, prevalence, and disability-adjusted life-year (DALY) burden of ulcerative colitis (UC) in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023), and to examine demographic drivers and future trends. MethodsUC data for China, the world, and 204 countries and territories were extracted from the GBD 2023 Results Tool. Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR), with 95% uncertainty interval (UI), were obtained. Joinpoint regression was used to estimate average annual percent change (AAPC) and 95% confidence interval (CI). Spearman rank correlation, inequality and frontier analyses, Das Gupta decomposition, and autoregressive integrated moving average (ARIMA) models were used to assess associations with the sociodemographic index (SDI), cross-country burden disparities, demographic drivers, and trends from 2024 to 2035, respectively. ResultsIn 2023, the ASIR, ASPR, and ASDR in China were 0.94, 5.95, and 5.94 per 100 000 population, respectively, lower than the corresponding global estimates of 2.87, 28.48, and 13.82 per 100 000 population. From 1990 to 2023, China’s ASIR and ASPR increased, with AAPCs of 2.720% (95% CI: 2.133%-3.309%) and 2.261% (95% CI: 1.617%-2.908%), whereas the ASDR decreased (AAPC=-3.056%, 95% CI: -3.449% to -2.662%). Globally, ASIR increased slightly, whereas ASPR and ASDR decreased. In China, the crude incidence, prevalence, and DALY rates peaked at ages 50-54 years, 60-64 years, and ≥95 years, respectively. ASIR and ASPR were positively correlated with SDI (rs=0.5794 and 0.6177, both P<0.001), whereas the correlation between ASDR and SDI was not statistically significant (rs=0.0666, P=0.343). In China, epidemiological change contributed most to increases in incident and prevalent cases, and changes in age-specific rates contributed most to the decline in DALYs; globally, population growth and population aging contributed most to the increase in DALYs. By 2035, China’s ASIR, ASPR, and ASDR were projected to be 1.23, 6.37, and 2.55 per 100 000 population, respectively. ConclusionsFrom 1990 to 2023, the age-standardized incidence and prevalence rates of UC increased in China, whereas the age-standardized DALY rate decreased, and peaks in absolute burden generally shifted toward middle-aged and older age groups. The projected directions may persist. These findings may provide reference for long-term UC management and health-resource planning.
6.Microbial Culture Results and Pathogen Profiles of Donor Corneas in Eye Bank
Jianping JI ; Huicong HU ; Zhancong OU ; Rongrong CHEN ; Jiabi LIANG ; Nandan WU ; Xiaojuan DONG ; Ting HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):886-898
ObjectiveTo analyze the microbial culture positivity rate, pathogen spectrum, prevalence of multidrug-resistant organisms (MDROs), and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province, and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections. MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center, Sun Yat-sen University, between 2018 and 2025. During surgery, donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing (AST). Culture-positive corneas were compared across study years, pathogen categories, and donor procurement sources. ResultsOf the 7 442 donor corneas, 251 were culture-positive, corresponding to an overall culture positivity rate of 3.37%, with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas, 178 (70.92%) yielded bacteria alone, 72 (28.68%) yielded fungi alone, and 1 (0.40%) yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii, Staphylococcus epidermidis, Stenotrophomonas maltophilia, Enterococcus faecium, and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates, predominantly Acinetobacter baumannii, Staphylococcus epidermidis, and Enterococcus faecium, and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program (HCRP) had a higher culture positivity rate than those obtained through Organ Procurement Organization (OPO) (P<0.000 1). Among culture-positive donor corneas, the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group (P=0.001 5), whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group (P=0.005 2). ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low, indicating that the risk of microbial contamination is controlled. However, pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance, together with optimized donor risk assessment and timely reporting of culture results, may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.
7.Burden and Trends of Ulcerative Colitis in China and Worldwide
Weiqing ZHANG ; Yizhong LIANG ; Meilan MO ; Zhulin WU ; Weijun LUO ; Dong ZHANG ; Derong LIN
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):857-867
ObjectiveTo assess changes in the incidence, prevalence, and disability-adjusted life-year (DALY) burden of ulcerative colitis (UC) in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023), and to examine demographic drivers and future trends. MethodsUC data for China, the world, and 204 countries and territories were extracted from the GBD 2023 Results Tool. Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR), with 95% uncertainty interval (UI), were obtained. Joinpoint regression was used to estimate average annual percent change (AAPC) and 95% confidence interval (CI). Spearman rank correlation, inequality and frontier analyses, Das Gupta decomposition, and autoregressive integrated moving average (ARIMA) models were used to assess associations with the sociodemographic index (SDI), cross-country burden disparities, demographic drivers, and trends from 2024 to 2035, respectively. ResultsIn 2023, the ASIR, ASPR, and ASDR in China were 0.94, 5.95, and 5.94 per 100 000 population, respectively, lower than the corresponding global estimates of 2.87, 28.48, and 13.82 per 100 000 population. From 1990 to 2023, China’s ASIR and ASPR increased, with AAPCs of 2.720% (95% CI: 2.133%-3.309%) and 2.261% (95% CI: 1.617%-2.908%), whereas the ASDR decreased (AAPC=-3.056%, 95% CI: -3.449% to -2.662%). Globally, ASIR increased slightly, whereas ASPR and ASDR decreased. In China, the crude incidence, prevalence, and DALY rates peaked at ages 50-54 years, 60-64 years, and ≥95 years, respectively. ASIR and ASPR were positively correlated with SDI (rs=0.5794 and 0.6177, both P<0.001), whereas the correlation between ASDR and SDI was not statistically significant (rs=0.0666, P=0.343). In China, epidemiological change contributed most to increases in incident and prevalent cases, and changes in age-specific rates contributed most to the decline in DALYs; globally, population growth and population aging contributed most to the increase in DALYs. By 2035, China’s ASIR, ASPR, and ASDR were projected to be 1.23, 6.37, and 2.55 per 100 000 population, respectively. ConclusionsFrom 1990 to 2023, the age-standardized incidence and prevalence rates of UC increased in China, whereas the age-standardized DALY rate decreased, and peaks in absolute burden generally shifted toward middle-aged and older age groups. The projected directions may persist. These findings may provide reference for long-term UC management and health-resource planning.
8.Microbial Culture Results and Pathogen Profiles of Donor Corneas in Eye Bank
Jianping JI ; Huicong HU ; Zhancong OU ; Rongrong CHEN ; Jiabi LIANG ; Nandan WU ; Xiaojuan DONG ; Ting HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):886-898
ObjectiveTo analyze the microbial culture positivity rate, pathogen spectrum, prevalence of multidrug-resistant organisms (MDROs), and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province, and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections. MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center, Sun Yat-sen University, between 2018 and 2025. During surgery, donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing (AST). Culture-positive corneas were compared across study years, pathogen categories, and donor procurement sources. ResultsOf the 7 442 donor corneas, 251 were culture-positive, corresponding to an overall culture positivity rate of 3.37%, with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas, 178 (70.92%) yielded bacteria alone, 72 (28.68%) yielded fungi alone, and 1 (0.40%) yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii, Staphylococcus epidermidis, Stenotrophomonas maltophilia, Enterococcus faecium, and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates, predominantly Acinetobacter baumannii, Staphylococcus epidermidis, and Enterococcus faecium, and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program (HCRP) had a higher culture positivity rate than those obtained through Organ Procurement Organization (OPO) (P<0.000 1). Among culture-positive donor corneas, the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group (P=0.001 5), whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group (P=0.005 2). ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low, indicating that the risk of microbial contamination is controlled. However, pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance, together with optimized donor risk assessment and timely reporting of culture results, may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.
9.Development of the "Clinical Ethics" Course for the Eight-Year Clinical Medicine Program: Explorations and Practices by an Interdisciplinary Teaching Team
Jiangli HAN ; Yali CONG ; Qiong BAI ; Shu LI ; Guangkuan XIE ; Tongyan HAN ; Chuan MA ; Ying YAO ; Fei DONG ; Huilin LIU ; Rui WU ; Qinggang GE ; Liang WANG ; Yuxi XIA ; Shixian GU ; Xuan HE ; Ning SHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1223-1229
With the rapid advancement of medical technology and the increasing complexity of clinical environments, competence in clinical ethical decision-making has become an indispensable core competency for exemplary physicians. However, traditional medical ethics education has long been confronted with the persistent challenges of theory-practice dissociation and the disconnect between pedagogical settings and clinical realities. Thus, how to construct a "Clinical Ethics" curriculum that aligns with the objectives of training high-caliber medical professionals has emerged as a critical and challenging issue in current medical education reform. To effectively address this challenge, the Office of Education at Peking University Third Hospital, since 2021, has assembled a multidisciplinary "Clinical Ethics" teaching and management team comprising faculty from Peking University School of Humanities and key clinical specialists from the hospital. In 2022, the "Clinical Ethics" elective course was formally launched for fourth-year students in the eight-year MD program who had completed coursework in "Medical Ethics" and organ-system-based curricula, with the aim of exploring and operationalizing a pre-clinical ethics education model tailored for senior medical students. The course employs a modular instructional design encompassing "theoretical review-case-based deliberation-clinical workshop", which effectively facilitates the deep integration of medical humanities with clinical practice.Following four years of iterative refinement through the "plan-act-observe-reflect" cycle, the course has demonstrated positive outcomes in enhancing students' ethical awareness and decision-making capabilities, and has preliminarily established a sustainable collaborative mechanism among the multidisciplinary faculty team. This article systematically delineates the course development background, pedagogical model and methodological innovations, and the multidisciplinary collaborative framework, alongside reflections and summaries based on implementation outcomes, with the intent of providing references for the future development of "Clinical Ethics" curricula.
10.Cordycepin Inhibits Fat Infiltration after Rotator Cuff Tear Injury by Regulating Wnt/β-catenin Signaling Pathway
Qiu'en XIE ; Dengwen LIANG ; Shao WU ; Xuhui HAO ; Liguang LIANG ; Bangxiang JIAN ; Junhong DONG ; Lei YANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):98-106
ObjectiveTo investigate the effect and mechanism of cordycepin in inhibiting fat infiltration after rotator cuff injuries in rats by regulating the Wnt/β-catenin signaling pathway, providing a theoretical basis for clinical treatment of rotator cuff injuries. MethodsFifty SPF-grade female SD rats were used in this study, with 10 randomly selected as the blank group. A rotator cuff injury repair model was established by supraspinatus tendon and suprascapular nerve compression. The successfully modeled rats were randomized into model and low-dose (20 mg·kg-1), medium-dose (40 mg·kg-1), and high-dose (80 mg·kg-1) cordycepin groups. After 6 weeks of treatment, the gait analysis was performed to assess the limb function in rats. Oil red O staining and Masson staining were employed to observe pathological changes in the muscle tissue. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the serum. Immunohistochemistry (IHC) was employed to detect the expression of peroxisome proliferator-activated receptor γ (PPARγ) and CCAAT/enhancer-binding protein α (C/EBPα), which are markers of adipogenesis. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot were employed to determine the mRNA and protein levels, respectively, of Wnt3a, Wnt10b, and β-catenin. ResultsCompared with the blank group, the model group showed decreases in stride length and paw print area (P<0.01), an increase in ratio of wet muscle mass reduction and a decrease in muscle fiber cross-sectional area (P<0.05), and decreased ratios of fat infiltration area and collagen fiber area (P<0.01). Additionally, the model group showed elevated levels of IL-1β, IL-6, and TNF-α (P<0.05), up-regulated protein levels of PPARγ and C/EBPα (P<0.01), and down-regulated mRNA and protein levels of Wnt3a, Wnt10b, and β-catenin (P<0.05, P<0.01). Compared with the model group, the low-, medium-, and high-dose cordycepin groups showed increases in stride length and paw print area (P<0.01), a decrease in ratio of wet muscle mass reduction and an increase in muscle fiber cross-sectional area (P<0.05), and increases in ratios of fat infiltration area and collagen fiber area (P<0.05, P<0.01). In addition, cordycepin lowered the serum levels of IL-1β, IL-6, and TNF-α (P<0.05, P<0.01), down-regulated the protein levels of PPARγ and C/EBPα (P<0.01), and up-regulated the mRNA and protein levels of Wnt3a, Wnt10b, and β-catenin (P<0.05, P<0.01). ConclusionCordycepin can improve the limb function, alleviate rotator cuff muscle atrophy, fat infiltration, and fibrosis, and inhibit inflammation in rats by regulating the Wnt/β-catenin signaling pathway.


Result Analysis
Print
Save
E-mail