1.Causal relationship between immune cells and knee osteoarthritis:a two-sample bi-directional Mendelian randomization analysis
Guangtao WU ; Gang QIN ; Kaiyi HE ; Yidong FAN ; Weicai LI ; Baogang ZHU ; Ying CAO
Chinese Journal of Tissue Engineering Research 2025;29(5):1081-1090
BACKGROUND:Knee osteoarthritis(KOA)is a common chronic inflammatory disease that causes damage to joint cartilage and surrounding tissues.Immune cells play an important role in the immune-inflammatory response in knee osteoarthritis,but the specific mechanisms involved are still not fully understood. OBJECTIVE:To evaluate the potential causal relationship between 731 immune cell phenotypes and the risk of knee osteoarthritis using Mendelian randomization. METHODS:Summary statistics of genome-wide association studies(GWAS)for 731 immune cell phenotypes(from GCST0001391 to GCST0002121)obtained from the GWAS catalog and GWAS data for knee osteoarthritis from the IEUGWAS database(ebi-a-GCST007090)were used.Inverse variance-weighted method,MR-Egger regression,weighted median method,weighted mode method,and simple mode method were employed to investigate the causal relationship between immune cells and knee osteoarthritis.Sensitivity analyses were conducted to assess the reliability of the Mendelian randomization results.Reverse Mendelian randomization analysis was also performed using the same methods. RESULTS AND CONCLUSION:The forward MR analysis indicated significant causal relationships(FDR<0.20)between knee osteoarthritis and four immune cell phenotypes,namely CD27 on CD24+CD27+in B cells(OR=1.026,P=0.000 26,Pfdr=0.18),CD33 on CD33dim HLA DR-in myeloid cells(OR=1.014,P=0.000 50,Pfdr=0.18),and CD45RA+CD28-CD8br%CD8br in Treg cells(OR=1.001,P=0.000 78,Pfdr=0.18),and PDL-1 on monocytes in mononuclear cells(OR=0.952,P=0.000 98,Pfdr=0.18).These immune cell phenotypes showed direct positive or negative causal associations with the risk of knee osteoarthritis.Reverse Mendelian randomization analysis revealed no significant causal relationships(FDR<0.20)between knee osteoarthritis as exposure and any of the 731 immune cell phenotypes.The results of sensitivity analysis show that the P-values of the Cochran's Q test and the MR-Egger regression method for bidirectional Mendelian randomization were both greater than 0.05,indicating that there is no significant heterogeneity and pleiotropy in the causal effect analysis between immune cell phenotypes and knee osteoarthritis.To conclude,there may be four potential causal relationships between immune cell phenotypes,such as CD27 on CD24+CD27+cells,CD33 on CD33dim HLA DR-cells,CD45RA+CD28-CD8br%CD8br cells,and PDL-1 on monocytes,and knee osteoarthritis.These findings provide valuable clues for studying the biological mechanisms of knee osteoarthritis and exploring early prevention and treatment strategies.They also offer new directions for the development of intervention drugs.
2.Evidence-based research on the nutritional and health effects of functional components of tea
Zhijian HE ; Yuping LI ; Fan BU ; Jia CUI ; Xinwen BI ; Yuanjie CUI ; Zhiyuan GUO ; Ming LI
Shanghai Journal of Preventive Medicine 2025;37(2):190-198
As a traditional nutritional and healthy cash crop in China, tea has certain significance in promoting human health and preventing and controlling chronic diseases. Studies have shown that the nutritional health effect of tea is due to its rich functional components, mainly including tea polyphenols, tea pigments, tea polysaccharides, theanine, alkaloids and other bioactive substances. At present, researchers from the academic circles have continuously carried out animal and human experiments on the health effects of various functional components of tea, which has accumulated abundant research data and materials. Based on this, this article reviews the literature on the nutritional and health effects of the main functional components of tea, and adopts the method of evidence-based research to screen and extract relevant data for qualitative and quantitative meta-analysis. Subsequently, the nutritional health effects of the five functional components of tea, namely tea polyphenols, tea pigments, tea polysaccharides, theanine, and alkaloids, are summarized and outlined. Studies have shown that tea polyphenols, tea pigments, tea polysaccharides, theanine and alkaloids have different health effects and are expected to play their unique roles in promoting human health and preventing and controlling diseases.
3.Research on The Construction and Application of Multiple Fluorescence Amplification System for Three Kinds of Stains
Yi-Fan BAI ; He-Miao ZHAO ; Jing CHEN ; Hong-Di LIU ; Rui-Qin YANG ; Chong WANG
Progress in Biochemistry and Biophysics 2025;52(4):982-994
ObjectiveA multiplex amplification system was constructed based on the capillary electrophoresis platform for simultaneous detection of saliva, semen, and vaginal secretions using tissue-specific RNA markers. The aim of this study is to identify the tissue origin of suspicious body fluid stains found at crime scenes and determine whether the body fluid stains at the crime scene are one or several types among saliva, semen, and vaginal secretions. MethodsThirty saliva samples, forty semen samples, and forty vaginal secretion samples (half from 2015 and half from 2024) were collected from healthy adult volunteers. Through primer designing, system formulation, and PCR condition optimization, a multiplex fluorescent amplification system was constructed. The specificity, sensitivity, and detection ability for mixed samples of this system were investigated, and it was tested using real crime scene materials. In the primer design stage, to reduce the requirements for RNA template quality, the amplification products were set within 80-300 bp. In the system formulation stage, dominant and subordinate primers were mainly considered. By reducing the concentration of dominant primers and increasing that of subordinate primers, a capillary electrophoresis spectrum with an appropriate peak height ratio was finally obtained. Additionally, gradient experiments were designed to adjust the concentrations of PCR reagents and PCR amplification conditions, and multiple versions of DNA amplification enzymes were optimized to achieve the best experimental results. ResultsThrough statistical analysis, there was no significant difference in the capillary electrophoresis of the 3 types of body fluid samples from the two years (2015 and 2024), demonstrating that the sample preservation method in this study can preserve samples for a relatively long time. The composite amplification system constructed in this study exhibited high specificity for all 3 types of body fluid, with no cross-reactions between the markers of each type of body fluid. The minimum detection thresholds for the 3 types of body fluid reached 0.002 9, 0.001 5, and 0.42 mg/L, respectively. This system also had a high degree of discrimination for mixed samples, especially for semen-saliva mixtures, where each body fluid marker could still be successfully detected when the concentration ratio of semen to saliva was 100:1. Meanwhile, in the two actual cases presented in this article, the application of this composite amplification system performed outstandingly. ConclusionThe composite amplification detection system constructed in this study can achieve the correct screening of saliva, semen, and vaginal secretions, overcoming the problems such as low specificity and sensitivity of marker tests and unbalanced RFU values of each marker in previous studies. The specificity and sensitivity meet the practical work requirements, and the operation is simple. It provides an analytical and identification method for body fluid stains in actual case and is applicable to the identification of the tissue origin of biological evidence at crime scenes involving sexual assault, indecent assault, and other criminal acts. In the future, more types of body fluid markers will be screened to expand the types of body fluids detected by the system, and body fluid-specific cSNP and cInDel genetic markers will be introduced to infer the sources (individuals and types) of mixed and complex stains more accurately.
4.Preliminary development of Health Literacy Evaluation Scale for Chinese High School Students
GUO Shihao, ZHU Fan, ZHU Guiyin, QI Tiantian, YANG Shuang, HU Bin, WU Huiyun, JIANG He, MA Yinghua
Chinese Journal of School Health 2025;46(5):676-680
Objective:
To develop a health literacy evaluation scale for Chinese high school students, providing a tool for dynamic monitoring of health literacy among high school students and evaluating the effectiveness of health school construction.
Methods:
Through theoretical research, an evaluation index system for health literacy of Chinese high school students was constructed. Two rounds of Delphi expert consultations were conducted to quantitatively screen the items, and the item pool was revised based on expert opinions to compile the health literacy evaluation scale for Chinese students. Two focus group interviews were held to collect suggestions from health educators, high school teachers, and high school students regarding optimized scale length, question types, difficulty and wording of the scale. The scale was revised accordingly. A pilot survey was conducted in Beijing and Tianjin in November 2024, and the reliability and validity of the scale were evaluated based on the pilot survey data.
Results:
The response rate in both rounds of Delphi expert consultations was over 80%, and the expert authority coefficient was over 0.70. The expert opinions were highly concentrated, and the dispersion was small. The revised item pool based on expert opinions contained 39 items. The revised scale based on the suggestions and opinions collected from the focus group interviews had a moderate number of questions and difficulty level. The pilot survey obtained 800 valid responses, with the response rate of 89.39%. The Cronbach α coefficient of the scale was 0.911, χ 2/df =3.321, the root mean square error of approximation was 0.054, the adjusted goodness-of-fit index was 0.991 , and the factor loadings of some items were less than 0.40.
Conclusion
The health literacy evaluation scale for Chinese high school students demonstrates scientific rigor and practical applicability, with good internal consistency and structural validity.
5.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
6.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
7.Hepatitis C virus infection status among drug users in Baoshan District
CHEN Jianshuang ; ZHU Liming ; LE Boxin ; WANG Chengyi ; LIU Xiaofeng ; HE Fan
Journal of Preventive Medicine 2025;37(2):168-172
Objective:
To investigate the prevalence and influencing factors of hepatitis C virus (HCV) infection among drug users in Baoshan District, Shanghai Municipality, so as to provide insights into strengthening HCV intervention among drug users.
Methods:
Drug users under community management in Baoshan District from 2017 to 2023 were recruited. Demographic information, drug use behaviors, sexual behaviors and receipt of intervention service were collected through questionnaire surveys. Blood samples were collected for HCV antibody testing, and the prevalence of anti-HCV antibody was analyzed. Factors affecting the prevalence of anti-HCV antibody among drug users were analyzed using a multivariable logistic regression model.
Results:
A total of 2 801 drug users were surveyed, including 2 233 males (79.72%) and 568 females (20.28%). The majority of drug users were aged 40 to <60 years (1 663 drug users, 59.37%). The prevalence of anti-HCV antibody was 28.35%, showing an overall upward trend from 2017 to 2023 (P<0.05). Multivariable logistic regression analysis showed that females (OR=1.468, 95%CI: 1.169-1.844), 40 years and over (40 to <50 years, OR=2.441, 95%CI: 1.838-3.242; 50 to <60 years, OR=2.377, 95%CI: 1.787-3.161; 60 to 97 years, OR=1.637, 95%CI: 1.163-2.304), using traditional drugs (OR=2.488, 95%CI: 1.967-3.147) or mixed drugs (OR=2.950, 95%CI: 1.974-4.409), having injected drugs (not share needles, OR=3.649, 95%CI: 2.849-4.673; share needles, OR=3.532, 95%CI: 1.851-6.738) and never using condoms during sexual contacts with spouses/cohabitants in the past year (OR=1.975, 95%CI: 1.354-2.879) were associated with a higher prevalence of anti-HCV antibody; the educational level of high school/technical secondary school (OR=0.483, 95%CI: 0.280-0.835) or college and above (OR=0.280, 95%CI: 0.129-0.608) was associated with a lower prevalence of anti-HCV antibody.
Conclusions
The prevalence of anti-HCV antibody among drug users in Baoshan District showed an upward trend from 2017 to 2023. Gender, age, educational level, type of drugs, history of drug injection and never using condoms during sexual contacts with spouses/cohabitants were influencing factors for prevalence of anti-HCV antibody among drug users.
8.Clinical Observation of Guben Quyu Jiedu Prescription in Treating Nocturnal Hypoxemia of COPD Combined with OSAHS
Yi HE ; Ziyu LI ; Wenjiang ZHANG ; Jinzhu GAO ; Changzheng FAN ; Beibei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):146-153
ObjectiveTo observe the clinical efficacy and safety of Guben Quyu Jiedu prescription in treating nocturnal hypoxemia of chronic obstructive pulmonary disease (COPD) combined with Obstructive sleep apnea hypopnea syndrome ( OSAHS ) (deficiency of lung, spleen and kidney with blood stasis and toxicity). MethodsThe paper used a forward-looking, random double-blind, placebo-controlled design method to select 96 patients with COPD combined with OSAHS, and their traditional Chinese medicines (TCM) syndrome differentiation was deficiency of lung, spleen and kidney with blood stasis and toxicity. These patients were randomly divided into the observation group and the control group, with 48 cases in each group. Based on conventional Western medicine treatment, the observation group was treated with Guben Quyu Jiedu prescription and the control group was treated with traditional Chinese medicine placebo. Both courses of treatment were 90 days. Then the paper compared the changes in minimum pulse oxygen saturation (SpO2) during the night, apnea index (AHI), OSAHS efficacy evaluation, TCM syndrome efficacy evaluation, and TCM symptom score before and after treatment between the two groups. ResultsThere were 5 withdrawals in the observation group and 8 withdrawals in the control group, so 43 cases in the observation group and 40 cases in the control group completed the trial. Compared with the condition before treatment, the minimum SpO2 during the night and AHI in the observation group were significantly improved at night (P<0.01) and were better than those in the control group (P<0.01). OSAHS efficacy in the observation group was better than in the control group (χ2=7.085, P<0.05). In terms of TCM syndrome efficacy, the total effective rate was 81.40% (35/43) in the observation group, significantly higher than that in the control group, which was 15.00% (6/40) (χ2=36.78, P<0.01). The TCM symptom scores of the two groups were improved compared with the condition before treatment, and the effect of the two groups was similar in the four main symptoms of snoring, choking, lethargy, and cough. However, the observation group was better than the control group in 10 details such as dizziness, headache, chest tightness, chest pain, wheezing, dry mouth, and thirst (P<0.05). ConclusionUsing Guben Quyu Jiedu prescription combined with conventional Western medicine can treat COPD combined with OSAHS hypoxemia at night (deficiency of lung, spleen and kidney with blood stasis and toxicity). In this way, the minimum pulse oxygen saturation (SpO2) of patients, the level of disease control, and the quality of life of patients can be improved, and the clinical symptoms can be relieved.
9.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine
Ziyi WANG ; Xingyu FAN ; Yuzhi JIA ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):230-236
Type 2 diabetes mellitus (T2DM) and hypertension are common and frequent chronic non-communicable diseases, which often coexist in clinical practice, resulting in a large number of cardiovascular events and deaths, and their case fatality rate far exceeds that of other factors such as dyslipidemia and obesity. Based on the diagnostic standards, guidelines, and animal model evaluation methods of T2DM with hypertension at home and abroad, this study summarized, evaluated, and analyzed the characteristics of the existing animal models of T2DM with hypertension based on the clinical symptoms in traditional Chinese and Western medicine. The animal models showing high fitting degrees with the clinical symptoms in Western medicine are mainly established by injection of streptozocin (STZ) in SHR rats in the surgical induction and chemical induction methods and feeding a high-fat and high-salt diet combined with STZ injection in SD rats in the dietary induction methods. The models showcasing high fitting degrees with the clinical symptoms in traditional Chinese medicine (TCM) are mainly established by the surgical induction method. Considering the fitting degrees and the advantages and disadvantages, the ideal modeling method for T2DM with hypertension is the two-kidney, one clip (2K1C) method (a surgical induction method) combined with feeding a high-fat and high-sugar diet and STZ injection. However, the available models lack the characteristics of TCM and the evaluation indicators have poor specificity. This study found that there are few animal models of T2DM with hypertension considering the characteristics of both disease and syndrome, which may be related to the identification and attribution of TCM syndromes in animal macroscopic information. In view of this problem, it is suggested that the evaluation criteria should be established and improved for the animal models combining disease and syndrome, which can help to evaluate the fitting degree of the pathological characteristics of different syndromes in the animal models of T2DM with hypertension. In this way, ideal animal models of T2DM with hypertension can be established to simulate the disease occurrence and development in the human body. The animal models are expected to provide an ideal approach for the further research on the pathogenesis of T2DM and its prevention and treatment with TCM, which is of great significance for the treatment and prevention of T2DM with hypertension and the prognosis of its complications. At the same time, breakthroughs in the basic syndrome models of comorbidities are expected to lay a foundation for the leapfrog development of TCM research.
10.Treatment of IgA Nephropathy by Tonifying Kidney and Invigorating Spleen as Well as Detoxifying and Relieving Sore-throat Based on PIgR-CR1-mediated Mucosal-renal Axis
Fan LI ; Hongan WANG ; He NAN ; Mingyu HE ; Chengji CUI ; Yinping WANG ; Yutong LIU ; Shoulin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):237-244
Immunoglobulin A nephropathy (IgAN) is the primary glomerulonephritis with the highest incidence rate in the world. It is also the main cause of end-stage renal disease (ESRD) in China, which has brought heavy economic burden to the society and patient families. Traditional Chinese medicine (TCM) has certain advantages in treating IgAN. In TCM, IgAN is classified into consumptive disease, hematuria, and edema categories, with the location in the kidney and involving the lung, liver, and spleen. Professor Ren Jixue, a master of TCM, believes that kidney deficiency and spleen deficiency are the root causes of IgAN, and the throat is the source of the disease. He proposed the theory of throat-kidney correlation and used the method of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat to treat IgAN, achieving significant therapeutic effects. Studies have shown that IgAN is closely related to mucosal immune defense. IgAN patients often experience recurrent and gradually worsening symptoms due to mucosal infections, and polymeric Ig receptor (PIgR) is an important component of mucosal defense function. The lack of PIgR leads to the accumulation of IgA molecules in the mucosal lamina propria, and the molecules enter the bloodstream in large quantities and ultimately deposit in the kidneys, causing kidney damage. Complement regulatory protein complement receptor type 1 (CR1) exists on red blood cells and glomeruli and has the function of inhibiting the activation and differentiation of B cells, clearing immune complexes, and inhibiting excessive activation of the complement system. Therefore, regulating the immune defense function through the mucosal-renal axis mediated by PIgR-CR1 will be an important target for preventing and treating IgAN. Based on the theory of throat-kidney correlation, this article explores the effects and molecular mechanisms of tonifying kidney and invigorating spleen as well as detoxifying and relieving sore-throat in preventing and treating IgAN by regulating the mucosal-kidney axis mediated by PIgR-CR1. It provides effective theoretical support and a scientific basis for TCM prevention and treatment of IgAN based on the theory of throat-kidney correlation.


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