1.Role and mechanism of mitochondrial calcium uniporter in the cytoskeleton of pancreatic ductal epithelial cells in a mouse model of acute pancreatitis
Qiaofeng CHEN ; Qingzi FU ; Huiying YANG ; Junbo HONG ; Liang ZHU ; Zhenzhen YANG ; Guodu TANG ; Shiyu ZHANG
Journal of Clinical Hepatology 2026;42(2):400-408
ObjectiveTo investigate the effect of mitochondrial calcium uniporter (MCU) on the cytoskeleton of pancreatic ductal epithelial cells in a mouse model of acute pancreatitis (AP) induced by caerulein (CAE), to analyze the role of MCU in the development of AP, and to provide a theoretical basis for clinical treatment. MethodsIn the in vivo experiment, wild-type male C57BL6/J mice, aged 4 weeks, were randomly divided into control group and AP group, with 6 mice in each group. The mice in the AP group were given intraperitoneal injection of CAE to establish a model of AP, and those in the control group were given intraperitoneal injection of an equal volume of normal saline. Serum and pancreatic tissue samples were collected after 24 hours of modeling. HE staining was used to observe pancreatic histopathological changes; Western Blot was used to measure the expression levels of MCU, glutathione peroxidase 4 (GPX4), and acyl-CoA synthetase long chain family member 4 (ASCL4); kits were used to measure the serum level of amylase. In the in vitro experiment, the human pancreatic ductal epithelial cell line HPDE6-C7 was co-cultured with CAE for 24 hours to establish an in vitro AP model, and the cells were divided into control group, CAE group, RR (an MCU activity inhibitor) group, CAE+RR group, Fer-1 (an ferroptosis inhibitor) group, CAE+Fer-1 group, Erastin (an ferroptosis inducer) group, and CAE+Erastin group. CCK-8 assay was used to observe the influence of different agents on cell viability; Western Blot was used to measure the expression levels of MCU, GPX4, and ASCL4; immunofluorescence assay was used to measure reactive oxygen species (ROS), actin cytoskeleton, and monolayer permeability; kits were used to measure the concentrations of malondialdehyde (MDA), glutathione (GSH), Fe2+, and total iron. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for comparison between two groups. ResultsIn the in vivo experiment, compared with the control group, the AP group had significant increases in pancreatic histopathological score, the serum level of amylase, and the expression levels of MCU and ASCL4, as well as a significant reduction in the expression of GPX4 (all P<0.05). In the in vitro experiment, compared with the control group, the CAE group had significant increases in the expression levels of MCU and ASCL4, a significant reduction in the expression of GPX4, and significant increases in the concentrations of Fe2+, total iron, and MDA, the green fluorescence intensity of ROS, and monolayer permeability, as well as a significant reduction in the concentration of GSH (all P<0.05), with the presence of actin cytoskeleton disruption. Compared with the CAE group, the CAE+RR group had a significant increase in the expression level of GPX4, a significant reduction in the expression level of ASCL4, and significant reductions in the concentrations of Fe2+, total iron, and MDA, the green fluorescence intensity of ROS, and monolayer permeability and a significant increase in the concentration of GSH (all P<0.05), with alleviation of actin cytoskeleton disruption. Compared with the CAE group, the CAE+Fer-1 group had significant reductions in the concentrations of Fe2+, total iron, and MDA, the green fluorescence intensity of ROS, and monolayer permeability and a significant increase in the concentration of GSH (all P<0.05), with alleviation of actin cytoskeleton disruption. Compared with the CAE group, the CAE+Erastin group had significant increases in the concentrations of Fe2+, total iron, and MDA, the green fluorescence intensity of ROS, and monolayer permeability and a significant reduction in the concentration of GSH (all P<0.05), with aggravation of actin cytoskeleton disruption. ConclusionDuring the onset of AP, MCU mediates oxidative stress-induced ferroptosis and leads to the disruption of the pancreatic ductal epithelial barrier, which may be one of the possible pathogeneses of AP.
2.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.
3.Source and carcinogenesis risk assessment of PM2.5-bound polycyclic aromatic hydrocarbons in Harbin, China
Zhen KANG ; Yang LIU ; Rao FU ; Xiaobo LIU ; Qianqi HONG ; Fei YAN
Journal of Public Health and Preventive Medicine 2026;37(4):6-10
Objective To analyze the pollution characteristics of PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) during the non-heating period, heating period, and haze period in Harbin, and infer their possible sources, and to evaluate their impact on population carcinogenesis. Methods From 2020 to 2022, sampling points were set up in different districts of Harbin. PM2.5 samples were regularly collected every month to analyze the contents of 10 types of PM2.5-bound 4-6 rings PAHs. The pollution characteristics of PAHs were analyzed during different monitoring periods (non-heating period, heating period, and haze period). The excess carcinogenesis risks of PM2.5-bound PAHs were assessed according to the Technical Specifications for Health Risk Assessment of Ambient Air Pollution and the U. S. Environmental Protection Agency (US EPA) risk assessment method. The characteristic ratio method and the positive matrix factorization (PMF) model were used to infer the sources of PAHs. Results The median mass concentrations of ambient PM2.5-bound 4-6 rings PAHs (ΣPAHs) during the non-heating period, heating period, and haze period were 6.44 ng/m3, 37.85 ng/m3, and 106.79 ng/m3, respectively. During the heating season and haze period, the concentrations of benzo[a]anthracene, benzo[k]fluoranthene, pyrene and fluoranthene were relatively high. The excess carcinogenic risks for ASF>16, ASF2-16 and ASF<2 caused by exposure to PM2.5-bound 4-6rings PAHs during the heating season were 2.34×10-6, 1.82×10-6, and 0.88×10-6, respectively, while the excess carcinogenic risks for the whole population during the heating season and haze period were 5.05×10-6 and 1.75×10-6, respectively. The results of the two source methods showed that the main characteristic elements during the heating season were fluoranthene, pyrene, benzo[a]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, and benzo[a]pyrene. According to the emission source standards, it was determined that the sources were mainly coal and biomass combustion, accompanied by traffic source emissions. Conclusion In Harbin, the PM2.5-bound 4-6 rings PAHs during the haze period is significantly higher than that during the heating period. The pollution is mainly from coal combustion emissions, accompanied by continuous traffic source pollution. The exposure to PAHs during the heating period poses a potential carcinogenic risk to the population.
4.Investigations of tick habitats and potential pathogens carried in urban environments of Jiangsu Province
Zhi-ming WU ; Ye TIAN ; Wei-fang YANG ; Hong-na CHEN ; Jian GAO ; Hui LIU ; Yu-fu ZHANG ; Gan CAO ; Hong-liang CHU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(3):192-197
Objective To investigate the species composition, distribution, density, and pathogen-carrying status of host-seeking ticks in urban environments of Jiangsu Province, and to provide a scientific basis for the prevention and control of tick-borne diseases in urban settings. Methods From April to September 2023, a survey on host-seeking ticks was conducted in three types of habitats (city parks, residential areas, and street greenbelts) across 54 counties (cities, districts) of 13 prefecture-level cities in Jiangsu Province by using the flagging method. RStudio 4.4.3 (Windows version) was employed to perform chi-square test analysis on the species composition of ticks across different months, and Friedman test (for multiple paired samples) was applied to analyze monthly changes in the average tick density index among different habitats. Quantitative real-time PCR was performed to detect pathogens in the captured ticks. Results A total of 863 host-seeking ticks were captured from 54 habitats in 24 counties (cities, districts) of 11 prefecture-level cities (Nanjing, Wuxi, Changzhou, Suzhou, Nantong, Huai'an, Yancheng, Yangzhou, Zhenjiang, Taizhou, and Suqian) in Jiangsu Province, whereas no ticks were captured in Xuzhou and Lianyungang. The collected ticks belonged to three species, with Haemaphysalis longicornis being the dominant species (accounting for 82.62%), followed by Haemaphysalis flava and Hae. phasiana. The average density index of ticks in positive habitats was 3.20 ticks/ (flag·100 m). In terms of tick density among prefecture-level cities, Wuxi had the highest density[13.55 ticks/(flag·100 m)], whereas Nanjing and Taizhou had the lowest[both,0.20 ticks/(flag·100 m)]. With respect to the types of positive habitats,46 positive city parks,7 positive residential areas, and 1 positive street greenbelt were found, with the average tick density index being 3.46, 1.86, and 3.60 ticks/flag · 100 m, respectively. No statistically significant differences were observed in the monthly variations in the average tick density index among different habitats (P>0.05). Pathogen detection showed no Bandavirus dabieense, Rickettsia, or Borrelia burgdorferi in the collected ticks. Conclusions Host-seeking ticks have established populations in urban environments across most prefecture-level cities in Jiangsu Province, with Hae. longicornis identified as the dominant species. City parks serve as the primary breeding habitats for these ticks. Strengthening tick surveillance and control measures in densely populated and frequently visited areas, such as city parks and residential neighborhoods, is crucial for the effective prevention and control of urban tick-borne diseases.
5.Changes in Astronaut Brain Function and Behavior Associated With Habitation on Low-Earth-orbit Space Stations
Hong-Ting JIANG ; You-Fu LUO ; Zheng-Jiang YANG ; Yuan YAO ; De-Zhong YAO ; Ke CHEN
Progress in Biochemistry and Biophysics 2026;53(10):2786-2796
During habitation on low-Earth-orbit (LEO) space stations, astronauts are exposed to a combination of orbital microgravity, space radiation, an enclosed and artificially controlled cabin environment, altered sleep-wake rhythms, and sustained operational and psychosocial demands. These factors can modify sensorimotor inputs, body-fluid distribution, arousal state, and task-related neural processing, thereby affecting brain function and behavior. Because evidence from real spaceflight remains limited by small samples, heterogeneous mission durations, and different measurement time points, this review integrates findings from real human spaceflight with relevant ground-based analog studies while treating real orbital studies as the primary source of evidence. We focus on electroencephalography (EEG) and event-related potentials (ERPs), structural and functional neuroimaging, and sensorimotor and cognitive outcomes, with particular attention to the direction, anatomical distribution, temporal course, and possible physiological significance of the reported changes. EEG studies indicate that long-duration spaceflight is associated with increased resting-state beta activity, particularly in sensorimotor and frontotemporal regions, together with state-dependent alterations in beta-band functional connectivity. In contrast, alpha source power and functional connectivity associated with the default mode network are reduced during long-duration missions, and some of these effects may persist into the early postflight period. Task-related electrophysiological findings further suggest that sustained mental workload can weaken frontocentral theta-temporoparietal gamma phase-amplitude coupling, whereas in-flight decision-making is accompanied by reduced P300 amplitude and reorganization of feedback-related potentials. Short-duration missions, however, have shown relative preservation of posterior dominant rhythms and some ERP measures, indicating that mission duration, recording state, and task demands substantially influence the observed electrophysiological phenotype. Neuroimaging provides complementary evidence at structural and network levels. Long-duration spaceflight has been associated with upward brain displacement, ventricular and cerebrospinal fluid expansion, regional gray- and white-matter remodeling, and alterations in white-matter structural connectivity. Functional magnetic resonance imaging (fMRI) studies further indicate reorganization of vestibular-sensorimotor, visual, and default mode networks. Some network changes recover after return to Earth, whereas others may remain detectable for months. Importantly, most MRI measurements are obtained after landing rather than in orbit; therefore, postflight findings may reflect a mixture of in-flight adaptation, the rapid transition back to 1 g, and subsequent readaptation rather than a single spaceflight effect. Behavioral evidence is most consistent for sensorimotor function. Early after return, astronauts frequently show impaired postural control, gait, spatial orientation, and coordination, consistent with reweighting among vestibular, visual, and proprioceptive information. By comparison, simple cognition and some critical operational tasks are often preserved. More subtle or high-load processes-including sustained attention, feedback evaluation, temporal processing, error monitoring, and metacognitive calibration may be more sensitive than global cognitive performance. This dissociation between neural change and preserved behavior suggests that altered brain activity should not automatically be interpreted as functional deterioration. Integrating the available modalities, we propose that LEO space-station habitation is better characterized by system-specific and stage-dependent neural adaptation than by a generalized increase or decline in brain function. The most coherent cross-modal pattern involves sensorimotor reorganization: reduced gravitational reference and weight-bearing feedback under microgravity may drive reweighting of vestibular, visual, and proprioceptive inputs, accompanied by changes in beta activity and vestibular-sensorimotor networks and followed by transient postflight sensorimotor deficits. A second major process involves fluid-related structural remodeling, in which cephalad fluid shifts and altered hydrostatic gradients may contribute to changes in cerebrospinal fluid spaces, ventricular volume, and brain tissue configuration. Resting-state and cognitive electrophysiological changes likely represent additional adjustments in network regulation and resource allocation, but their functional interpretation remains more dependent on sleep, workload, recording conditions, and individual differences. Future studies should move beyond isolated pre-post comparisons and group averages toward standardized longitudinal designs spanning preflight, multiple in-flight time points, and postflight recovery. Synchronized assessment of brain function, behavior, sleep, and key environmental parameters should be used to characterize individual adaptation trajectories and determine which neural changes reflect successful compensation, which predict delayed recovery, and which have genuine value for brain-health risk prediction and individualized countermeasures.
6.Predictive value of pre-treatment circulating tumor DNA genomic landscape in patients with relapsed/refractory multiple myeloma undergoing anti-BCMA CAR-T therapy: Insights from tumor cells and T cells
Rongrong CHEN ; Chunxiang JIN ; Kai LIU ; Mengyu ZHAO ; Tingting YANG ; Mingming ZHANG ; Pingnan XIAO ; Jingjing FENG ; Ruimin HONG ; Shan FU ; Jiazhen CUI ; Simao HUANG ; Guoqing WEI ; He HUANG ; Yongxian HU
Chinese Medical Journal 2025;138(19):2481-2490
Background::B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T (CAR-T) therapy yield remarkable responses in patients with relapsed/refractory multiple myeloma (R/RMM). Circulating tumor DNA (ctDNA) reportedly exhibits distinct advantages in addressing the challenges posed by tumor heterogeneity in the distribution and genetic variations in R/RMM.Methods::Herein, the ctDNA of 108 peripheral blood plasma samples from patients with R/RMM at the First Affiliated Hospital, School of Medicine, Zhejiang University was thoroughly investigated before administration of anti-BCMA CAR-T therapy to establish its predictive potential. Flow cytometry is used primarily to detect subgroups of T cells or CAR-T cells.Results::In this study, several tumor and T cell effector-mediated factors were considered to be related to treatment failure by an integrat analysis, including higher percentages of multiple myeloma (MM) cells in the bone marrow ( P = 0.0125), lower percentages of CAR-T cells in the peripheral blood at peak ( P = 0.0375), and higher percentages of CD8 + T cells ( P = 0.0340). Furthermore, there is a substantial correlation between high ctDNA level (>143 ng/mL) and shorter progression-free survival (PFS) ( P = 0.007). Multivariate Cox regression analysis showed that high levels of ctDNA (>143 ng/mL), MM-driven high-risk mutations (including IGLL5 [ P = 0.004], IRF4 [ P = 0.024], and CREBBP [ P = 0.041]), number of multisite mutations, and resistance-related mutation ( ERBB4, P = 0.040) were independent risk factors for PFS. Conclusion::Finally, a ctDNA-based risk model was built based on the above independent risk factors, which serves as an adjunct non-invasive measure of substantial tumor burden and a prognostic genetic feature that can assist in predicting the response to anti-BCMA CAR-T therapy.
7.The mediating role of anxiety/depression emotions between sleep quality and cognitive function in adolescents with attention deficit hyperactivity disorder
Anxiu ZHOU ; Yanhong FU ; Ling QIN ; Hairun LIU ; Hong ZHANG ; Siyan HUANG ; Lixian YANG ; Chunling YAO
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(8):692-697
Objective:To explore the mediating role of anxiety/depression emotions between sleep quality and cognitive function in adolescents with attention deficit hyperactivity disorder(ADHD).Methods:A cross-sectional study design was adopted, involving 204 ADHD adolescents aged 12-18 who were treated between January 2021 and November 2023.All participants were assessed using the Pittsburgh sleep quality index(PSQI)for sleep quality, the self-rating anxiety scale(SAS) and self-rating depression scale(SDS) for emotional states.Four cognitive information processing processes(planning, simultaneous processing, attention, and successive processing) were evaluated by the Das-Naglieri cognitive assessment system(DN: CAS). Data were statistically analyzed using SPSS 23.0 and Zstats software, including descriptive statistics, Spearman correlation analysis, and mediation effect analysis.Results:Among ADHD adolescents, girls exhibited significantly higher rates of sleep disturbance(71.59%(63/88) vs 43.97%(51/116), χ2=15.490, P<0.001)and depressive emotion(47.73%(42/88) vs 33.62%(39/116), χ2=4.159, P=0.041)compared to boys.High school students had a significantly higher rate of sleep disturbance than middle school students(64.84%(59/91) vs 48.67%(55/113), χ2=5.341, P=0.021). Spearman correlation analysis revealed that sleep quality(8.00(6.00, 11.00)) in ADHD adolescents was significantly and positively correlated with anxiety(38.00(32.00, 46.00); r=0.504, P<0.01) and depression(46.00(39.00, 54.00); r=0.427, P<0.01). And sleep quality, anxiety and depression were significantly and negatively correlated with the DN: CAS total score(109.5(91.25, 123.75); r=-0.158--0.237, P<0.05). Mediation analysis indicated that anxiety mediated the relationship between sleep quality and attention function(indirect effect β=-0.159, Bootstrap 95% CI=-0.287--0.046). Conclusion:ADHD adolescents exhibit complex interactions among sleep quality, emotion, and cognitive function, sleep quality indirectly affects attention function through anxiety.
8.Visualization Analysis on Research Literature about Astragalus Polysaccharides from 2013 to 2023
Hong LI ; Liu LI ; Qiuqing HUANG ; Shiyao YANG ; Junju ZOU ; Fan XIAO ; Qin XIANG ; Xiu LIU ; Yanling FU ; Yongjun WU ; Rong YU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(6):73-79
Objective To analyze the research status and hotspots in the field of astragalus polysaccharides;To provide references for further research.Methods Research literature about astragalus polysaccharides was retrieved from CNKI,Wanfang Data,VIP,PubMed,and Web of Science databases from 1st,Jan.2013 to 1st,July 2023.NoteExpress 3.7 software was used to manage the literature and ultimately establish a database.Excel 2019,CiteSpace 6.2.2R and VOSviewer 1.6.18 were used to visually analyze the publication volume,authors,institutions,and keywords of the included literature.Results A total of 2 462 articles were included,with 1 284 Chinese articles and 1 178 English articles.The main research institutions were Gansu University of Chinese Medicine,Shandong University of Traditional Chinese Medicine,and Beijing University of Chinese Medicine.The core authors of Chinese literature were Liu Yongqi,Wang Hongxin,Lu Meili,etc.The core authors of English literature included Zhang Wei,Li Ke,Yang Xiaojun,etc.High-frequency keywords of Chinese literature included Astragali Radix,rats,polysaccharides,cell apoptosis,and oxidative stress,etc.High frequency keywords in English literature included expression,in vitro,oxidative stress,apoptosis,etc.Conclusion The research on astragalus polysaccharides focuses on their pharmacological effects and mechanisms.Intestinal flora,immune regulation,autophagy and apoptosis are the hot action mechanisms in this field.The focus of disease research involves tumor and diabetes,and antiviral,anti infection and other pharmacological effects are the research trend.
9.Influencing factors of responsive caregiving among infant mothers in Weifang City
Ziyuan FU ; Fei YANG ; Mo ZHOU ; Xinxuan LI ; Ruoning WANG ; Ningxuan CUI ; Jing HUANG ; Yixin ZHANG ; Huafang JIANG ; Yuhua GUO ; Hong ZHOU
Journal of Peking University(Health Sciences) 2025;57(3):481-486
Objective:To describe the current status of responsive caregiving behavior of infant mothers,to analyze their influencing factors and pathways using the information-motivation-behavioral skills(IMB)model,and to provide a basis for further interventions related to responsive caregiving be-haviors and comprehensive promotion of early childhood development.Methods:This study was a cross-sectional survey using convenience sampling.Questionnaires were used to collect basic information about mothers and their infants,as well as data on mothers' responsive caregiving behavior,knowledge of re-sponsive caregiving,social support,and parenting self-efficacy.Multivariate linear regression models were employed to analyze the influencing factors of responsive caregiving behavior,and structural equa-tion modeling was used to analyze the pathways of these influencing factors.The criterion for inadequate responsive caregiving is defined as scores not exceeding the lower quartile(P25)of the total score.Results:Among 510 mothers of aged 0-12 months infants in Weifang City,the average score for respon-sive caregiving behavior was 16.41±3.99.The proportion of inadequate responsive caregiving was 25.7%.Mothers in the insufficient responsive caregiving group had lower scores in knowledge(7.70±1.41),social support(57.92±15.16),and parenting self-efficacy(30.36±6.48)compared with those in the sufficient group,with statistically significant differences(P<0.001).Logistic regres-sion analysis indicated that the influencing factors for responsive caregiving included the level of know-ledge about responsive parenting[adjusted OR(aOR)=0.795,95%CI:0.566-0.838],social support(aOR=0.979,95%CI:0.961-0.996),and parenting self-efficacy(aOR=0.894,95%CI:0.857-0.932).Structural equation modeling revealed that knowledge of responsive caregiving(β=0.089,P=0.031),social support(β=0.153,P=0.001),and parenting self-efficacy(β=0.296,P<0.001)were directly related to responsive caregiving behavior.Additionally,knowledge of responsive caregiving indirectly affected responsive caregiving behavior through parenting self-efficacy(β=0.095,P=0.014),and social support indirectly affected responsive caregiving behavior through parenting self-efficacy(β=0.497,P<0.001).Conclusion:The current level of responsive caregiving behavior among mothers of 0-1-year-old infants in Weifang City is not satisfactory.Future development of responsive care-giving interventions should focus on providing caregivers with relevant knowledge of responsive caregiving based on their needs.Additionally,it is essential to offer social support from multiple aspects to enhance caregivers' parenting self-efficacy,thereby promoting improvements in responsive caregiving behavior.
10.An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design.
Cheng ZHANG ; Yi-Sen NIE ; Chuan-Tao ZHANG ; Hong-Jing YANG ; Hao-Ran ZHANG ; Wei XIAO ; Guang-Fu CUI ; Jia LI ; Shuang-Jing LI ; Qing-Song HUANG ; Shi-Yan YAN
Journal of Integrative Medicine 2025;23(2):138-144
Progressive pulmonary fibrosis (PPF) is a progressive and lethal condition with few effective treatment options. Improvements in quality of life for patients with PPF remain limited even while receiving treatment with approved antifibrotic drugs. Traditional Chinese medicine (TCM) has the potential to improve cough, dyspnea and fatigue symptoms of patients with PPF. TCM treatments are typically diverse and individualized, requiring urgent development of efficient and precise design strategies to identify effective treatment options. We designed an innovative Bayesian adaptive two-stage trial, hoping to provide new ideas for the rapid evaluation of the effectiveness of TCM in PPF. An open-label, two-stage, adaptive Bayesian randomized controlled trial will be conducted in China. Based on Bayesian methods, the trial will employ response-adaptive randomization to allocate patients to study groups based on data collected over the course of the trial. The adaptive Bayesian trial design will employ a Bayesian hierarchical model with "stopping" and "continuation" criteria once a predetermined posterior probability of superiority or futility and a decision threshold are reached. The trial can be implemented more efficiently by sharing the master protocol and organizational management mechanisms of the sub-trial we have implemented. The primary patient-reported outcome is a change in the Leicester Cough Questionnaire score, reflecting an improvement in cough-specific quality of life. The adaptive Bayesian trial design may be a promising method to facilitate the rapid clinical evaluation of TCM effectiveness for PPF, and will provide an example for how to evaluate TCM effectiveness in rare and refractory diseases. However, due to the complexity of the trial implementation, sufficient simulation analysis by professional statistical analysts is required to construct a Bayesian response-adaptive randomization procedure for timely response. Moreover, detailed standard operating procedures need to be developed to ensure the feasibility of the trial implementation. Please cite this article as: Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY. An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design. J Integr Med. 2025; 23(2): 138-145.
Female
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Humans
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Male
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Bayes Theorem
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Disease Progression
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Drugs, Chinese Herbal/therapeutic use*
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Medicine, Chinese Traditional/methods*
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Pulmonary Fibrosis/therapy*
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Quality of Life
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Randomized Controlled Trials as Topic
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Research Design
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Adaptive Clinical Trials as Topic


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