1.Traditional Chinese medicine for recurrent pregnancy loss: A systematic review and network meta-analysis
Zilin LONG ; Houyu ZHAO ; Fengqi LIU ; Meng ZHANG ; Junchang LIU ; Siyan ZHAN ; Feng SUN
Science of Traditional Chinese Medicine 2026;4(1):87-95
Background: Recurrent pregnancy loss undermines the physical and mental health of women. Recent randomized controlled trials have reported some effects of traditional Chinese medicine (TCM); however, whether various TCM methods have different effectiveness remains unclear. Objective: To comprehensively evaluate the efficacy and adverse events of TCM for patients with RPL and to explore whether various TCM methods have different effectiveness. Methods: Ten databases were searched up to May 27, 2024. The risk of bias was assessed using the RoB2 tool. The certainty of the evidence was evaluated using the grading of Recommendations, Assessment, Development, and Evaluation tool. Pairwise and network analyses were conducted using Stata 18.0. Results: A total of 47 randomized controlled trials enrolling 6678 women with RPL were included. Pairwise analysis showed that use of TCM had a significantly lower miscarriage rate (RR 0.50 [95% CI 0.45, 0.55]), lower preterm birth rate (RR 0.81 [95% CI 0.67, 0.98), and lower adverse event rate (RR 0.46 [95% CI 0.37, 0.58]). Moreover, use of TCM was associated with a higher alive-fetus rate (RR 1.21 [95% CI 1.15, 1.26]), live-birth rate (RR 1.20 [95% CI 1.15, 1.25]), and full-term rate (RR 1.37 [95% CI 1.23, 1.53]) compared with nonuse of TCM. Network analysis demonstrated that Bushenshugan combined with conventional Western medicine was ranked the best for the reduction of miscarriage rate. Discussion: Use of TCM is more likely to improve pregnancy outcomes and reduce adverse events compared with nonuse of TCM in patients with RPL. Different TCM methods have differences in reducing the miscarriage rate. The Bushenshugan method might be a potential optimal TCM therapy, but more high-quality evidence is needed to further validate and evaluate the efficacy and safety.
2.Epidemiological characteristics of febrile seizure among children under 6 years old in Ningbo City from 2015 to 2021
Guangxu LIU ; Liang ZHANG ; Houyu ZHAO ; Siwei DENG ; Junting YANG ; Ning LI ; Rui MA ; Yan HE ; Guozhang XU ; Zhike LIU ; Siyan ZHAN
Journal of Peking University(Health Sciences) 2025;57(3):584-591
Objective:To describe the epidemiological characteristics and changes of febrile seizure(FS)among children under 6 years old in Ningbo City,Zhejiang Province from 2015 to 2021.Methods:Based on the Ningbo Regional Health Information Platform,a dynamic cohort was established using vacci-nation registration information,and the cases of FS were identified by the diagnostic results of Chinese terms or International Classification of Diseases 10th revision(ICD-10)R56.0 code in the electronic medical records.The first visit of FS during the observation period was defined as a new case,and a re-currence case was defined as the case with a visit interval of more than 7 days.The 95%confidence in-terval(CI)of FS incidence density was calculated by the Poisson distribution.Results:From January 2015 to June 2020,there were 1.3 million children under 6 years old in Ningbo,with male accounting for 52.87%.The median follow-up time was 2.83(1.55-4.00)years.During the follow-up period,12 776 new onset cases had FS,with more males than females,with an overall incidence density of 4.34(95%CI:4.27-4.40)/1 000 person-years and a recurrence rate of 21.63%.There was a higher inci-dence density in children who were male,born in Ningbo and of non-mobility.The incidence density of FS was higher in urban areas than in rural and rural-urban fringe areas,and the incidence density was different among districts and counties.The peak density was found in children aged 18-23 months[8.42(95%CI:8.11-8.74)/1 000 person-years].From 2015 to 2019,the incidence density in-creased with calendar year(Ptrend<0.001),and the highest was 5.62(95%CI:5.43-5.81)/1 000 person-years.The incidence density of FS decreased significantly during the period between 2020 and 2021.The incidence density was higher in winter.Conclusion:From 2015 to 2019,the overall inci-dence density of FS in children under 6 years old in Ningbo City presented an increasing trend.More at-tention should be paid to the health education,the improvement of the health maintenance model,the en-hancement of the cognition of FS,the identification and treatment of FS among high-risk population and regions so as to prevent its recurrence and reduce the disease burden during the corona virus disease 2019(COVID-19)epide-mic.
3.Interpretation of the Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition)(Ⅲ):comparison of global guidelines
Jinan YAN ; Yunxiao WU ; Xiaolu NIE ; Houyu ZHAO ; Siyan ZHAN ; Feng SUN
Chinese Journal of Pharmacoepidemiology 2025;34(3):241-259
It has been not been updated for nearly 5 years since the Pharmacoepidemiology Professional Committee of the Chinese Pharmaceutical Association released the Guide on Methodological Standards in Pharmacoepidemiology in China(1st edition)in 2019,and an update is urgently needed.This study adopts a systematic review approach to comprehensively search for global pharmacoepidemiology methodological guidelines and analyze their development status.By extracting the frameworks and key elements of the guidelines,the China's guide was compared with other included guidelines,its shortcomings were analysed,and pragmatic and feasible suggestions for improvement in line with China's national conditions,were proposed in order to provide references for updating China's guide.A systematic search was conducted by searching PubMed,Embase,CNKI,WanFang Data and 17 official websites of international academic organizations for pharmacoepidemiology and regulatory agencies from countries or regions including Europe,the United States,Japan,and China,etc.,and relevant guidelines or standards were screened based on predefined inclusion and exclusion criteria,resulting in the inclusion of 33 methodological guidelines or standards for pharmacoepidemiological studies.A qualitative synthesis approach was then employed to extract core elements from the guidelines through thematic categorization and content summarization,followed by a descriptive comparative analysis.The results indicate that the 1st edition of the China's guide provides relatively comprehensive guidance on adverse drug reaction reporting and publication of research findings.However,there are gaps in study protocol development,data analysis during study implementation,study reporting,and specific study scenarios.By integrating and drawing upon the latest international pharmacoepidemiology methodology guidelines while balancing comprehensiveness,practicality,and user-friendliness,this study provides recommendations for updating the China's guide.
4.Research advances in chemokines and their receptors in cognitive disorders
Houyu ZHAO ; Kun LIANG ; Zeyuan YU ; Wei DING ; Yukun WEN ; Jianming HUANG ; Yiqun FANG
Journal of Chongqing Medical University 2025;50(7):920-925
Cognitive impairment is the main clinical manifestation of many nervous system diseases such as stroke,multiple sclerosis,and neurodegeneration,and neuroinflammation is one of the key mechanisms for the onset of cognitive disorders.Chemokines are a class of highly conserved small-molecule secretory proteins that bind to the corresponding chemokine receptors located on cell mem-brane,activating downstream signaling pathways and playing an important role in cell migration,proliferation,differentiation,and sur-vival.In the central nervous system,chemokines and their receptors are involved in immune response and can exert a certain regulatory effect on neuroinflammation.This article reviews the research advances in chemokines and their receptors in cognitive disorders,in or-der to provide new insights and targets for the early diagnosis and treatment of related diseases.
5.Correlation analysis of genetic and environmental factors with clinical characteristics of pediatric upper urinary tract calculi
Youquan ZHAO ; Xiaochuan WANG ; Boyu YANG ; Chen NING ; Houyu ZHOU ; Huimin ZHAO ; Xiaochen WANG ; Ruiyu YUE ; Shao ZHANG ; Manjiang SUN ; Jun LI
Chinese Journal of Urology 2025;46(10):728-733
Objective:To investigate the influence of genetic and environmental factors on the clinical characteristics of upper urinary tract calculi in pediatric patients.Methods:This study was a retrospective case series. The clinical data of 179 children under the age of 14 with upper urinary tract calculi treated at Beijing Friendship Hospital,Capital Medical University,from August 2014 to February 2023 were analyzed. There were 121 males(67.60%)and 58 females(32.40%),with a median age at onset of 2.10(1.14,5.17)years. Thirty-three cases(18.44%)had a family history of urinary stone disease. Stone characteristics was defined by CT,with a median stone burden(sum of the diameters of all stones)of 1.3(1.00,1.60)cm. Fifty-four(30.17%)children had staghorn calculi. Multiple stones were present in 92 cases(51.40%),and bilateral stones in 52 cases(29.05%),with hydronephrosis was present in 119 children(66.48%). The median follow-up time was 67 months,and 36 children(20.11%)experienced stone recurrence. Dietary habits and related information were collected by electronic questionnaire,including a total of 115 children(64.25%)with an unbalanced diet,101(56.42%)with insufficient water intake,and 32 children(17.88%)with a preference for a high-protein diet. Tap water was used as the source of drinking water by 128 patients(71.51%),and 107(59.78%)took dietary supplements. Whole-exome sequencing revealed that 55 children(30.73%)carried pathogenic mutations in stone-related genes. Binary logistic regression was used for univariate analysis of above risk factors. Variables with P < 0.1 in univariate analysis and without multicollinearity were included in multivariate logistic regression to further screen for independent risk factors. Results:Multivariate analysis confirmed that carrying stone-related pathogenic gene mutations( OR = 3.06,95% CI 1.25?7.45, P = 0.014)and insufficient water intake( OR = 3.28,95% CI 1.14?9.47, P = 0.028)were independent risk factors for higher stone burden. A high-protein diet( OR = 2.40,95% CI 1.03?5.63, P = 0.044),carrying stone-related pathogenic gene mutations( OR = 4.57,95% CI 2.21?9.46, P<0.01),and a family history of stones( OR = 3.18,95% CI 1.28 ~ 7.91, P = 0.013)were independent risk factors for staghorn calculi. Multiple stones were closely associated with a family history of stones( OR = 2.66,95% CI 1.15-6.17, P = 0.022)and carrying stone-related pathogenic gene mutations( OR = 3.22,95% CI 1.60-6.48, P = 0.001). Moreover,carrying stone-related pathogenic gene mutations( OR = 5.19,95% CI 2.52?13.82, P < 0.01)were an independent risk factor for stone recurrence,whereas dietary supplement intake was a protective factor( OR = 0.26,95% CI 0.11?0.62, P = 0.002). Conclusions:Genetic and environmental factors play significant roles in the occurrence and development of pediatric upper urinary tract stones. A high-protein diet as well as a positive family history of stones are independent risk factors for staghorn calculi,and insufficient water intake is a critical environmental factor for stone formation,while appropriate use of dietary supplements may help reduce the risk of stone recurrence. Genetic testing indicates that approximately 30% of children carry stone-related pathogenic gene mutations,and these patients prone to severe stone and an increased risk of recurrence.
6.Global progress and trend in research of target trial emulation: a bibliometric and visualization analysis
Zilin LONG ; Houyu ZHAO ; Zuoxiang LIU ; Feng SUN
Chinese Journal of Epidemiology 2025;46(7):1262-1268
Objective:To explore the progress and trend in research of target trial emulation (TTE) and provide reference for research in this field.Methods:A literature retrival of research papers in this field published as of November 30, 2024 was conducted based on three databases (i.e. PubMed, Web of Science, and Scopus). The papers which were highly cited were analyzed by Bibliometrix package in R 4.3.2. The co-occurrence network of keywords were analyzed by using software VOSviewer. The keyword burst test was carried out with software CiteSpace.Results:A total of 685 papers from 314 journals were included. The annual number of the papers published showed a significant growth in recent three years. JAMA Network Open had the highest publication mumber related to TTE (34 papers), Annals of Internal Medicine had the highest H-index and American Journal of Epidemiology had the highest total citations. In the 2 997 authors, Hernán MA made a greatest contribution. In the 2 046 institutions, Harvard Medical School was at leading position. The analysis on highly cited papers and keyword co-occurrence showed that TTE was mainly used in the studies of COVID-19 vaccine, cancer and the treatment efficacy and safety of chronic diseases. The analysis on the co-occurence of keyword burst test showed that keywords frequently used until 2024 were COVID-19 vaccine, cardiovascular disease and breast cancer. Conclusions:TTE is mainly used in the studies of public health emergency (such as COVID-19), patients with cancer and chronic diseases. TTE will play a crucial role when randomized controlled trial is difficult to conduct or current evidence requirement can not be met.
7.Reassessing the scope of real-world data applications and the value of real-world evidence
Feng SUN ; Meng ZHANG ; Houyu ZHAO ; Zhirong YANG ; Junli ZHU ; Jing LI ; Linong JI ; Jiefu YANG ; Siyan ZHAN
Chinese Journal of Epidemiology 2025;46(6):1079-1084
In the past decade, real-world data (RWD) research has undergone significant transformations due to data aggregation and processing technologies. However, there is still a lack of consensus regarding the scope of RWD applications and the value of real-world evidence (RWE). This study briefly outlined the origins of the concept of RWD study and its early research scope to promote further development in this area. We also reviewed the understanding of RWD applications and research models from the five perspectives of healthcare professionals, medical institutions, decision-making departments, cross-regional cooperation model, and the practice of the One-Health model. Finally, we systematically summarized the renewed understanding of the value of RWE while looking ahead to the challenges and future developments in this field.
8.Revision process of the Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition)
Jinan YAN ; Yunxiao WU ; Xiaolu NIE ; Houyu ZHAO ; Siyan ZHAN ; Feng SUN
Chinese Journal of Pharmacoepidemiology 2025;34(2):121-135
Pharmacoepidemiology is a scientific discipline that applies epidemiological principles and methods to study the utilization and effects of pharmaceuticals in populations.It plays a crucial role in promoting rational drug use and improving public health outcomes.High-quality pharmacoepidemiological research relies on rigorous methodological frameworks.Chinese Pharmaceutical Association(CPA)has officially initiated the development/revision of the of the Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition)in 2024.This revision project was supported by the Pharmacoepidemiology Committee of CPA,and was led by the Department of Epidemiology and Biostatistics at Peking University School of Public Health,which provided methodological guidance,in collaboration with multidisciplinary experts from across the country.Building on the experience of the 1st edition's development,the working group conducted a qualitative systematic review,to extract key information from global pharmacoepidemiology-related guidelines,laying the foundation for the development/revision proposals of the 2nd edition.Subsequently,through two rounds of Delphi method expert consultations and qualitative interviews,alongside extensive discussions within the working group,the draft revision of the guideline was created.Finally,through an expert consensus meeting using the Nominal Group Technique(NGT),a consensus was reached,resulting in a methodological guideline that integrates international perspectives with local applicability for pharmacoepidemiological research in China.The 2nd edition consists of 41 entries,including 8 primary entries,20 secondary entries,and 13 tertiary entries.It comprehensively covers key aspects such as study protocol development,study implementation,adverse event reporting,research report writing,and dissemination of study findings.Additionally,it addresses specific application scenarios and topics,as well as the application of artificial intelligence and real-world studies.
9.Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition)and their series interpretation(1):an overview
Yunxiao WU ; Jinan YAN ; Xiaolu NIE ; Houyu ZHAO ; Siyan ZHAN ; Feng SUN
Chinese Journal of Pharmacoepidemiology 2025;34(1):2-11
Pharmacoepidemiology is an interdisciplinary discipline that applies epidemiological research methods to evaluate the application and effect of drugs within population.Standardizing pharmacoepidemiological research methods is crucial for ensuring the quality of research and promoting the development of the discipline.The Pharmacoepidemiology Professional Committee of Chinese Pharmaceutical Association developed the Guide on Methodological Standards in Pharmacoepidemiology(1st edition),in 2019,but has not been updated in over five years.Other,countries/regions such as Europe,America,Japan and South Korea have made a lot of progress in developing and updating the guidelines.Therefore,the rapid development of pharmacoepidemiology in our country and the growing need to align with international standards make it essential to update the guidelines.The second edition of the guidelines was developed through a process that included systematic reviews,practical surveys,and multidisciplinary collaboration.Compared with the first edition,the updated version has made many important changes in research design,data sources,specific application scenarios and more,and added new contents such as the application of artificial intelligence.The purpose of this paper is to emphasize the necessity of updating the guidelines,selecting important changes and formulating interpretation plans.It aims to provide references for relevant professionals to comprehensively understand and apply the new guidelines,and to promote the standardized development and quality of pharmacoepidemiologic research in our country,further advancing the field.
10.Global progress and trend in research of target trial emulation: a bibliometric and visualization analysis
Zilin LONG ; Houyu ZHAO ; Zuoxiang LIU ; Feng SUN
Chinese Journal of Epidemiology 2025;46(7):1262-1268
Objective:To explore the progress and trend in research of target trial emulation (TTE) and provide reference for research in this field.Methods:A literature retrival of research papers in this field published as of November 30, 2024 was conducted based on three databases (i.e. PubMed, Web of Science, and Scopus). The papers which were highly cited were analyzed by Bibliometrix package in R 4.3.2. The co-occurrence network of keywords were analyzed by using software VOSviewer. The keyword burst test was carried out with software CiteSpace.Results:A total of 685 papers from 314 journals were included. The annual number of the papers published showed a significant growth in recent three years. JAMA Network Open had the highest publication mumber related to TTE (34 papers), Annals of Internal Medicine had the highest H-index and American Journal of Epidemiology had the highest total citations. In the 2 997 authors, Hernán MA made a greatest contribution. In the 2 046 institutions, Harvard Medical School was at leading position. The analysis on highly cited papers and keyword co-occurrence showed that TTE was mainly used in the studies of COVID-19 vaccine, cancer and the treatment efficacy and safety of chronic diseases. The analysis on the co-occurence of keyword burst test showed that keywords frequently used until 2024 were COVID-19 vaccine, cardiovascular disease and breast cancer. Conclusions:TTE is mainly used in the studies of public health emergency (such as COVID-19), patients with cancer and chronic diseases. TTE will play a crucial role when randomized controlled trial is difficult to conduct or current evidence requirement can not be met.

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