1.Quality assessment of guidelines/consensuses on traditional Chinese medicine/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease
Ruimin JIAO ; Jingjie ZHAO ; Juanjuan LI ; Wei CHEN ; Chaoru HAN ; Li LI ; Chunjun XU ; Hong YOU
Journal of Clinical Hepatology 2025;41(3):446-452
ObjectiveTo evaluate the methodological quality and reporting quality of published guidelines/consensuses on traditional Chinese medicine (TCM)/integrated traditional Chinese and Western medicine diagnosis and treatment of nonalcoholic fatty liver disease (NAFLD), and to provide a basis for formulating guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD in the future. MethodsDatabases including PubMed, Embase, Web of Science, CNKI, Wanfang Data, and CBM and the websites of China Association of Chinese Medicine and China Association of Integrative Medicine were searched for related articles published up to September 1, 2024. Two clinical researchers independently assessed the methodological quality and reporting quality of the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD by using Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT). ResultsA total of nine guidelines/consensuses were included after literature screening, with four guidelines and five expert consensuses. The scores of different domains assessed by AGREE Ⅱ for the nine guidelines/consensuses were as follows: scope and purpose (47.1%), stakeholder involvement (41.0%), rigor of development (21.6%), clarity of presentation (40.2%), applicability (19.0%), and editorial independence (19.6%). The recommendation level of the articles was B level (recommended after revision) for four articles and C level (not recommended) for five articles. The RIGHT assessment showed high reporting rates for “Basic Information” and “Background”, while other areas needed to be improved. Currently, there was no international standard for the guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD, and the quality of these guidelines/consensuses needed to be enhanced to ensure comprehensiveness and credibility. ConclusionThere is still potential for improving the quality of guidelines/consensuses on TCM/integrated traditional Chinese and Western medicine diagnosis and treatment of NAFLD, and AGREE Ⅱ and RIGHT checklists should be strictly followed to ensure the fairness, scientific rigor, and transparency of these guidelines/consensuses.
2.The Effects of the Intelligent Hearing-assistive System on Hearing Benefits to Cochlear Implant Recipients
Liyang XIANG ; Juanjuan LI ; Yan HAN ; Jinjian WANG ; Dian YANG ; Tingjun YANG ; Li YIN ; Sui HUANG
Journal of Audiology and Speech Pathology 2024;32(1):43-48
Objective To study the effects of the intelligent hearing-assistive system incorporated in Nuro-tron cochlear implants(CI),including the autonomic acoustic scene recognition(ASR),intelligent strategy config-uration as well as the objective and subjective hearing improvements on recipients.Methods ① To evaluate the per-formance of the ASR matule,in a sound-proof room,the preset five kinds of test audios,including speech,noise,speech in noise,pure music(without human voice)and non-pure Music(with human voice)were played.Each type of scenes included 6 to 9 5 min test files.The prediction accuracy and scene switching times were calculated.② In order to evaluate the noise-reduction performance of the ABeam technology in the speech enhancement module,13 Nurotron? CI recipients were recruited and their speech recognition rate when ABeam was"ON"and"OFF"with noise coming from 90°,180°or 270°were tested,individually.Also,their subjective hearing feedback was evaluated through visual analogue scale(VAS)evaluation.Results The ASR module achieved high prediction performance,with prediction accuracy 99%±4%,96%±9%,94%±12%,94%±15%,92%±13%for speech,noise,noisy speech,pure music and non-pure music,respectively.The scene transation times for each individual scene were 1.1 ±0.3,1.4±0.7,1.3±0.5,1.4±0.8 and 1.3±0.5,indicating that the prediction was also stable.When noise came from the sides and behind of recipients and speech signal from the front,the adaptive dual microphone noise re-duction algorithm ABeam significantly increased the speech recognition score(SRS)in 5 dB signal-to-noise(SNR)environment(P<0.001),with an average increase of 15.92%.Especially when the noise came from 180 degree backward,the SRS increased 28.68%when ABeam was"0N",which was significantly higher than when ABeam was"OFF"(P<0.01).Conclusion The intelligent hearing-assistive system can help CI recipients automatically configure appropriate SPSs under different environments,improving the speech intelligibility and hearing comfort.
3.Status of anemia and its association with feeding patterns in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture
Xiaolan MA ; Huiling WANG ; Ting CAO ; Xiaorong MA ; Juanjuan XU ; Qi HAN ; Haolan MA ; Xiaoyang HE ; Jianhua MA ; Gexiang ZHANG
Chinese Journal of Child Health Care 2024;32(3):273-279
【Objective】 To investigate the anemia status of infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture, Gansu Province, and to comprehensively evaluate the differences in feeding behaviors between anaemic and normal children through the infant and child feeding index (ICFI) and feeding knowledge scores, so as to provide reference for the guidance of infants and young children feeding in ethnic minority areas and the promotion of children′s growth and development. 【Methods】 Taking infants and young children aged 6 - 24 months in Linxia Prefecture as the study subjects, a multi-stage random sampling method was used to select children who met the requirements from 5 townships and 5 villages in 7 counties in 2019 and 2020.Periphral blood samples were collected to test the level of hemoglobin, so as to determine the anemia status.Meanwhile, physical examination was performed and a questionnaire survey of guardians was conducted to analyze the association betweenanaemia and feeding patterns 【Results】 A total of 3 901 infants and children were included in this study, of whom 729 (18.70%) were anaemic, with a mean ICFI score of 12.56±2.70 and a mean feeding knowledge score of 1.97±1.01.There was no statistically significant association of low feeding knowledge score and low ICFI with anaemia after adjusting for confounders (P>0.05), Unqualified meat addition in ICFI was a risk factor for anaemia (OR=1.355, P=0.042), while non-bottle feeding in the past 24 hours (OR=0.762, P=0.021), and breastfeeding in the past 24 hours of infants and toddlers aged 12 - 24 months (OR=0.228, P=0.018) were protective factor for anemia in infants and toddlers aged 12 - 24 months. 【Conclusions】 The average prevalence of anemia in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture of Gansu Province is high, but the level of infant feeding and the level of feeding knowledge of caregivers are low.Early adherence to breastfeeding, timely addition of supplementary food, and more comsumpution of meat for children are conducive to preventing anemia.
4.Visual analysis of clinical research on traditional Chinese medicine syndrome types of depression based on Gephi
Yi DU ; Kejia LIU ; Chaoru HAN ; Shuai XU ; Juanjuan LI ; Jingjie ZHAO
Military Medical Sciences 2024;48(7):537-542
Objective To summarize the common traditional Chinese medicine(TCM)syndrome types and syndrome characteristics of depressive disorder(DD)by analyzing the existing clinical research literature,and to provide a basis for TCM syndrome classification and research on DD.Methods The documents related to TCM syndrome classification of DD were retrieved systematically from China National Knowledge Infrastructure(CNKI),China Biology Medicine Literature Service System(SinoMed),China Science and Technology Journal Database(VIP)and China Academic Journals Full-text Database(WanFang).The literature was organized and analyzed,and Gephi software was used to do the visual analysis.Results A total of 262 literature that met the criteria were included in the study.The annual average number of publications exceeds 10 articles since 2010.The top 5 syndrome types in TCM were Liver Qi Stagnation(LQS)type,Liver Stagnation and Spleen Deficiency(LSSD)type,Heart and Spleen Deficiency(HSD)type,Liver Stagnation and Phlegm Obstruction type and Liver Stagnation and Kidney Deficiency type,viscera syndrome classification mainly involved Liver,Spleen,Heart,Kidney and Gallbladder.The main syndrome type based on deficiency-excess syndrome classification was excess type.The strongest correlation of excess type was LQS,the strongest correlation of deficiency types was HSD,and the strongest correlation of deficiency and excess mixed syndrome type was LSSD.Conclusion The publication volume of literature related to TCM syndrome types of DD shows a fluctuating upward trend.The occurrence and development of DD are related to dysfunction of multiple organs,and liver stagnation is the core syndrome,which may run through the entire process of DD.
5.Analysis of the characteristics of SPTB gene variants among 16 children with Hereditary spherocytosis.
Yangyang GE ; Juanjuan LI ; Ye HAN ; Hua XIE ; Shaofang SHANGGUAN ; Qian JIANG ; Xiaoli CHEN ; Rong LIU
Chinese Journal of Medical Genetics 2023;40(3):269-275
OBJECTIVE:
To analyze the clinical characteristics and spectrum of SPTB gene variants among 16 Chinese children with Hereditary spherocytosis (HS) and explore their genotype-phenotype correlation.
METHODS:
Sixteen children who were diagnosed with HS at the Affiliated Hospital of Capital Institute of Pediatrics from November 2018 to July 2022 were selected as the research subjects. Genetic testing was carried out by whole exome sequencing. Candidate variants were verified by Sanger sequencing and subjected to bioinformatic analysis and prediction of 3D structure of the protein. Correlation between the SPTB genotypes and clinical phenotypes was analyzed using Chi-squared test.
RESULTS:
The male-to-female ratio of the HS patients was 6 : 10, with the median age being 7-year-and-10-month. Clinical features of the patients have included anemia, reticulocytosis and gradual onset of splenomegaly. Mild, moderate and severe anemia have respectively occurred in 56.25% (9/16), 31.25% (5/16) and 12.50% (2/16) of the patients. SPTB gene variants were detected in all patients, among which 10 were unreported previously and 7 were de novo in origin. Loss of function (LOF) variants accounted for 93.75% (15/16). Only one missense variant was detected. Eleven, 4 and 1 of the variants had occurred in the repeat domain, CH1 domain, and dimerization domain, respectively. There was no significant correlation between the type or domain of the SPTB gene variants with the clinical features such as severity of anemia (x² = 3.345, P > 0.05). All of the variants were predicted to be pathogenic or likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics.
CONCLUSION
Mild to moderate anemia are predominant clinical features of the HS children harboring a SPTB gene variant, for which LOF variants are the main mutational type. The clinical feature of HS is unaffected by the type of the variants.
Child
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Female
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Humans
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Male
;
Computational Biology
;
Genetic Testing
;
Genomics
;
Genotype
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Spherocytosis, Hereditary/genetics*
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East Asian People/genetics*
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Spectrin/genetics*
6.Clinical feature and genetic analysis of a patient with Idiopathic hypogonadotropic hypogonadism due to a novel variant of CHD7 gene.
Xin WANG ; Qian DENG ; Juanjuan WANG ; Wenjuan CAI ; Jian GAO ; Yanping HAN ; Yuqing CHEN
Chinese Journal of Medical Genetics 2023;40(7):847-850
OBJECTIVE:
To explore the clinical feature and genetic etiology of a patient with normosmic idiopathic hypogonadotropic hypogonadism (nIHH) due to variant of CHD7 gene.
METHODS:
A patient who had presented at Anhui Provincial Children's Hospital in October 2022 was selected as the study subject. Clinical data of the patient was collected. The patient and his parents were subjected to trio-whole exome sequencing. Candidate variant was verified by Sanger sequencing and bioinformatic analysis.
RESULTS:
The patient had featured delayed development of secondary sexual characteristics but normal olfactory function. Genetic testing revealed that he has harbored a c.3052C>T (p.Pro1018Ser) missense variant of the CHD7 gene, for which both of his parents were of the wild type. The variant has not been recorded in the PubMed and HGMD databases. Analysis of amino acid sequences suggested that the variant site is highly conserved, and the variant may affect the stability of protein structure. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.3032C>T variant was classified as a likely pathogenic (PS2+PM2_Supporting+PP2+PP3+PP4).
CONCLUSION
The delayed development of secondary sexual characteristics of the patient may be attributed to the c.3052C>T (p.Pro1018Ser) variant of the CHD7 gene. Above finding has expanded the variation spectrum of the CHD7 gene.
Child
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Humans
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Male
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Amino Acid Sequence
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Computational Biology
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DNA Helicases/genetics*
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DNA-Binding Proteins/genetics*
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Genetic Testing
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Genomics
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Hypogonadism/genetics*
;
Mutation
7.Effect of Loki Zupa on Airway Remodeling in Asthma Based on UPLC-MS Combined with Network Pharmacology and Experimental Verification
Jiani LIU ; Li LI ; Xue HAN ; Yue CHEN ; Wei LI ; Juanjuan DIAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(24):87-97
ObjectiveTo investigate the effect of Loki Zupa on airway remodeling in asthma based on ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS)combined with network pharmacology and experimental verification. MethodThe chemical constituents in Loki Zupa were identified by UPLC-MS. The potential active constituents of Loki Zupa were screened out based on literature retrieval, oral availability (OB) and drug-likeness (DL) in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and Lipinski's rule of five in SwissADEM. The constituent targets of Loki Zupa were obtained through the SwissTargetPrediction. The relevant targets of airway remodeling in asthma were screened out from Online Mendelian Inheritance in Man(OMIM), GeneCards, DrugBank, and DisGeNET. The STRING was used to conduct protein-protein interaction (PPI) among the main targets. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses were carried out through DAVID. Finally, an asthmatic airway remodeling model was induced by ovalbumin (OVA) in mice, followed by hematoxylin and eosin(HE), periodic acid Schiff(PAS), and Masson staining for the observation of the pathological conditions of lung tissues. The inflammatory cells in the bronchoalveolar lavage fluid(BALF) of mice were detected. The protein expression levels in mouse lung tissues were detected by Western blot and key signaling pathways were further determined. ResultEighty-two constituents were detected in the negative ion mode and 74 in the positive ion mode by UPLC-MS. Thirty-six candidate constituents and 578 predicted targets of Loki Zupa were screened out through network pharmacology, and 173 common targets with airway remodeling in asthma were obtained, including key compounds such as sebacic acid, pectolinarigenin, naringenin, apigenin, and potential targets such as protein kinase B1(Akt)1 and hypoxia-inducible factor 1α(HIF-1α). As predicted by KEGG enrichment analysis, Loki Zupa mainly exerted the effect against airway remodeling in asthma through phosphatidylinositol 3-kinase (PI3K)/Akt, HIF-1α, mitogen-activated protein kinase (MAPK), and other signaling pathways. Animal experiments showed that the compound formula of Loki Zupa could reduce the proliferation of airway goblet cells in asthmatic mice, improve the deposition of collagen under the airway epithelium, and decrease the up-regulated relative expression levels of phosphorylate(p)-Akt/Akt and HIF-1α by OVA sensitization in mice (P<0.05, P<0.01), which was consistent with the results of network pharmacology. ConclusionUPLC-MS combined with network pharmacology was used to preliminarily clarify the chemical composition of Loki Zupa and its underlying mechanism in intervention in airway remodeling in asthma. Specifically, Loki Zupa presumably synergistically intervened in airway remodeling in asthma through key targets represented by Akt1 and HIF-1α, and multiple pathways represented by the PI3K/Akt and HIF-lα pathways, which is expected to provide ideas for further research on Loki Zupa.
8.Clinical characteristics and genetic analysis of an ethnic Han Chinese child with Keppen-Lubinsky syndrome due to a de novo KCNJ6 mutation.
Jian GAO ; Juanjuan WANG ; Yanping HAN ; Qian DENG ; Xin WANG ; Wenjuan CAI ; Yuqing CHEN
Chinese Journal of Medical Genetics 2022;39(1):35-38
OBJECTIVE:
To investigate the clinical characteristics and genetic basis for a child with Keppen-Lubinsky syndrome (KPLBS).
METHODS:
Trio-whole exome sequencing (Trio-WES) was carried out for the proband and her parents. Candidate variant was verified by Sanger sequencing and bioinformatic analysis.
RESULTS:
The child has featured peculiar facies including large eyes, alar hypoplasia, microretrognathia, premature aging appearance in addition with growth delay and mental retardation. Trio-WES has identified that she has carried a de novo variant of the KCNJ6 gene, namely c.460G>C (p.Gly154Arg). The variant has not been recorded in the database. Prediction of protein structure indicated that the variant may affect the potassium ion selective filtration structure channel in the transmembrane region of KCNJ6 protein, which may result in up regulation of the function of the channel.
CONCLUSION
The de novo c.460G>C (p.Gly154Arg) variant of the KCNJ6 gene probably underlay the KPLBS in this child. Above finding has enriched the genotypic and phenotype spectrum of this syndrome.
Cataract
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China
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Female
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G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics*
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Humans
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Hypogonadism/congenital*
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Intellectual Disability/genetics*
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Mutation
;
Whole Exome Sequencing
9.Establishment of fingerprint ,content determination and chemical pattern recognition of decoction pieces and dispensing granules of Gardenia jasminoides
Chaofeng LIANG ; Xiaoke HAN ; Yadong QIN ; Bin XU ; Jun QI ; Juanjuan ZHOU
China Pharmacy 2022;33(14):1718-1723
OBJECTIVE To establish the fingerp rint of decoction pi eces and dispensing granules of Gardenia jasminoides ,to determine the contents of 6 components,so as to evaluate its quality combined with chemical pattern recognition. METHODS High performance liquid chromatography (HPLC)was used. Using geniposide as the reference ,Similarity Evaluation System for Chromatographic Fingerprint of TCM (2012 edition)was used to draw the fingerprints of 20 batches of G. jasminoides decoction pieces and 10 batches of G. jasminoides dispensing granules. Similarity evaluation and common peaks identification were conducted. The same HPLC method was adopted to determine the contents of deacetyl asperulosidic acid methyl ester ,geniposide, picrocrocin,rutin,crocin-Ⅰ and crocin- Ⅱ. ORIGIN 9.1 software was used for hierarchical clustering analysis ,and SIMCA 16.0 software was used for principal component analysis (PCA) and partial least squares-discriminant analysis. The differential components affecting the quality of decoction pieces and dispensing granules were screened by taking the variable importance in projection(VIP)value>1 as the standard. RESULTS There were 24 common peaks for both 20 batches of G. jasminoides decoction piece and 10 batches of G. jasminoides dispensing granules ;a total of 22 common peaks were found in the fingerprints of 30 batches of samples ,and the similarity was not lower than 0.96;six common peaks were identified ,i.e. deacetyl asperulosidic acid methyl ester (peak 2),geniposide(peak 6),picrocrocin(peak 9),rutin(peak 11),crocin-Ⅰ(peak 15),crocin-Ⅱ(peak 17). Average contents of above 6 components in G. jasminoides decoction pieces were 1.04,57.00,1.30,1.03,9.63 and 0.99 mg/g, respectively;those of G. jasmin oides dispensing granules were 0.96,17.04,0.37,0.27,0.73 and 0.04 mg/g,respectively. PCA results showed that G. jasminoides decoction pieces and G. jasminoides dispensing granules were clustered into respective one category ,which was consistent with results of cluster analysis. There were 9 common peaks with VIP value >1, which were 16,14,3,17(crocin-Ⅱ),15(crocin-Ⅰ),18, 22, 2 (deacetyl asperulosidic acid methyl ester) and 21. CONCLUSIONS The estab lished fingerprint and content determination method are simple and reproducible. Combined with chemical pattern recognition ,it can be used to evaluate the quality of decoction pieces and dispensing granules of G. jasminoides . Nine corresponding components represented by peak 16 and so on are the differential components that affect the quality of them.
10.Optimized thyroid transcription factor-1 core promoter-driven microRNA-7 expression effectively inhibits the growth of human non-small-cell lung cancer cells.
Shipeng CHEN ; Lian GUAN ; Xu ZHAO ; Jing YANG ; Longqing CHEN ; Mengmeng GUO ; Juanjuan ZHAO ; Chao CHEN ; Ya ZHOU ; Yong HAN ; Lin XU
Journal of Zhejiang University. Science. B 2022;23(11):915-930
Targeted gene therapy has become a promising approach for lung cancer treatment. In our previous work, we reported that the targeted expression of microRNA-7 (miR-7) operated by thyroid transcription factor-1 (TTF-1) promoter inhibited the growth of human lung cancer cells in vitro and in vivo; however, the intervention efficiency needed to be further improved. In this study, we identified the core promoter of TTF-1 (from -1299 bp to -871 bp) by 5' deletion assay and screened out the putative transcription factors nuclear factor-1 (NF-1) and activator protein-1 (AP-1). Further analysis revealed that the expression level of NF-1, but not AP-1, was positively connected with the activation of TTF-1 core promoter in human non-small-cell lung cancer (NSCLC) cells. Moreover, the silencing of NF-1 could reduce the expression level of miR-7 operated by TTF-1 core promoter. Of note, we optimized four distinct sequences to form additional NF-1-binding sites (TGGCA) in the sequence of TTF-1 core promoter (termed as optTTF-1 promoter), and verified the binding efficiency of NF-1 on the optTTF-1 promoter by electrophoretic mobility shift assay (EMSA). As expected, the optTTF-1 promoter could more effectively drive miR-7 expression and inhibit the growth of human NSCLC cells in vitro, accompanied by a reduced transduction of NADH dehydrogenase (ubiquinone) 1α subcomplex 4 (NDUFA4)/protein kinase B (Akt) pathway. Consistently, optTTF-1 promoter-driven miR-7 expression could also effectively abrogate the growth and metastasis of tumor cells in a murine xenograft model of human NSCLC. Finally, no significant changes were detected in the biological indicators or the histology of some important tissues and organs, including heart, liver, and spleen. On the whole, our study revealed that the optimized TTF-1 promoter could more effectively operate miR-7 to influence the growth of human NSCLC cells, providing a new basis for the development of microRNA-based targeting gene therapy against clinical lung cancer.
Animals
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Humans
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Mice
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Carcinoma, Non-Small-Cell Lung/therapy*
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Lung Neoplasms/metabolism*
;
MicroRNAs/metabolism*
;
Nuclear Proteins/metabolism*
;
Thyroid Gland/pathology*
;
Thyroid Nuclear Factor 1/genetics*
;
Transcription Factors/metabolism*

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