1.Expert Consensus on the Ethical Requirements for Generative AI-Assisted Academic Writing
You-Quan BU ; Yong-Fu CAO ; Zeng-Yi CHANG ; Hong-Yu CHEN ; Xiao-Wei CHEN ; Yuan-Yuan CHEN ; Zhu-Cheng CHEN ; Rui DENG ; Jie DING ; Zhong-Kai FAN ; Guo-Quan GAO ; Xu GAO ; Lan HU ; Xiao-Qing HU ; Hong-Ti JIA ; Ying KONG ; En-Min LI ; Ling LI ; Yu-Hua LI ; Jun-Rong LIU ; Zhi-Qiang LIU ; Ya-Ping LUO ; Xue-Mei LV ; Yan-Xi PEI ; Xiao-Zhong PENG ; Qi-Qun TANG ; You WAN ; Yong WANG ; Ming-Xu WANG ; Xian WANG ; Guang-Kuan XIE ; Jun XIE ; Xiao-Hua YAN ; Mei YIN ; Zhong-Shan YU ; Chun-Yan ZHOU ; Rui-Fang ZHU
Chinese Journal of Biochemistry and Molecular Biology 2025;41(6):826-832
With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.
2.Health Risks from Exposure to PM 2.5-bound Polycyclic Aromatic Hydrocarbons in Fumes Emitted from Various Cooking Styles and Their Respiratory Deposition in a City Population Stratified by Age and Sex.
Jun Feng ZHANG ; Xi CHEN ; Ke GAO ; Shui Yuan CHENG ; Wen Jiao DUAN ; Li Ying FU ; Jian Jia LI ; Shu Shu LAN ; Cui Lan FANG
Biomedical and Environmental Sciences 2025;38(10):1230-1245
OBJECTIVES:
To characterize fine particulate matter (PM 2.5)-bound polycyclic aromatic hydrocarbons (PAHs) emitted from different cooking fumes and their exposure routes and assess their health-associated impact to provide a reference for health risk prevention from PAH exposure across different age and sex groups.
METHODS:
Sixteen PM 2.5-bound PAHs emitted from 11 cooking styles were analyzed using GC-MS/MS. The health hazards of these PAHs in the Handan City population (stratified by age and sex) were predicted using the incremental lifetime cancer risk ( ILCR) model. The respiratory deposition doses ( RDDs) of the PAHs in children and adults were calculated using the PM 2.5 deposition rates in the upper airway, tracheobronchial, and alveolar regions.
RESULTS:
The total concentrations of PM 2.5-bound PAHs ranged from 61.10 to 403.80 ng/m 3. Regardless of cooking styles, the ILCR total values for adults (1.23 × 10 -6 to 3.70 × 10 -6) and older adults (1.28 × 10 -6 to 3.88 × 10 -6) exceeded the acceptable limit of 1.00 × 10 -6. With increasing age, the ILCR total value first declined and then increased, varying substantially among the population groups. Cancer risk exhibited particularly high sensitivity to short exposure to barbecue-derived PAHs under equivalent body weights. Furthermore, barbecue, Sichuan and Hunan cuisine, Chinese cuisine, and Chinese fast food were associated with higher RDDs for both adults and children.
CONCLUSION
ILCR total values exceeded the acceptable limit for both females and males of adults, with all cooking styles showing a potentially high cancer risk. Our findings serve as an important reference for refining regulatory strategies related to catering emissions and mitigating health risks associated with cooking styles.
Humans
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Polycyclic Aromatic Hydrocarbons/analysis*
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Cooking/methods*
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Male
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Female
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Particulate Matter/analysis*
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Adult
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Child
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Middle Aged
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Air Pollutants/analysis*
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Adolescent
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Air Pollution, Indoor/analysis*
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Young Adult
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Child, Preschool
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Aged
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China
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Inhalation Exposure
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Age Factors
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Sex Factors
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Cities
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Infant
3.Expert Consensus on the Ethical Requirements for Generative AI-Assisted Academic Writing
You-Quan BU ; Yong-Fu CAO ; Zeng-Yi CHANG ; Hong-Yu CHEN ; Xiao-Wei CHEN ; Yuan-Yuan CHEN ; Zhu-Cheng CHEN ; Rui DENG ; Jie DING ; Zhong-Kai FAN ; Guo-Quan GAO ; Xu GAO ; Lan HU ; Xiao-Qing HU ; Hong-Ti JIA ; Ying KONG ; En-Min LI ; Ling LI ; Yu-Hua LI ; Jun-Rong LIU ; Zhi-Qiang LIU ; Ya-Ping LUO ; Xue-Mei LV ; Yan-Xi PEI ; Xiao-Zhong PENG ; Qi-Qun TANG ; You WAN ; Yong WANG ; Ming-Xu WANG ; Xian WANG ; Guang-Kuan XIE ; Jun XIE ; Xiao-Hua YAN ; Mei YIN ; Zhong-Shan YU ; Chun-Yan ZHOU ; Rui-Fang ZHU
Chinese Journal of Biochemistry and Molecular Biology 2025;41(6):826-832
With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.
4.Design of self-aid pressurized heating tourniquet
Chu-Lan XIAO ; Fu-Qiang LI ; Si-Ping LU ; Jun-Hui LI
Chinese Medical Equipment Journal 2024;45(3):111-114
Objective To design a self-aid pressurized heating tourniquet to decrease the mortality and morbidity of post-traumatic hemorrhage of limbs in highland cold regions.Methods The tourniquet was in the form of long strip and consisted of a gas generating heating mechanism,an inflatable cuff,a decompression mechanism and a micro timer.The gas generating heating mechanism was composed of an inner cylinder and an outer cylinder,which were fixed with screws;the inflatable cuff had two variations for the upper limb and lower limb respectively,with fabric for fixing on the outer side and an airbag set on the inner side;the decompression mechanism had a pressurized valve as its main component;the electronic micro timer was secured to the slot on the gas generating heating mechanism by an insertion clasp.Results The tourniquet developed enabled self-aid hemostasis in 1 to 2 s for post-traumatic hemorrhage of limbs in highland cold regions,and could effectively prevent the affected limb from losing temperature.Conclusion The tourniquet developed gains advantages in easy operation,hemostasis,heat preservation and adjustable pressure,which is of significance for enhancing the self-aid ability for post-traumatic hemorrhage of limbs in highland cold regions.[Chinese Medical Equipment Journal,2024,45(3):111-114]
5.Clinical trial of montelukast combined with loratadine in the treatment of patients with allergic rhinitis
Yin FU ; Sheng LI ; Jin-shan LAN ; Hui-mei LI ; Jing XU ; Shao-jun XU
The Chinese Journal of Clinical Pharmacology 2024;40(24):3533-3537
Objective To observe the clinical efficacy and safety of montelukast tablets combined with loratadine tablets in the treatment of allergic rhinitis(AR).Methods AR patients were divided into control group and treatment group according to the cohort method.The control group was given 10 mg of loratadine tablets orally once a day.On this basis,the treatment group was given 10 mg of montelukast tablets orally once a day.Both groups were treated for 8 weeks.Clinical efficacy,nasal symptom scores,inflammation cells and mediators[eosinophil cationic protein(ECP)and eosinophil(EOS)],immunoglobulin E(IgE),inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)],nasal mucosal tissue growth factor[insulin growth factor-1 receptor(IGF-IR),fibrogrowth factor-2(FGF-2)],and recurrence rate were compared between the two groups.And evaluated safety.Results After treatment,the total effective rates in the treatment group and the control group were 95.10%(97 cases/102 cases)and 80.61%(79 cases/98 cases),with statistically significant difference(P<0.05).After treatment,visual analogue scale(VAS)scores for nasal symptoms in the treatment group and the control group were 1.25±0.16 and 3.01±0.70;ECP levels were(370.18±13.34)and(457.31±17.60)ng·mL-1;EOS were(2.95±0.53)%and(3.98±1.14)%;IgE levels were(119.37±7.65)and(179.55±11.63)U·mL-1;IL-6 levels were(106.27±7.13)and(135.41±10.90)ng·L-1;IL-8 levels were(108.36±6.72)and(129.47±10.33)ng·L-1;IL-10 levels were(17.14±4.55)and(13.59±3.76)ng·L-1;IGF-IR were 3.70±0.63 and 2.47±0.51;FGF-2 were 3.93±0.72 and 2.19±0.40.There were statistically significant differences in the above indexes between the treatment group and the control group(all P<0.05).The recurrence rates in the treatment group and the control group at 6 and 12 months after treatment were 7.84%and 17.35%,15.69%and 25.51%.The differences were statistically significant(all P<0.05).Adverse drug reactions in the treatment group mainly included nausea,weakness,headache and diarrhea.Adverse drug reactions in the control group mainly included nausea,weakness and headache.The total incidence rates of adverse drug reactions in the treatment group and the control group were 5.88%and 4.08%,without statistically significant difference(P>0.05).Conclusion Compared with loratadine tablets,montelukast tablets combined with loratadine tablets is more effective in the treatment of AR,without increasing adverse drug reactions.
6.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
7.Clinical trial of montelukast combined with loratadine in the treatment of patients with allergic rhinitis
Yin FU ; Sheng LI ; Jin-shan LAN ; Hui-mei LI ; Jing XU ; Shao-jun XU
The Chinese Journal of Clinical Pharmacology 2024;40(24):3533-3537
Objective To observe the clinical efficacy and safety of montelukast tablets combined with loratadine tablets in the treatment of allergic rhinitis(AR).Methods AR patients were divided into control group and treatment group according to the cohort method.The control group was given 10 mg of loratadine tablets orally once a day.On this basis,the treatment group was given 10 mg of montelukast tablets orally once a day.Both groups were treated for 8 weeks.Clinical efficacy,nasal symptom scores,inflammation cells and mediators[eosinophil cationic protein(ECP)and eosinophil(EOS)],immunoglobulin E(IgE),inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)],nasal mucosal tissue growth factor[insulin growth factor-1 receptor(IGF-IR),fibrogrowth factor-2(FGF-2)],and recurrence rate were compared between the two groups.And evaluated safety.Results After treatment,the total effective rates in the treatment group and the control group were 95.10%(97 cases/102 cases)and 80.61%(79 cases/98 cases),with statistically significant difference(P<0.05).After treatment,visual analogue scale(VAS)scores for nasal symptoms in the treatment group and the control group were 1.25±0.16 and 3.01±0.70;ECP levels were(370.18±13.34)and(457.31±17.60)ng·mL-1;EOS were(2.95±0.53)%and(3.98±1.14)%;IgE levels were(119.37±7.65)and(179.55±11.63)U·mL-1;IL-6 levels were(106.27±7.13)and(135.41±10.90)ng·L-1;IL-8 levels were(108.36±6.72)and(129.47±10.33)ng·L-1;IL-10 levels were(17.14±4.55)and(13.59±3.76)ng·L-1;IGF-IR were 3.70±0.63 and 2.47±0.51;FGF-2 were 3.93±0.72 and 2.19±0.40.There were statistically significant differences in the above indexes between the treatment group and the control group(all P<0.05).The recurrence rates in the treatment group and the control group at 6 and 12 months after treatment were 7.84%and 17.35%,15.69%and 25.51%.The differences were statistically significant(all P<0.05).Adverse drug reactions in the treatment group mainly included nausea,weakness,headache and diarrhea.Adverse drug reactions in the control group mainly included nausea,weakness and headache.The total incidence rates of adverse drug reactions in the treatment group and the control group were 5.88%and 4.08%,without statistically significant difference(P>0.05).Conclusion Compared with loratadine tablets,montelukast tablets combined with loratadine tablets is more effective in the treatment of AR,without increasing adverse drug reactions.
8.Sleep-improving mechanisms of Jiu Wei Bu Xue Oral Liquid on regulating Glu/GABA balance in insomnia rats based on network pharmacology and experimental verification
Jie WEI ; Xiao-dong LAN ; Dong-mei LI ; Jun-hui HE ; Zhen MENG ; Dong-mei WEI ; Yi LI ; Fu-quan PENG ; Gui-ning WEI ; Ruo-gan HUANG
Acta Pharmaceutica Sinica 2023;58(6):1484-1495
This study aimed to investigate the mechanism of Jiu Wei Bu Xue Oral Liquid on insomnia rats combining the methods of network pharmacology, molecular docking and experimental verification. UPLC-Q-TOF-MS/MS method and TCMIP, TCMSP databases were used to collect the ingredients and targets of Jiu Wei Bu Xue Oral Liquid. Protein-protein interactions and network analysis were performed to screen the key network targets and putative active ingredients of Jiu Wei Bu Xue Oral Liquid in treatment of insomnia, and then following by biological function and KEGG pathway analysis. Then binding ability for key network targets and putative active ingredients were predicted with molecular docking. The prediction targets were validated in para-chlorophenylalanine (PCPA) induced insomnia rats with administration of Jiu Wei Bu Xue Oral Liquid (2, 4, 8 mL·kg-1) for 7 days. Pentobarbital sodium induced sleeping test were performed to evaluate the synergistic sleep-aiding effect of Jiu Wei Bu Xue Oral Liquid. Then glutamic acid (Glu),
9.Therapeutic effect of ursodeoxycholic acid-berberine supramolecular nanoparticles on ulcerative colitis based on supramolecular system induced by weak bond.
Shan GAO ; Feng GAO ; Jing-Wei KONG ; Zhi-Jia WANG ; Hao-Cheng ZHENG ; Xin-Qi JIANG ; Shu-Jing XU ; Shan-Lan LI ; Ming-Jun LU ; Zi-Qi DAI ; Fu-Hao CHU ; Bing XU ; Hai-Min LEI
China Journal of Chinese Materia Medica 2023;48(10):2739-2748
Ulcerative colitis(UC) is a recurrent, intractable inflammatory bowel disease. Coptidis Rhizoma and Bovis Calculus, serving as heat-clearing and toxin-removing drugs, have long been used in the treatment of UC. Berberine(BBR) and ursodeoxycholic acid(UDCA), the main active components of Coptidis Rhizoma and Bovis Calculus, respectively, were employed to obtain UDCA-BBR supramolecular nanoparticles by stimulated co-decocting process for enhancing the therapeutic effect on UC. As revealed by the characterization of supramolecular nanoparticles by field emission scanning electron microscopy(FE-SEM) and dynamic light scattering(DLS), the supramolecular nanoparticles were tetrahedral nanoparticles with an average particle size of 180 nm. The molecular structure was described by ultraviolet spectroscopy, fluorescence spectroscopy, infrared spectroscopy, high-resolution mass spectrometry, and hydrogen-nuclear magnetic resonance(H-NMR) spectroscopy. The results showed that the formation of the supramolecular nano-particle was attributed to the mutual electrostatic attraction and hydrophobic interaction between BBR and UDCA. Additionally, supramolecular nanoparticles were also characterized by sustained release and pH sensitivity. The acute UC model was induced by dextran sulfate sodium(DSS) in mice. It was found that supramolecular nanoparticles could effectively improve body mass reduction and colon shortening in mice with UC(P<0.001) and decrease disease activity index(DAI)(P<0.01). There were statistically significant differences between the supramolecular nanoparticles group and the mechanical mixture group(P<0.001, P<0.05). Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6), and the results showed that supramolecular nanoparticles could reduce serum TNF-α and IL-6 levels(P<0.001) and exhibited an obvious difference with the mechanical mixture group(P<0.01, P<0.05). Flow cytometry indicated that supramolecular nanoparticles could reduce the recruitment of neutrophils in the lamina propria of the colon(P<0.05), which was significantly different from the mechanical mixture group(P<0.05). These findings suggested that as compared with the mechanical mixture, the supramolecular nanoparticles could effectively improve the symptoms of acute UC in mice. The study provides a new research idea for the poor absorption of small molecules and the unsatisfactory therapeutic effect of traditional Chinese medicine and lays a foundation for the research on the nano-drug delivery system of traditional Chinese medicine.
Animals
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Mice
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Colitis, Ulcerative/drug therapy*
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Ursodeoxycholic Acid/adverse effects*
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Berberine/pharmacology*
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Interleukin-6
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Tumor Necrosis Factor-alpha/pharmacology*
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Drugs, Chinese Herbal/pharmacology*
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Colon
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Nanoparticles
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Dextran Sulfate/adverse effects*
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Disease Models, Animal
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Colitis/chemically induced*
10.Efficacy and safety of secondary allogeneic hematopoietic stem cell transplantation in 70 patients with recurrent hematologic malignancies after transplantation.
Ting Ting HAN ; Yang LIU ; Yao CHEN ; Yuan Yuan ZHANG ; Hai Xia FU ; Chen Hua YAN ; Xiao Dong MO ; Feng Rong WANG ; Jing Zhi WANG ; Wei HAN ; Yuhong CHEN ; Huan CHEN ; Yuqian SUN ; Yi Fei CHENG ; Yu WANG ; Xiao Hui ZHANG ; Xiao Jun HUANG ; Lan Ping XU
Chinese Journal of Hematology 2023;44(6):458-464
Objectives: To investigate the role of donor change in the second hematopoietic stem cell transplantation (HSCT2) for hematological relapse of malignant hematology after the first transplantation (HSCT1) . Methods: We retrospectively analyzed patients with relapsed hematological malignancies who received HSCT2 at our single center between Mar 1998 and Dec 2020. A total of 70 patients were enrolled[49 males and 21 females; median age, 31.5 (3-61) yr]. Results: Forty-nine male and 21 female patients were enrolled in the trial. At the time of HSCT2, the median age was 31.5 (3-61) years old. Thirty-one patients were diagnosed with acute myeloid leukemia, 23 patients with ALL, and 16 patients with MDS or other malignant hematology disease. Thirty patients had HSCT2 with donor change, and 40 patients underwent HSCT2 without donor change. The median relapse time after HSCT1 was 245.5 (26-2 905) days. After HSCT2, 70 patients had neutrophil engraftment, and 62 (88.6%) had platelet engraftment. The cumulative incidence of platelet engraftment was (93.1±4.7) % in patients with donor change and (86.0±5.7) % in patients without donor change (P=0.636). The cumulative incidence of CMV infection in patients with and without donor change was (64.0±10.3) % and (37.0±7.8) % (P=0.053), respectively. The cumulative incidence of grade Ⅱ-Ⅳ acute graft versus host disease was (19.4±7.9) % vs (31.3±7.5) %, respectively (P=0.227). The cumulative incidence of TRM 100-day post HSCT2 was (9.2±5.1) % vs (6.7±4.6) % (P=0.648), and the cumulative incidence of chronic graft versus host disease at 1-yr post-HSCT2 was (36.7±11.4) % versus (65.6±9.1) % (P=0.031). With a median follow-up of 767 (271-4 936) days, 38 patients had complete remission (CR), and three patients had persistent disease. The CR rate was 92.7%. The cumulative incidences of overall survival (OS) and disease-free survival (DFS) 2 yr after HSCT2 were 25.8% and 23.7%, respectively. The cumulative incidence of relapse, OS, and DFS was (52.6±11.6) % vs (62.4±11.3) % (P=0.423), (28.3±8.6) % vs (23.8±7.5) % (P=0.643), and (28.3±8.6) % vs (22.3±7.7) % (P=0.787), respectively, in patients with changed donor compared with patients with the original donor. Relapses within 6 months post-HSCT1 and with persistent disease before HSCT2 were risk factors for OS, DFS, and CIR. Disease status before HSCT2 and early relapse (within 6 months post-HSCT1) was an independent risk factor for OS, DFS, and CIR post-HSCT2. Conclusion: Our findings indicate that changing donors did not affect the clinical outcome of HSCT2.
Humans
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Male
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Female
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Adult
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Child, Preschool
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Child
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Adolescent
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Young Adult
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Middle Aged
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Retrospective Studies
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Hematologic Neoplasms/therapy*
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Hematopoietic Stem Cell Transplantation/adverse effects*
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Leukemia, Myeloid, Acute/therapy*
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Recurrence
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Graft vs Host Disease/etiology*
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Chronic Disease

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