1.Literature analysis of clinical features and risk factors of drug-induced hypofibrinogenemia
Xiao WEN ; Le CAI ; Ao GAO ; Man ZHU
China Pharmacy 2025;36(13):1648-1654
OBJECTIVE To explore clinical characteristics and risk factors of drug-induced hypofibrinogenemia, providing a reference for rational clinical drug use. METHODS Retrospective case analyses literature on drug-induced hypofibrinogenemia were collected from domestic and international databases from their inception to December 31, 2024. The patients’ gender, age, fibrinogen (FIB) levels before and after treatment, drug types, the incidence of drug-induced hypofibrinogenemia, time of occurrence, bleeding rates, clinical manifestations, risk factors, and protective factors were all analyzed. RESULTS A total of 40 retrospective case analysis studies were included, involving 17 313 patients. Patient age ranged from 0.83 to 78.40 years, with males accounting for 16.90%-81.00%. The involved drugs comprised 5 categories and 13 specific agents, including tigecycline, snake venom hemocoagulase, tocilizumab, and alteplase, etc. The incidence of drug-induced hypofibrinogenemia ranged from 0 to 100%, occurring between 2 hours and 9 months after drug administration, and FIB levels rebounded in most patients after drug discontinuation. The bleeding rate varied from 0% to 91.30%, including epistaxis, airway bleeding, gastrointestinal bleeding, and cerebral hemorrhage. Risk factors included high drug dosage, prolonged treatment duration, abdominal infection, advanced age, and low baseline FIB levels. Protective factors were only mentioned in studies on tigecycline, including skin and soft tissue infections and high baseline FIB levels. CONCLUSIONS Drug-induced hypofibrinogenemia is commonly associated with tigecycline, hemocoagulase, and tocilizumab. Its clinical features vary depending on the drug, and risk factors include high drug dosage, prolonged treatment, low baseline FIB levels, and advanced age. For high-risk medications, individualized medication management and monitoring of FIB levels are recommended.
2.Effects of peripheral blood-derived exosomes intervened by Naozhenning on injury of neuron induced by microglia
Li GAO ; Le ZHAO ; Liya WU ; Weiyi ZHANG ; Nan LI ; Nannan WEI ; Yonghui WANG
China Pharmacy 2025;36(19):2393-2398
OBJECTIVE To study the effects of peripheral blood-derived exosomes (Exo) intervened by Naozhenning (NZN) on injury of neuron cells HT22 induced by microglia BV-2 cells. METHODS Wistar rats were selected to prepare peripheral blood- derived Exo intervened by NZN (66.83 g/kg), referred to as NZN-Exo; peripheral blood-derived Exo intervened by normal saline and piracetam (PLXT, 1.62 g/kg) were prepared using the same method, denoted as KB-Exo and PLXT-Exo respectively, and all Exo were subsequently identified. Meanwhile, BV-2 cells were stimulated with 1 μg/mL lipopolysaccharide (LPS) to prepare LPS- stimulated supernatant, and non-LPS-stimulated supernatant was prepared following the same protocol. HT22 cells were divided into four groups: KB-Exo group (treated with non-LPS-stimulated supernatant+KB-Exo), model group (treated with LPS-stimulated supernatant+KB-Exo), PLXT-Exo group (treated with LPS-stimulated supernatant+PLXT-Exo), and NZN-Exo group (treated with LPS-stimulated supernatant+NZN-Exo), with the concentration of the corresponding Exo in all groups being 50 μg/mL. After 24 hours of culture, the proliferation of HT22 cells was detected by the CCK-8 assay and EdU assay; the apoptosis of HT22 cells was detected; the microstructure of HT22 cells was observed; the contents of interleukin-1β (IL-1β), IL-10, nuclear factor-κB (NF- κB), and tumor necrosis factor-α (TNF-α) in HT22 cells were measured, as well as the expression levels of TNF-α, NOD-like receptor thermal protein domain associated protein 3 (NLRP3), Caspase-1, B-cell lymphoma-2( Bcl-2), and Bcl-2-associated X protein (Bax). RESULTS KB-Exo, PLXT-Exo and NZN-Exo were successfully prepared, and all Exo exhibited typical cup-shaped contours and membrane-enclosed characteristics. Compared with KB-Exo group, model group showed significantly decreased cell proliferation rates (detected by CCK-8 and EdU), intracellular IL-10 levels, and Bcl-2 protein expression levels (P<0.05); while the cell apoptosis rate, intracellular levels of IL-1β, TNF-α, and NF-κB, as well as the expression levels of NLRP3, TNF-α, Caspase-1, and Bax proteins were significantly increased (P<0.05). Additionally, in the model group, the cells showed volume swelling, incomplete cell membrane, nucleolar rupture, significant swelling and deformation of mitochondria, and severe vacuolization. Compared with model group, the above quantitative indicators in the PLXT-Exo group and NZN-Exo group were significantly reversed (P<0.05), with large and round cell nuclei, intact nuclear membranes, and reduced mitochondrial vacuolization. CONCLUSIONS Peripheral blood-derived Exo intervened by naozhenning can alleviate the injury of neuronal cells HT22 by inhibiting inflammatory responses and cell apoptosis.
3.The Development and Application of Chatbots in Healthcare: From Traditional Methods to Large Language Models
Zixing WANG ; Le QI ; Xiaodan LIAN ; Ziheng ZHOU ; Aiwei MENG ; Xintong WU ; Xiaoyuan GAO ; Yujie YANG ; Yiyang LIU ; Wei ZHAO ; Xiaolin DIAO
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1170-1178
With the rapid advancement of artificial intelligence technology, chatbots have shown great potential in the healthcare sector. From personalized health advice to chronic disease management and psychological support, chatbots have demonstrated significant advantages in improving the efficiency and quality of healthcare services. As the scope of their applications expands, the relationship between technological complexity and practical application scenarios has become increasingly intertwined, necessitating a more comprehensive evaluation of both aspects. This paper, from the perspective of he althcare applications, systematically reviews the technological pathways and development of chatbots in the medical field, providing an in-depth analysis of their performance across various medical scenarios. It thoroughly examines the advantages and limitations of chatbots, aiming to offer theoretical support for future research and propose feasible recommendations for the broader adoption of chatbot technologies in healthcare.
4.Mechanistic modeling for cation exchange chromatography process of trastuzumab and its application
Le-yi LI ; Xu YAN ; Jing-yu JIAO ; Dan GAO ; Dong GAO ; Hai-bin QU
Acta Pharmaceutica Sinica 2024;59(5):1391-1398
Cation exchange chromatography, as a commonly used separation and purification technique in biopharmaceutical manufacturing, is often employed for downstream processes to separate target monoclonal antibodies from their charge variants. For samples with complex and poorly resolved charge variant profiles, the collection solely based on ultraviolet detection does not provide specific compositional information for individual charge variants, making it challenging to determine the range of pooled fractions directly. Subsequent laborious fractionation analysis is then required to guide collection according to production requirements. A mechanistic model for the cation exchange chromatography process of the target monoclonal antibody's critical components was established, and it was employed to assist in product collection. The model accurately predicted the elution peak shapes of the modeled variants, with a root mean square error between predicted and actual values below 0.009. In comparison to the online ultraviolet-based collection method, the model-assisted collection method not only visualized the chromatographic process but also increased the relative productivity by fourfold while ensuring compliance rate.
5.Research progress on the endocytosis pathway of nanoscale metal-organic frameworks drug carriers
Yu-xuan WANG ; Wen-jia XIE ; Hui-le GAO ; Xi-bo PEI
Acta Pharmaceutica Sinica 2024;59(5):1196-1209
Metal-organic frameworks (MOFs) are crystalline materials with a multidimensional porous network structure, formed through coordination bonds with metal ions as nodes and organic ligands as connecting bridges. Due to their excellent physicochemical properties, MOFs have extensive applications in the field of biomedicine, ranging from antibacterials, drug carriers, imaging to sensors. Nanoscale metal-organic frameworks (nMOFs), commonly utilized drug carriers, can gain enhanced safety, targeted delivery, and superior therapeutic effect through endocytosis. In this review, we comprehensively summarize the factors influencing the endocytosis of nMOFs, focusing on three key physicochemical properties, particle size, morphology and surface modification. Based on different illness models, the review succinctly summarizes the latest advancements in understanding the endocytosis pathways of nMOFs while critically reflecting on the inherent limitations of current research methods. Lastly, the review offers valuable insights into future research methodologies and objectives, aiming to lay the groundwork and provide meaningful guidance for the synthesis and development of nMOFs as promising versatile drug carriers.
6.Mechanism of Naozhenning granules in regulating mitochondrial energy metabolism in multiple cerebral concussion rats
Li GAO ; Le ZHAO ; Nannan WEI ; Liya WU ; Tiantian WANG ; Weiyi ZHANG ; Yonghui WANG
China Pharmacy 2024;35(9):1050-1056
OBJECTIVE To explore the mechanism of Naozhenning granules in regulating mitochondrial energy metabolism in hippocampal tissue of multiple cerebral concussion (MCC) model rats. METHODS SPF grade Wistar rats were used to prepare MCC models using the “free fall impact method”. The successfully modeled rats were divided into model group, piracetam group, and Naozhenning granule low-dose, medium-dose and high-dose groups, and a normal group was also set up, with 8 rats in each group. Rats in each treatment group orally administered corresponding drugs at doses of 0.324 g/kg for the piracetam group and 2.25, 4.5 and 9 g/kg for the Naozhenning granule low-dose, medium-dose and high-dose groups; the normal group and model group were given equal volumes of normal saline; once a day, for 14 consecutive days. The motor exploration ability, learning and memory ability of rats were tested; the adenosine triphosphate (ATP) content in the hippocampal tissue of rat was detected; the changes in the mitochondrial structure of hippocampal tissue was observed; the fluorescence intensity of mitochondrial dynamin- related protein 1 (Drp1), mitochondrial fission protein 1 (Fis1), mitochondrial fusion 1 (Mfn1), and optic atrophy protein 1 (Opa1) were detected in the hippocampal tissue of rat; the protein expression levels of peroxisome proliferator activated receptor gamma coactivator-1α(PGC-1α), nuclear respiratory factor-1(NRF-1),mitochondrial transcription factor A(TFAM), Wnt-3a,β-catenin in hippocampal tissue of rat were detected. RESULTS Compared with the normal group, the total exercise distance, number of central grid entries, number of upright positions, new object recognition index, mitochondrial ATP content, fluorescence intensity of Mfn1 and Opa1, the protein expression levels of PGC-1α、NRF-1、TFAM、Wnt-3a、 β-catenin in the model group were significantly reduced (P<0.01), while the rest time and fluorescence intensity of Drp1 and Fis1 in hippocampal tissue were significantly increased (P<0.01). The results of transmission electron microscopy showed that the mitochondria in the hippocampal tissue were significantly swollen, with a large number of broken and reduced cristae, and some mitochondria had myeloid changes in the membrane. Compared with the model group, the levels/contents of the above indicators in rats of each administration group showed varying degrees of reversal, and most of the differences were statistically significant (P<0.05 or P<0.01); the degree of mitochondrial swelling in the hippocampal tissue was reduced, with a small amount of broken and reduced cristae, fuzzy fractures appeared in local areas of the rough endoplasmic reticulum. CONCLUSIONS Naozhenning granules can improve the motor exploration, learning and memory abilities of MCC model rats, repair neuronal damage, and exert neuroprotective effects. Its mechanism may be related to activating Wnt/β-catenin signaling pathway,maintaining the balance of mitochondrial division and fusion,and promoting mitochondrial biosynthesis.
7.Effect of Naozhenning Granules on Energy Metabolism of Cortical Mitochondria in Rat Model of Post-concussion Syndrome
Nannan WEI ; Liya WU ; Tiantian WANG ; Qizhao LIU ; Weiyi ZHANG ; Yonghui WANG ; Li GAO ; Le ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):107-113
ObjectiveTo explore the effects of Naozhenning granules on the memory function and neuron cells in the rat model of post-concussion syndrome based on mitochondrial biosynthesis. MethodSPF-grade Wistar rats were used to establish the multiple cerebral concussion (MCC) model by the weight-drop method. The successfully modeled rats were assigned into model, piracetam (0.324 g·kg-1), and low-, medium-, and high-dose (2.25, 4.5, and 9 g·kg-1, respectively) Naozhenning groups. The rats were administrated with corresponding drugs by gavage and those in the blank group and model group were administrated the same volume of normal saline once a day for 14 days. The general state of rats was observed before and after treatment. The open field test and new object recognition test were conducted to examine the motor and memory abilities of rats. Hematoxylin-eosin staining was employed to observe the pathological changes of cortical neurons in rats. Western blot and real-time polymerase chain reaction were employed to determine the protein and mRNA levels, respectively, of peroxisome proliferator-activated receptor γ-coactivator-1α (PGC-1α), nuclear respiratory factor-1 (NRF-1), and transcription factor A mitochondrial (TFAM) in rat cortex. ResultCompared with the blank group, the model group showed anxious and manic mental status, yellow and messy fur, and reduced food intake. In the open field experiment, the model group showed reduced total movement distance, times of entering the central grid, and times of rearing decreased and increased resting time compared with the blank group (P<0.01). The model group had lower recognition index of new objects than the blank group (P<0.01). In addition, the modeling caused reduced neurons with sparse distribution and deformed, broken, and irregular nucleoli and down-regulated the mRNA and protein levels of PGC-1α, NRF-1, and TFAM in the cortex (P<0.01). Compared with the model group, piracetam and Naozhenning improved the mental state, coat color, food intake, and activities of rats. In the open field test, piracetam and Naozhenning increased the total movement distance, the times of entering the central grid, and the times of rearing and shortened the resting time (P<0.05, P<0.01). The piracetam and Naozhenning groups had higher recognition index of new objects than the model group (P<0.05, P<0.01). Compared with the model group, the piracetam and Naozhenning groups showed increased neurons with tight arrangement and large and round nuclei, and some cells with irregular morphology and turbid cytoplasm. Furthermore, piracetam and medium-dose Naozhenning upregulated the protein levels of PGC-1α, NRF-1, and TFAM (P<0.01). Low-dose Naozhenning upregulated the protein levels of NRF-1 and TFAM (P<0.01), and high-dose Naozhenning upregulated the protein levels of PGC-1α and TFAM in the cortex (P<0.01). The mRNA levels of PGC-1α, NRF-1, and TFAM in the cortex were upregulated in the piracetam group and Naozhenning groups (P<0.05, P<0.01). ConclusionNaozhenning granules can improve the motor, memory, and learning, repair the neuronal damage, and protect the nerve function in the rat model of MCC by promoting mitochondrial biosynthesis.
8.Phase Separation of Biomacromolecules and Its Important Role in Transcriptional Regulation
Xiang-Dong ZHAO ; Le WANG ; Lu-Jie MA ; De-Bao XIE ; Meng-Di GAO ; Ya-Nan MENG ; Fan-Li ZENG
Progress in Biochemistry and Biophysics 2024;51(4):743-753
Cells not only contain membrane-bound organelles (MBOs), but also membraneless organelles (MLOs) formed by condensation of many biomacromolecules. Examples include RNA-protein granules such as nucleoli and PML nuclear bodies (PML-NBs) in the nucleus, as well as stress granules and P-bodies in the cytoplasm. Phase separation is the basic organizing principle of the form of the condensates or membraneless organelles (MLOs) of biomacromolecules including proteins and nucleic acids. In particular, liquid-liquid phase separation (LLPS) compartmentalises and concentrates biological macromolecules into liquid condensates. It has been found that phase separation of biomacromolecules requires some typical intrinsic characteristics, such as intrinsically disordered regions, modular domains and multivalent interactions. The phase separation of biomacromolecules plays a key role in many important cell activities. In recent years, the phase separation of biomacromolecules phase has become a focus of research in gene transcriptional regulation. Transcriptional regulatory elements such as RNA polymerases, transcription factors (TFs), and super enhancers (SEs) all play important roles through phase separation. Our group has previously reported for the first time that long-term inactivation or absence of assembly factors leads to the formation of condensates of RNA polymerase II (RNAPII) subunits in the cytoplasm, and this process is reversible, suggesting a novel regulatory model of eukaryotic transcription machinery. The phase separation of biomacromolecules provides a biophysical understanding for the rapid transmission of transcriptional signals by a large number of TFs. Moreover, phase separation during transcriptional regulation is closely related to the occurrence of cancer. For example, the activation of oncogenes is usually associated with the formation of phase separation condensates at the SEs. In this review, the intrinsic characteristics of the formation of biomacromolecules phase separation and the important role of phase separation in transcriptional regulation are reviewed, which will provide reference for understanding basic cell activities and gene regulation in cancer.
9.Diagnostic efficacy of optimized T-SPOT.TB in differentiating spinal tu-berculosis from other spinal infection
Ying ZHOU ; Xiao-Jiang HU ; Zhong-Jing JIANG ; Jun-Bao CHEN ; Guang ZHANG ; Hong-Qi ZHANG ; Yan-Bing LI ; Qi-Le GAO
Chinese Journal of Infection Control 2024;23(2):148-154
Objective To explore the efficacy of T-cell spot test of tuberculosis infection(T-SPOT.TB)in the differential diagnosis of spinal tuberculosis(STB),and optimize diagnostic efficacy through the optimal cut-off value of receiver operating characteristic(ROC)curve.Methods Clinical data of patients with spinal infection in a hospi-tal from January 2010 to May 2019 were collected,including preoperative T-SPOT.TB test results,white blood cell count,C-reactive protein,erythrocyte sedimentation rate,procalcitonin,and tuberculosis antibodies,etal.Clinical diagnosis was conducted based on diagnostic criteria.The sensitivity and specificity of T-SPOT.TB in preoperative diagnosis of STB and other spinal infection was analyzed,and the diagnostic efficacy of the optimized T-SPOT.TB indicators was evaluated.Results A total of 132 patients were included in this study,out of whom 78 patients(59.09%)were diagnosed with STB,and 54(40.91%)were diagnosed with non-tuberculosis(non-TB)spinal in-fection.The sensitivity and specificity of T-SPOT.TB in differential diagnosis of STB were 67.68%and 66.67%,respectively.Univariate logistic regression analysis showed that compared with non-TB spinal infection,the OR va-lue of T-SPOT.TB test in diagnosing STB was 4.188(95%CI:1.847-9.974,P<0.001).The optimized T-SPOT.TB evaluation index through ROC curve to determine the optimal cut-off values of ESAT-6,CFP-10,and CFP-10+ESAT-6 for differential diagnosis of STB and non-TB spinal infection were 12.5,19.5,and 36,respec-tively,and area under curve(AUC)values were 0.765 6,0.741 5,and 0.778 6,respectively,all with good diag-nostic efficacy.CFP-10+ESAT-6 had the highest AUC.CFP-10+ESAT-6 specific spot count had higher efficacy in the diagnosis of STB,with a diagnostic accuracy of 75.56%,higher than 67.42%of pre-optimized T-SPOT.TB.Conclusion T-SPOT.TB test has high diagnostic efficacy in differentiating STB from non-TB spinal infection.Posi-tivity in T-SPOT.TB test,especially with spot count of CFP-10+ESAT-6 over 36,indicates a higher likelihood of STB.
10.Fluorescent probes and imaging techniques for deep-tissue optical imaging:a review
Yuxiang GAO ; Le GUO ; Hui LI ; Xueliang ZHANG ; Nuernisha ALIFU
Chinese Journal of Medical Physics 2024;41(2):169-174
The research advancements in probes for deep-tissue imaging and adaptive optical imaging technologies are summarized,aiming to offer a new perspective for life science and interdisciplinary research.The review firstly gives an introduction on the probes emitting in the near-infrared-Ⅱ region,including fluorescence,bioluminescence,chemiluminescence,and persistent luminescence,and then elaborates direct sensing methods for rapid measurement and correction of wavefront distortions,as well as indirect sensing methods for correcting complex optical aberrations.The continuous updating of the above techniques and methods has enabled optical imaging to successfully penetrate deeper tissues with a remarkable reduction of background noise for higher image quality.

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