1.Facilitators and barriers to work-related musculoskeletal disorder prevention behaviors among healthcare professionals: A comprehensive review
Haijing MA ; Su’e YUAN ; Hui ZHU ; Yujia CHEN ; Ping SONG ; Huiqin YU ; Yunxia LI
Journal of Environmental and Occupational Medicine 2026;43(3):387-394
Work-related musculoskeletal disorders (WMSDs) represent a significant occupational health challenge among healthcare professionals globally, posing substantial threats to physical and mental well-being as well as work sustainability. Adopting preventive behaviors—including ergonomic postural adjustments, optimized work-rest scheduling, proper use of protective and assistive equipment, and regular physical activity—is essential for mitigating the risk of WMSDs. Guided by the social ecological model, the review synthesized current evidence on the determinants of WMSDs preventive behaviors across four levels: intrapersonal characteristics, work environment conditions, interpersonal support, and policy/institutional factors. The findings suggest that higher educational attainment, favorable health-related behavioral patterns, optimized ergonomic work environments, adoption of supportive collaborative systems, strong organizational support, as well as policy safeguards facilitate preventive behavior adoption. Conversely, limited prevention-related knowledge, low risk perception, insufficient physical activity, excessive workload, lack of appropriate protective equipment, inadequate ergonomic training, a prevailing culture of presenteeism, and inadequate policy implementation constitute significant barriers. Multi-dimensional intervention strategies targeting these determinants are warranted to enhance preventive behaviors, reduce the risk of WMSDs, and strengthen occupational health protection for healthcare professionals.
2.A prediction model for mild cognitive impairment risk among the elderly
MA Zongkang ; LIU Xinglang ; LI Huihui ; HE Guowei ; YAN Ping ; ZHANG Chuanrong ; MA Xuan ; CHE Yajie ; YU Shan ; CHEN Fenghui
Journal of Preventive Medicine 2026;38(2):124-129
Objective:
To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening.
Methods :
From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA).
Results:
A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764.
Conclusion
The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.
3.HER2 in Metastatic Colorectal Cancer: Diagnostic and Therapeutic Opportunities and Challenges
Zhao-Tao PAN ; Feng-Yu GAI ; Chen CHEN ; Tong LI ; Yan-Ping QING
Progress in Biochemistry and Biophysics 2026;53(4):936-950
Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the second leading cause of cancer-related mortality worldwide. Despite therapeutic advancements over recent decades, the prognosis for patients with metastatic CRC (mCRC) remains poor. Approximately 2%-4% of mCRC cases exhibit human epidermal growth factor receptor 2 (HER2) amplification or overexpression, defining a distinct molecular subtype. This HER2-positive status is strongly associated with primary resistance to anti-epidermal growth factor receptor (EGFR) therapies, which are the standard of care for patients with RAS wild-type tumors. Beyond its well-established role in breast and gastric cancers, HER2 has emerged as a pivotal biomarker and actionable therapeutic target in mCRC. However, selecting appropriate treatment strategies remains challenging due to patient heterogeneity and diverse molecular subtypes. This review systematically summarizes the molecular biology, diagnostic strategies, and advances in targeted therapies for HER2-positive mCRC. On the diagnostic front, we discuss the applications of immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), and circulating tumor DNA (ctDNA) detection technologies. We highlight discrepancies in diagnostic criteria across key clinical trials—such as HERACLES, DESTINY, and MOUNTAINEER—underscoring the urgent need for standardized, CRC-specific definitions to ensure consistent patient selection and comparability of efficacy data across studies. Although NGS enables comprehensive genomic profiling, its cost-effectiveness relative to traditional methods must be carefully considered. Therapeutically, we summarize clinical trial data for HER2-directed agents, including tyrosine kinase inhibitors (TKIs) such as tucatinib and lapatinib, monoclonal antibodies like trastuzumab, bispecific antibodies, and antibody-drug conjugates (ADCs) such as trastuzumab deruxtecan. We review dual-targeting strategies and note recent FDA approvals that represent significant milestones in second-line treatment. Additionally, we explore the potential of combining immune checkpoint inhibitors with HER2-targeted therapies to enhance antitumor immunity through mechanisms including antibody-dependent cellular cytotoxicity (ADCC) and modulation of the tumor microenvironment. ADCs enable precise delivery of cytotoxic payloads, reducing off-target toxicity while effectively inhibiting oncogenic pathways. A substantial portion of this review is dedicated to dissecting the molecular mechanisms underlying primary and acquired resistance to HER2-targeted therapies—persistent challenges that limit clinical benefit. These mechanisms include reactivation of downstream signaling pathways such as PI3K/AKT/mTOR and MAPK, concurrent mutations in genes like KRAS or BRAF, and alterations in HER2 expression that compromise treatment efficacy. For instance, specific HER2 mutations (e.g., L755S) can reduce drug binding affinity, while ctDNA monitoring facilitates early detection of emerging resistance clones during disease progression, thereby enabling timely therapeutic adjustments. Tumor heterogeneity and dynamic interactions with the microenvironment further complicate resistance patterns observed in clinical practice. HER2-targeted therapy represents a new frontier in precision oncology for mCRC, offering renewed hope for improving patient outcomes. Realizing this potential will require continued optimization of diagnostic algorithms and treatment workflows. Future efforts must focus on overcoming resistance, validating liquid biopsy approaches for dynamic monitoring, and establishing unified clinical guidelines. HER2 has become an essential biomarker for stratifying mCRC patients beyond traditional RAS and BRAF status, underscoring the shift from empiric treatment to biomarker-driven precision medicine. International, multidisciplinary collaboration will be critical to validate emerging biomarkers and refine treatment algorithms globally.
4.Regulatory effect of astragaloside Ⅰ and calycosin on a mouse model of cholestatic liver fibrosis
Xiaoyu JIANG ; Wei LIU ; Jiamei CHEN ; Ping LIU ; Chunhui LI
Journal of Clinical Hepatology 2026;42(5):1083-1092
ObjectiveTo identify and validate the optimal compatibility dosage of astragaloside Ⅰ (ASⅠ) and calycosin (CY) in the treatment of cholestatic liver fibrosis. MethodsA 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet was used to establish a mouse model of liver fibrosis, and the uniform design method was used to identify the optimal combination ratio of the saponin component ASⅠ and the flavonoid component CY in Astragalus membranaceus. In the uniform design experiment, 80 male C57/BL6J mice were divided into normal group, model group, total astragalosides (TAS) group, groups A — F with a uniform design, and obeticholic acid (OCA) group using a random number table, with 8 mice in each group. The multiple regression analysis was used to establish the optimal regression equation and obtain the potential optimal combination ratio. The in vivo efficacy of the empirically optimal combination identified in the uniform design and the optimal dose combination predicted by the regression equation were compared for validation. A one-way analysis of variance was used for comparison of continuous data between multiple groups; the Levene test was used to determine the homogeneity of variance, and the least significant difference t-test was used for comparison of data with homogeneity of variance between two groups, while the Dunnett T3 test was used for comparison of data with heterogeneity of variance. ResultsIn the uniform design regimen, the JYB combination (3.125 mg/kg ASI+50 mg/kg CY) significantly reduced the serum levels of alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total bile acid (TBA), total bilirubin (TBil), and indirect bilirubin (IBil) in mice with DDC-induced cholestatic liver fibrosis (all P<0.05), and it also reduced hepatic Hyp content (P<0.01), semi-quantified collagen deposition area (P<0.001), and the mRNA expression levels of Acta2, Col1a1, Ck7, Ck19, Adgre1, TLR4, TNF-α, and CCL5 in liver tissue (all P<0.05). The regression equation showed that 50 mg/kg ASⅠ+50 mg/kg CY was the potential optimal combination, which was named as P1 combination. However, subsequent validation experiments showed that P1 combination only significantly improved the serum levels of AST and IBil and hepatic Hyp content in DDC mice (all P<0.05), with no significant impact on hepatic collagen deposition and the mRNA expression levels of Acta2, Ck7, Ck19, Adgre1, and CCL5 (all P>0.05). In contrast, the JYB combination significantly improved the serum levels of ALP, ALT, AST, TBA, TBil, and IBil, hepatic collagen deposition, hepatic Hyp content, and the mRNA expression levels of Acta2, Col1a1, Ck7, Ck19, Adgre1, TLR4, TNF-α, and CCL5 (all P<0.05). ConclusionThis study shows that the JYB combination (3.125 mg/kg ASⅠ+50 mg/kg CY) can significantly alleviate DDC-induced liver fibrosis, with comparable efficacy to total saponins from Astragalus membranaceus, and compared with ASⅠ or CY administered alone, the JYB combination has a significantly better regulatory effect on the serum levels of ALP and TBA.
5.Noninvasive Screening for Chronic Atrophic Gastritis Using Photoplethysmography-derived Meridian-labelled Harmonic Parameters
Yun-Qing LE ; Jian-Xin CHEN ; Ai-Ping CHEN ; Zhi-Hong LI
Progress in Biochemistry and Biophysics 2026;53(5):1178-1194
ObjectiveChronic atrophic gastritis (CAG) is usually diagnosed by gastroscopy and histopathological biopsy. These procedures remain the reference standard, but their invasive nature and resource requirements may limit their use in large-scale population screening and repeated follow-up. A convenient and reproducible method for noninvasive auxiliary screening may help identify individuals who require further endoscopic assessment. Fingertip photoplethysmography (PPG) provides a noninvasive recording of peripheral pulse waves and allows harmonic features to be extracted from the signal. In this study, the so-called meridian-related variables were defined as PPG-derived harmonic parameters labelled according to meridian nomenclature, rather than as direct measurements of meridian physiology. This study aimed to compare these harmonic parameters between patients with CAG and non-CAG controls, identify parameters that remained different after age adjustment, and develop a multivariable model for noninvasive auxiliary screening and pre-endoscopic risk stratification of CAG. MethodsA total of 343 participants were included, comprising 171 patients with CAG and 172 non-CAG controls. CAG diagnosis was established using gastroscopy and histopathology as the reference standard. Fingertip PPG signals were collected using a PPG-based pulse acquisition device. Eight PPG-derived harmonic parameters labelled according to meridian nomenclature were extracted for analysis. Between-group differences were first assessed using nonparametric tests. Age-adjusted analyses were then performed to reduce potential confounding by age. The false discovery rate (FDR) method was applied for multiple-comparison correction. A multivariable logistic regression model integrating age and multiple harmonic parameters was constructed. Model performance was evaluated using receiver operating characteristic (ROC) analysis and the area under the curve (AUC). Internal validation performance was assessed using stratified five-fold cross-validation and bootstrap optimism correction. Threshold performance was examined using both a high-specificity strategy and a Youden index-based cutoff. Decision curve analysis was used to evaluate the model’s net clinical benefit across a range of threshold probabilities. ResultsAll eight harmonic parameters were non-normally distributed. In the univariate analysis, the stomach-labelled harmonic parameter (ST), bladder-labelled harmonic parameter (BL), and liver-labelled harmonic parameter (LR) differed between the CAG and non-CAG groups. After age adjustment and FDR correction, only ST and BL remained statistically significant. Compared with non-CAG controls, patients with CAG showed higher ST values and lower BL values. This finding indicates an associated differential harmonic pattern that was not fully explained by age distribution. However, the discriminative ability of a single harmonic parameter was limited. The best-performing single indicator was ST, with an AUC of 0.652 (95% CI: 0.595-0.707). The multivariable model integrating age and multiple harmonic parameters achieved an AUC of 0.791 (95% CI: 0.743-0.835), representing an improvement of 0.139 over ST alone. In internal validation, stratified five-fold cross-validation yielded a mean AUC of 0.753 (95% CI: 0.715-0.781), and the bootstrap optimism-corrected AUC was 0.748. These results suggest that the model retained moderate discriminative performance after internal validation.At a specificity of at least 95%, the model achieved a sensitivity of only 40.4% (95% CI: 25.7%-49.7%). This high-specificity cutoff may be suboptimal as the preferred threshold for an initial screening setting because of the potential risk of missed CAG cases. The Youden index-based optimal cutoff was 0.419, corresponding to a sensitivity of 80.7% and a specificity of 62.8%. This threshold may better match the practical aim of noninvasive auxiliary screening, where sensitivity is usually prioritized to reduce missed cases. Decision curve analysis showed that, within a threshold probability range of 10%-55%, the model provided higher net clinical benefit than the reference strategies of recommending gastroscopy for all participants or for none. ConclusionPatients with CAG showed associated harmonic differences in fingertip PPG-derived features, mainly characterized by higher ST and lower BL values after age adjustment and FDR correction. Compared with a single harmonic parameter, the multivariable model showed better overall discrimination and retained moderate internal validation performance. These findings suggest that PPG-derived harmonic parameters labelled according to meridian nomenclature may provide auxiliary information for noninvasive auxiliary screening and front-line triage before gastroscopic confirmation in CAG. The present results support further validation rather than immediate clinical implementation. External validation in independent, multicenter, and preferably prospective screening cohorts is needed to assess the model’s generalizability, screening performance, and potential clinical utility.
6.Noninvasive Screening for Chronic Atrophic Gastritis Using Photoplethysmography-derived Meridian-labelled Harmonic Parameters
Yun-Qing LE ; Jian-Xin CHEN ; Ai-Ping CHEN ; Zhi-Hong LI
Progress in Biochemistry and Biophysics 2026;53(5):1178-1194
ObjectiveChronic atrophic gastritis (CAG) is usually diagnosed by gastroscopy and histopathological biopsy. These procedures remain the reference standard, but their invasive nature and resource requirements may limit their use in large-scale population screening and repeated follow-up. A convenient and reproducible method for noninvasive auxiliary screening may help identify individuals who require further endoscopic assessment. Fingertip photoplethysmography (PPG) provides a noninvasive recording of peripheral pulse waves and allows harmonic features to be extracted from the signal. In this study, the so-called meridian-related variables were defined as PPG-derived harmonic parameters labelled according to meridian nomenclature, rather than as direct measurements of meridian physiology. This study aimed to compare these harmonic parameters between patients with CAG and non-CAG controls, identify parameters that remained different after age adjustment, and develop a multivariable model for noninvasive auxiliary screening and pre-endoscopic risk stratification of CAG. MethodsA total of 343 participants were included, comprising 171 patients with CAG and 172 non-CAG controls. CAG diagnosis was established using gastroscopy and histopathology as the reference standard. Fingertip PPG signals were collected using a PPG-based pulse acquisition device. Eight PPG-derived harmonic parameters labelled according to meridian nomenclature were extracted for analysis. Between-group differences were first assessed using nonparametric tests. Age-adjusted analyses were then performed to reduce potential confounding by age. The false discovery rate (FDR) method was applied for multiple-comparison correction. A multivariable logistic regression model integrating age and multiple harmonic parameters was constructed. Model performance was evaluated using receiver operating characteristic (ROC) analysis and the area under the curve (AUC). Internal validation performance was assessed using stratified five-fold cross-validation and bootstrap optimism correction. Threshold performance was examined using both a high-specificity strategy and a Youden index-based cutoff. Decision curve analysis was used to evaluate the model’s net clinical benefit across a range of threshold probabilities. ResultsAll eight harmonic parameters were non-normally distributed. In the univariate analysis, the stomach-labelled harmonic parameter (ST), bladder-labelled harmonic parameter (BL), and liver-labelled harmonic parameter (LR) differed between the CAG and non-CAG groups. After age adjustment and FDR correction, only ST and BL remained statistically significant. Compared with non-CAG controls, patients with CAG showed higher ST values and lower BL values. This finding indicates an associated differential harmonic pattern that was not fully explained by age distribution. However, the discriminative ability of a single harmonic parameter was limited. The best-performing single indicator was ST, with an AUC of 0.652 (95% CI: 0.595-0.707). The multivariable model integrating age and multiple harmonic parameters achieved an AUC of 0.791 (95% CI: 0.743-0.835), representing an improvement of 0.139 over ST alone. In internal validation, stratified five-fold cross-validation yielded a mean AUC of 0.753 (95% CI: 0.715-0.781), and the bootstrap optimism-corrected AUC was 0.748. These results suggest that the model retained moderate discriminative performance after internal validation.At a specificity of at least 95%, the model achieved a sensitivity of only 40.4% (95% CI: 25.7%-49.7%). This high-specificity cutoff may be suboptimal as the preferred threshold for an initial screening setting because of the potential risk of missed CAG cases. The Youden index-based optimal cutoff was 0.419, corresponding to a sensitivity of 80.7% and a specificity of 62.8%. This threshold may better match the practical aim of noninvasive auxiliary screening, where sensitivity is usually prioritized to reduce missed cases. Decision curve analysis showed that, within a threshold probability range of 10%-55%, the model provided higher net clinical benefit than the reference strategies of recommending gastroscopy for all participants or for none. ConclusionPatients with CAG showed associated harmonic differences in fingertip PPG-derived features, mainly characterized by higher ST and lower BL values after age adjustment and FDR correction. Compared with a single harmonic parameter, the multivariable model showed better overall discrimination and retained moderate internal validation performance. These findings suggest that PPG-derived harmonic parameters labelled according to meridian nomenclature may provide auxiliary information for noninvasive auxiliary screening and front-line triage before gastroscopic confirmation in CAG. The present results support further validation rather than immediate clinical implementation. External validation in independent, multicenter, and preferably prospective screening cohorts is needed to assess the model’s generalizability, screening performance, and potential clinical utility.
7.Factors influencing willingness to participate in health science popularization among medical workers in Guangdong Province
Bingjun SONG ; Ying ZHAO ; Mengxiong WU ; Zhiwei LU ; Fan YANG ; Ping CHEN ; Caiwen LI ; Xibo WANG ; Kun HUANG ; Ziqian ZHENG
China Occupational Medicine 2026;53(2):162-167
Objective To analyze the status of willingness to participate in health science popularization (HSP) and its influencing factors among medical workers in Guangdong Province. Methods A total of 462 medical workers in Guangdong Province were recruited as the study subjects using a stratified convenience sampling method. The Questionnaire on Influencing Factors of Willingness to Participate in Health Science Popularization, developed by the research team, was used to investigate their willingness to participate in HSP and related variables, including previous communication experience, attitude, moral belief, descriptive norm, injunctive norm, self-efficacy, and social support. Hierarchical regression analysis was used to identify the influencing factors of willingness to participate in HSP. Results The median and 25th and 75th percentiles score of willingness to participate in HSP was 4.0 (3.8, 4.5), indicating a moderately high level of willingness. The HSP participation willingness score was positively correlated with scores for previous communication experience, attitude, moral belief, descriptive norm, injunctive norm, self-efficacy, and social support (Spearman correlation coefficients were 0.513, 0.384, 0.507, 0.533, 0.463, 0.556, and 0.435, respectively; all P<0.01). Hierarchical regression analysis showed that previous communication experience, moral belief, descriptive norm and self-efficacy positively predicted willingness to participate in HSP (all P<0.05). Medical workers in the non-Pearl River Delta region had lower willingness than those in the Pearl River Delta region for HSP participation (P<0.05). Conclusion There is still room for improving willingness for HSP participation among healthcare professionals in Guangdong Province. It is recommended to enhance self-efficacy through communication skills training, strengthen professional ethics education, foster a positive peer engagement atmosphere, and intensify resource support and capacity building for HSP in the non-Pearl River Delta region, to improve HSP participation willingness among medical workers in Guangdong Province.
8.Impact of Intrapartum Ultrasound as a Replacement for Vaginal Examination in Labor Assessment on Vaginal Delivery Complications
Jinhui CUI ; Xinjuan CHEN ; Liping OUYANG ; Ling LI ; Jianhui FAN ; Zeping HUANG ; Ping LI
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(2):360-367
ObjectiveTo evaluate whether the use of intrapartum ultrasound (IPUS) to monitor the labor process, as alternative method of traditional vaginal examination (VE), could reduce the incidence of postpartum complications associated with vaginal delivery. MethodsA total of 360 primiparas who underwent cervical dilation balloon induction of labor (IOL) and achieved successful vaginal delivery after childbirth at the Third Affiliated Hospital of Sun Yat-sen University between January 2022 and December 2023, were included in the retrospective study with half assessed for labor progress using IPUS (n=180) and the other half using VE (n=180). The differences in the relevant indicators of the labor process and the complications of vaginal delivery were compared between the two groups of pregnant women. ResultsThere was no significant difference in the duration of membrane rupture, the first stage of labor and the second stage of labor between the two groups. However, the number of VE in the IPUS group was significantly lower [nulliparous: 4 (3-4) vs. 6 (5-8), P<0.001; multiparous: 2 (2-3) vs. 4 (3-5), P<0.001]. The IPUS group experienced a lower incidence of postpartum fever compared to the VE group [1.67%(3/180) vs. 7.22%(13/180), P=0.006], while other complications of vaginal delivery, such as fever during labor, postpartum hemorrhage (PPH), laceration, poor wound healing and uroschesis, were not significantly different (all P > 0.05). The logistic regression analysis confirmed that the use of IPUS served as a protective factor for postpartum fever with an OR of 0.06 [95% CI (0.01, 0.36); P=0.002], while the duration of membrane rupture was a risk factor [OR: 1.12; 95% CI (1.03, 1.22); P = 0.011]. ConclusionsIPUS, as an alternative to traditional VE, does not affect the progress of labor. However, it can significantly reduce the frequency of VE and the incidence of postpartum fever, thereby facilitating the rapid recovery of postpartum women, which makes it clinically valuable for application.
9.Chinese medical and pharmaceutical expert consensus on the clinical application of romosozumab
Liqian MO ; Zefu CHEN ; Huiyi WU ; Ping ZHENG ; Zhongmin ZHANG ; Yilei LI
China Pharmacy 2026;37(20):2640-2646
OBJECTIVE To standardize the rational clinical use of romosozumab in China, define suitable patient populations, optimize full-course treatment strategies, and strengthen medication risk management.METHODS This consensus was initiated by the Pharmacy Administration Committee of Guangdong Province Hospital Association and registered on the International Practice Guidelines Registry Platform. Twenty-five experts in pharmacy and orthopedics were organized to identify 7 core clinical questions through 2 rounds of questionnaires and seminars. Chinese and English databases were systematically retrieved, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess evidence quality and recommendation strength and to formulate consensus recommendations, which were refined based on expert review.RESULTS Seven recommendations were developed, covering the applicable populations of romosozumab, sequential and switching therapy, and management of fractures and cardiovascular risk during treatment. The pharmaceutical characteristics of romosozumab, as well as other key points for clinical application, including efficacy monitoring, management of missed doses, contraindications, major adverse reactions, and medication adherence, were also summarized.CONCLUSIONS This consensus provides evidence-based guidance and practical reference for the safe, effective, and standardized use of romosozumab in Chinese patients, which may facilitate individualized treatment of patients with osteoporosis at high fracture risk and reduce fracture risk.
10.Quality evaluation of Lufu pill based on fingerprint chromatography and multi-component content determination
Xiaohong GUO ; Ping TANG ; Jie LI ; Jingxiang AO ; Juan CHEN ; Min YANG ; Jing LENG
China Pharmacy 2026;37(20):2693-2699
OBJECTIVE To evaluate the quality of Lufu Pill (LFP).METHODS The high-performance liquid chromatography (HPLC) fingerprint of LFP was established using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine (2012 Edition), and similarity evaluation was performed. Hierarchical cluster analysis (HCA), principal component analysis (PCA), and orthogonal partial least squares-discriminant analysis (OPLS-DA) were performed using SIMCA 14.1 software. The contents of strychnine, brucine, liquiritin, notoginsenoside R 1 , ginsenoside Rg 1 , ginsenoside Rb 1 , licoricesaponin G 2 , and ginsenoside Rd in 12 batches of samples were determined by the HPLC method.RESULTS A total of 26 common peaks were identified in the HPLC fingerprint of 12 batches of LFP samples, and eight common peaks were identified as strychnine (peak 3), brucine (peak 4), liquiritin (peak 6), notoginsenoside R 1 (peak 7), ginsenoside Rg 1 (peak 8), ginsenoside Rb 1 (peak 15), licoricesaponin G 2 (peak 17), and ginsenoside Rd (peak 18). The similarities of 12 batches of LFP samples were all greater than 0.90. The results of HCA and PCA both showed that the 12 batches of samples were divided into two categories: S2, S4-S6, and S12 were grouped into one category, while S1, S3, S7-S11 were grouped into another category. The upper control limits for Hotelling’s T 2 and DMod X were 16.631 and 1.578, respectively. The variable importance in projection values of ginsenoside Rg 1 (peak 8), ginsenoside Rb 1 (peak 15), peak 20, strychnine (peak 3), peak 11, notoginsenoside R 1 (peak 7), peak 2, peak 17, peak 13, peak 10, ginsenoside Rd (peak 18), peak 23, peak 26, peak 21, and peak 24 were greater than 1.The content determination results showed that strychnine, brucine, liquiritin, notoginsenoside R 1 , ginsenoside Rg 1 , ginsenoside Rb 1 , licoricesaponin G 2 , and ginsenoside Rd were 0.005%-0.018%, 0.005%-0.010%, 0.050%-0.118%, 0.033%-0.073%, 0.132%-0.248%, 0.122%-0.242%, 0.021%-0.043%, and 0.016%-0.048%, respectively.CONCLUSIONS The established HPLC fingerprint and content determination method are accurate and reproducible, and can be used for the quality evaluation of LFP. Ginsenoside Rg 1 , ginsenoside Rb 1 , strychnine, notoginsenoside R 1 , and ginsenoside Rd may be the differential components affecting its overall quality.


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