1.Treatment Principles and Paradigm of Diabetic Microvascular Complications Responding Specifically to Traditional Chinese Medicine
Anzhu WANG ; Xing HANG ; Lili ZHANG ; Xiaorong ZHU ; Dantao PENG ; Ying FAN ; Min ZHANG ; Wenliang LYU ; Guoliang ZHANG ; Xiai WU ; Jia MI ; Jiaxing TIAN ; Wei ZHANG ; Han WANG ; Yuan XU ; .LI PINGPING ; Zhenyu WANG ; Ying ZHANG ; Dongmei SUN ; Yi HE ; Mei MO ; Xiaoxiao ZHANG ; Linhua ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):272-279
To explore the advantages of traditional Chinese medicine (TCM) and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications (DMC), refine key pathophysiological insights and treatment principles, and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine, hosted by the China Association of Chinese Medicine, was held in Beijing, 2024. Experts in TCM, Western medicine, and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis, diagnostic and treatment challenges, and mechanism research related to DMC, ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development, research prioritization, and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM, strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.
2.Role of endoplasmic reticulum stress-mediated DEAD-box helicase 3 X-linked in a mouse model of concanavalin A-induced immune-mediated liver injury
Zhenzhen PAN ; Ling XU ; Xianru ZHU ; Zihao FAN ; Yaling CAO ; Yinkang MO ; Sai YAN ; Feng REN
Journal of Clinical Hepatology 2026;42(1):134-142
ObjectiveTo investigate the role of DEAD-box helicase 3 X-linked (DDX3X) in immune-mediated liver injury (ILI), and to clarify its mechanism by regulating endoplasmic reticulum stress (ERS)-dependent apoptotic pathway and its association with the clinical progression of hepatitis B. MethodsMice were given injection of concanavalin A (ConA) via the caudal vein to establish a model of ILI, PBS (control group) and different concentrations of ConA were injected into the tail vein of hepatocyte-specific DDX3X-knockout mice (DDX3XΔHep and DDX3X-flox mice (DDX3Xfl/fl), respectively.. The log-rank survival analysis, measurement of the serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and HE staining of liver tissue were performed to assess liver injury, and qRT-PCR and Western Blot were used to measure the mRNA and protein expression levels of glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), and DDX3X in liver tissue. Intraperitoneal injection of 4-phenylbutyric acid (4-PBA, 100 mg/kg) was performed to inhibit ERS. Serum samples (n=30) and liver tissue samples (n=6) were collected from healthy controls, chronic hepatitis B (CHB) patients, and hepatitis B virus-associated liver failure (HBV-LF) patients; ELISA was used to measure the serum level of DDX3X, and qRT-PCR/Western Blot was used to analyze the expression of targets in liver tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the control group of mice, the expression of DDX3X in the liver of mice induced by ConA was significantly increased after liver injury (P<0.05), and hepatocyte-specific DDX3X knockout increased the 72-hour survival rate of mice by 55% (compared with 20% in the DDX3Xfl/fl group), with significant reductions in the serum levels of ALT and AST (P<0.000 1) and the expression levels of the ERS markers GRP78 and CHOP (P<0.05). After ERS was inhibited by 4-PBA, there was alleviation of liver injury (with reductions in ALT and AST, P <0.001) and a reduction in DDX3X expression (P<0.01). The analysis of clinical samples showed that the mRNA and protein expression levels of liver DDX3X in CHB patients and HBV-LF patients were significantly higher than those in healthy controls (all P<0.01), and there was a significant increase in the serum level of DDX3X in HBV-LF patients (P<0.000 1). ConclusionDDX3X exacerbates ILI by regulating the ERS-dependent apoptotic pathway (GRP78/CHOP), and its expression is associated with the progression of hepatitis B. Therefore, it can be used as a potential therapeutic target.
3.Insomnia and quality of life as chain mediators between negative life events and depression severity in adolescents with depressive disorders
Xu ZHANG ; Lewei LIU ; Jiawei WANG ; Feng GENG ; Daming MO ; Changhao CHEN ; Zhiwei LIU ; Xiangwang WEN ; Xiangfen LUO ; Huanzhong LIU
Acta Universitatis Medicinalis Anhui 2026;61(1):163-168
ObjectiveTo explore the relationship between negative life events and depression severity in adolescent patients with depressive disorder, as well as the chain mediating role of insomnia symptoms and quality of life. Methods374 outpatient patients and hospitalized patients with adolescent depressive disorders were enrolled. The Adolescent Life Event Scale (ASLEC), the Insomnia Severity Index (ISI), the World Health Organization Quality of Life Questionnaire Short Form (WHOQOL-BREF), and the Center for Epidemiology Depression Scale (CES-D) were used to evaluate the negative life event situation, insomnia symptoms, quality of life level and depression severity of the subjects, respectively. In addition, the PROCESS 4.0 macroprogram was used to analyze the chain mediating effect of insomnia symptoms and quality of life between negative life events and depression severity in patients with adolescent depressive disorder. ResultsThe results of correlation analysis showed that there was a significant correlation between negative life events and insomnia symptoms, quality of life, and depression severity (all P<0.05). In addition, the results of chain mediation showed that negative life events had a significant direct effect on depression severity, with an effect size of 0.12 (P<0.001). Insomnia symptoms and quality of life played a mediating role in the relationship between negative life events and depression severity in patients with adolescent depressive disorders, with indirect effect sizes of 0.062 (95%CI: 0.040-0.087) and 0.091 (95%CI: 0.059-0.123), respectively. It could also play a chain mediation role, and the effect size was 0.039 (95%CI: 0.024-0.057). ConclusionNegative life events experienced by patients with adolescent depressive disorder not only directly affect the severity of depressive symptoms, but may also indirectly exacerbate depression through insomnia symptoms and quality of life.
4.Evaluation of the public health governance capacity in Jiangsu Province
Peiyu FENG ; Anning MA ; Peiwu SHI ; Qunhong SHEN ; Chaoyang ZHANG ; Zheng CHEN ; Chuan PU ; Lingzhong XU ; Zhaohui GONG ; Tianqiang XU ; Panshi WANG ; Chao HAO ; Zhi HU ; Mo HAO ; Hua WANG ; Chengyue LI
Shanghai Journal of Preventive Medicine 2026;38(2):146-152
ObjectiveTo evaluate the public health governance capacity in Jiangsu Province and provide an optimized pathway for the construction of a “strong, rich, beautiful, and high-quality” new Jiangsu. MethodsA total of 806 policy documents, 658 public information reports, and 148 research literatures related to public health governance capacity in Jiangsu Province from January 1995 to December 2023 were collected. The status of current public health goverance was assessed based on the evaluation criteria suitable for public health systems, and the strengths and the weaknesses of the system were identified. ResultsThe public health governance capability of Jiangsu Province was scored at 738.3 points, ranking 3rd nationally. Maternal health care and emergency response capacities achieved leading positions nationwide, both ranking 2nd. Jiangsu had exhibited a standardized guidance in the strategic level, a well-established management mechanism, an extensive coverage in information collection, and a scientifically established health targets setting. However, bottlenecks remained, including an unclear division of responsibilities across organizational departments, an insufficient public-health workforce, the absence of a stable growth mechanism for government funding investment, and difficulties in promptly identifying public needs. ConclusionJiangsu’s public-health system demonstrates leading nationally, yet several components remain underdeveloped. Future efforts should consolidate advantages while addressing weaknesses, further diversify content and forms, establish a stable funding increase mechanism, and clarify departmental functions, thereby providing solid health support for realizing the developmental goals of a “strong, rich, beautiful and high-quality” new Jiangsu.
5.Evaluation of public health governance capacity in Zhejiang Province
Haiyan LI ; Ting CHEN ; Chengyue LI ; Huihui HUANGFU ; Wei WANG ; Qunhong SHEN ; Chaoyang ZHANG ; Zheng CHEN ; Chuan PU ; Lingzhong XU ; Anning MA ; Zhaohui GONG ; Tianqiang XU ; Panshi WANG ; Hua WANG ; Chao HAO ; Zhi HU ; Peiwu SHI ; Mo HAO
Shanghai Journal of Preventive Medicine 2026;38(2):153-158
ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.
6.Mechanism of Yishen Qubi Tongluo Formula (益肾祛痹通络方) in the Treatment of Rheumatoid Arthritis:Based on Network Pharmacology,Molecular Docking and Experimental Verification
Liuping XU ; Canyu YANG ; Ying LU ; Lisha MO ; Qiang CHI ; Yuan XIA ; Shuijuan LIU ; Mingliang QIU
Journal of Traditional Chinese Medicine 2026;67(5):557-566
ObjectiveTo explore the mechanism of Yishen Qubi Tongluo Formula (益肾祛痹通络方, YQTF) in the treatment of rheumatoid arthritis(RA). MethodsNetwork pharmacology was employed to retrieve and screen the active components and potential targets of YQTF as well as RA-related targets using databases including TCMSP, BATMAN, ETCM and GEO. The intersection of targets related to active components and RA-related targets was identified, and a protein-protein interaction (PPI) network was constructed. Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed, and a drug-active component-common target network of YQTF in the treatment of RA was established. The core components of YQTF were molecularly docked with key targets. Human rheumatoid arthritis synovial fibroblast cell line MH7A was divided into blank group, model group, methotrexate group and YQTF group. The blank group was cultured with 10% fetal bovine serum, while the other three groups were stimulated with 10 μg/L of recombinant human tumor necrosis factor-α (TNF-α) for 24 h to establish the RA cell model. On this basis, the methotrexate group was treated with methotrexate suspension at a concentration of 20 μmol/L, and the YQTF group was treated with 10% YQTF-medicated serum. After 48 h of intervention, the levels of TNF-α and interleukin-17A(IL-17A)contents in cell supernatants were detected by enzyme-linked immunosorbent assay (ELISA), and mRNA expressions of phosphatidylinositol 3-kinase(PI3K), protein kinase B(AKT) and mammalian target of rapamycin(mTOR) were detected by real-time quantitative polymerase chain reaction (RT-qPCR). ResultsNetwork pharmacological analysis identified 209 active components and 583 potential target genes of YQTF, as well as 818 RA-related targets. A total of 29 common targets were obtained from the intersection of drug-related targets and RA-related targets. Quercetin,β-sitosterol, kaempferol, stigmasterol and luteolin were the core active components of YQTF for the treatment of RA, while matrix metalloproteinase-9 (MMP9), prostaglandin-endoperoxide synthase 2 (PTGS2), Toll-like receptor 4 (TLR4), tumor protein p53 (TP53) and transcription factor AP-1 subunit JUN were the key targets. The GO and KEGG pathway enrichment analysis showed that the involved biological processes and pathways were mainly associated with antioxidant responses, PI3K-AKT signaling pathway and Toll-like receptor (TLR) signaling pathway. Molecular docking results showed that MMP9 and PTGS2 exhibited high binding affinities with quercetin, β-sitosterol, kaempferol, stigmasterol and luteolin; TLR4 exhibited high binding activities with β-sitosterol, stigmasterol and luteolin; and TP53 showed high binding affinity with luteolin. The results of cell experiments showed that compared with the control group, the contents of TNF-α and IL-17A as well as the mRNA expressions of AKT and mTOR in the model group significantly increased (P<0.05 or P<0.01). Compared with the model group, all the above indicators significantly decreased in the YQTF group, while the contents of TNF-α and the mRNA expression of AKT significantly decreased in the methotrexate group (P<0.05 or P<0.01). ConclusionThe mechanism of YQTF in the treatment of RA may be associated with reducing inflammatory cytokine secretion and inhibiting the activation of the PI3K-AKT-mTOR signaling pathway.
7.Pathological changes and macrophage polarization in the liver and spleen of mice infected with Angiostrongylus cantonensis
Xiaoyu QIN ; Yuchun CAI ; Yang HONG ; Fanna WEI ; Yahong HU ; Yumeng CAI ; Yuan HU ; Ting ZHANG ; Xiaojin MO ; Bin XU ; Yan LU ; Jiahui SUN ; Yan ZHOU ; Zelin ZHU ; Muxin CHEN
Chinese Journal of Schistosomiasis Control 2026;38(2):169-183
Objective To investigate the temporal changes in pathological damage and macrophage polarization in liver and spleen tissues of mice infected with Angiostrongylus cantonensis, and to preliminarily unravel the peripheral immune responses during the early stage of A. cantonensis infection. Methods Forty female BALB/c mice at ages of 6 to 8 weeks were randomly divided into four groups, including the control group and 7-, 14-, and 21-day infection groups, with 10 mice in each group. Each mouse in the infection groups was inoculated with 30 third-stage (L3) larvae of A. cantonensis by oral gavage, and five mice were randomly selected from each infection group on days 7, 14, and 21 post-infection, while mice in the control group were given the same volume of physiological saline and five mice were randomly selected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled. The histopathological changes of mouse liver and spleen tissues were observed using hematoxylin and eosin (HE) staining, and the percentage of positive staining area and the co-localization positive rates of the macrophage surface antigens F4/80, CD86, and CD206 were quantified in mouse liver and spleen tissues using immunohistochemical and immunofluorescence staining. In addition, five mice were collected from each infection group on days 7, 14, and 21 post-infection, and five mice were collected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled for detection of macrophage markers CD86 and CD206 and macrophage phenotyping using flow cytometry, and the expression of M1 macrophage markers, including inducible nitric oxide synthase (Nos2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and M2 markers, including arginase 1 (Arg1), mannose receptor C-type 1 (Mrc1) and chitinase-like protein 3 (Chil3) was quantified in mouse liver and spleen tissues using real-time quantitative PCR (RT-qPCR) assay. Results Proliferative lesions of the hepatocyte were observed in mouse liver tissues and the follicular structures of the mouse spleen white pulp were disrupted 21 days post-infection with A. cantonensis. Immunohistochemical staining showed that there were significant differences in the percentages of F4/80, CD86 and CD206 positive staining areas in the liver and spleen tissues among the four groups of mice (F = 242.40, 197.14, 183.19, 157.65, 242.35 and 146.24; all P values < 0.001), and the percentages of positive staining in the liver and spleen tissues of mice in the 14-day infection group [(4.45 ± 0.51)%, (3.74 ± 0.67)%, (8.32 ± 0.72)%, (16.56 ± 1.14)%, (11.62 ± 0.52)%, and (8.29 ± 0.72)%, respectively] and the 21-day infection group [(3.70 ± 0.11)%, (3.22 ± 0.43)%, (11.53 ± 1.03)%, (12.59 ± 1.05)%, (9.02 ± 0.83)%, and (11.67 ± 1.10)%, respectively] were higher than in the control group [(0.35 ± 0.16)%, (0.40 ± 0.02)%, (0.93 ± 0.05)%, (2.78 ± 0.26)%, (2.33 ± 0.20)%, and (1.85 ± 0.20)%, respectively] (all P values < 0.05). Immunofluorescence staining showed significant differences in the positive rates of F4/80 co-localization with CD86 and CD206 in mouse liver and spleen tissues among the four groups (F = 24.42, 25.28, 54.51 and 130.55; all P values < 0.001). Flow cytometry detected significant differences in the proportions of CD86+ and CD206+ macrophages in mouse liver and spleen tissues among the four groups (F = 67.98, 18.41, 29.77, 172.80; all P values < 0.001), and the proportions of CD206+ macrophages in the liver and spleen of the 21-day infection group were significantly higher than those in the control group [(9.25 ± 2.55)% vs (3.83 ± 0.72)%, and (4.22 ± 0.56)% vs (0.47 ± 0.18)%, respectively] (both P values < 0.05). In addition, RT-qPCR assay quantified significant differences in the relative mRNA expression of M1 macrophage markers (IL-1β, TNF-α and Nos2) and M2 macrophage markers (Arg1, Chil3 and Mrc1) in mouse liver and spleen tissues among the four groups (F = 41.30, 31.82, 199.33, 19.96, 62.01, 119.76, 23.67, 95.90, 72.27, 82.59, 123.41 and 29.75; all P values < 0.05). Conclusions A. cantonensis infection may cause progressive pathological damage in mouse liver and spleen tissues, accompanied by dynamic temporal changes in macrophage polarization. M1 macrophage polarization predominates at the early stage of A. cantonensis infection and shifts towards M2 polarization at the later stages, suggesting that M2 polarization may participate in immune regulation at late stages of A. cantonensis infection by suppressing excessive inflammatory responses and promoting tissue repair.
8.Mechanisms of Core Compound Formula and Compatibility of Traditional Chinese Medicine Components for Prevention and Treatment of Chronic Atrophic Gastritis Based on Huazhuo Jiedu Therapy
Fan GAO ; Xiaoxuan MO ; Fengyue XU ; Jiaye TIAN ; Xinmeng ZHAO ; Jianming JIANG ; Qiuhong GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):51-64
ObjectiveTo reveal the compatibility rules of the core compound formula and traditional Chinese medicine (TCM) components for prevention and treatment of chronic atrophic gastritis (CAG) by Huazhuo Jiedu (turbidity-resolving and detoxifying) therapy through uniform design in view of the potential regulatory pathway of endogenous turbid-toxin retention in CAG, elucidate the potential pathway by which the compound formulas regulate the Wnt/β-catenin-connexin 43 (CX43) signaling axis, demonstrated the efficacy enhancement and toxicity attenuation among the components, thus providing experimental evidence for the scientific application of multi-component, multi-target compatibility in TCM compound formulas. MethodsA mouse model of CAG was established with N-methyl-N-nitrosourea (MNU). Sixty mice were randomly allocated into 5 groups (n=12 per group): blank control, model, low-dose Huazhuo Jiedu core compound formula (HXFF-L, 4.004 g·kg-1), high-dose Huazhuo Jiedu core compound formula (HXFF-H, 8.008 g·kg-1), and positive control (folic acid at 11 mg·kg-1 + vitamin B12 at 14 mg·kg-1). The therapeutic efficacy and molecular mechanism of the core compound formula were evaluated by hematoxylin-eosin (HE) staining, Alcian blue-periodic acid-Schiff (AB-PAS) staining, enzyme-linked immunosorbent assay (ELISA), transmission electron microscopy (TEM), immunofluorescence assay, and Western blot. The chemical components of the core compound formula were detected and effective components were screened by ultra-high performance liquid chromatography coupled with quadrupole-orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS). Another 120 mice were randomized into blank control, model, and 8 HXFF component-combination groups with different dosages (uniform design groups 1-8, n=12 per group). A uniform design was adopted, with pathological scores of mouse gastric tissue as well as serum levels of pepsinogen Ⅰ (PGⅠ), pepsinogen Ⅱ (PGⅡ), and gastrin 17 (GAS17) set as dependent variables. Multivariate linear regression analysis was performed to predict the optimal proportion of core components in the compound formula and explore its compatibility rules. ResultsPharmacodynamic validation showed that compared with the blank control group, the model group had decreased gastric weight index (P<0.01) and increased pathological damage score and inflammatory factor levels (P<0.01). Compared with the model group, these indicators were reversed in the HXFF-L, HXFF-H, and positive control groups (P<0.05, P<0.01). Immunofluorescence results showed that CX43 expression was downregulated in the model group compared with the blank control group (P<0.01) and upregulated in the HXFF-H and positive control groups compared with the model group (P<0.05, P<0.01). Western blot results showed that compared with the blank control group, the model group demonstrated upregulated protein levels of Wnt and β-catenin in the gastric tissue (P<0.01). Compared with those in the model group, the protein level of Wnt was downregulated in the HXFF-L, HXFF-H, and positive control groups (P<0.05, P<0.01), while that of β-catenin was downregulated only in the HXFF-H group (P<0.05). A total of 25 compounds were identified in the core compound formula, including 9 from Coptidis Rhizoma, 10 from Pogostemonis Herba, 2 from Scorpio, and 4 from Lilii Bulbus. According to the category and origin of compounds, Coptidis Rhizoma alkaloids, Pogostemonis Herba volatile oils, Scorpio peptides, and Lilii Bulbus alkaloids were finally selected for component research. The predicted optimal combination of TCM components was as follows: Coptidis Rhizoma alkaloids at 75 mg·kg-1, Pogostemonis Herba volatile oils at 2.25 mg·kg-1, Scorpio protein extract at 90 mg·kg-1, and Lilii Bulbus alkaloids at 9 mg·kg-1. Coptidis Rhizoma alkaloids, Scorpio protein extract, Pogostemonis Herba volatile oils, and Lilii Bulbus alkaloids can ameliorate pathological lesions of the gastric tissue. Scorpio protein extract exerted positive regulatory effects on the gastric function, while Pogostemonis Herba volatile oils and Lilii Bulbus alkaloids showed negative correlations with partial gastric function indicators. Further investigations are required to clarify their dose-effect relationships and safety profiles. ConclusionThis study, for the first time, predicts the optimal proportion and synergistic regulatory mechanism of the core compound formula of Huazhuo Jiedu therapy, revealing the synergistic compatibility logic of its components. It provides a novel strategy for the precise TCM treatment of CAG and the modern development of compound formulas.
9.Mechanisms of Core Compound Formula and Compatibility of Traditional Chinese Medicine Components for Prevention and Treatment of Chronic Atrophic Gastritis Based on Huazhuo Jiedu Therapy
Fan GAO ; Xiaoxuan MO ; Fengyue XU ; Jiaye TIAN ; Xinmeng ZHAO ; Jianming JIANG ; Qiuhong GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(21):51-64
ObjectiveTo reveal the compatibility rules of the core compound formula and traditional Chinese medicine (TCM) components for prevention and treatment of chronic atrophic gastritis (CAG) by Huazhuo Jiedu (turbidity-resolving and detoxifying) therapy through uniform design in view of the potential regulatory pathway of endogenous turbid-toxin retention in CAG, elucidate the potential pathway by which the compound formulas regulate the Wnt/β-catenin-connexin 43 (CX43) signaling axis, demonstrated the efficacy enhancement and toxicity attenuation among the components, thus providing experimental evidence for the scientific application of multi-component, multi-target compatibility in TCM compound formulas. MethodsA mouse model of CAG was established with N-methyl-N-nitrosourea (MNU). Sixty mice were randomly allocated into 5 groups (n=12 per group): blank control, model, low-dose Huazhuo Jiedu core compound formula (HXFF-L, 4.004 g·kg-1), high-dose Huazhuo Jiedu core compound formula (HXFF-H, 8.008 g·kg-1), and positive control (folic acid at 11 mg·kg-1 + vitamin B12 at 14 mg·kg-1). The therapeutic efficacy and molecular mechanism of the core compound formula were evaluated by hematoxylin-eosin (HE) staining, Alcian blue-periodic acid-Schiff (AB-PAS) staining, enzyme-linked immunosorbent assay (ELISA), transmission electron microscopy (TEM), immunofluorescence assay, and Western blot. The chemical components of the core compound formula were detected and effective components were screened by ultra-high performance liquid chromatography coupled with quadrupole-orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS). Another 120 mice were randomized into blank control, model, and 8 HXFF component-combination groups with different dosages (uniform design groups 1-8, n=12 per group). A uniform design was adopted, with pathological scores of mouse gastric tissue as well as serum levels of pepsinogen Ⅰ (PGⅠ), pepsinogen Ⅱ (PGⅡ), and gastrin 17 (GAS17) set as dependent variables. Multivariate linear regression analysis was performed to predict the optimal proportion of core components in the compound formula and explore its compatibility rules. ResultsPharmacodynamic validation showed that compared with the blank control group, the model group had decreased gastric weight index (P<0.01) and increased pathological damage score and inflammatory factor levels (P<0.01). Compared with the model group, these indicators were reversed in the HXFF-L, HXFF-H, and positive control groups (P<0.05, P<0.01). Immunofluorescence results showed that CX43 expression was downregulated in the model group compared with the blank control group (P<0.01) and upregulated in the HXFF-H and positive control groups compared with the model group (P<0.05, P<0.01). Western blot results showed that compared with the blank control group, the model group demonstrated upregulated protein levels of Wnt and β-catenin in the gastric tissue (P<0.01). Compared with those in the model group, the protein level of Wnt was downregulated in the HXFF-L, HXFF-H, and positive control groups (P<0.05, P<0.01), while that of β-catenin was downregulated only in the HXFF-H group (P<0.05). A total of 25 compounds were identified in the core compound formula, including 9 from Coptidis Rhizoma, 10 from Pogostemonis Herba, 2 from Scorpio, and 4 from Lilii Bulbus. According to the category and origin of compounds, Coptidis Rhizoma alkaloids, Pogostemonis Herba volatile oils, Scorpio peptides, and Lilii Bulbus alkaloids were finally selected for component research. The predicted optimal combination of TCM components was as follows: Coptidis Rhizoma alkaloids at 75 mg·kg-1, Pogostemonis Herba volatile oils at 2.25 mg·kg-1, Scorpio protein extract at 90 mg·kg-1, and Lilii Bulbus alkaloids at 9 mg·kg-1. Coptidis Rhizoma alkaloids, Scorpio protein extract, Pogostemonis Herba volatile oils, and Lilii Bulbus alkaloids can ameliorate pathological lesions of the gastric tissue. Scorpio protein extract exerted positive regulatory effects on the gastric function, while Pogostemonis Herba volatile oils and Lilii Bulbus alkaloids showed negative correlations with partial gastric function indicators. Further investigations are required to clarify their dose-effect relationships and safety profiles. ConclusionThis study, for the first time, predicts the optimal proportion and synergistic regulatory mechanism of the core compound formula of Huazhuo Jiedu therapy, revealing the synergistic compatibility logic of its components. It provides a novel strategy for the precise TCM treatment of CAG and the modern development of compound formulas.
10.Analysis of parental expectations for the development and related factors of children with autism spectrum disorder
Chinese Journal of School Health 2026;47(9):1312-1316
Objective:
To assess parental expectations for the development of children with autism spectrum disorder (ASD) and identify factors associated with these expectations, so as to provide references for improving rehabilitation outcomes and long term development in children with ASD.
Methods:
From June 2024 to January 2026, a total of 877 children with ASD and their parents were recruited from 27 rehabilitation institutions in Hefei. The children had been diagnosed by chief physicians at tertiary level hospitals. Demographic characteristics and data on parental expectations were collected by the Parental Expectations Questionnaire. Differences in parental expectations between groups were assessed using the Mann-Whitney U- test and Kruskal-Wallis H-test, and associated factors were examined using quantile regression.
Results:
The mean item score for overall parental expectations among parents of children with ASD was (4.55±0.47), and scores for all dimensions were higher than those among parents of typically developing children ( t =11.11-31.14, all P <0.01). Child age, school enrollment, and maternal personality were associated with daily living expectation scores, learning and special talents and strengths expectation scores, and special talents and strengths expectation scores, respectively ( H =6.16-8.18, all P <0.05). Parents of preterm children had higher expectations for social interaction, physical and mental well being, and daily living than parents of non-preterm children ( Z =-2.56, -2.48, -2.39, all P <0.05). Multivariate quantile regression analysis showed that children’s age was associated with the expected level of self care ability; school enrollment status was associated with the expected level of learning and specialty strengths; maternal personality was associated with the expected levels of social competence, physical and mental health, self care ability, and specialty strengths; parental age was associated with the expected levels of physical and mental health and specialty strengths; and parental educational attainment was associated with the expected level of self care ability ( β =-0.36-0.41, all P <0.05).
Conclusion
Parents of children with ASD in Hefei generally have high expectations for their children s development across the domains of learning, daily living, social interaction, and physical and mental well being.


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