1.Improving the Certainty of Evidence in Animal Experiment Systematic Review/Meta-Analysis: An Empirical Study of the GRADE Method
Tengfei LI ; Qingyong ZHENG ; Jianguo XU ; Yiyi LI ; Yongjia ZHOU ; Caihua XU ; Mingyue ZHANG ; Jiexiang TIAN ; Gang WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(1):101-111
Animal experiments are essential tools in biomedical research, serving as a bridge between basic research and clinical trials. Systematic reviews and meta-analyses (SRs/MAs) of animal experiments are crucial methods for integrating evidence from animal experiment, which can facilitate the translation of findings into clinical research, reduce translational risks, and promote resource integration in basic research. With the continuous development of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, its application in SRs/MAs of animal experiments has gained increasing attention. This article first outlines the principles and specific applications of the GRADE methodology in SRs/MAs of animal experiments, including qualitative descriptive systematic reviews, meta-analyses, and network meta-analyses. It then deeply analyzes the misuse of the GRADE methodology in practice, including incorrect evidence grading, improper classification of evidence, misapplication in qualitative systematic reviews, inconsistencies between the documentation of the upgrading and downgrading process and results, and inappropriate use for making recommendations. Furthermore, this article comprehensively discusses the factors influencing the grading of evidence certainty in SRs/MAs of animal experiments, including the impact of bias risk, indirectness, inconsistency, imprecision, and publication bias on evidence downgrading, as well as the role of large effect sizes and cross-species consistency in evidence upgrading. Finally, in response to the issues discussed, improvement strategies are proposed, including further research and optimization of the GRADE methodology for SRs/MAs of animal experiments, the development of reporting guidelines tailored to the characteristics of SRs/MAs in animal experiment research, and enhanced professional training for researchers in the GRADE methodology. This article aims to improve the quality of evidence in SRs/MAs of animal experiments, strengthen their reliability in clinical decision-making, and promote the more efficient translation of findings from animal experiment research into clinical practice.
2.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
3.Clinical Efficacy Evaluation of Tanreqing Injection Combined with Ceftazidime in Treatment of Phlegm Heat Obstructing Lung Syndrome in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Mengmeng ZHANG ; Qiao LI ; Qingyong XIONG ; Jiayao LI ; Linna XIE ; Jiasheng LU ; Zegeng LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):170-175
ObjectiveTo explore the effect of Tanreqing injection combined with Ceftazide on the clinical efficacy, lung function, and laboratory inflammatory index of patients suffering from phlegm heat obstructing lung syndrome in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). MethodFrom June 2021 to June 2023, 76 patients diagnosed with phlegm heat obstructing lung syndrome in AECOPD were enrolled in the respiratory and critical medical department of Jieshou Hospital of Traditional Chinese Medicine. They were randomly divided into a control group and an observation group with 38 cases each. The control group used Ceftazidime intravenous drip and other conventional oxygen inhalation and antispasmodic treatment measures of western medicine. The observation group received Tanreqing injection intravenous drip based on the treatment of the control group, with a course of 10 days. The changes of laboratory indicators such as hs-CRP, calcitonin (PCT), and interleukin-6 (IL-6) before and after treatment were analyzed, and the improvement of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), one second rate (FEV1/FVC), assessment and improvement of the British Medical Research Society’s dyspnea index (mMRC), self-evaluation test of chronic obstructive pulmonary disease patients (CAT), and traditional Chinese medicine syndrome score was compared. In addition, the total effective rate between the two groups after treatment was compared. ResultAfter treatment, the hs-CRP, PCT, IL-6, FEV1, FVC, FEV1/FVC, mMRC, CAT scores, and traditional Chinese medicine syndrome evaluation of both groups improved (P<0.01). After treatment, compared with the control group, the observation group showed more significant improvements in hs-CRP, PCT, IL-6, FEV1, FVC, FEV1/FVC, mMRC, CAT scores, and traditional Chinese medicine syndrome evaluation, and the difference was statistically significant (P<0.05,P<0.01). The total clinical effective rate of the control group was 86.84% (33/38), while that of the observation group was 94.74% (36/38). The therapeutic effect of the observation group was better than that of the control group (χ2=8.471, P<0.05). ConclusionTanreqing injection combined with Ceftazidime has obvious efficacy in the treatment of phlegm heat obstructing lung syndrome in AECOPD, which is better than the treatment of Ceftazidime antibiotics alone. It can reduce the risk of acute exacerbation, alleviate clinical symptoms, and delay the decline of lung function.
4.Based on the correlation between "yang transforming qi,yin shaping up the body" and epicardial adipose tissue,discussing the prevention and treatment strategies of atrial fibrillation by traditional Chinese medicine
Jin LIU ; Qingyong HE ; Gaocan REN ; Yixiang LI
Journal of Beijing University of Traditional Chinese Medicine 2024;47(8):1131-1138
Epicardial adipose tissue (EAT) is a fat reservoir close to the myocardium and visceral pericardium. It has special anatomical and physiological characteristics. The volume and deposition site of EAT are closely related to the occurrence and development of atrial fibrillation (AF). This article discusses the connotation of the traditional Chinese medicine theory," yang transforming qi and yin shaping up the body",and holds that the essence of abnormal accumulation of EAT is "yang transforming qi deficiency and yin constituting form too much". Yin pathogen gradually accumulates,local yin and yang imbalance occurs,and abnormal secretion occurs. With the extension of time,the intrinsic yang heat is accompanied and becomes increasingly exuberant. Finally,yin is difficult to control yang,resulting in EAT infiltrating normal tissues,inducing and promoting the occurrence and progression of AF. Under the guidance of this theory,when distinguishing the amount of yin and yang between the body and EAT,considering the ability of "yang transforming qi" and "yin constituting form" in the whole and part,the method of supporting yang and eliminating yin should be reasonably selected. At the beginning of the disease,it is mainly to restore "yang transforming qi". By avoiding the accumulation of evil from the yin,it dissipates the body of the yin that has become. When the disease progresses,it is necessary to " eliminate pathogenic factor",supplemented by different treatment methods such as eliminating dampness,activating qi,and promoting blood circulation. Furthermore,the whole course of the disease should take care of the patient's deficiency,pay attention to strengthening yang and tonifying the healthy qi,and eliminate yin and evil promptly to improve clinical efficacy.
5.Advances and Challenges in the Research of Integration Methods of Animal Experimental Evidence
Qingyong ZHENG ; Tengfei LI ; Jianguo XU ; Yongjia ZHOU ; Zhichao MA ; Na WANG ; Molan LI ; Wenjing YANG ; Peirun WU ; Haidong WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2024;44(5):567-576
Integrating evidence from animal experiments is a critical component of biomedical research, providing essential prior information for in-depth investigations of disease mechanisms and new drug development. Animal models have played an irreplaceable role in simulating human diseases. However, the integration of evidence from animal experiments has faced numerous challenges, including insufficient emphasis, significant heterogeneity in study designs, high publication bias, and discrepancies with clinical research practices. This paper first identifies existing issues in the original research evidence from animal experiments, such as the selection and applicability of animal models, considerations in the design of experimental studies, and factors influencing the translation of animal experimental evidence. It then discusses various methods for integrating this evidence, including systematic review and meta-analysis, overview of systematic review/umbrella review, scoping review, and evidence mapping, while highlighting recent advancements in their application. Finally, the paper addresses the main challenges currently encountered in the integration of evidence from animal experiments and proposes targeted improvement strategies aimed at enhancing the efficiency of translating research outcomes into clinical practice and promoting the advancement of evidence-based medicine. By continuously optimizing original experimental research protocols and evidence integration practices, this work aims to establish a more efficient and scientific environment for the synthesis of evidence from animal experiments, ultimately contributing to clinical trials and human health.
6.Study on correlation between circulating exosome miR-485-3p and STYX expression with onset of premature coronary heart disease
Fan WANG ; Qingyong LI ; Yujie LIU ; Jingcai LUO ; Jinling SU ; Tongwen DING ; Qi SUN
Chongqing Medicine 2024;53(16):2462-2466,2471
Objective To investigate the correlation between the expression of circulating exosome miR-485-3p and STYX with the risk of premature coronary heart disease.Methods A total of 50 inpatients with early onset coronary heart disease diagnosed by coronary angiography or CT angiography (CTA) in Af-filiated Puyang Municipal People's Hospital of Xinxiang Medical College from August to December 2023 were selected as the study group and 50 patients with excluded coronary artery disease by examination during the same period were included in the control group.The general clinical data of the two groups were collected,the plasma exosome miR-485-3p and STYX levels were detected.The degree of coronary arterial lesions in the pa-tients of the study group was evaluated by the Gensini score.The Spearman correlation analysis was used to analyze the relationship between plasma exosome miR-485-3p and STYX with LDL and Gensini score.The re-ceiver operating characteristic (ROC) curve was used to analyze the diagnostic value of plasma exosome miR-485-3p and STYX in the diagnosis of premature coronary heart disease.The multivariate logistic regression was used to determine the independent risk factors for premature coronary heart disease.Results Compared with the control group,the family history of coronary heart disease,smoking history,LDL and plasma exo-some miR-485-3p level in the study group were increased,the plasma STYX level was decreased and the differences were statistically significant (P<0.05);the Spearman correlation analysis showed that miR-485-3p was positively correlated with LDL (r=0.546) and Gensini score (r=0.485),and negatively correlated with STYX (r=-0.576).STYX was negatively correlated with LDL (r=-0.389) and Gensini score (r=-0.531).The ROC curve showed that the area under the curve of miR-485-3p,STYX and their combination in the diagnosis of premature coronary heart disease was 0.821 (95%CI:0.736-0.906),0.850 (95%CI:0.772-0.927) and 0.899 (95%CI:0.837-0.960) respectively.Conclusion The expression of circulating exosome miR-485-3p in premature coronary heart disease is up-regulated and the expression of STYX is down-regulated,the both are closely related to the degree of coronary artery lesion,which could be used as the po-tential biomarkers for the diagnosis of premature coronary heart disease.
7.Four Treatises on the Clinical Application of Zhizichi Decoction
Ruolin DU ; Qingyong HE ; Shangjin LI ; Shanshan YU
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(9):168-172
This article mainly analyzed the clinical application of Zhizichi Decoction should focus on the following four aspects:Firstly,based on the concept of prescription,the main application of formula of Zhizichi Decoction is chest tightness and stuffiness,often accompanied by burning pain,restlessness,and insomnia;the second is to follow the traditional dosage method,using 48-55 g of Sojae Preparatum Semen for Zhizichi Decoction.If patients are particularly restless,they can reuse up to 90 g of Sojae Preparatum Semen;the third is to analyze the syndromes and clinical applications of Zhizichi Decoction;fourthly,based on clinical experience,the main application of formula of the commonly used overlapping classic formulas in Zhizichi Decoction.The changes in clinical symptoms are complex.In order to achieve comprehensive therapeutic effects,the concept of similar formulas and the addition and subtraction of ancient formulas can be followed.Classic formulas can be used in combination to expand the scope of clinical treatment of Zhizichi Decoction.
8.Research progress in the treatment of sleep disorder in chronic fatigue syndrome with external therapy of Traditional Chinese Medicine
Chuwen FENG ; Qingyong WANG ; Yuanyuan QU ; Zhongren SUN ; Yulin WANG ; Jing LU ; Yuying SHAO ; Binbin LI ; Tao CHEN ; Shuhao GUO ; Tiansong YANG
International Journal of Traditional Chinese Medicine 2023;45(2):248-252
Traditional Chinese Medicine (TCM) external therapy for sleep disorder of chronic fatigue syndrome (CFS) has good anti-fatigue effect and can improve sleep quality of patients. The treatment for sleep disorders of CFS with TCM external treatment mainly adopts acupuncture, moxibustion, massage, TCM bath, transcutaneous acupoint electrical stimulation and auricular point sticking, etc., or alone, or comprehensive application, or combined with oral Chinese materia medica. The appropriate treatment method can be selected according to the patients' condition and compliance, which reflects the unique advantages of TCM syndrome differentiation and treatment and the treatment according to people and time. The existing research still needs to further form a standardized and recognized diagnosis and treatment system, so as to better guide clinical popularization and application.
9.Impacts of pre-pregnancy body mass index, gestational diabetes mellitus and gestational weight gain on perinatal outcomes and mode of delivery
Yanyu LYU ; Dongmei FU ; Heru WANG ; Xiaoying WANG ; Qingyong XIU ; Xiaohong WANG ; Xiaodai CUI ; Rong MI ; Li LI
Chinese Journal of Neonatology 2023;38(7):412-418
Objective:To study the impacts of pre-pregnancy body mass index (BMI), gestational diabetes mellitus (GDM) and gestational weight gain (GWG) on perinatal outcomes and mode of delivery.Methods:From November 2016 to December 2017, single-pregnancy women in early pregnancy (<13 weeks) regularly checked-up at our hospital were enrolled in this prospective cohort study and followed up until delivery. They were assigned into four groups according to pre-pregnancy BMI: obese group (≥28.0 kg/m 2), overweight group(24.0-<28.0 kg/m 2), normal group (18.5-<24.0 kg/m 2) and underweight group(<18.5 kg/m 2). A 75-g oral glucose tolerance test was performed at 24-28 weeks of pregnancy to screen for GDM. The optimal GWG was 11.0-16.0 kg for underweight group, 8.0-14.0 kg for normal group, 7.0-11.0 kg for overweight group and 5.0-9.0 kg for obesity group. The effects of pre-pregnancy BMI, GDM and GWG on perinatal outcomes and delivery mode were evaluated using multivariate logistic regression methods. Results:A total of 802 pregnant women were included. The incidences of pre-pregnancy overweight and obesity were 21.8% and 8.9%, respectively. The incidence of GDM was 14.1%. 57.2% of the participants experienced excessive GWG. The incidences of macrosomia, low birth weight and premature birth were 7.1%, 2.7% and 2.2%, respectively. The incidence of Cesarean delivery (C-section) was 37.7%. Pre-pregnancy obesity [adjusted odds ratio ( AOR)=4.355, 95% confidence interval ( CI) 1.900-9.980] and excessive GWG ( AOR=3.799, 95% CI 1.796-8.034) were independent risk factors for macrosomia. Excessive GWG was a protective factor for low birth weight ( AOR=0.279, 95% CI 0.084-0.928) and inadequate GWG was a risk factor for low birth weight ( AOR=10.954, 95% CI 3.594-33.382) and premature birth ( AOR=8.796, 95% CI 2.628-29.438). Compared with the normal group, overweight group had an increased risk of C-section ( AOR=1.817, 95% CI 1.119-2.949). Compared with pregnant women without pre-pregnancy overweight/obesity, GDM nor excessive GWG, any combination of two of the above-mentioned three factors increased the risks of macrosomia ( AOR=3.908, 95% CI 1.630-9.370) and C-section ( AOR=2.269, 95% CI 1.325-3.886). The risks of macrosomia and C-section were the highest when all three factors existed. Conclusions:Pre-pregnancy obesity and excessive GWG are independent risk factors for macrosomia and pre-pregnancy overweight is a risk factor of C-section. Exposure to any two of the three factors (pre-pregnancy overweight/obesity, GDM and excessive GWG) increases risks of macrosomia and C-section and the highest risk is observed when all three factors are present.
10.Preliminary study of stereotactic cardiac radioablation in radiotherapy of ventricular arrhythmia
Jing LI ; Qingyong CHEN ; Guangjun LI ; Yan LI ; Yingjie ZHANG ; Changhu LI ; Long BAI ; Renming ZHONG ; Yinbo HE ; Sen BAI ; Qing YANG ; Feng XU
Chinese Journal of Radiation Oncology 2022;31(3):260-265
Objective:To introduce the stereotactic cardiac radioablation (SCRA) based on the stereotactic body radiotherapy (SBRT), and comprehensively evaluate the new approach by short-term effectiveness and safety.Methods:Patients with ventricular arrhythmia (VA) were evaluated and included in this clinical trial, who were immobilized by vacuum bag and performed simulation with 4-dimensional computed tomography (4DCT). In this study, the planning target volume (PTV) was set as the target to design a SBRT plan using volumetric modulated arc therapy (VMAT), which was evaluated by dose parameters such as R 50%, homogeneity index and conformity index, etc. The results of Holter and echocardiography were monitored during the follow-up and compared with the data before treatment. Results:Three subjects with ventricular tachycardia (VT) and one with premature ventricular contraction (PVC) received the same prescription of 25 Gy in a single fraction. The average volume of PTV was 71.4 cm 3(60.3-89.4 cm 3). The average time of beam delivery was 12.0 min (4.5-21.0 min). And the short-term follow-up lasted for an average of 18 weeks (14-25 weeks), which showed significant decrease in both VT and PVC load without complications. Conclusion:This study reports the implementation method of SCRA and proves its short-term effectiveness and safety, but the effects and standards of the key radiotherapy techniques still need to be explored.

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