1.Risk Identification Model of Coronary Artery Stenosis Constructed Based on Random Forest
Yongfeng LV ; Yujing WANG ; Leyi ZHANG ; Yixin LI ; Na YUAN ; Jing TIAN
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(1):138-146
ObjectiveTo establish a risk recognition model for coronary artery stenosis by using a machine learning method and to identify the key causative factors. MethodsPatients aged ≥18 years,diagnosed with coronary heart disease through coronary angiography from January 2013 to May 2020 in two prominent hospitals in Shanxi Province, were continuously enrolled. Logistic regression,back propagation neural network (BPNN), and random forest(RF)algorithms were used to construct models for detecting the causative factors of coronary artery stenosis. Sensitivity (TPR), specificity (TNR), accuracy (ACC), positive predictive value (PV+), negative predictive value (PV-), area under subject operating characteristic curve (AUC), and calibration curve were used to compare the discrimination and calibration performance of the models. The best model was then employed to predict the main risk variables associated with coronary stenosis. ResultsThe RF model exhibited superior comprehensive performance compared to logistic regression and BPNN models. The TPR values for logistic regression,BPNN,and RF models were 75.76%, 74.30%, and 93.70%, while ACC values were 74.05%, 72.30%, and 79.49%, respectively. The AUC values were:logistic regression 0.739 9; BPNN 0.723 1; RF 0.752 2. Manifestations such as chest pains,abnormal ST segments on ECG,ventricular premature beats with hypertension, atrial fibrillation, regional wall motion abnormalities(RWMA) by color echocardiography, aortic regurgitation(AR), pulmonary insufficiency (PI), family history of cardiovascular diseases,and body mass index(BMI)were identified as top ten important variables affecting coronary stenosis according to the RF model. ConclusionsRandom forest model shows the best comprehensive performance in identification and accurate assessment of coronary artery stenosis. The prediction of risk factors affecting coronary artery stenosis can provide a scientific basis for clinical intervention and help to formulate further diagnosis and treatment strategies so as to delay the disease progression.
2.The distribution pattern of traditional Chinese medicine syndromes and influencing factors for primary liver cancer: An analysis of 415 cases
Zhiyao SHI ; Xiaofei FAN ; Yu GAO ; Shaojian REN ; Shiyu WU ; Xixing WANG
Journal of Clinical Hepatology 2025;41(1):84-91
ObjectiveTo investigate the influencing factors for traditional Chinese medicine (TCM) syndromes of primary liver cancer, and to provide a theoretical basis for the TCM syndrome differentiation and standardized treatment of liver cancer. MethodsTCM syndrome differentiation was performed for 415 patients who were admitted to Shanxi Institute of Traditional Chinese Medicine and were diagnosed with primary liver cancer based on pathological or clinical examinations from January 2019 to December 2023. The chi-square test was used for comparison of categorical data between groups, and the unordered polytomous logistic regression model was used to investigate the influencing factors for TCM syndromes of liver cancer. ResultsThe common initial symptoms of the 415 patients with primary liver cancer included pain in the liver area (31.81%), abdominal distension (25.30%), abdominal pain (15.18%), and weakness (13.98%), and the main clinical symptoms included poor appetite (70.84%), fatigue (69.16%), pain in the liver area (67.47%), poor sleep (59.04%), abdominal distension (53.01%), and constipation (52.53%). There were significant differences in TCM syndromes between patients with different sexes, courses of the disease, clinical stages, Child-Pugh classes, presence or absence of intrahepatic and extrahepatic metastasis, and presence or absence of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (all P<0.05). The logistic regression analysis showed that male sex was a risk factor for damp-heat accumulation (odds ratio [OR]=2.036, P=0.048) and the syndrome of spleen-kidney Yang deficiency (OR=5.240, P<0.001); a course of disease of<1 year was a risk factor for damp-heat accumulation (OR=2.837, P=0.004) and syndrome of Qi stagnation and blood stasis (OR=2.317, P=0.021), but it was a protective factor against syndrome of spleen-kidney Yang deficiency (OR=0.385, P=0.005); Child-Pugh class A/B was a protective factor against liver-kidney Yin deficiency (OR=0.079, P<0.001); intrahepatic metastasis was a risk factor for liver-kidney Yin deficiency (OR=5.117, P=0.003) and syndrome of spleen-kidney Yang deficiency (OR=3.303, P=0.010); TACE was a protective factor against liver-kidney Yin deficiency (OR=0.171, P<0.001) and syndrome of spleen-kidney Yang deficiency (OR=0.138, P<0.001); radiofrequency ablation was a risk factor for damp-heat accumulation (OR=4.408, P<0.001) and liver-kidney Yin deficiency (OR=32.036, P<0.001). ConclusionSex, course of disease, Child-Pugh class, intrahepatic metastasis, TACE, and radiofrequency ablation are the main influencing factors for TCM syndromes of liver cancer.
3.Time-series study on the impact of atmospheric fine particulate matter PM2.5 on short-term pulmonary function in elderly patients with chronic obstructive pulmonary disease in Taiyuan City
Yingying SHAO ; Chen WANG ; Anfeng CUI ; Haodong WANG ; Tian-e LUO
Journal of Public Health and Preventive Medicine 2025;36(1):18-22
Objective To explore the effect of fine particulate matter (PM2.5) in Taiyuan City on short-term pulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD). Methods Among the 1 015 elderly COPD patients admitted to the respiratory departments of five general hospitals in Taiyuan City from December 2021 to December 2023 were retrospectively selected for research; medical records, air pollutant data and meteorological data were analyzed; the relationship between PM2.5 and lung function indicators and air pollutants was analyzed; the impact of PM2.5 on lung function and its lag effect were analyzed; the cumulative effect of PM2.5 concentration on the risk of pulmonary ventilation dysfunction was analyzed; The influence of gender and age on the relationship between PM2.5 and patients ' short-term pulmonary function was analyzed. Results PM2.5, respirable particulate matter (PM10), sulfur dioxide (SO2), carbon monoxide (CO) were negatively correlated with average temperature and average humidity (P<0.05) ; Nitrogen dioxide (NO2), ozone (O3) were negatively correlated with average temperature (P<0.05) ; There was a positive correlation among PM2.5, PM10, SO2, CO, NO2, and O3 (P<0.05) ; Elevated PM2.5 is an independent risk factor for decreased lung function and increased air pollutants (P<0.05) ; At lag0 and lag1, PM2.5 concentration was negatively correlated with lung function in a dose-response manner (P<0.05); daily average PM2.5 concentration at lag0 was a dangerous effect (P<0.05). Conclusion The impact of PM2.5 concentration on lung function has a certain time lag. An increase in PM2.5 concentrations can lead to a decline in lung function.
4.Ethical exploration of the text-to-video large model Sora empowering healthcare
Chinese Medical Ethics 2025;38(2):195-200
As an emerging artificial intelligence (AI), the text-to-video large model Sora possesses powerful functions that previous AI did not have. In the medical field, medical staff can use the Sora model to achieve efficient medical education, patient health consultation, medical research, and other activities. Studying the innovative application scenarios, ethical issues, and governance paths of the current Sora model is of great significance for utilizing the new AI technology to promote and improve medical experience and quality, as well as to grasp the future development direction of AI in the field of healthcare.
5.Dihuang Yinzi Improves Cognitive Function of Mouse Model of Learning and Memory Impairments by Regulating Synaptic Plasticity via SIRT2
Wenting WANG ; Yangjing HAO ; Wenna SU ; Qinqing LI ; Shifeng CHU ; Junlong ZHANG ; Wenbin HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):9-17
ObjectiveTo investigate the effects of Dihuang Yinzi on the cognitive function in the mouse model of learning and memory impairments induced by scopolamine (SCOP) and explore the treatment mechanism. MethodsA mouse model of learning and memory impairment was induced by intraperitoneal injection of SCOP. Sixty male C57BL/6J mice were randomized into six groups: control (0.9% NaCl, n=10), model (SCOP 1 mg·kg-1·d-1, n=10), low-, medium-, and high-dose Dihuang Yinzi (SCOP 1 mg·kg-1·d-1 + Dihuang Yinzi 5.5, 11.0, and 22.0 g·kg-1·d-1, n=10), and donepezil (SCOP 1 mg·kg-1·d-1 + donepezil 0.84 mg·kg-1·d-1, n=10). Mice were administrated with corresponding drugs for 6 weeks. Modeling started in the 4th week, and mice in other groups except the control group were injected with SCOP intraperitoneally 40 min after daily gavage. Behavioral testing began in the 5th week, 30 min after modeling each day. The Morris water maze and novel object recognition tests were carried out to evaluate the spatial learning and memory function of mice. Nissl staining was employed to observe the survival of neurons and Nissl bodies in the hippocampal CA1 region. Western blot was employed to determine the protein levels of silent information regulator 2 (SIRT2), α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor 1 (GluA1), protein kinase A (PKA), cAMP response element-binding protein (CREB), phosphorylated-CREB (p-CREB), postsynaptic density protein 95 (PSD95), growth-associated protein-43 (GAP-43), and synaptophysin (SYN) in the hippocampus. Immunofluorescence was used to detect the expression of doublecortin (DCX) in the hippocampal dentate gyrus (DG) region. ResultsCompared with the control group, the model group showed impaired learning and memory (P<0.01), obvious neuronal damage in the hippocampal CA1 region, a reduction in neuron survival (P<0.01), a decrease in DCX expression in the hippocampal DG region (P<0.01), down-regulated proteins levels of GluA1, PKA, p-CREB/CREB, PSD95, SYN, and GAP-43 in the hippocampal tissue (P<0.05, P<0.01), and an up-regulated protein level of SIRT2 (P<0.01). Compared with the model group, the medium- and high-dose Dihuang Yinzi groups and the donepezil group showed improvements in learning and memory (P<0.05, P<0.01), while the low-, medium-, and high-dose Dihuang Yinzi groups and the donepezil group had increased neuron survival (P<0.05, P<0.01). The medium-dose Dihuang Yinzi group and the donepezil group showed increased DCX expression (P<0.05, P<0.01). The medium- and high-dose Dihuang Yinzi groups and the donepezil group showed up-regulation in the protein levels of GluA1, PKA, p-CREB/CREB, PSD95, SYN, and GAP-43 (P<0.05, P<0.01) and down-regulation in the protein level of SIRT2 (P<0.01). ConclusionDihuang Yinzi can improve the cognitive function in the mouse model of learning and memory impairments induced by SCOP by inhibiting the upregulation of SIRT2, activating the PKA/CREB signaling pathway, improving synaptic plasticity, and reducing hippocampal neuronal damage.
6.Advances in inflammatory response mechanism and anti-inflammatory treatment with dry eye disease
Pingping WANG ; Fan JIANG ; Simin LI ; Dongxia YAN ; Juan CHENG
International Eye Science 2025;25(3):440-445
In recent years, the incidence of dry eye disease(DED)is increasing, positioning it as one of the most prevalent diseases affecting the ocular surface. Inflammatory response is the pathological basis of DED, involving various inflammatory mediators and inflammatory signaling pathways. Consequently, anti-inflammatory treatment emerges as a fundamental strategy for preventing and managing DED. This review summarizes the classic inflammatory factors involved in the development and progression of DED, including interleukins, tumor necrosis factor, matrix metalloproteinases, chemokines, and cell adhesion molecules. It also discusses the relevant inflammatory signaling pathways: the MAPKs pathway, NF-κB pathway, Wnt pathway and TLR pathway. Additionally, this review addresses the mechanisms of action and alterations in relevant biomarkers associated with current first-line recommended anti-inflammatory therapies, including corticosteroids, immunosuppressants, nonsteroidal anti-inflammatory drugs, and traditional Chinese medicine approaches to inflammation management. This comprehensive overview aims to enhance understanding of the inflammatory mechanisms underlying DED while exploring future therapeutic prospects.
7.Advances in inflammatory response mechanism and anti-inflammatory treatment with dry eye disease
Pingping WANG ; Fan JIANG ; Simin LI ; Dongxia YAN ; Juan CHENG
International Eye Science 2025;25(3):440-445
In recent years, the incidence of dry eye disease(DED)is increasing, positioning it as one of the most prevalent diseases affecting the ocular surface. Inflammatory response is the pathological basis of DED, involving various inflammatory mediators and inflammatory signaling pathways. Consequently, anti-inflammatory treatment emerges as a fundamental strategy for preventing and managing DED. This review summarizes the classic inflammatory factors involved in the development and progression of DED, including interleukins, tumor necrosis factor, matrix metalloproteinases, chemokines, and cell adhesion molecules. It also discusses the relevant inflammatory signaling pathways: the MAPKs pathway, NF-κB pathway, Wnt pathway and TLR pathway. Additionally, this review addresses the mechanisms of action and alterations in relevant biomarkers associated with current first-line recommended anti-inflammatory therapies, including corticosteroids, immunosuppressants, nonsteroidal anti-inflammatory drugs, and traditional Chinese medicine approaches to inflammation management. This comprehensive overview aims to enhance understanding of the inflammatory mechanisms underlying DED while exploring future therapeutic prospects.
8.Application of Recombinant Collagen in Biomedicine
Huan HU ; Hong ZHANG ; Jian WANG ; Li-Wen WANG ; Qian LIU ; Ning-Wen CHENG ; Xin-Yue ZHANG ; Yun-Lan LI
Progress in Biochemistry and Biophysics 2025;52(2):395-416
Collagen is a major structural protein in the matrix of animal cells and the most widely distributed and abundant functional protein in mammals. Collagen’s good biocompatibility, biodegradability and biological activity make it a very valuable biomaterial. According to the source of collagen, it can be broadly categorized into two types: one is animal collagen; the other is recombinant collagen. Animal collagen is mainly extracted and purified from animal connective tissues by chemical methods, such as acid, alkali and enzyme methods, etc. Recombinant collagen refers to collagen produced by gene splicing technology, where the amino acid sequence is first designed and improved according to one’s own needs, and the gene sequence of improved recombinant collagen is highly consistent with that of human beings, and then the designed gene sequence is cloned into the appropriate vector, and then transferred to the appropriate expression vector. The designed gene sequence is cloned into a suitable vector, and then transferred to a suitable expression system for full expression, and finally the target protein is obtained by extraction and purification technology. Recombinant collagen has excellent histocompatibility and water solubility, can be directly absorbed by the human body and participate in the construction of collagen, remodeling of the extracellular matrix, cell growth, wound healing and site filling, etc., which has demonstrated significant effects, and has become the focus of the development of modern biomedical materials. This paper firstly elaborates the structure, type, and tissue distribution of human collagen, as well as the associated genetic diseases of different types of collagen, then introduces the specific process of producing animal source collagen and recombinant collagen, explains the advantages of recombinant collagen production method, and then introduces the various systems of expressing recombinant collagen, as well as their advantages and disadvantages, and finally briefly introduces the application of animal collagen, focusing on the use of animal collagen in the development of biopharmaceutical materials. In terms of application, it focuses on the use of animal disease models exploring the application effects of recombinant collagen in wound hemostasis, wound repair, corneal therapy, female pelvic floor dysfunction (FPFD), vaginal atrophy (VA) and vaginal dryness, thin endometritis (TE), chronic endometritis (CE), bone tissue regeneration in vivo, cardiovascular diseases, breast cancer (BC) and anti-aging. The mechanism of action of recombinant collagen in the treatment of FPFD and CE was introduced, and the clinical application and curative effect of recombinant collagen in skin burn, skin wound, dermatitis, acne and menopausal urogenital syndrome (GSM) were summarized. From the exploratory studies and clinical applications, it is evident that recombinant collagen has demonstrated surprising effects in the treatment of all types of diseases, such as reducing inflammation, promoting cell proliferation, migration and adhesion, increasing collagen deposition, and remodeling the extracellular matrix. At the end of the review, the challenges faced by recombinant collagen are summarized: to develop new recombinant collagen types and dosage forms, to explore the mechanism of action of recombinant collagen, and to provide an outlook for the future development and application of recombinant collagen.
9.Experience in Staged Differentiation and Treatment of Cirrhotic Ascites Based on the Theory of Tonification and Purging
Haihang DONG ; Yujie CAI ; Huiqin ZHANG ; Yan CHEN ; Yuying TU ; Dongling WANG ; Yinqiang ZHANG
Journal of Traditional Chinese Medicine 2025;66(5):532-536
It is believed that patients with cirrhotic ascites exhibit a pathological mechanism characterized by the decline of healthy qi and the accumulation of pathogenic factors. Clinically, treatment should be based on the theory of tonification and purging, with a staged approach distinguishing between the active phase and the remission phase. The balance between tonification and purging should be adjusted according to the progression of pathogenic and healthy actors. In the acute phase, purging should take precedence over tonification, using purging as a means of tonification to facilitate the flow of water and qi through the triple energizer. The severity of water retention, dampness, blood stasis, and heat should be carefully assessed to ensure thorough elimination of pathogenic factors while avoiding harm to healthy qi. Medication adjustments should be made once the pathogenic factors are significantly weakened. In the remission phase, an integrated approach combining both tonification and purging should be adopted, incorporating purging within tonification to clear residual pathogens and prevent recurrence. Concurrently, proactive treatment of the underlying disease is essential to achieve complete recovery and prevent the recurrence of ascites.
10.Optimization Strategy and Practice of Traditional Chinese Medicine Compound and Its Component Compatibility
Zhihao WANG ; Wenjing ZHOU ; Chenghao FEI ; Yunlu LIU ; Yijing ZHANG ; Yue ZHAO ; Lan WANG ; Liang FENG ; Zhiyong LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):299-310
Prescription optimization is a crucial aspect in the study of traditional Chinese medicine (TCM) compounds. In recent years, the introduction of mathematical methods, data mining techniques, and artificial neural networks has provided new tools for elucidating the compatibility rules of TCM compounds. The study of TCM compounds involves numerous variables, including the proportions of different herbs, the specific extraction parts of each ingredient, and the interactions among multiple components. These factors together create a complex nonlinear dose-effect relationship. In this context, it is essential to identify methods that suit the characteristics of TCM compounds and can leverage their advantages for effective application in new drug development. This paper provided a comprehensive review of the cutting-edge optimization experimental design methods applied in recent studies of TCM compound compatibilities. The key technical issues, such as the optimization of source material selection, dosage optimization of compatible herbs, and multi-objective optimization indicators, were discussed. Furthermore, the evaluation methods for component effects were summarized during the optimization process, so as to provide scientific and practical foundations for innovative research in TCM and the development of new drugs based on TCM compounds.


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