1.A bibliometric and visual analysis of the literature published in the journal of Organ Transplantation since its inception
Xi CAO ; Tao HUANG ; Qiwei YANG ; Lin YU ; Xiaowen WANG ; Wenfeng ZHU ; Haoqi CHEN ; Ning FAN ; Genshu WANG
Organ Transplantation 2026;17(1):133-142
Objective To systematically analyze the literature characteristics of Journal of Organ Transplantation since its inception. Methods Using the China National Knowledge Infrastructure (CNKI) academic journal full-text database as the data source, all articles published in the Journal of Organ Transplantation from January 2010 to August 2025 were retrieved. After excluding non-academic papers, a total of 1 568 research papers were included. R language 4.3.0, Bibliometrix package 3.2.1, and Citespace software were used to analyze the number of publications, publishing institutions, authors, keywords and other aspects. Results The number of publications in Journal of Organ Transplantation increased from an average of 82 articles per year in the early years after its inception to 113 articles per year in recent years, a growth of 37.8%. The geographical distribution of publishing institutions covers 32 provinces, cities and autonomous regions nationwide, mainly concentrated in the South China, East China and North China regions, and has now basically covered the central and western regions in recent years. The author collaboration network includes 45 authors distributed across 7 major collaboration clusters, forming a stable multi-level national research system centered on key university-affiliated hospitals. The high-frequency keywords are dominated by "liver transplantation" (425 times) and "kidney transplantation" (396 times). The theme evolution shows a clear three-stage characteristic: initially focusing on clinical technology application, deepening to immune mechanism exploration in the middle stage, and recently (since 2022) focusing on cutting-edge research areas such as xenotransplantation. Conclusions Journal of Organ Transplantation has witnessed the rapid development of China's organ transplantation cause, fully reflecting the research status and trends in China's organ transplantation field, and has provided an important platform for the future development and international cooperation in China's organ transplantation field.
2.Study on the effects and mechanisms of Lycium ruthenicum Murr. in improving sleep
Ming QIAO ; Yao ZHAO ; Yi ZHU ; Yexia CAO ; Limei WEN ; Yuehong GONG ; Xiang LI ; Juanchen WANG ; Tao WANG ; Jianhua YANG ; Junping HU
China Pharmacy 2026;37(1):24-29
OBJECTIVE To investigate the effects and mechanisms of Lycium ruthenicum Murr. in improving sleep. METHODS Network pharmacology was employed to identify the active components of L. ruthenicum and their associated disease targets, followed by enrichment analysis. A caffeine‑induced zebrafish model of sleep deprivation was established , and the zebrafish were treated with L. ruthenicum Murr. extract (LRME) at concentrations of 0.1, 0.2 and 0.4 mg/mL, respectively; 24 h later, behavioral changes of zebrafish and pathological alterations in brain neurons were subsequently observed. The levels of inflammatory factors [interleukin-6 (IL-6), IL-1β, IL-10, tumor necrosis factor-α (TNF-α)], oxidative stress markers [superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), catalase (CAT)], and neurotransmitters [5- hydroxytryptamine (5-HT), γ-aminobutyric acid (GABA), glutamic acid (Glu), dopamine (DA), and norepinephrine (NE)] were measured. The protein expression levels of protein kinase B1 (AKT1), phosphorylated AKT1 (p-AKT1), epidermal growth factor receptor (EGFR), B-cell lymphoma 2 (Bcl-2), sarcoma proto-oncogene,non-receptor tyrosine kinase (SRC), and heat shock protein 90α family class A member 1 (HSP90AA1) in the zebrafish were also determined. RESULTS A total of 12 active components and 176 intersecting disease targets were identified through network pharmacology analysis. Among these, apigenin, naringenin and others were recognized as core active compounds, while AKT1, EGFR and others served as key targets; EGFR tyrosine kinase inhibitor resistance signaling pathway was identified as the critical pathway. The sleep improvement rates in zebrafish of LRME low-, medium-, and high-dose groups were 54.60%, 69.03% and 77.97%, 开发。E-mail:hjp_yft@163.com respectively, while the inhibition ratios of locomotor distance were 0.57, 0.83 and 0.95, respectively. Compared with the model group, the number of resting counts, resting time and resting distance were significantly increased/extended in LRME medium- and high-dose groups (P<0.05). Neuronal damage in the brain was alleviated. Additionally, the levels of IL-6, IL-1β, TNF-α, MDA, Glu, DA and NE, as well as the protein expression levels of AKT1, p-AKT1, EGFR, SRC and HSP90AA1, were markedly reduced (P<0.05), while the levels of IL-10, SOD, GSH-Px, CAT, 5-HT and GABA, as well as Bcl-2 protein expression, were significantly elevated (P<0.05). CONCLUSIONS L. ruthenicum Murr. demonstrates sleep-improving effects, and its specific mechanism may be related to the regulation of inflammatory responses, oxidative stress, neurotransmitter balance, and the EGFR tyrosine kinase inhibitor resistance signaling pathway.
3.Treatment of Hyperuricemia and Gouty Arthritis by Buyang Huanwu Tongfeng Decoction via Inhibition of PPAR-γ/NF-κB/AGEs/RAGE Pathway Based on Network Pharmacology
Yue CAO ; Wanmei YAO ; Tao YANG ; Man YANG ; Ruimin JIA ; Rongrong LU ; Xue FENG ; Biwang LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):182-192
ObjectiveThis paper aims to investigate the potential molecular biological mechanism of Buyang Huanwu Tongfeng decoction in treating hyperuricemia and gouty arthritis by network pharmacology and molecular docking technology and preliminarily verify the mechanism through animal experiments. MethodsThe active ingredients and targets in the Buyang Huanwu Tongfeng decoction were obtained by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and ETCM databases. The DisGeNET and GeneCards databases were utilized to acquire disease targets associated with hyperuricemia and gouty arthritis. These disease targets were then intersected with drug targets to identify key targets. The R language ClusterProfiler package and Python were employed for conducting gene ontology(GO) enrichment analysis and Kyoto encyclopedia of genes and genomes(KEGG) enrichment analysis. The regulatory network diagram of the drug-key target-function-pathway was visualized using Cytoscape 3.9.1 software, and the protein-protein interaction (PPI) network for key targets was depicted. Finally, the hub gene was determined through topological analysis. Auto Dock, PyMOL, and other software were used for molecular docking to explore the possible therapeutic mechanism of Buyang Huanwu Tongfeng decoction for hyperuricemia and gouty arthritis. In animal experiments, a composite rat model of hyperuricemia induced by intraperitoneal injection of oteracil potassium combined with gouty arthritis induced by the modified Coderre method was established. Through hematoxylin-eosin(HE) staining, uric acid test, enzyme linked immunosorbent assay(ELISA), Western blot, and real-time polymerase chain reaction(Real-time PCR), the molecular mechanism and key targets of Buyang Huanwu Tongfeng decoction for treating hyperuricemia and gouty arthritis were observed. ResultsAfter screening and removing duplicate values, 76 active ingredients and 15 key targets were finally obtained. GO enrichment analysis yielded that the treatment of hyperuricemia and gouty arthritis with Buyang Huanwu Tongfeng decoction was significantly associated with acute inflammatory response, astrocyte activation, regulation of interleukin (IL)-8 production, nuclear receptor activity, and binding of growth factor receptor. KEGG pathway enrichment analysis obtained that the key target genes were significantly associated with the IL-17 signaling pathway, advanced glycosylation end/receptor of advanced glycation endproducts(AGE/RAGE) signaling pathway, anti-inflammatory, and other pathways. PPI network indicated that albumin(ALB), peroxisome proliferator-activated receptor-γ (PPAR-γ), IL-6, IL-1β, and C-reactive protein(CRP) were the key protein targets. The molecular docking results showed that ALB had the strongest binding force with beta-carotene (β-carotene). Biochemical results showed that blood uric acid decreased in the Buyang Huanwu Tongfeng decoction groups. HE staining results showed that the low-dose (7.76 g·kg-1·d-1), medium-dose (15.53 g·kg-1·d-1), and high-dose (31.05 g·kg-1·d-1) groups of Buyang Huanwu Tongfeng decoction had different degrees of remission, and the remission of the high-dose group was the most obvious. Fibroblastic tissue hyperplasia in synovial joints accompanied with inflammatory cell infiltration, as well as inflammatory cell infiltration in renal tissue of the high-dose group was significantly reduced, followed by the medium-dose and low-dose groups, and the expression of ALB, PPAR-γ, IL-6, IL-1β, and CRP was down-regulated to different degrees. ConclusionBy regulating the targets such as ALB, PPAR-γ, IL-6, IL-1β, and CRP, inhibiting the PPAR-γ/nuclear transcription factor (NF)-κB pathway, and reducing AGEs/RAGE-mediated inflammation, Buyang Huanwu Tongfeng decoction exerts anti-inflammatory and analgesic effects and activates blood circulation and diuresis in the treatment of hyperuricemia and gouty arthritis.
4.Frontier technologies and development trends of network pharmacology: a patent bibliometric analysis.
Li TAO ; Zhi-Peng KE ; Tuan-Jie WANG ; Zhen-Zhong WANG ; Liang CAO ; Wei XIAO
China Journal of Chinese Materia Medica 2025;50(11):3070-3078
This study systematically analyzed the global research landscape, technological composition, and core patents in the field of networks target and network pharmacology, and proposes further suggestions based on the IncoPat patent citation database and VOSviewer bibliometric network visualization tool. Using patent literature metrics and scientific knowledge mapping method, technological innovation pathways, research hotspots, and future directions in this field were further revealed. In particular, this field is moving towards data-driven, intelligent, and systematic approaches. Patent analysis indicated that most patent applications in this domain focused on traditional Chinese medicine(TCM), which have provided key engineering technical approaches to explore and solve complex problems of TCM. By integrating big data and artificial intelligence technologies, network targets and network pharmacology have conferred high-precision screening and quality control of key components and targets in herbal formulations and prescriptions, accelerating the clinical translation and industrialization of TCM-based new drugs and health products with medicine-food homology. Therefore, it is essential to optimize the patent protection system and establish integrated technology platforms in this field for ensuring the competitiveness of technological achievements in research and clinical application. These efforts will advance the widespread application and high-quality development of TCM modernization, precision medicine, and innovative drug discovery.
Bibliometrics
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Patents as Topic
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Humans
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Medicine, Chinese Traditional
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Network Pharmacology/trends*
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Drugs, Chinese Herbal/pharmacology*
5.Dynamic immunological characteristics in acute rejection model of cervical heterotopic heart transplantation in mice
Xi CAO ; Tao HUANG ; Jiwei YANG ; Xiaowen WANG ; Wenfeng ZHU ; Haoqi CHEN ; Ning FAN ; Genshu WANG
Organ Transplantation 2025;16(2):256-263
Objective To establish an acute rejection model of cervical heart transplantation in mice and evaluate the survival and dynamic rejection process post-transplantation. Methods Mice were randomly divided into sham operation group (n=10), syngeneic transplantation group (n=21), and allogeneic transplantation group (n=65). Sham operation, syngeneic cervical heart transplantation, and allogeneic cervical heart transplantation were performed respectively. The survival of recipient mice and grafts, histopathological changes of graft tissues, subpopulations of splenic lymphocytes, and expression of inflammatory factors in serum and grafts were observed. Results The survival rate and graft survival rate of the sham operation group and syngeneic transplantation group were 100% at 7 days after surgery. In the allogeneic transplantation group, 5 cases failed and died on the first day after surgery. The survival rate at 7 days after surgery was 86%, and all surviving mice had grafts that stopped beating at 7 days after surgery. The allogeneic transplantation group showed significant rejection at 7 days after surgery, accompanied by tissue damage and CD8+ T cell infiltration. The proportion of CD8+ T cells in the spleen continued to rise post-operation, while the proportion of CD4+ T cells showed a downward trend. The expression of interferon-γ in serum and grafts peaked at 5 days after surgery, while the expression of tumor necrosis factor-α showed no statistical significance. Conclusions Acute rejection following heart transplantation in mice intensifies between 5 to 7 days after surgery, which may be a critical time window for immunological intervention.
6.Treating immunoglobulin A nephropathy based on the " qi cycle in round" theory
Leying ZHAO ; Yaoxian WANG ; Zhen WANG ; Yaotan LI ; Boning CAO ; Jiayin TAO ; Danting LI ; Qingqing LIU
Journal of Beijing University of Traditional Chinese Medicine 2025;48(2):223-228
Immunoglobulin A (IgA) nephropathy is a globally prevalent type of primary glomerulonephritis, characterized by complex symptoms and diverse clinical manifestations. The internationally recognized " multiple hit hypothesis" explains the systemic immune disease features of IgA nephropathy. However, current treatment strategies primarily focus on local pathological changes, inadequately addressing its complex systemic mechanisms. The " qi cycle in round" theory, an integral concept of the academic thought of HUANG Yuanyu, a prominent medical expert from the Qing Dynasty, offers a concise and insightful framework for understanding complex pathologies. For example, this theory provides valuable insights for elucidating the pathogenesis of IgA nephropathy and guiding its clinical management by simplifying intricate systemic processes. This study applies the " qi cycle in round" theory to postulate that patients with IgA nephropathy experience disrupted qi flow owing to spleen-stomach qi deficiency and dampness-heat accumulation. These imbalances manifest as internal symptoms, such as diarrhea; external vulnerability to illness; upper body symptoms, like sore throat; and lower body symptoms, such as hematuria and proteinuria. Pathologically, the condition is characterized by immune complex deposition. This article also emphasizes strategies that prioritize tonifying spleen-stomach qi to enhance the pivotal functions of transportation and transformation. Regulating qi and relieving stagnation are emphasized to harmonize ascending and descending dynamics. Additionally, eliminating turbidity and unblocking collaterals are highlighted to promote qi transformation. These approaches aim to restore the harmonious operation of organ qi dynamics and harmonious qi transformation functions. This study aims to provide a reference for syndrome differentiation and IgA nephropathy treatment using traditional Chinese medicine based on the " qi cycle in round" theory.
7.Action Mechanism of Resolving Dampness and Phlegm of Pinelliae Rhizoma Praeparatum Based on Interconnection Between Lung and Large Intestine
Xingbao TAO ; Chentao ZHAO ; Xiaofu ZHU ; Hao WU ; Jun HE ; Weiguo CAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):122-131
ObjectiveTo investigate the effects of Pinelliae Rhizoma Praeparatum (PRP) on lung tissue, gut microbiota, and short-chain fatty acid (SCFA) metabolism in a model of mice with cold fluid retention in the lung and explore its mechanism of action in resolving dampness and phlegm based on the interconnection between the lung and large intestine. MethodsFifty female ICR mice were randomly divided into a normal group, model group, positive control group (Xiaoqinglong granules, 6.5 g·kg-1), and high-dose and low-dose PRP decoction groups (3.0, 1.5 g·kg-1), with 10 mice in each group. A model of mice with cold fluid retention in the lung was established using ovalbumin (OVA) sensitization combined with cold-water immersion. Drug interventions were conducted from day 18 to day 33 for 15 consecutive days. The airway resistance value of the mice was measured using a non-invasive pulmonary function analyzer. Phlegm-resolving effects were evaluated via a microplate reader. Eosinophil and neutrophil counts in bronchoalveolar lavage fluid (BALF) were analyzed using an automated hematology analyzer. Serum levels of total immunoglobulin E (IgE), interferon-γ (IFN-γ), interleukin-4 (IL-4), and BALF levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) were quantified by enzyme-linked immunosorbent assay (ELISA). Lung histopathology was assessed using hematoxylin-eosin (HE) staining. Immunohistochemistry (IHC) was employed to detect mucin 5AC (MUC5AC) and aquaporin 5 (AQP5) protein expression in lung tissue. Gut microbiota composition was analyzed via agarose gel electrophoresis, and fecal SCFA levels were measured by gas chromatography-mass spectrometry (GC-MS). ResultsCompared with the normal group, the model group exhibited significantly increased airway resistance value (RI) (P<0.05), elevated eosinophil and neutrophil counts and IL-6 and IL-8 levels in BALF (P<0.05), increased serum IgE and IL-4 levels (P<0.05), with reduced IFN-γ levels (P<0.05). It also showed thickened bronchial walls, widened alveolar septa, narrowed lumens, and mucus plugs in lung tissue, upregulated MUC5AC protein expression and downregulated AQP5 protein expression (P<0.05), decreased relative abundance of beneficial gut microbiota (Firmicutes, Clostridia, Clostridiales, Lactobacillaceae, and Lactobacillus), and increased abundance of harmful microbiota (Bacteroidetes, Bacteroidia, Bacteroidales, Muribaculaceae, and Muribaculum). In addition, the model group presented reduced fecal SCFA levels (acetate, propionate, and butyrate) (P<0.05). After the intervention of PRP decoction, compared to the model group, all drug administration groups showed decreased RI (P<0.05), increased phenol red excretion, declined eosinophil and neutrophil counts and IL-6, IL-8, IgE, and IL-4 levels (P<0.05), and improved IFN-γ levels (P<0.05) and lung pathology improved. The MUC5AC protein expression decreased (P<0.05), and the AQP5 protein expression increased (P<0.05). The disorder of gut microbiota was improved, and the diversity of gut microbiota was restored, with a significantly increased relative abundance ratio of beneficial microbiota (P<0.05) and a significantly reduced relative abundance ratio of harmful microbiota (P<0.05). The SCFA levels (acetate, propionate, and butyrate) increased (P<0.05). The efficacy indicators of serum inflammatory factors (IgE, IL-4, and IFN-γ), phlegm-resolving effect, airway resistance, total pathological score, and the protein expression of MUC5AC and AQP5 were correlated with gut microbiota and SCFAs. ConclusionPRP decoction alleviates cold-phlegm syndrome by modulating the gut-lung axis, promoting beneficial gut microbiota, enhancing SCFA production, restoring the balance of gut microbiota, and suppressing respiratory inflammation. This study provides novel insights into the TCM theory of interconnection between the lung and large intestine.
8.Action Mechanism of Resolving Dampness and Phlegm of Pinelliae Rhizoma Praeparatum Based on Interconnection Between Lung and Large Intestine
Xingbao TAO ; Chentao ZHAO ; Xiaofu ZHU ; Hao WU ; Jun HE ; Weiguo CAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):122-131
ObjectiveTo investigate the effects of Pinelliae Rhizoma Praeparatum (PRP) on lung tissue, gut microbiota, and short-chain fatty acid (SCFA) metabolism in a model of mice with cold fluid retention in the lung and explore its mechanism of action in resolving dampness and phlegm based on the interconnection between the lung and large intestine. MethodsFifty female ICR mice were randomly divided into a normal group, model group, positive control group (Xiaoqinglong granules, 6.5 g·kg-1), and high-dose and low-dose PRP decoction groups (3.0, 1.5 g·kg-1), with 10 mice in each group. A model of mice with cold fluid retention in the lung was established using ovalbumin (OVA) sensitization combined with cold-water immersion. Drug interventions were conducted from day 18 to day 33 for 15 consecutive days. The airway resistance value of the mice was measured using a non-invasive pulmonary function analyzer. Phlegm-resolving effects were evaluated via a microplate reader. Eosinophil and neutrophil counts in bronchoalveolar lavage fluid (BALF) were analyzed using an automated hematology analyzer. Serum levels of total immunoglobulin E (IgE), interferon-γ (IFN-γ), interleukin-4 (IL-4), and BALF levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) were quantified by enzyme-linked immunosorbent assay (ELISA). Lung histopathology was assessed using hematoxylin-eosin (HE) staining. Immunohistochemistry (IHC) was employed to detect mucin 5AC (MUC5AC) and aquaporin 5 (AQP5) protein expression in lung tissue. Gut microbiota composition was analyzed via agarose gel electrophoresis, and fecal SCFA levels were measured by gas chromatography-mass spectrometry (GC-MS). ResultsCompared with the normal group, the model group exhibited significantly increased airway resistance value (RI) (P<0.05), elevated eosinophil and neutrophil counts and IL-6 and IL-8 levels in BALF (P<0.05), increased serum IgE and IL-4 levels (P<0.05), with reduced IFN-γ levels (P<0.05). It also showed thickened bronchial walls, widened alveolar septa, narrowed lumens, and mucus plugs in lung tissue, upregulated MUC5AC protein expression and downregulated AQP5 protein expression (P<0.05), decreased relative abundance of beneficial gut microbiota (Firmicutes, Clostridia, Clostridiales, Lactobacillaceae, and Lactobacillus), and increased abundance of harmful microbiota (Bacteroidetes, Bacteroidia, Bacteroidales, Muribaculaceae, and Muribaculum). In addition, the model group presented reduced fecal SCFA levels (acetate, propionate, and butyrate) (P<0.05). After the intervention of PRP decoction, compared to the model group, all drug administration groups showed decreased RI (P<0.05), increased phenol red excretion, declined eosinophil and neutrophil counts and IL-6, IL-8, IgE, and IL-4 levels (P<0.05), and improved IFN-γ levels (P<0.05) and lung pathology improved. The MUC5AC protein expression decreased (P<0.05), and the AQP5 protein expression increased (P<0.05). The disorder of gut microbiota was improved, and the diversity of gut microbiota was restored, with a significantly increased relative abundance ratio of beneficial microbiota (P<0.05) and a significantly reduced relative abundance ratio of harmful microbiota (P<0.05). The SCFA levels (acetate, propionate, and butyrate) increased (P<0.05). The efficacy indicators of serum inflammatory factors (IgE, IL-4, and IFN-γ), phlegm-resolving effect, airway resistance, total pathological score, and the protein expression of MUC5AC and AQP5 were correlated with gut microbiota and SCFAs. ConclusionPRP decoction alleviates cold-phlegm syndrome by modulating the gut-lung axis, promoting beneficial gut microbiota, enhancing SCFA production, restoring the balance of gut microbiota, and suppressing respiratory inflammation. This study provides novel insights into the TCM theory of interconnection between the lung and large intestine.
9.Research progress on financial incentives for improving medication adherence
Tiantian TAO ; Yi CAO ; Mengdie ZHANG ; Pingyu CHEN
China Pharmacy 2025;36(10):1266-1270
Financial incentives, as an intervention in behavioral therapy, have been proven to be beneficial in many health behaviors, such as drug addiction treatment, long-term antiviral therapy, and the prevention and treatment of chronic diseases. At present, typical financial incentive schemes mainly include commitment contracts and lottery-based models. Key factors in the design of such interventions include the adaptability of behavioral economic principles and medication behavior, the effectiveness and cost-effectiveness of design scheme, and the acceptability of intervention population. Although financial incentives have accumulated rich experience in health behavior interventions abroad, research on medication adherence remains limited, with existing intervention scheme design and mechanism constraints, and their effectiveness potentially varying across different cultural and social environments. China should explore practical models of financial incentives to enhance medication adherence, considering patients’ medication patterns and socio-cultural factors.
10.Impacts of pre-pregnancy exposure to per- and polyfluoroalkyl substances on menstrual characteristics among women undergoing assisted reproductive technology
Huyi TAO ; Yujie CAO ; Yitao PAN ; Jiuru ZHAO ; Zhiwei LIU ; Yu GAO ; Ying TIAN
Journal of Environmental and Occupational Medicine 2025;42(6):652-660
Background Per- and polyfluoroalkyl substances (PFAS) are a class of persistent organic pollutants widely used in various products, leading to population exposure and long-term accumulation. At present, there is a lack of research on the relationships between pre-pregnancy PFAS and menstrual characteristics among women undergoing assisted reproductive technology (ART) in China. Objective To explore the relationships between pre-pregnancy PFAS exposure among women undergoing ART and menstrual characteristics prior to assisted reproductive treatment. Methods This study employed a cross-sectional research design, recruiting women undergoing ART treatment at the Reproductive Clinic of the International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, from 2017 to 2020 as study participants. Ultra-high-performance liquid chromatography-tandem mass spectrometry was used to detect 42 types of PFAS in pre-pregnancy serum samples. Questionnaires were administered to collect information on demographic characteristics, lifestyle habits, and menstrual characteristics (average menstrual cycle length, average menstrual period length, menstrual irregularities, and menstrual bleeding volume) of women undergoing ART. Multiple linear regression, binary logistic regression, and multinomial logistic regression analyses were performed to investigate the relationships between individual PFAS exposure before pregnancy and menstrual characteristics among ART women. Additionally, weighted quantile sum (WQS) model was applied to analyze the association between PFAS mixtures and menstrual characteristics. Results In the pre-pregnancy serum samples of the study population, 15 PFAS were detected in more than 60% of the samples, including perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), perfluorobutanesulfonic acid (PFBS), perfluorohexanesulfonic acid (PFHxS), perfluoroheptanesulfonic acid (PFHpS), perfluorooctanesulfonic acid (PFOS), 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA), 8:2 chlorinated polyfluorinated ether sulfonate (8:2 Cl-PFESA), perfluoro-2-propoxypropanoic acid (HFPO-DA), perfluoro-2-methoxyacetic acid (PFMOAA), and perfluoro-(3,5,7,9,11-pentaoxadodecanoic) acid (PFO5DoDA). Among them, PFOA had the highest median concentration of 9.160 ng·mL−1. The single PFAS exposure analysis revealed a positive correlation between PFAS and irregular menstrual cycles. Specifically, for every natural-log unit (e) increase in PFOA, PFBS, or PFHxS level, the incidence of irregular menstrual cycles increased by 57%, 42%, or 39%, respectively. Most PFAS were positively correlated with the average number of menstrual cycle days, such as PFHpA (b=1.08, 95%CI: 0.11, 2.05), PFOA (b=1.69, 95%CI: 0.39, 3.00), PFBS (b=1.23, 95%CI: 0.25, 2.22), PFHxS (b=1.47, 95%CI: 0.61, 2.32), PFHpS (b=1.48, 95%CI: 0.35, 2.61), and 6:2 Cl-PFESA (b=0.90, 95%CI: 0.08, 1.72). Furthermore, levels of PFHpA (OR=1.39, 95%CI: 1.06, 1.82), PFOA (OR=1.58, 95%CI: 1.09, 2.30), PFBS (OR=1.37, 95%CI: 1.04, 1.80), PFHxS (OR=1.34, 95%CI: 1.05, 1.71), PFHpS (OR=1.53, 95%CI: 1.10, 2.14), and 6:2 Cl-PFESA (OR=1.34, 95%CI: 1.06, 1.70) were positively correlated with low menstrual blood volume, while PFOA (OR=0.40, 95%CI: 0.23, 0.71), PFHpS (OR=0.45, 95%CI: 0.29, 0.71), and HFPO-DA (OR=0.68, 95%CI: 0.48, 0.97) were negatively correlated with high menstrual blood volume. The mixed exposure model showed that PFAS mixtures were positively correlated with the average number of menstrual cycle days (b=1.60, 95%CI: 0.49, 2.71), irregular menstrual cycles (OR=1.77, 95%CI: 1.19, 2.63), and low menstrual blood volume (OR=1.59, 95%CI: 1.08, 2.35), but negatively correlated with high menstrual blood volume (OR=0.40, 95%CI: 0.22, 0.73). Conclusion Women undergoing ART in Shanghai are widely exposed to PFAS prior to conception. Exposure to PFAS before pregnancy may be related to menstrual characteristics among women seeking ART before undergoing fertility treatments, but additional data from larger populations are required to validate the findings of this study.


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