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.Oxidative Stress of Qidan Tangshen Granules (芪丹糖肾颗粒) in Treatment of 95 Patients with Early Diabetic Kidney Disease with Qi Deficiency,Blood Stasis,and Kidney Deficiency Syndrome:A Double-Blind,Double-Simulated,Randomized Controlled Trial
Jie ZHANG ; Yilei CONG ; Tengfei WU ; Qin LIU ; Yue YUAN ; Shilei CUI ; Hua YANG
Journal of Traditional Chinese Medicine 2025;66(7):695-703
ObjectiveTo evaluate the clinical efficacy and safety of Qidan Tangshen Granules (芪丹糖肾颗粒, QTG) in the treatment of early diabetic kidney disease (DKD) with qi deficiency, blood stasis, and kidney deficiency syndrome, and to explore its mechanism. MethodsA double-blind, double-simulated method was used to enroll 200 patients with early DKD and qi deficiency, blood stasis, and kidney deficiency syndrome. Patients were randomly assigned in a 1∶1 ratio to the treatment group (100 cases) and the control group (100 cases). The treatment group received QTG plus a valsartan capsule simulant, while the control group received valsartan capsules plus a QTG simulant, both for 12 weeks. The primary outcome was the urinary albumin-to-creatinine ratio (UACR). Secondary outcomes included estimated glomerular filtration rate (eGFR), fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG), glycated hemoglobin (HbA1c), and traditional Chinese medicine (TCM) syndrome scores (including individual symptom scores for fatigue, dull complexion, soreness and weakness of the waist and knees, headache and chest pain, irritability, spontaneous sweating, thirst and polydipsia, polyphagia, polyuria, numbness of the limbs, and the total TCM syndrome score). Oxidative stress markers including serum 8-hydroxy-2'-deoxyguanosine (8-OHDG), 3-nitrotyrosine (3-NT), and superoxide dismutase (SOD) were also assessed. Clinical efficacy and TCM syndrome efficacy were evaluated after treatment, and routine blood tests, urinalysis, and liver function tests were conducted and adverse reaction during the tria was recorded to assess safety. ResultsA total of 191 patients completed the study (95 in the treatment group and 96 in the control group). The treatment group showed significant reductions in UACR, FBG, PBG, and HbA1c levels after treatment (P<0.05 or P<0.01). The single TCM symptom scores except for polyphagia and total TCM syndrome scores significantly decreased (P<0.05 or P<0.01). Compared to the control group, the treatment group had signi-ficantly lower UACR, FBG, PBG levels, and total TCM syndrome scores, sinlge symptoms scores except for polyphagia and limb numbness (P<0.05 or P<0.01). Among 40 randomly selected patients (21 cases in the treatment group and 19 cases in the control group) for oxidative stress analysis, there were no significant differences in SOD, 3-NT, and 8-OHDG levels before and after treatment within or between groups (P>0.05). The overall effective rate in the treatment group was 64.2% (61/95) and 39.6% (38/96) in the control group, while the TCM syndrome efficacy rates were 80.0% (76/95) and 24.0% (23/96), respectively, with the treatment group showing superior efficacy (P<0.01). No significant differences were observed in routine blood tests, urinalysis, or liver function indices before and after treatment in either group (P>0.05). The incidence of adverse reactions was 8.4% (8/95) in the treatment group and 9.4% (9/96) in the control group, with no statistically significant difference (P>0.05). ConclusionQTG can effectively reduce UACR and blood glucose levels, alleviate clinical symptoms, and improve clinical efficacy in patients with early DKD with qi deficiency, blood stasis, and kidney deficiency syndrome. The treatment is well-tolerated and safe, with no significant impact on oxidative stress markers.
3.Five-year outcomes of metabolic surgery in Chinese subjects with type 2 diabetes.
Yuqian BAO ; Hui LIANG ; Pin ZHANG ; Cunchuan WANG ; Tao JIANG ; Nengwei ZHANG ; Jiangfan ZHU ; Haoyong YU ; Junfeng HAN ; Yinfang TU ; Shibo LIN ; Hongwei ZHANG ; Wah YANG ; Jingge YANG ; Shu CHEN ; Qing FAN ; Yingzhang MA ; Chiye MA ; Jason R WAGGONER ; Allison L TOKARSKI ; Linda LIN ; Natalie C EDWARDS ; Tengfei YANG ; Rongrong ZHANG ; Weiping JIA
Chinese Medical Journal 2025;138(4):493-495
4.The value of applying animal model teaching in improving scientific research ability of graduate students in interventional medicine
Yifan LI ; Pengchao ZHAN ; Zhen LI ; Huzhi RONG ; Yue GAO ; Wenguang ZHANG ; Kewei REN ; Tengfei LI ; Xin LI ; Shuwen YE ; Yuyuan ZHANG
Journal of Interventional Radiology 2025;34(1):96-100
Objective To evaluate the application of rabbit liver cancer model in teaching interventional medicine for graduate students.Methods A total of 10 first-year master graduate students majoring in Radiological Imaging(Interventional Medicine).who were studying at Zhengzhou University of China,were enrolled in this study.The rabbit liver cancer model was used as the experimental teaching materials.The teaching contents included the establishment of rabbit liver cancer model,the interventional operation of rabbit liver cancer,the method of scientific research and teaching,the evaluation of the teaching effect,and the survey of student satisfaction.Results Under the guidance of teaching tutor,the success rate of VX2 rabbit liver cancer modeling performed by the 10 master graduate students majoring in interventional medicine was 100%,and the mean operational quality assessment score was(11.5±2.0)points.During the operation of interventional surgery,the success rate of femoral artery puncture was also 100%,and the mean score for each interventional operation was(11.8±2.3)points.The students'experimental designs were evaluated by the expert group,the results were as follows:2 cases were rated as excellent,7 cases were rated as good,and one case was rated as moderate.The degree of students'satisfaction with experimental teaching method was high,the specific scores of each item are as follows:the understanding of the rabbit liver cancer model was(4.80±0.40)points,the command of interventional technology was(4.60±0.49)points,and the quality and practicability of teaching materials was(4.90±0.30)points.Conclusion This teaching method of using rabbit liver cancer model experiment can improve the animal experiment ability,interventional operation ability and scientific research innovation ability of graduate students.Animal model teaching method is an innovation of teaching mode for graduate students majoring in interventional medicine.
5.Analysis of molecular epidemic characteristics of H3N2 influenza viruses in Guangzhou City during the COVID-19 pandemic
Lan CAO ; Tengfei ZHOU ; Yiyun CHEN ; Mengmeng MA ; Dan XIA ; Yanhui LIU ; Kuibiao LI ; Biao DI ; Pengzhe QIN ; Zhoubin ZHANG
Chinese Journal of Preventive Medicine 2024;58(3):351-357
To monitor and analyze the molecular variation of the H3N2 influenza virus in Guangzhou during the COVID-19 pandemic, respiratory samples of influenza-like cases from influenza monitoring sentinel hospitals were collected from influenza monitoring sentinel hospitals for virus isolation and whole genome sequencing. The results showed that during COVID-19, there was only one peak of H3N2 influenza in the second quarter of 2022 in Guangzhou (the positive rate was 52.23%), and the epidemic intensity and duration were both higher than those in 2019. The HA gene and NA gene of the epidemic strain in Guangzhou in 2022 belonged to the 3C.2a1b. 2a. 1a. 1 branch, which had a good antigenic site matching with the vaccine strain (A/Cambodia/e0826360/2020) from 2021 to 2022 and had no antigen drift. In 2022 strains, the variation of antigen determinant mainly occurred in the I48T of C region, while no variation occurred in the A, B, D, and E regions. The binding site of the HA protein receptor was consistent with the vaccine strain (A/Cambodia/e0826360/2020). Most of the strains in 2022 carried 13 glycosylation sites on the HA protein, but an outbreak of strains caused a loss of glycosylation sites at 24-NST. In conclusion, the strains that caused the epidemic of H3N2 influenza in Guangzhou in 2022 were not evolved or transmitted from the local strains in 2019 during the COVID-19 pandemic.
6.New intraoral digital impression with pneumatic gingival retraction used in the restoration of crown for posterior teeth: a case report
Xinkai XU ; Meizi ZHANG ; Zhongning LIU ; Yuchun SUN ; Hu CHEN ; Weiwei LI ; Xiaoyi ZHAO ; Yongjie JIA ; Shujuan XIAO ; Chao MA ; Xiaojun CHEN ; Tengfei JIANG ; Xiaobo ZHAO ; Sukun TIAN
Chinese Journal of Stomatology 2024;59(10):1044-1048
In fixed prosthodontics, clear exposure of the preparation margin is the prerequisite for obtaining accurate digital impressions and improving the marginal fit of restorations. To resolve the issues associated with the cord retraction technique, such as pain, acute injury, and prolonged procedural time, this study proposes a new technology for intraoral digital impression taking with pneumatic gingival retraction. The new scanning head blows a high-speed airflow that instantaneously separates the free gingiva, locally exposing the subgingival preparation margin. Combined with the farthest point preservation stitching algorithm based on the distance from the normal vector and high-speed laser scanning photography, it achieves global preparation edge data and gingival reconstruction, realizing painless, non-invasive, and efficient precise acquisition of the preparation margin. Using this new technique, a patient with a full porcelain crown restoration on a posterior tooth was treated. The digital impression revealed a clear margin of the preparation, and the crown made from this data has a good marginal fit.
7.Effect of nimodipine combined with minimally invasive puncture on neurological function,hemody-namics and serum inflammatory factor levels in patients with hypertensive intracerebral hemorrhage
Yangyang HU ; Changjuan WANG ; Jingjing DU ; Binglin GOU ; Long ZHANG ; Yang LIU ; Tengfei WANG
Journal of Xinxiang Medical College 2024;41(9):852-856,861
Objective To explore the effect of nimodipine combined with minimally invasive puncture on neurological function,hemodynamics,and serum inflammatory factor levels in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 108 patients with HICH treated at the Second Affiliated Hospital of Hebei North University from June 2019 to May 2022 were selected as the research subjects.They were divided into an observation group(n=55)and a control group(n=53)according to the treatment method.All patients in the two groups received minimally invasive puncture;on this basis,the patients in the observation group were treated with nimodipine for one month.The neurological deficit of patients in the two groups was evaluated by the National Institute of Health Stroke Scale(NIHSS)score before and after treatment.Before and after treatment,5 mL of fasting venous blood was taken from patients in the morning,and the serum was obtained by centrifugation.The serum levels of brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were detected by enzyme-linked immunosorbent assay.Ultrasonic transcranial Doppler blood flow analyzer was used to monitor the hemodynamic indexes such as mean blood flow velocity(Vm),resistance index(RI)and pulsitility index(PI)of patients in the two groups before and after treatment.The adverse reactions such as headache,dizziness,infection and rebleeding were recorded in the two groups after treatment.Results There was no statistically significant difference in the NIHSS score and serum NSE and BDNF levels between the two groups before treatment(P>0.05).After treatment,the NIHSS score and serum NSE level of patients in the two groups were significantly lower than those before treatment,while the serum BDNF level was significantly higher than that before treatment(P<0.05).After treatment,the NIHSS score and serum NSE level of patients in the observation group were significantly lower than those in the control group,while the serum BDNF level was significantly higher than that in the control group(P<0.05).There was no statistically significant difference in the Vm,PI and RI between the two groups before treatment(P>0.05).After treatment,the Vm and PI of patients in the two groups were significantly higher than those before treatment,while the RI was significantly lower than that before treatment(P<0.05).After treatment,the Vm and PI of patients in the observa-tion group were significantly higher than those in the control group,while the RI was significantly lower than that in the control group(P<0.05).There was no statistically significant difference in serum TNF-α,IL-6,and CRP levels between the two groups before treatment(P>0.05).The levels of serum TNF-α,IL-6,and CRP of patients in the two groups after treatment were significantly lower than those before treatment(P<0.05).After treatment,serum TNF-α,IL-6,and CRP levels of patients in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in patients in the control group and observation group was 7.55%(4/53)and 9.09%(5/55),respectively,and the difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion Nimodipine combined with minimally invasive puncture can effectively improve the blood perfusion rate of HICH patients,reduce the degree of inflammatory response,and alleviate the patients'neurological function damage.
8.Mechanism of Nephrotoxicity Induced by Ecliptasaponin A Based on Computational Toxicology
Han LI ; Ling SONG ; Yunhang GAO ; Tengfei CHEN ; Suzhen MU ; Weiya CHEN ; Guangping ZHANG ; Wang HUO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):72-80
ObjectiveTo predict the potential nephrotoxic components in traditional Chinese medicine health food products based on the Traditional Chinese Medicine Toxicity Alert System and Basic Toxicology Database (TCMTAS-BTD), screen and validate the predicted components by cell and animal experiments, and decipher the mechanism of nephrotoxicity by network pharmacology. MethodTCMTAS-BTD was utilized to predict the toxicity of 3 540 compounds found in the catalogue of traditional Chinese health food ingredients. In the cell experiment, the top 5 compounds with high toxicity probability were screened by measurement of cell proliferation and viability (CCK-8) and high-content screening. ICR mice were randomized into a control group, a low-dose (2.91 mg·kg-1·d-1) ecliptasaponin A, and a high-dose (29.1 mg·kg-1·d-1) ecliptasaponin A group, with 10 mice in each group, and treated continuously for 28 days. During the experiment, the general conditions of the rats were observed, and the kidney index was calculated. The levels of serum creatinine (SCr) and blood urea nitrogen (BUN) in the serum as well as the content of malondialdehyde (MDA) and superoxide dismutase (SOD) in the renal tissue were measured. The pathological changes of the kidney were observed. Network pharmacology was employed to predict the potential pathways of nephrotoxicity. Finally, the pathway-associated proteins were validated by Western blot. ResultThe top 5 compounds with high probability of nephrotoxicity were ecliptasaponin A, chrysophanol, rutaecarpine, tanshinoneⅠ, and geniposidic acid. In the cell experiment, CCK-8 results showed that 10 μmol·L-1 ecliptasaponin A, 60 μmol·L-1 chrysophanol, 40 μmol·L-1 rutaecarpine, and 20 μmol·L-1 tanshinone I altered the viability of HK-2 cells. High-content analysis showed that 10 μmol·L-1 ecliptasaponin A, chrysophanol, rutaecarpine, and tanshinone Ⅰ reduced the cell number (P<0.05, P<0.01). The animal experiment showed that the mice in the high-dose ecliptasaponin A group presented slow movement, slow weight gain (P<0.01), increased kidney index (P<0.01), elevated SCr, BUN, and MDA levels (P<0.01), and lowered SOD level (P<0.01). Mild histopathological changes were observed in the high-dose ecliptasaponin A group. The network pharmacology results showed that the key targets of nephrotoxicity induced by ecliptasaponin A were mainly enriched in the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, prostatic cancer and lipid and atherosclerosis pathways. Western blot results verified that high dose of ecliptasaponin A raised the phosphorylation levels of PI3K and Akt (P<0.01). ConclusionOn day 28 of administration, 29.1 mg·kg-1 ecliptasaponin A was found to induce renal injury in rats. The mechanism may be related with the PI3K/Akt signaling pathway, which implied that excessive and prolonged usage of Ecliptae Herba may increase the incidence of adverse drug reactions.
9.16S rDNA Sequencing Reveals Effect of Tanreqing Injection on Pulmonary Flora in Rat Model of COPD
Qian LUO ; Rui FU ; Bo PENG ; Weiya CHEN ; Xiaolu WEI ; Tengfei CHEN ; Ling SONG ; Yunhang GAO ; Guangping ZHANG ; Hongping HOU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):98-103
ObjectiveTo study the effect of Tanreqing injection (TRQ) on the pulmonary flora in the rat model of chronic obstructive pulmonary disease (COPD). MethodWistar rats were randomized into control, model, and TRQ groups. The rats in other groups except the control group were treated by smoking combined with intratracheal instillation of lipopolysaccharide for the modeling of COPD. The TRQ group was intraperitoneally injected with TRQ (2 g·kg-1). At the end of the experiment, after blood collection from the abdominal aorta of the rats, the lung tissue was collected for hematoxylin-eosin and picric sirius red staining to reveal the pathological changes. The lung lavage fluid was collected, and the diversity and relative abundance of lung flora in different groups were analyzed by 16S rDNA amplicon sequencing. ResultThe lungs of the control group were normal, and those of the model group showed neutrophil infiltration, telangiectasia, lung hemorrhage and emphysema in individual cases, and thickening of collagen fibers in the trachea. Compared with the model group, the TRQ group showed significantly improved lungs and recovered collagen fibers. The MLI analysis showed that compared with the control group, the model group showcased increased alveolar space (P<0.01), which was reduced in the TRQ group (P<0.05). Compared with the control group, the model group showed increased wall thickness (P<0.01), and the increase was attenuated in the TRQ group (P<0.01). TRQ increased the Simpson index and altered the α diversity of pulmonary flora. The results of principal co-ordinate analysis showed that TRQ changed the β diversity and reduced the β diversity index of pulmonary flora. At the genus level, the model group showed increased relative abundance of g_Bacillus and g_Brevundimonas and decreased relative abundance of g_Pseudomonas, compared with the control group. After treatment with TRQ, the relative abundance of g_Stenotrophomonas increased, and that of g_Bacillus decreased. The LEfSe of differential taxa between groups showed that the modeling increased the relative abundance of g_Lachnospiraceae_NK4A136_group, and TRQ treatment increased the relative abundance of g_Rhodococcus and g_Stenotrophomonas. ConclusionTRQ can regulate the diversity of pulmonary flora and restore the balance of bacterial genera in the rat model of COPD, which may be one of the mechanisms of the prevention and treatment of COPD with TRQ.
10.Construction and Experimental Validation of Chemically-induced Cough Model Based on Cough Waveforms
Yunhang GAO ; Ling JIA ; Han LI ; Ling SONG ; Cong GUO ; Tengfei CHEN ; Hongping HOU ; Weiya CHEN ; Guangping ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):230-236
ObjectiveTo construct a cough model induced by chemical stimuli by whole-body plethysmography (WBP) for counting coughs based on cough waveforms, and use this model to explore the antitussive effect of GK-A. MethodDifferent chemical stimuli were used to induce coughs in mice or guinea pigs. Respiratory waveforms were monitored by WBP, and the recognizable and typical cough waveforms were selected for cough counting. Guinea pigs were induced to cough with different concentrations of citric acid or capsaicin, and cough waveforms were used to optimize the stimulation conditions. The optimized guinea pig model of cough was validated with dextromethorphan, and the optimized guinea pig model of capsaicin-induced cough was used to evaluate the antitussive effect of GK-A. ResultWBP could count the coughs induced by capsaicin and citric acid in guinea pigs by recognizable and typical respiratory waveforms. The optimized stimulation conditions were capsaicin concentration of 100 µmol·L-1 and nebulization for 2 min. The validation results showed that compared with the model group, the dextromethorphan group of guinea pigs had reduced coughs (P<0.05) and prolonged cough latency (P<0.01). GK-A prolonged the cough latency (P<0.05) and reduced coughs (P<0.05) in the mouse model of ammonia-induced cough. In the guinea pig model of capsaicin-induced cough, GK-A prolonged cough latency (P<0.05), reduced coughs (P<0.05), and decreased substance P (SP) content in the guinea pig serum (P<0.05, P<0.01). ConclusionA guinea pig model of capsaicin-induced cough was successfully established based on cough waveform counting, which provided an objective and accurate cough counting method. GK-A has antitussive effects, possibly by inhibiting the neuropeptide SP.

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