1.Development and validation of a dampness constitution prediction model based on clinical laboratory indicators
Xixi XIE ; Chunmin KANG ; Xinyan CHEN ; Haibiao LIN ; Xiaobin WU ; Xianzhang HUANG
Chinese Journal of Laboratory Medicine 2025;48(7):930-937
Objective:To develop a clinical predictive model for dampness constitution based on laboratory testing indicators.Methods:A retrospective cohort study was conducted on 1 355 healthy individuals who underwent physical examinations at the Health Examination Center of Guangdong Provincial Hospital of Traditional Chinese Medicine from October 1 st, 2022 to October 31 st, 2023. Basic information and blood routine, blood glucose, liver function, lipid metabolism, and kidney function test results of 1 355 apparently healthy individuals were collected. According to the diagnostic criteria for dampness constitution in traditional Chinese medicine, they were divided into a dampness constitution group (683 cases, including 394 with phlegm-dampness constitution and 289 with damp-heat constitution) and a non-dampness constitution group (672 cases). Among them, there were 547 males and 136 females in the dampness constitution group, with an age of 38.0 (32.0, 45.0) years; and there were 355 males and 317 females in the non-dampness constitution group, with an age of 33.0 (27.0, 41.0) years. A total of 1 355 apparently healthy individuals were randomly divided into a training set ( n=948) and a validation set ( n=407) using computer-generated random numbers in a 7∶3 ratio. Logistic regression analysis was employed to identify risk factors associated with dampness constitution. Utilizing these identified risk factors, a predictive model was constructed and subsequently visualized. The model′s predictive accuracy, consistency, and clinical utility were assessed using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Results:Among 1 355 subjects, there were statistically significant differences ( P<0.05) in gender, age, body mass index (BMI), blood glucose, some indicators of renal function, some indicators of blood routine, liver function, and four indicators of lipid metabolism between the dampness constitution group and the non-dampness constitution group. Gender ( OR=0.434,95 %CI 0.253-0.738), Cr ( OR=0.981,95 %CI 0.967-0.996), BMI ( OR=1.366,95 %CI 1.290-1.450), and LDL-C ( OR=1.388,95 %CI 1.014-1.897) were independent risk factors for dampness constitution ( P<0.05). A nomogram was subsequently developed based on these identified risk factors. The areas under the ROC curves (AUC) of the training set and validation set were 0.810 (95 %CI 0.783-0.837) and 0.804 (95 %CI 0.762-0.846), respectively. Conclusion:Gender,BMI,Cr and LDL-C were risk factors for the development of dampness constitution, and the clinical predictive model has clinical application value in predicting the risk of dampness constitution.
2.Impact of limonin on necrotic apoptosis of myocardial cells in rats with myocardial infarction by regulating the receptor-interacting protein 1/receptor-interacting protein 3/mixed-lineage kinase domain-like protein signaling pathway
Xixi TIAN ; Jianfei WU ; Siliang HAN ; Yichao ZHANG ; Jing MA
Journal of Chongqing Medical University 2025;50(8):1096-1102
Objective:To investigate the impact of limonin(LIM)on the necrotic apoptosis of myocardial cells in rats with myocardial infarction(MI)by regulating the receptor-interacting protein 1(RIP1)/receptor-interacting protein 3(RIP3)/mixed-lineage kinase domain-like protein(MLKL)signaling pathway.Methods:A total of 60 Sprague-Dawley rats were randomly divided into sham-operation group(Sham group),MI model group(Model group),low-dose LIM group(LIM-L group,25 mg/kg LIM),high-dose LIM group(LIM-H group,50 mg/kg LIM),and high-dose LIM+RIP1 inhibitor Nec-1 group(LIM-H+Nec-1 group,50 mg/kg LIM+0.6 mg/kg Nec-1),with 12 rats in each group.A rat model of MI was established by ligation of the coronary artery.The changes of cardiac func-tion were examined for each group;HE staining was used to observe the pathological changes of myocardial tissue;the 2,3,5-triphen-yltetrazolium chloride-Evans blue method was used to measure myocardial infarct area;the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method was used to observe the necrotic apoptosis of myocardial cells;quantitative real-time PCR and Western blot were used to measure the expression levels of mRNAs and proteins associated with the RIP1/RIP3/MLKL signaling pathway and the expression of apoptosis-related proteins.Results:Compared with the Sham group,the Model group had significant re-ductions in left ventricular ejection fraction,left ventricular systolic pressure,and the expression level of B-cell lymphoma-2(Bcl-2)in myocardial tissue(all P<0.001)and significant increases in left ventricular end-systolic volume,left ventricular end-diastolic pres-sure,left ventricular end-diastolic volume,myocardial infarct area,cell apoptosis rate,the mRNA and protein expression levels of RIP1,RIP3,and MLKL in myocardial tissue,and the protein expression levels of Bcl-2 associated X protein and cysteinyl aspartate-specific proteinase 3 in myocardial tissue(all P<0.001),as well as swelling and disordered arrangement of myocardial cells with ne-crosis and massive inflammatory cell infiltration on HE pathological sections.Compared with the Model group,the LIM-H group showed reverse changes in the above indicators(RIP1 mRNA:P=0.002,RIP3 mRNA:P=0.008,and the other indexes P were all<0.001),with alleviations of myocardial histopathological injury and inflammatory cell infiltration.Nec-1 promoted the effect of LIM in alleviating the necrotic apoptosis of myocardial cells in MI rats.Conclusion:LIM may alleviate the necrotic apoptosis of myocardial cells in MI rats by downregulating the RIP1/RIP3/MLKL signaling pathway.
3.REG-augmented decellularized porcine cornea/hydroxyethyl methacrylate in situ integrated composite artificial cornea
Yuan XIN ; Xixi WU ; Liang QUAN ; Hengtong ZHANG ; Qiang AO
Chinese Journal of Tissue Engineering Research 2025;29(16):3388-3399
BACKGROUND:Currently,artificial corneas used for full-thickness transplantation lack biological activity and mechanical adaptability.Composite artificial corneas face interface issues between the corneal button and surrounding components.OBJECTIVE:To prepare an integrated artificial cornea with peptide enhancement,matched mechanical strength to natural cornea,and excellent transparency via in situ ultraviolet light curing of decellularized porcine cornea.METHODS:Non-ionic decellularization reagent Triton X-100 combined with ultrasonic freeze-thawing and super nucleases was utilized to prepare decellularized porcine cornea.Hydroxyethyl methacrylate monomer and photoinitiator were introduced into the decellularized porcine cornea simultaneously.Ultraviolet light with a filter was used to cover the peripheral region except for the central area,where polymerization was initiated using 275 nm ultraviolet light.After removal of unreacted monomers and initiators,the central optical zone was obtained.Similarly,the posterior lamellar layer was polymerized to form the hydrophobic barrier zone.Finally,REG active polypeptide was introduced to obtain in situ integrated full-layer artificial cornea.The physical properties,mechanical properties,transparency,degradation properties and in vivo and in vitro biocompatibility of artificial cornea were characterized.RESULTS AND CONCLUSION:(1)An optical region with the co-existence of polymer and collagen fibers was constructed in situ using hydroxyethyl methacrylate in the central region of decellularized porcine cornea.Under scanning electron microscopy,the upper surface of the artificial cornea was rough and irregular,with obvious concave and convex structure,and the lower surface was relatively smooth.The artificial cornea had mechanical properties close to those of natural cornea.The transparency of the optical zone reached 80%of that of the natural cornea.After soaking in PBS aseptic solution containing collagenase,it could preserve the solidified optical region and hydrophobic barrier zone,and maintain the basic structure of cornea.The artificial cornea had good cytocompatibility,could provide a suitable adhesion and growth environment for cells,was conducive to the migration and adhesion of corneal epithelial cells,promoted the growth of vascular endothelial cells and the formation of new blood vessels,and promoted the epithelialization process.The artificial cornea had good biocompatibility and safety after 12 weeks of subcutaneous implantation in SD rats,and could reduce the acute inflammatory reaction at the initial stage of implantation.(2)The results show that the integrated full-layer artificial cornea prepared by the experiment has the potential as a full-layer artificial cornea scaffold.
4.Development and Validation of Dampness Syndrome of TCM Prediction Model Based on Blood Multiple Laboratory Indicators
Chunmin KANG ; Yingyi FENG ; Xixi XIE ; Haibiao LIN ; Xiaobin WU ; Xianzhang HUANG ; Zhimin YANG
Journal of Modern Laboratory Medicine 2025;40(5):94-100,106
Objective To explore the risk factors associated with the occurrence of dampness syndrome based on peripheral blood multiple laboratory indicators,construct predictive model and validate it.Methods A retrospective analysis was conducted on 180 patients who visited the Preventive Treatment Center of Guangdong Provincial Hospital of Chinese Medicine from May 2022 to December 2023.They were divided into two groups according to the diagnostic criteria:the damp syndrome of TCM group(n=118)and the balanced yin-yang constitution group(n=62),with the latter serving as the"non-syndrome"control group for dampness syndrome.Serum biochemical indicators were detected by electrochemiluminescence(ECL),immune cell subsets were analyzed through flow cytometer,and routine blood parameters were assessed using an automatic hematology analyzed.Logistic regression analysis was employed to screen risk factors and develop a predictive model.The Bootstrap method was used for data resampling to draw the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA)to evaluate the predictive value,consistency,and clinical efficacy of the model.Results Compared with the balanced yin-yang constitution group,the damp syndrome of TCM group showed increased levels of insulin(INS),non-high-density lipoprotein cholesterol(non HDL-C),red blood cells(RBC)and the proportion of CD4+T cells,the proportion of triglyceride(TG)>1.70 mmol/L,total cholesterol(TC)>5.20 mmol/L,low-density lipoprotein cholesterol(LDL-C)>3.37 mmol/L,and high-density lipoprotein cholesterol(HDL-C)≤1.15 mmol/L were also significantly higher,with statistical significance(U/t/χ2=-2.900~4 626,all P<0.05).Logistic regression analysis showed that INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and the proportion of CD4+T cells were independent risk factors for the occurrence of damp syndrome of TCM(all P<0.05).Based on the screened risk factors,a forecasting model was established and a nomogram was plotted.The model had an area under the ROC curve area under curve(AUC)of 0.747(95%CI=0.672~0.822),a Brier score of 0.184 for the calibration curve,and demonstrated clinical net benefit at threshold probabilities ranging from 0.30 to 1.00.Conclusion The forecasting model constructed based on INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and CD4+T cells ratio has a high predictive value for damp syndrome of TCM.
5.Sinicization and reliability and validity test of the Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care
Hangcheng LIU ; Xixi LI ; Xiaoying ZHONG ; Haoyue GAN ; Hongjin WU ; Linqian HE ; Fang YANG
Chinese Journal of Practical Nursing 2025;41(2):103-111
Objective:To sinicize the Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care (OCBS-MPPRBC) to test its reliability and validity, and to provide an evaluation tool for evaluating the degree of compulsive behaviors of postpartum mothers regarding baby care.Methods:Following the principles of Brislin translation, back translation and cross-cultural adaptation, the Chinese version of OCBS-MPPRBC was formed. A convenient sampling method was used to investigate 360 women in Mianyang Central Hospital from November 2023 to February 2024, and to test the reliability and validity of the Chinese version OCBS-MPPRBC. The critical ratio method and the total correlation analysis method were used for item analysis, the reliability test was based on Cronbach α coefficient and half-reliability method, and the content validity index, exploratory factor analysis, confirmatory factor analysis and aggregate validity were used for validity test. Results:A total of 352 women aged 21-41 (31.55 ± 3.17) years who met the exclusion criteria were included. The Chinese version of OCBS-MPPRBC contained 9 items, and 2 common factors were extracted by exploratory factor analysis, and the cumulative total variance contribution rate was 65.523%. The content validity index of the scale level was 0.89, the content validity index of each item level was 0.86-1.00, and the Cronbach α coefficient of the total scale was 0.844, and the half-folded reliability was 0.759. The results of confirmatory factor analysis showed that the fitting index of the Chinese version of the OCBS-MPPRBC model was better. Conclusions:The Chinese version of the OCBS-MPPRBC scale has good reliability and validity, and has good operability, which can be used to evaluate the degree of compulsive behavior of postpartum mothers about baby care in China.
6.Summary of the best evidence for non-surgical treatment and management of patients with pelvic organ prolapse
Linqian HE ; Xixi LI ; Hongjin WU ; Siyang LAN ; Hong JIANG
Chinese Journal of Modern Nursing 2025;31(4):453-461
Objective:To retrieve and summarize the evidence regarding the non-surgical treatment and management of patients with pelvic organ prolapse (POP) .Methods:According to the "6S" evidence pyramid model, clinical guidelines, expert consensus, systematic reviews, clinical decisions, and clinical best practices related to the non-surgical treatment and management of patients with POP were systematically searched in databases and websites such as UpToDate, National Institute for Health and Clinical Excellence, Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guidelines International Network, National Guideline Clearinghouse, PubMed, China National Knowledge Infrastructure. The search period was from the establishment of the database to January 31, 2024. Two investigators independently conducted literature quality assessment and extracted relevant information according to the Appraisal of Guidelines for Research and EvaluationⅡ and the Australia JBI Evidence-Based Health Care Center evaluation tools. The Australia JBI quality level of evidence and grade of recommendation (2014 version) were used for evidence integration and grading.Results:A total of 15 papers were finally included, including three clinical decisions, eight guidelines, two best practices, one expert consensus, and one systematic review. A total of 39 pieces of best evidence were summarized in nine areas of examination and assessment, treatment plan, lifestyle, expectant therapy, functional exercise, physical therapy, pessary, drug therapy, and follow-up observation.Conclusions:This study summarizes the best evidence on the non-surgical treatment and management of POP patients, which is scientific and comprehensive, and provides an evidence-based basis for medical and nursing staff to develop non-surgical treatment and management protocols for POP patients and self-management of POP patients.
7.Development and Validation of Dampness Syndrome of TCM Prediction Model Based on Blood Multiple Laboratory Indicators
Chunmin KANG ; Yingyi FENG ; Xixi XIE ; Haibiao LIN ; Xiaobin WU ; Xianzhang HUANG ; Zhimin YANG
Journal of Modern Laboratory Medicine 2025;40(5):94-100,106
Objective To explore the risk factors associated with the occurrence of dampness syndrome based on peripheral blood multiple laboratory indicators,construct predictive model and validate it.Methods A retrospective analysis was conducted on 180 patients who visited the Preventive Treatment Center of Guangdong Provincial Hospital of Chinese Medicine from May 2022 to December 2023.They were divided into two groups according to the diagnostic criteria:the damp syndrome of TCM group(n=118)and the balanced yin-yang constitution group(n=62),with the latter serving as the"non-syndrome"control group for dampness syndrome.Serum biochemical indicators were detected by electrochemiluminescence(ECL),immune cell subsets were analyzed through flow cytometer,and routine blood parameters were assessed using an automatic hematology analyzed.Logistic regression analysis was employed to screen risk factors and develop a predictive model.The Bootstrap method was used for data resampling to draw the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA)to evaluate the predictive value,consistency,and clinical efficacy of the model.Results Compared with the balanced yin-yang constitution group,the damp syndrome of TCM group showed increased levels of insulin(INS),non-high-density lipoprotein cholesterol(non HDL-C),red blood cells(RBC)and the proportion of CD4+T cells,the proportion of triglyceride(TG)>1.70 mmol/L,total cholesterol(TC)>5.20 mmol/L,low-density lipoprotein cholesterol(LDL-C)>3.37 mmol/L,and high-density lipoprotein cholesterol(HDL-C)≤1.15 mmol/L were also significantly higher,with statistical significance(U/t/χ2=-2.900~4 626,all P<0.05).Logistic regression analysis showed that INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and the proportion of CD4+T cells were independent risk factors for the occurrence of damp syndrome of TCM(all P<0.05).Based on the screened risk factors,a forecasting model was established and a nomogram was plotted.The model had an area under the ROC curve area under curve(AUC)of 0.747(95%CI=0.672~0.822),a Brier score of 0.184 for the calibration curve,and demonstrated clinical net benefit at threshold probabilities ranging from 0.30 to 1.00.Conclusion The forecasting model constructed based on INS,TC>5.20 mmol/L,HDL-C≤1.15 mmol/L,and CD4+T cells ratio has a high predictive value for damp syndrome of TCM.
8.REG-augmented decellularized porcine cornea/hydroxyethyl methacrylate in situ integrated composite artificial cornea
Yuan XIN ; Xixi WU ; Liang QUAN ; Hengtong ZHANG ; Qiang AO
Chinese Journal of Tissue Engineering Research 2025;29(16):3388-3399
BACKGROUND:Currently,artificial corneas used for full-thickness transplantation lack biological activity and mechanical adaptability.Composite artificial corneas face interface issues between the corneal button and surrounding components.OBJECTIVE:To prepare an integrated artificial cornea with peptide enhancement,matched mechanical strength to natural cornea,and excellent transparency via in situ ultraviolet light curing of decellularized porcine cornea.METHODS:Non-ionic decellularization reagent Triton X-100 combined with ultrasonic freeze-thawing and super nucleases was utilized to prepare decellularized porcine cornea.Hydroxyethyl methacrylate monomer and photoinitiator were introduced into the decellularized porcine cornea simultaneously.Ultraviolet light with a filter was used to cover the peripheral region except for the central area,where polymerization was initiated using 275 nm ultraviolet light.After removal of unreacted monomers and initiators,the central optical zone was obtained.Similarly,the posterior lamellar layer was polymerized to form the hydrophobic barrier zone.Finally,REG active polypeptide was introduced to obtain in situ integrated full-layer artificial cornea.The physical properties,mechanical properties,transparency,degradation properties and in vivo and in vitro biocompatibility of artificial cornea were characterized.RESULTS AND CONCLUSION:(1)An optical region with the co-existence of polymer and collagen fibers was constructed in situ using hydroxyethyl methacrylate in the central region of decellularized porcine cornea.Under scanning electron microscopy,the upper surface of the artificial cornea was rough and irregular,with obvious concave and convex structure,and the lower surface was relatively smooth.The artificial cornea had mechanical properties close to those of natural cornea.The transparency of the optical zone reached 80%of that of the natural cornea.After soaking in PBS aseptic solution containing collagenase,it could preserve the solidified optical region and hydrophobic barrier zone,and maintain the basic structure of cornea.The artificial cornea had good cytocompatibility,could provide a suitable adhesion and growth environment for cells,was conducive to the migration and adhesion of corneal epithelial cells,promoted the growth of vascular endothelial cells and the formation of new blood vessels,and promoted the epithelialization process.The artificial cornea had good biocompatibility and safety after 12 weeks of subcutaneous implantation in SD rats,and could reduce the acute inflammatory reaction at the initial stage of implantation.(2)The results show that the integrated full-layer artificial cornea prepared by the experiment has the potential as a full-layer artificial cornea scaffold.
9.Sinicization and reliability and validity test of the Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care
Hangcheng LIU ; Xixi LI ; Xiaoying ZHONG ; Haoyue GAN ; Hongjin WU ; Linqian HE ; Fang YANG
Chinese Journal of Practical Nursing 2025;41(2):103-111
Objective:To sinicize the Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care (OCBS-MPPRBC) to test its reliability and validity, and to provide an evaluation tool for evaluating the degree of compulsive behaviors of postpartum mothers regarding baby care.Methods:Following the principles of Brislin translation, back translation and cross-cultural adaptation, the Chinese version of OCBS-MPPRBC was formed. A convenient sampling method was used to investigate 360 women in Mianyang Central Hospital from November 2023 to February 2024, and to test the reliability and validity of the Chinese version OCBS-MPPRBC. The critical ratio method and the total correlation analysis method were used for item analysis, the reliability test was based on Cronbach α coefficient and half-reliability method, and the content validity index, exploratory factor analysis, confirmatory factor analysis and aggregate validity were used for validity test. Results:A total of 352 women aged 21-41 (31.55 ± 3.17) years who met the exclusion criteria were included. The Chinese version of OCBS-MPPRBC contained 9 items, and 2 common factors were extracted by exploratory factor analysis, and the cumulative total variance contribution rate was 65.523%. The content validity index of the scale level was 0.89, the content validity index of each item level was 0.86-1.00, and the Cronbach α coefficient of the total scale was 0.844, and the half-folded reliability was 0.759. The results of confirmatory factor analysis showed that the fitting index of the Chinese version of the OCBS-MPPRBC model was better. Conclusions:The Chinese version of the OCBS-MPPRBC scale has good reliability and validity, and has good operability, which can be used to evaluate the degree of compulsive behavior of postpartum mothers about baby care in China.
10.Summary of the best evidence for non-surgical treatment and management of patients with pelvic organ prolapse
Linqian HE ; Xixi LI ; Hongjin WU ; Siyang LAN ; Hong JIANG
Chinese Journal of Modern Nursing 2025;31(4):453-461
Objective:To retrieve and summarize the evidence regarding the non-surgical treatment and management of patients with pelvic organ prolapse (POP) .Methods:According to the "6S" evidence pyramid model, clinical guidelines, expert consensus, systematic reviews, clinical decisions, and clinical best practices related to the non-surgical treatment and management of patients with POP were systematically searched in databases and websites such as UpToDate, National Institute for Health and Clinical Excellence, Australia Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, Guidelines International Network, National Guideline Clearinghouse, PubMed, China National Knowledge Infrastructure. The search period was from the establishment of the database to January 31, 2024. Two investigators independently conducted literature quality assessment and extracted relevant information according to the Appraisal of Guidelines for Research and EvaluationⅡ and the Australia JBI Evidence-Based Health Care Center evaluation tools. The Australia JBI quality level of evidence and grade of recommendation (2014 version) were used for evidence integration and grading.Results:A total of 15 papers were finally included, including three clinical decisions, eight guidelines, two best practices, one expert consensus, and one systematic review. A total of 39 pieces of best evidence were summarized in nine areas of examination and assessment, treatment plan, lifestyle, expectant therapy, functional exercise, physical therapy, pessary, drug therapy, and follow-up observation.Conclusions:This study summarizes the best evidence on the non-surgical treatment and management of POP patients, which is scientific and comprehensive, and provides an evidence-based basis for medical and nursing staff to develop non-surgical treatment and management protocols for POP patients and self-management of POP patients.

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