1.Analysis of the demands for pharmaceutical clinic service and influential factors based on Kano model
Han SHAN ; Xuan YE ; Zihan GUO ; Jing WU ; Jinwei HU ; Xiaopei TONG ; Yufei BIN ; Jiyong LIU ; Qiong DU ; Mengmeng WANG
China Pharmacy 2025;36(22):2850-2855
OBJECTIVE To explore the characteristics and influential factors of pharmaceutical clinic service demands, providing evidence for optimizing pharmaceutical service models and facilitating pharmaceutical service models of pharmacist role transformation. METHODS A cross-sectional survey design was adopted, and 410 outpatient participants were selected from Fudan University Shanghai Cancer Center through convenience sampling for questionnaire administration from February to May 2025. Kano model was applied to analyze the demand attributes of 25 pharmaceutical services, while questionnaires were used to assess patients’ awareness and demand status. Subgroup analyses were conducted based on key demographic variables such as gender, age, educational attainment, and economic burdens, to SACA- systematically examine the differences in Kano attribute classification among patients in each subgroup. RESULTS The awareness rate of pharmaceutical outpatient services among patients was only 14.63%, yet those who were aware demonstrated a significantly higher demand rate for such services compared to those who were unaware (P<0.001). The demand for pharmaceutical clinic services exhibited a hierarchical characteristic: twelve items were identified as attractive attributes (e. g., providing suggestions for more affordable treatment options, offering online consultation services, etc.), five items as expected attributes (e.g., having a good attitude and being able to patiently answer your questions, etc.), three items as must-have attributes (e.g., providing guidance on medication dosage and usage, providing guidance on medication precautions, etc.), five items as indifferent attributes (e.g., providing treatment plan recommendations based on the patient’s condition). There were zero items classified as reverse attribute. Subgroup analysis revealed that female patients showed greater concern for “neat and clean attire of medical staff” than male patients (P<0.001); patients under 60 years of age demonstrated stronger demand for “providing treatment plan recommendations based on patients’ conditions” compared to patients aged 60 or above (P=0.016); those with below high school education placed greater emphasis on “providing guidance on medication precautions” compared to those with a high school education or above (P=0.011); patients with lower economic burdens exhibited stronger preferences for “neat and clean attire of medical staff ” (P=0.002). CONCLUSIONS The public awareness rate of pharmaceutical clinic services is considerably low; however, those who are aware of such services demonstrate significantly higher demand. The medication safety-related services and convenience-oriented demands should be prioritized in the development of pharmaceutical clinics. Moreover, the study also revealed that factors such as gender, age, educational level, and economic burdens exert significant influences on patients’ service demands.
2.Structures and functions of the MICOS: Pathogenesis and therapeutic implications in Alzheimer's disease.
Zihan WANG ; Kaige ZHANG ; Minghao HUANG ; Dehao SHANG ; Xiaomin HE ; Zhou WU ; Xu YAN ; Xinwen ZHANG
Acta Pharmaceutica Sinica B 2025;15(6):2966-2984
Mitochondrial dysfunction is a critical factor in the pathogenesis of Alzheimer's disease (AD). The mitochondrial contact site and cristae organizing system (MICOS) plays a pivotal role in shaping the inner mitochondrial membrane, forming cristae junctions and establishing interaction sites between the inner and outer mitochondrial membranes and thereby serving as a cornerstone of mitochondrial structure and function. In the past decade, MICOS abnormalities have been extensively linked to AD pathogenesis. In particular, dysregulated expression of MICOS subunits and mutations in MICOS-related genes have been identified in AD, often in association with hallmark pathological features such as amyloid-β plaque accumulation, neurofibrillary tangle formation, and neuronal apoptosis. Furthermore, MICOS subunits interact with several etiologically relevant proteins, significantly influencing AD progression. The intricate crosstalk between these proteins and MICOS subunits underscores the relevance of MICOS dysfunction in AD. Therapeutic strategies targeting MICOS subunits or their interacting proteins may offer novel approaches for AD treatment. In the present review, we introduce current understanding of MICOS structures and functions, highlight MICOS pathogenesis in AD, and summarize the available MICOS-targeting drugs potentially useful for AD.
3.Synergistic strategies of scaffold construction and drug delivery systems for cartilage regeneration.
Qiyao ZHANG ; Pei FENG ; Zihan PEI ; Yinsheng CAO ; Kun JIANG ; Xiong CAI ; Ping WU
Chinese Journal of Biotechnology 2025;41(8):3049-3063
In recent years, the rapid development of transportation and sports industries, coupled with the accelerated population aging in China, has led to a steady increase in the incidence of articular cartilage injuries, wear, and degenerative changes. Currently, the clinical treatment options for cartilage defects primarily include conservative therapies and surgical interventions, both of which have certain limitations. Cartilage tissue engineering (CTE), as a novel technology, provides an infinite prospect for cartilage regeneration and repair. Because of the abilities of scaffolds to mimic the natural cartilage structure, exhibit excellent biocompatibility and biomimetic mechanical properties, and promote cell adhesion and proliferation, scaffolds are considered effective delivery systems for growth factors, genes, and drugs. This review summarizes the clinical treatments for cartilage defects and their limitations, discusses the materials and preparation techniques of scaffolds used in CTE, with a particular focus on drug-loaded scaffold delivery systems in cartilage repair and regeneration, and offers a perspective on the future application of drug-loaded CTE. The aim is to provide theoretical guidance and new approaches for the repair of cartilage defects.
Tissue Engineering/methods*
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Humans
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Tissue Scaffolds
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Drug Delivery Systems/methods*
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Regeneration
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Cartilage, Articular/physiology*
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Animals
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Biocompatible Materials
4.Clinical comprehensive evaluation of three oral Janus kinase inhibitors for atopic dermatitis
Kerui YIN ; Ziyang WU ; Wanqing WANG ; Yongfu HANG ; Zihan WANG ; Jingjing ZHANG ; Jianguo ZHU
China Pharmacy 2024;35(12):1419-1425
OBJECTIVE To comprehensively evaluate the three oral Janus kinase inhibitors (JAKi) such as upadacitinib, abrocitinib and baricitinib in the treatment of atopic dermatitis. METHODS The six dimensions of safety, efficacy, economy, appropriateness, accessibility and innovativeness were used for evaluation. Meta-analysis was conducted to evaluate the safety and efficacy of three oral JAKi; pharmacoeconomic studies were searched, and the treatment costs were calculated to evaluate the economy of each JAKi. Appropriateness was described based on literature review and drug labels. Accessibility of three oral JAKi was assessed by using a questionnaire survey. The innovation of JAKi was elucidated from the perspective of its mechanism of action. RESULTS In terms of safety, the incidence of upper respiratory tract infection (OR=1.47, 95%CI of 1.04-2.08, P=0.03) and nasopharyngitis (OR=1.44, 95%CI of 1.06-1.95, P=0.02) in the upadacitinib 30 mg group was significantly higher than that in the placebo group; the incidence of nasopharyngitis in baricitinib 4 mg group was significantly higher than that in the placebo group (OR=2.24, 95%CI of 1.39-3.61, P=0.000 8) and baricitinib 2 mg group (OR=0.48, 95%CI of 0.31-0.74,P=0.001). In terms of efficacy, regardless of the dosage, all three JAKi groups were superior to the placebo group, and the high-dose groups of upadacitinib and abrocitinib were superior to the low-dose groups (P<0.000 1). In terms of economy, the annual treatment cost of baricitinib was the lowest (13 870.0 yuan), but it has not been approved for atopic dermatitis indication in China; next was upadacitinib (27 192.5 yuan). In terms of appropriateness, the overall appropriateness of the three JAKis was good, but none of them was suitable for patients with severe liver injury. In terms of accessibility, baricitinib had the highest availability rate (59.4%), but the affordability of upadacitinib was relatively good under China’s medical insurance system. In terms of innovation, among the three types of JAKi, upadacitinib and abrocitinib had better innovation. CONCLUSIONS Three oral JAKi treatments for atopic dermatitis have controllable safety and good efficacy. Considering the issue of medical insurance reimbursement, it is recommended that Chinese patients use upadacitinib.
5.Activation of ALDH2 alleviates hypoxic pulmonary hypertension in mice by upregulating the SIRT1/PGC-1α signaling pathway
Lei WANG ; Fenlan BIAN ; Feiyang MA ; Shu FANG ; Zihan LING ; Mengran LIU ; Hongyan SUN ; Chengwen FU ; Shiyao NI ; Xiaoyang ZHAO ; Xinru FENG ; Zhengyu SUN ; Guoqing LU ; Pinfang KANG ; Shili WU
Journal of Southern Medical University 2024;44(10):1955-1964
Objective To investigate whether activation of mitochondrial acetal dehydrogenase 2(ALDH2)alleviates hypoxic pulmonary hypertension by regulating the SIRT1/PGC-1α signaling pathway.Methods Thirty 8-week-old C57 BL/6 mice were randomized into control,hypoxia,and hypoxia+Alda-1(an ALDH2 activator)group(n=10),and the mice in the latter two groups,along with 10 ALDH2 knockout(ALDH2-/-)mice,were exposed to hypoxia(10%O2,90%N2)with or without daily intraperitoneal injection of Alda-1 for 4 weeks.The changes in right ventricular function and pressure(RVSP)of the mice were evaluated by echocardiography and right ventricular catheter test,and pulmonary artery pressure was estimated based on RVSP.Pulmonary vascular remodeling,right ventricular injury,myocardial α-SMA expression,distal pulmonary arteriole muscle normalization,right ventricular cross-sectional area,myocardial cell hypertrophy,and right cardiac hypertrophy index were assessed with HE staining,immunofluorescence staining and WGA staining,and the expressions of ALDH2,SIRT1,PGC-1α,P16INK4A and P21CIP1 were detected.In pulmonary artery smooth muscle cells with hypoxic exposure,the effect of Alda-1 and EX527 on cell senescence and protein expressions was evaluated using β-galactose staining and Western blotting.Results The wild-type mice with hypoxic exposure showed significantly increased RVSP,right ventricular free wall thickness and myocardial expressions of P16INK4A and P21CIP1,which were effectively lowered by treatment with Alda-1 but further increased in ALDH2-/-mice.In cultured pulmonary artery smooth muscle cells,hypoxic exposure significantly increased senescent cell percentage and cellular expressions of P16INK4A and P21CIP1,which were all lowered by treatment with Alda-1,but its effect was obviously attenuated by EX527 treatment.Conclusion ALDH2 alleviates hypoxia-induced senescence of pulmonary artery smooth muscle cells by upregulating the SIRT1/PGC-1α signaling pathway to alleviate pulmonary hypertension in mice.
6.LncRNA MAGI2-AS3 enhances cisplatin sensitivity of non-small cell lung cancer cells by regulating the miR-1269a/PTEN/AKT pathway
Xirui FAN ; Zhilin QI ; Yuanjie DENG ; Zihan YANG ; Li SUN ; Guohao LI ; Juanjuan LIANG ; Fei WU ; Liwen YUAN
Journal of Southern Medical University 2024;44(10):2033-2043
Objective To investigate the mechanism mediating the regulatory effect of lncRNA MAGI2-AS3 on cisplatin(DDP)resistance in non-small cell lung cancer(NSCLC).Methods MAGI2-AS3 and miR-1269a expression levels were detected by qRT-PCR in DDP-sensitive lung cancer cell lines(A549 and H1299)and their resistant counterparts(A549/DDP and H1299/DDP).In A549 and H1299 cells with MAGI2-AS3 silencing and A549/DDP and H1299/DDP cells overexpressing MAGI2-AS3,the effects of 20 μmol/L DDP on cell viability and apoptosis were examined with CCK-8 assay,colony formation assay,flow cytometry and Western blotting,and the changes in epithelial-mesenchymal transition(EMT)were assessed with wound healing and Transwell assays.The interaction between MAGI2-AS3,miR-1269a and PTEN was predicted using GEPIA,StarBase and miRDB and verified with luciferase reporter gene assay and radioimmunoprecipitation(RIP)assay.A miR-1269a mimic and pcDNA3.1-PTEN plasmid were used to perform the rescue assay.Results MAGI2-AS3 expression was significantly downregulated in lung cancer tissues(P<0.05)in association with a poor prognosis(P<0.05).In the two DDP-resistant lung cancer cell lines,MAGI2-AS3 expression was significantly lowered as compared with the sensitive cells.Silencing MAGI2-AS3 significantly enhanced cell viability and promoted EMT of A549 and H1299 cells irrespective of DDP treatment,and also decreased DDP-induced apoptosis of the cells.In A549/DDP and H1299/DDP cells,MAGI2-AS3 overexpression strongly repressed cell viability and EMT irrespective of DDP treatment and promoted DDP-induced cell apoptosis.Luciferase reporter gene and RIP assays confirmed the binding of MAGI2-AS3 with miR-1269a and the binding of miR-1269a with 3'-UTR domain of PTEN.The rescue assay demonstrated that MAGI2-AS3 acted as a sponge for miR-1269a to promote PTEN expression and downregulate AKT phosphorylation,thus inhibiting EMT and promoting DDP-induced apoptosis of A549/DDP cells.Conclusion MAGI2-AS3 enhances DDP sensitivity of NSCLC by targeted regulation of the miR-1269a/PTEN/AKT signaling axis.
7.A study on the association between insulin resistance and genome-wide DNA methylation based on Shanghai monozygotic twins
Jingyuan FENG ; Rongfei ZHOU ; Hongwei LIU ; Zihan HU ; Fei WU ; Huiting WANG ; Junhong YUE ; Zhenni ZHU ; Fan WU
Chinese Journal of Epidemiology 2024;45(7):932-940
Objective:To explore the association between insulin resistance (IR) and genome-wide DNA methylation based on Shanghai twin study.Methods:Monozygotic twins (MZ) from Shanghai were recruited during 2012-2013, 2017-2018, and 2022-2023. Data were collected by questionnaire survey, physical examination and laboratory tests. Genome-wide DNA methylation was quantified. Generalized linear mixed effect model was applied to analyze the association between methylation level at each site and homeostatic model assessment 2-insulin resistance (HOMA2-IR). Non-paired and paired designs were used to assess the association between DNA methylation and phenotype of IR. Cluster analysis was conducted to identify the clusters of top significant sites. Generalized linear regression was performed to examine the differential methylation patterns from clusters.Results:A total of 100 MZ pairs were included in this study. Hypermethylated cg10535199-2q23.1 ( β=0.74%, P=1.51×10 -7, OR=1.06, 95% CI: 1.03-1.09) and ch.17.49619327- SPOP ( β=0.23%, P=7.54×10 -7, OR=1.17, 95% CI: 1.08-1.28) were identified with suggestive significance. After correcting for multiple testing, no sites reached genome-wide significance. There was no statistical significance in the paired analysis. Two clusters with hypomethylated ( β=-0.39%, P<0.001) and hypermethylated ( β=0.47%, P<0.001) patterns were observed for HOMA2-IR. Conclusions:IR was significantly associated with DNA methylation, and genetic factors might contribute to the association.
8.Disulfiram: A novel repurposed drug for cancer therapy
Min ZENG ; Baibei WU ; Wenjie WEI ; Zihan JIANG ; Peiqiang LI ; Yuanting QUAN ; Xiaobo HU
Chinese Medical Journal 2024;137(12):1389-1398
Cancer is a major global health issue. Effective therapeutic strategies can prolong patients’ survival and reduce the costs of treatment. Drug repurposing, which identifies new therapeutic uses for approved drugs, is a promising approach with the advantages of reducing research costs, shortening development time, and increasing efficiency and safety. Disulfiram (DSF), a Food and Drug Administration (FDA)-approved drug used to treat chronic alcoholism, has a great potential as an anticancer drug by targeting diverse human malignancies. Several studies show the antitumor effects of DSF, particularly the combination of DSF and copper (DSF/Cu), on a wide range of cancers such as glioblastoma (GBM), breast cancer, liver cancer, pancreatic cancer, and melanoma. In this review, we summarize the antitumor mechanisms of DSF/Cu, including induction of intracellular reactive oxygen species (ROS) and various cell death signaling pathways, and inhibition of proteasome activity, as well as inhibition of nuclear factor-kappa B (NF-κB) signaling. Furthermore, we highlight the ability of DSF/Cu to target cancer stem cells (CSCs), which provides a new approach to prevent tumor recurrence and metastasis. Strikingly, DSF/Cu inhibits several molecular targets associated with drug resistance, and therefore it is becoming a novel option to increase the sensitivity of chemo-resistant and radio-resistant patients. Studies of DSF/Cu may shed light on its improved application to clinical tumor treatment.
9.Delayed intraparenchymal hemorrhage following treatment of intracranial aneurysms with flow diverter
Zihan ZHOU ; Yongqiang WU ; Geng GUO
International Journal of Cerebrovascular Diseases 2024;32(3):227-232
Flow director (FD) is one of endovascular treatment methods for intracranial aneurysms. Delayed intraparenchymal hemorrhage (DIPH) is a serious complication after FD, which may lead to severe neurological deterioration, poor outcome, and even death. The mechanism of DIPH is currently not fully understood and may be associated with factors such as the morphological characteristics of the aneurysm, hemodynamic changes, hemorrhagic transformation of postoperative ischemic lesions, drug treatment regimens, and immune inflammatory response. This article reviews the DIPH following treatment of intracranial aneurysms with FD, in order to provide reference for perioperative management.
10.Activation of ALDH2 alleviates hypoxic pulmonary hypertension in mice by upregulating the SIRT1/PGC-1α signaling pathway
Lei WANG ; Fenlan BIAN ; Feiyang MA ; Shu FANG ; Zihan LING ; Mengran LIU ; Hongyan SUN ; Chengwen FU ; Shiyao NI ; Xiaoyang ZHAO ; Xinru FENG ; Zhengyu SUN ; Guoqing LU ; Pinfang KANG ; Shili WU
Journal of Southern Medical University 2024;44(10):1955-1964
Objective To investigate whether activation of mitochondrial acetal dehydrogenase 2(ALDH2)alleviates hypoxic pulmonary hypertension by regulating the SIRT1/PGC-1α signaling pathway.Methods Thirty 8-week-old C57 BL/6 mice were randomized into control,hypoxia,and hypoxia+Alda-1(an ALDH2 activator)group(n=10),and the mice in the latter two groups,along with 10 ALDH2 knockout(ALDH2-/-)mice,were exposed to hypoxia(10%O2,90%N2)with or without daily intraperitoneal injection of Alda-1 for 4 weeks.The changes in right ventricular function and pressure(RVSP)of the mice were evaluated by echocardiography and right ventricular catheter test,and pulmonary artery pressure was estimated based on RVSP.Pulmonary vascular remodeling,right ventricular injury,myocardial α-SMA expression,distal pulmonary arteriole muscle normalization,right ventricular cross-sectional area,myocardial cell hypertrophy,and right cardiac hypertrophy index were assessed with HE staining,immunofluorescence staining and WGA staining,and the expressions of ALDH2,SIRT1,PGC-1α,P16INK4A and P21CIP1 were detected.In pulmonary artery smooth muscle cells with hypoxic exposure,the effect of Alda-1 and EX527 on cell senescence and protein expressions was evaluated using β-galactose staining and Western blotting.Results The wild-type mice with hypoxic exposure showed significantly increased RVSP,right ventricular free wall thickness and myocardial expressions of P16INK4A and P21CIP1,which were effectively lowered by treatment with Alda-1 but further increased in ALDH2-/-mice.In cultured pulmonary artery smooth muscle cells,hypoxic exposure significantly increased senescent cell percentage and cellular expressions of P16INK4A and P21CIP1,which were all lowered by treatment with Alda-1,but its effect was obviously attenuated by EX527 treatment.Conclusion ALDH2 alleviates hypoxia-induced senescence of pulmonary artery smooth muscle cells by upregulating the SIRT1/PGC-1α signaling pathway to alleviate pulmonary hypertension in mice.

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