1.Multi-label fundus disease classification using dual-branch deep learning: an intelligent diagnosis framework inspired by traditional Chinese medicine Five Wheels theory
Xin HE ; Xiaohui LI ; Jun PENG ; Lei LEI ; Dan SHU ; Li XIAO ; Qinghua PENG ; Xiaoxia XIAO
Digital Chinese Medicine 2026;9(1):80-90
Objective:
To develop a dual-branch deep learning framework for accurate multi-label classification of fundus diseases, addressing the key limitations of insufficient complementary feature extraction and inadequate cross-modal feature fusion in existing automated diagnostic methods.
Methods:
The fundus multi-label classification dataset with 12 disease categories (FMLC-12) dataset was constructed by integrating complementary samples from Ocular Disease Intelligent Recognition (ODIR) and Retinal Fundus Multi-Disease Image Dataset (RFMiD), yielding 6 936 fundus images across 12 retinal pathology categories, and the framework was validated on both FMLC-12 and ODIR. Inspired by the holistic multi-regional assessment principle of the Five Wheels theory in traditional Chinese medicine (TCM) ophthalmology, the dual-branch multi-label network (DBMNet) was developed as a novel framework integrating complementary visual feature extraction with pathological correlation modeling. The architecture employed a TransNeXt backbone within a dual-branch design: one branch processed red-green-blue (RGB) images to capture color-dependent features, such as vascular patterns and lesion morphology, while the other processed grayscale-converted images to enhance subtle textural details and contrast variations. A feature interaction module (FIM) effectively integrated the multi-scale features from both branches. Comprehensive ablation studies were conducted to evaluate the contributions of the dual-branch architecture and the FIM. The performance of DBMNet was compared against four state-of-the-art methods, including EfficientNet Ensemble, transfer learning-based convolutional neural network (CNN), BFENet, and EyeDeep-Net, using mean average precision (mAP), F1-score, and Cohen's kappa coefficient.
Results:
The dual-branch architecture improved mAP by 15.44 percentage points over the single-branch TransNeXt baseline, increasing from 34.41% to 44.24%, and the addition of FIM further boosted mAP to 49.85%. On FMLC-12, DBMNet achieved an mAP of 49.85%, a Cohen’s kappa coefficient of 62.14%, and an F1-score of 70.21%. Compared with BFENet (mAP: 45.42%, kappa: 46.64%, F1-score: 71.34%), DBMNet outperformed it by 4.43 percentage points in mAP and 15.50 percentage points in kappa, while BFENet achieved a marginally higher F1-score. On ODIR, DBMNet achieved an F1-score of 85.50%, comparable to state-of-the-art methods.
Conclusion
DBMNet effectively integrates RGB and grayscale visual modalities through a dual-branch architecture, significantly improving multi-label fundus disease classification. The framework not only addresses the issue of insufficient feature fusion in existing methods but also demonstrates outstanding performance in balancing detection across both common and rare diseases, providing a promising and clinically applicable pathway for standardized, intelligent fundus disease classification.
2.Quality changes of volatile oil and chlorogenic acid compounds during extraction process of Artemisiae Argyi Folium: process analysis based on chemical composition, physicochemical properties, and biological activity.
Dan-Dan YANG ; Hao-Zhou HUANG ; Xin-Ming CHEN ; Lin HUANG ; Ya-Nan HE ; Zhen-Feng WU ; Xiao-Ming BAO ; Ding-Kun ZHANG ; Ming YANG
China Journal of Chinese Materia Medica 2025;50(11):3001-3012
To explore the variation laws of volatile oil during the extraction process of Artemisiae Argyi Folium and its impact on the quality of the medicinal solution, as well as to achieve precise control of the extraction process, this study employed headspace solid phase microextraction gas chromatography-mass spectrometry(HS-SPME-GC-MS) in combination with multiple light scattering techniques to conduct a comprehensive analysis, identification, and characterization of the changes in volatile components and the physical properties of the medicinal solution during the extraction process. A total of 82 volatile compounds were identified using the HS-SPME-GC-MS technique, including 21 alcohols, 15 alkenes, 14 ketones, 9 acids, 6 aldehydes, 5 phenols, 3 esters, and 9 other types of compounds. At different extraction time points(15, 30, 45, and 60 min), 71, 72, 64, and 44 compounds were identified in the medicinal solution, respectively. It was observed that the content of volatile components gradually decreased with the extension of extraction time. Through multivariate statistical analysis, four compounds with significant differences during different extraction time intervals were identified, namely 1,8-cineole, terpinen-4-ol, 3-octanone, and camphor. RESULTS:: from multiple light scattering techniques indicated that at 15 minutes of extraction, the transmittance of the medicinal solution was the lowest(25%), the particle size was the largest(0.325-0.350 nm), and the stability index(turbiscan stability index, TSI) was the highest(0-2.5). With the extension of extraction time, the light transmittance of the medicinal solution improved, stability was enhanced, and the particle size decreased. These laws of physicochemical property changes provide important basis for the control of Artemisiae Argyi Folium extraction process. In addition, the changes in the bioactivity of Artemisiae Argyi Folium extracts during the extraction process were investigated through mouse writhing tests and antimicrobial assays. The results indicated that the analgesic and antimicrobial effects of the medicinal solution were strongest at the 15-minute extracting point. In summary, the findings of this study demonstrate that the content of volatile oil in Artemisiae Argyi Folium extracts gradually decreases with the extension of extraction time, and the variation in volatile oil content directly influences the physicochemical properties and pharmacological efficacy of the medicinal solution. This discovery provides important scientific reference for the optimization of Artemisiae Argyi Folium extraction processes and the development and application of process analytical technologies.
Oils, Volatile/pharmacology*
;
Artemisia/chemistry*
;
Gas Chromatography-Mass Spectrometry
;
Drugs, Chinese Herbal/pharmacology*
;
Chlorogenic Acid/pharmacology*
;
Solid Phase Microextraction
;
Quality Control
3.Effects of Yishen Yangsui formula() on pyroptosis in the spinal cord tissue in rats with degenerative cervical myelopathy.
Guo-Liang MA ; He YIN ; Bo XU ; Min-Shan FENG ; Dan ZHANG ; Dian ZHANG ; Xiao-Kuan QIN ; Li-Guo ZHU ; Bo-Wen YANG ; Xin CHEN
China Journal of Orthopaedics and Traumatology 2025;38(5):532-539
OBJECTIVE:
To preliminarily investigate the effects and mechanism of action of Yishen Yangsui Formula (, YSYSF)on the recovery of neurological function in rats with degenerative cervical myelopathy.
METHODS:
Fifty adult SD female rats were randomly divided into control group, sham group, model group, YSYSF group and positive drug group by using randomized numerical table method. In the model group, YSYSF group and positive drug group, polyvinyl alcohol acrylamide interpenetrating network hydrogel(water-absorbent swelling material) was used to construct a rat spinal cord chronic compression model. The sham group was implanted with the water-absorbent swelling material and then removed without causing spinal cord compression. The control group, the sham group and the model group were given equal amounts of saline by gavage, the group of YSYSF was given Chinese herbal medicine soup by gavage 9.1 g·kg-1 once a day, and the positive drug group was given tetrahexylsalicylglucoside sodium monosialate ganglioside by intraperitoneal injection 4.2 mg·kg-1 once a day. The motor function of the rats was assessed by the BBB method after 1, 3, 7, and 14 d of drug administration. The spinal cord tissues were taken from rats executed 14 d after drug administration, and the morphological changes of the spinal cord compression site were observed by HE staining, and the expression levels of Caspase-1, GSDMD, NLRP3, PYCARD, IL-1β, and IL-18 were detected in the area of spinal cord injury by Western blot method.
RESULTS:
The BBB scores of the control group and the sham group were normal at all time points after modeling, which were higher than the BBB scores of the model group, the YSYSF, and the positive drug group (P<0.05). From the 3rd day after gavage, at all time points, the BBB scores of rats in the YSYSF group and the positive drug group were higher than those of rats in the model group (P<0.05). The staining pattern of HE spinal cord tissue was normal in the control group and the sham group, and the HE spinal cord in the model group was severely damaged with a large number of neuron deaths, whereas the damage to the spinal cord and neuron cells was reduced in the YSYSF group and the positive drug group. The expression levels of caspase-1, GSDMD, NLRP3, PYCARD, IL-1β and IL-18 in the spinal cord of the model group were significantly higher than those of the sham group (P<0.0001), and the expression levels of caspase-1, GSDMD, NLRP3, PYCARD, IL-1β, and IL-18 in the YSYSF group and the drug group were significantly lower than those in the model group (P<0.05).
CONCLUSION
YSYSF can improve the motor function of rats with degenerative cervical spinal cord disease, alleviate the pathological changes, and promote the recovery of spinal cord neurological function. The specific mechanism may be related to the inhibition of the activation of inflammatory vesicles NLRP3 and PYCARD, the reduction of the release of inflammatory factors IL-1β and IL-18, the reduction of the expression of caspase-1 and GSDMD, the reduction of cellular death, and the inhibition of inflammatory response.
Animals
;
Female
;
Drugs, Chinese Herbal/administration & dosage*
;
Rats
;
Rats, Sprague-Dawley
;
Pyroptosis/drug effects*
;
Spinal Cord/pathology*
;
NLR Family, Pyrin Domain-Containing 3 Protein
;
Spinal Cord Diseases/drug therapy*
;
Interleukin-1beta/metabolism*
4.Pharmacological actions of the bioactive compounds of Epimedium on the male reproductive system: current status and future perspective.
Song-Po LIU ; Yun-Fei LI ; Dan ZHANG ; Chun-Yang LI ; Xiao-Fang DAI ; Dong-Feng LAN ; Ji CAI ; He ZHOU ; Tao SONG ; Yan-Yu ZHAO ; Zhi-Xu HE ; Jun TAN ; Ji-Dong ZHANG
Asian Journal of Andrology 2025;27(1):20-29
Compounds isolated from Epimedium include the total flavonoids of Epimedium , icariin, and its metabolites (icaritin, icariside I, and icariside II), which have similar molecular structures. Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects, especially in improving sexual function, hormone regulation, anti-osteoporosis, immune function regulation, anti-oxidation, and anti-tumor activity. To date, we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system. However, their actions in other tissues have been reviewed in recent years. This review critically focuses on the Epimedium , its bioactive compounds, and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system. Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.
Male
;
Epimedium/chemistry*
;
Humans
;
Genitalia, Male/drug effects*
;
Flavonoids/therapeutic use*
;
Animals
5.Retrospective Analysis of Venetoclax Combined with Azacitidine Compared with "3+7" or Similar Regimens for Newly Diagnosed Patients with Acute Myeloid Leukemia.
Lu-Lu WANG ; Juan ZHANG ; Yue ZHANG ; Yong ZHANG ; Xiao-Min DONG ; Dan-Yang ZHANG ; Ting-Ting CHEN ; Yun-Hui ZHOU ; Teng WANG ; Hui-Ling LAN ; He-Bing ZHOU
Journal of Experimental Hematology 2025;33(3):672-681
OBJECTIVE:
To retrospectively analyze the clinical data of newly diagnosed acute myeloid leukemia (AML) patients treated with venetoclax combined with azacitidine (Ven/Aza) or standard "3+7" regimen and similar regimens, collect real-world study data, compare the treatment response and adverse events between the two regimens, as well as perform survival analysis.
METHODS:
To retrospectively analyze the efficacy, survival, and adverse reactions of newly diagnosed AML patients treated with Ven/Aza (24 cases) and "3+7" regimens (117 cases ) in our hospital from September 2009 to March 2023, as well as factors influencing outcomes. A propensity score matching (PSM) was performed on age and Eastern Cooperative Oncology Group performance status (ECOG PS) to obtain a 1:1 matched cohort of 20 pairs, and the efficacy and survival before and after the matching were compared.
RESULTS:
The median age of patients in the Ven/Aza group was 69 years, while that in the "3+7" group was 56 years (P <0.001). Objective remission rate (ORR) was 62.5% in Ven/Aza group and 74.8% in "3+7" group (P >0.05). The median overall survival (OS) in the Ven/Aza group was 522 days, while that in the "3+7" group was 1 002 days (P >0.05). After controlling the two variables of age and ECOG PS, a PSM cohort of 20 pairs was obtained, in which the ORR was 65% in Ven/Aza group and 60% in "3+7" group (P >0.05). The median OS was 522 days and 629 days, and median progression-free survival (PFS) was 531 days and 198 days between the two groups, respectively. There were no statistically significant differences in OS and PFS between the two groups (both P >0.05). Additionally, the incidence of adverse events in the Ven/Aza group was significantly reduced.
CONCLUSION
The overall cohort shows that the "3+7" regimen has advantages in efficacy and survival, but Ven/Aza regimen is relatively safer. After performing PSM on age and ECOG PS, the Ven/Aza group showed improved efficacy, and a longer median PFS compared to "3+7" group.
Humans
;
Leukemia, Myeloid, Acute/drug therapy*
;
Retrospective Studies
;
Sulfonamides/administration & dosage*
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Azacitidine/administration & dosage*
;
Bridged Bicyclo Compounds, Heterocyclic/administration & dosage*
;
Aged
;
Middle Aged
;
Male
;
Female
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Treatment Outcome
6.Chinese Medicine for Treatment of COVID-19: A Review of Potential Pharmacological Components and Mechanisms.
Qian-Qian XU ; Dong-Dong YU ; Xiao-Dan FAN ; He-Rong CUI ; Qian-Qian DAI ; Xiao-Ying ZHONG ; Xin-Yi ZHANG ; Chen ZHAO ; Liang-Zhen YOU ; Hong-Cai SHANG
Chinese journal of integrative medicine 2025;31(1):83-95
Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease that has been prevalent since December 2019. Chinese medicine (CM) has demonstrated its unique advantages in the fight against COVID-19 in the areas of disease prevention, improvement of clinical symptoms, and control of disease progression. This review summarized the relevant material components of CM in the treatment of COVID-19 by searching the relevant literature and reports on CM in the treatment of COVID-19 and combining with the physiological and pathological characteristics of the novel coronavirus. On the basis of sorting out experimental methods in vivo and in vitro, the mechanism of herb action was further clarified in terms of inhibiting virus invasion and replication and improving related complications. The aim of the article is to explore the strengths and characteristics of CM in the treatment of COVID-19, and to provide a basis for the research and scientific, standardized treatment of COVID-19 with CM.
Humans
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Drugs, Chinese Herbal/pharmacology*
;
COVID-19 Drug Treatment
;
SARS-CoV-2/drug effects*
;
COVID-19/therapy*
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Medicine, Chinese Traditional/methods*
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Antiviral Agents/pharmacology*
;
Animals
7.Cation Channel TMEM63A Autonomously Facilitates Oligodendrocyte Differentiation at an Early Stage.
Yue-Ying WANG ; Dan WU ; Yongkun ZHAN ; Fei LI ; Yan-Yu ZANG ; Xiao-Yu TENG ; Linlin ZHANG ; Gui-Fang DUAN ; He WANG ; Rong XU ; Guiquan CHEN ; Yun XU ; Jian-Jun YANG ; Yongguo YU ; Yun Stone SHI
Neuroscience Bulletin 2025;41(4):615-632
Accurate timing of myelination is crucial for the proper functioning of the central nervous system. Here, we identified a de novo heterozygous mutation in TMEM63A (c.1894G>A; p. Ala632Thr) in a 7-year-old boy exhibiting hypomyelination. A Ca2+ influx assay suggested that this is a loss-of-function mutation. To explore how TMEM63A deficiency causes hypomyelination, we generated Tmem63a knockout mice. Genetic deletion of TMEM63A resulted in hypomyelination at postnatal day 14 (P14) arising from impaired differentiation of oligodendrocyte precursor cells (OPCs). Notably, the myelin dysplasia was transient, returning to normal levels by P28. Primary cultures of Tmem63a-/- OPCs presented delayed differentiation. Lentivirus-based expression of TMEM63A but not TMEM63A_A632T rescued the differentiation of Tmem63a-/- OPCs in vitro and myelination in Tmem63a-/- mice. These data thus support the conclusion that the mutation in TMEM63A is the pathogenesis of the hypomyelination in the patient. Our study further demonstrated that TMEM63A-mediated Ca2+ influx plays critical roles in the early development of myelin and oligodendrocyte differentiation.
Animals
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Cell Differentiation/physiology*
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Oligodendroglia/metabolism*
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Mice, Knockout
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Mice
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Male
;
Myelin Sheath/metabolism*
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Humans
;
Child
;
Cells, Cultured
;
Oligodendrocyte Precursor Cells/metabolism*
8.Clinical Study of Repeated Transcranial Magnetic Stimulation Combined with Mindfulness-Based Cognitive Therapy in Patients with Alcohol Withdrawal Syndrome
Xiao-ling LIU ; Hong-he ZHANG ; Jun-ling YE ; Xiu-ying ZHENG ; Zi-yan PENG ; Dan-ni HUANG
Progress in Modern Biomedicine 2025;25(11):1847-1854,1878
Objective:To observe the clinical efficacy of repetitive transcranial magnetic stimulation(rTMS)combined with mindfulness-based cognitive therapy(MBCT)in patients with alcohol withdrawal syndrome(AWS).Methods:The 120 patients with AWS who were observed in this study were all male patients admitted to our hospital from June 2021 to June 2024,the patients were divided into group A(conventional treatment,40 cases),group B(group A combined with rTMS,40 cases),and group C(group B combined with MBCT,40 cases)according to random number table method.The clinical efficacy,self-control ability[Modified Clinical Institution Alcohol Dependence Withdrawal Assessment Scale(CIWA-Ar)score,Visual Analog Scale of Psychological Craving for Alcohol(VAS)score and Pennsylvania Alcohol Craving Scale(PACS)score],anxiety and depression degree assessment[Hamilton Depression Scale(HAMD)score,Hamilton Anxiety Scale(HAMA)score]and quality of life[36 Short Form Health Survey(SF-36)Score],relapse rate and readmission rate were compared among the three groups.Results:The total effective rate of group A,group B and group C increased successively(P<0.05).The CIWA-Ar,PACS and VAS scores in group B and group C after treatment were lower than those in group A,and group C was lower than that in group B(P<0.05).The HAMD and HAMA scores of group B and group C after treatment were lower than those in group A,and group C was lower than that in group B(P<0.05).The SF-36 score of group B and group C after treatment was higher than those in group A,and group C was higher than that in group B(P<0.05).Relapse rate and readmission rate in groups B and C were lower than those in group A,and group C was lower than that in group B(P<0.05).Conclusion:The application of rTMS combined with MBCT in patients with AWS can improve clinical efficacy and quality of life,alleviate anxiety and depression,improve patients' self-control ability,reduce relapse rate and readmission rate,with definite effects.
9.CiteSpace-based analysis of research hotspots and trends in field of medical device utilization management
Hong-dan WANG ; Ben-xing ZHANG ; Xiao-xiao HE ; Zhen-wei DU
Chinese Medical Equipment Journal 2025;46(7):63-67
Scholarly articles published in the Web of Science database from January 1,2004 to November 10,2024 in the field of medical device utilization management were collected.CiteSpace-based bibliometric analysis of the included literature was performed in terms of the year of publication,region of publication,highly cited literature and highly cited journals and keywords.The Internet of Things(IoT),cloud computing and wearable devices were identified as the current research hotspots in the field of medical device utilization management.References were provided for further research related to medical device utilization management.[Chinese Medical Equipment Journal,2025,46(7):63-67]
10.The expression and clinical value of ferritinophagy-related gene ELAVL1 in multiple myeloma
Rui ZHANG ; Bingjie WAN ; Xiaomin REN ; Gustave MUNYURANGABO ; Xiao YU ; Jiyu MIAO ; Peihua ZHANG ; Hongwei LIU ; Dan YANG ; Lin LI ; Qiao LI ; Siyu LUO ; Aili HE ; Guangyao KONG ; Yachun JIA
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(3):504-510
Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P<0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P<0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P<0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P<0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

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