1.Ethical considerations of using the deceased as medical research subjects
Zhaolong LU ; Xiaoyun CHEN ; Yongchuan CHEN ; Mengjie YANG ; Qiang LIU ; Hui JIANG ; Zhonglin CHEN
Chinese Medical Ethics 2025;38(11):1447-1452
The relevant laws and regulations regarding the utilization of the deceased as medical research subjects are not yet fully developed in China nowadays. Taking the deceased as research subjects as a starting point, this paper discussed the definition of the deceased and the scope of their interest protection from multiple perspectives. It posited that the scope of interest protection for the deceased encompassed two components: spiritual personality interests and material personality interests represented by the remains. The spiritual personality interests of the deceased included identification information such as name, portrait, reputation, honor, privacy, and personal information, as well as medical and health information. The personal information of the deceased was not directly affected by the individual’s life and death status and remained relatively independent. In terms of ethical review, the research team approached from two perspectives: the remains and the personal information of the deceased. Based on the standard of whether the research subjects involve a human body, research with the remains of the deceased as the medical research subjects was classified as non-clinical research. According to the standard of whether a human body is clinically operated, research with the personal information of the deceased (including medical and health information) as the medical research subjects was recognized as clinical research without human research operation. This approach provided evidence for the application of existing laws and regulations in ethical review and record management. The ethical review of investigator-initiated clinical research conducted in medical and health institutions, as well as the regulatory conditions for exemption from ethical review, were examined. The forms, content, and acquisition of informed consent were summarized, and the risk-benefit characteristics of the research activity were evaluated, with a view to providing a basis for the smooth and compliant implementation of research activities involving the deceased as medical research subjects.
2.Tranexamic acid-fatty alcohol polyoxyethylene ether conjugation/PVA foam for venous sclerotherapy via vascular damage and inhibiting plasmin system.
Jizhuang MA ; Keda ZHANG ; Wenhan LI ; Yu DING ; Yongfeng CHEN ; Xiaoyu HUANG ; Tong YU ; Di SONG ; Haoran NIU ; Huichao XIE ; Tianzhi YANG ; Xiaoyun ZHAO ; Xinggang YANG ; Pingtian DING
Acta Pharmaceutica Sinica B 2025;15(6):3291-3304
Venous system diseases mainly include varicose veins and venous malformations of lower limbs and the genital system. Most of them are chronic diseases that cause serious clinical symptoms to patients and affect their health and quality of life. Sclerotherapy has become the first-line therapy for venous system diseases. However, there are problems such as incomplete fibrosis and vascular recanalization after sclerotherapy, and improper operation will cause serious adverse consequences. Therefore, exploring a safe and effective sclerotherapy strategy is essential for developing clinically successful sclerotherapy. To solve the above problems, we proposed a new sclerotherapy strategy with a dual mechanism of "vascular damage and plasmin (PLA) system inhibition." We intended to construct a novel cationic surfactant (AEOx-TA) by reacting tranexamic acid (TA), a parent structure, with fatty alcohol polyoxyethylene ether (AEOx) by ester bonds. AEOx-TA could damage vascular endothelium and initiate a coagulation cascade effect to induce thrombus. Furthermore, AEOx-TA could be degraded by esterase and release the parent drug, TA, which could inhibit the PLA system to inhibit the degradation of thrombus and extracellular matrix and promote the process of vascular fibrosis. In addition, such surfactant-based sclerosants have foam-forming properties, and they can be blended with polyvinyl alcohol (PVA) to prepare a highly stable foam formulation (AEOx-TA/P), which can achieve a precise drug delivery and prolonged drug retention time, thereby improving drug efficacy and reducing the risk of ectopic embolism. Overall, the novel cationic surfactant AEOx-TA provides a new avenue to resolve the bottleneck: surfactant sclerosants' efficiency is relatively low in the current sclerotherapy.
3. Transcriptomic analysis of the molecular mechanism of Tiaopi Chengqi decoction improving gastric digestive function in mice with food accumulation
Xiaoyun WANG ; Huaizhou ZHAO ; Liguo TONG ; Haijie JI ; Qian YANG ; Ping WANG ; Haiyan LU ; Mingsuo SONG
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(3):252-259
AIM:To explore the molecular mechanism of Tiaopi Chengqi decoction (TpCqD) improving hyperthermia and high-protein food-induced hyperphagia mice based on transcriptomics. METHODS:C57 mice were randomly divided into a control group, model group, low-dose TpCqD group, high-dose TpCqD group, and domperidone group. The general condition of the experimental mice was observed and the average food intake was counted, and the rate of gastric emptying and intestinal propulsion was determined for each group of mice. H&E staining was used to observe pathological changes in gastric tissue. PAS staining was used to observe glycogen changes in gastric tissue. Pepsin activity was determined by colorimetry. pH value of gastric contents was measured by acid-base titration. Transcriptome sequencing was used to analyze the differential genes in gastric tissue, a volcano map and a cluster heat map were made for the differential genes, and KEGG was used to analyze the signal pathway enrichment of the differential genes. RT-qPCR verified the differential genes obtained by screening. RESULTS:After treatment with TpCqD, the body weight and average food intake of mice with food accumulation increased (P<0.05), and the intestinal propulsion rate and gastric emptying speed of mice with food accumulation accelerated (P<0.05). TpCqD could protect gastric tissue structure and glycogen degradation, increase pepsin activity (P<0.05), and reduce gastric content pH (P<0.05). Transcriptome results showed that TpCqD could regulate the expression of Acox2 and cilp2, regulate fat digestion and absorption, protein digestion and absorption, and pancreatic secretion signals. RT-qPCR showed that compare with model group, TpCqD up-regulated Acox2 (P<0.05) and down-regulated the mRNA level of cilp2 (P<0.05). CONCLUSION:TpCqD ameliorated digestive dysfunction in mice with high-calorie and high-protein diets leading to food accumulation involving the regulation of the fat and sugar metabolism genes Acox2 and cilp2, and pancreatic secretory signaling.
4.Preparation and brain targeting via nasal route of asenapine maleate microemulsion gel
Shuijie ZHANG ; Xiaoyun TONG ; Yuan ZENG ; Gang LEI
China Pharmacist 2024;27(2):199-208
Objective To prepare asenapine maleate microemulsion gel(ASPM-Emulgel)and evaluate its brain targeting by nasal administration.Methods The prescription composition and dosage of asenapine maleate microemulsion(ASPM-Emul)was determined according to the equilibrium solubility of asenapine maleate(ASPM)in different oils,emulsifiers,co-emulsifiers and the compatibility results of excipients,and ASPM-Emul was prepared into a gel with carbomer 940 as the gel matrix.The particle size distribution and microstructure of ASPM-Emul were investigated.The in vitro release rates and permeability in sheep nasal mucosa of ASPM-Emul and ASPM Emulgel were compared using the Franz diffusion cell method.The nasal ciliary toxicity of ASPM-Emulgel was investigated using the in vivo toad maxillary model method.Brain targeting of ASPM-Emulgel by nasal administration in rats was evaluated.Results According to the results of equilibrium solubility and compatibility,Maisine 35-1,Tween 80 and Transcutol P were selected as the oil phase,emulsifier and co-emulsifier of ASPM-Emul,respectively,with the ratio of 4 ∶ 4 ∶ 2.ASPM-Emul was a light blue semi-transparent microemulsion with a particle size of(73.6±7.4)nm.The microemulsion was regularly spherical and uniformly dispersed under transmission electron microscopy.The results of in vitro release and permeation showed that the release rate of ASPM-Emul was relatively fast,while the release rate of ASPM-Emulgel remained stable.However,the permeability of the two formulations in sheep nasal mucosa was basically similar.ASPM-Emul and ASPM-Emulgel showed no significant toxicity to nasal cilia of toad.Compared with the tail vein ASPM group,the drug content in the brain of ASPM-Emul and ASPM-Emulgel significantly increased after nasal administration,both exhibiting significant brain targeting,and the drug targeting efficiency(DTE)of ASPM-Emulgel was higher.Conclusion The preparation of ASPM into microemulsion gel can significantly improve the brain targeting after nasal administration,and is expected to improve the clinical therapeutic effect of ASPM.
5.Study on inhibitory effects of Wubao capsule on airway inflammation in asthmatic model mice by regulating the upstream and downstream cytokines of type Ⅱ innate lymphoid cells
Qiushi ZHANG ; Feng HUANG ; Xiaoyun TONG ; Zhuya YANG ; Baojing LI ; Yuping LIN ; Lu QU ; Jian NIE ; Chunyan HU
China Pharmacy 2023;34(2):156-160
OBJECTIVE To study the effects of Wubao capsule on airway inflammation in asthmatic model mice by regulating upstream and downstream cytokines of type Ⅱ innate lymphoid cells (ILC2s). METHODS Totally 40 female BABL/c mice were randomly divided into normal group, model group, positive control group (dexamethasone 1 mg/kg), Wubao capsule low-dose and high-dose groups (0.5, 1 g/kg), with 8 mice in each group. Asthma models were induced by ovalbumin (OVA) sensitization and nebulization. Each group was given normal saline or drug intragastrically for 7 consecutive days. The contents of IgE and OVA-IgE in serum, the contents of interleukin 5 (IL-5), IL-9, IL-13, IL-25, IL-33, thymic stromal lymphopoietin (TSLP) and mucin 5AC (MUC5AC) in bronchoalveolar lavage fluid (BALF) were determined by ELISA. HE staining was used to observe the pathological changes of lung tissues in mice. PAS staining was used to observe the changes of goblet cell proliferation in each group. The number of ILC2s in lung tissue was determined by flow cytometry (except for Wubao capsule low-dose group). RESULTS Compared with model group, the contents of IgE and OVA-IgE in serum and the contents of IL-5, IL-9, IL-13, IL-25, IL-33, TSLP and MUC5AC in BALF were significantly reduced in Wubao capsule high-dose and low-dose groups (P<0.01). The infiltration of inflammatory cells and the thickening of basement membrane in lung tissue was alleviated to varying degrees, and the proliferation of goblet cells was inhibited; the number of ILC2s in lung tissues of mice in Wubao capsule high-dose group was significantly reduced (P<0.01). CONCLUSIONS Wubao capsule could effectively reduce the number of ILC2s in lung tissue, the contents of upstream and downstream cytokines of ILC2s in BALF of asthmatic model mice, so as to inhibit the airway inflammation and improve asthma.
7.Reflection and Practice on the Implementation of "Exemption from Ethical Review" in Medical Institutions
Zhonglin CHEN ; Mengjie YANG ; Xiaoyun CHEN ; Li LING ; Xumin HOU ; Xuening LI ; Yu FENG
Chinese Medical Ethics 2023;36(7):736-741
From the perspective of medical institutions, this paper sorted out the contents of Article 32 of the Measures for Ethical Review of Life Sciences and Medical Research Involving Human regarding "exemption from ethical review". At the same time, combined with domestic and foreign regulations, this paper deeply considered and analyzed the applicable premise and special circumstances of the provisions from the implementation level, and then put forward suggestions from the perspective of practical operation of medical institutions, with a view to providing some practical guidance and reference for ethical practitioners of medical institutions.
8.SS-31 inhibits O3 -mediated airway hyperresponsiveness and mucus hypersecretion in mice
Meiqin Xie ; Chenfei Li ; Qi Liu ; Jiali Weng ; Hai Zhang ; Feng Li ; Xiaoyun Fan
Acta Universitatis Medicinalis Anhui 2023;58(6):908-913
Objective :
To investigate whether Mitochondria-targeted antioxidant peptide SS-31 can inhibit the ozone ( O3 ) -induced mice lung airway hyperresponsiveness and mucus hypersecretion.
Methods :
Eight-week C57BL /6 mice were randomized into four groups,including phosphate buffer saline (PBS) + Air group,SS-31 + Air group, PBS + O3 group and SS-31 + O3 group.C57BL /6 mice were injected intraperitoneally with SS-31 ( 10 mg / kg) one hour before ozone exposure ,and then single-exposed to ozone at a concentration of 5. 01 × 10 -6 mol / m3 for 3 hours.After 24 hours,airway hyperresponsiveness(AHR) and bronchoalveolar lavage fluid (BALF) cells numbers were measured.Lung tissue schiff periodic acid shiff (PAS) staining,malondialdehyde (MDA) ,inflammatory factors ( interleukin,IL ) -1 β , IL-6 ,IL-18 and monocyte chemoattractant protein-1 ( MCP-1 ) ) and mucin factor (MUC5B) were detected,and the protein expression levels of NOD-like receptor thermal protein domain associated protein 3 (NLRP3) ,pro-Caspase 1 / Caspase 1 (p20) ,Gasdermin D ( GSDMD) and Cleaved GSDMD were determined by Western blot.
Results:
O3 exposure caused both mice lung airway hyperresponsiveness and mucus hypersecretion.However,SS-31 could inhibit the O3 -induced airway hyperresponsiveness and mucus secretion,reduce the levels of oxidative stress and inflammatory factor mRNA expression ,and downregulate the protein expression level of NLRP3 and the activated forms of Caspase 1 and GSDMD.
Conclusion
SS-31 could suppress O3 -induced mice airway hyperresponsiveness and mucus hypersecretion by inhibiting the NLRP3 / Caspase 1 / GSDMD signaling pathway.
9.Effect of hepatocyte fatty degeneration induced by free fatty acid on macrophage polarization
Xiaoyun LI ; Xixi NI ; Jing HUA
Journal of Clinical Hepatology 2021;37(2):385-389
ObjectiveTo investigate the effect of hepatocyte fatty degeneration induced by free fatty acid on macrophage polarization and the possible mechanism. MethodsPrimary hepatocytes of C57BL/6 mice were isolated by in situ collagenase perfusion, and then the hepatocytes were divided into control (NC) group and mixed free fatty acid (FFA) treatment group. A conditioned medium (CM) was prepared for hepatocytes and was used for the intervention of RAW264.7 macrophages. Oil red O staining was used to observe lipid deposition in hepatocytes; real-time PCR was used to measure the mRNA expression of lipid metabolism genes and macrophage M1/M2 polarization markers; ELISA was used to measure the levels of cytokines in supernatant; Western blot was used to measure the expression of proteins involved in the Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) pathway in macrophages. The independent samples t-test was used for comparison between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the Tukey test was used for further comparison between two groups. ResultsCompared with the NC group, the FFA treatment group had the deposition of massive lipid droplets in hepatocytes and significant increases in triglyceride and total cholesterol (t=15.65 and 3.49, both P<005). Besides, FFA significantly increased the mRNA expression of the lipid synthesis genes SREBP1C and FASN (t=2.89 and 2.82, both P<0.05) and reduced the mRNA expression of the lipid decomposition genes ACOX1 and CPT1A (t=14.30 and 3.36, both P<005) in hepatocytes. FFA also induced significant increases in the levels of the inflammatory cytokines interleukin-6 (IL-6), interleukin-1β, and tumor necrosis factor-α (TNF-α) in supernatant (all P<0.05). Compared with the CM-NC group, the CM-FFA group had significant increases in the mRNA expression of the M1 phenotype markers iNOS2, TNF-α, and IL-6 (all P<0.05) and a significant reduction in the mRNA expression of the M2 phenotype marker interleukin-10 (P<0.05). Moreover, Western blot showed that CM-FFA significantly upregulated the protein expression of TLR4, p-NF-κBp65, and p-IκBα in macrophages (t=2.88, 3.69, and 3.54, all P<0.05). ConclusionFFA-induced hepatocyte fatty degeneration and inflammation can promote M1 macrophage polarization, thereby initiating and triggering the development and progression of nonalcoholic fatty liver disease.
10.Epidemiology of drug-induced liver injury
Journal of Clinical Hepatology 2021;37(11):2510-2514
The incidence rate of drug-induced liver injury (DILI) is increasing year by year, and DILI has become one of the common liver diseases in clinical practice and has attracted the attention of the whole world. It is known that a variety of drugs, including Chinese herbal medicine and dietary supplements, can cause various types of acute or chronic liver injury, and acute liver failure may occur in severe cases, leading to death or liver transplantation. This article elaborates on the global prevalence of DILI and the distribution of common suspected drugs.


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